Insulin delivery devices

Everyone with type 1 diabetes requires insulin from diagnosis and more than 30% of people with type 2 diabetes eventually need insulin because of progressive failure of pancreatic beta cells. People with type 2 diabetes are often reluctant to commence insulin and some will require assistance with their injections. Over the past five years a number of new insulin delivery systems have become available that can make insulin administration easier. A number of factors, including patient preference, influence the choice of device. A thorough assessment of the individual's self-care capacity is important and appropriate education is imperative when starting insulin.

An investigation of the development of navigation design guidelines for online educational applications delivery to a primary school audience

Despite growing interest in educational websites for children, there has been surprisingly little research conducted into the design of websites intended for a younger audience. This research aims to determine how the design principles identified in the extant body of literature, might be fused with the development practices currently employed within a focus organisation (case study organisation), to synthesise and partially validate a set of website navigation design guidelines for use when developing website navigation for primary school students, between the ages of nine and twelve years.

Electronic markets and service delivery: requisite competencies for virtual environments

Electronic markets have a short but dynamic history. How an electronic market can be successfully developed remains in dispute. There is a clear need to better understand the nature of electronic markets themselves and, in particular, to review important developments in their conceptualisation. To enable a deeper understanding of these issues, we decided to restrict our investigation to electronic markets in the agricultural export sector. Agribusiness is a natural early adopter of digital marketplaces because of the industry’s traditional reliance on markets and current take-up of global supply chain management (Wilkins, Swatman and Castleman, 2002). We review two portals from this sector that aimed to simplify access to regulatory documentation. The earlier implementation had its funding withdrawn after one year, whilst the more recently established portal is rapidly becoming a showcase project for the stakeholders. We use a composite theory based on Bijker (1995) and Nowotny et al (2001) to establish a framework for analysing our data. We also refer to a body of literature characterising intangible services and their design and its implications for emarket implementations. Our findings indicate that governance style is in fact closely related to the success or failure of specific sites. We also found support for earlier research indicating that expectations and understanding of electronic markets are still evolving.

Teaching quality and tutorial delivery : experience of a second year marketing unit

The higher education sector, the world over, is faced with the challenging task of servicing an increasingly diverse international student community in the globally competitive education market. The rising expectation of students of education outcomes, varied learning styles and orientations of the student population have brought in challenges such as providing a high quality educational environment with changes in curricula and pedagogy (Coldrake, 2001) to negotiate the cultural and linguistic diversity and the resulting expectations of students. The 'quality' of teaching and learning is high on the agenda among the key issues that had emerged from policy developments to meet these challenges.

Using the SPQ2F instrument (Biggs, 2003) and depth interviews, this paper investigates the study 3J'PToaches of students enrolled in a second year marketing unit in an Australian university focusing on the learning contexts in which learning occurs. The findings indicate that there are no significant differences in study approaches of students and that the study approaches differ according the learning context. The paper concludes that student perceptions on learning contexts assist in the development of teaching strategies that lead to quality outcomes, higher student satisfaction and providing universities a competitive edge in marketing its services to prospective students.

Responding to the learner diversity : an inquiry into the delivery of a second year marketing unit

This paper reports on the outcome of an inquiry into the learner diversity and the delivery of a second year marketing subject in an Australian university. Using Biggs’s revised SPQ2F instrument (Biggs, 2003), it analyses the learning approaches of students and the opportunities for developing teaching strategies for better learning outcomes. The results suggest that overall students seem to adopt deep learning than surface learning though they differ in terms of the learning contexts. Moreover, no significant differences among students in regard to the study approach domains except for minor variation related to specific items in the instrument.

Effect of low-dose mobile versus traditional epidural techniques on mode of delivery: a randomised controlled trial

Background

Epidural analgesia is the most effective labour pain relief but is associated with increased rates of instrumental vaginal delivery and other effects, which might be related to the poor motor function associated with traditional epidural. New techniques that preserve motor function could reduce obstetric intervention. We did a randomised controlled trial to compare low-dose combined spinal epidural and low-dose infusion (mobile) techniques with traditional epidural technique.
Methods

Between Feb 1, 1999, and April 30, 2000, we randomly assigned 1054 nulliparous women requesting epidural pain relief to traditional (n=353), low-dose combined spinal epidural (n=351), or low-dose infusion epidural (n=350). Primary outcome was mode of delivery, and secondary outcomes were progress of labour, efficacy of procedure, and effect on neonates. We obtained data during labour and interviewed women postnatally.
Findings

The normal vaginal delivery rate was 35·1% in the traditional epidural group, 42·7% in the low-dose combined spinal group (odds ratio 1·38 [95% CI 1·01–1·89]; p=0·04); and 42·9% in the low-dose infusion group (1·39 [1·01–1·90]; p=0·04). These differences were accounted for by a reduction in instrumental vaginal delivery. Overall, 5 min APGAR scores of 7 or less were more frequent with low-dose technique. High-level resuscitation was more frequent in the low-dose infusion group.

Delivery and assessment strategies to improve on- and off-campus student performance in structural mechanics

This paper considers the delivery and assessment strategies used in two structural mechanics units at Deakin University, a leader in distance education in Australia. The two units have had unacceptably high rates of student failure. Student perceptions of the delivery method were analysed and an investigation was carried out of the performance of 329 (173 on- and 156 off-campus) students enrolled in the two units. An analysis of the assignment, laboratory and examination marks is presented. Consideration is also given to the total marks. The results show that on-campus students performed better in structural mechanics than their off-campus counterparts. Plots of the distributions of student performance for the three assessment methods are provided (for each unit) and high failure rates are linked to low examination marks. Students tended to perform best in assignments and worst in examinations. Parametric statistical tests show a correlation between the marks obtained in continuous assessment and in examinations, and it is therefore proposed that, in order to improve performance, the students must be encouraged to participate fully in all aspects of the course. Many students were unenthusiastic about laboratory practical sessions and did not think they aided their understanding of the theoretical material. Motivation to participate is often dependent on the perceived relevance of a given task and its contribution to the total mark and, thus, to help motivate students to participate fully in the continuous assessment tasks, the authors propose several changes to the delivery methods, as well as to assessment criteria and marking schemes.

Massive data delivery in unstructured peer-to-peer networks with network coding

With more and more multimedia applications on the Internet, such as IPTV, bandwidth becomes a vital bottleneck for the booming of large scale Internet based multimedia applications. Network coding is recently proposed to take advantage to use network bandwidth efficiently. In this paper, we focus on massive multimedia data, e.g. IPTV programs, transportation in peer-to-peer networks with network coding. By through study of networking coding, we pointed out that the prerequisites of bandwidth saving of network coding are: 1) one information source with a number of concurrent receivers, or 2) information pieces cached at intermediate nodes. We further proof that network coding can not gain bandwidth saving at immediate connections to a receiver end; As a result, we propose a novel model for IPTV data transportation in unstructured peer-to-peer networks with network coding. Our preliminary simulations show that the proposed architecture works very well.

Flexible delivery in the Australian vocational education and training sector: Barrier to success identified in cases studies of four adult learners

Government policy in Australia is increasingly encouraging training organisations in the Vocational Education and Training (VET) sector to adopt flexible delivery approaches, but some researchers are sounding a note of caution. Evidence is emerging that Australian VET learners are not universally ready for flexible delivery, and this is reflected in high attrition rates and low pass rates. The literature on flexible delivery identifies a number of specific factors that can impact on the success of adult learners. However, there seems to be agreement that failure or dropout is not determined by a single factor, but by the interaction of a number of factors that build up over time. To understand these factors, we need to understand the learners - what their participation in education means to them, the context in which they are studying, and the numerous inter-connected factors that contribute to their failure to achieve a successful outcome. This paper discusses four case studies from a research project that followed up a small number of adult learners who enrolled in flexible delivery VET courses but did not achieve a successful outcome.

Bypassing luminal barriers, delivery to a gut addressin by parenteral targeting elicits local IgA responses

Induction of mucosal immunity, particularly to subunit vaccines, has been problematic. The primary hurdle to successful mucosal vaccination is the effective delivery of vaccine antigen to the mucosal associated lymphoid tissue. Physical and chemical barriers restrict antigen access and, moreover, immune responses induced in the mucosa can be biased towards tolerance or non-reactivity. We proposed that these difficulties could be circumvented by targeting antigen to the gastrointestinal associated lymphoid tissue via systemic (parenteral) rather than alimentary routes, using antibodies specific for the mucosal addressin cellular adhesion molecule-1 (MAdCAM). After intravenous or intramuscular injection of such rat antibodies in mice, we found a greatly enhanced (up to 3 logs) anti-rat antibody response. MAdCAM targeting induces a rapid IgA antibody response in the gut and vastly improves the systemic antibody response. Targeting also enhanced T cell proliferation and cytokine responses. Parenteral targeting of mucosal addressins may represent a generic technique for bypassing mucosal barriers and eliminating the need for adjuvants in the induction of proximal and systemic immunity.

Reflections on teaching and learning online: quality program design, delivery and support issues from a cross-global perspective

This reflective paper began with a discussion of the online program design and delivery experiences of three senior faculty members at the University of Calgary (Canada) and Deakin University (Australia), which was recorded at Deakin University. After drawing on this recording in their research and practice, one faculty member from each institution decided to review and expanded upon their intervening experiences in terms of issues of quality program design, delivery, and support issues when teaching, and learning in different cultural contexts. The authors discovered that these issues are as important today as they were when they met to record the interview, and have concluded their discussion here with thoughts about the teaching, student, and administrative supports that institutions engaged in online program delivery cross-culturally must address in order to successfully deliver quality online programs worldwide.

Intracellular drug delivery by sulfatide-mediated liposomes to gliomas

We described here a liposomal carrier system in which the targeting ligand was sulfatide, a glycosphingolipid known to bind several extracellular matrix (ECM) glycoproteins whose expression was highly up-regulated in many tumors. In vitro experiments with human glioma cell lines demonstrated that robust intracellular uptake of the liposomes depended specifically on the presence of sulfatide as the key liposomal component. Significant amount of the liposomes remained largely intact in the cytoplasm for hours following their internalization. When anticancer drug doxorubicin (DOX) was encapsulated in such liposomes, most of the drug was preferably delivered into the cell nuclei to exert its cytotoxicity. Use of this drug delivery system to deliver DOX for treatment of tumor-bearing nude mice displayed much improved therapeutic effects over the free drug or the drug carried by polyethylene glycol (PEG)-grafted liposomes. Our results demonstrate a close link between effective intracellular uptake of the drug delivery system and its therapeutic outcome. Moreover, the sulfatide-containing liposomes (SCL) may represent an interesting ligand-targeted drug carrier for a wide spectrum of cancers in which sulfatide-binding ECM glycoproteins are expressed.

Brokering knowledge : managing knowledge in a network of government and non-government human service delivery agencies

This paper examines aspects of knowledge management that are particularly important in the network of human service delivery agencies in Victoria. This network is characterised by four features: it is a cluster of networked organisations; professionals and others may act as knowledge brokers within and between organisations in the network; rapid change in both knowledge and organisation accentuates the importance of innovative knowledge and emergent organisation over and above routine instrumental knowledge within stable organisation; and consequently there is an underlying concern with dialogical rather than instrumental knowledge and its management, and particularly how it constitutes and is constituted by organisation. The paper describes the analytical tools that we consider particularly important in examining this situation – in particular, the distinction between instrumental and dialogical knowledge, and the role of knowledge brokers (and professionals as knowledge brokers). It concludes by relating this analysis to broader issues in organisation studies, and suggests paths for further examination of these issues.