Framework For Delivery Research Articles

Framework of IBD Care Delivery Across Ages.

IBD care has gone through a real transformation over the last century, moving from the mere unidirectional interaction between the physician and the patient to a stronger framework with multiple stakeholders who interconnect and strengthen each other. The patient has evolved from a passive subject to the central pole in the care pathway. Key elements of the future framework include patient self-care and empowerment, and remote monitoring [eHealth]. This care will be delivered by a multidisciplinary team acknowledging the pivotal role of the IBD nurse, and emphasising and measuring the quality of its work. The big challenge for the future is to establish a financially viable model to make this evolution durable in the long term, and this by using the principles of value-based health care.

Developing an Ideal Change Management Framework for Enhancing Service Delivery in Government Parastatals: A Case Study of Kampala Capital City Authority in Uganda.

Purpose: This study aims to develop an ideal change management framework specifically tailored to government parastatals in Uganda, focusing on the Kampala Capital City Authority (KCCA), to enhance service delivery. Methodology: The research adopted a cross-sectional and exploratory approach, utilizing both quantitative and qualitative methods. The study population comprised 298 participants from various departments within KCCA. Data collection involved self-administered questionnaires, interviews with key informants, and documentary review. Validation of study instruments was conducted using the Content Validity Index, and reliability was assessed through Cronbach’s Alpha coefficient. Quantitative data were analyzed using descriptive statistics, correlation analysis, and bivariate regression, while qualitative data underwent content analysis. Findings: The study concluded that the change management process for service delivery in government parastatals in Uganda is well-defined. However, the ideal change management framework necessary for improving service delivery among these parastatals remains unidentified. Recommendations: Based on the findings, it is recommended that KCCA administrators adopt a more holistic approach to change management, addressing various enabling factors and components necessary to enhance service delivery effectively.

Digital Innovations and Competitive Advantage of Commercial Banks in Kenya

Purpose: The purpose of the study was to ascertain the role of digital banking technological innovations in enhancing competitive advantage among commercial banks in Kenya. Specifically, the study sought to examine the influence of digital technological innovations for market, digital banking innovations for differentiation, digital innovations for customer satisfaction and the influence of ICT infrastructure on competitive advantage of commercial banks in Kenya Methodology: Descriptive research design was adopted for the present study. The study was carried out in Kenya, covering all the 39 solvent commercial banks in Kenya as of 31st March 2024. The study adopted the census data collection method from the headquarters of the 22 solvent commercial banks belonging to Tier 3. Four key officers including the sales manager, loan officer, relationship manager, and risk manager totaling to 88 were sampled to participate in the study. Findings: The findings indicate that there is a significant relationship between market positioning and competitive advantage (B = 0.292, p = 0.003). On the other hand, Differentiation is established to have a negligible influence on competitive advantage in this model (B = 0.027, p = 0.852). Customer Satisfaction comes out strongly, as a factor that defines competitive advantage (Coefficient = 0.247, P = 0.046). Unique Contribution to Theory, Policy and Practice: The study recommends that Kenyan commercial banks invest in continuous digital innovation, particularly in mobile and Internet banking, to strengthen market positioning, improve brand perception, and offer personalized services. Banks should also enhance their ICT frameworks for better service delivery, data protection, and adaptability to market changes. Emphasizing mobile banking innovations and staying updated with emerging digital trends will help banks reduce customer acquisition costs, expand their customer base, and maintain a competitive edge in a dynamic industry.

Vaccines and vaccination in prison settings: availability and model of service delivery in 20 European countries.

Prisons, due to various risk factors, are environments that are conducive to infectious disease transmission, with significantly higher prevalence of infectious diseases within prisons compared to the general population. This underscores the importance of preventive measures, particularly vaccination. As part of the international project "Reaching the hard-to-reach: Increasing access and vaccine uptake among the prison population in Europe" (RISE-Vac), this study aimed to map the availability and delivery framework of vaccination services in prisons across Europe and beyond. A questionnaire designed to collect data on the availability and delivery model of vaccination services in prisons was validated and uploaded in SurveyMonkey in July 2023. Then, it was submitted to potential participants, with at least one representative from each European country. Potential participants emailed an invitation letter by the RISE-Vac partners and by the European Organization of Prison and Correctional Services (EUROPRIS). Twenty European countries responded. Vaccines are available in European countries, although their availability differs by country and type of vaccine. The first dose is offered to people living in prisons (PLP), mostly within one month, COVID-19 is the most widely offered vaccine. In all countries, vaccines are actively offered by healthcare workers; in most countries, there is no evaluation of vaccination status among people who work in prison. The survey shows variance in vaccine availability for PLP and staff across countries and vaccine types. Quality healthcare in prisons is not only a matter of the right to health but also a critical public health investment: enhancing vaccine uptake consistently among PLP and staff should be prioritized.

Beyond Index Conditions: Applying a Multimorbidity Approach to Renal Cancer Nursing

ObjectiveThis article aims to describe the key components of renal cancer nursing and multimorbidity nursing, and reflects on how adopting a multimorbidity approach to renal cancer nursing can help nurses provide holistic patient care. MethodsThis is a discussion paper drawing on relevant evidence and theory. ResultsRenal cancer nurses have a highly specialised knowledge base and are able to use this expertise to deliver excellent care to people with cancer. However, lots of people with cancer have other conditions as well. Adopting a multimorbidity approach to nursing care provides a more holistic framework for care delivery. ConclusionsCancer nurses are ideally placed to support patients in this way, so they are able to deliver care which accounts for factors such as treatment burden and how this impacts on patients and carers. Implications for nursing practiceNurses who care for people with renal cancer should view their patients through the lens of multimorbidity. This involves screening for other chronic conditions, considering polypharmacy, providing emotional support and continuity of care, and coordinating care in a way that accounts for the potentially burdensome nature of the patient's interactions with health care.

Application of the Hub-and-Spoke Model in Antimicrobial Stewardship Programmes: A Scoping Review

Background: The hub-and-spoke model (HSM) offers a framework for efficient healthcare service delivery. This scoping review seeks to explore the implementation and effectiveness of the HSM in antimicrobial stewardship (AMS) programmes. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guideline was followed. A systematic search was conducted in four electronic databases (PubMed, Medline, Cochrane Library, and Google Scholar) from inception until January 2024. Studies where the HSM was used for delivering any AMS activity, intervention, or action, were included. No study-specific filters were applied and all populations, study designs, and health settings were included. Data screening and selection were achieved using Rayyan. Three authors independently screened studies, with conflicts resolved by a fourth author. Data were narratively synthesised. Standard appraisal tools were impractical; however, critical evaluation of data collection and outcome reporting was ensured. Results: Out of 1438 articles, three were included in the scoping review. The primary interventions utilising the HSM in AMS involved reducing antibiotic misuse, training healthcare professionals, case-based learning, establishing AMS programmes, developing antibiograms, and formulating policies or guidelines pertinent to AMS. The studies demonstrated significant clinical improvements in AMS. Clinical outcomes from the studies include a significant reduction in antimicrobial usage and improved antibiotic management, with a notable decrease in days on antimicrobial therapy and increased antibiotic de-escalation. Key facilitators for AMS programme success were tailored education, collaborative learning, strong leadership, strategic practices, and data-driven decisions. Key barriers were leadership challenges, change resistance, knowledge gaps, inadequate data systems, resource limitations, and technological constraints. Conclusions: The review identified a literature gap in HSM use in AMS programmes. Further studies are needed to assess HSM’s effectiveness, feasibility, and cost-effectiveness in AMS contexts.

Development of a tool to assess financial advocacy service delivery.

21 Background: In 2023, the Association of Cancer Care Centers (ACCC) Financial Advocacy Network published Financial Advocacy Services Guidelines developed through an expert-led, consensus-driven process (1). The Guidelines provide a framework for equitable delivery of financial advocacy (FA) services to address patients’ financial concerns. The Guidelines cover 3 domains: financial advocacy services and functions, program management functions, and partner engagement functions. ACCC adapted the Guidelines into a Financial Advocacy Services Assessment Tool to help cancer care organizations assess and improve service delivery and to advance research of organization-level FA practices across the U.S. Methods: ACCC convened an expert task force to guide this work. ACCC conducted a scan of implementation science literature and health care organizational assessments to inform the development of a rating system for each of the 43 guidelines. Four service delivery levels were identified, and a score was assigned to each level (Table). The tool was programmed in Qualtrics to provide a total score and average score per guideline for each FA domain and sub-domain. The task force added unscored questions about organizational demographics, barriers, and readiness to enable aggregate research and sub-group analysis. ACCC invited members of the Financial Advocacy Network to participate in a pilot via email invitation and provided opportunities for open-ended feedback. Results: 20 cancer centers participated in the pilot between March-May 2024. 15% were academic institutions and 85% were community-based programs (18% of which are directly affiliated with an academic institution). Respondents reported the tool was easy to use and informative for quality improvement efforts. See Table 1 for total scores for initial pilot. Conclusions: Pilot results reflect that all participating cancer centers are already engaged in some level of FA services. Broader dissemination and analysis is ongoing. The assessment provides centers with a practical resource to assess alignment to guidelines and identify opportunities for quality improvement. Regular review of aggregate results will help ACCC provide benchmarks for areas of service delivery, identify barriers to implementation, and monitor trends in FA staffing. 1. Kajdic Hodzic R, Liang MI, et al. Developing consensus-based oncology financial advocacy services guidelines. JCO Oncol Pract. 2023;19(suppl 11):38. Levels of FA service delivery and pilot total scores. Level Description % of pilot cancer centers Level 1 Not performing financial advocacy services. 0% Level 2 Making progress with financial advocacy services, but it is done informally or inconsistently. 35% Level 3 Performing financial advocacy services consistently in at least one key area of the organization. 60% Level 4 Reliably performing financial advocacy services across all key areas of the organization. 5%

Implementation of Technical Communication Pedagogy in Higher Education Institutions: A Systematic Literature Review

One of the most significant needs in technical communication is to teach students how to communicate complex technical information. This paper systematically reviews the literature to map technical communication (TC) pedagogical strategies and theoretically underpinned approaches. The overall purpose is to illuminate patterns and trends in research that describe TC pedagogy, specifically learning objectives, method of delivery, content, assessment strategies, and theoretical frameworks. Following PRISMA guidelines, the study conducted detailed content analysis on 39 publications from 2017 to 2023 based on specific inclusion criteria.. Results show increasing trends in interdisciplinary, inclusive, and technology-driven approaches and recurrent themes of student-centered objectives, technology-based delivery, and diverse assessments, with Rhetorical Theory being the dominant theoretical framework in TC pedagogy research. Based on the findings, it is recommended that future research and practice in TC pedagogy prioritize the integration of comprehensive theoretical frameworks, such as social constructivism, genre theory, and rhetorical theory, to enhance the effectiveness of teaching strategies and better prepare students for the evolving demands of the modern workforce.

Chrysin Embedded Metal Organic Framework for Anticancer Drug Delivery.

Metal-organic frameworks (MOFs) have garnered significant attention in the field of cancer drug delivery owing to their porosity, high drug-loading capacity, and large surface area. In our recent research, we synthesized a redox-responsive MOF using zirconium (Zr) as the metal ion and 4,4-dithiobisbenzoic acid (DTBA) as the organic linker. The synthesis method employed was the hydrothermal method, and it was observed that the MOF synthesized at 400°C had a particle size of less than 200 nm and a zeta potential of +35 mV, indicating its suitability as a carrier for drug delivery. Chrysin, a natural anticancer drug, was used in this study. Glutathione, which is abundantly present in tumor cells, cleaves the disulfide bond in the organic ligand (DTBA), leading to faster drug release. By incorporating chrysin into the synthesized MOF, we observed faster in vitro drug release, with 88 and 89% at pH 7.4 and 5.5, respectively. The synthesis of ZrDTBA MOF opens up new opportunities for its application in drug delivery.

Green composite synthesis based on aluminum fumarate metal-organic framework (MOF) for doxorubicin delivery: An in vitro study

The development of an eco-friendly and cost-effective drug delivery system (DDS) remains a challenge in cancer treatment. This study suggests a novel, eco-friendly, and cost-effective method to synthesize aluminum fumarate (A520) MOF using tangerine peel extract (TPE) as a pH-sensitive coating agent on a reduced graphene oxide (rGO) substrate. The system also incorporates the 2,2′-bipyridine dimethyltin diisothiocyanate complex, (Sn(bpy), as an organotin complex) to enhance therapeutic efficacy while minimizing off-target effects. In vitro cellular and molecular cytotoxicity examinations were conducted using HEK-293 and MCF-7 cell lines to evaluate cytotoxicity after 24 and 72 h. The findings of the MTT assay indicated that the final nanocarriers, without and with doxorubicin (DOX), exhibited relative cell viability of 95 % and 55 %, respectively, highlighting the system's potential for efficient and safe drug delivery. The TPE coating created a pH-sensitive DDS with high drug loading efficiency (DLE) (59.1 %) and low cytotoxicity. Drug release was studied over 200 h at pH 5.5 and 7.2. The augmented drug release profile (47 %) demonstrated a targeted release and successful inhibition of premature release in acidic environments due to pH-sensitive TPE molecules. The efficacy of targeted drug delivery to the MCF-7 cell was evaluated using 2D fluorescence microscopy, which demonstrated successful delivery of drugs to the cells. This innovative approach addresses the limitations of existing studies while promoting biocompatibility, stability, and functionality in DDSs.

An Optimal Framework for the Effective Delivery of the Radiation to the target by Considering the Case of Head and Neck Cancer

An Optimal Framework for the Effective Delivery of the Radiation to the target by Considering the Case of Head and Neck Cancer

130 Promoting health enhancing physical activity through social prescribing in Wales: A delivery and recommendations framework for nature-based wellbeing support programmes

130 Promoting health enhancing physical activity through social prescribing in Wales: A delivery and recommendations framework for nature-based wellbeing support programmes

Role of Nano Particle Drug Delivery System in Antifungal Therapy

Effective illnesses are currently treated with oral and common effective strategies. Oral and effective courses encounter numerous challenges, including pharmaceutical drug interactions, higher metabolic rate, unfavorable retention, and toxicity. Controlled drug release has not been demonstrated using conventionally useful measuring forms such as gels, salves, and creams. According to written accounts, several lakhs of people are affected and over 1.5 lakh people are thought to have died as a result of infectious contaminations. The high prevalence of parasite infections, which has been disrupted by an expansion in inclination factors, has become a concerning general medical issue. It is essential to thoroughly investigate the relationships between the specifics, the organization method, pharmacological properties, pharmacokinetics, pharmacodynamics, strength, sufficiency, safety, and clinical signs in order to improve a successful novel antifungal medication delivery framework. This audit article looks at several types of nanoparticle processes that are used to deliver antifungal drugs, such as dendrimers, polymeric nanoparticles, inorganic nanoparticles, and nanoparticles based on phospholipids (nanovesicles).

Review on Nanogel as a Novel Platform for Smart Drug Delivery System

One of the most popular applications of nanotechnology in both topical and internal medicine administration to the body is nanogel technology. The materials comprising the nanoparticulate frameworks are less than 100 nm in a single measurement. The goal of this review paper is to provide a concise overview of the most recent developments in the nanogel medicine delivery framework with regard to drug loading and swelling. It categorises according to links (chemical and physical) and responding behaviour. This article is to give a broad overview of nanogels, their innovative use in many contexts, and current synthesis techniques. NGs use drugs for a variety of reasons, including diagnostics, gene targeting, organ targeting, and many more. Different pulmonary, nasal, transdermal, intra-ocular, oral, and parenteral routes can be used to give NGs. The primary goals of this review are to present broad details on NGs, their characteristics, multiple categories, medication targeting strategies, kinds of drug delivery systems, assessment techniques, and cutting-edge uses for NGs in depth. Keywords: Nanogel, DLS, CD, mechanism of drug release, classification, application

Could the minimum intervention oral care framework help improve the quality of oral health delivery and access to NHS primary dental care?

Access to NHS primary dental care services is a perennial issue in the UK. Two aspects must be considered when measuring access to dental care: ‘entry access', which relates to service availability resulting in realised initial or continued access; and ‘effective access', the delivery of effective, equitable and efficient care, which manifests as equitable and optimal outcomes of care. It is proposed that the minimum intervention oral care (MIOC) delivery framework provides a person-focused, prevention-based, susceptibility/needs-related, team-delivered approach to ensuring effective access to primary oral and dental care. A theory of change model could identify the key barriers to overcome the implementation of the MIOC approach, involving all key stakeholders in primary oral and dental care delivery.

Pursuing a Deep Ecology of Rural Volunteerism: An Extended Conceptual Framework for Sustainable Social Service Delivery and Community Development

Pursuing a Deep Ecology of Rural Volunteerism: An Extended Conceptual Framework for Sustainable Social Service Delivery and Community Development

Understanding the Standard for Tele-Services as Part of Hearing Aid Fitting Management

Recently, the International Organization for Standardization (ISO) published ISO 21388-2, which focuses on tele-services as part of hearing aid fitting management (tHAFM). This report introduces the fundamental aspects of ISO 21388-2 for tele-services in hearing aid fitting to assist in the proper adoption and utilization of tHAFM services in South Korea. The primary goal of tHAFM is to achieve the highest rehabilitation outcomes for hearing aid users, equivalent to those of traditional face-to-face services. It specifies the precondition requirements and general frameworks for tele-service delivery. As there is still a lack of reporting on the provision of tele-services related to hearing aid fitting in South Korea, future research should focus more on providing and validating the effectiveness of tele-services for domestic hearing aid users. Additionally, there is a need to establish step-by-step guidelines and professional education programs based on the ISO 21388-2 standard for the utilization of tHAFM. It is expected that the ISO 21388-2 standard will serve as a fundamental guideline for hearing aid professionals in effectively providing tele-services to achieve these goals.

Aggregation and Sedimentation Stability of Nanoscale Zeolitic Imidazolate Framework (ZIF‐8) Nanocomposites for Antimicrobial Agent Delivery Applications

ABSTRACTThe applications of nanoscale zeolitic imidazolate frameworks (ZIF‐8) for antimicrobial drug delivery depend on the aqueous suspension stability of the ZIF‐8 which is influenced by their crystallinity, size, shape, aggregation, and surface chemistry. This study evaluated the stability of ZIF‐8 nanoparticles in terms of their aggregation and sedimentation characteristics. ZIF‐8 nanocomposites were synthesized with methanol via sonication at 30°C for 1 h. The effect of drying methods (oven drying at 80°C, and vacuum drying at 35°C), number of washing steps (0 = no wash, 1, 2, 3), and washing medium (washing with water and ethanol instead of methanol, and redispersion in water and ethanol) on the suspension stability was evaluated. The impact of added xanthan gum (XG) and poly‐L‐lysine (PL) as suspension media was also evaluated. ZIF‐8 nanoparticles were also synthesized using ethanol and suspended in PL. % transmittance and zeta potential were measured for freshly prepared ZIF‐8 suspensions in PL and after freeze‐drying and resuspending in water. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), and x‐ray diffraction (XRD) analysis were utilized for the assessment of the crystallinity, structure, and morphology of the samples. Antibacterial activity was evaluated by disc diffusion test against Escherichia coli. Dried methanol‐synthesized ZIF‐8 nanoparticles did not suspend in water; only the ZIF‐8 nanoparticles synthesized with reduced washing times and no drying treatment were resuspended in the water, XG and PL solutions. Instead, the ethanol‐synthesized ZIF‐8 nanoparticles were resuspended in water even after being washed three times and dried in a vacuum oven. SEM and TEM images and XRD patterns showed that alcohol can form well‐defined ZIF‐8 nanoparticles. FTIR spectra showed that ZIF‐8 had typical peaks of ZIF‐8 reported by others. Although particle size increased, the PL coating provided a 32.22% increase in zeta potential of ZIF‐8 nanoparticles from 36.25 to 47.93 mV (p < 0.05) and prevented aggregation and sedimentation of the nanoparticles without changing their morphology. All the tested ZIF‐8 nanoparticles showed antibacterial activity with the PL‐coated ZIF‐8 having the highest effect followed by the ZIF‐8 nanoparticles synthesized in ethanol.

Guidelines for biomimetic 3D/4D printing in drug delivery

Four-dimensional printing, sometimes known as 4DP, is becoming an increasingly popular area of study. Utilization of “shrewd” materials in 3D printing considers the making of items that answer non-mechanical boosts (like dampness, electric or attractive fields, UV, temperature, pH, or particle arrangement) by progressively changing their shape after some time, as modified. These things could be printed with a shape-moving component that is constrained by a PC. Gadgets made with 4D printing innovation exploit time as the final aspect in their activity. 4D shrewd designs have been concentrated on in the logical writing for a really long time, much before the coming of 3D printing. Medicine delivery at the nano-, miniature, and full-scale scales have all been investigated utilizing ideas from shape development and self-gathering. This study lays forward a far-reaching set of rules for utilizing biomimetic 3D/4D printing techniques in drug delivery frameworks. Biomimetic 3D/4D printing has arisen as a game-changing method in the field of medicine delivery, considering unmatched accuracy and command over drug discharge qualities. In particular, this study looks at the manners by which 3D and 4D printing are being utilized as prescription delivery techniques and with regards to customized medication in the pharmaceutical business.

Association between the hearing aid and mental health outcomes in people with hearing impairment: A case-control study among 28 European countries

BackgroundHearing loss affects over 1.5 billion individuals globally, with significant implications for mental health. This study investigates the association between hearing aid use and mental health outcomes, by particularly focusing on depression and unmet mental health needs (UMHN), across a diverse international sample. MethodsUtilizing data from the third wave of the European Health Interview Survey (EHIS), this study involved 17,660 participants with hearing impairment from 28 countries. The study examined the association between hearing aid use and mental health outcomes, including the likelihood of moderate and severe depression and UMHN due to lack of contact with general practitioners (GPs) and mental health specialists. Logistic regression models, adjusted for socio-demographic characteristics, health risk behaviours, and other relevant variables, were employed. Inverse probability weights were used to mitigate potential selection bias. ResultsHearing aid usage was associated with significantly lower likelihoods of moderate depression (Odds Ratio [OR] = 0.58, 95%CI = [0.54, 0.63]) and severe depression (OR = 0.61, 95%CI = [0.55, 0.69]), compared to non-usage. Hearing aid usage was also associated with reduced UMHN due to lack of GP contact for moderate (OR = 0.82, 95%CI = [0.75, 0.89]) and severe depression (OR = 0.75, 95%CI = [0.59, 0.95]). The depression risk reductions were greater among females and higher-educated subgroups but lower in individuals aged ≥65 years. Income level and rurality also impacted UMHN due to the lack of GP contact. No associations were found between hearing aids and UMHN due to the lack of mental health specialist contact. ConclusionsHearing aid adoption showed protective associations against mood disorders and lowered unmet primary mental healthcare needs. Tailoring intervention strategies to vulnerable sociodemographic profiles could optimize mental health benefits among those with hearing loss. Integrating hearing health services within mental healthcare delivery frameworks is vital amidst the rising global burden.