Search results for: home delivery

Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

Abstract:

Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint

Procedia PDF Downloads 391

Authors: Asem Alhnity, Nicholas Pickett

Abstract:

The leisure home industry is experiencing an increase in sales due to the rise in popularity of staycations. However, there is also a demand for improvements in thermal and structural behaviour from customers. Existing standards and codes of practice outline the requirements for leisure home design. However, there is a lack of expertise in applying Finite Element Analysis (FEA) to complex structures in this industry. As a result, manufacturers rely on standardized design approaches, which often lead to excessively engineered or inadequately designed products. This study aims to address this issue by investigating the impact of the habitation structure on chassis performance in leisure homes. The aim of this research is to comprehensively analyse the impact of the habitation structure on chassis performance in leisure homes. By employing FEA on the entire unit, including both the habitation structure and the chassis, this study seeks to develop a novel framework for designing and analysing leisure homes. The objectives include material reduction, enhancing structural stability, resolving existing design issues, and developing innovative modular and wooden chassis designs. The methodology used in this research is quantitative in nature. The study utilizes FEA to analyse the performance of leisure home chassis under various loads. The analysis procedures involve running the FEA simulations on the numerical model of the leisure home chassis. Different load scenarios are applied to assess the stress and deflection performance of the chassis under various conditions. FEA is a numerical method that allows for accurate analysis of complex systems. The research utilizes flexible mesh sizing to calculate small deflections around doors and windows, with large meshes used for macro deflections. This approach aims to minimize run-time while providing meaningful stresses and deflections. Moreover, it aims to investigate the limitations and drawbacks of the popular approach of applying FEA only to the chassis and replacing the habitation structure with a distributed load. The findings of this study indicate that the popular approach of applying FEA only to the chassis and replacing the habitation structure with a distributed load overlooks the strengthening generated from the habitation structure. By employing FEA on the entire unit, it is possible to optimize stress and deflection performance while achieving material reduction and enhanced structural stability. The study also introduces innovative modular and wooden chassis designs, which show promising weight reduction compared to the existing heavily fabricated lattice chassis. In conclusion, this research provides valuable insights into the impact of the habitation structure on chassis performance in leisure homes. By employing FEA on the entire unit, the study demonstrates the importance of considering the strengthening generated from the habitation structure in chassis design. The research findings contribute to advancements in material reduction, structural stability, and overall performance optimization. The novel framework developed in this study promotes sustainability, cost-efficiency, and innovation in leisure home design.

Keywords: static homes, caravans, motor homes, holiday homes, finite element analysis (FEA)

Procedia PDF Downloads 79

Authors: Samuel Fernandes, Dylan Kato, Emin Burak Onat, Patrick Keyantuo, Raja Sengupta, Amine Bouzaghrane

Abstract:

The COVID-19 pandemic has spread across the United States, forcing cities to impose stay-at-home and shelter-in-place orders. Building operations had to adjust as non-essential personnel worked from home. But as buildings prepare for personnel to return, they need to plan for safe operations amid new COVID-19 guidelines. In this paper we propose a methodology for capacity and flow modeling of personnel within buildings to safely operate under COVID-19 guidelines. We model personnel flow within buildings by network flows with queuing constraints. We study maximum flow, minimum cost, and minimax objectives. We compare our network flow approach with a simulation model through a case study and present the results. Our results showcase various scenarios of how buildings could be operated under new COVID-19 guidelines and provide a framework for building operators to plan and operate buildings in this new paradigm.

Keywords: network analysis, building simulation, COVID-19

Procedia PDF Downloads 142

Authors: Yihenew Simegniew Birhan, Hsieh Chih Tsai

Abstract:

The recent advancements in synthetic chemistry and nanotechnology fostered the development of different nanocarriers for enhanced intracellular delivery of pharmaceutical agents to tumor cells. Polymeric micelles (PMs), characterized by small size, appreciable drug loading capacity (DLC), better accumulation in tumor tissue via enhanced permeability and retention (EPR) effect, and the ability to avoid detection and subsequent clearance by the mononuclear phagocyte (MNP) system, are convenient to improve the poor solubility, slow absorption and non-selective biodistribution of payloads embedded in their hydrophobic cores and hence, enhance the therapeutic efficacy of chemotherapeutic agents. Recently, redox-responsive polymeric micelles have gained significant attention for the delivery and controlled release of anticancer drugs in tumor cells. In this study, we synthesized redox-responsive diselenide bond containing amphiphilic polymer, Bi(mPEG-PLGA)-Se₂ from mPEG-PLGA, and 3,3'-diselanediyldipropanoic acid (DSeDPA) using DCC/DMAP as coupling agents. The successful synthesis of the copolymers was verified by different spectroscopic techniques. Above the critical micelle concentration, the amphiphilic copolymer, Bi(mPEG-PLGA)-Se₂, self-assembled into stable micelles. The DLS data indicated that the hydrodynamic diameter of the micelles (123.9 ± 0.85 nm) was suitable for extravasation into the tumor cells through the EPR effect. The drug loading content (DLC) and encapsulation efficiency (EE) of DOX-loaded micelles were found to be 6.61 wt% and 54.9%, respectively. The DOX-loaded micelles showed initial burst release accompanied by sustained release trend where 73.94% and 69.54% of encapsulated DOX was released upon treatment with 6mM GSH and 0.1% H₂O₂, respectively. The biocompatible nature of Bi(mPEG-PLGA)-Se₂ copolymer was confirmed by the cell viability study. In addition, the DOX-loaded micelles exhibited significant inhibition against HeLa cells (44.46%), at a maximum dose of 7.5 µg/mL. The fluorescent microscope images of HeLa cells treated with 3 µg/mL (equivalent DOX concentration) revealed efficient internalization and accumulation of DOX-loaded Bi(mPEG-PLGA)-Se₂ micelles in the cytosol of cancer cells. In conclusion, the intelligent, biocompatible, and the redox stimuli-responsive behavior of Bi(mPEG-PLGA)-Se₂ copolymer marked the potential applications of diselenide-linked mPEG-PLGA micelles for the delivery and on-demand release of chemotherapeutic agents in cancer cells.

Keywords: anticancer drug delivery, diselenide bond, polymeric micelles, redox-responsive

Procedia PDF Downloads 96

Authors: Daniel Klimovský

Abstract:

Slovakia belongs to the most fragmented countries if one looks at its local government structure. The Slovak central governments implemented both broad devolution and fiscal decentralization some decades ago. However, neither territorial consolidation nor size categorization of local competences and powers has been implemented yet. Taking this fact into account, it is clear that the local governments are challenged not only by their citizens as customers but also by effectiveness as well as efficiency of delivered services. The paper is focused on behavior of the local governments in Slovakia and their approaches towards other local partners, including other local governments. Analysis of set of interviews shows that inter-municipal cooperation is the most common local partnership in Slovakia, but due to diversity of the local governments, this kind of cooperation leads to both intended and unintended outcomes. While in many cases the local governments are more efficient as well as effective in delivery of local services thanks to inter-municipal cooperation, there are many cases where inter-municipal cooperation fails, and it brings rather questionable or even negative outcomes.

Keywords: local governments, local partnerships, inter-municipal cooperation, delivery of local services

Procedia PDF Downloads 241

Authors: Pankaj Kumar Kalita

Abstract:

Ineffectiveness of formal institutional mechanisms such as official audit to improve public service delivery has been a serious concern to scholars working on governance reforms in developing countries. Scholars argue that public service delivery in local self-governing institutions can be improved through application of informal mechanisms such as social accountability. Social accountability has been reinforced with the engagement of citizens and civic organizations in the process of service delivery to reduce the governance gap in developing countries. However, there are challenges that may impede the scope of establishing social accountability initiatives in the performance of local self-governing institutions. This study makes an attempt to investigate the factors that may impede the scope of establishing social accountability, particularly in culturally heterogeneous societies like India. While analyzing the implementation of two rural development schemes by Panchayats, the local self-governing institutions functioning in rural Assam in India, this study argues that the scope of establishing social accountability in the performance of local self-governing institutions, particularly in culturally heterogeneous societies in developing countries will be impeded by the absence of inter-caste and inter-religion networks. Data has been collected from five selected districts of Assam using in-depth interview method and survey method. The study further contributes to the debates on 'good governance' and citizen-centric approaches in developing countries.

Keywords: citizen engagement, local self-governing institutions, networks, social accountability

Procedia PDF Downloads 300

Authors: T. Lazzarini, M. Imbiki, P. E. Sutter, G. Borragan

Abstract:

While several strategies, such as the development of more efficient appliances, the financing of insulation programs or the rolling out of smart meters represent promising tools to reduce future energy consumption, their implementation relies on people’s decisions-actions. Likewise, engaging with consumers to reshape their behavior has shown to be another important way to reduce energy usage. For these reasons, integrating the human factor in the energy transition has become a major objective for researchers and policymakers. Digital education programs based on tangible and gamified user interfaces have become a new tool with potential effects to reduce energy consumption4. The B2020 program, developed by the firm “Économie d’Énergie SAS”, proposes a digital platform to encourage pro-environmental behavior change among employees and citizens. The platform integrates 160 eco-behaviors to help saving energy and water and reducing waste and CO2 emissions. A total of 13,146 citizens have used the tool so far to declare the range of eco-behaviors they adopt in their daily lives. The present work seeks to build on this database to identify the potential impact of adopted energy-saving behaviors (n=62) to reduce the use of energy in buildings. To this end, behaviors were classified into three categories regarding the nature of its implementation (Eco-habits: e.g., turning-off the light, Eco-actions: e.g., installing low carbon technology such as led light-bulbs and Home-Refurbishments: e.g., such as wall-insulation or double-glazed energy efficient windows). General Linear Models (GLM) disclosed the existence of a significantly higher frequency of Eco-habits when compared to the number of home-refurbishments realized by the platform users. While this might be explained in part by the high financial costs that are associated with home renovation works, it also contrasts with the up to three times larger energy-savings that can be accomplished by these means. Furthermore, multiple regression models failed to disclose the expected relationship between energy-savings and frequency of adopted eco behaviors, suggesting that energy-related practices are not necessarily driven by the correspondent energy-savings. Finally, our results also suggested that people adopting more Eco-habits and Eco-actions were more likely to engage in Home-Refurbishments. Altogether, these results fit well with a growing body of scientific research, showing that energy-related practices do not necessarily maximize utility, as postulated by traditional economic models, and suggest that other variables might be triggering them. Promoting home refurbishments could benefit from the adoption of complementary energy-saving habits and actions.

Keywords: energy-saving behavior, human performance, behavioral change, energy efficiency

Procedia PDF Downloads 175

Authors: Merve Kadioğlu, Nevin H. Şahin

Abstract:

Purpose: This research is organized to determine the influence of the web-based learning program. The program has been developed to gain information about normal delivery skill that is one of the topics of nursing students who take the woman health and illness. Material and Methods: The methodology of this study was applied as pre-test post-test single-group quasi-experimental. The pilot study consisted of 28 nursing student study groups who agreed to participate in the study. The findings were gathered via web-based technologies: student information form, information evaluation tests, Web Based Training Material Evaluation Scale and web-based learning environment feedback form. In the analysis of the data, the percentage, frequency and Wilcoxon Signed Ranks Test were used. The Web Based Instruction Program was developed in the light of full learning model, Mayer's research-based multimedia development principles and Gagne's Instructional Activities Model. Findings: The average scores of it was determined in accordance with the web-based educational material evaluation scale: ‘Instructional Suitability’ 4.45, ‘Suitability to Educational Program’ 4.48, ‘Visual Adequacy’ 4.53, ‘Programming Eligibility / Technical Adequacy’ 4.00. Also, the participants mentioned that the program is successful and useful. A significant difference was found between the pre-test and post-test results of the seven modules (p < 0.05). Results: According to pilot study data, the program was rated ‘very good’ by the study group. It was also found to be effective in increasing knowledge about normal labor.

Keywords: normal delivery, web-based learning, nursing students, e-learning

Procedia PDF Downloads 160

Authors: Carlos V. Gonzalez

Abstract:

Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

Procedia PDF Downloads 429

Authors: Deepak Kakde, Steve Howdle, Derek Irvine, Cameron Alexander

Abstract:

The poor aqueous solubility is one of the major obstacles in the formulation development of many drugs. Around 70% of drugs are poorly soluble in aqueous media. In the last few decades, micelles have emerged as one of the major tools for solubilization of hydrophobic drugs. Micelles are nanosized structures (10-100nm) obtained by self-assembly of amphiphilic molecules into the water. The hydrophobic part of the micelle forms core which is surrounded by a hydrophilic outer shell called corona. These core-shell structures have been used as a drug delivery vehicle for many years. Although, the utility of micelles have been reduced due to the lack of sustainable materials. In the present study, a novel methoxy poly(ethylene glycol)-b-poly(ε-decalactone) (mPEG-b-PεDL) copolymer was synthesized by ring opening polymerization (ROP) of renewable ε-decalactone (ε-DL) monomers on methoxy poly(ethylene glycol) (mPEG) initiator using 1,5,7-triazabicyclo[4.4.0]dec-5-ene (TBD) as a organocatalyst. All the reactions were conducted in bulk to avoid the use of toxic organic solvents. The copolymer was characterized by nuclear magnetic resonance spectroscopy (NMR), gel permeation chromatography (GPC) and differential scanning calorimetry (DSC).The mPEG-b-PεDL block copolymeric micelles containing indomethacin (IND) were prepared by nanoprecipitation method and evaluated as drug delivery vehicle. The size of the micelles was less than 40nm with narrow polydispersity pattern. TEM image showed uniform distribution of spherical micelles defined by clear surface boundary. The indomethacin loading was 7.4% for copolymer with molecular weight of 13000 and drug/polymer weight ratio of 4/50. The higher drug/polymer ratio decreased the drug loading. The drug release study in PBS (pH7.4) showed a sustained release of drug over a period of 24hr. In conclusion, we have developed a new sustainable polymeric material for IND delivery by combining the green synthetic approach with the use of renewable monomer for sustainable development of polymeric nanomedicine.

Keywords: dopolymer, ε-decalactone, indomethacin, micelles

Procedia PDF Downloads 274

Authors: Muhammad Mehran Arshad Khan, Chengliang Wang, Zou Minhui, Danyal Badar Soomro

Abstract:

Security of the smart home in terms of behavior activity pattern recognition is a totally dissimilar and unique issue as compared to the security issues of other scenarios. Sensor devices (low capacity and high capacity) interact and negotiate each other by detecting the daily behavior activity of individuals to execute common tasks. Once a device (e.g., surveillance camera, smart phone and light detection sensor etc.) is compromised, an adversary can then get access to a specific device and can damage daily behavior activity by altering the data and commands. In this scenario, a group of common instruction processes may get involved to generate deadlock. Therefore, an effective suitable security solution is required for smart home architecture. This paper proposes seamless distributed Scheme which fortifies low computational wireless devices for secure communication. Proposed scheme is based on lightweight key-session process to upheld cryptic-link for trajectory by recognizing of individual’s behavior activities pattern. Every device and service provider unit (low capacity sensors (LCS) and high capacity sensors (HCS)) uses an authentication token and originates a secure trajectory connection in network. Analysis of experiments is revealed that proposed scheme strengthens the devices against device seizure attack by recognizing daily behavior activities, minimum utilization memory space of LCS and avoids network from deadlock. Additionally, the results of a comparison with other schemes indicate that scheme manages efficiency in term of computation and communication.

Keywords: authentication, key-session, security, wireless sensors

Procedia PDF Downloads 303

Authors: Fei Ye, Åsa Barrefelt, Manuchehr Abedi-Valugerdi, Khalid M. Abu-Salah, Salman A. Alrokayan, Mamoun Muhammed, Moustapha Hassan

Abstract:

With appropriate encapsulation in functional nanoparticles drugs are more stable in physiological environment and the kinetics of the drug can be more carefully controlled and monitored. Furthermore, targeted drug delivery can be developed to improve chemotherapy in cancer treatment, not only by enhancing intracellular uptake by target cells but also by reducing the adverse effects in non-target organs. Inorganic imaging agents, delivered together with anti-cancer drugs, enhance the local imaging contrast and provide precise diagnosis as well as evaluation of therapy efficacy. We have developed biodegradable polymeric vesicles as a nanocarrier system for multimodal bio-imaging and anticancer drug delivery. The poly (lactic-co-glycolic acid) PLGA) vesicles were fabricated by encapsulating inorganic imaging agents of superparamagnetic iron oxide nanoparticles (SPION), manganese-doped zinc sulfide (MN:ZnS) quantum dots (QDs) and the anticancer drug busulfan into PLGA nanoparticles via an emulsion-evaporation method. T2-weighted magnetic resonance imaging (MRI) of PLGA-SPION-Mn:ZnS phantoms exhibited enhanced negative contrast with r2 relaxivity of approximately 523 s-1 mM-1 Fe. Murine macrophage (J774A) cellular uptake of PLGA vesicles started fluorescence imaging at 2 h and reached maximum intensity at 24 h incubation. The drug delivery ability PLGA vesicles was demonstrated in vitro by release of busulfan. PLGA vesicles degradation was studied in vitro, showing that approximately 32% was degraded into lactic and glycolic acid over a period of 5 weeks. The biodistribution of PLGA vesicles was investigated in vivo by MRI in a rat model. Change of contrast in the liver could be visualized by MRI after 7 min and maximal signal loss detected after 4 h post-injection of PLGA vesicles. Histological studies showed that the presence of PLGA vesicles in organs was shifted from the lungs to the liver and spleen over time.

Keywords: biodegradable polymers, multifunctional nanoparticles, quantum dots, anticancer drugs

Procedia PDF Downloads 454

Authors: H. S. Kumara

Abstract:

The rapid process of urbanization and the growing number of the metropolitan cities and its region call for better governance in India. This article attempts to argue that spatial planning really matters for measuring the governance at metropolitan scale. These study explore to metropolitan governance and spatial planning and its interrelationship issues, concepts and evolution of spatial planning in India and critically examines the multi actors’ scenario for measuring metropolitan governance by means of spatial planning in context with reviewing various master plans, concept of multi-actors viewpoint on role of spatial planning related to zoning regulations, master plan implementations and effective service delivery issues. This paper argues and concludes that the spatial planning of Bangalore directly impact on measuring metropolitan governance.

Keywords: metropolitan governance, spatial planning, service delivery, multi-actors’, opinion survey, master plan

Procedia PDF Downloads 573

Authors: Lena Ernstgård, Aishwarya M. Dwivedi, Johan Lundström, Gunnar Johanson

Abstract:

A simple inexpensive olfactometer was constructed to enable valid measures of detection threshold of low concentrations of vapours of chemicals. The delivery system consists of seven syringe pumps, each connected to a Tedlar bag containing a predefined concentration of the test chemical in the air. The seven pumps are connected to a 8-way mixing valve which in turn connects to a birhinal nose piece. Chemical vapor of known concentration is generated by injection of an appropriate amount of the test chemical into a Tedlar bag with a known volume of clean air. Complete vaporization is assured by gentle heating of the bag from the outside with a heat flow. The six test concentrations are obtained by adding different volumes from the starting bag to six new Tedlar bags with known volumes of clean air. One bag contains clean air only. Thus, six different test concentrations and clean air can easily be tested in series by shifting the valve to new positions. Initial in-line measurement with a photoionization detector showed that the delivery system quickly responded to a shift in valve position. Thus 90% of the desired concentration was reached within 15 seconds. The concentrations in the bags are verified daily by gas chromatography. The stability of the system in terms of chemical concentration is monitored in real time by means of a photo-ionization detector. To determine lateralization thresholds, an additional pump supplying clean air is added to the delivery system in a way so that the nostrils can be separately and interchangeably be exposed to clean air and test chemical. Odor and lateralization thresholds were determined for three aldehydes; acrolein, crotonaldehyde, and hexanal in 20 healthy naïve individuals. Aldehydes generally have a strong odour, and the selected aldehydes are also considered to be irritating to mucous membranes. The median odor thresholds of the three aldehydes were 0.017, 0.0008, and 0.097 ppm, respectively. No lateralization threshold could be identified for acrolein, whereas the medians for crotonaldehyde and hexanal were 0.003 and 0.39 ppm, respectively. In conclusion, we constructed a simple, inexpensive olfactometer that allows for stable and easily measurable concentrations of vapors of the test chemical. Our test with aldehydes demonstrates that the system produces valid detection among volunteers in terms of odour and lateralization thresholds.

Keywords: irritation, odour delivery, olfactometer, smell

Procedia PDF Downloads 202

Authors: Songul Aktas, Turkan Pasinlioglu, Kiymet Yesilcicek Calik

Abstract:

Introduction: Emphatic approach during labor increases both quality of care and birth satisfaction of mothers. Besides; maternal satisfaction statements and expressions about midwives who assist labor contribute to a positive birth perception and wish to give vaginal delivery again. Aim: The study aimed at investigating the effect of empathy training given to midwives on mothers’ satisfaction with midwives and their birth perception. Material/Method: This experimental study was undertaken between February 2013 and January 2014 at a public hospital in Trabzon Province. The population of the study was composed of mothers who gave vaginal delivery and the sample was composed of 222 mothers determined with power analyzes. Ethical approval and written informed consents were obtained. Mothers who were assisted by midwives during 1st, 2nd and 3rd phases of delivery and first two postpartum hours were included. Empathy training given to midwives included didactic narration, creative drama, psychodrama techniques and lasted 32 hours. The data were collected before the empathy training (BET), right after empathy training (RAET) and 8 weeks later after birth (8WLAB). Mothers were homogenous in terms of socio-demographic, obstetric characteristics. Data were collected with a questionnaire and were analyzed with Chi-square tests. Findings: Rate of mother’s satisfaction with midwives was 36.5% in BET, 81.1% in RAET and 75.7% in 8WLAB. Key mother’s satisfaction with midwives were as follows: 27.6% of mothers told that midwives were “smiling-kind” in BET, 39.6% of them in RAET and 33.7% of them in 8WLAB; 31% of mothers told that midwives were “understanding” in BET, 38.2% of them in RAET and 33.7% of them in 8WLAB; 15.7% of mothers told that midwives were “reassuring” in BET, 44.9% of them in RAET and 39.3% of them in 8WLAB;19.5% of mothers told that midwives were “encouraging and motivating” in BET, 39.8% of them in RAET and 19.8% of mothers told that midwives were “informative” in BET, 45.6% of them in RAET and 35.1% of them in 8WLAB (p<0.05). Key mother’s dissatisfaction with midwives were as follows: 55.3% of mothers told that midwives were “poorly-informed” in BET, 17% of them in RAET and 27.7% of them in 8WLAB; 56.9% of mothers told that midwives were “poorly-listening” in BET, 17.6% of them in RAET and 25.5% of them in 8WLAB; 53.2% of mothers told that midwives were “judgmental-embarrassing” in BET, 17% of them in RAET and 29.8% of them in 8WLAB; 56.2% of mothers told that midwives had “fierce facial expressions” in BET, 15.6% of them in RAET and 28.1% of them in 8WLAB. Rates of mothers’ perception that labor was “easy” were 8.1% in BET, 21.6% in RAET and 13.5% in 8WLAB and rates of mothers’ perception that labor was “very difficult and tiring” were 41.9% in BET, 5.4% in RAET and 13.5% in 8WLAB (p<0.05). Conclusion: The effect of empathy training given to midwives upon statements that described mothers’ satisfaction with midwives and their birth perception was positive. Note: This study was financially funded by TUBİTAK project with number 113S672.

Keywords: empathy training, labor perception, mother’s satisfaction with midwife, vaginal delivery

Procedia PDF Downloads 343

Authors: Ankita Singh, Chandan Gorain, Amirul I. Mallick

Abstract:

Successful adherence of the mucosal epithelial cells is the key early step for Campylobacter jejuni pathogenesis (C. jejuni). A set of Surface Exposed Colonization Proteins (SECPs) are among the major factors involved in host cell adherence and invasion of C. jejuni. Among them, constitutively expressed surface-exposed lipoprotein adhesin of C. jejuni, JlpA, interacts with intestinal heat shock protein 90 (hsp90α) and contributes in disease progression by triggering pro-inflammatory response via activation of NF-κB and p38 MAP kinase pathway. Together with its ability to express in the bacterial surface, higher sequence conservation and predicted predominance of several B cells epitopes, JlpA protein reserves its potential to become an effective vaccine candidate against wide range of Campylobacter sps including C. jejuni. Given that chickens are the primary sources for C. jejuni and persistent gut colonization remain as major cause for foodborne pathogenesis to humans, present study explicitly used chickens as model to test the immune-protective efficacy of JlpA protein. Taking into account that gastrointestinal tract is the focal site for C. jejuni colonization, to extrapolate the benefit of mucosal (intragastric) delivery of JlpA protein, a food grade Nisin inducible Lactic acid producing bacteria, Lactococcus lactis (L. lactis) was engineered to express recombinant JlpA protein (rJlpA) in the surface of the bacteria. Following evaluation of optimal surface expression and functionality of recombinant JlpA protein expressed by recombinant L. lactis (rL. lactis), the immune-protective role of intragastric administration of live rL. lactis was assessed in commercial broiler chickens. In addition to the significant elevation of antigen specific mucosal immune responses in the intestine of chickens that received three doses of rL. lactis, marked upregulation of Toll-like receptor 2 (TLR2) gene expression in association with mixed pro-inflammatory responses (both Th1 and Th17 type) was observed. Furthermore, intragastric delivery of rJlpA expressed by rL. lactis, but not the injectable form, resulted in a significant reduction in C. jejuni colonization in chickens suggesting that mucosal delivery of live rL. lactis expressing JlpA serves as a promising vaccine platform to induce strong immune-protective responses against C. jejuni in chickens.

Keywords: chickens, lipoprotein adhesion of Campylobacter jejuni, immuno-protection, Lactococcus lactis, mucosal delivery

Procedia PDF Downloads 122

Authors: Syed Abdul Rehman Khan

Abstract:

In today’s world, information sharing plays a vital role in successful operations of supply chain; and boost to the profitability of the organizations (end-to-end supply chains). Many researches have been completed over the role of information sharing in supply chain. In this research article, we will investigate the ‘how information sharing can boost profitability & productivity of the organization; for this purpose, we have developed one conceptual model and check to that model through collected data from companies. We sent questionnaire to 369 companies; and will filled form received from 172 firms and the response rate was almost 47%. For the data analysis, we have used Regression in (SPSS software) In the research findings, our all hypothesis has been accepted significantly and due to the information sharing between suppliers and manufacturers ‘quality of material and timely delivery’ increase and also ‘collaboration & trust’ will become more stronger and these all factors will lead to the company’s profitability directly and in-directly. But unfortunately, companies could not avail the all fruitful benefits of information sharing due to the fear of ‘compromise confidentiality or leakage of information’.

Keywords: collaboration, information sharing, risk factor, timely delivery

Procedia PDF Downloads 395

Authors: Anil Bhandari, Imran Khan Pathan, Peeyush K. Sharma, Rakesh K. Patel, Suresh Purohit

Abstract:

The purpose of this study was to prepare time and pH dependent release tablets of Ayurvedic Churna formulation and evaluate their advantages as colon targeted drug delivery system. The Vidangadi Churna was selected for this study which contains Embelin and Gallic acid. Embelin is used in Helminthiasis as therapeutic agent. Embelin is insoluble in water and unstable in gastric environment so it was formulated in time and pH dependent tablets coated with combination of two polymers Eudragit L100 and ethyl cellulose. The 150mg of core tablet of dried extract and lactose were prepared by wet granulation method. The compression coating was used in the polymer concentration of 150mg for both the layer as upper and lower coating tablet was investigated. The results showed that no release was found in 0.1 N HCl and pH 6.8 phosphate buffers for initial 5 hours and about 98.97% of the drug was released in pH 7.4 phosphate buffer in total 17 hours. The in vitro release profiles of drug from the formulation could be best expressed first order kinetics as highest linearity (r2= 0.9943). The results of the present study have demonstrated that the time and pH dependent tablets system is a promising vehicle for preventing rapid hydrolysis in gastric environment and improving oral bioavailability of Embelin and Gallic acid for treatment of Helminthiasis.

Keywords: embelin, gallic acid, Vidangadi Churna, colon targeted drug delivery

Procedia PDF Downloads 339

Authors: Dong-An Wang

Abstract:

All kinds of microspheres have been extensively employed as carriers for drug, gene and therapeutic cell delivery. Most therapeutic cell delivery microspheres rely on a two-step methodology: fabrication of microspheres and subsequent seeding of cells onto them. In this study, we have developed a novel one-step cell encapsulation technique using a convenient and instant water-in-oil single emulsion approach to form cell-encapsulated gelatin microspheres. This technology is adopted for hyaline cartilage tissue engineering, in which autologous chondrocytes are used as therapeutic cells. Cell viability was maintained throughout and after the microsphere formation (75-100 µm diameters) process that avoids involvement of any covalent bonding reactions or exposure to any further chemicals. Further encapsulation of cell-laden microspheres in alginate gels were performed under 4°C via a prompt process. Upon the formation of alginate constructs, they were immediately relocated into CO2 incubator where the temperature was maintained at 37°C; under this temperature, the cell-laden gelatin microspheres dissolved within hours to yield similarly sized cavities and the chondrocytes were therefore suspended within the cavities inside the alginate gel bulk. Hence, the gelatin cell-laden microspheres served two roles: as cell delivery vehicles which can be removable through temperature curing, and as porogens within an alginate hydrogel construct to provide living space for cell growth and tissue development as well as better permeability for mutual diffusions. These cell-laden microspheres, namely “temperature-cured dissolvable gelatin microsphere based cell carriers” (tDGMCs), were further encapsulated in a chondrocyte-laden alginate scaffold system and analyzed by WST-1, gene expression analyses, biochemical assays, histology and immunochemistry stains. The positive results consistently demonstrated the promise of tDGMC technology in delivering these non-anchorage dependent cells (chondrocytes). It can be further conveniently translated into delivery of other non-anchorage dependent cell species, including stem cells, progenitors or iPS cells, for regeneration of tissues in internal organs, such as engineered hepatogenesis or pancreatic regeneration.

Keywords: biomaterials, tissue engineering, microsphere, hydrogel, porogen, anchorage dependence

Procedia PDF Downloads 371

Authors: Timothy Antoniuk

Abstract:

This paper will demonstrate why the most successful and livable cities in the future will require multi-disciplinary designers to develop a deep understanding of peoples’ changing lifestyles, and why new generations of deeply integrated products, services and experiences need to be created. Disseminating research from the UNEP Creative Economy Reports and through a variety of other consumption and economic-based statistics, a compelling argument will be made that it is peoples’ living spaces that offer the easiest and most significant affordances for inducing positive changes to their wellbeing, and to a city’s economic and environmental prosperity. This idea, that leveraging happiness, wellbeing and prosperity through creating new concepts and typologies of ‘home’, puts people and their needs, wants, desires, aspirations and lifestyles at the beginning of the design process, not at the end, as so often occurs with current-day multi-unit housing construction. As an important part of the creative-reflective and statistical comparisons that are necessary for this on-going body of research and practice, Professor Antoniuk created the Micro Habitation Lab (mHabLab) in 2016. By focusing on testing the functional and economic feasibility of activating small spaces with different types of architectural robotics, a variety of movable, expandable and interactive objects have been hybridized and integrated into the architectural structure of the Lab. Allowing the team to test new ideas continually and accumulate thousands of points of feedback from everyday consumers, a series of on-going open houses is allowing the public-at-large to see, physically engage with, and give feedback on the items they find most and least valuable. This iterative approach of testing has exposed two key findings: Firstly, that there is a clear opportunity to improve the macro and micro functionality of small living spaces; and secondly, that allowing people to physically alter smaller elements of their living space lessens feelings of frustration and enhances feelings of pride and a deeper perception of “home”. Equally interesting to these findings is a grouping of new research questions that are being exposed which relate to: The duality of space; how people can be in two living spaces at one time; and how small living spaces is moving the Extended Home into the public realm.

Keywords: architectural robotics, extended home, interactivity, micro living spaces

Procedia PDF Downloads 150

Authors: Abiodun Afolabi, Rufus Adesoji Adedoyin

Abstract:

This study investigated and compared the effects of gym-based exercise programme (GEBP) and audio-visual guided home-based exercise programme (AVGHBEP) on selected Anthropometric variables (Weight (W), Body Mass Index (BMI), Waist Circumference (WC), Hip Circumference (HC), Thigh Circumference (TC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), Waist-Thigh-Ratio (WTR), Biceps Skinfold Thickness (BSFT), Triceps Skinfold Thickness (TSFT), Suprailliac Skinfold Thickness (SISFT), Subscapular Skinfold Thickness (SSSFT) and Percent Body Fat (PBF)); and Cardiovasular variables (Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR)) of overweight and obese students of Federal College of Education (Special), Oyo, Oyo State, Nigeria, with a view to providing information and evidence for GBEP and AVGHBEP in reducing overweight and obesity for promoting cardiovascular fitness. Eighty overweight and obese students (BMI ≥ 25 Kg/m²) were involved in this pretest-posttest quasi experimental study. Participants were randomly assigned into GBEP (n = 40) and AVGBBEP (n = 40) groups. Anthropometric and cardiovascular variables were measured using a weighing scale, height meter, tape measure, skinfold caliper and electronic sphygmomanometer following standard protocols. GBEP and AVGHBEP were implemented following a circuit training (aerobic and resistance training) pattern with a duration of 40-60 minutes, thrice weekly for twelve weeks. GBEP consisted of gymnasium supervised exercise programme while AVGHBEP is a Visual Display guided exercise programme conducted at the home setting. Data were analyzed by Descriptive and Inferential Statistics. The mean ages of the participants were 22.55 ± 2.55 and 23.65 ± 2.89 years for the GBEP group and AVGHBEP group, respectively. Findings showed that in the GBEP group, there were significant reductions in anthropometric variables and adiposity measures of Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR, and PBF at week 12 of the study. Similarly, in the AVGHBEP group, there were significant reductions in Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR and PBF at the 12th week of intervention. Comparison of the effects of GEBP and AVGHBEP on anthropometric variables and measures of adiposity showed that there was no significant difference between the two groups in weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHR, WHtR, WTR and PBF between the two groups at week 12 of the study. Furthermore, findings on the effects of exercise on programmes on cardiovascular variables revealed that significant reductions occurred in SBP in GBEP group and AVGHBEP group respectively. Comparison of the effects of GBEP and AVGHBEP on cardiovascular variables showed that there was no significant difference in SBP, DBP and HR between the two groups at week 12 of the study. It was concluded that the Audio-Visual Guided Home-based Exercise Programme was as effective as the Gym-Based Exercise Programme in causing a significant reduction in anthropometric variables and body fat among college students who are overweight and obese over a period of twelve weeks. Both Gymnasium-Based Exercise Programme and Audio-Visual Guided Home-Based Exercise Programme led to significant reduction in Systolic Blood Pressure over a period of weeks. Audio-Visual Guided Home-Based Exercise Programme can, therefore, be used as an alternative therapy in the non-pharmacological management of people who are overweight and obese.

Keywords: gym-based exercises, audio-visual guided home-based exercises, anthropometric parameters, cardiovascular parameters, overweight students, obese students

Procedia PDF Downloads 18

Authors: Abdel-Aziz M. Mohamed

Abstract:

This research proposes a methodology to estimate the customer order lead time in the supply chain based on the process capability index. The cases when the process output is normally distributed and when it is not are considered. The relationships between the system capability indices in both service and manufacturing applications, delivery system reliability and the percentages of orders delivered after their promised due dates are presented. The proposed method can be used to examine the current process capability to deliver the orders before the promised lead-time. If the system was found to be incapable, the method can be used to help revise the current lead-time to a proper value according to the service reliability level selected by the management. Numerical examples and a case study describing the lead time estimation methodology and testing the system capability of delivering the orders before their promised due date are illustrated.

Keywords: lead-time estimation, process capability index, delivery system reliability, statistical analysis, service achievement index, service quality

Procedia PDF Downloads 545

Authors: Surajj Sarode, G. P. Vadnere, G. Vidya Sagar

Abstract:

Compression coating is one of the strategies for delivering drug to the colon based on Gastrointestinal PH and transit time concept. The main aim of these formulations to develop rapidly disintegrating Zaltoprofen core tablets compression-coated with a mixture of time-dependent hydrophilic swellable polymer HPMC K 15 and PH responsive soluble polymer Chitosan and Guar gum in different ratios. The effect of the proportion of HPMC, Chitosan and Guar gum in the coat on premature drug release in upper part (Stomach and small intestine) of GIT and the amount of drug release in colon target area was studied. The formulations are carried out by using Direct Compression method. Sodium starch Glycolate used for rapid disintegration. FTIR used for Drug-Polymer Interaction studies. The prepared tablets were evaluated for hardness, thickness, friability, in-vitro disintegration, in-Vitro dissolution and in-vitro kinetic study.

Keywords: zaltoprofen, chitosan, formulation, drug delivery

Procedia PDF Downloads 430

Authors: Arindam Pramanik, Parimal Karmakar

Abstract:

We have explored the synergistic anti-cancer activity of copper ion and acetylacetone complex containing 1,3 diketone group (like curcumin) in metallorganic compound “Copper acetylacetonate” (CuAA). The cytotoxicity mechanism of CuAA complex was evaluated on various cancer cell lines in vitro. Among these, reactive oxygen species (ROS), glutathione level (GSH) in the cell was found to increase. Further mitochondrial membrane damage was observed. The fate of cell death was found to be induced by apoptosis. For application purpose, we have developed a novel biodegradable, non-toxic polymer-based nanoparticle which has hydrophobically modified core for loading of the CuAA. Folic acid is conjugated on the surface of the polymer (chitosan) nanoparticle for targeting to cancer cells for minimizing toxicity to normal cells in-vivo. Thus, this novel drug CuAA has an efficient anticancer activity which has been targeted specifically to cancer cells through polymer nanoparticle.

Keywords: anticancer, apoptosis, copper nanoparticle, targeted drug delivery

Procedia PDF Downloads 460

Authors: Khusboo Agrawal, S. Saraf

Abstract:

Quercetin, a flavonol provides a cellular protection against UV induced oxidative damages due to its excellent free radical scavenging activity and direct pro-apoptopic effect on tumor cells. However, its topical use is limited due to its unfavorable physicochemical properties. The present study was aimed to evaluate the potential of mesoporous silica nanoparticles as topical carrier system for quercetin delivery. Complexes of quercetin with mesoporous silica was prepared with different weight ratios and characterized by thermo gravimetric analysis, X-ray diffraction, high resolution TEM, FT-IR spectroscopy, zeta potential measurements and differential scanning calorimetry The protective effect of this vehicle on UV-induced degradation of the quercetin was investigated revealing a certain positive influence of the inclusion on the photostability over time. Epidermal accumulation and transdermal permeation of this molecule were ex vivo evaluated by using Franz diffusion cells. The immobilization of Quercetin in mesoporous silica nanoparticles (MSNs) increased the stability without undermining the antioxidant efficacy.

Keywords: cancer, MSNs, quercetin, topical delivery

Procedia PDF Downloads 287

Authors: Nnadi Ezekiel Ejiofor

Abstract:

The construction industry plays a decisive role in the healthy development of any nation. Not only large but even small construction projects contribute to a country’s economic growth. There is a need for good management to ensure successful delivery and sustainability because of the plethora of risks that have resulted in low-profit margins for contractors, cost and schedule overruns, poor quality delivery, and abandoned projects. This research reviewed Capitalization on Sustainable Risk Management. Questionnaires and oral interviews conducted were utilized as means of data collection. One hundred and ninety-eight (198) large construction firms in Nigeria form the population of this study. 15 (fifteen) companies that emanated from merger and acquisition were used for the study. The instruments used for data collection were a researcher-developed structured questionnaire based on a five-point rating scale, interviews, focus group discussion, and secondary sources (bill of quantities and stock and exchange commission). The instrument was validated by two experts in the field. The reliability of the instrument was established by applying the split-half method. Kendall’s coefficient of concordance was used to test the data, and a degree of agreement was obtained. Data were subjected to descriptive statistics and analyzed using analysis of variance, t-test, and SPSS. The identified impacts of capitalization were an increase in turnover (24.5%), improvement in the image (24.5%), risk reduction (20%), business expansion (17.3%), and geographical spread (13.6%). The study strongly advocates the inclusion of risk management evaluation as part of the construction procurement process.

Keywords: capitalization, project delivery, risks, risk management, sustainability

Procedia PDF Downloads 41

Authors: M. Louise Humbert, Karen E. Chad, Natalie E. Houser, Marta E. Erlandson

Abstract:

Physical literacy is the motivation, confidence, physical competence, knowledge, and understanding to value and takes responsibility for engagement in physical activities for life. In recent years, physical literacy has emerged as a determinant of health, promoting a positive lifelong physical activity trajectory. Physical literacy’s holistic approach and emphasis on the intrinsic valuation of movement provide an encouraging avenue for intervention among children to develop competent and confident movers. Although there is research on physical literacy interventions, no evidence exists on the outcomes of multi-sectoral interventions involving a combination of home, school, and community contexts. Since children interact with and in a wide range of contexts (home, school, community) daily, interventions designed to address a combination of these contexts are critical to the development of physical literacy. Working with school administrators and teachers, sports and recreation leaders, and community members, our team of university and community researchers conducted and evaluated one of the first multi-contextual and multi-sectoral physical literacy interventions in Canada. Schools played a critical role in this multi-sector intervention, and in this project, teachers and administrators focused their actions on developing physical literacy in students 10 to 14 years of age through the instruction of physical literacy-focused physical education lessons. Little is known about the experiences of educators when they work alongside an array of community representatives to develop physical literacy in school-aged children. Given the uniqueness of this intervention, we sought to answer the question, ‘What were the experiences of school-based educators involved in a multi-sectoral partnership focused on creating a physical literacy enriched community intervention?’ A thematic analysis approach was used to analyze data collected from interviews with educators and administrators, informal conversations, documents, and observations at workshops and meetings. Results indicated that schools and educators played the largest role in this multi-sector intervention. Educators initially reported a limited understanding of physical literacy and expressed a need for resources linked to the physical education curriculum. Some anxiety was expressed by the teachers as their students were measured, and educators noted they wanted to increase their understanding and become more involved in the assessment of physical literacy. Teachers reported that the intervention’s focus on physical literacy positively impacted the scheduling and their instruction of physical education. Administrators shared their desire for school and division-level actions targeting physical literacy development like the current focus on numeracy and literacy, treaty education, and safe schools. As this was one of the first multi-contextual and multi-sectoral physical literacy interventions, it was important to document creation and delivery experiences to encourage future growth in the area and develop suggested best practices.

Keywords: physical literacy, multi sector intervention, physical education, teachers

Procedia PDF Downloads 88

Authors: Odufu Ifakachukwu Clifford

Abstract:

Developing country governments are struggling to meet the basic needs and demands of citizens, especially so for the rural poor. With tightly constrained budgets, these governments have followed the lead of developed countries that have sought to restructure public service delivery through privatization, contracting out, public-private partnerships, and similar reforms. Such reforms in service delivery are generally welcomed when it is believed that private sector partners are better equipped to provide certain services than are governments. With respect to basic and essential services, however, a higher degree of uncertainty and apprehension exists as the focus shifts from simply minimizing the costs of delivering services to broadening access to all citizens. The constitution stipulates that everyone has the right to have access to sufficient food and water. Affordable and/or subsidized water, then, is not a privilege but a basic right of all citizens. Citizens elect political representatives to serve in office, with their sole mandate being to provide for the needs of the citizenry. As governments pass on some amount of responsibility for service delivery to private businesses, these governments must be able to exercise control in order to account to the people for the work done by private partners. This paper examines the legislative and policy frameworks as well as the environment within which PPPs take place in South Africa and the extent to which accountability can be strengthened in this environment. Within the aforementioned backdrop of PPPs and accountability, the constricted focus area of the paper aims to assess the extent to which the provision of clean and safe consumable water in South Africa is sustainable, cost-effective in terms of provision, and affordable to all.

Keywords: privatisation, accountability, essential services, government

Procedia PDF Downloads 40

Authors: Yann Jean Tan, Hui Meng Er, Choy Sin Lee, Shew Fung Wong, Wen Huei Lim

Abstract:

Griseofulvin is a long standing fungistatic agent against dermatophytosis. Nevertheless, it has several drawbacks such as poor and highly variable bio availability, long duration of treatment, systemic side effects and drug interactions. Targeted treatment for the superficial skin infection, dermatophytosis via topical route could be beneficial. Nevertheless, griseofulvin is only available in the form of oral preparation. Hence, it generates interest in developing a topical formulation for griseofulvin, by using lipid nano particle as the vehicle. Lipid nanoparticle is a submicron colloidal carrier with a core that is solid in nature (lipid). It has combined advantages of various traditional carriers and is a promising vehicle for topical delivery. The griseofulvin loaded lipid nano particles produced using high pressure homogenization method were characterized and investigated for its skin targeting effect in vitro. It has a mean particle size of 179.8±4.9 nm with polydispersity index of 0.306±0.011. Besides, it showed higher skin permeation and better skin targeting effect compared to the griseofulvin suspension.

Keywords: lipid nanoparticles, griseofulvin, topical, dermatophytosis

Procedia PDF Downloads 437

Authors: Iwona Kasior

Abstract:

Purpose: Pelvic organ prolapse is the descent of pelvic organs into the vaginal opening. Currently, few trials have been conducted to determine the influence of pelvic floor muscle training in decreasing stage or symptoms associated with pelvic organ prolapse. The purpose of this case study is to determine whether pelvic floor muscle training can decrease the stage of pelvic organ prolapse and related symptoms. Case Presentation: This is the case of a 55-year-old female; recently diagnosed with midline cystocele, stage three. She has undergone corrective surgery that failed. She has now resorted to managing the condition with a home exercise regimen of voluntary pelvic floor muscle contractions, topical vaginal crème prescribed by her gynecologist, and slight lifestyle modifications. Methods: The patient was treated by a physical therapist for evaluation, vaginal exam, and educated in the ‘knack’ maneuver, lifestyle modifications, and proper technique of performing pelvic floor muscle contractions. The subject continued with a home exercise program with a specific regimen of pelvic floor muscle contractions and topical vaginal crème. Outcome: As determined by her physical therapist and the subject, her pelvic floor muscle strength had increased following the pelvic floor muscle training regimen and the use of the ‘knack’ maneuver. The subject reported a small decrease in the size of bulging prolapse and related symptoms of dryness, odor, vaginal discomfort, and the sensation of descent. Conclusion: Pelvic floor muscle training helped to lessen the degree of the prolapse, but not significantly enough to decrease the diagnosed stage.

Keywords: Kegel exercises, pelvic floor, pelvic organ prolapse, physical therapy

Procedia PDF Downloads 168