Enhancing Customer Participation for Superior Value Outcomes in Knowledge Intensive Business Services

Siirretty Doriast

Senior Recital, Mark Mekhail, piano

The presentation of this senior recital will fulfill in part the requirements for the Bachelor of Music degree in Jazz Studies. Mark Mekhail studies piano with Wells Hanley

Culture in Mind: Fostering a Sense of Belonging for Students of Color in Wellness-Affiliated Spaces

The purpose of this study was to bridge the gap between students of color and mental health resources at a predominantly white institution. Previous research demonstrates that negative mental health outcomes are positively correlated with students who feel a lack of belonging while on campus. These negative outcomes are felt more pronouncedly by students of color. Furthermore, students of color are shown to underutilize mental health resources relative to their white-identifying peers. Utilizing my positionality as a person of color working within a wellness office, I worked with students of color, wellness professionals, and multicultural professionals to ask what more can be done to serve students of color. Through surveys, interviews, and interactive activities, we found that increased and intentional collaboration between wellness and multicultural services is needed. Further, it was found that increased visibility, relationship-building, and co-created practices with wellness staff helps students connect with wellness services

Genipin-crosslinked electrospun collagen nanofibers

Tissue engineering deals with creating tissues, using patient-derived cells, in order to restore, maintain or improve existing tissue function. In traditional tissue engineering, tissues are grown in-vitro prior to insertion in the body, and thus a scaffold is needed to support and guide the cells during growth. Nanofibrous scaffolds are considered promising since they mimic the extracellular matrix, have a high surface area-to-volume ratio, and possess excellent porosity and pore interconnectivity. In this research collagen type I nanofibers were fabricated using electrospinning. Collagen nanofibers were unstable in aqueous environments, and thus crosslinking was required. Glutaraldehyde, which is cytotoxic to cells, is currently the chemical crosslinking agent used by most research groups to stabilize collagen nanofibers. In this thesis, a novel approach, using genipin (a natural crosslinking agent), was introduced to crosslink the electrospun collagen nanofibers. Genipin has been proven to be significantly less cytotoxic compared to glutaraldehyde

Making a difference with home visiting : studies of an intervention in multicultural, disadvantaged settings in Sweden

Introduction: Inequalities in health, including child health, occur even in welfare countries like Sweden because of unequal distribution of the social determinants of health. Children’s health is poorer in multicultural and disadvantaged neighborhoods in Stockholm, compared with the Stockholm County average. Poorer child health can be related to parents’ lower social position in society, which is associated both with poorer health and lower health literacy (HL). Parents’ low HL relates to poorer knowledge and competencies in healthrelated issues and has negative consequences on children’s health. However, parents’ HL can be improved, and the well-established Swedish Child Health Care (CHC) program reaches all families with children from 0–5 years. Furthermore, an extended postnatal home visiting program for first-time parents, provided as a supplement to the CHC program was initiated in 2013 in Rinkeby, one of the multicultural and disadvantaged Stockholm neighborhoods to address obvious disparities in child health outcomes. The intervention consists of six joint extended home visits, conducted by CHC nurses and parental advisors from preventive social services during the child’s first 15 months of life. Postnatal home visiting is an evidencebased method in improving families and children’s psychosocial conditions among vulnerable families across the globe. This thesis includes four studies exploring the impacts of the extended postnatal home visiting program on parents and children. Aims: The overall aim of this thesis was to increase knowledge about the possible effects of an extended postnatal home visiting program within Swedish Child Health Care regarding parental experiences, parents’ health literacy, and child health, in multicultural, socioeconomically disadvantaged settings. Methods: This thesis used a multi-method approach consisting of one qualitative and three quantitative studies. All studies were conducted through CHC centers in multicultural, disadvantaged settings in northwest Stockholm from 2015 to 2020. The qualitative in-depth interview study with nine migrant fathers explored their perspectives on participating in the extended postnatal home visiting program and analyses used constructivist grounded theory. Data for the cross-sectional quantitative study (N=193) was collected through face-to face and phone interviews with first-time parents of newborn children, through structured questionnaires including the HLS-EU-Q16 tool (Swedish version), designed to measure comprehensive HL (CHL) in general populations. Psychometric properties of HLS-EU-Q16 that were evaluated through statistical methods, including exploratory factor analyses were: internal consistency, reliability, construct validity, floor and ceiling effects, reproducibility, ease of scoring, time to administer, and content validity. Face-to-face and phone interviews with first-time parents through structured questionnaires, including HLS-EU-Q16, were also used to collect data for the two quasi-experimental studies with pre-and post-measures. Pre-measures were conducted when first-time parents’ children were newborns and post-measures were conducted when children turned 15–18 months old (N=151). Additional data from the medical records of participants’ children and earlier published findings about measles, mumps, rubella (MMR) immunization coverage in the intervention area were used. Both quasi-experimental studies explored change in parents’ CHL from pre-to post-measures. One of the studies made comparisons of the change of parents’ CHL within and between the intervention group that attended the extended postnatal home visiting program vs. the comparison group that attended the ordinary Swedish CHC program. Data analyses used descriptive statistics, parametric/non-parametric tests, and general linear regression models. The other quasi-experimental study explored differences in children’s health outcomes (breastfeeding, MMR immunization, children’s exposure to smoke, language development and children’s healthcare utilization) and the associations between parents’ CHL and the children’s health outcomes (N=127) after participation in the intervention vs. the ordinary CHC program. Data analyses used descriptive statistics, nonparametric tests, and linear and logistic regression analyses. Results: Migrant fathers described their improved child-related knowledge and parental confidence during the in-depth interviews, as well as access to available societal resources that came about due to the extended postnatal home visiting program. One factor solution of exploratory factor analyses for HLS-EU-Q16 (Swedish version) explained 37.7% of the total variance of the tool when evaluating psychometric properties. Migrant background, educational level, and access to support from social networks had significant effects on CHL. Challenges related to comprehension of the HLS-EU-Q16 questions were found among participants with migrant backgrounds but were also expressed by Swedish-born participants. Significantly improved CHL after the extended home visiting program was only found in a sub-group of parents who needed an interpreter within the intervention group (F=11.429, p<0.001), and when compared with the corresponding sub-group of parents who attended the ordinary CHC program (F=5.025, p=0.027). A significantly reduced number of additional visits to the CHC center was observed in the intervention group (Kruskal-Wallis=10.063, p=0.002) but the rate of children’s normal language development at the age of 18 months was significantly lower in the intervention group, at 0.363 (95%CI [0.141,0.932]. MMR immunization coverage in the intervention site was higher after the program implementation in comparison with before (Chi2 =3.988, p=0.046). Changes in parents’ CHL after the home visits were not related to children’s health outcomes. Conclusions: This thesis indicates some positive impacts of the extended postnatal home visiting program on migrant fathers, parents’ CHL, and child health. The findings show the importance of including migrant fathers in home visiting programs, as it is beneficial to them in their parental role. When exploring parents’ CHL more specifically as an outcome of the extended postnatal home visiting program, despite HLS-EU-Q16 tools’ acceptable psychometric properties, the use of additional methods to measure parents’ HL is suggested in similar settings, as the questionnaire may not cover relevant aspects of HL. Even if parents’ comprehensive HL was measured to be improved in a sub-group of parents, HLSEU- Q16 is not measuring parents’ child-related HL, specifically. Further research is proposed to explore the extended home visiting program’s positive impacts on additional child health outcomes and their relationship to parental child-related HL in similar settings, as the research field remains relatively unexplored

Hypofractionated SBRT versus conventionally fractionated EBRT for prostate cancer: comparison of PSA slope and nadir.

BackgroundPatients with early stage prostate cancer have a variety of curative radiotherapy options, including conventionally-fractionated external beam radiotherapy (CF-EBRT) and hypofractionated stereotactic body radiotherapy (SBRT). Although results of CF-EBRT are well known, the use of SBRT for prostate cancer is a more recent development, and long-term follow-up is not yet available. However, rapid post-treatment PSA decline and low PSA nadir have been linked to improved clinical outcomes. The purpose of this study was to compare the PSA kinetics between CF-EBRT and SBRT in newly diagnosed localized prostate cancer.Materials/methods75 patients with low to low-intermediate risk prostate cancer (T1-T2; GS 3 + 3, PSA &lt; 20 or 3 + 4, PSA &lt; 15) treated without hormones with CF-EBRT (&gt;70.2 Gy, &lt;76 Gy) to the prostate only, were identified from a prospectively collected cohort of patients treated at the University of California, San Francisco (1997-2012). Patients were excluded if they failed therapy by the Phoenix definition or had less than 1 year of follow-up or &lt;3 PSAs. 43 patients who were treated with SBRT to the prostate to 38 Gy in 4 daily fractions also met the same criteria. PSA nadir and rate of change in PSA over time (slope) were calculated from the completion of RT to 1, 2 and 3 years post-RT.ResultsThe median PSA nadir and slope for CF-EBRT was 1.00, 0.72 and 0.60 ng/ml and -0.09, -0.04, -0.02 ng/ml/month, respectively, for durations of 1, 2 and 3 years post RT. Similarly, for SBRT, the median PSA nadirs and slopes were 0.70, 0.40, 0.24 ng and -0.09, -0.06, -0.05 ng/ml/month, respectively. The PSA slope for SBRT was greater than CF-EBRT (p &lt; 0.05) at 2 and 3 years following RT, although similar during the first year. Similarly, PSA nadir was significantly lower for SBRT when compared to EBRT for years 2 and 3 (p &lt; 0.005).ConclusionPatients treated with SBRT experienced a lower PSA nadir and greater rate of decline in PSA 2 and 3 years following completion of RT than with CF-EBRT, consistent with delivery of a higher bioequivalent dose. Although follow-up for SBRT is limited, the improved PSA kinetics over CF-EBRT are promising for improved biochemical control

A 25 micron-thin microscope for imaging upconverting nanoparticles with NIR-I and NIR-II illumination.

Rationale: Intraoperative visualization in small surgical cavities and hard-to-access areas are essential requirements for modern, minimally invasive surgeries and demand significant miniaturization. However, current optical imagers require multiple hard-to-miniaturize components including lenses, filters and optical fibers. These components restrict both the form-factor and maneuverability of these imagers, and imagers largely remain stand-alone devices with centimeter-scale dimensions. Methods: We have engineered INSITE (Immunotargeted Nanoparticle Single-Chip Imaging Technology), which integrates the unique optical properties of lanthanide-based alloyed upconverting nanoparticles (aUCNPs) with the time-resolved imaging of a 25-micron thin CMOS-based (complementary metal oxide semiconductor) imager. We have synthesized core/shell aUCNPs of different compositions and imaged their visible emission with INSITE under either NIR-I and NIR-II photoexcitation. We characterized aUCNP imaging with INSITE across both varying aUCNP composition and 980 nm and 1550 nm excitation wavelengths. To demonstrate clinical experimental validity, we also conducted an intratumoral injection into LNCaP prostate tumors in a male nude mouse that was subsequently excised and imaged with INSITE. Results: Under the low illumination fluences compatible with live animal imaging, we measure aUCNP radiative lifetimes of 600 μs - 1.3 ms, which provides strong signal for time-resolved INSITE imaging. Core/shell NaEr0.6Yb0.4F4 aUCNPs show the highest INSITE signal when illuminated at either 980 nm or 1550 nm, with signal from NIR-I excitation about an order of magnitude brighter than from NIR-II excitation. The 55 μm spatial resolution achievable with this approach is demonstrated through imaging of aUCNPs in PDMS (polydimethylsiloxane) micro-wells, showing resolution of micrometer-scale targets with single-pixel precision. INSITE imaging of intratumoral NaEr0.8Yb0.2F4 aUCNPs shows a signal-to-background ratio of 9, limited only by photodiode dark current and electronic noise. Conclusion: This work demonstrates INSITE imaging of aUCNPs in tumors, achieving an imaging platform that is thinned to just a 25 μm-thin, planar form-factor, with both NIR-I and NIR-II excitation. Based on a highly paralleled array structure INSITE is scalable, enabling direct coupling with a wide array of surgical and robotic tools for seamless integration with tissue actuation, resection or ablation

Surgical Management of Wounds

In surgical speciality, understanding of the wound healing is absolutely necessary. There are different kinds of wounds that require treatment which is most appropriate to them. In this chapter, we have discussed treatment for different types of wounds in four main types according to WHO Classification. Pros and cons of different types of materials used for cleaning and dressing are discussed. Dressing materials are discussed in detail. We have described the process of wound healing. There are various factors that influence wound healing and we have specifically described how they differ in primary and secondary wound healing. Usage of various kinds of dressing materials and their mechanism of action is described in detail. We have specifically highlighted the role of community nurses and tissue viability nurses. Since the availability and the recognition of tissue viability nurses, the cost of wound treatment has come down considerably and it is also very popular with the patients. Vacuum-assisted closure (VAC) therapy is very helpful in large wounds that are producing a lot of exudates. The VAC pulls the skin edges together and removes the exudate. Other adjunctive therapies are also mentioned but they are not available in most hospitals and therefore detailed descriptions are not provided

DESIGN AND CONSTRUCTION OF A PROTOTYPE SOLAR UPDRAFT CHIMNEY IN ASWAN/EGYPT

This work is part of a joint project funded by the Science and Technology Development Fund (STDF) of the Arab republic of Egypt and the Federal Ministry of Education and Research (BMBF) of the Federal Republic of Germany. Continuation of the use of fossil fuels in electricity production systems causes many problems such as: global warming, other environmental concerns, the depletion of fossil fuels reserves and continuing rise in the price of fuels. One of the most promising paths to solve the energy crisis is utilizing the renewable energy resources. In Egypt, high insolation and more than 90 percent available desert lands are two main factors that encourage the full development of solar power plants for thermal and electrical energy production. With an average temperature of about 40 °C for more than half of the year and average annual sunshine of about 3200 hours, which is close to the theoretical maximum annual sunshine hours, Aswan is one of the hottest and sunniest cities in the world. This climatic condition makes the city an ideal place for implementing solar energy harvesting projects from solar updraft tower. Therefore, a Solar Chimney Power Plant (SCPP) is being installed at Aswan City. The chimney height is 20.0 m, its diameter is 1.0m and the collector is a four-sided pyramid, which has a side length of 28.5 m. A mathematical model is used to predict its performance. The model shows that the plant can produce a maximum theoretical power of 2 kW. Moreover, a CFD code is used to analyse the temperature and velocity distribution inside the collector, turbine and chimney at different operating conditions. Static calculations, including dead weight and wind forces on the solar updraft chimney and its solar collector, have been performed for the prototype. Mechanical loading and ambient impact on highly used industrial structures such as chimneys and masts cause lifetime-related deteriorations. Structural degradations occur not only from rare extreme loading events, but often as a result of the ensemble of load effects during the life-time of the structure. A Structural Health Monitoring (SHM), framework for continuous monitoring, is implemented on the solar tower. For the ongoing case study, the types of impacts, the development of the strategic sensor positioning concept, examples of the initially obtained results and further prospects are discussed. Additional wind tunnel tests have been performed to investigate the flow situation underneath the solar collector and inside the transition section. The flow situation in and around the SCPP has been simulated by a combination of the wind tunnel flow and a second flow inside the solar tower. Different wind tunnel velocities and volume flow rates have been measured respectively. Particle Image Velocimetry (PIV) measurements give some indication of the flow situation on the in- and outside of the solar tower and underneath the collector roof. Numerical simulations have been performed with the ANSYS Fluent to validate the experimental tests