Day 1 :
University of Surrey, UK
Keynote: Primary health care in criminal justice settings with alcohol identification and brief advice: What are the best settings for a randomised controlled trial?
Time : 09:15-09:45
Clive Tobutt is a Registered Nurse (Adult & Mental Health Nursing and Practice Educator). He completed a Post-Graduate Diploma in Addiction Studies at the Institute of Psychaitry, London University and an MSc degree in Sociology (Health & Illness) from London South Bank University. He is currently pursuing PhD at the University of Winchester. He is a Teaching Fellow (Mental Health Nursing) at Surrey University and has been serving as an Editorial Board Member of the Advances of Dual Diagnosis Journal.
To identify areas in the English criminal justice system where deployment of alcohol screening and brief interventions could reduce alcohol consumption and its related harms. This paper is about rapid review of the existing evidence, both for prevalence of alcohol use disorders and the effectiveness of screening and brief interventions in criminal justice settings as well as conducting key informant interviews. There have been no randomised controlled trials in police custody settings, although there have been feasibility studies. There has been only one trial in the magistrates court, and those incarcerated and released from prison would be novel subjects for an RCT. However, with young offenders, there is lack of trails and none from the United Kingdom and with the advancement of AssestPlus screening, it would appear more feasible to embed a research team here than in other criminal justice settings. Suggested settings for further research of alcohol brief interventions are from the magistrates court, prison and youth justice settings. Each present methodological challenges with regards to conducting a RCT, however Youth Justice Settings may offer an advantage above other settings.
Medical Insurance Consulting stp Cannavò & Partners srl, Italy
Time : 09:45-10:15
Giovanni Cannavo is a Medical Legal Expert with a Degree in Medicine, Specialization in Surgery and in Insurance & Legal Medicine. He is the CEO of Medical Insurance Consulting stp Cannavò & Partners srl and Medexpert srl, he is the President of the Scientific Society Melchiorre Gioia and General Secretary of Ceredoc (Confédération Européenne d'Experts en Evaluation et Réparation du Dommage Corporel). He was Component of the European Parliament Member Rothley's Team for drafting the European Barème. He was a Member of the Ministry of Health's Commission to create a Medical Table System for assessing personal injuries. He was a Contributor to drafting the first example of Electronic Medical Report, developed by Medexpert and patent registered in Italy.
In the past, the medical profession was highly respected and prestigious in Italy and all over the world. The doctor-patient relationship was characterized by complete trust and mistakes as well as negligence of clinicians were deemed as misfortunes or fate. In the last 20 years, because of a growing belief in medical science, patients have become intolerant towards medical mistakes and the phenomenon of Medical Malpractice has risen. The extreme consequence of a complete faith in medicine is that patients believe that they can always be cured and, otherwise, they think they are a victim of medical errors. The roots of this relatively new phenomenon can be found in the activities of associations devoted to the defense of patients’ rights resting upon the stronger belief in one’s civil rights, mass media attention to malpractice cases, evolution of jurisprudence in favor of patients together with the rise of esthetic surgery where there is a legal obligation of a favorable result. This has favored lawsuits against doctors in an abnormal manner, thus leading to a congestion of tribunals, the escape from the market of insurance companies and the skyrocketing of insurance costs for doctors which have reached 50,000 euros. On the other hand, doctor’s practice “defensive medicine”, as it was called, rising e.g., laboratory tests and radiological examination prescriptions. In order to contain these expenses, Italian Government issued the first law - Balduzzi Law - that established some limits in favor of clinicians. At present, a new law - Disegno di Legge 2224 - DDL Gelli - was approved by the Higher Chamber (Senate) on 17th January 2017 and should be effective shortly. Our presentation, in the plenary session of the Conference, focuses on the contents of this recently issued law that can stimulate a thought-provoking discussion being it both a reference point for debate and comparison about medical malpractice.
Via Medica International Healthcare, UAE
Time : 10:15-10:45
Amer Alata completed his High School (USA), and higher education at the University of Michigan. He graduated with high distinction; majoring in Psychology and a minor in Philosophy. After his graduation, he earned his Doctor of Medicine; MD degree from Ross University School of Medicine. His career focus was on medical education and training. He held the position of Medical Programs Director at a private institution for over 4 years. He then held other positions including Medical Practice Manager for a chain of successful primary care outpatient urgent care centers in Michigan, USA. His acculturation in the UAE dates back to early 2015. He first held the position of Business Manager for Aster Grace Nursing and Physiotherapy, located in Abu Dhabi. Currently, he holds the position of the Medical Director for Via Medica International Healthcare.
Quality is essential for all types of healthcare settings and even more important in primary healthcare settings as there is a higher flow of patients. In order to ensure quality, each facility ought to set quality metrics. The choice of the quality metrics must be meaningful to the facility, as the outcomes relate to, and impact, the strategy of the facility. Providing high quality care at all times is a challenge, but even more challenging is the choice of the key performance indicators. The learning objectives of this presentation are: Recognizing the importance of quality metrics in primary healthcare setting; developing an understanding of how to select the appropriate key performance indicators (KPIs); demonstrating an understanding of the KPI format and; candidate KPIs for primary healthcare setting. Key performance indicators are simply tools that help us, objectively measure performance. Furthermore, they provide an insight into continuous improvement; paving the way to measure quality and successfully meet targets. Quality metrics, in the form of key performance indicators, help facilities and provider with: Understanding the established process and procedures; clarifying vague processes elements; increasing and measuring efficiency of the process; establishing baseline and comparing own facilities to others, as well as established national and international benchmarks; providing an input into the facility’s strategy, policies, and procedures and; establishing transparency.
- Primary Health Care
Primary Care Medicine
Quality in Primary Care
Family Medicine and Primary Care
Location: JW Marriott Hotel Dubai
McGill University, Canada
Title: A Scoping review of the contextual influences shaping the success of primary care nurse practitioner-led clinics across Canada: What lessons can be gleaned for Quebec?
Time : 11:05-11:25
Norma Ponzoni is a Faculty Lecturer at the McGill Ingram School of Nursing, Quebec, Canada. She is the Academic Coordinator for the Nurse Practitioner Programs. She has graduate degrees in Nursing and Education and is completing her PhD in Educational Psychology at McGill. She has several publications in peer-reviewed journals and is nationally and internationally well-known in the area of nursing education and advanced practice. Her research is focused on primary care and the process by which it can be facilitated and the delivery of professional development to rural regions that make this care possible to isolated populations.
Nurse Practitioner (NP)-led clinics, where NPs retain administrative control, have the potential to address current issues of access to primary care services. In Canada, the government of Ontario successfully established 26 publicly-funded clinics over a 5-year period; while in the neighboring province of Quebec, where similar problems exist, the government has only recently funded one NP-led clinic in 2016 after significant political pressure. Inspired by Ontario’s story, this study aimed to understand the initial context and the factors that eventually made conditions favorable; something that can guide Quebec in its struggles to get NP-led clinics off the ground. Using a scoping approach, we retained 8 papers, of which only one was a published ethnography. We used the Edward’s Whole System Change Model to explain the profound effect and interrelatedness of all contributing factors. Core to explaining this dynamic within the healthcare system is the pervasiveness of the biomedical model and a lack of understanding of the NP’s scope of practice; this influences the conditions by which publically-funded care is remunerated and the level of inter-professional collaboration. NPs ‘rallying’ around the cause and engaging in political lobbying and networking is what seemed to make the difference historically in Ontario, and more recently in Quebec. In conclusion, NP-led clinics are a viable and effective option for a large number of Canadian patients who do not have access to primary care providers.
UCSP Sao Neutel/ FIMS/ ESSM/ GESEX, Portugal
Time : 11:25-11:45
Carla Veiga Rodrigues has completed her Master in ‘Risky behaviors on a student’s population from Vila Nova de Gaia’ from the Health Sciences School at University of Minho. She is currently a GP resident at UCSP São Neutel, Chaves and is an emergency Doctor on the Medical Vehicle of INEM (National Institute of Medical Emergency). She takes a special interest in adolescence and sexuality, being a founding member of FIMS (Iberic Federation of Medicine and Sexuality), an active member of the European Society of Sexual Medicine (ESSM) and the Coordinator of the Sexuality Studies Group from the Portuguese National Family Practitioners Association. She focuses her work on communication skills, presented a workshop on Motivational Interviewing in Wonca Europe 2016 and is currently finishing a book on the subject. She's also Editor of the Scientific Open Access journal 'MGF&Ciências'.
According to the World Health Organization, sexuality is a key aspect of the human being, encompassing sex, gender identity, sexual orientation, eroticism, intimacy and reproduction. Sexuality is broader than the individual experience of sex and it can and should be addressed on consultations as part of a person-centered medical approach. Despite the elevated prevalence of sexual related problems, Sexuality-related Communication (SRC) is often neglected by the General Practitioner. How can we do it and why are we so oblivious to this issue? Are we prepared to do so? Pre-graduate training is scarce and heterogeneous between the profusion of Medical faculties. Post-graduate training is expensive and mainly focused on dysfunction rather than functionality or part of a relationship. Nevertheless, patients expect their doctors to address the topic and studies show that sexual health concerns may never be voiced if the patient is left with the responsibility to introduce it. The lack of comfort, the reluctance to talk about sexuality or the fear of offending the patients limits our performance and makes SRC less clear or objective than it should be, decreasing our ability to educate our patients regarding Sexual Health. Sexual health should be a cornerstone of preventive medicine. In order to improve our skills we must bring SRC to light, face our limitations. Only then we’ll be able to enhance our performance on consultation and create strategies to improve our quality of care to populations.
Mahidol University, Thailand
Title: Attitudes and awareness about organ donation amongst patients visiting Ramathibodi Hospital: An in-depth interview qualitative research
Time : 11:45-12:05
Veerachai Sachdev is a Family Physician specialised in Palliative Medicine and currently studying Master’s in Medical Ethics and Law at the University of Edinburgh, UK. Following completion of Bachelors of Medicine and Surgery at the University of Adelaide, he went into General Practice training in rural parts of South Australia. He returned to Thailand and joined Ramathibodi Hospital, Mahidol University as a part time Consultant involved in Post-graduate and Under-graduate teaching and Palliative Care service. Organ transplantation has shown to benefit patients who receive the organ by having a better quality of life, with renal transplant being the most common transplanted organ worldwide. Whilst most of the patients interviewed had little to no objection towards organ donation, however there is still a lack of understanding of the difference between cadaveric donors towards organ donor for transplantation. Buddhist teaching had also supports altruism and a minority of patient still belief in reincarnation and had they donated their organs and this may have implication in their next life.
Objective: To understand the belief in regards to the attitudes and awareness about organ donation amongst patients visiting a tertiary hospital in Bangkok.
Design: An in-depth interview was conducted on 38 participants at Family Medicine Department; participants were aged between 18-78 years. Participants were identified as Buddhist (92%), Islam (5%) and Christian (3%).
Recruitment: Patients were recruited randomised and unselected similar to “real life practice” and consent was obtained prior to conducting interview.
Results: 6 themes were identified which aimed to address the attitudes and awareness of organ donation amongst patients visiting Ramathibodi Hospital. The themes include: Perception on organ donation; Personal view on death and dying; General knowledge about organ donation; Understanding the law and regulation about organ donation; Religious belief and implication on organ donation and; “opt-in” organ donor on national identity card.
Conclusion: An organ transplant may represent a new life for an individual receiving the organ, at the same time a sense of hope removed from the depths of sorrow and grief in the case of a dead donor. Today, the major obstacles regarding organ transplantation in Thailand is the lack of organ donor. In 2014, there were over 4.431 patients registered with Thai Red Cross to receive organ donation and only 432 people actually received which accumulated to 9.7% of total patients waiting to receive an organ.
Title: Ongoing statin therapy during hospitalization for acute myocardial infarction. Learning for general practitioners and cardiologists
Time : 12:05-12:25
Ghena Shabana has MD with honor from Debrecen Medical University, Hungary. She Qualified as Specialist in Family Medicine by Swedish National Board of Health and Welfare. She works as Cosmetic Medical Consultant and as SAVA Project researcher (Survery of Atherosclerosis in Västmanland). She is an Expert group member of Heart/Vascular and Gastrointestinal Västmanlands Medicine Committee.
Background & Objectives: Patients with high cardiovascular risk should receive statin drugs as primary prevention of cardiovascular events according to current guidelines. This study aimed to determine the prevalence of AMI patients on statin treatment at hospitalization. The prevalence of statin treatment among AMI patients with known diabetes, known angina pectoris and previous AMI were studied separately. We also investigated blood lipids upon admission of patients with AMI in relation to national guidelines of recommended levels of lipids.
Methods: Consecutive patients (n=771) ≤ 80 years of age hospitalized for AMI during the period 2005-2012 were included in the study. ECG and biomarkers according to criteria recommended by the European Society of Cardiology (ESC) were used to diagnose AMI. Blood lipids and blood pressure were taken when patients were enrolled in the study at admission. Previous myocardial infarction, angina, stroke, diabetes, smoking habits and hypertension were diagnosed by self-reports verified by medical records.
Main Results: More than half of the statin treated had a LDL cholesterol level below the recommended level 2.5 mmol/L. LDL cholesterol level is 1.0 mmol/L lower among statin-treated than non-statin treated. 30% of diabetics, 22% of previous myocardial infarction patients and 31% of angina patients were not on statin therapy as primary prevention, when they were hospitalized for their first AMI. There is a large potential for improvement of statin therapy of patients at high risk for AMI. A study on why some AMI patients with known diabetes, known angina pectoris and previous AMI are not on statin treatment is needed.
Al Jafel International Hospital, Saudi Arabia
Time : 12:25-12:45
Musfer ALshalawi joined Al Jafel International Hospital, Riyadh as an Executive Director responsible for overall business operation development and strategic plans. He has more than 20 years of experience in healthcare management in government, private and overseas hospitals, like the New Castle General Hospital/Royal London Hospital in UK, Royal Commission Hospital Yanbu KSA, Al-Hada Military Hospital Taif KSA etc. Over the course of his career, he has taken over various roles such as Quality Director/Patient Affairs Director, Project Manager/Human Resources Director and other management positions. He graduated at John Hopkins University, as Quality Specialist and has participated in 27 international symposium and summits in the healthcare management as a speaker (lecturer). He gives various lectures on healthcare and quality/leadership/strategy & planning/ communication/teamwork. He has also been giving lectures in all hospitals (CBAHI/JCI standards) as a part of his job. He is a member of ISQUA (International Society for Quality in Health Care) and Saudi Management Association.
The objective of this study was to highlight the system’s thinking perspective to ensure quality health care, thereby transforming the healthcare delivery system, changing healthcare design, structure and processes to correct inherent structural deficiencies. Around the world, healthcare organizations are encountering growing pressures to simultaneously improve the quality and safety of health and well being of the public, cut costs and remain competitive. To achieve these goals, a number of assessment mechanisms have been used to address quality in medical care organizations. The most common are JCI/ISO/EFQM and another accreditation. However, evidence from hospitals and PHC-based studies, suggests that external evaluation may be effectively used to complement internal processes. The value added is optimal when there is a clear, mutual understanding of purpose, a teamwork approach and a commitment to use the results of all forms of evaluation to shape a change agenda. But the success of TQM is constrained by many variables such as, poor commitment from leadership and inadequate information system. There is also a decline of attention to the diseases, instead of addressing the patients’ needs and experience. As a direct consequence, there is an increasing fear for lack of focus on patient-centered quality and safety. Nevertheless, implementation focuses more on the individual part, whereas organizational and managerial aspects are minimized or even neglected altogether. From system thinking perspective, the foundations of quality are functions of several variables. Accreditation programmers are most effective when they are in conjunction with other strategies to address patient needs, accessibility, information, service costs, accountability and compliance. The implementation of successful TQM requires a fundamental shift in thinking - from how to best provide a wide variety of independent services to how to effectively combine individual service components into an integrated health care experience that meets patient needs and preferences. Extensive redesign of the basic work processes, advocates may result in significant changes, in scope, task responsibilities, professional autonomy and reporting relationships. Health care/system redesign involves making systematic changes to primary care practices and health systems to improve the quality, efficiency and effectiveness of patient care. The focus should be on two aspects, first understanding the interdependencies of different dimensions existing in the healthcare delivery experience and the changes identified to improve quality care which is measurable and accountable for. Conceptualizing the healthcare services as a structured system is the essential prerequisite to the management of effective changes and excellence. Second, is to drive change and improve healthcare performances, as it is critical and vital to know what matters to the customers by maximizing the patient’s care experience, this not only includes respect, the bond of trust, the shared decision making, but also the well-coordinated correspondences and overall efficiency. It goes without saying that understanding your organization as a system is the essential prerequisite to the management of effective change, as it enables leaders and workers to understand that the majority of performance is caused by how the system has been designed.
Directorate of Health Affairs, Saudi Arabia
Title: Evidence based medicine workshop. Randomized controlled trial of the efficacy on physician’s knowledge and skills
Time : 12:45-13:05
Nadira A Al-Baghli is a consultant in family & community medicine graduated from King Faisal University, KSA, and having a Master’s degree in Medical Education from Arabian Gulf University, Bahrain. She was the Director of Infection Control in Eastern Province, KSA for 5 years. Currently, she is working in consultation clinics in Dammam, Directorate of Health Affairs, EP, KSA. She has published more than 15 papers in reputed journals about chronic diseases and medical education programs. She has special interests in biostatistics, EBM, and infection control.
Objectives: To assess the effect of Evidence Based Medicine (EBM) workshop on knowledge and skills of physicians towards EBM use in the near future as well as in the long run.
Methods: This is a randomized controlled trial conducted in the primary health care administration center in Dammam, Saudi Arabia between October and November 2008. Fifty-nine primary care physicians in the intervention group participated in the EBM workshops, while 89 physicians from the control group attended other primary health care activities other than EBM workshop. The main outcome was to measure the change in the participants’ level of awareness and competencies in EBM components (including formulation of questions, literature searching, critical thinking and appraisal) using a pre-designed questionnaire before, immediately after, and 4 months after the workshop.
Results: Evidence Based Medicine workshops improved physician’s scores in all components of EBM, from 38.9%±20.0% at pre-test to 81.4%±10.6% post-test, and sustained this improvement to a lesser degree to 66.8%±10.0% 4 months post-intervention test (p<0.001 for the differences in all scores).
Conclusion: Participating in EBM workshop significantly enhanced physicians’ ability to formulate questions, performed literature search, critical appraisal, and applied best-evidence in clinical practice, which retained up to 4 months post-test.
Silverio Di Rocca has completed his Graduation in Dentistry, Post-graduate degree in Functional Orthopaedics both from the University of Buenos Aires, Argentina. He has also done a degree in Dentistry and Prosthetic at the University of Turin, Italy and a Doctorate in Dentistry and Prosthetic at University of Turin, Italy. He is the Director of the M P R International School, Vice President International representative and Founder of API Swiss (International Association of Posturology Switzerland). He is also a Professor in Amocoac Diplomate in Mexico and COMEI, College of Dentistry in Mexico, Associate Professor in I.C.O.M (International College of Osteopathic Medicine) Milan, Italy and an International Honorary member of AMOCOAC
The Body Equilibrium System (B.E.D) : The first and only appliance designed exclusively for rehabilitation therapists (physiotherapists, osteopaths, chiropractors, etc.) for postural rehabilitation, capable of overriding the stomatognatic system. It is the first device on the market able to counteract the negative effects of the stomatognatic system during rehabilitation.
Nayoro Ciy University, Japan
Time : 14:30-14:50
Yoshiko Hasebe has been working at Nayoro City University School of Health Science. She is a Professor of Adult Nursing, and has her expertise in evaluation and passion in improving the nursing practice. She has published many textbooks and DVDs about nursing arts in Japan.
Many cancer patients on outpatient chemotherapy complain of dysgeusia. Thus, we searched the literature database of four journals that publish articles related to anti-cancer chemotherapy and taste perception, and reviewed knowledge useful for nursing care of cancer patients. We found that dysgeusia frequently occurred at a relatively early stage when FOLFOX/FOLFIRI combined with 5-FU, or regimens involving a taxane and related agents were used. The risk of dysgeusia was significantly higher with DTX than with other regimens. This can be explained by the formation of a chelate between 5-FU and zinc, which in turn elevates urinary excretion of zinc, leading to zinc deficiency. Perception of all basic tastes (saltiness, sweetness, sourness, and umami), except bitterness, tend to be impaired. The frequency of impairment of saltiness perception appeared to be relatively high. Taxanes and related regimens were associated with a high occurrence rate of impairment of umami perception and with severe changes in saltiness perception. Considering the report showing the link between the impairment of saltiness perception and low plasma zinc levels, regimens involving 5-FU is likely to cause disorders in saltiness perception. Possible causes of dysgeusia attributed to anti-cancer agents include inhibition of taste bud metabolism, lingual nerve disorder and zinc deficiency. It is likely that dysgeusia in patients receiving a taxane and related agents is attributed to peripheral nerve disorders, since these agents do not cause zinc deficiency. Experimental S-1 administration in rats suggested the possibility that dysgeusia is caused by damage to the gustatory nerve but not mucosal epithelia and taste buds. Regimens involving relatively low doses of 5-FU, for example CMF and FEC therapies, can cause dysgeusia, although it did not appear severe enough to influence patients’ appetite. The frequency of dysgeusia in patients receiving gemcitabine (GEM) was also significantly low.
Al Balqa' Applied University, Jordan
Time : 14:50-15:10
Siham M Al-Momani is an Associated Professor in the area of Primary Health Care, Midwifery and Nursing Education in the Faculty of Allied Medical Sciences, and the past Assistant Dean for staff development and continuing education at Zarqa College in Al-Balqaa Applied University, Jordan. She holds a Doctoral degree from Amman Arab University for Post-Graduated Studies, Jordan. Her area of specialty is nursing learning and instruction, while her research interests include; clinical nursing learning, community service and educational technology. She has several publications and conference papers. She received her BS and Master’s degree in Nursing Education from University of Jordan and has been taught in Princess Muna College of Nursing Mutah University (1987 – 2000). She is a member in the Jordanian Nursing Council (JNC) and the Jordanian Nursing Council for Nurses and Midwifes (JNCM).
Primary health nurses are the largest profession working in primary health. The importance of improving the quality of care provided to primary health care consumers had been identified by health organization worldwide. In order to achieve this improvement, primary health nurses need to take the lead in developing the culture of compassionate care. Compassion- Includes managing every client’s as an individual and taking time to ensure that all clients feel their needs are being addressed in dignified and respectful way. Compassionate care, must be accompanied by professionalism at all times. Six action areas which include; care, compassion, competence, communication, courage and commitment to ensure developing the culture of compassionate care in primary health care services will be discussed.
Retno Asti Werdhani is an academic staff from Department of Community Medicine, Faculty of Medicine Universitas Indonesia since 2001. She joined the faculty member because she has passion in primary care and wanted to involve in primary care physicians (PCP) development through education, health service, and research. Her current dissertation on development of care coordinator instrument measurement for PCP got cumlaude results and on process for intellectual license’s right
Statement of the Problem: Modern medical care requires teamwork, therefore it requires leadership competency. As a care coordinator, Primary Care Physician (PCP) requires planning, organizing, implementation, and evaluation for their works. Therefore, a model of leadership in medicine is needed to be implemented in Primary Care.
Methodology & Theoretical Orientation: A literature search was conducted during research about developing care coordinator instrument and its relationship with leadership. All keywords was collected and formed into framework.
Findings: Transformational leadership was stated as a leadership style that is suitable for health services. It is similar to patient centered approach which understands ideas, concerns, and expectations of patients. A transformational leadership was also explore ideas, concerns, and expectations of followers, open to aspirations and needs of followers, provide stimulation, explain vision and objectives, encourage followers to pursue these objectives, and reach mutual agreement for goals achievement. It was identical to the interaction of physicians (as leader) and patient (as follower). Patients generally need encouragement and motivation, and physician should understand the real needs of patient. Thus, patient’s case management should be well prepared and explained in accordance to patient's needs and can be agreed upon as well as implemented with the appropriate respective roles. A leader needs to do various aspects related to the managerial process for carrying out the implemented activities. The same management process can also be done by PCP in carrying out various activities required to achieve patient’s target management. Such activities include planning up to building networks.
Conclusion & Significance: Primary Care Physicians are expected to have leadership competencies and transformational leadership to support their performance as care coordinator. This capability can be gained through capacity strengthening based on patient’s needs with holistic, comprehensive, integrated, and continuous approach, as well as building relationships with other stakeholders.
Necmettin Erbakan University , Turkey
Time : 15:30-15:50
Zeynep Altuntas has completed his PhD at the age of 24 years from Selcuk University , Meram School of Medicine. In 2005 she worked at the Mayo Clinic as a research fellow. In 2007 she received Plastic and Reconstructive Surgery expertise from Selcuk Universty. She has published more than 20 papers in reputed journals. Her studies on wound healing and regenerative medicine continue.
Statement of the Problem: Recently, autologous platelet rich plasma are being used to treat acute and chronic injuries in an attempt to jump start healing due to being too much growth factor source. However, the homologous (allogenic) platelet rich plasma has been investigated in several studies to treat chronic wounds. To the best of our knowledge, it has not been studied as injection for articular and soft tissue injuries. In this study, our objective was to treat different kinds of soft tissue and joint disorders with homologous platelet rich plasma and investigate the effects of it.
Methods: We applied 164 injection of homologous PRP to 109 patients. 63 patient had knee pain, 12 patients had temporomandibular joint pain, 7 patients had tennis elbow, 9 patients had shoulder pain, 15 patients had lumbar pain, 3 patients had pain on the Achilles tendon. The 139 injection were made intra-articulary and 25 injections were applied into the the soft tissue. We repeated the injection in 16 patients. All of the patients were followed for one year.
Findings: No severe adverse events or complications related to the injections were observed during the treatment or follow-up period. All of the patients were very satisfied with the treatment and had reported pain relief and increase of their life standarts. Second session were performed to the seventeen patients after six months due to the resumption of their aches. However , they were also reported significant increase in the quality of their lives .
Conclusion & Significance: This study showed Homologous PRP could be safely used without complications or adverse effects. Additionally all of the patients reported a significant satisfication from the treatment.
University of Wollongong, UAE
Time : 16:10-16:30
Manal Ali Ghandour is currently working with DHCR with expertise in health informatics, quality and healthcare management. She has attained her Master’s degree in Quality Management in 2008 from UOWD and her BSc degree in Nursing from Jordan University in 1994. In 2012, she worked as Adjunct faculty in Al Ain Men’s College of Higher technology and was a Project manager for Fatima College of Health Sciences. She has led the Health Education Program implementation in Abu Dhabi and Al Ain ADEC schools in 2011. She helped DOHMS to implement the fully integrated HIS system in Dubai in 2003. She had yearly presentations in the International Conferences as Health Informatics, Wireless Technology, Health Management, Clinical Effectiveness, Hospital Management & Quality Management.
Primary health care doctor should be the essential access to any care and most of the healthcare. Currently and due to many socio-economic reasons, the patients have the freedom to see consultants and specialists thinking that they can get a better care? In this presentation we will discuss multi factors that lead to this conclusion. My discussion will not definitely get the cure or the golden answer for this dilemma but it will enlighten the regulators, policy makers, service providers and doctors on what is happening and why it is happening. The cost of healthcare is rising and this will make it difficult for law socio economic classes to cope with or get treated. Many medical errors are going unnoticed due to this bizarre situation. We will explore together some solutions and recommendations.
Intercare Health Center, UAE
Time : 16:30-16:50
Nas Al-Jafari graduated from The University of Nottingham in 2004. He has a broad range of experience in a variety of specialties, and became a member of The Royal College of General Practitioners in 2009. He has gone on to obtain further specialist qualifications, and it is this wide range of clinical experience that has proved invaluable for his holistic and integrative approach to patient care. He has a particular focus on modifying lifestyle factors influencing long-term health and chronic disease. He has brought the same ethos to Abu Dhabi, offering safe and effective care with maximal patient comfort and satisfaction.
In 1970, Ancel Keys published the ‘seven countries study’, which systematically examined the relationship between lifestyle and cardiovascular disease. Strong associational findings from Key’s study forged the way for the first US dietary guidelines in 1980. In a changing tide of opinion, dietary cholesterol has since been agreed and is of no relevance, according to the 2015 US dietary guidelines, and LDL-cholesterol has been shunned as a predictor of cardiovascular disease. Yet, statins, aimed at reducing total and LDL-cholesterol, have revolutionized the way we treat cardiovascular disease, and continue to forge the way for more novel treatments, like the PCSK9 inhibitors. This talk examines the evidence behind the diet-heart hypothesis and leads on to questioning the validity of current approaches to medical therapy.
Nehal Shata MD, MPH began her career in Public Health as a Paediatrics Teaching Assistant at King -Abdulaziz University Jeddah, Saudi Arabia. She obtained her Master of Public Health at the Johns Hopkins University Bloomberg School of Public Health. Her capstone project on child abuse outlined an overview of the situation in Saudi Arabia. After completing her degree, she did a year at Johns Hopkins School of Medicine as a Post-doctoral Research Fellow investigating how sleep disturbance during critical illness modulates outcomes in children. She is currently a Pediatric Resident at McGill University in Montreal, Canada, where she will continue her work as a Child Advocate in Public Health
Statement of the Problem: In Saudi Arabia, child abuse still having underreporting problem, and remains a common problem in the country. Professionals and public servants of all child-focused fields must combat this problem through the implementation of an awareness program to increase reporting and easy detection of abuse.
Methodology & Theoretical Orientation: The search engines used for this review were: PubMed databases, PsycINFO, and Google Scholar. The research limited results to within Saudi Arabia and utilized the following keywords: maltreatment, child protective services, reporting child abuse, child abuse types.
Findings & Conclusion: Child abuse is a public health concern globally, as well as within Saudi Arabia. A reporting system to indicate its prevalence was introduced to Saudi Arabia in 2010, and served as the first annual registry report for the region. Since that time, through the efforts of the National Family Safety Program, the reporting data has improved. According to current literature, physical abuse and neglect are currently the most common types of abuse, followed by sexual and emotional abuse. Parents are the most common perpetrators. The most common risk factors include: large family size of more than six people, paternal unemployment, and/or divorced parents. Although child protection teams now exist and notify the social protection department, police, and regional principals, under-recognition and under-reporting continue to pose major challenges.
Recommendations: The recommendations put forth at the conclusion of this review are as follows: first, public child abuse prevention programs must be implemented which apply to all thirteen regions of Saudi Arabia, including rural areas. Secondly, health care providers should receive training to recognize and report child abuse through implementation and follow-through on guidelines, workshops, and mandatory training programs. Additionally, it is important to implement a large-scale parenting education program for parents, as they are the most common perpetrators. Implementation of school curriculum which teaches children how to protect themselves from abuse will also be vital. Finally, to conduct and evaluate the effectiveness of these preventive programs regularly, with emphasis on sustainability and regular follow ups as key elements of a successful program.
King Abdulaziz University, KSA
Meral Abualjadayel completed her medical education from King Abdulaziz University, KSA. She is currently Pediatric Students Club Co-founder, Academic Education Unit President At King Abdul-Aziz University-faculty of Medicine. She also Volunteers in the Clinical skills mentoring program. She is the Organizer In "World Kidney Day" Event Held in King Abdulaziz University Hospital
Renal oncocytoma was first described by Zippelin 1942 as a malignant entity, however, Klein and valensi were able to demonstrate its benign characters in the year 1976. The current the World Health Organization have classified renaloncocytomas as benign renal neoplasms in 2004. Renal oncocytoma is the second most common benign renal neoplasm after angiomyolipoma, comprising 3-7% of all renal tumors, usually occur during the seventh decade of life varying from 20 to 86 years of age with males predominance. Zhou defined renal oncocytoma as a benign epithelial neoplasm composed of round-to polygonal-cells with abundant mitochondriarich eosinophilic cytoplasm, thought to arise from the intercalated cells in the kidney. The size of the tumors varies from 0.6 to 14 cm(7). Unfortunately, most oncocytomas are very difficult to be differentiated from renal cell carcinoma both clinically and radio graphically. Development of renal oncocytoma in pediatric age group is very uncommon with no cases found within our review of the world literature. We report herein the first case of renal oncoytoma in a 14 year old young lady.
María del Pilar Marcos Martínez has completed her studies from University of Alicante and Post-doctoral studies about tobacco addiction from Barcelona University School of Medicine. She is the Director of a Public Medical Centre in Petrer (Alicante). She has worked in different projects about Public Health such as tobacco control, violence against women and community activities for more than 20 years. She usually takes part in national and international scientific congresses as Speaker or as a Member of the scientific committee. She is implicated in teaching young doctors in Primary Healthcare these days.
Positive health is a way of looking at the actions with care in order to improve everything that people, families and communities can do to take care of their own health. Positive health and wellbeing of our population should be one of the most important targets nowadays. As Michael Marmot said, “If the major determinants of health are social, so must be the remedies”. This social understanding is central to the process of change to reduce the burden of disease. How we can make it possible and why it is so important is the purpose of my intervention. It’s really essential to reduce inequalities in health and wellbeing by attending our communities in a complete perspective. I live in a town which has 35,000 citizens. It has two public medical centers and I work in one of them. It is mostly an urban population, but it also has a big rural region. The nearest hospital is at about 10 minutes by car. We try to prepare and develop activities to our community at any time during the year; but we specially perform an intensive week of community activities once a year. The main goal is to improve conditions of life referring to wellness. It is essential to look at the population, to review the overarching principles of good practice, detect local needs and priorities, identify the available assets and choose the kind of actions to implement. Other relevant element is the involvement of different members of society such as politicians and the education system. How we educate and socialize our children is really important to get a future healthy population. Making strong links between all of them could be interesting to be successful. Community activities are essential to obtain efficient interventions.