QUESTION
Human Augmentation and the Blurring Lines: Technological advancements like brain-computer interfaces and wearable exoskeletons are pushing the boundaries of human capabilities. How can human informatics guide the ethical development and use of human augmentation technologies, ensuring they enhance rather than redefine what it means to be human?

ANSWER
1. Introduction
First, while only a few of these technologies are in use or close to implementation today, the timescale between development and implementation may not be adequate for thorough examination of ethical issues before it is too late to affect how the technology will be used. Policy regarding the use of enhancement technologies has tended to lag behind scientific and technological progress, enforcing a reactive rather than proactive approach to ethical evaluation. Second, ethical debate and policy regarding human enhancement technologies has been quite fragmented and not born much fruit in terms of policy and guidelines for scientists and developers of these technologies. This form of corporate social responsibility is crucial for maintaining a proactive approach to ethical evaluation. Allhoff has proposed that the best means to address issues in the long term is to shape the nature and direction of technological change, steering it towards more desirable ends, and enhancing oversight, and looking to its social implications from the outset (Allhoff 2010). Thus it is necessary to examine the ethical issues surrounding human augmentation technologies in a broad and inclusive manner and make it a priority to integrate policy and guidelines for scientists into the fabric of these technologies’ development.
Human augmentation technologies, which have the potential to bring about radical improvements to the human condition, are increasingly evoking public and academic debate. Labeled as the most important social and ethical issue of the twenty-first century (Allhoff et al. 2009), the development and use of human enhancement technologies has spurred a plethora of argument from ethicists, scientists, policymakers, and the general public. People are concerned about how it will affect what it means to be human, the distribution of the technology, and the potential for new forms of unequal social pressure to enhance. Others are hopeful about the possibility of new treatments for currently incurable diseases and conditions, as well as providing a means to improve the intellectual, physical, and psychological capacity of humans. The rapid development of these technologies presents two main challenges for the gradual process of ethical evaluation and policy development.
1.1. Background of Human Augmentation Technologies
The goal of human augmentation, to use medical technology in order to improve physical performance or even overcome disabilities, has existed for thousands of years. The development of new medical techniques and the convergence of these techniques with computer technology, new materials sciences and nanotechnology, will have far-reaching effects on the lives of every human being, as well as on the global ecosystem. To discuss the future of human augmentation, it is important to understand the historical precedents. The past three decades have seen incredible advances in medical technology. Joint replacements, dental reconstruction, organ transplants, cosmetic surgery, and the alleviation of mental illnesses through drug therapy are now commonplace in the developed world. These developments have been driven by a number of factors, including the desire of individuals to lead more fulfilling lives, an aging global population, and the economic and social benefits that improved health provides. The development of human augmentation technologies has been largely driven by the needs and capabilities of the medical industry. It is, however, the commercial potential of such technologies, particularly in an age of growing economic inequality and a global ‘knowledge economy’, that is likely to be the ultimate driving force behind the future development and convergence of these technologies. The medical industry has traditionally been conservative and slow to implement radical new procedures. Often new technologies were tested and perfected on relatively small and specific patient groups. As these technologies became more refined and costs were reduced, wider ranges of patients were treated. Many possibly beneficial medical technologies have had limited success as they were superseded by new technologies or were not seen as economically viable by the industry. This has resulted in an increasing proportion of the world’s population being left behind by the rapid pace of change in the medical industry.
1.2. Importance of Ethical Considerations
There are ethical issues associated with the development and offering of human augmentation technologies. The implications of the effectiveness and pervasiveness of those technologies will have wide-ranging effects on society. In the short term, human enhancement technologies might exacerbate social inequalities and create a two-tier society, further the gap between the haves and the have-nots. Because many enhancement technologies will initially be costly, they may be deployed first and most aggressively by those who can afford them, thus widening the gap and ultimately solidifying the advantages that already accrue to the more affluent members of society. This might, in turn, lead the wealthy to distance themselves from the less fortunate, leading to an erosion of empathy and the virtual marginalization of the unenhanced. This potential future is dystopic, and the transparency and openness to scrutiny of the later on possible more drastic changes to our species, whether by genetic enhancement or cybernetic technologies, would reduce the possibility that we could slide into such a state unwittingly. If a given alteration to humanity is deemed so undesirable that it should be prevented at all costs, knowing what constitutes that kind of alteration and having an open forum to decide its nature and the steps to prevent it is critical. Human augmentation technologies pose subtle changes to human nature, and it is important that we make decisions about these technologies intentionally, rather than let them determine the future of humanity by happenstance.
2. Human Informatics: Guiding the Ethical Development
2.1. Definition and Scope of Human Informatics
2.2. Role of Human Informatics in Technology Development
2.3. Ethical Principles in Human Informatics
3. Human Augmentation Technologies: Enhancing Human Capabilities
3.1. Brain-Computer Interfaces: Expanding Cognitive Abilities
3.2. Wearable Exoskeletons: Enhancing Physical Performance
3.3. Prosthetic Limbs: Restoring Functionality
4. Ethical Considerations in Human Augmentation
4.1. Autonomy and Informed Consent
4.2. Privacy and Data Security
4.3. Equality and Accessibility
5. Ensuring Ethical Use of Human Augmentation Technologies
5.1. Regulatory Frameworks and Policies
5.2. Ethical Design and Development Guidelines
5.3. Education and Awareness
6. Implications of Human Augmentation on Society
6.1. Impact on Employment and Workforce
6.2. Social and Cultural Norms
6.3. Psychological and Emotional Effects
7. Future Perspectives and Challenges
7.1. Emerging Technologies in Human Augmentation
7.2. Balancing Innovation and Ethical Considerations
7.3. Addressing Potential Risks and Unintended Consequences
8. Conclusion

question

1- What does the term ‘germs’ usually refer to? 
2- What do all germs have in common? 
3- Define the term ‘modes of transmission’ and give an example. 
4- What is a major disadvantage to a virus, if it replicates too much, too quickly? 
5- If there’s too little of a virus, what is a disadvantage (to the virus) if you don’t experience any symptoms? 
6- List the characteristics of a successful virus. 
7- What does the trade-off hypothesis predict for rhinovirus? 
8- Why does the malaria virus do not require a mobile host? 
9- What can we do to minimize the harmfulness of infectious diseases?
Answer
1. Introduction to Germs
It is highly improbable that a person of adult age could have lived in a household in a semi-sterile environment or worked in an industry which has top-notch cleanliness. Even though people may not be able to visualize germs, mold, and other biohazardous agents, they are always aware of the precautionary methods and practices which aim to bound these unwanted visitors from the realm of clean indoor living or working space. Whether it is teaching children to wash their hands before meals or, in some cases, after, using antibacterial soaps and lotions or spraying down kitchen and bathroom surfaces with chemical disinfectants, people are fighting a seemingly never-ending battle to rid our living spaces of germs. With the recent outbreak of diseases such as SARS, H1N1 virus, and increasingly high numbers of food poisoning cases, it is becoming more important to have a comprehensive understanding of what a germ is and its role as a causative agent of disease. The infamous people of the pre-germ theory era conducted acts such as opening the abdominal cavities of the deceased using bare hands and with no more protection than a blood-stained apron, to cutting the utensils and items used in surgery and not washing them, have an extreme appreciation of what a germ is and the effect of its presence.
1.1. Definition of ‘Germs’
Enough to be seen with the unaided eye. We will call these invisible living beings germs. This definition includes bacteria, fungi, various parasites, and viruses. Germs are limited by being too small to see without a microscope. Bacteria are made up of only one cell, but they are all around us and on us and even in us. Fungi are multi-celled plant-like organisms (such as mushrooms) that also include single-celled species (such as yeasts) and are also found everywhere, often in the form of mold. Many parasites are large enough to be seen. For example, worms are parasites. But this definition includes some parasites that are too small to be seen, such as the ones that cause malaria, which are single-celled organisms called plasmodia. The only exception to this definition is viruses, which are smaller than the smallest cells. While not all viruses are germs in the usual sense, this definition includes them because they are the cause of very many infectious diseases, and they are the only living organisms whose natural state is to exist only inside cells. Viruses are difficult to classify as microorganisms, as they are not truly alive. But they are invariably disease-causing, and this is the key attribute to germs in the context of infectious diseases.
1.2. Common Types of Germs
Viruses are small capsules containing genetic material. They are parasites in other organisms, including people, causing a range of diseases. The common cold, influenza, and warts are all caused by viruses. A virus can only reproduce within the cells of the host it invades, as it reprograms the cell to produce the components necessary for its replication. In most cases, viruses damage or kill the cells, then lie dormant for a period of time before reappearing, causing extensive long-term damage. The cell damage and the immune system’s response to the infection cause the symptoms of viral diseases. The immune system usually eliminates the virus from the body, and the infection is resolved. However, in some cases, such as HIV and Epstein-Barr, the virus evades the immune system, and the infection becomes chronic. Antiviral drugs are selective for viruses in that they can impair virus replication without harming normal host cells. However, due to the difficulty in targeting the viruses and not the host cells, these drugs often have limited effectiveness.
Bacteria are tiny, one-celled creatures that get nutrients from their environments in order to live. In some cases, that environment is a human body. Some bacteria actually cause disease, while others are helpful and even necessary to good health. Lactobacillus bulgaricus, for example, lives in the intestines and helps digest food. The bacteria in yogurt is probably the most known example of Lactobacillus bulgaricus. A few bacteria, such as the mycobacteria, are not harmful in general but can cause disease in a person whose immune system is not working properly. For example, Mycobacterium avium-intracellulare can cause a serious disease. More information is available on this in the Immune System and Disorders Article. Bacteria can cause many types of infections varying in severity. Infections occur as the bacteria try to make the body an environment more suitable for them to live in, reproducing and furthering their harmful effects. In infecting the body, bacteria can damage cells or interfere with cell function. They may release toxins which can damage the whole body. This then becomes a generalized infection. Symptoms of infection can vary but often include inflammation, fever, and fatigue. Bacterial infections are usually treated with antibiotics, which are chemicals designed to destroy or weaken the bacteria. High-level or broad-spectrum antibiotics are effective against a wide range of bacteria, and low-level antibiotics are often used to keep certain bacteria at bay. Amoxicillin use for prevention of Urinary Tract infections is an example of this. Antibiotics seldom have no effect on symptoms since they may cause removal of the bacteria and toxins that have caused damage or particular symptoms. Antibiotics have had a major impact on the length and severity of bacterial infections and on general public health.
Many people are familiar with the term “germs” referring to the tiny, microscopic organisms that cause disease. Until the invention of the microscope, scientists did not realize that germs existed, and people thought that disease was caused by bad air, spirits, a punishment from a god or simply fate. However, we now know that 4 main types of germs cause infectious disease. These are bacteria, viruses, fungi, and protozoa. Each of these types has its own structure, behaviors, and effects on the human body.
1.3. Role of Germs in Infectious Diseases
The organisms explained in the previous sections cause disease because they circle the primary location of the infectious organism that multiplies and causes trouble for the host. Now, disease is essentially a battle between two invasive organisms: the germ and the human. Disease occurs when the germ is successful in the battle with the human. The severity of that battle is what determines the severity of the disease. They are successful at causing disease when there is a portal of entry available to them. They are able to attach to the cells, grow and multiply, remain undetected by the immune system, and then cause damage to the cells and tissues. Germs in general are very adaptable, and that is why they are very successful at causing disease. Unfortunately, not all new strategies for the germ are successful in overcoming the immune system and resulting in disease. An example of this is the common cold, where there are over 200 different viruses that cause cold-like symptoms. Usually, it is insufficient in overcoming the immune system to cause serious illness, and symptoms of disease are only mild. This is known as colonization of the host, and many common diseases are simply a result of the germ trying to colonize and the battle between the germ and human causing only mild disease.
2. Common Characteristics of Germs
2.1. Key Features of Germs
2.2. Similarities Among Different Types of Germs
2.3. Importance of Understanding Germs’ Commonalities
3. Modes of Transmission
3.1. Definition of ‘Modes of Transmission’
3.2. Examples of Different Modes of Transmission
3.3. Significance of Understanding Transmission Methods
4. Viral Replication and Disadvantages
4.1. Consequences of Excessive Virus Replication
4.2. Negative Impact of Rapid Virus Replication
4.3. Effects of Overabundance on Virus Survival
5. Implications of Low Virus Levels
5.1. Disadvantages of Insufficient Virus Presence
5.2. Lack of Symptoms and Virus Survival
5.3. Importance of Detecting Low Virus Levels
6. Characteristics of Successful Viruses
6.1. Traits of Highly Effective Viruses
6.2. Factors Contributing to Virus Success
6.3. Understanding Successful Virus Traits
7. Trade-Off Hypothesis for Rhinovirus
7.1. Predictions Based on the Trade-Off Hypothesis
7.2. Implications for Rhinovirus Survival
7.3. Analyzing the Trade-Off Hypothesis in Rhinovirus
8. Malaria Virus and Host Mobility
8.1. Factors Influencing Malaria Virus Transmission
8.2. Lack of Mobile Host Requirement in Malaria Virus
8.3. Understanding Malaria Virus Transmission Mechanisms
9. Minimizing Harmfulness of Infectious Diseases
9.1. Strategies for Controlling Infectious Diseases
9.2. Importance of Preventive Measures
9.3. Promoting Public Health Initiatives

question
1. The chapter on time management describes priority setting as a critical step in good time management.  Give an example where you personally or have seen a leader fall into one of the time wasters described in the chapter-why did this behavior create time waste?  What are some strategies you have developed to minimize wasted time and analyze how might you apply these?
2. The text states that fiscal planning should reflect the organizations philosophy, goals and objectives.  What evidence of this have you discovered in your employment?
3. Briefly describe your experience or exposure to health care finances.  Evaluate how this has this helped you in being more conscious of balancing cost and quality?
4. Develop a career map for your 5, 10 and 20 year career goals. See learning exercise in Chapter 11 for more details.  You may wish to “Google”  Career Map for some ideas. (application)
5. Analyze the benefits of creating a resume. (analysis).   Appraise steps (if any) you have made towards building your resume such as what can/should be included (evaluation)

Answer
1. Time Management and Priority Setting
It is also possible to distinguish between a time waster and a time spender. Measures of time and how it is spent often reveal a common pattern in research. People who are disorganized and lack time management often feel that they need more time to get work done and often say “I haven’t got enough time.” The truth is, they have enough time for what they want to do. They often have a high amount of wasted time or what we refer to as “lost time.” This is time that they cannot account for with specific results utilizing the time. High amounts of lost time correlate with lower efficiency in work. A time spender is different; they enjoy their free time and generally feel that they are well organized.
In the Ford example, he did not realize his phone call was pre-empting an agenda item, he lacked verbal skills, and he did not take any follow-up action. This is the behavior of someone who is not skilled in time management. Wasted time can be classified into two different types: internal and external time. The behavior demonstrated in the phone call has caused Dart to experience external time, which is a gap in results. Ford’s lack of verbal skills and failure to take action has caused him to lose time that could have been spent on the agenda item. This has caused internal time, which is time spent doing something different from what was intended. The simplest way to identify wasted time is to compare actual results to desired results in work, home, or study loads. Time is wasted if there is no match in results.
Effective time management is a person who is skillful, organized, and experienced in their work and other daily activities. “Time management” is the process of exercising conscious control over how much time to spend on specific activities. People who don’t know the importance of time always let time control them. In fact, they will lose one thing that they’ll never get again in the rest of their life: time. But for people who understand the importance of time, they are able to do all of their wants and even more. They can also find free time to rest their body and mind. The purpose is that they can find happiness in what they achieve because they can utilize their time effectively. Usually, everyone wants to achieve the best result in the work they do. But sometimes, and often, something can disrupt their work, making the time they spend useless. Wasted time is the gap between expected and actual results in work.
1.1. Example of a Leader Falling into a Time Waster
In the following section, we have an example of a leader who fell into a time waster which Snow has described to be one of the time wasters, comfort. At her previous place of employment, the company developed a system and tool to effectively track and manage employees’ goals and the contribution of each employee towards those goals. The leaders at each level had a set of goals and it was required that they spend at least 5-10% of their time performing activities that directly contributed to those goals. The Vice President level leaders and above were to be assessed yearly based on their efforts towards those goals. Snow’s role was to support company-wide development and in very large part through developing front line employees to be able to take on more responsibilities and excel into higher level positions. He had a great deal of autonomy as to how he would do this and his ultimate goal was to create a larger development organization and then fill it with more developed internal candidates. At the time, there was a very good chance that the system and tools used to track leadership’s goals would be utilized by development which is what led Snow to want to figure out how to get development ‘ready’ for going through the leadership track. He decided that if he were to look at the potential leaders in the development organization as the future leaders he was developing now, he could angle some developmental work with them in a way that would directly benefit leadership in addition to benefiting the individuals. This had occurred to him in late 2006 and the turning point which led to his time wasting happened at a later date. In describing this example we will first show how the behavior was normal and this is key to identifying time wasting behaviors. We will do this by comparing the old behavior to the new time wasting behavior, followed by a then and now comparison. The old and new needs to be chronologically accurate and the then and now should be a side by side comparison of how things were done before compared to now.
1.2. Analysis of Time Waste Caused by the Behavior
The leader spends a significant amount of time responding to emails in an attempt to keep his inbox in single figures. While it is important for a leader to be responsive, it is not necessary to respond to every email as soon as it hits the inbox. The majority of emails can be directed to the trash or a subfolder, the sender can be advised to take alternative action or it may not require a response at all. By cleaning his inbox, the leader is placing a high priority on a task that can easily be delegated to others. This behavior has the potential to impact the efficiency of subordinates who may be awaiting replies or further instructions on the task. In this instance, the leader had wasted his own time and that of his subordinates with little benefit to the achievement of organizational goals.
This section provides a description of how leaders waste time and the impact their time wasting behavior has on subordinates and organizational goals. It is intended to be used as an educational tool to help leaders identify time wasting behavior in themselves and others and understand the repercussions of that behavior. A case can then be made as to why certain time management and priority setting strategies would be beneficial.
1.3. Strategies to Minimize Wasted Time
The more you can increase your awareness of how you are using your time, the easier it will be to identify where and how your time is wasted. Keep a detailed daily diary of how you are using your time. This can be quite tedious and take some effort, as it’s best to write down what you are doing as you are doing it. After a few days to a week, review your diary and identify your time-wasting activities. Determine what the causes or triggers are for those activities, as well as the associated thoughts and emotions. The more you can increase your awareness of the thoughts and emotions that lead to time-wasting activities, the better chance you have of preventing them. With that knowledge, identify alternative activities that are more constructive and better serve your goals. Now schedule the alternative activities, taking into consideration when and where is the best time to do them. This is known as a situational self-management plan, and it is a very effective way to change behavior.
Each of the strategies suggested takes a proactive approach to minimize potential time wasted. Set clear goals and prioritize tasks. If unsure as to what tasks to prioritize, then apply a SMART criteria to determine what are the best courses of action to take. When you set specific goals with measurable outcomes, it is easier to prioritize the tasks at hand. An example of a specific goal is to increase the efficiency of a specific task so that it will take less time. Then you would measure the time the task takes periodically after implementing changes to determine whether the intended outcome had been met. A specific goal that has a measurable outcome provides a strong sense of accomplishment and will help you prioritize tasks.
1.4. Application of Strategies in Personal Context
Frequently, I believe that the quickest way to do an activity is to do it myself. In the short term, that is frequently true. On the other hand, the time I spend teaching the other person to take on the task in my place will frequently save time in the long term and can also lead to a higher quality outcome. I am prepared to admit that I often take the easy option of doing it myself as I frequently convince myself that I can complete the task quicker than explaining what needs to be done to someone else. If I can change this behavior and actually judge whether the task is worth doing myself or delegating it to someone else, I can use my saved time on more strategic tasks. This will involve some assessment of the task in terms of priority and also the other person’s skill/knowledge level. This is something that I will have to develop with practice, trial and error.
Personal strategies for minimising wasted time in my job…
2. Fiscal Planning Aligned with Organizational Philosophy, Goals, and Objectives
2.1. Evidence of Alignment in Employment
3. Experience and Exposure to Healthcare Finances
3.1. Brief Description of Experience
3.2. Evaluation of Increased Consciousness in Balancing Cost and Quality
4. Career Mapping for 5, 10, and 20 Year Goals
4.1. Development of Career Map
4.2. Utilizing Learning Exercise in Chapter 11
4.3. Exploration of Career Map Examples
5. Benefits of Creating a Resume
5.1. Analysis of Resume Benefits

question
 In this discussion, explain and describe the Emergency Management Plan: Financial Management. How does financial management play a significant role in planning for tactical and operational endeavors? 
Answer
1. Introduction
Financial management is one of the key elements of every management plan. It provides the systematic approach in which the organization could allocate the financial resources to operational and capital requirements. This is defined by Pride et al. (2006), in which financial management is the operational activity whereby the funds of an organization are allocated and controlled to attain the organizational objectives. The principal objective of financial management in emergency management planning is to provide the most effective and efficient approach in which the organization could utilize the financial resources to prepare for, respond to, and recover from any potential emergencies or disasters. This also includes disaster risk reduction activities in which the organization could minimize the probability of a disaster occurring.
As this research paper is a management plan on financial management, the definition of an “Emergency Management Plan” stated by the Emergency Management Australia (2004) is “a plan that identifies measures which can be taken to eliminate hazards, reduce risk, and prepare for, respond to, and recover from a disaster.”
The research-based emergency management essay should be a tutorial and a management tool in which the emergency management plan would be developed effectively and efficiently. For emergency management plans to be effectively developed for the city or the municipality, the emergency management needs to understand what an emergency management plan is and its importance.
1.1. Definition of Emergency Management Plan
The emergency management planning process should take an “all hazards” approach given that the impacts of many hazards can be mitigated in similar ways and that it is hard to predict the type of disaster that will befall a particular place or community. An all hazards approach ensures that the strategy is relevant and useful to a broad range of scenarios. The emergency management plan will then identify and prioritize the most significant risks to be addressed. Note that in the context of a household emergency management plan, a “risk” may be any unplanned event that has the potential to disrupt the normal routine of the household.
An emergency management plan is simply the application of managerial process to the creation of a strategy that will allow the best chance of preserving the safety of a defined group at a point in time in the future.
An emergency management plan serves as a “road map” of sorts for how to keep your family safe and respond in an emergency. An emergency management plan is a dynamic guide for changing circumstances to minimize damage and ensure the safety and security of you and your family. This plan should be assembled by the head of the household and disseminated to each family member. It should identify the specific roles and responsibilities of family members in the context of the risk scenarios identified and the preparation and response strategies that will follow.
1.2. Importance of Financial Management in Emergency Management Planning
Effective financial management is an integral part of the overall emergency management plan. In every stage of emergency management, it is crucial to mobilize resources and spend funds wisely. Recurring natural disasters in various countries have encouraged emergency management authorities to consider providing funding for recovery and preparedness activities, in addition to response efforts. But despite the consensus that sound financial management is essential in emergency management, there has been little empirical research on the topic, and there is no clear understanding of what comprises good financial management in the emergency management context. This paper, based on a recently completed Ph.D. thesis, begins by defining financial management in the context of emergency management and establishing the significance of the topic. The subsequent section discusses various types of resources that are available to finance emergency management activities, and identifies the trends and imbalances regarding the allocation of resources between mitigation and preparedness activities, and response and recovery activities. The paper then presents a delineation of the key components of emergency management finance, and explains how accounting and accountability fit into the wider financial management framework.
2. Fund Allocation
2.1. Determining Financial Needs
2.2. Budgeting for Emergency Response Efforts
2.3. Allocating Funds to Different Operational Areas
3. Resource Acquisition
3.1. Identifying Funding Sources
3.2. Applying for Grants and Financial Assistance
3.3. Establishing Partnerships with Organizations for Financial Support
4. Financial Risk Assessment
4.1. Evaluating Potential Financial Risks
4.2. Developing Contingency Plans for Financial Emergencies
4.3. Mitigating Financial Risks through Insurance and Contracts
5. Financial Reporting
5.1. Establishing Financial Reporting Mechanisms
5.2. Monitoring and Tracking Financial Expenditures
5.3. Generating Financial Reports for Transparency and Accountability
6. Financial Auditing
6.1. Conducting Regular Financial Audits
6.2. Ensuring Compliance with Financial Regulations and Policies
6.3. Identifying Areas for Improvement in Financial Management
7. Cost-Benefit Analysis
7.1. Assessing the Cost Effectiveness of Emergency Management Strategies
7.2. Analyzing the Benefits and Returns on Financial Investments
8. Financial Training and Education
8.1. Providing Financial Management Training for Emergency Management Personnel
8.2. Enhancing Financial Literacy within the Emergency Management Team
8.3. Promoting Financial Awareness among Stakeholders
9. Financial Planning for Recovery
9.1. Developing Financial Strategies for Post-Emergency Recovery
9.2. Allocating Funds for Reconstruction and Rehabilitation Efforts
9.3. Implementing Long-Term Financial Plans for Sustainable Recovery
10. Conclusion

1. Introduction
Now there are so many emerging technologies that can help therapy, and one of them is a mobile app. A mobile app has very broad access and is suitable for use in reminder and monitoring systems. It can be an alternative to the reminder systems that have been tried using short message service. This mobile app can provide added value in a reminder system because it can have a direct connection to monitoring. Furthermore, this app might facilitate more patients with a variety of features, for example, a simple reminder with a calendar display, education using video, and a chat with medical personnel.
Enhancing adherence to medication can be done in many ways. The previous meta-analysis showed that adherence could improve significantly using reminding systems. The reminder systems themselves can be tailored to the patient’s problem, for example, reminders for patients who are forgetful or education for patients who do not take the meds due to their beliefs. Although reminding systems have proved to be effective at improving adherence, there was not one patient who did not go back to non-adherence. Patients stop taking their meds because they feel no benefit or the meds cause adverse effects. To detect this, a monitoring system is needed. The monitoring can detect whether a patient is still taking their meds and what the outcome of the meds is. This information can be used as feedback to the patient because the patient is still not aware that what they are feeling now is the result of discontinuation of meds. Detection of the outcome of meds is used as a consideration for doctors whether to adjust or change the therapy that has been done. Taking it a step further, the result of monitoring can also be used as evidence for research on the meds. Although so promising, there was not one study that reported using monitoring systems for meds. This drug monitoring can be a bridge to the continuation of the use of reminding systems.
Adherence to medication is so essential that without it, it can cause serious health problems, even death. There are so many clinical studies that have observed the problem of low adherence to medication and have tried to explain it. One of the studies showed that non-adherence to meds reaches 4% – 23% in developed countries, 2% – 59% in developing countries, and 1% – 50% in developed countries. Another study reviewed adherence to meds in long-term therapy in more detail and concluded that most of the patients stopped taking their meds when the meds showed no benefit for them or when the meds caused adverse effects. Low adherence to medication happens not only in developing countries but also in developed countries with different kinds of health problems and meds. This leads to the necessity of finding any method to improve adherence to medication.
1.1. Background
Improved adherence to medication could save many lives and reduce health care costs. Reasons given for poor adherence are varied. They include patient beliefs about their illness and medication (e.g. what it is, its cause, expected duration and perceived severity), characteristics of the treatment regimen (e.g. complexity, duration and side effects) and also importantly, characteristics of the patient. This is a substantial task for the healthcare professional to identify and try to change in order to improve adherence. High rates of poor adherence led to recommendations to assess patient adherence on each visit. However, patients have been shown to overestimate their adherence and many physicians do not accurately assess their patient’s adherence [4]. A study of orthopaedic outpatients found a 40% discrepancy between physician and patient reports of recommended treatment regimens [5]. A more accurate and convenient method of monitoring patient adherence is needed.
The World Health Organisation recognises that improving adherence to medication is crucial to improving health outcomes. Patients with chronic conditions often do not adhere to their medication regimens. A review of 569 studies examining adherence to long-term medication regimens found that on average 24% of doses were not taken; adherence was 75%; and half of the patients stopped their medication within a year [2]. Poor adherence is a major cause of increased morbidity and mortality as well as a reduced quality of life. A study of 96,000 hypertensive patients found that a 20% decrease in adherence was associated with a 14% increase in the risk of death or MI [3]. It is estimated that increasing adherence to medication regimens would have a greater impact on the health of the population than any improvement in specific medical treatments.
1.2. Purpose
The purpose of this essay is to examine the effect of enhanced therapy and drug monitoring on medication adherence. It will also discuss the use of technology in aiding medication adherence. The focus is on the improvements in adherence resulting from the use of a combined intervention of a modified directly observed therapy (MDOT) monitoring system in conjunction with home-based video in asthmatic children and their caregivers. This intervention has not been discussed in prior studies and the early evidence of its efficacy is encouraging. Asthma is chosen as the model disease because of its prevalence, high rate of hospitalization, and necessity for preventative therapy. With the high usage of inhaled corticosteroids and their known side effects, adherence must make adherence a primary concern in the care of pediatric asthma. This essay will use this ongoing study as a reference in the relationship between adherence and clinical outcome. The evidence from other studies on the effects of adherence on clinical outcome will be cited to show the importance of adherence in the care of chronic illness. Technology has been widely used to monitor adherence, and this essay will examine its effect in comparison to traditional methods of adherence monitoring. This essay will also explore possible future advances in medical adherence and how they may affect clinical outcomes in chronic illness.
1.3. Scope
The scope of this essay is to determine if medication adherence among adults 18-64 years of age with a diagnosis of schizophrenia can be increased through the use of technology-assisted therapy drug monitoring and to identify barriers to use of the technology. Medications to treat chronic conditions have often proven to be effective; however, only if taken as prescribed. Among individuals with schizophrenia, nonadherence to antipsychotic medications can range from 40-89% and tends to be highest during the first few months after initial prescription. Nonadherence with antipsychotic regimens can result in a higher risk of relapse, rehospitalization, and suicide-related events and is also associated with higher total costs of care. Types of adherence measurement in the research included: pill count, self-report, clinician rating, monitoring of appointments, and biochemical measures. The most often used approach to measure medication adherence is a patient self report which tends to overestimate adherence levels. Due to limitations of research designs and cultural differences in validity of adherence measures, it is suggested that multiple measures should be used in adherence research. An interactive Voice Response System was found to be effective in specifically identifying nonadherent individuals and inquiring about their reasons for nonadherence. However, this method does not assess actual medication taking, relies on a landline telephone, and is no longer commonly used. Currently the most effective way to monitor medication adherence is using electronic methods. Assessment of electronic monitoring adherence interventions found a significant but small effect in improving adherence when compared to control groups (OR=1.50, 95% CI 1.19-1.90). Due to the findings of this meta-analysis, our research question, was there a change in adherence to antipsychotic medications among adults with schizophrenia after the use of technology-assisted therapy drug monitoring, is relevant in the determination of more effective methods for improving medication adherence.
2. Importance of Medication Adherence
2.1. Impact on Patient Outcomes
2.2. Economic Implications
2.3. Challenges in Medication Adherence
3. Technology-Assisted Therapy
3.1. Definition and Overview
3.2. Types of Technology-Assisted Therapy
3.2.1. Mobile Applications
3.2.2. Smart Pill Dispensers
3.2.3. Electronic Monitoring Devices
4. Drug Monitoring in Medication Adherence
4.1. Role of Drug Monitoring
4.2. Methods of Drug Monitoring
4.2.1. Urine Drug Testing
4.2.2. Blood Testing
4.2.3. Saliva Testing
5. Benefits of Technology-Assisted Drug Monitoring
5.1. Real-Time Data Collection
5.2. Improved Accuracy and Compliance
5.3. Enhanced Patient Engagement
6. Challenges and Limitations
6.1. Privacy and Security Concerns
6.2. Technological Barriers
6.3. Patient Acceptance and Adoption
7. Case Studies
7.1. Case Study 1: Implementation of Mobile Applications
7.2. Case Study 2: Smart Pill Dispenser Pilot Program
7.3. Case Study 3: Electronic Monitoring Device in Clinical Trials
8. Future Directions and Innovations
8.1. Artificial Intelligence in Medication Adherence
8.2. Wearable Technology for Drug Monitoring
8.3. Integration with Electronic Health Records