Delivery Process Research Articles

Digital Health Education and Training for Undergraduate and Graduate Nursing Students: Scoping Review.

As technology will continue to play a pivotal role in modern-day health care and given the potential impact on the nursing profession, it is vitally important to examine the types and features of digital health education in nursing so that graduates are better equipped with the necessary knowledge and skills needed to provide safe and quality nursing care and to keep abreast of the rapidly evolving technological revolution. In this scoping review, we aimed to examine and report on available evidence about digital health education and training interventions for nursing students at the undergraduate and graduate levels. This scoping review was conducted using the Joanna Briggs Institute methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive search strategy was developed and applied to identified bibliographic databases including MEDLINE (Ovid; 1946 to present), Embase (Ovid; 1974 to present), CINAHL (EBSCOhost; 1936 to present), ERIC (EBSCOhost; 1966 to present), Education Research Complete (EBSCOhost; inception to present), and Scopus (1976 to present). The initial search was conducted on March 3, 2022, and updated searches were completed on January 11, 2023, and October 31, 2023. For gray literature sources, the websites of select professional organizations were searched to identify relevant digital health educational programs or courses available to support the health workforce development. Two reviewers screened and undertook the data extraction process. The review included studies focused on the digital health education of students at the undergraduate or graduate levels or both in a nursing program. Studies that discussed instructional strategies, delivery processes, pedagogical theory and frameworks, and evaluation strategies for digital health education; applied quantitative, qualitative, and mixed methods; and were descriptive or discussion papers, with the exception of review studies, were included. Opinion pieces, editorials, and conference proceedings were excluded. A total of 100 records were included in this review. Of these, 94 records were identified from database searches, and 6 sources were identified from the gray literature. Despite improvements, there are significant gaps and limitations in the scope of digital health education at the undergraduate and graduate levels, consequently posing challenges for nursing students to develop competencies needed in modern-day nursing practice. There is an urgent need to expand the understanding of digital health in the context of nursing education and practice and to better articulate its scope in nursing curricula and enforce its application across professional nursing practice roles at all levels and career trajectories. Further research is also needed to examine the impact of digital health education on improving patient outcomes, the quality of nursing care, and professional nursing role advancement. RR2-10.11124/JBIES-22-00266.

Exploring pNIPAM lyogels: Experimental study on swelling equilibria in various organic solvents and mixtures, supported by COSMO-RS analysis

Stimuli-responsive lyogels are considered to be smart materials due to their capability of undergoing significant macroscopic changes in response to external triggers. Due to their versatile and unique properties, smart lyogels exhibit great potential in various applications such as drug delivery or actuation processes. While Poly-N-isopropylacrylamide (pNIPAM) is widely known as a thermo-responsive material, it also shows significant solvent-responsive swelling behavior. For the systems tested, polar solvents induce strong swelling due to hydrogen bonding with the amide group, nonpolar solvents lead to significant shrinkage of the lyogels. The aim of this study is to investigate and to model this behavior for future application in chemical or biochemical reactors. As a current area of research, incorporating smart lyogel technology into (bio-)chemical reactors facilitates the development of smart reactor systems. Applying thermodynamic modelling with the gE model COSMO-RS on the monomer or oligomers of pNIPAM, the correlation between solvent-polymer interactions and the degree of swelling can be observed. pNIPAM derivatives exhibit low infinite dilution activity coefficients (IDACs) in polar solvents with large degrees of swelling, while displaying an increase of IDACs in nonpolar solvents. Hydrogen bonds dominate the swelling behavior of lyogels not only in pure solvents but also in mixtures of solvents with varying polarity. Even in mixtures containing high amounts of nonpolar solvents, large degrees of swelling were observed due to the uptake of the polar solvent in the lyogel matrix. This effect can be observed in binary solvent mixtures but also in representative mixtures along an esterification reaction with varying carboxylic chain length of alcohol and carboxylic acids.

Unraveling mRNA delivery bottlenecks of ineffective delivery vectors by co-transfection with effective carriers

The messenger RNA (mRNA) SARS-CoV-2 vaccines have demonstrated the therapeutic potential of this novel drug modality. Protein expression is the consequence of a multistep delivery process that relies on proper packaging into nanoparticle carriers to protect the mRNA against degradation enabling effective cellular uptake and endosomal release, and liberating the mRNA in the cytosol. Bottlenecks along this route remain challenging to pinpoint. Although methods to assess endosomal escape of carriers have been developed, versatile strategies to identify bottlenecks along the delivery trajectory are missing. Here, it is shown that co-incubating an inefficient nanoparticle formulation with an efficient one solves this problem. Cells were co-incubated with mRNA nanoparticles formed with either the efficient cell-penetrating peptide (CPP) PepFect14 or the inefficient CPP nona-arginine (R9). Co-transfection enhanced cellular uptake and endosomal escape of R9-formulated mRNA, resulting in protein expression, demonstrating that both vectors enter cells along the same route. In addition, cells were transfected with a galectin-9-mCherry fusion protein to detect endosomal rupture. Remarkably, despite endosomal release, mRNA remained confined to punctate structures, identifying mRNA liberation as a further bottleneck. In summary, co-transfection offers a rapid means to identify bottlenecks in cytosolic mRNA delivery, supporting the rational design and optimization of intracellular mRNA delivery systems.

A Study on Challenges and Optimization of Last Mile Delivery and its Impact on Customer Satisfaction.

The last mile delivery, the final stage of the delivery process from a distribution center to the end user, plays a critical role in the supply chain, significantly influencing customer satisfaction. Against the backdrop of a rapidly growing e-commerce sector, the demand for swift and flexible delivery options has made last-mile delivery a vital determinant of overall customer satisfaction. This study analyzes the impact of optimizing last-mile delivery on customer satisfaction and loyalty, highlighting that efficient last-mile operations can lead to continued use of the delivery service. Key areas contributing to last-mile delivery challenges include timeliness, condition of delivered items, communication during delivery, flexibility of delivery options, and overall customer experience. The study concludes that addressing these challenges and implementing effective strategies is essential for meeting customer expectations and enhancing satisfaction in the competitive e-commerce landscape. The findings and recommendations provide a comprehensive roadmap for businesses aiming to improve their last-mile delivery operations and boost customer satisfaction.

Penyuluham Hukum Dampak Penggunaan Gadget Secara Berlebihan Bagi Anak Usia Sekolah Dasar di SDN Sidodadi 2 Sidoarjo

In this era of digitalization, almost all Indonesian people use gadgets. This also seems to have become an inseparable phenomenon in this era of digitalization, especially among young people in Indonesia, including elementary school children. The impact of using the gadget itself also varies, ranging from the positive impact that can be taken and the negative impact that must be avoided. Lack of knowledge about the impact of gadget use for elementary school children, students of the Faculty of Law UPN Veteran East Java conducted socialization at SDN Sidodadi 2. The target of this socialization activity is 5th grade elementary school children with a total of 55 students. This socialization activity aims to provide understanding and legal knowledge about the impact of excessive use of gadgets, especially since 5th grade elementary school children are the age when the transition from children to the adolescent phase is born. This socialization activity uses a special approach method so that in the delivery process it can be well received and on target. The results of socialization activities are summarized into reports and journals so that benefits and learning can reach the wider community.

Sistem Informasi Manajemen E-Budidaya CV.Tarkiz Paz Banua

The development of information technology has had a significant impact on various sectors,including animal husbandry. Livestock sustainability requires effective and inexpensive solutions.This research was born in response to a request from livestock sector operators to the softwarehouse company CV.Tarkiz Paz Banua to develop an E-Budidaya management information system.The aim of the close collaboration between software companies and livestock sector operators isto increase the affordability of livestock operations, with a focus on providing food and medicineto livestock. This research involves designing and developing an E-Budidaya management systemthat facilitates product sales, and ensures quick access to product information. By utilizing digitaltechnology, it is hoped that the ordering, payment and product delivery processes can be carriedout efficiently, thereby increasing customer satisfaction and strengthening business relationshipsbetween partners and operators in the livestock sector. The E-Budidaya management informationmanagement system also provides the latest information on livestock products, includinginstructions for use, nutritional composition and dosage recommendations, thereby increasingagricultural knowledge and providing added value to the company's products. This study reflectsthe contribution of positive collaborative innovation between software companies and livestock companies through effective digital solutions that improve operational efficiency, customerservice and product added value in narrow markets.

Narative Review The Effect of Endorphin Massage and Counter Pressure During Labor On Endorphin Hormone Release

Background: Labor pain is a subjective experience associated with uterine contractions, stretching of the cervix, and descent of the fetal head. According to the World Health Organization (WHO), every year, 210 million pregnancies occur in the world, and 20 million women experience pain due to childbirth. Of the 2700 mothers giving birth, 30% experienced severe pain, 20% of labor was accompanied by very severe pain, and 15% experienced mild pain. Non-pharmacological therapy continues to be developed in the world of obstetrics, which aims to provide comfort during the birthing process. Endorphin massage and counter pressure are non-pharmacological therapies that can stimulate the release of endorphins and reduce pain and anxiety during childbirth. Objective: This study aims to determine the effect of endorphin massage and counter pressure during labor on the release of endorphin hormones and their benefits. Methods: This research method was a literature review study. Journal searches were carried out by applying online databases such as PubMed, Garuda Portal, ScienceDirect, and Google Scholar. Articles were selected based on inclusion and exclusion criteria. Results: The analysis was carried out on 32 research articles. It was found that endorphin massage and counter pressure are non-pharmacological techniques to overcome and reduce labor pain and anxiety through the help of endorphin hormones which are useful for a smooth delivery process. Conclusion: The influence of endorphin massage and counter pressure during labor on the release of endorphin hormones, which are useful for reducing labor pain, reducing anxiety, increasing comfort, and speeding up the labor process.

Part II of a two-step mixed-methods approach in developing the Growth Talent Mindsets for Sports Coaches Intervention 2.0: The coaches’ perceptions of delivery and possible psychological processes of change

The current study follows up on the first-time implementation of the GrowTMindS Intervention described in Part I, with an overall aim of improving sports coaches’ beliefs in their talent as a coach (coach talent mindset, C-TM) and their athletes’ talent (athlete talent mindset, A-TM) as being malleable. By drawing on the user-centered design approach, we first refined the intervention using the insight provided by the coaches in Part I. A mixed-method approach then evaluated the second-time implementation, which included 33 participants (Mage = 38.76, SD = 16.55; 13 women, 20 men) in the quantitative strand and 11 informants (Mage = 39.09, SD = 14.10; 5 women, 6 men) in the sequential qualitative strand. The coaches represented the sports of swimming, bandy, ski sports, golf, and orienteering. The quantitative results indicate that the intervention targeted the coaches’ talent mindsets as their growth C-TM and A-TM scores increased from pre-test to post-test a year and a half after the intervention. The qualitative findings substantiate these results, showing how an increase at scale also appears meaningful concerning their belief in their own and their athletes’ developments. The findings also helped us to understand how the embracing, or possibly refuting, of intervention delivery may substantiate different trajectories of change, and thereby provided insight into the difficulty of targeting and the complexity of psychological processes and behavioral change. By considering the changes in coaches’ growth C-TM and A-TM, we assume that the GrowTMindS Intervention is ready for testing in a Phase III efficacy trial.

Designing a Midwife-Led Birth Center Program Based on the MAP-IT Model: A Sequential Explanatory Mixed-Methods Study

BackgroundIn recent decades, medical supervision of the labor and delivery process has expanded beyond its boundaries to the extent that in many settings, childbirth has become a medical event. This situation has influenced midwifery care. One of the significant barriers to midwives providing care to pregnant women is the medicalization of childbirth. So far, the policies and programs of the Ministry of Health to reduce medical interventions and cesarean section rates have not been successful. Therefore, the current study aims to be conducted with the purpose of “Designing a Midwife-Led Birth Center Program Based on the MAP-IT Model”.Methods/designThe current study is a mixed-methods sequential explanatory design by using the MAP-IT model includes 5 steps: Mobilize, Assess, Plan, Implement, and Track, providing a framework for planning and evaluating public health interventions in a community. It will be implemented in three stages: The first phase of the research will be a cross-sectional descriptive study to determine the attitudes and preferences towards establishing a midwifery-led birthing center focusing on midwives and women of childbearing age by using two researcher-made questionnaires to assess the participants’ attitudes and preferences toward establishing a midwifery-led birthing center. Subsequently, extreme cases will be selected based on the participants’ average attitude scores toward establishing a midwifery-led birthing center in the quantitative section. In the second stage of the study, qualitative in-depth interviews will be conducted with the identified extreme cases from the first quantitative phase and other stakeholders (the first and second steps of the MAP-IT model, namely identifying and forming a stakeholder coalition, and assessing community resources and real needs). In this stage, the conventional qualitative content analysis approach will be used. Subsequently, based on the quantitative and qualitative data obtained up to this stage, a midwifery-led birthing center program based on the third step of the MAP-IT model, namely Plan, will be developed and validated using the Delphi method.DiscussionThis is the first study that uses a mixed-method approach for designing a midwife-led maternity care program based on the MAP-IT model. This study will fill the research gap in the field of improving midwife-led maternity care and designing a program based on the needs of a large group of pregnant mothers. We hope this program facilitates improved eligibility of midwifery to continue care to manage and improve their health easily and affordably.Ethical codeIR.MUMS.NURSE.REC. 1403. 014.

Barriers and facilitators to the delivery of a biopsychosocial education and exercise programme for patients with chronic low back pain in Ghana. A qualitative study

Purpose Low back pain management has evolved with researchers advocating for a biopsychosocial management model. The biopsychosocial management model has been predominantly applied in high-income countries and underexplored in low- and middle-income countries including Ghana. This study aimed to explore the potential barriers and facilitators to patients with chronic low back pain (CLBP) and physiotherapists engagement with a biopsychosocial intervention (exercise and patient education) as part of a feasibility study. Material and methods This was a qualitative study embedded within a mixed-methods, sequential, feasibility study, in Ghana, applying semi-structured interviews. Two categories of participants involved in this study were, two trained physiotherapists, and six patients with CLBP, sampled within the feasibility study. Results Regarding the barriers and facilitators to the delivery of the BPS intervention, five interlinked themes emerged from the thematic analysis. These were: structure and process of delivery; patients’ expectations; patients’ health beliefs, autonomy, and engagement; external influences and personal and professional characteristics of physiotherapists. Conclusion The themes that emerged from this study demonstrated many positive facilitators based on participants’ improved understanding of LBP and the clarity and purpose of the biopsychosocial intervention. The results therefore demonstrate a potential to deliver the biopsychosocial intervention in a Ghanaian context.

Labor patterns of spontaneous first-stage labor in Chinese women with normal neonatal outcomes.

Friedman's standards, developed almost 50 years ago, may no longer align with the needs of today's obstetric population and current pregnancy management practices. This study aims to analyze contemporary labor patterns and estimate labor duration in China, focusing on first-stage labor data from Chinese parturients with a spontaneous onset of labor. This retrospective observational study utilized data from electronic medical records of a tertiary hospital in Changsha, Hunan. Out of a total of 2,689 parturients, exclusions were made for multiple gestations, preterm, post-term, or stillbirth, cesarean delivery, non-vertex presentation, and neonatal intensive care unit admission. Average labor curves were constructed by parity using repeated-measure analysis, and labor duration was estimated through interval-censored regression, stratified by cervical dilation at admission. We performed an analysis to assess the impact of oxytocin augmentation and amniotomy on labor progression and conducted a sensitivity analysis using women with complicated outcomes. Nulliparous women take over 180 minutes for cervical dilation from 3 to 4 cm, and the duration from 5 to 6 cm exceeds 145 minutes. Multiparous women experience shorter labor durations than nulliparous. Labor acceleration is observed after 5 cm in nulliparous, but no distinct inflection point is evident in the average labor curve. In the second stage of labor, the 95th percentile for nulliparous, with and without epidural analgesia, is 142 minutes and 127 minutes, respectively. These findings provide valuable insights for the reassessment of labor and delivery processes in contemporary obstetric populations, including current Chinese obstetric practice.

Regulating the Distribution and Accumulation of Charged Molecules by Progressive Electroporation for Improved Intracellular Delivery.

The cell membrane separates the intracellular compartment from the extracellular environment, constraining exogenous molecules to enter the cell. Conventional electroporation typically employs high-voltage and short-duration pulses to facilitate the transmembrane transport of molecules impermeable to the membrane under natural conditions by creating temporary hydrophilic pores on the membrane. Electroporation not only enables the entry of exogenous molecules but also directs the intracellular distribution of the electric field. Recent advancements have markedly enhanced the efficiency of intracellular molecule delivery, achieved through the utilization of microstructures, microelectrodes, and surface modifications. However, little attention is paid to regulating the motion of molecules during and after passing through the membrane to improve delivery efficiency, resulting in an unsatisfactory delivery efficiency and high dose demand. Here, we proposed the strategy of regulating the motion of charged molecules during the delivery process by progressive electroporation (PEP), utilizing modulated electric fields. Efficient delivery of charged molecules with an expanded distribution and increased accumulation by PEP was demonstrated through numerical simulations and experimental results. The dose demand can be reduced by 10-40% depending on the size and charge of the molecules. We confirmed the safety of PEP for intracellular delivery in both short and long terms through cytotoxicity assays and transcriptome analysis. Overall, this work not only reveals the mechanism and effectiveness of PEP-enhanced intracellular delivery of charged molecules but also suggests the potential integration of field manipulation of molecular motion with surface modification techniques for biomedical applications such as cell engineering and sensitive cellular monitoring.

A Review Paper on the Crucial Factors that Influencing RMC Delivery Operation

The delivery process of ready-mix concrete (RMC) is a critical component in construction projects, influencing the quality, efficiency, and timeliness of concrete placement. This abstract explores the various factors that impact the RMC delivery process, ranging from logistical considerations to concrete properties and customer requirements. Key factors affecting RMC delivery include the distance to the construction site, traffic conditions, weather, regulatory constraints, batching plant operations, order volume, customer specifications, concrete mix design, truck capacity, and communication channels among stakeholders. Each of these factors can significantly influence the success of RMC delivery, posing challenges and opportunities for optimization.

Pre-service teachers’ perceptions of mathematics education and social justice

Many instances have presented mathematics as a difficult subject for students, and some of these difficulties have been perceived as an injustice to those who suffer from it. Meanwhile, no child is to be left behind in building a just society if all were to experience the collective good of mathematics. For this reason, it became necessary to explore pre-service teachers’ perceptions of mathematics as social justice in their lived experiences. In doing this, the qualitative interpretive approach was adopted, where qualitative data was collected, transcribed, and analysed using the case study design. A sample of eleven pre-service teachers were involved in the study. The findings indicated that the pre-service teachers had experienced severe issues of mathematics as social justice in their previous schooling that were unfair to them. However, they now felt mathematics could be interesting if delivered in a manner that let their voices be heard in the delivery process.

Quality indicators for integrating oncology and home palliative care in Japan: modified Delphi study.

Home palliative care service increases the chance of dying at home, particularly for patients with advanced cancer, but late referrals to home palliative care services still exist. Indicators for evaluating programs that can facilitate the integration of oncology and home palliative care have not been defined. This study developed quality indicators for the integration of oncology and home palliative care in Japan. We conducted a systematic literature review (Databases included CENTRAL, MEDLINE, EMBASE, and Emcare) and a modified Delphi study to develop the quality indicators. Panelists rated a potential list of indicators using a 9-point scale over three rounds according to two criteria: appropriateness and feasibility. The criterion for the adoption of candidate indicators was set at a total mean score of 7 or more. Final quality indicators with no disagreement were included. Of the 973 publications in our initial search, 12 studies were included. The preliminary list of quality indicators by systematic literature review comprised 50 items. In total, 37 panelists participated in the modified Delphi study. Ultimately, 18 indicators were identified from the following domains: structure in cancer hospitals, structure in home palliative care services, the process of home palliative care service delivery, less aggressive end-of-life care, patient's psychological comfort, caregiver's psychological comfort, and patient's satisfaction with home palliative care service. Comprehensive quality indicators for the integration of oncology and home palliative care were identified. These indicators may facilitate interdisciplinary collaboration between professional healthcare providers in both cancer hospitals and home palliative care services.

Anonymous Complaint Aggregation for Secure Messaging

Private messaging platforms provide strong protection against platform eavesdropping, but malicious users can use privacy as cover for spreading abuse and misinformation. In an attempt to identify the sources of misinformation on private platforms, researchers have proposed mechanisms to trace back the source of a user-reported message (CCS '19,'21). Unfortunately, the threat model considered by initial proposals allowed a single user to compromise the privacy of another user whose legitimate content the reporting user did not like. More recent work has attempted to mitigate this side effect by requiring a threshold number of users to report a message before its origins can be identified (NDSS '22). However, the state of the art scheme requires the introduction of new probabilistic data structures and only achieves a "fuzzy" threshold guarantee. Moreover, false positives, where the source of an unreported message is identified, are possible. This paper introduces a new threshold source tracking technique that allows a private messaging platform, with the cooperation of a third-party moderator, to operate a threshold reporting scheme with exact thresholds and no false positives. Unlike prior work, our techniques require no modification of the message delivery process for a standard source tracking scheme, affecting only the abuse reporting procedure, and do not require tuning of probabilistic data structures.

Phát triển và chuyển giao nhanh sản phẩm, dịch vụ tài chính số sử dụng nền tảng low-code

The 4th Industrial Revolution has a profound impact on social life in general as well as the Finance sector in particular. Industrial Revolution 4.0 not only creates a basis for developing new business models, diversifying distribution channels and improving user experience, but also changes the way of developing financial products and services in the digital environment based on new platforms and development methods. New platforms and development methods allow for shortening the time to develop and transfer financial and banking products and services while still ensuring they meet security requirements and facilitate deployment on the infrastructure as well as conversion to a cloud environment. Using the method of document review and analysis, the article deeply analyzes the low-code platform and proposes combined method Scurm- Extreme Programming for software development using the low-code platform integrated with Continuous Integration- Continuous Delivery process.

Consumer adoption of digital health services: A systematic literature review and research agenda

AbstractDigital health services (DHSs) have revolutionized the healthcare sector to provide quality care facilities that are affordable, efficient, and universally accessible. By making patients the focus of the healthcare delivery process, these services can offer more personalized and effective health solutions and thus facilitate a more robust and resilient health ecosystem. The adoption of these services increased manifold during the COVID‐19 pandemic and gained immense attention from researchers across the globe. Despite this, there is limited knowledge about the facets of DHS adoption from the consumers' perspective. Thus, it is imperative to synthesize the extant literature to provide a holistic view of DHS adoption. This article offers an organized, retrospective view of the DHS literature, using a framework‐based systematic review approach to identify factors contributing to DHS adoption from the consumers' perspective. To do this, 63 articles from the Web of Science database over the last 23 years were systematically reviewed using two well‐known organising frameworks. The Antecedents‐Decisions‐Outcomes framework uncovers the known associations of constructs in the DHS literature. Followed by the theories‐contexts‐methods framework that offers information on the theoretical, contextual, and methodological approaches applied in the DHS research. Additionally, the article identifies the major gaps in the existing body of literature and offers a few recommendations for future investigation for researchers and practitioners in the fields of consumer behaviour, technology, and health management. The global perspective of this review has multiple ramifications that can foster a more sustainable healthcare system by giving insight into consumers' perspectives.

Design Basis Model for Hosting Small Modular Reactors

AbstractTo provide energy security and head off further increases in global temperatures, an aggressive transition from fossil fuels to other types of energy implies the need to possibly construct hundreds of nuclear power plants in the near future. However, the real and perceived risks of nuclear energy remain a significant impediment to that transition.This paper describes a comprehensive work process that combines the rigor of model‐based systems engineering (MBSE) with 1) the Idaho National Laboratory's (INL) decades of experience with small reactors and with 2) modern project delivery processes. The objective is to reduce the risks of building new facilities or converting existing facilities to nuclear power generation.

IMPLEMENTASI DESIGN THINKING DALAM PERANCANGAN UI/UX APLIKASI JASA CATERING (JASCAT)

The catering business is an opportunity for entrepreneurs, especially for those with a cooking hobby. Currently, the catering business is highly competitive and rapidly growing with the technology era. The catering ordering process is still mostly through SMS or phone, and the lack of information and promotion makes the ordering and delivery process of food take a long time. This study aims to create a food ordering application online. This study applies Design Thinking to improve the user experience of the JASCAT application. The study uses the 5 stages of Design Thinking (empathize, define, ideate, prototype, test) to address user problems. UI/UX design is understood based on needs and solving user problems. Tests show that the JASCAT application designed with Figma has a score of 93 in the "Best Acceptable" category. The results of the study conclude that the UI/UX design of the JASCAT application with Figma is successfully applied with Design Thinking and has a score of 93 on the SUS test