Search results for: family drug court
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5348

Search results for: family drug court

3908 Effects and Coping Strategies of Cyber Bullying in Pakistan: A Gender Response

Authors: Rabia Qusien

Abstract:

New media has emerged as a significant force in the society which connects people across the globe. Where new media brought many advantages for its users, there is a darker aspect of new technology in the form of cyberbullying. Researcher has employed survey method to reach to its targeted audience. Sample of 604 respondents was selected from one of metropolitan city of Pakistan Lahore to collect the data. Equal sample from both genders was selected to apply gender analysis. Results of this study indicate that cyber bullying is having significant psychological and educational effects. Females face more cyber bullying incidents as compared to males so they face more severe effects of cyber bullying. A comprehensive analysis of managing strategies depicts that mostly youth tries to handle this issue personally but at times they seek the support of their family and friends when they face severe issues. Due to privacy concerns females get more upset and they are more likely to seek social support from friends and family.

Keywords: cyber bullying, cyber victims, educational impacts, psychological impacts

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3907 Biophysical Analysis of the Interaction of Polymeric Nanoparticles with Biomimetic Models of the Lung Surfactant

Authors: Weiam Daear, Patrick Lai, Elmar Prenner

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The human body offers many avenues that could be used for drug delivery. The pulmonary route, which is delivered through the lungs, presents many advantages that have sparked interested in the field. These advantages include; 1) direct access to the lungs and the large surface area it provides, and 2) close proximity to the blood circulation. The air-blood barrier of the alveoli is about 500 nm thick. The air-blood barrier consist of a monolayer of lipids and few proteins called the lung surfactant and cells. This monolayer consists of ~90% lipids and ~10% proteins that are produced by the alveolar epithelial cells. The two major lipid classes constitutes of various saturation and chain length of phosphatidylcholine (PC) and phosphatidylglycerol (PG) representing 80% of total lipid component. The major role of the lung surfactant monolayer is to reduce surface tension experienced during breathing cycles in order to prevent lung collapse. In terms of the pulmonary drug delivery route, drugs pass through various parts of the respiratory system before reaching the alveoli. It is at this location that the lung surfactant functions as the air-blood barrier for drugs. As the field of nanomedicine advances, the use of nanoparticles (NPs) as drug delivery vehicles is becoming very important. This is due to the advantages NPs provide with their large surface area and potential specific targeting. Therefore, studying the interaction of NPs with lung surfactant and whether they affect its stability becomes very essential. The aim of this research is to develop a biomimetic model of the human lung surfactant followed by a biophysical analysis of the interaction of polymeric NPs. This biomimetic model will function as a fast initial mode of testing for whether NPs affect the stability of the human lung surfactant. The model developed thus far is an 8-component lipid system that contains major PC and PG lipids. Recently, a custom made 16:0/16:1 PC and PG lipids were added to the model system. In the human lung surfactant, these lipids constitute 16% of the total lipid component. According to the author’s knowledge, there is not much monolayer data on the biophysical analysis of the 16:0/16:1 lipids, therefore more analysis will be discussed here. Biophysical techniques such as the Langmuir Trough is used for stability measurements which monitors changes to a monolayer's surface pressure upon NP interaction. Furthermore, Brewster Angle Microscopy (BAM) employed to visualize changes to the lateral domain organization. Results show preferential interactions of NPs with different lipid groups that is also dependent on the monolayer fluidity. Furthermore, results show that the film stability upon compression is unaffected, but there are significant changes in the lateral domain organization of the lung surfactant upon NP addition. This research is significant in the field of pulmonary drug delivery. It is shown that NPs within a certain size range are safe for the pulmonary route, but little is known about the mode of interaction of those polymeric NPs. Moreover, this work will provide additional information about the nanotoxicology of NPs tested.

Keywords: Brewster angle microscopy, lipids, lung surfactant, nanoparticles

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3906 Family Satisfaction with Neuro-Linguistic Care for Patients with Alzheimer’s Disease

Authors: Sara Sahraoui

Abstract:

This research studied the effect of Alzheimer's disease (AD) on language information processing in subjects with Alzheimer’s disease (AD) who were bilingual (French and dialectical Arabic). The results show a disorder of certain semantic aspects of their mother tongue (L1). On the other hand, grammatical levels appeared to be relatively unaffected in oral speech in L1 but were disturbed in the second language (L2). In consequence, we constructed a cognitive-language stimulation protocol for bilingual patients (PSCLAB) to respond to this disorder. The efficacy of this protocol in terms of rehabilitation was assessed in 30 such patients through discourse analysis carried out before and after initiating the protocol. The results show that cognitive/language training using the PSCLAB appears to improve the language behaviour of bilingual patients with AD. However, this survey study aims to verify the satisfaction of patients’ relatives with the results of cognitive language training by PSCLAB. We developed a brief instrument to measure the satisfaction of family members. The results report that the patient's relatives are satisfied with the results of cognitive training by PSCLAB.

Keywords: satisfaction, Alzheimer's disease, rehabilitation, levels language

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3905 Count Regression Modelling on Number of Migrants in Households

Authors: Tsedeke Lambore Gemecho, Ayele Taye Goshu

Abstract:

The main objective of this study is to identify the determinants of the number of international migrants in a household and to compare regression models for count response. This study is done by collecting data from total of 2288 household heads of 16 randomly sampled districts in Hadiya and Kembata-Tembaro zones of Southern Ethiopia. The Poisson mixed models, as special cases of the generalized linear mixed model, is explored to determine effects of the predictors: age of household head, farm land size, and household size. Two ethnicities Hadiya and Kembata are included in the final model as dummy variables. Stepwise variable selection has indentified four predictors: age of head, farm land size, family size and dummy variable ethnic2 (0=other, 1=Kembata). These predictors are significant at 5% significance level with count response number of migrant. The Poisson mixed model consisting of the four predictors with random effects districts. Area specific random effects are significant with the variance of about 0.5105 and standard deviation of 0.7145. The results show that the number of migrant increases with heads age, family size, and farm land size. In conclusion, there is a significantly high number of international migration per household in the area. Age of household head, family size, and farm land size are determinants that increase the number of international migrant in households. Community-based intervention is needed so as to monitor and regulate the international migration for the benefits of the society.

Keywords: Poisson regression, GLM, number of migrant, Hadiya and Kembata Tembaro zones

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3904 A Qualitative Study to Analyze Clinical Coders’ Decision Making Process of Adverse Drug Event Admissions

Authors: Nisa Mohan

Abstract:

Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.

Keywords: adverse drug events, clinical coders, decision making, hospital admissions

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3903 The Effects of Gender and Socioeconomic Status on Academic Motivation: The Case of Lithuania

Authors: Ausra Turcinskaite-Balciuniene, Jonas Balciunas, Gediminas Merkys

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The problematic of gender and socioeconomic status biased differences in academic motivation patterns is discussed. Gender identity is understood according to symbolic interactionism perspective: as a result of reflected appraisals, social comparisons, self-attributions, and identifications, shaped by social environment and family context. The effects of socioeconomic status on academic motivation are conceptualized according to Bourdieu’s habitus concept, reflecting the role of unconscious and internalized cultural signals, proper to low and high socioeconomic status family contexts. Since families differ by various socioeconomic features, the hypothesis about possible impact of parents’ socioeconomic status on their children’s academic motivation interfering with gender socialization effects is held. The survey, aiming to seize gender differences in academic motivation and self-recorded improvement-oriented efforts as a result of socialization processes operating in the families of low and high socioeconomic status, was designed. The results of Lithuanian higher education students’ survey are presented and discussed.

Keywords: academic motivation, gender, socialization, socioeconomic status

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3902 Conservation Planning of Paris Polyphylla Smith, an Important Medicinal Herb of the Indian Himalayan Region Using Predictive Distribution Modelling

Authors: Mohd Tariq, Shyamal K. Nandi, Indra D. Bhatt

Abstract:

Paris polyphylla Smith (Family- Liliaceae; English name-Love apple: Local name- Satuwa) is an important folk medicinal herb of the Indian subcontinent, being a source of number of bioactive compounds for drug formulation. The rhizomes are widely used as antihelmintic, antispasmodic, digestive stomachic, expectorant and vermifuge, antimicrobial, anti-inflammatory, heart and vascular malady, anti-fertility and sedative. Keeping in view of this, the species is being constantly removed from nature for trade and various pharmaceuticals purpose, as a result, the availability of the species in its natural habitat is decreasing. In this context, it would be pertinent to conserve this species and reintroduce them in its natural habitat. Predictive distribution modelling of this species was performed in Western Himalayan Region. One such recent method is Ecological Niche Modelling, also popularly known as Species distribution modelling, which uses computer algorithms to generate predictive maps of species distributions in a geographic space by correlating the point distributional data with a set of environmental raster data. In case of P. polyphylla, and to understand its potential distribution zones and setting up of artificial introductions, or selecting conservation sites, and conservation and management of their native habitat. Among the different districts of Uttarakhand (28°05ˈ-31°25ˈ N and 77°45ˈ-81°45ˈ E) Uttarkashi, Rudraprayag, Chamoli, Pauri Garhwal and some parts of Bageshwar, 'Maximum Entropy' (Maxent) has predicted wider potential distribution of P. polyphylla Smith. Distribution of P. polyphylla is mainly governed by Precipitation of Driest Quarter and Mean Diurnal Range i.e., 27.08% and 18.99% respectively which indicates that humidity (27%) and average temperature (19°C) might be suitable for better growth of Paris polyphylla.

Keywords: biodiversity conservation, Indian Himalayan region, Paris polyphylla, predictive distribution modelling

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3901 A Novel Peptide Showing Universal Effect against Multiple Viruses in Vitro and in Vivo

Authors: Hanjun Zhao, Ke Zhang, Bojian Zheng

Abstract:

Background: So far, there is no universal antiviral agent which can inhibit multiple viral infections. More and more drug-resistant viral strains emerge after the antiviral drug application for treatment. Defensins are the front line of host innate immunity and have broad spectrum antibacterial and antiviral effects. However, there is limited data to show if these defensins have good antiviral activity in vivo and what the antiviral mechanism is. Subjects: To investigate a peptide with widespread antivirus activity in vitro and in vivo and illustrate the antiviral mechanism. Methods: Antiviral peptide library designed from mouse beta defensins was synthesized by the company. Recombinant beta defensin was obtained from E. coli. Antiviral activity in vitro was assayed by plaque assay, qPCR. Antiviral activity in vivo was detected by animal challenge with 2009 pandemic H1N1 influenza A virus. The antiviral mechanism was assayed by western blot, ELISA, and qPCR. Conclusions: We identify a new peptide which has widespread effects against multiple viruses (H1N1, H5N1, H7N9, MERS-CoV) in vitro and has efficient antivirus activity in vivo. This peptide inhibits viral entry into target cells and subsequently blocks viral replication. The in vivo study of the antiviral peptide against other viral infections and the investigation of its more detail antiviral mechanism are ongoing.

Keywords: antiviral peptide, defensin, Influenza A virus, mechanism

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3900 The Psychological and Behavioral Problems of Children of the First Years and Their Interest in School Education

Authors: Amina Salem Attia

Abstract:

This east project consists in studying The child's mental health is the medium through which he expresses his thoughts, so pay attention to it because it is an essential building block in the process of building the child's future personality, where it gives him a balance between feelings and mental thoughts, and since the family is the child's first guardian, it greatly affects his personality and psychological development. As the disturbed environment contributes to behavioral deviations and mental disorders, unlike the stable environment, which plays a major role in developing the child's abilities and forming his psychologically sound attitudes, this should not be forgotten about the role of the school, it is also the second social institution after the family and has a major impact on the child's mental health as it contributes It is important in forming the child's personality and developing his skills and achieving his healthy psychological development, by providing him with psychological care and helping him to solve his problems by using models that are valid for the behavior that is taught to him or that the teachers present in their daily behavior with him.

Keywords: psychological, behavioral problems, children, school education

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3899 Gold-Mediated Modification of Apoferritin Surface with Targeting Antibodies

Authors: Simona Dostalova, Pavel Kopel, Marketa Vaculovicova, Vojtech Adam, Rene Kizek

Abstract:

Protein apoferritin seems to be a very promising structure for use as a nanocarrier. It is prepared from intracellular ferritin protein naturally found in most organisms. The role of ferritin proteins is to store and transport ferrous ions. Apoferritin is a hollow protein cage without ferrous ions that can be prepared from ferritin by reduction with thioglycolic acid or dithionite. The structure of apoferritin is composed of 24 protein subunits, creating a sphere with 12 nm in diameter. The inner cavity has a diameter of 8 nm. The drug encapsulation process is based on the response of apoferritin structure to the pH changes of surrounding solution. In low pH, apoferritin is disassembled into individual subunits and its structure is “opened”. It can then be mixed with any desired cytotoxic drug and after adjustment of pH back to neutral the subunits are reconnected again and the drug is encapsulated within the apoferritin particles. Excess drug molecules can be removed by dialysis. The receptors for apoferritin, SCARA5 and TfR1 can be found in the membrane of both healthy and cancer cells. To enhance the specific targeting of apoferritin nanocarrier, it is possible to modify its surface with targeting moieties, such as antibodies. To ensure sterically correct complex, we used a a peptide linker based on a protein G with N-terminus affinity towards Fc region of antibodies. To connect the peptide to the surface of apoferritin, the C-terminus of peptide was made of cysteine with affinity to gold. The surface of apoferritin with encapsulated doxorubicin (ApoDox) was coated either with gold nanoparticles (ApoDox-Nano) or gold (III) chloride hydrate reduced with sodium borohydride (ApoDox-HAu). The applied amount of gold in form of gold (III) chloride hydrate was 10 times higher than in the case of gold nanoparticles. However, after removal of the excess unbound ions by electrophoretic separation, the concentration of gold on the surface of apoferritin was only 6 times higher for ApoDox-HAu in comparison with ApoDox-Nano. Moreover, the reduction with sodium borohydride caused a loss of doxorubicin fluorescent properties (excitation maximum at 480 nm with emission maximum at 600 nm) and thus its biological activity. Fluorescent properties of ApoDox-Nano were similar to the unmodified ApoDox, therefore it was more suited for the intended use. To evaluate the specificity of apoferritin modified with antibodies, we used ELISA-like method with the surface of microtitration plate wells coated by the antigen (goat anti-human IgG antibodies). To these wells, we applied ApoDox without targeting antibodies and ApoDox-Nano modified with targeting antibodies (human IgG antibodies). The amount of unmodified ApoDox on antigen after incubation and subsequent rinsing with water was 5 times lower than in the case of ApoDox-Nano modified with targeting antibodies. The modification of non-gold ApoDox with antibodies caused no change in its targeting properties. It can therefore be concluded that the demonstrated procedure allows us to create nanocarrier with enhanced targeting properties, suitable for nanomedicine.

Keywords: apoferritin, doxorubicin, nanocarrier, targeting antibodies

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3898 A Brief History of Kampo Extract Formulations for Prescription in Japan

Authors: Kazunari Ozaki, Mitsuru Kageyama, Kenki Miyazawa, Yoshio Nakamura

Abstract:

Background: Kampo (Japanese Traditional medicine) is a medicine traditionally practiced in Japan, based on ancient Chinese medicine. Most Kampo doctors have used decoction of crude drug pieces for treatment. 93% of the Kampo drugs sold in Japan are Kampo products nowadays. Of all Kampo products, 81% of them are Kampo extract formulations for prescription, which is prepared in powdered or granulated form from medicinal crude drug extracts mixed with appropriate excipient. Physicians with medical license for Western medicine prescribe these Kampo extract formulations for prescription in Japan. Objectives: Our study aims at presenting a brief history of Kampo extract formulations for prescription in Japan. Methods: Systematic searches for relevant studies were conducted using not only printed journals but also electronic journals from the bibliographic databases, such as PubMed/Medline, Ichushi-Web, and university/institutional websites, as well as search engines, such as Google and Google Scholar. Results: The first commercialization of Kampo extract formulations for general use (or OTC (over-the-counter) Kampo extract formulation) was achieved after 1957. The number of drugs has been subsequentially increased, reaching 148 Kampo extract formulation for prescription currently. Conclusion: We provide a history of Kampo extract formulations for prescription in Japan. The originality of this research is that it analyzes the background history of Kampo in parallel with relevant transitions in the government and insurance systems.

Keywords: health insurance system, history, Kampo, Kampo extract formulation for prescription, OTC Kampo extract formulation, pattern corresponding prescription (Ho-sho-so-tai) system

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3897 Author’s Moral Rights in the Copyright Laws of the Baltic States: Comparative Legal Analysis

Authors: Sintija Zalane

Abstract:

This paper examines the protection and implementation of authors' moral rights in the copyright laws of Latvia, Lithuania, and Estonia, focusing on their legal frameworks in light of the Berne Convention. The analysis highlights how moral rights, such as authorship attribution, integrity of the work, and opposition to derogatory treatment, are upheld in these jurisdictions. The study compares national approaches to posthumous protection of moral rights and their interplay with economic rights. Drawing on legal texts and court decisions, the paper identifies challenges in enforcement and suggests harmonization opportunities to strengthen the moral rights framework across the Baltic region.

Keywords: authors’ moral rights, copyright laws, Baltic states, legal frameworks, berne convention, posthumous protection

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3896 An Analytical View to the Habitat Strategies of the Butterfly-Like Insects (Neuroptera: Ascalaphidae)

Authors: Hakan Bozdoğan

Abstract:

The goal of this paper is to evaluate the species richness, diversity and structure of in different habitats in the Kahramanmaraş Province in Turkey by using a mathematical program called as Geo-Gebra Software. The Ascalaphidae family comprises the most visually remarkable members of the order Neuroptera due to large dimensions, aerial predatory behaviour and dragonfly-like (or even butterfly-like) habits, allowing an immediate recognition also for occasional observers. Otherwise, they are one of the more poorly known families of the order in respect to biology, ecology and especially larval morphology. This discrepancy appears particularly noteworthy considering that it is a fairly large family (ca. 430 species) widely distributed in tropical and temperate areas of the World. The use of Dynamic Geometry, Analytical Softwares provides researchers a great way of visualising mathematical objects and encourage them to carry out tasks to interact with such objects and add to support of their researching. In this study we implemented; Circle with Center Through Point, Perpendicular Line, Vectors and Rays, Segments and Locus to elucidate the ecological and habitat behaviours of Butterfly-like lacewings in an analytical plane by using Geo-Gebra.

Keywords: neuroptera, Ascalaphidae, geo-gebra software, habitat selectivity

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3895 A Critical Analysis of the Concept of Unconscionable Abuse under the South African Company Law

Authors: Siphethile Phiri

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Although a company is a legal entity with separate legal personality, the courts are empowered to review and set aside the personality of a company on the ground of ‘an unconscionable abuse’. The process is called piercing of the corporate veil. Of interesting note however, it is controversial as to what the concept of ‘unconscionable abuse’ entails. The purpose of this study is to explore this concept in an attempt to understand its proper meaning and how it bears on the powers of the company director to take decision on behalf of the company as a juristic entity. Given the confounding provision, an attempt is made to identify the circumstances in which the courts may pierce the corporate veil and also to investigate the extent to which the courts can do so. The results of this study show that the term unconscionable abuse is a legislative innovation to justify the court’s interference with the separate legal personality functions of a company.

Keywords: company law, unconscionable abuse, director, companies act

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3894 Impact of Microwave Heating Temperatures on the Pharmaceutical Powder Characteristics

Authors: Maha Al-Ali, Selvakannan Periasamy, Rajarathinam Parthasarathy

Abstract:

Drying temperature is an important factor impacting the physicochemical properties of the dried materials, particularly the pharmaceutical powders. Drying of pharmaceuticals by using microwave radiation is very limited, and the available information about the interaction between the electromagnetic radiations and the pharmaceutical material is still scarce. Therefore, microwave drying process is employed in this work to dry the wet (moisturised) granules of the formulated naproxen-sodium drug. This study aims to investigate the influences of the microwave radiation temperatures on the moisture removal, the crystalline structure, the size and morphology of the dried naproxen-sodium particles, and identify any potential changes in the chemical groups of the drug. In this work, newly formulated naproxen-sodium is prepared and moisturized by wet granulation process and hence dried by using microwave radiation at different temperatures. Moisture analyzer, Fourier-transform infrared spectroscopy, powder X-ray diffraction, and scanning electron microscope are used to characterise the non-moisturised powder (reference powder), the moisturised granules, and the dried particles. The results show that microwave drying of naproxen-sodium at high drying temperature is more efficient than that at low temperatures in terms of the moisture removal. Although there is no significant change in the chemical structure of the dried particles, the particle size, crystallinity and morphology are relatively changed with changing of heating temperature.

Keywords: heating temperature, microwave drying, naproxen-sodium, particle size

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3893 Stress and Overload in Mothers and Fathers of Hospitalized Children: A Comparative Study

Authors: Alessandra Turini Bolsoni Silva, Nilson Rogério Da Silva

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The hospitalization process for long periods and the experience of invasive and painful clinical procedures can trigger a set of stressors in children, family members and professionals, leading to stress. Mothers are, in general, the main caregivers and, therefore, have a high degree of sadness and stress with an impact on mental health. However, the father, in the face of the mother's absence, needs to assume other responsibilities such as domestic activities and healthy children in addition to work activities. In addition, he has to deal with changes in family and work relationships during the child's hospitalization, with disagreements and changes in the relationship with the partner, changes in the relationship with the children, and finding it difficult to reconcile the new tasks as a caregiver and work. A consequence of the hospitalization process is the interruption of the routine activities of both the child and the family members responsible for the care, who can go through stressful moments due to the consequences of family breakdown, attention focused only on the child and sleepless nights. In this sense, both the mother and the father can have their health affected by their child's hospitalization. The present study aims to compare the prevalence of stress and overload in mothers and fathers of hospitalized children, as well as possible associations with activities related to care. The participants were 10 fathers and 10 mothers of children hospitalized in a hospital located in a medium-sized city in the interior of São Paulo. Three instruments were used for data collection: 1) Script to characterize the participants; 2) The Lipp Stress Symptom Inventory (ISSL, 2000) 3) Zarit Burden Interview Protocol – ZBT. Contact was made with the management of the hospital in order to present the objectives of the project, then authorization was requested for the participation of the parents; after an agreement, the time and place were convenient for the participant to carry out the interview. Thus, they signed the Free and Informed Consent Term. Data were analyzed according to the instrument application manuals and organized in Figures and Tables. The results revealed that fathers and mothers have their family and professional routine affected by the hospitalization of their children, with the consequent presence of stress and overload indicators. However, the study points to a greater presence of stress and overload in mothers due to their role as the main caregiver, often interrupting their professional life to exercise care. In the case of the father, the routine is changed due to taking on household chores and taking care of the other children, with the professional life being less affected. It is hoped that the data can guide future interventions that promote and develop strategies that favor care and, at the same time, preserve the health of caregivers and that include mothers and fathers, considering that both are affected, albeit in a different way.

Keywords: stress, overload, caregivers, parents

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3892 Moderating Effect of Owner's Influence on the Relationship between the Probability of Client Failure and Going Concern Opinion Issuance

Authors: Mohammad Noor Hisham Osman, Ahmed Razman Abdul Latiff, Zaidi Mat Daud, Zulkarnain Muhamad Sori

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The problem that Malaysian auditors do not issue going concern opinion (GC opinion) to seriously financially distressed companies is still a pressing issue. Policy makers, particularly the Financial Statement Review Committee (FSRC) of Malaysian Institute of Accountant, have raised this issue as early as in 2009. Similar problem happened in the US, UK, and many developing countries. It is important for auditors to issue GC opinion properly because such opinion is one signal about the viability of a company much needed by stakeholders. There are at least two unanswered questions or research gaps in the literature on determinants of GC opinion. Firstly, is client’s probability of failure associated with GC opinion issuance? Secondly, to what extent influential owners (management, family, and institution) moderate the association between client probability of failure and GC opinion issuance. The objective of this study is, therefore, twofold; (1) To examine the extent of the relationship between the probability of client failure and the issuance of GC opinion and (2) To examine the level of management, family, and institutional ownerships moderate the association between client probability of failure and the issuance of GC opinion. This study is quantitative in nature, and the sources of data are secondary (mainly company’s annual reports). A total of four hypotheses have been developed and tested on data accumulated from annual reports of seriously financially distressed Malaysian public listed companies. Data from 2006 to 2012 on a sample of 644 observations have been analyzed using panel logistic regression. It is found that certainty (rather than probability) of client failure affects the issuance of GC opinion. In addition, it is found that only the level of family ownership does positively moderate the relationship between client probability of failure and GC opinion issuance. This study is a contribution to auditing literature as its findings can enhance our understanding about audit quality; particularly on the variables that are associated with the issuance of GC opinion. The findings of this study shed light on the roles family owners in GC opinion issuance process, and this would open ways for the researcher to suggest measures that can be used to tackle the problem of auditors do not want to issue GC opinion to financially distressed clients. The measures to be suggested can be useful to policy makers in formulating future promulgations.

Keywords: audit quality, auditing, auditor characteristics, going concern opinion, Malaysia

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3891 Component Composition of Biologically Active Substances in Extracts of Some Species from the Family Lamiaceae Lindl.

Authors: Galina N. Parshina, Olga N. Shemshura, Ulzhan S. Mukiyanova, Gulnur M. Beisetbayeva

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From a medical point of view some species from the family Lamiaceae Lindl. attract the attention of scientists. Many plant species from this family are used in science and medicine. Some researchers believe that the medicinal properties of these plants are caused by the action on the organism of the individual components (camphor, menthol, thymol, eugenol, phenols, flavonoids, alcohols, and their derivatives) or the entire complex of essential oils. Biologically active substances (BAS), isolated from these medicinal plants can be an effective supplement in the complex treatment of infectious diseases. The substances of the phenolic group such as flavonoids and phenolic acids; and also alkaloids included in the component composition of the plants from the family Lamiaceae Lindl. present the scientific and practical interest for future investigations of their biological activity and development of medicinal products. The research objects are the species from the family Lamiaceae Lindl., cultivated in the North-Kazakhstan region. In this abstract, we present the results of the investigation of polyphenolic complex (flavonoids and phenolic acids) and alkaloids in aqueous and ethanol extracts. Investigation of the qualitative composition of flavonoids in the aqueous extracts showed that the species Monarda Diana contains flavone, Dracocephalum moldavica contains rutin, Ocimum basilicum (purple form) contains both ruin and quercetin. Biochemical analysis revealed that the ethanol extract of Monarda Diana has phenolic acids, similar to protocatechuic and benzoic acids by their chromatographic characteristics. But the aqueous extract contains four phenolic acids, one of which is an analogue of gentisic acid; and the other three are not identified yet. The phenolic acids such as benzoic and gentisic acids identified in ethanol extracts of species Ocimum basilicum (purple form) and Satureja hortensis, correspondingly. But the same phenolic acids did not appear in aqueous extracts. The phenolic acids were not determined neither in the ethanol or aqueous extracts of species Dracocephalum moldavica. The biochemical analysis did not reveal the content of alkaloids in aqueous extracts of investigated plants. However, the alkaloids in the amount of 5-13 components were identified in the ethanolic extracts of plants by the qualitative reactions. The results of analysis with reagent of Dragendorff showed that next amounts of alkaloids were identified in extracts of Monarda Diana (6-7), Satureja hortensis (6), Ocimum basilicum (7-9) and Dracocephalum moldavica (5-6). The reactions with reagent of Van-Urca showed that next amounts of alkaloids were identified in extracts of Monarda Diana (9-12), Satureja hortensis (9-10), two alkaloids of them with Rf6=0,39 and Rf6=0,31 similar to roquefortine), Ocimum basilicum (11) and Dracocephalum moldavica (13, two of them with Rf5=0,34 and Rf5=0,33 by their chromatographic characteristics similar to epikostaklavin).

Keywords: biologically active substances, Lamiaceae, component composition, medicinal plant

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3890 Reclaiming the Lost Jewish Identity of a Second Generation Holocaust Survivor Raised as a Christian: The Role of Art and Art Therapy

Authors: Bambi Ward

Abstract:

Children of Holocaust survivors have been described as inheriting their parents’ trauma as a result of ‘vicarious memory’. The term refers to a process whereby second generation Holocaust survivors subconsciously remember aspects of Holocaust trauma, despite not having directly experienced it. This can occur even when there has been a conspiracy of silence in which survivors chose not to discuss the Holocaust with their children. There are still people born in various parts of the world such as Poland, Hungary, other parts of Europe, USA, Canada and Australia, who have only learnt of their Jewish roots as adults. This discovery may occur during a parent’s deathbed confession, or when an adult child is sorting through the personal belongings of a deceased family member. Some Holocaust survivors chose to deny their Jewish heritage and raise their children as Christians. Reasons for this decision include the trauma experienced during the Holocaust for simply being Jewish, the existence of anti-Semitism, and the desire to protect one’s self and one’s family. Although there has been considerable literature written about the transgenerational impact of trauma on children of Holocaust survivors, there has been little scholarly investigation into the effects of a hidden Jewish identity on these children. This paper presents a case study of an adult child of Hungarian Holocaust survivors who was raised as a Christian. At the age of eight she was told about her family’s Jewish background, but her parents insisted that she keep this a secret, even if asked directly. She honoured their request until she turned forty. By that time she had started the challenging process of reclaiming her Jewish identity. The paper outlines the tension between family loyalty and individual freedom, and discusses the role that art and art therapy played in assisting the subject of the case study to reclaim her Jewish identity and commence writing a memoir about her spiritual journey. The main methodology used in this case study is creative practice-led research. Particular attention is paid to the utilisation of an autoethnographic approach. The autoethnographic tools used include reflective journals of the subject of the case study. These journals reflect on the subject’s collection of autobiographical data relating to her family history, and include memories, drawings, products of art therapy, diaries, letters, photographs, home movies, objects, and oral history interviews with her mother. The case study illustrates how art and art therapy benefitted a second generation Holocaust survivor who was brought up having to suppress her Jewish identity. The process allowed her to express subconscious thoughts and feelings about her identity and free herself from the burden of the long term secret she had been carrying. The process described may also be of assistance to other traumatised people who have been trying to break the silence and who are seeking to express themselves in a positive and healing way.

Keywords: art, hidden identity, holocaust, silence

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3889 Cultural Awareness, Intercultural Communication Competence and Academic Performance of Foreign Students Towards an Education ASEAN Integration in Global Education

Authors: Rizalito B. Javier

Abstract:

Research has shown that foreign students with higher levels of cultural awareness and intercultural communication competence tend to have better academic performance outcomes. This study aimed to find out the cultural awareness, intercultural communication competence, and academic performance of foreign students and its relationships among variables. Methods used were descriptive-comparative and correlational research design, quota purposive sampling technique while frequency counts and percentages, mean and standard deviation, T, and F-test and chi-square were utilized to analyze the data. The results revealed that the majority of the respondents were under the age bracket of 21-25 years old, mostly males, all single, and mostly citizens of Papua New Guinea, Angolan, Vanuatu, Tanzanian, Nigerian, Korean, Rwanda, and Myanmar. Most language spoken was English, many of them were born again Christians, the majority took BS business management degree program, their studies mainly supported by their parents, they had stayed in the Philippines for 3-4 years, and most of them attended five to six times of cultural awareness/competence workshop-seminars, majority of their parent’s occupations were family own business, and had been earning a family monthly income of P61,0000 and above. The respondents were highly aware of their culture in terms of clients’ issues. The intercultural communication competence of the respondents was slightly aware in terms of intercultural awareness, while the foreign students performed good remarks in their average academic performance. However, the profiles of the participants in terms of age, gender, civil status, nationality, course/degree program taken, support to the study, length of stay, workshop attended, and parents’ occupation have significant differences in the academic performance except for the type of family, language spoken, religion and family monthly income. Moreover, cultural awareness was significantly related to intercultural communication competence, and both were not related to academic performance. It is recommended that foreign students be provided with cultural orientation programs, offered language support services, promoted intercultural exchange activities, and implemented inclusive teaching practices to allow students to effectively navigate and interact with people from different cultural backgrounds, fostering a more inclusive and collaborative learning environment.

Keywords: cultural competence, communication competence, intercultural competence, and culture-academic performance.

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3888 Sexual Health and Sexual Risk Behavior of the Youth with HIV Positive in Northeastern Part, Thailand

Authors: Orathai Srithongtham, Ubonsri Thabuddha

Abstract:

The youth with HIV positive is not difference from the general youth in term of sexual needs. Sexual health is crucial the most to support the youth with HIV positive to be sexual well-being. This study aims to elucidate the sexual health on protection from STDs (Sexual Transmitted Diseases) and HIV transmission and to explain sexual risk behavior of the youth with HIV positive. The target group was the youth with HIV positive about 23 cases from two provinces in northeastern part of Thailand. Qualitative method was applied for collecting data by in-depth interview. Content analysis was use for data analysis. The youth with HIV positive was protection from STDs and HIV transmission by using the condom during sexual activity. The reason to deny the condom use were ashamed, condom is not a part of life, no have fit size, and the youth fear to stigmatized as a mental disorder and fear to stigmatized as going to fuck someone. The youth who trust with nurse in clinic was dare to request the condom by face. Sexual activity without condom use is sexual risk behavior. The major causes were couple trust and the sexual enjoyment first and sexual active competition with friend without condom use. The concern on HIV was the boyfriend or girlfriend not accepts the HIV positive people, worry about the HIV transmutation, and finally not compliance to ARV drug. The youth with HIV positive was lacking of the knowledge on sexual health on the issues of access to condom and the concern to keep on relationship with the boyfriend or girlfriend. This concern issues was led to the non-adherence of ARV drug and HIV distribution. To provide the sexual health service is more essential to the youth with HIV positive.

Keywords: sexual health, sexual risk behavior, youth, HIV

Procedia PDF Downloads 477
3887 Accelerated Molecular Simulation: A Convolution Approach

Authors: Jannes Quer, Amir Niknejad, Marcus Weber

Abstract:

Computational Drug Design is often based on Molecular Dynamics simulations of molecular systems. Molecular Dynamics can be used to simulate, e.g., the binding and unbinding event of a small drug-like molecule with regard to the active site of an enzyme or a receptor. However, the time-scale of the overall binding event is many orders of magnitude longer than the time-scale of simulation. Thus, there is a need to speed-up molecular simulations. In order to speed up simulations, the molecular dynamics trajectories have to be ”steared” out of local minimizers of the potential energy surface – the so-called metastabilities – of the molecular system. Increasing the kinetic energy (temperature) is one possibility to accelerate simulated processes. However, with temperature the entropy of the molecular system increases, too. But this kind ”stearing” is not directed enough to stear the molecule out of the minimum toward the saddle point. In this article, we give a new mathematical idea, how a potential energy surface can be changed in such a way, that entropy is kept under control while the trajectories are still steared out of the metastabilities. In order to compute the unsteared transition behaviour based on a steared simulation, we propose to use extrapolation methods. In the end we mathematically show, that our method accelerates the simulations along the direction, in which the curvature of the potential energy surface changes the most, i.e., from local minimizers towards saddle points.

Keywords: extrapolation, Eyring-Kramers, metastability, multilevel sampling

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3886 The Pharmacogenetics of Type 1 Cannabinoid Receptor (CB1) Gene Associated with Adverse Drug Reactions in Thai Patients

Authors: Kittitara Chunlakittiphan, Patompong Satapornpong

Abstract:

Introduction: The variation of genetics affects how our body responds to pharmaceuticals elucidates the correlation between long-term use of medical cannabis and adverse drug reactions (ADRs). Medical cannabis is regarded as the treatment for chronic pain, cancer pain, acute pain, psychological disorders, multiple sclerosis and migraine management. However, previous studies have shown that delta-9-Tetrahydrocannabinol (THC), an ingredient found in cannabis, was the cause of ADRs in CB1 receptors found in humans. Previous research suggests that distributions of the cannabinoid type 1 (CB1) receptor gene and pharmacogenetic markers, which vary amongst different populations, might affect incidences of ADRs. Although there is an evident need to investigate the level of the CB1 receptor gene (rs806365), studies on the distribution of CB1-pharmacogenetics markers in Thai patients are limited. Objective: Therefore, the aim of this study is to investigate the distribution of the rs806365 polymorphism in Thai patients who have been treated with medical cannabis. Materials and Methods: We enrolled 31 Thai patients with THC-induced ADRs and 34 THC-tolerant controls to take part in this study. All patients with THC-induced ADRs were accessed through a review of medical records by physicians. EDTA blood of 3ml was collected to obtain the CNR1 gene (rs806365) and genotyping of this gene was conducted using the real-time PCR ViiA7 (ABI, Foster City, CA, USA) following the manufacturer’s instruction. Results: The sample consisted of 65 patients (40/61.54%) were females and (25/38.46%) were males, with an age range of 19-87 years, who have been treated with medical cannabis. In this study, the most common THC-induced ADRs were dry mouth and/or dry throat, tachycardia, nausea, and arrhythmia. Across the whole sample, we found that 52.31% of Thai patients carried a heterozygous variant (rs806365, CT allele). Moreover, the number of rs806365 (CC, homozygous variant) carriers totaled seventeen people (26.15%) amongst the subjects of Thai patients treated with medical cannabis. Furthermore, 17 out of 22 patients (77.27%) who experienced severe ADRs: Tachycardia and/or arrhythmia, carried an abnormal rs806365 gene (CT and CC alleles). Conclusions: The results propose that the rs806365 gene is widely distributed amongst the Thai population and there is a link between this gene and vulnerability to developing THC-induced ADRs after being treated with medical cannabis. Therefore, it is necessary to screen for the rs806365 gene before using medical cannabis to treat a patient.

Keywords: rs806365, THC-induced adverse drug reactions, CB1 receptor, Thai population

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3885 Evaluation of Trabectedin Safety and Effectiveness at a Tertiary Cancer Center at Qatar: A Retrospective Analysis

Authors: Nabil Omar, Farah Jibril, Oraib Amjad

Abstract:

Purpose: Trabecatine is a is a potent marine-derived antineoplastic drug which binds to the minor groove of the DNA, bending DNA towards the major groove resulting in a changed conformation that interferes with several DNA transcription factors, repair pathways and cell proliferation. Trabectedin was approved by the European Medicines Agency (EMA; London, UK) for the treatment of adult patients with advanced stage soft tissue sarcomas in whom treatment with anthracyclines and ifosfamide has failed, or for those who are not candidates for these therapies. The recommended dosing regimen is 1.5 mg/m2 IV over 24 hours every 3 weeks. The purpose of this study was to comprehensively review available data on the safety and efficacy of trabectedin used as indicated for patients at a Tertiary Cancer Center at Qatar. Methods: A medication administration report generated in the electronic health record identified all patients who received trabectedin between November 1, 2015 and November 1, 2017. This retrospective chart review evaluated the indication of trabectedin use, compliance to administration protocol and the recommended monitoring parameters, number of patients improved on the drug and continued treatment, number of patients discontinued treatment due to side-effects and the reported side effects. Progress and discharged notes were utilized to report experienced side effects during trabectedin therapy. A total of 3 patients were reviewed. Results: Total of 2 out of 3 patients who received trabectedin were receiving it for non-FDA and non-EMA, approved indications; metastatic rhabdomyosarcoma and ovarian cancer stage IV with poor prognosis. And only one patient received it as indicated for leiomyosarcoma of left ureter with metastases to liver, lungs and bone. None of the patients has continued the therapy due to development of serious side effects. One patient had stopped the medication after one cycle due to disease progression and transient hepatic toxicity, the other one had disease progression and developed 12 % reduction in LVEF after 12 cycles of trabectedin, and the third patient deceased, had disease progression on trabectedin after the 10th cycle that was received through peripheral line which resulted in developing extravasation and left arm cellulitis requiring debridement. Regarding monitoring parameters, at baseline the three patients had ECHO, and Creatine Phosphokinase (CPK) but it was not monitored during treatment as recommended. Conclusion: Utilizing this medication as indicated with performing the appropriate monitoring parameters as recommended can benefit patients who are receiving it. It is important to reinforce the intravenous administration via central intravenous line, the re-assessment of left ventricular ejection fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan at 2- to 3-month intervals thereafter until therapy is discontinued, and CPK and LFTs levels prior to each administration of trabectedin.

Keywords: trabectedin, drug-use evaluation, safety, effectiveness, adverse drug reaction, monitoring

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3884 Magnitude and Outcome of Resuscitation Activities at Rwanda Military Hospital for the Period of April 2013-September 2013

Authors: Auni Idi Muhire

Abstract:

Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

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3883 Journey to Cybercrime and Crime Opportunity: Quantitative Analysis of Cyber Offender Spatial Decision Making

Authors: Sinchul Back, Sun Ho Kim, Jennifer LaPrade, Ilju Seong

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Due to the advantage of using the Internet, cybercriminals can reach target(s) without border controls. Prior research on criminology and crime science has largely been void of empirical studies on journey-to-cybercrime and crime opportunity. Thus, the purpose of this study is to understand more about cyber offender spatial decision making associated with crime opportunity factors (i.e., co-offending, offender-stranger). Data utilized in this study were derived from 306 U.S. Federal court cases of cybercrime. The findings of this study indicated that there was a positive relationship between co-offending and journey-to-cybercrime, whereas there was no link between offender-stranger and journey-to-cybercrime. Also, the results showed that there was no relationship between cybercriminal sex, age, and journey-to-cybercrime. The policy implications and limitations of this study are discussed.

Keywords: co-offending, crime opportunity, journey-to-cybercrime, offender-stranger

Procedia PDF Downloads 179
3882 The Role of Cultural Expectations in Emotion Regulation among Nepali Adolescents

Authors: Martha Berg, Megan Ramaiya, Andi Schmidt, Susanna Sharma, Brandon Kohrt

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Nepali adolescents report tension and negative emotion due to perceived expectations of both academic and social achievement. These societal goals, which are internalized through early-life socialization, drive the development of self-regulatory processes such as emotion regulation. Emotion dysregulation is linked with adverse psychological outcomes such as depression, self-harm, and suicide, which are public health concerns for organizations working with Nepali adolescents. This study examined the relation among socialization, internalized cultural goals, and emotion regulation to inform interventions for reducing depression and suicide in this population. Participants included 102 students in grades 7 through 9 in a post-earthquake school setting in rural Kathmandu valley. All participants completed a tablet-based battery of quantitative measures, comprising transculturally adapted assessments of emotion regulation, depression, and self-harm/suicide ideation and behavior. Qualitative measures included two focus groups and semi-structured interviews with 22 students and 3 parents. A notable proportion of the sample reported depression symptoms in the past 2 weeks (68%), lifetime self-harm ideation (28%), and lifetime suicide attempts (13%). Students who lived with their nuclear family reported lower levels of difficulty than those who lived with more distant relatives (z=2.16, p=.03), which suggests a link between family environment and adolescent emotion regulation, potentially mediated by socialization and internalization of cultural goals. These findings call for further research into the aspects of nuclear versus extended family environments that shape the development of emotion regulation.

Keywords: adolescent mental health, emotion regulation, Nepal, socialization

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3881 Biomimetic Systems to Reveal the Action Mode of Epigallocatechin-3-Gallate in Lipid Membrane

Authors: F. Pires, V. Geraldo, O. N. Oliveira Jr., M. Raposo

Abstract:

Catechins are powerful antioxidants which have attractive properties useful for tumor therapy. Considering their antioxidant activity, these molecules can act as a scavenger of the reactive oxygen species (ROS), alleviating the damage of cell membrane induced by oxidative stress. The complexity and dynamic nature of the cell membrane compromise the analysis of the biophysical interactions between drug and cell membrane and restricts the transport or uptake of the drug by intracellular targets. To avoid the cell membrane complexity, we used biomimetic systems as liposomes and Langmuir monolayers to study the interaction between catechin and membranes at the molecular level. Liposomes were formed after the dispersion of anionic 1,2-dipalmitoyl-sn-glycero-3-[phospho-rac-(1-glycerol)(sodium salt) (DPPG) phospholipids in an aqueous solution, which mimic the arrangement of lipids in natural cell membranes and allows the entrapment of catechins. Langmuir monolayers were formed after dropping amphiphilic molecules, DPPG phospholipids, dissolved in an organic solvent onto the water surface. In this work, we mixed epigallocatechin-3-gallate (EGCG) with DPPG liposomes and exposed them to ultra-violet radiation in order to evaluate the antioxidant potential of these molecules against oxidative stress induced by radiation. The presence of EGCG in the mixture decreased the rate of lipid peroxidation, proving that EGCG protects membranes through the quenching of the reactive oxygen species. Considering the high amount of hydroxyl groups (OH groups) on structure of EGCG, a possible mechanism to these molecules interact with membrane is through hydrogen bonding. We also investigated the effect of EGCG at various concentrations on DPPG Langmuir monolayers. The surface pressure isotherms and infrared reflection-absorption spectroscopy (PM-IRRAS) results corroborate with absorbance results preformed on liposome-model, showing that EGCG interacts with polar heads of the monolayers. This study elucidates the physiological action of EGCG which can be incorporated in lipid membrane. These results are also relevant for the improvement of the current protocols used to incorporate catechins in drug delivery systems.

Keywords: catechins, lipid membrane, anticancer agent, molecular interactions

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3880 Investigation of a Technology Enabled Model of Home Care: the eShift Model of Palliative Care

Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons

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Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.

Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team

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3879 Development of Wound Dressing System Based on Hydrogel Matrix Incorporated with pH-Sensitive Nanocarrier-Drug Systems

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

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The growing significance of transdermal systems, in which skin is a route for systemic drug delivery, has generated a considerable amount of data which has resulted in a deeper understanding of the mechanisms of transport across the skin in the context of the controlled and prolonged release of active substances. One of such solutions may be the use of carrier systems based on intelligent polymers with different physicochemical properties. In these systems, active substances, e.g. drugs, can be conjugated (attached), immobilized, or encapsulated in a polymer matrix that is sensitive to specific environmental conditions (e.g. pH or temperature changes). Intelligent polymers can be divided according to their sensitivity to specific environmental stimuli such as temperature, pH, light, electric, magnetic, sound, or electromagnetic fields. Materials & methods—The first stage of the presented research concerned the synthesis of pH-sensitive polymeric carriers by a radical polymerization reaction. Then, the selected active substance (hydrocortisone) was introduced into polymeric carriers. In a further stage, bio-hybrid sodium alginate/poly(vinyl alcohol) – SA/PVA-based hydrogel matrices modified with various carrier-drug systems were prepared with the chemical cross-linking method. The conducted research included the assessment of physicochemical properties of obtained materials i.e. degree of hydrogel swelling and degradation studies as a function of pH in distilled water and phosphate-buffered saline (PBS) at 37°C in time. The gel fraction represents the insoluble gel fraction as a result of inter-molecule cross-linking formation was also measured. Additionally, the chemical structure of obtained hydrogels was confirmed using FT-IR spectroscopic technique. The dynamic light scattering (DLS) technique was used for the analysis of the average particle size of polymer-carriers and carrier-drug systems. The nanocarriers morphology was observed using SEM microscopy. Results & Discussion—The analysis of the encapsulated polymeric carriers showed that it was possible to obtain the time-stable empty pH-sensitive carrier with an average size 479 nm and the encapsulated system containing hydrocortisone with an average 543 nm, which was introduced into hydrogel structure. Bio-hybrid hydrogel matrices are stable materials, and the presence of an additional component: pH-sensitive carrier – hydrocortisone system, does not reduce the degree of cross-linking of the matrix nor its swelling ability. Moreover, the results of swelling tests indicate that systems containing higher concentrations of the drug have a slightly higher sorption capacity in each of the media used. All analyzed materials show stable and statically changing swelling values in simulated body fluids - there is no sudden fluid uptake and no rapid release from the material. The analysis of FT-IR spectra confirms the chemical structure of the obtained bio-hybrid hydrogel matrices. In the case of modifications with a pH-sensitive carrier, a much more intense band can be observed in the 3200-3500 cm⁻¹ range, which most likely originates from the strong hydrogen interactions that occur between individual components.

Keywords: hydrogels, polymer nanocarriers, sodium alginate/poly(vinyl alcohol) matrices, wound dressings.

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