Search results for: healthcare delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3265

Search results for: healthcare delivery

3115 Expert-Based Validated Measures for Improving Quality Healthcare Services Utilization among Elderly Persons: A Cross-Section Survey

Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

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3114 A Proposal to Tackle Security Challenges of Distributed Systems in the Healthcare Sector

Authors: Ang Chia Hong, Julian Khoo Xubin, Burra Venkata Durga Kumar

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Distributed systems offer many benefits to the healthcare industry. From big data analysis to business intelligence, the increased computational power and efficiency from distributed systems serve as an invaluable resource in the healthcare sector to utilize. However, as the usage of these distributed systems increases, many issues arise. The main focus of this paper will be on security issues. Many security issues stem from distributed systems in the healthcare industry, particularly information security. The data of people is especially sensitive in the healthcare industry. If important information gets leaked (Eg. IC, credit card number, address, etc.), a person’s identity, financial status, and safety might get compromised. This results in the responsible organization losing a lot of money in compensating these people and even more resources expended trying to fix the fault. Therefore, a framework for a blockchain-based healthcare data management system for healthcare was proposed. In this framework, the usage of a blockchain network is explored to store the encryption key of the patient’s data. As for the actual data, it is encrypted and its encrypted data, called ciphertext, is stored in a cloud storage platform. Furthermore, there are some issues that have to be emphasized and tackled for future improvements, such as a multi-user scheme that could be proposed, authentication issues that have to be tackled or migrating the backend processes into the blockchain network. Due to the nature of blockchain technology, the data will be tamper-proof, and its read-only function can only be accessed by authorized users such as doctors and nurses. This guarantees the confidentiality and immutability of the patient’s data.

Keywords: distributed, healthcare, efficiency, security, blockchain, confidentiality and immutability

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3113 Improving Post Release Outcomes

Authors: Michael Airton

Abstract:

This case study examines the development of a new service delivery model for prisons that focuses on using NGO’s to provide more effective case management and post release support functions. The model includes the co-design of the service delivery model and innovative commercial agreements that encourage embedded service providers within the prison and continuity of services post release with outcomes based payment mechanisms. The collaboration of prison staff, probation and parole officers and NGO’s is critical to the success of the model and its ability to deliver value and positive outcomes in relation to desistance from offending.

Keywords: collaborative service delivery, desistance, non-government organisations, post release support services

Procedia PDF Downloads 371
3112 Drug Delivery to Solid Tumor: Effect of Dynamic Capillary Network Induced by Tumor

Authors: Mostafa Sefidgar, Kaamran Raahemifar, Hossein Bazmara, Madjid Soltani

Abstract:

The computational methods provide condition for investigation related to the process of drug delivery, such as convection and diffusion of drug in extracellular matrices, and drug extravasation from microvascular. The information of this process clarifies the mechanisms of drug delivery from the injection site to absorption by a solid tumor. In this study, an advanced numerical method is used to solve fluid flow and solute transport equations simultaneously to show how capillary network structure induced by tumor affects drug delivery. The effect of heterogeneous capillary network induced by tumor on interstitial fluid flow and drug delivery is investigated by this multi scale method. The sprouting angiogenesis model is used for generating capillary network induced by tumor. Fluid flow governing equations are implemented to calculate blood flow through the tumor-induced capillary network and fluid flow in normal and tumor tissues. The Starling’s law is used for closing this system of equations and coupling the intravascular and extravascular flows. Finally, convection-diffusion-reaction equation is used to simulate drug delivery. The dynamic approach which changes the capillary network structure based on signals sent by hemodynamic and metabolic stimuli is used in this study for more realistic assumption. The study indicates that drug delivery to solid tumors depends on the tumor induced capillary network structure. The dynamic approach generates the irregular capillary network around the tumor and predicts a higher interstitial pressure in the tumor region. This elevated interstitial pressure with irregular capillary network leads to a heterogeneous distribution of drug in the tumor region similar to in vivo observations. The investigation indicates that the drug transport properties have a significant role against the physiological barrier of drug delivery to a solid tumor.

Keywords: solid tumor, physiological barriers to drug delivery, angiogenesis, microvascular network, solute transport

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3111 A Realist Review of Interventions Targeting Maternal Health in Low- and Middle-income Countries

Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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3110 Understanding Awareness, Agency and Autonomy of Mothers and Potential of Digital Technology in Expanding Maternal Health Information Access: A Survey of Mothers in Urban India

Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

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3109 Impact of Technology on Product Quality, Speed up Delivery and Cost

Authors: Rehan Ullah

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This paper explores the hypothesis that technology can be used to improve product quality, speed up delivery and reduced cost. For companies improving the quality of their products, reducing the cost and improving the speed of delivery makes them favorable to the client who feels like all their needs have been met. The research occurs between the months of January 2018 to April 2018 which is about four months. The research experiment design uses the pretest-posttest experimental design set up between two companies both using the traditional method of manufacturing with no technology. In one company technology is introduced while in the other company the process remains the same traditional method of production. Both companies analyze the results at the end of a four-month period before a conclusion is drawn from both the pretest and the final test. The experiment results show that technology improves quality of the product, improves the speed of delivery while at the same time reduce cost benefiting both the producer and the client. Technology should, therefore, be implemented in companies to give them an edge over the competition. With technology in companies, the United States can reclaim production from overseas companies that have taken over by providing cheap labor. Better satisfied customers mean more production which in turn means more jobs for the people in the United States.

Keywords: technology, quality of product, speed up delivery, cost

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3108 An Approach for Ensuring Data Flow in Freight Delivery and Management Systems

Authors: Aurelija Burinskienė, Dalė Dzemydienė, Arūnas Miliauskas

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This research aims at developing the approach for more effective freight delivery and transportation process management. The road congestions and the identification of causes are important, as well as the context information recognition and management. The measure of many parameters during the transportation period and proper control of driver work became the problem. The number of vehicles per time unit passing at a given time and point for drivers can be evaluated in some situations. The collection of data is mainly used to establish new trips. The flow of the data is more complex in urban areas. Herein, the movement of freight is reported in detail, including the information on street level. When traffic density is extremely high in congestion cases, and the traffic speed is incredibly low, data transmission reaches the peak. Different data sets are generated, which depend on the type of freight delivery network. There are three types of networks: long-distance delivery networks, last-mile delivery networks and mode-based delivery networks; the last one includes different modes, in particular, railways and other networks. When freight delivery is switched from one type of the above-stated network to another, more data could be included for reporting purposes and vice versa. In this case, a significant amount of these data is used for control operations, and the problem requires an integrated methodological approach. The paper presents an approach for providing e-services for drivers by including the assessment of the multi-component infrastructure needed for delivery of freights following the network type. The construction of such a methodology is required to evaluate data flow conditions and overloads, and to minimize the time gaps in data reporting. The results obtained show the possibilities of the proposing methodological approach to support the management and decision-making processes with functionality of incorporating networking specifics, by helping to minimize the overloads in data reporting.

Keywords: transportation networks, freight delivery, data flow, monitoring, e-services

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3107 Notions of Criticality in Strategic Management of Hospitality Services in Nigeria

Authors: Chigozie P. Ugochukwu Okoro

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While the needs of the traveling public are becoming more evolving due to the ever-changing tourism ecosphere; there is a seeming inability to sustain competitive advantage through hospitality enterprise service quality differentials and effective service delivery. Contending with these evolving needs demands a re-assessment of the notions that drive service evolvement thoughts pattern and service delivery processes management in the hospitality enterprise. The intent of this study was to explicate the trends of the evolving needs of the traveling public that are critical to hospitality enterprise service management. The hypothetical study used customer satisfaction to dissect the strategic implication of perception, experience, and socio-cultural engagements in customization of hospitality enterprise services. The study found out that customer perception is cognitive and does not shape service customization. The study also elucidated that customer experience which can be evaluated, is critical in service structure determination and delivery. Socio-cultural engagement is intrinsic in driving service diversification. The study recommends tourists’ audit and cognitive insights as strategic actions for re-designing service efficiency and delivery in hospitality enterprise service management.

Keywords: hospitality enterprise services, strategic management, quality service delivery, notions of criticality

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3106 Survival Analysis Based Delivery Time Estimates for Display FAB

Authors: Paul Han, Jun-Geol Baek

Abstract:

In the flat panel display industry, the scheduler and dispatching system to meet production target quantities and the deadline of production are the major production management system which controls each facility production order and distribution of WIP (Work in Process). In dispatching system, delivery time is a key factor for the time when a lot can be supplied to the facility. In this paper, we use survival analysis methods to identify main factors and a forecasting model of delivery time. Of survival analysis techniques to select important explanatory variables, the cox proportional hazard model is used to. To make a prediction model, the Accelerated Failure Time (AFT) model was used. Performance comparisons were conducted with two other models, which are the technical statistics model based on transfer history and the linear regression model using same explanatory variables with AFT model. As a result, the Mean Square Error (MSE) criteria, the AFT model decreased by 33.8% compared to the existing prediction model, decreased by 5.3% compared to the linear regression model. This survival analysis approach is applicable to implementing a delivery time estimator in display manufacturing. And it can contribute to improve the productivity and reliability of production management system.

Keywords: delivery time, survival analysis, Cox PH model, accelerated failure time model

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3105 Perception of Healthcare Workers Regarding the Psychological Impact of COVID-19 on Their Children

Authors: Saima Batool, Saima Rafique

Abstract:

Background and Objective: Pandemics like COVID-19 adversely affect children’s behavior and psychological development by disrupting routine life activities. Children of healthcare workers are exposed additionally due to the fear of parental exposure to the virus. The objective of this study was to assess the perception of frontline healthcare workers (HCWs) regarding the psychological impact of the COVID-19 pandemic on their children. We also sought to identify the difference in the psychological impact on children of male and female healthcare workers. Methods: A survey questionnaire was developed comprising 10 questions about the perception of HCWs regarding the psychological impact of COVID-19 on their children. It was distributed both online and face-to-face among 150 healthcare professionals working in training and non-training posts in 4 public and 5 nongovernment hospitals in Pakistan. The mean and standard deviation were calculated for each survey item using Statistical Package for the Social Sciences 26.0. Results: The response rate was 71.3%, and the majority (64.2%) of the healthcare professionals were ≥30 years of age. Ninety-two HCWs (85.98%) either agreed or strongly agreed that parental separation from their kids for long hours during the pandemic had a negative psychological impact on their children. There was a significant difference in the perceived psychological impact of COVID-19 on the children of male and female HCWs, with a mean survey score of 2.29 ± 1.82 and 1.69 ± 0.79, respectively (t = 2.29, p-value = 0.024). Conclusion: Children of healthcare workers experience more stress and anxiety because of long duty hours and working in high-risk settings. Continuous psychological support and counseling services may be adopted formally to prevent unforeseen adverse events or any long-term negative impact on their physical and mental health.

Keywords: healthcare workers, pandemic, COVID-19, anxiety, psychological

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3104 Prevalence of Caesarean-Section Delivery and Its Determinants in India: Evidence for Fifth National Family Health Surveys

Authors: Daisy Saikia

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Long-term maternal health issues with Caesarean section deliveries are significant. Thus, this study aims to investigate the prevalence of caesarean section deliveries in India and to comprehend its associated predictors in light of the high caesarean section delivery rate. The study uses data from the fifth National Family Health Surveys (NFHS-5) round. Specifically, live births to women aged 15-49 in the 5 years preceding the survey. Binary logistic regression was used to check the adjusted effects of the predictor variables on caesarean section delivery. STATA/SE v16.0 was used for the data analysis with a 5% significance level. Twenty-two per cent of the live births to women were delivered by caesarean section. There was socio-economic, demographic and geographical variation in the prevalence of caesarean section delivery in India. Increasing age, body mass index, marital status, mother’s occupation and education, birth order, place of delivery, full ANC, non-tribal status, wealth quintile and region are significantly associated with caesarean section deliveries in India. Caesarean section deliveries should only be performed when essential from a medical perspective, and regions, where the rate is too high, should follow the guidelines. Additionally, it needs to be investigated whether private hospitals compel patients to have caesarean section deliveries to increase their revenue. Thus, these unnecessary deliveries must be examined immediately for safe childbirth and the wellness of both mother and child.

Keywords: caesarean section, delivery, maternal health, India

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3103 Fabrication and Characterization of Dissolvable Microneedle Patches Using Different Compositions and Ratios of Hyaluronic Acid and Zinc Oxide Nanoparticles

Authors: Dada Kolawole Segun

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Transdermal drug delivery has gained popularity as a non-invasive method for controlled drug release compared to traditional delivery routes. Dissolvable transdermal patches have emerged as a promising platform for delivering a variety of drugs due to their ease of use. The objective of this research was to create and characterize dissolvable transdermal patches using various compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. A micromolding technique was utilized to fabricate the patches, which were subsequently characterized using scanning electron microscopy, atomic force microscopy, and tensile strength testing. In vitro drug release studies were conducted to evaluate the drug release kinetics of the patches. The study found that the mechanical strength and dissolution properties of the patches were influenced by the hyaluronic acid and zinc oxide nanoparticle ratios used in the fabrication process. Moreover, the patches demonstrated controlled delivery of model drugs through the skin, highlighting their potential for transdermal drug delivery applications. The results suggest that dissolvable transdermal patches can be tailored to meet specific requirements for drug delivery applications using different compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. This development has the potential to improve treatment outcomes and patient compliance in various therapeutic areas.

Keywords: transdermal drug delivery, characterization, skin permeation, biodegradable materials

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3102 A Study on the Computation of Gourava Indices for Poly-L Lysine Dendrimer and Its Biomedical Applications

Authors: M. Helen

Abstract:

Chemical graph serves as a convenient model for any real or abstract chemical system. Dendrimers are novel three dimensional hyper branched globular nanopolymeric architectures. Drug delivery scientists are especially enthusiastic about possible utility of dendrimers as drug delivery tool. Dendrimers like poly L lysine (PLL), poly-propylene imine (PPI) and poly-amidoamine (PAMAM), etc., are used as gene carrier in drug delivery system because of their chemical characteristics. These characteristics of chemical compounds are analysed using topological indices (invariants under graph isomorphism) such as Wiener index, Zagreb index, etc., Prof. V. R. Kulli motivated by the application of Zagreb indices in finding the total π energy and derived Gourava indices which is an improved version over Zagreb indices. In this paper, we study the structure of PLL-Dendrimer that has the following applications: reduction in toxicity, colon delivery, and topical delivery. Also, we determine first and second Gourava indices, first and second hyper Gourava indices, product and sum connectivity Gourava indices for PLL-Dendrimer. Gourava Indices have found applications in Quantitative Structure-Property Relationship (QSPR)/ Quantitative Structure-Activity Relationship (QSAR) studies.

Keywords: connectivity Gourava indices, dendrimer, Gourava indices, hyper GouravaG indices

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3101 Qualitative Analysis of Healthcare Providers and Administrators’ Perceptions, Expectations, Barriers, and Facilitators Towards Pharmacists in Mental Healthcare in Saudi Arabia

Authors: Badar Dhehawi A. Aldhafeeri

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Objective: To explore the views and experiences of healthcare providers (HCPs) and their expectations toward pharmacists in mental healthcare, in addition to their acceptance of new pharmacist roles. Barriers and facilitators that are emerging in the process of developing enhanced pharmacist-related roles were also explored. Methods: Qualitative semi-structured face-to-face interviews were conducted with HCPs who had worked in mental health services in Saudi Arabia. The data were thematically analysed using a constant comparison with NVivo software to develop a series of key themes from the interviews. Results: Most HCPs indicated that they rarely interacted with pharmacists. They expected pharmacists to educate both patients and other healthcare workers in the future. Concerns were raised regarding inadequate pharmacy education and lack of clinical training for pharmacists. Conclusion: This study revealed that interactions between HCPs and pharmacists concerning mental health are still limited. A communication strategy for addressing mental health issues should be developed among pharmacists and other HCPs.

Keywords: pharmacist, pharmacy student, saudi arabia, qualitative research

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3100 Healthcare Workers’ Knowledge and Attitude Toward Telemedicine During the COVID-19 Pandemic: A Global Survey

Authors: Saman Naqvi

Abstract:

Introduction: Telemedicine is the practise of providing remote healthcare to patients via the utilisation of communication technologies. Its application has become increasingly important since the Coronavirus Disease 2019 (COVID-19) pandemic. It is essential to determine the knowledge and attitudes of healthcare professionals concerning its use in order to maximise its application. Purpose: We aim to examine and evaluate the current understanding and perceptions of medical staff toward the use of telemedicine. Methods: In this cross-sectional study, we surveyed 1091 healthcare professionals worldwide. Following an extensive review of the literature, data were gathered using a questionnaire. To depict the participant profile, frequency, percentages, and cumulative percentages were determined. Results: The majority of respondents had either heard of (90.9%), seen (65.3%), or were familiar with (74.6%) how telemedicine is implemented in practice. 72.2% of people were familiar with the tools that could be applied to this technology. Those with a medical degree and experience of under five years were found to be more familiar with telemedicine. Additionally, opinions on providing healthcare remotely were largely favorable, with 80% of respondents stating that it reduced staff burden and 80.6% thinking that it eliminated unnecessary transportation costs. Furthermore, 83% expressed that it saves clinicians' time. However, 20% of participants believed telemedicine adds to staff workload and 40% of healthcare professionals felt it compromises patient privacy and information confidentiality. Conclusion: Despite being a new and developing practice in many countries, telemedicine appears to have a bright future. This is crucial during a pandemic as it provides effective healthcare while maintaining social isolation measures. Moreover, the majority of the participants in this study demonstrated a good understanding and a favorable attitude toward telemedicine.

Keywords: healthcare system, global survey, knowledge, attitude, covid 19, telemedicine

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3099 The Effect of Backing Layer on Adhesion Properties of Single Layer Ketoprofen Transdermal Drug Delivery System

Authors: Maryam Hamedanlou, Shahla Hajializadeh

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The transdermal drug delivery system is one of the types of novel drug delivery system that the drug is absorbed into the skin. The major considerations for designing and producing transdermal patch are small size, suitable drug release and good adhering. In this study, drug-in-adhesive transdermal patch contained non-steroidal anti-inflammatory ketoprofen is prepared. Also, the effect of non-woven fabric and plastic backing layers on adhesion properties is assessed. The results of the test, demonstrated the use of plastic backing layer increases tack and peel rather than non-woven fabric type. The balance tack with plastic backing layer patch is 6.7 (N/mm2), and the fabric one is 3.8 (N/mm2), and their peel is 9.2 (N/25mm) and 8.3 (N/25mm) by arrangement.

Keywords: transdermal drug delivery system, single layer patch of ketoprofen, plastic layer, fabric backing layer

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3098 South African Municipal Service Delivery Failure and Public Value Theory

Authors: Andrew Enaifoghe

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Municipalities are the most fundamental units of governance, and they are responsible for providing basic services and supporting growth in the areas they rule. South African local government is primarily understood in terms of service delivery, and the South African constitution provides municipalities with the responsibility of mobilizing economic resources, to better the lives of all people. Essential public services are the primary pillars of enhanced quality of life, and appropriate supplies of safe water and sanitation are required for life, well-being, and human dignity. Therefore, having access to basic services is directly tied to social inclusion and social capital, and towns' inability to offer services can have a negative influence on social and economic growth. The problem of service delivery is seen as one of the biggest challenges facing South African municipalities today. This study attempts to assess South African municipal service delivery. Focusing on the main causes of service delivery challenges, the study also looks at the impact of these challenges to identify ways to minimize such challenges by introducing legal instruments such as municipal budgeting and annual reports. A qualitative design was adopted, and data were collected using a desktop technique and analyzed based on content. While public engagement in municipal affairs is required by law, considerable work has to be done to ensure successful participation. Finally, municipalities were deemed to need to do more to improve human capacity to offer services.

Keywords: municipalities, service delivery, corruption, monitoring, South Africa

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3097 Overcoming the Impacts of Covid-19 Outbreak Using Value Integrated Project Delivery Model

Authors: G. Ramya

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Value engineering is a systematic approach, widely used to optimize the design or process or product in the designing stage. It used to achieve the client's obligation by increasing the functionality and attain the targeted cost in the cost planning. Value engineering effectiveness and benefits decrease along with the progress of the project since the change in the scope of the work and design will account for more cost all along the lifecycle of the project. Integrating the value engineering with other project management activities will promote cost minimization, client satisfaction, and ensure early completion of the project in time. Previous research studies suggested that value engineering can integrate with other project delivery activities, but research studies unable to frame a model that collaborates the project management activities with the job plan of value engineering approach. I analyzed various project management activities and their synergy between each other. The project management activities and processes like a)risk analysis b)lifecycle cost analysis c)lean construction d)facility management e)Building information modelling f)Contract administration, collaborated, and project delivery model planned along with the RIBA plan of work. The key outcome of the research is a value-driven project delivery model, which will succeed in dealing with the economic impact, constraints and conflicts arise due to the COVID-19 outbreak in the Indian construction sector. Benefits associated with the structured framework is construction project delivery that ensures early contractor involvement, mutual risk sharing, and reviving the project with a cost overrun and delay back on track ,are discussed. Keywords: Value-driven project delivery model, Integration, RIBA plan of work Themes: Design Economics

Keywords: value-driven project delivery model, Integration, RIBA

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3096 Improving Security in Healthcare Applications Using Federated Learning System With Blockchain Technology

Authors: Aofan Liu, Qianqian Tan, Burra Venkata Durga Kumar

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Data security is of the utmost importance in the healthcare area, as sensitive patient information is constantly sent around and analyzed by many different parties. The use of federated learning, which enables data to be evaluated locally on devices rather than being transferred to a central server, has emerged as a potential solution for protecting the privacy of user information. To protect against data breaches and unauthorized access, federated learning alone might not be adequate. In this context, the application of blockchain technology could provide the system extra protection. This study proposes a distributed federated learning system that is built on blockchain technology in order to enhance security in healthcare. This makes it possible for a wide variety of healthcare providers to work together on data analysis without raising concerns about the confidentiality of the data. The technical aspects of the system, including as the design and implementation of distributed learning algorithms, consensus mechanisms, and smart contracts, are also investigated as part of this process. The technique that was offered is a workable alternative that addresses concerns about the safety of healthcare while also fostering collaborative research and the interchange of data.

Keywords: data privacy, distributed system, federated learning, machine learning

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3095 Chitosan-Whey Protein Isolate Core-Shell Nanoparticles as Delivery Systems

Authors: Zahra Yadollahi, Marjan Motiei, Natalia Kazantseva, Petr Saha

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Chitosan (CS)-whey protein isolate (WPI) core-shell nanoparticles were synthesized through self-assembly of whey protein isolated polyanions and chitosan polycations in the presence of tripolyphosphate (TPP) as a crosslinker. The formation of this type of nanostructures with narrow particle size distribution is crucial for developing delivery systems since the functional characteristics highly depend on their sizes. To achieve this goal, the nanostructure was optimized by varying the concentrations of WPI, CS, and TPP in the reaction mixture. The chemical characteristics, surface morphology, and particle size of the nanoparticles were evaluated.

Keywords: whey protein isolated, chitosan, nanoparticles, delivery system

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3094 Development of Nanoparticulate Based Chimeric Drug Delivery System Using Drug Bioconjugated Plant Virus Capsid on Biocompatible Nanoparticles

Authors: Indu Barwal, Shloka Thakur, Subhash C. Yadav

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The plant virus capsid protein based nanoparticles are extensively studied for their application in biomedical research for development of nanomedicines and drug delivery systems. We have developed a chimeric drug delivery system by controlled in vitro assembly of separately bioconjugated fluorescent dye (as reporting molecule), folic acid (as receptor binding biomolecule for targeted delivery) and doxorubicin (as anticancer drug) using modified EDC NHS chemistry on heterologously overexpressed (E. coli) capsid proteins of cowpea chlorotic mottle virus (CCMV). This chimeric vehicle was further encapsidated on gold nanoparticles (20nm) coated with 5≠ thiolated DNA probe to neutralize the positive charge of capsid proteins. This facilitates the in vitro assembly of modified capsid subunits on the gold nanoparticles to develop chimeric GNPs encapsidated targeted drug delivery system. The bioconjugation of functionalities, number of functionality on capsid subunits as well as virus like nanoparticles, structural stability and in vitro assembly were confirmed by SDS PAGE, relative absorbance, MALDI TOF, ESI-MS, Circular dichroism, intrinsic tryptophan fluorescence, zeta particle size analyzer and TEM imaging. This vehicle was stable at pH 4.0 to 8.0 suitable for many organelles targeting. This in vitro assembled chimeric plant virus like particles could be suitable for ideal drug delivery vehicles for subcutaneous cancer treatment and could be further modified for other type of cancer treatment by conjugating other functionalities (targeting, drug) on capsids.

Keywords: chimeric drug delivery vehicles, bioconjugated plant, virus, capsid

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3093 Infusion Pump Historical Development, Measurement and Parts of Infusion Pump

Authors: Samuel Asrat

Abstract:

Infusion pumps have become indispensable tools in modern healthcare, allowing for precise and controlled delivery of fluids, medications, and nutrients to patients. This paper provides an overview of the historical development, measurement, and parts of infusion pumps. The historical development of infusion pumps can be traced back to the early 1960s when the first rudimentary models were introduced. These early pumps were large, cumbersome, and often unreliable. However, advancements in technology and engineering over the years have led to the development of smaller, more accurate, and user-friendly infusion pumps. Measurement of infusion pumps involves assessing various parameters such as flow rate, volume delivered, and infusion duration. Flow rate, typically measured in milliliters per hour (mL/hr), is a critical parameter that determines the rate at which fluids or medications are delivered to the patient. Accurate measurement of flow rate is essential to ensure the proper administration of therapy and prevent adverse effects. Infusion pumps consist of several key parts, including the pump mechanism, fluid reservoir, tubing, and control interface. The pump mechanism is responsible for generating the necessary pressure to push fluids through the tubing and into the patient's bloodstream. The fluid reservoir holds the medication or solution to be infused, while the tubing serves as the conduit through which the fluid travels from the reservoir to the patient. The control interface allows healthcare providers to program and adjust the infusion parameters, such as flow rate and volume. In conclusion, infusion pumps have evolved significantly since their inception, offering healthcare providers unprecedented control and precision in delivering fluids and medications to patients. Understanding the historical development, measurement, and parts of infusion pumps is essential for ensuring their safe and effective use in clinical practice.

Keywords: dip, ip, sp, is

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3092 Behavior and Obesity: The Perception of Healthcare Professionals Concerning the Role of Behavior on Obesity

Authors: Saeed Wahass

Abstract:

Objective: Obesity is epidemic, affecting all societies and cultures. Most serious medical illnesses are attributed to obesity. For this reason, all healthcare systems worldwide have focused on obesity for both intervention and prevention. However, there is scientific evidence supporting that obesity is treatable through implementing different modalities of interventions. They include biological interventions like medications and bariatric surgeries and behavioral interventions. It seems healthcare professionals may suggest the quick and the easiest interventions for obesity like surgery, ignoring other modesties that might require efforts from their sides and patients as well. Searching on the onset, progression and prevention, behavior plays a major role. As a result, psychological interventions have become increasingly core for intervention and prevention of obesity. They are effective and cost effective in dealing with obesity. Methods: A questionnaire describing the role of behavior on obesity and the way it can be prevented and treated was distributed to a group of health professionals who are dealing with obesity e.g. bariatric surgeons, bariatric physicians, psychologists, health educators, nurses and social workers. Results: 88% of healthcare professionals believed that behavior plays a major role on the onset and progression of obesity, 95% of them recognized that obesity can be prevented with consideration for behavior factors. A major proportion (87%) of the respondents see that psychological interventions are effective and cost effective in treating obesity. Conclusions: It optimistically appears that the majority of healthcare professionals believe that behavior is a key component in understanding, preventing and treating obesity. This outcome may help in developing specific training courses for healthcare professionals, who are dealing with obesity concerning the way they can treat patients behaviorally and, moreover, educating the community.

Keywords: behavior, obesity, healthcare provider, psychological interventions

Procedia PDF Downloads 470
3091 Using Short Narrative Film to Drive Healthcare Policy: A Case Study

Authors: T. L. Granzyk, S. Scarborough, J. DeCosmo

Abstract:

The use of health-related or medical narratives has gained increasing anecdotal and research-based support as a successful device for changing health behavior and outcomes. These narratives, in the form of oral storytelling, short films, and educational documentaries, for example, are most effective when including empathetic characters that transport viewers into the story and command both their attention and emotional response. This case study outlines how and why one large health system created a short narrative film for their internal Sepsis Awareness campaign, which told the dramatic story of a patient recovering from a missed sepsis diagnosis, leaving her a quad-amputee. Results include positive global anecdotal response to the film from healthcare professionals and patients, as well as use of the film to support legislation, ultimately passed in favor of the formation of Sepsis Awareness Workgroups in Maryland. Authors conclude that narrative films can be used successfully to initiate healthcare legislation and to increase internal and external awareness of health-related areas in need of greater improvement and support. As such, healthcare leaders and stakeholders would benefit from learning how to intentionally create, cultivate, and curate narratives from within their own health systems that elicit an empathetic response.

Keywords: healthcare policy, healthcare narratives, sepsis awareness, short films

Procedia PDF Downloads 82
3090 Formulation and Characterization of Antimicrobial Chewing Gum Delivery of Some Herbal Extracts for Treatment of Periodontal Diseases

Authors: Reenu Yadav, Vidhi Guha, Udit N. Soni, Jay Ram Patel

Abstract:

Chewing gums are mobile novel drug delivery systems, with a potential for administering drugs either for local action or for systemic absorption via the buccal route. An antimicrobial chewing gum delivery system of the methanolic extracts of Beatea monosperma (barks and twigs), Cordia obliqua (leaves and seeds) and Cuminun cyminum (seeds) against periodontal diseases caused by some oral pathogens, was designed and characterized on various parameters.The results of the study support the traditional application of the plants and suggest, plant extracts possess compounds with antimicrobial properties that can be used as potential antimicrobial agents and gums can be a good carrier of herbal extracts. Developed formulation will cure/protect from various periodontal diseases. Further development and evaluations chewing gums including the isolated compounds on the commercial scale and their clinical and toxicological studies are the future challenges.

Keywords: periodontal diseases, herbal chewing gum, herbal extracts, novel drug delivery systems

Procedia PDF Downloads 369
3089 Assessing the Quality of Maternity Care in Sub-Saharan Africa Using the Donabedian Quality of Care Framework: A Systematic Scoping Review

Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

Abstract:

Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

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3088 Synthesis and Characterisation of Starch-PVP as Encapsulation Material for Drug Delivery System

Authors: Nungki Rositaningsih, Emil Budianto

Abstract:

Starch has been widely used as an encapsulation material for drug delivery system. However, starch hydrogel is very easily degraded during metabolism in human stomach. Modification of this material is needed to improve the encapsulation process in drug delivery system, especially for gastrointestinal drug. In this research, three modified starch-based hydrogels are synthesized i.e. Crosslinked starch hydrogel, Semi- and Full- Interpenetrating Polymer Network (IPN) starch hydrogel using Poly(N-Vinyl-Pyrrolidone). Non-modified starch hydrogel was also synthesized as a control. All of those samples were compared as biomaterials, floating drug delivery, and their ability in loading drug test. Biomaterial characterizations were swelling test, stereomicroscopy observation, Differential Scanning Calorimetry (DSC), and Fourier Transform Infrared Spectroscopy (FTIR). Buoyancy test and stereomicroscopy scanning were done for floating drug delivery characterizations. Lastly, amoxicillin was used as test drug, and characterized with UV-Vis spectroscopy for loading drug observation. Preliminary observation showed that Full-IPN has the most dense and elastic texture, followed by Semi-IPN, Crosslinked, and Non-modified in the last position. Semi-IPN and Crosslinked starch hydrogel have the most ideal properties and will not be degraded easily during metabolism. Therefore, both hydrogels could be considered as promising candidates for encapsulation material. Further analysis and issues will be discussed in the paper.

Keywords: biomaterial, drug delivery system, interpenetrating polymer network, poly(N-vinyl-pyrrolidone), starch hydrogel

Procedia PDF Downloads 229
3087 Principles and Practice of Therapeutic Architecture

Authors: Umedov Mekhroz, Griaznova Svetlana

Abstract:

The quality of life and well-being of patients, staff and visitors are central to the delivery of health care. Architecture and design are becoming an integral part of the healing and recovery approach. The most significant point that can be implemented in hospital buildings is the therapeutic value of the artificial environment, the design and integration of plants to bring the natural world into the healthcare environment. The hospital environment should feel like home comfort. The techniques that therapeutic architecture uses are very cheap, but provide real benefit to patients, staff and visitors, demonstrating that the difference is not in cost but in design quality. The best environment is not necessarily more expensive - it is about special use of light and color, rational use of materials and flexibility of premises. All this forms innovative concepts in modern hospital architecture, in new construction, renovation or expansion projects. The aim of the study is to identify the methods and principles of therapeutic architecture. The research methodology consists in studying and summarizing international experience in scientific research, literature, standards, methodological manuals and project materials on the research topic. The result of the research is the development of graphic-analytical tables based on the system analysis of the processed information; 3d visualization of hospital interiors based on processed information.

Keywords: therapeutic architecture, healthcare interiors, sustainable design, materials, color scheme, lighting, environment.

Procedia PDF Downloads 101
3086 Effects of Bone Marrow Derived Mesenchymal Stem Cells (MSC) in Acute Respiratory Distress Syndrome (ARDS) Lung Remodeling

Authors: Diana Islam, Juan Fang, Vito Fanelli, Bing Han, Julie Khang, Jianfeng Wu, Arthur S. Slutsky, Haibo Zhang

Abstract:

Introduction: MSC delivery in preclinical models of ARDS has demonstrated significant improvements in lung function and recovery from acute injury. However, the role of MSC delivery in ARDS associated pulmonary fibrosis is not well understood. Some animal studies using bleomycin, asbestos, and silica-induced pulmonary fibrosis show that MSC delivery can suppress fibrosis. While other animal studies using radiation induced pulmonary fibrosis, liver, and kidney fibrosis models show that MSC delivery can contribute to fibrosis. Hypothesis: The beneficial and deleterious effects of MSC in ARDS are modulated by the lung microenvironment at the time of MSC delivery. Methods: To induce ARDS a two-hit mouse model of Hydrochloric acid (HCl) aspiration (day 0) and mechanical ventilation (MV) (day 2) was used. HCl and injurious MV generated fibrosis within 14-28 days. 0.5x106 mouse MSCs were delivered (via both intratracheal and intravenous routes) either in the active inflammatory phase (day 2) or during the remodeling phase (day 14) of ARDS (mouse fibroblasts or PBS used as a control). Lung injury accessed using inflammation score and elastance measurement. Pulmonary fibrosis was accessed using histological score, tissue collagen level, and collagen expression. In addition alveolar epithelial (E) and mesenchymal (M) marker expression profile was also measured. All measurements were taken at day 2, 14, and 28. Results: MSC delivery 2 days after HCl exacerbated lung injury and fibrosis compared to HCl alone, while the day 14 delivery showed protective effects. However in the absence of HCl, MSC significantly reduced the injurious MV-induced fibrosis. HCl injury suppressed E markers and up-regulated M markers. MSC delivery 2 days after HCl further amplified M marker expression, indicating their role in myofibroblast proliferation/activation. While with 14-day delivery E marker up-regulation was observed indicating their role in epithelial restoration. Conclusions: Early MSC delivery can be protective of injurious MV. Late MSC delivery during repair phase may also aid in recovery. However, early MSC delivery during the exudative inflammatory phase of HCl-induced ARDS can result in pro-fibrotic profiles. It is critical to understand the interaction between MSC and the lung microenvironment before MSC-based therapies are utilized for ARDS.

Keywords: acute respiratory distress syndrome (ARDS), mesenchymal stem cells (MSC), hydrochloric acid (HCl), mechanical ventilation (MV)

Procedia PDF Downloads 654