Day 1 :
Keynote Forum
Jawahar Jay Kalra
University of Saskatchewan, Canada
Keynote: Quality care and patient safety: Global approaches to medical error disclosure
Time : 09:10-09:35
Biography:
Jawahar Jay Kalra, an educator, researcher, and quality health care advocate, is a Professor of Pathology in the University of Saskatchewan and has served as Head of the Department of Pathology and Laboratory Medicine. He is recognized for his many contributions as a clinical scientist, academic leader, and health system administrator. He has been a pioneer in establishing guidelines for thyroid-function testing, quality assurance program and contributed nationally and internationally in the area of total quality management. He has published extensively and is the author of the book “Medical Errors and Patient Safety: Strategies to reduce and disclose medical errors and improve patience safety.”
Abstract:
Disclosure of an adverse event is an important element in managing the consequences of a medical error. We have previously reported the Canadian provincial initiatives encouraging open disclosure of a critical event and have suggested its integration into a ‘no-fault’ model. We reviewed and compared the various medical error disclosure initiatives across the globe (USA, Australia, New Zealand, and United Kingdom) to analyze the progress made in this area. In Australia, disclosure policy integrates the disclosure process with risk management analysis towards investigating the critical events. In New Zealand, in any adverse event, patients are rehabilitated and compensated through a no-fault state funded compensation scheme. The United States Joint Commission on Accreditation of Healthcare Organizations mandated an open disclosure of any critical event during care to the patient or their families’. Effective communication between health care providers, patients and their families throughout the disclosure process is integral in sustaining and developing the physician patient relationship. The Canadian provincial initiatives, though similar in content, remain isolated because of their non-mandatory nature on disclosure. In conclusion, the designing of an error disclosure policy requires integration of various aspects including bioethics, physician-patient communication, quality of care, and team-based care delivery. The complexities of medical error disclosure to patients present ideal opportunities for medical educators to probe how learners are balancing the ethical complexities involved in error disclosure. We suggest that a uniform policy centered on addressing errors in a non-punitive manner and respecting the patient’s right to an honest disclosure be implemented.
Keynote Forum
Andrew W Gottschalk
Ochsner Health System, USA
Keynote: An evidence-based, multidisciplinary team approach to sports concussion management
Time : 09:35-10:00
Biography:
rnAndrew W Gottschalk, MD trained in Sports Medicine at both Mayo Clinic and Cleveland Clinic. His extensive experience includes treating athletes of all levels of competition, including those in the NFL, NBA, MLB, and NCAA Division I. As the Ochsner Health System’s Director of Primary Care Sports Medicine, he serves as Head Medical Team Physician for the NBA New Orleans Pelicans. He is also an avid writer; his multiple publication projects include his regular newspaper column, “The Sports Medicine Doctor.” He is the current Musculoskeletal Health Editor for the medical journal Evidence-Based Practice.rn
Abstract:
Recent studies demonstrate dramatically improved health outcomes when a multidisciplinary care team model is utilized in the treatment of complex medical diagnoses. These studies have focused on improving outcomes in the treatment of chronic conditions such as diabetes mellitus, hypertension, and congestive heart failure. The multidisciplinary care team model has been shown to reduce medical complications, reduce number of hospital admissions, and improve overall quality of life in patients with these diseases. So strong is the evidence in favour of these models that they have become the standard of care in many medical systems in the United States and around the world. The multidisciplinary care team approach is now being evaluated for application in more acute settings, such as post-operative recovery. Studies confirm that the coordinated efforts, shared knowledge, and ongoing communication of the multidisciplinary care team significantly improve outcomes in these more acute settings as well. Applying the multidisciplinary care team approach in the treatment of sports concussions is as necessary as it is promising. In our model, when an athlete is concussed we immediately assign a Medical Team, a Home Team, and a School Team. Each team is responsible for well-defined aspects of the concussed athlete’s treatment, including symptom monitoring, symptom reporting, and treatment. The ultimate goals of this multidisciplinary care team approach to sports concussion treatment are to: reduce concussion symptoms and improve patient comfort; maximize safe and healthy brain recovery and; minimize time away from sports participation.
Keynote Forum
Marc Matthews
Mayo Clinic, USA
Keynote: Reevaluating the value of primary care using design thinking
Time : 10:00-10:25
Biography:
Marc Matthews graduated from the University of Maryland School of Medicine and completed his residency training at the Mayo Clinic. His first task at Mayo was to redesign a community health clinic around the community’s definition of health, and this work led to a deeper understanding of how the healthcare system is not very aware of what it means for a community to be healthy. He is the Associate Medical Director of the Mayo Clinic Office of Population Health Management and an Assistant Professor of Family Medicine. In these roles, he focuses on rethinking the way large healthcare organizations deliver care.
Abstract:
Primary care is at a critical crossroads. Our current delivery systems are unsustainable and lack the resilience to survive in new environments where total cost of care, patient experience, and patient centered outcomes are the primary determinants of success. In order for primary care to remain relevant and viable, new solutions must be created that are practical and transformative, attract and retain new patients and provide high value, high satisfaction services that meet their consumer needs. Our cost of care must come down and our quality must remain high in order for us to be able to deliver affordable care in future reimbursement realities. Our institution approached this problem by using the tools of design thinking to develop a novel patient centered approach and then implemented this population health management model across primary care clinics in multiple geographic areas. Population Health Management has become a hot topic of conversation in medical literature and popular media, but the concept is poorly defined and implementation of a population health framework is not well understood. Here we report the initial results of our implementation, which suggests increased patient and staff satisfaction with little impact on finances in a fee for service environment. We also uncovered significant cultural barriers to implementation that are likely to be universal.
- Track 10: Primary Care Nurse Practitioner
Track 11: Public Health Concepts
Track 12: Dental Primary Care
Location: The Oberoi Dubai, Dubai
Chair
Gustavo H. Marin
UNICEN, Argentina
Co-Chair
Nick Richards
SEHA Dialysis Services, Abu Dhabi
Session Introduction
Nasseer A Masoodi
Hamad Medical Corporation, Qatar
Title: Implementing a patient centered care model for chronic disease management at HMC-opportunities, challenges and lessons learned
Time : 09:00-09:20
Biography:
Nasseer A Masoodi is a Senior Consultant and Vice Chair for General Internal Medicine at Hamad Medical Corporation, Doha (Qatar). Prior to his arrival in Qatar, he was a primary care physician at The Villages Health System, The Villages-FL (USA), and Vice President of Health service and Chief Medical Informatics Officer for ACV Inc. Dowling Park-FL (USA). He was a Member of Medical Informatics Committee of American College of Physicians. He also served as a Member of PMC (performance measures committee) of American College of Physicians from April 2009-April 2013. He also served as Associate Professor of Geriatrics at FSU College of Medicine Tallahassee-FL. He is boarded in Internal Medicine, Geriatrics, Hospice and Palliative Care. He received his MBA through University of Massachusetts Amherst (USA) and his Post Baccalaureate Certificate in Clinical Informatics through Johns Hopkins University School of Medicine, USA. He is an Associate Editor of British Journal of Medical Practitioners, Specialist Editor for DynaMed and reviewer for many national and international journals including McMaster University’s the McMaster Online Rating of Evidence (MORE). He has published many research and review articles in peer reviewed journals.
Abstract:
Despite growing recognition of the cost effectiveness of patient-centered care, most of the nations fall short of achieving it and Qatar is no exception. As life expectancy is increasing in Qatar, the number of patients with chronic comorbidities is expected to increase, care for those patients can be challenging especially with the current status of fragmented care. Hamad Medical Corporation (HMC) has been the principal public healthcare provider in the State of Qatar and is dedicated to deliver the safest, most effective and most compassionate care to each and every one of our patients. Management of multiple chronic conditions requires a strong trusting relationship between the care team and the patients. This presentation will shed light on what it takes to initiate the implementation of patient-centered care in ambulatory health care settings for management of chronic diseases at HMC. The findings and recommendations of this presentation are based solely on our effort to design and implement strategies for achieving excellence in patient-centered care in Qatar. Since, Qatar shares significant similarities with rest of the Middle East region; the opportunities, challenges and lessons learned may be of benefit to the audience in their efforts to implement such initiatives elsewhere.
Abraham Mainaji Amlogu
State House Medical Centre, Nigeria
Title: A nutrition-sensitive approach to delay the progression of HIV to AIDS among people living with HIV (PLWH) in Nigeria
Time : 09:20-09:40
Biography:
Abraham Mainaji Amlogu is a Consultant Clinical Pharmacist at the State House Medical Centre, Abuja, Nigeria. He holds a PhD in Public Health Nutrition from the University of Westminster, London. He is an Associate Fellow of the Higher Education Academy in UK, a Fellow of the Royal Society of Tropical Medicine and Hygiene, a Fellow and an Examiner with the West Africa Postgraduate College of Pharmacists. He has published in a lot of international reputed journals and has been serving as an Editorial Board Member of the international Journal of Functional Foods in Health and Diseases.
Abstract:
In 2005, the World Health Organization (WHO) reported complex interaction between nutrition and HIV/AIDS. Evidence highlights that under-nutrition weakens the immune system and in people living with HIV (PLWHIV) in particular, this increases their susceptibility to AIDS. The aim of the study was to ascertain the nutrition-sensitivity approach through a tailored functional recipe designed to attenuate the progression of HIV to AIDS among people living with HIV in Nigeria. Local foods, known for their availability, accessibility, macro and micronutrient strengths were selected and optimized into a nutritional functional meal (Amtewa). 400 PLWHIV (adult males and females; average age 35 years ± 5 SD) were recruited from HIV treatment centers in Abuja, through simple randomization process. The effect of daily consumption of Amtewa meal (354.92 kcal/100g/day) for 6 months was ascertained through the nutritional status indicator (mid upper arm circumference - MUAC) and biochemical indices (CD4 count) of the study participants who were/were not taking the intervention meal. After 6 months, the mean CD4 cell count (cell/mm3) for antiretroviral therapy (ART)-intervention group (n=200) increased by 12.12%. Mean-MUAC (cm) also increased by 2.52% within the same period. On the contrary, there were decreases in control groups (n=200) after 6 months of the study. Mean CD4 count decreased by 14.9% and mean-MUAC decreased by 2.28%. Moreover, Student’s T-test analysis suggested a strong association and synergistic effect between the intervention meal and mean CD4 count in the group of participants on ART (p=0.05). These results ascertained the effectiveness of Amtewa meal on health status of HIV infected subjects and also underpinned its significant position within the National Health Services framework as innovative nutrition-sensitive approach to delay the progression of HIV to AIDS in Nigeria.
Geeta Ahlawat
Pt B D Sharma PGIMS Rohtak, India
Title: Airway management in emergency and trauma patients
Time : 09:40-10:00
Biography:
Geeta Ahlawat is a Graduate and Post-Graduate of Gujarat University, Ahmedabad, presently working as a Professor in Anesthesiology and Critical care, Rohtak, Haryana. She has 26 publications to her credit and her areas of interest are innovations in the field of emergency and trauma, airway management and cardiac anesthesia.
Abstract:
Airway management forms the vital component of treatment for emergency and trauma patients. A timely secured airway for injured patients is directly proportionate to the effectiveness of the treatment provided and hence the outcome achieved. Though a lot of advanced techniques have come up worldwide in this field, many are not available in emergency settings as well as in areas with only primary health care facilities especially in developing countries like India. I wish to correlate the best available options for airway management with primary health care settings in emergency and trauma patients in my talk.
Savita Saini
Pandit Bhagwat Dayal Sharma PGIMS Rohtak, India
Title: Securing airway –Awake
Time : 10:00-10:20
Biography:
Savita Saini is working as a Senior Professor in the Department of Anesthesiology and Critical care at Pt. BDS PGIMS Rohtak, Haryana, India. She completed her medical education from Bhopal University Bhopal, (MP) and joined the Anesthesiology Department in 1986. Since then, she is working with keen interest in all fields of anesthesia especially airway management and obstetrics anesthesia. She has been an invited faculty at various national & zonal conferences and examiner to Postgraduate anesthesia examinations of various universities. She is a member of various scientific societies and has published many scientific publications in various national/international journals.
Abstract:
Airway management is one of the prime responsibilities of anesthesiologist. Secure airway is central to the care of patients during general anesthesia and in ICU. An unobstructed airway is the key for adequate oxygenation. Tracheal intubation on direct laryngoscopy is the commonest and quickest way to secure the airway. However, this may turn out to be difficult or may even fail on certain occasions. Difficulties with tracheal intubation/airway management are important cause of morbidity and mortality. However with advent of supraglottic airway devices (SGADs), the scenario of can’t ventilate and intubate has changed. But still, there are situations which demand tracheal intubations be performed. In such circumstances where mask ventilation is expected to be difficult or there are problems with use of SGADs, securing airway awake is a logical choice. Awaken fibre optic intubation has been considered gold standard and technique of choice for elective management of an expected difficult airway and is tolerated well by the patients. However, this requires expensive and delicate equipment and expertise which may not be available in emergency departments; hence an alternative plan must be available to secure the airway awake. For example, awake use of SGADs and assisted intubation, conventional direct laryngoscopy and use of video laryngoscope. The technique of awaken intubation using flexible fibre optic endoscope/flexible video endoscope requires topicalization of the airway (blocking of main airway reflexes i.e. gag, cough and glottic closure reflexes) and adequate patient preparation in terms of anxiolysis, drying of airway secretions and adequate oxygenation. Local anesthetics are the cornerstone of airway topical/nerve block anesthesia. It is the state of art technique for anticipated difficult airway and must be learnt.
Shanthi Ramasubramaniam
University of Buraimi, Oman
Title: A study on the management of health promoting behavior among adolescents through adolescent friendly centre services approach in a selected private school
Time : 10:20-10:40
Biography:
Shanthi Ramasubramaniam is a registered Nurse and Midwife with Master’s in Maternity Nursing specality (1999). She has completed a Post-graduate diploma in Educational Technology (2008). Recently, she completed her PhD viva voice and currently working as a Clinical Instructor at College of Health Sciences, University of Buraimi.
Abstract:
Aim: The aim of the study is to examine the health promoting behavior among adolescents through the adolescent friendly center services initiated at school campus. This study also wanted to investigate the receptiveness and perception of adolescent friendly services by parents, teachers and adolescents. Methodology: Through the process of Triangulation the research design was formulated and applied to suit the concept of the study (survey, one group pretest and posttest design was used). Data collection procedure: The data collection was done for a period of 9 months in 3 phases. A 5 point likert scale was used to assess the perception and receptiveness of parents, teachers and adolescents on adolescent friendly services at school. The multi-dimensional student life satisfaction scale was used to assess various aspects of adolescent’s life including family, friends, school, environment and self-esteem. The data were collected from 269 adolescents, 160 parents and 21 teachers. Findings: The study reported that students were benefitted by the adolescent friendly services. The students, parents and teachers had positive perception regarding the adolescent friendly services. The students, parents and teachers gave a positive feedback regarding the services. Majority (51.7%) of adolescents perception is that the parent is the suitable person to provide guidance and counseling to them. Parents (76.3%) perceive that Principal/teacher as the best person to provide guidance and counseling to adolescents, while the teachers (71.4%) feel that health care person is the suitable person to provide guidance and counseling to adolescents. The perception of the 3 group of people differs significantly, thus denoting each group has different opinion on the same issue from their own point of view. The results of the study revealed that the component of the MSLSS scale “self” has a significant (at 0.01 levels) difference in the mean scores of the adolescents, obtained before and after the initiation of the adolescent friendly center service at school. Conclusion: The study brings to attention the need for professional counseling and help related to awareness of adolescent friendly services and ways to solve issues regarding adolescent health.
Dybesh Regmi
United Arab Emirates University, UAE
Title: Motivational interviewing- A necessity in medical education
Time : 11:00-11:20
Biography:
Dybesh Regmi is working as an Assistant Professor in the Department of Family Medicine at UAE University. He also holds a faculty membership at the Department of Family and Community Medicine at the University of Toronto. He completed his residency training in Family Medicine at McMaster University. He has been an examiner for the College of Family Physicians of Canada and was a peer assessor for the regulatory body in the province of Ontario.
Abstract:
Primary care is focused on prevention and adoption of healthy behaviors by the general population. A proven effective tool for patient behavior modification that has been utilized is Motivational Interviewing (MI). Compared to the trans-theoretical model which focuses on the stages of change, MI promotes personal desire for change within the patient. Such self-promotion of change is enhanced by the fact that the technique allows the patient to resolve doubts and identify barriers for change. Numerous studies have shown that MI is more effective than traditional method of giving advice to elicit behavior change particularly in weight loss, dyslipidemia and lowering of blood pressure. Furthermore, research indicates that techniques of MI are best taught by workshop sessions by experts who utilize MI within their primary care. The expert clinician asks open ended questions, assesses level of motivation and confidence and then tailors the interview accordingly. Ultimately, the expert determines the structure and direction of the interview, the patient is responsible for the change. Clerkship and residency programs should consider incorporating MI into their communication skills, thus enabling future primary care providers to be effective clinicians.
Majid Zakeri
Mashhad University of Medical Sicience, Iran
Title: Enhancement of gingival wound healing by local application of silver nanoparticles periodontal dressing following surgery: A histological assessment in animal model
Time : 11:00-11:20
Biography:
Majid Zakeri has completed his DDS from Mashhad University of Medical Sciences, Iran and Fellowship in Aesthetic Dentistry from Universita degli Studi di Genova, Italy DISC (2014). He is the Technical Director of Novin Dentistry Clinic affliated to Red Cresent of Khorasan Razavi Province, Iran. He has 3 inventions in dentistry feild: Dentistry Mouth Opener; Nanopack Dressing for Oral Surgery and; Nano Silver Stitch for Oral Operation. He has won silver prize from Seoul Intenational Inventaion Fair 2009 ( SIIF 2009) and special award from Association of Russian House for International Scientific and Technological Cooperation in Seoul International Invention Fair 2009 (SIIF 2009). He serves as a peer rewiever for the British Journal of Medicine and Medical Research and member of International Federation of Inventors Associations (IFIA) Agent in Iran.
Abstract:
Background: The value of periodontal dressing and its effects on periodontal wound healing have been questioned. Besides, the early healing of the gingival and periodontal wounds in oral cavity should be emphasized to promote the treatment outcome. Several studies pointed out a potential positive effect of silver nanoparticles (NPs) on the healing process of skin wounds. Aim: The present work aimed to design silver NPs periodontal dressing and then, evaluated its effects on gingival wound healing following operation. Methods: Thirty healthy adolescent female rabbits were used in this study. They had intact teeth and the clinical and radiographic examination revealed no periodontal disease. Silver NPs were added to carbonate methyl cellulose as base with 2 different concentrations of 25% v/v (Group A) and 50% v/v (Group B). On the basis of simple randomized allocation, gingivectomy was performed at the buccal gingiva of the left and right mandibular incisors and subsequently, untreated wounds in the control area were covered with periodontal pack and periodontal dressings A and B were applied in the test regions. Histological changes were monitored in day 4 and 7 post operation to evaluate the inflammatory and repair stage of healing process. Results: We observed significant difference in the inflammatory and repair parameters of the healing process between surgical sites treated with this periodontal dressing and control group. Besides, wounds treated with silver NPs dressing in general terms had all the hallmarks of relatively complete healing one week post operatively. Conclusion: The results indicated positive potential therapeutic effects for this new formulation of periodontal dressing on acceleration of surgical wound healing that led to the improvement of periodontal treatment consequences following operation.
Pradeep K Jha
Indian Institute of Technology (Kharagpur), India
Title: Micro-macro balance in contraceptive development driven healthcare
Time : 11:20-11:40
Biography:
Pradeep K Jha is a Senior Research Scientist at IIT (Kharagpur) and Visiting Faculty in J P Business School, Meerut. He also served as a Management Consultant of several start-ups like IcubedG Ideas Pvt. Ltd. and SG ArtHeart Pvt.Lt. Has completed MSc (Med Chem), MSc (TQM), PhD in Health Care Management from Gautam Buddha Technical University, Lucknow and EUROMA Summer Post-Doctoral training in Global Operation Management in Hungary. He developed a quality tool for health care industry. His main areas of research are quality Healthcare, Nanomedicine and Biomedical implant. He is Member of WABT France, EUROMA, ISSRF, SAI Professional Societies and Referee of several science and management journals. He has published 15 papers in international journals and presented more than seventy papers at national and international conferences.
Abstract:
Widely spreading inter-disciplinary science demands the need to fulfill the gap of scaling from micro (good laboratory practices) to macro (good manufacturing practices) level in medical/contraceptive manufacturing to achieve ideal healthcare. This article explores a new methodological approach based on information sharing co-ordination for linking the micro and macro-dimensions while pursuing biopolymer based contraceptive development and large-scale research involving it. Current study proposes the rationale of multilevel analysis called ‘Multi Approach System (MAS)’ as one analytical strategy, which deals the above perceptional pattern imbalance with help of ‘Lagrangian Concept’ by simultaneous examination of macro-level and micro-level factors. The use of MAS raises theoretical and methodological issues related to the theoretical model, the conceptual distinction between macro-level and micro level variables, the ability to differentiate ‘independent’ effects, the reciprocal relationship between factors at different levels, and the increased complexity that these models imply. It was found that MAS in combination with Lagrangian method is quite efficient to correlate micro-level (good laboratory practices) and macro-level studies (good manufacturing practices) for novel drug development. This idea of non-holonomic constraint is being implemented in real case example of bioactive polymer contraceptive manufacturing wherein time, speed and operator are three continuously changing parameters and are like wheels of manufacturing that ought to be controlled continuously. This interdisciplinary research will explore the dimension of quality assurance mechanism of medical/contraceptive product and way to implement the interdisciplinary coordination approach for quality manufacturing and continuous quality improvement in healthcare.
Samy Abdel Samad Nasef
Pharos University, Alexandria
Title: The prevalence of musculoskeletal disorders among dentists in Alexandria
Time : 11:40-12:00
Biography:
Samy Abdel Samad Nasef is the Dean of Faculty of Physical Therapy, Pharos University, Alexandria. He is a PhD holder (1993) (channel emission between Cairo University and Indian University, USA). He is the Associate Editor of the Journal of Advanced Research, Cairo University and has published more than 30 papers in conferences and Journal of Physical Therapy, Cairo University.
Abstract:
The purpose of this study was to assess the Musculoskeletal Disorders (MSD) among dentists in Alexandria and to investigate some risk factors that may be associated with the occurrence of MSD. 210 dentists working in the public dental clinics were included in this study. Specially designed questionnaire was used for collection of data that serves the purposes of this study. The majority of dentists (90%) had MSD symptoms. Results showed that the most affected region related to MSD was low back area (53.9%) followed by neck (47.6%), shoulder (33.8%) and wrist (23.3%). Females had higher percentage of MSD (91.8%) compared to males (85.7%). Lower back and neck related symptoms increased with age (p=0.048 & p=0.014), respectively. The mild pain was documented with age while sever pain was shown in old age. Dentists who are specialist in orthodontic and endodontic had the highest percentage of MSD (100%). Logistic regression analysis for the risk factors revealed that repetitive movements of hands were the most leading factor to MSD followed by bending of back and neck. The results illustrate the importance of establishing preventive measures to dentists to avoid MSD.
Gülnaz Karatay
Tunceli University, Turkey
Title: Reproductive health and influencing factors of female student who staying a dormitory of credit and dormitories agency
Time : 12:00-12:20
Biography:
I am a associate professor in Public Health Nursing, in the Tunceli University Health High School in Turkey. I completed my master and doctorate program Hacettepe University Faculty of Health Science in Ankara, Turkey. My academic background and work experience as a Nurse-Researcher has enabled me to develop a range of skills. Accordingly I have been in Prato Hospital in Italy-Florence for 3 months and US-Wisconsin Madison University for 3 months. My research focuses on motivational interviewing for smoking cessation, improving congnitive function of the elderly, prevention of substance use in adolescent period and women health.
Abstract:
Objective: To evaluate reproductive health and influencing factors of female student who staying a dormitory of credit and dormitories agency. Methods: This descriptive type of research was conducted in a dormitory with 465 female students between June 20 to 25, 2015 period. Research data were collected with face to face interview technique using genital health status of female students and ınfluencing factor questionnaires. The obtained data were analyzed on SPSS database using number, percentages and Chi-square significance test. Results: The students whose average age is 1.74+21:42 stated that 60.6% of them take a bath once a week, 41.2% of them change their underwear twice a week, 18.7% of them don’t take bath during menstruation and 47.5% of them use daily pad. It was seen that 72.7% of the students didn’t wash their hands before entering to toilet and 38.5% of them didn’t make their genital area cleaninig properly. In the last one year period when students stay at dormitory, students expressed that 69.7% of them experienced burning and pain while urinating, 72.9% of them experienced the problem of itchy vaginal discharge like white cheese cut, 20.9% of them stated expreincing the problem of foul-smelling discharge with green-yellow color; the majority of students who have vaginal discharge expressed that they didn’t go to doctor. Conclusion: It was seen that the girls remaining in the dormitory had some problems related genital health and hygiene.
Salwan Tariq Al-Ani
UIT Arctic University of Norway, Norway
Title: Symptoms, signs and biomarkers during exacerbations of asthma and COPD in primary care: Which findings are most strongly related to a drop in lung function?
Time : 12:20-12:40
Biography:
Salwan Tariq Al-Ani is a PhD student at the Arctic University of Norway since 2011; he is doing his research about asthma and COPD in primary care as a part time. He is working as a General Practitioner and community medicine Doctor in Fauske Municipality in the north of Norway. During the last 4 years, he published 2 articles about the exacerbation of asthma and COPD from his research and attended many scientific meetings and conferences like IPCRG, GRIN and Nordic congress and presented abstracts from his research in these meetings.
Abstract:
Background: Little is known about the association between lung function and other physiological changes with the clinical course of the exacerbation of asthma and COPD in primary care. The purpose of this study was to describe these changes and the association between them at the time of presentation. Aims: To describe the changes in symptoms, signs and biomarkers during acute exacerbation of asthma or COPD in primary care, and to identify which findings are most strongly related to a drop in lung function. Methods: Patients aged 40 years or more registered with diagnosis of asthma and/or COPD in the previous 5 years from seven general practice offices in Norway were identified, and 1111 patients were invited for baseline examinations. Those included were asked to contact their GPs if they experience exacerbations during the following year. Symptoms, chest findings, CRP, pulse oximetry and spirometry were registered both at baseline and during exacerbations. COPD clinical questionnaire (CCQ) was used to register the symptoms. Results: Of the 376 patients in stable phase included at baseline, 95 patients experienced one or more exacerbation during the study period. Of the 88 patients, who underwent spirometry during exacerbation, the FEV1 had dropped 10% or more in 36 patients (40.9%). Crackles recorded at exacerbation, but not at baseline and a drop in oxygen saturation of at least 2% to 94% or less were the findings most strongly associated with a 10% or more reduction in FEV1. Conclusion: Most respiratory symptoms and chest findings changed during the acute exacerbations of asthma or COPD, but chest signs, together with a decrease in oxygen saturation were much stronger indicators of a drop in lung function than were the respiratory symptoms.
Amna Khalifa Alhadari
Dubai hospital, UAE
Title: Overview of the management of chronic kidney disease (CKD) in adults: The role of pre dialysis educational program
Time : 12:40-13:00
Biography:
Amna Khalifa Alhadari has graduated from Sheffield University–collage of medicine, Nephrology. She is now working as a Specialist Consultant in Nephrology department in Dubai Hospital.
Abstract:
Prevalence of end-stage renal disease (ESRD) has been rising steadily, chronic kidney disease is a silent killer, being silent is responsible for its late diagnosis. When the disease is silent (asymptomatic), it is usually detected by primary health care physician on routine testing or incidentally while testing for other problems. It is expected that a growing number of asymptomatic CKD patients will be managed in the primary care setting. There are simple steps to diagnose the disease, and its stages. Some factors such as controlling blood sugar in diabetics and blood pressure in hypertensives may delay the progression of the disease, avoiding nephrotoxins such as nonsteroidal anti-inflammatory pain killers may also help delay the needs for renal replacement therapy. These reversible factors could be tackled in primary health care and the time is defined when the care should be shared with the nephrologist. Complications of CKD starts and the symptoms appears with GFR being <30ml/min although it might start earlier in diabetics, this is the stage where the patients should be referred to the nephrologist to attend the pre dialysis educational clinics and to plan their further treatment under the supervision of the expertise and also to meet others who have similar problems. These support groups can be of great help psychologically, being gone through the same steps. Recently, predialysis educational clinics providing information about kidney disease, options for the management of CKD prior to dialysis (including pharmacological and dietary management) and the options for renal replacement therapy, proved to improve outcomes in management of CKD. Similar clinic has been initiated in Dubai hospital with great results.
Duric N S
Helse Fonna Hospital, Norway
Title: ADHD children and adolescents: Long-term randomized controlled study
Biography:
Duric N S is Child and Adolescent Psychiatrist and Clinical Researcher at Helse Fonna Hospital in Norway. She obtained her medical degree from the University of Sarajevo in 1980 after which she pursued specializations in ear, nose and throat from the Clinical University Center of Sarajevo (1988) and child and adolescent psychiatry from Mental Health Clinic Kristiansand, Norway (2001). She completed her PhD from the University of Bergen. She has published many articles in prestigious journals and has served as a scientific reviewer of repute. She has a long engagement as a member and leader of charity work.
Abstract:
ADHD is one of the largest groups in psychiatric health care for children and adolescents in Norway. Early recognition and diagnosis, proper organization and appropriate treatment have a positive effect on the self-esteem and development of the child as well as probable socioeconomic benefits for society. The need for mental health support for ADHD children is one of the upcoming issues and needs to address whether the detection and treatment can be given to primary health care (PHC). Different treatment approaches aimed at improving ADHD core symptoms have been assessed. Despite the beneficial effects of most treatment approaches, existing problems with those that do not respond well to treatment or have adverse drug reactions, call for alternative or complementary treatments. A randomized controlled clinical study was performed to explore the ability of PHC to identify ADHD symptoms and to evaluate the use of short and long-term efficacy of standard stimulant medication and neurofeedback as the single and multimodal treatment to treat ADHD in children and adolescents. The high referral rate and low incidence of ADHD-diagnosed children and adolescents at the Child Adolescent Mental Health Clinic demonstrated a need to improve the understanding of ADHD in PHC. Pre-referral screenings and additional screening guidelines in the community and PHC environments is recommended. Findings provide new evidence for the long-term efficacy of multimodal treatment of stimulant medication and NF. However, more research is needed to explore if multimodal treatment is suitable for ADHD children and adolescents with insufficiently response to single MED treatment.
Mohammed Almarri
Hamad General Hospital, Qatar
Title: Asthma management guideline in adult for primary care physicians
Biography:
Mohammed Almarri has done his MBBS at Royal College of Surgeons School of Medicine Dublin, Ireland. He worked as a Clinical Instructor at University of South Alabama Medical center at Alabama and as an Assistant Professor at Weil Cornell Medical College in Qatar. He is currently working as a Senior Consultant of pulmonary, critical care and sleep medicine at Hamad General Hospital Doha Qatar
Abstract:
This is the first Qatari guidelines for the diagnosis and management of asthma, developed primarily to standardize the care for asthmatic at the primary and secondary care to match the best practice worldwide, as recent data showed poor management of the asthma especially in the primary care. The main objective of the guidelines, is to deliver the vast knowledge of recent pathophysiology of asthma and different guidelines from all over the world into simple practical guidelines to understand and easy to use by non-asthma specialists, including primary care and general practice physicians. The guidelines covered both the adults and children in diagnosis and management of chronic asthma and acute exacerbation of asthma based on the available evidence, local literature, and the current situation in Qatar and Gulf Council Countries (GCC). There was an emphasis on asthma phenotypes and disease control in approaching the management of asthma as it is the ultimate goal of treatment.
Biography:
Pawlin Vasanthi Joseph completed her PhD in the field of Environment Management and Biotechnology from the Defence Research and Development Organization – Centre for Life Sciences, Bharathiar University, Coimbatore, India. She has published 10 papers in peer reviewed journals and has presented 14 papers in national and international conferences. Currently, she is the Head of the Department of Zoology at Nirmala College and Co-ordinates the Career Oriented Program in Vermitechnology and the Star College Scheme for strengthening of Life Sciences, Department of Biotechnology, Government of India.
Abstract:
Background: Maps show well the spatial configuration of information. Considerable effort is devoted to the development of Geographical Information Systems (GIS) that increase understanding of public health problems and in particular to collaborate efforts among Clinicians, Epidemiologists, Ecologists, and Geographers to map and forecast disease risk. Objectives: Small populations tend to give rise to the most extreme disease rates, even if the actual rates are similar across the areas. Such situations will follow the decision-makers attention on these areas when they scrutinize the map for decision making or resource allocation. As an alternative, maps can be prepared using P-values (probabilistic values). Materials & Methods: The statistical significance of rates rather than the rates themselves are used to map the results. The incidence rates calculated for each village from 2000 to 2009 were used to estimate λ, the expected number of cases in the study area. The obtained results are mapped using Arc GIS 10.0. Results: The likelihood of infections from low to high is depicted in the map and it is observed that 5 villages namely, Odanthurai, Coimbatore Corporation, Ikkaraiboluvampatti, Puliakulam, and Pollachi Corporation are more likely to have significantly high incidences. Conclusion: In the probability map, some of the areas with exceptionally high or low rates disappear. These are typically small unpopulated areas, whose rates are unstable due to the small number of problems. The probability map shows more specific regions of relative risks and expected outcomes.
- Track 1: Primary Health Care
Track 2: Primary Care Medicine
Location: The Oberoi Dubai, Dubai
Chair
Jay Kalra
University of Saskatchewan ,Canada
Co-Chair
Andrew W. Gottschalk
Ochsner Health System, USA
Session Introduction
Brian Littlechild
University of Hertfordshire, UK
Title: The management of violence and aggression against staff in mental health work: responding effectively through a co-production approach to issues for service users, carers, staff and agencies.
Time : 10:40-11:00
Biography:
Brian Littlechild holds a PhD and is a Research Lead in the Department of Nursing and Social Work at the University of Hertfordshire, UK. A Qualified and Registered Social Worker, he worked in hospitals and in the community with particular mental health needs before working in universities. He has published 44 books/book chapters/monographs, and 28 refereed journal articles. He has carried out 20 qualitative and mixed methods research projects, and published widely on, amongst other areas, mental health issues for young and adult offenders, mental health and risk assessment, and on violence from parents in child protection work.
Abstract:
This presentation examines the causes and consequences of violence from mental health patients on staff, the patients themselves, and others in their formal and informal networks. It addresses how best to respond to staff and patients after such incidents, and the potential for jointly produced solutions to the problem. The presentation is based on analysis of the evidence arising from a review of the research and wider literature, and how we might analyse this evidence in order to produce best practice in policy guidance and direct work with patients, including the evidence and recommendations from the UK’s National Institute for Health and Care Excellence (NIHCE) Guideline Development Group’s systematic review on ‘Violence and Aggression: The short-term management of violent and physically threatening behaviour in mental health, health and community settings’ (2015). The presentation will consider how the use of restorative justice and mediation techniques can be used as a nuanced approach to heal the damaging effects on staff and others, in conjunction with the use of co-production approaches with service users and staff, in order to encourage staff groups, agencies, and personal learning for patients and staff involved to reduce the risk of further such situations. The presentation will take into account a key feature of health care policies in the United Kingdom, concerning service user involvement in patient care. Key issues in taking this approach are addressed, with methods for how to do this in practice covered, with a model proposed for enacting such approaches.
Gillian Hood
Queen Mary, University of London, UK
Title: The diabetes Myquest consultation tool© study
Time : 11:00-11:20
Biography:
Gill Hood has been involved in diabetes care since qualifying as a nurse in 1984 and from 1997 began working in diabetes research. She managed the NE London Diabetes Research Network from 2007-2013 increasing patient recruitment 5 fold during this period and conducting her own research into fasting during Ramadan for people with diabetes, how older adults manage diabetes over time, and improving the patient-doctor consultation in diabetes. Gill is also an original member of the EU funded Diamap study which aimed to project diabetes research milestones for the next ten years. She is also involved with patient and public information groups encouraging users to discuss research and be more involved. She is an honorary research fellow at Queen Mary, University of London (QMUL) and continues to manage diabetes clinical research at QMUL. Gill is the Workforce Development and Patient and Public Involvement and Engagement Lead for the North West London Clinical Research Network funded by the National Institute of Health Research. In her capacity as Workforce Lead Gill runs course in Clinical Research for nurses and allied health professionals. She also runs courses for patients and the public who want to be involved with research. Gill is a member of the Foundation of European Nurses in Diabetes (FEND) and the Novo Nordisk Research Foundation for Nurses and Allied Health Professionals. Gill’s diabetes research interests are in ethnic minorities and engaging hard to reach groups in research, diabetes and older adults, health professional education, and patient and public involvement.
Abstract:
Background: The consultation between nurses and patients is an important aspect of managing diabetes, which can improve clinical outcomes. It can also be a frustrating experience due to limited time, training, and unidentified patient emotional problems. The diabetes MyQuest Consultation Tool© is a collaboration between nurses and patients to provide a meaningful guide to consultations through a patient questionnaire. The questionnaire combines clinical information, self-care statements and approved psychological scales, so that patients’ needs can be more readily recognised and addressed. Aims: The aim of this pilot study was to provide a supportive, structured, and time-efficient tool for patients and nurses to use, to optimise diabetes self-care, and to identify any mental health problems. Methods: This pilot study was a mix of methods in randomised control trial involving patients with type 2 diabetes and with no current mental health problems. Patients were randomised to routine consultations (control) or to use the MyQuest Consultation Tool© in their diabetes appointment (intervention). Patients were given pre and post measures of diabetes knowledge (DK), consultation satisfaction (PNIF), empowerment (DES) and interviewed. Results: 120 patients (40-90 years; m=67 years) were consented into the study. Of these, 106 patients (66 male; 40 female; average diabetes duration 9 years) completed all study visits. There were significant changes for the whole sample between pre and post study measures of DK (0.0001*), PNIF (0.0004*) and DES (0.0010*). 38% of participants scored below the clinical cut-off point on the WHO-5 Wellbeing Index indicating a need for clinical intervention. Qualitative results demonstrated a strong preference for using this tool, highlighting its empowering structure and guidance. Conclusion: This pilot study demonstrates: High acceptability of the diabetes MyQuest Consultation Tool©; positive changes in diabetes knowledge, satisfaction and empowerment; identification of unknown mental health problems; but only slight changes in HbA1c, BMI and Cholesterol. A longer term study is now needed to test whether MyQuest could also improve clinical measures in addition to providing welcomed structure for the consultation. With T2D remaining at epidemic proportions, MyQuest may be an efficient, realistic and cost effective strategy for managing diabetes in primary care.
Clive Tobutt
University of Surrey, UK
Title: Delivering primary health care in community justice settings: Motivational interviewing brief interventions to reduce alcohol consumption in hazardous drinkers
Time : 11:20-11:40
Biography:
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 in Sociology (Health & Illness) from London South Bank University. He is currently a PhD student at the Univertsity of Winchester. He is a teaching Fellow (Mental Health Nursing) at Surrey University and a Senior Lecture at the University of Winchester. He has published 8 papers in reputed journals and has been serving as an Editorial Board Member of the Advances of Dual Diagnosis Journal.
Abstract:
Alcohol has an association with intoxication and violence. Hazardous drinkers may be caight up in the criminal justice system as there is a relationship between alcohol and violence. For example, the risks of violence and offending behaviour increase with alcohol intoxication. A number of offences have been linked with hazardous drinking, including, criminal damage, theft, drunk and disorderly, violent assault, grievious bodily harm, domestic violence, sexual offences, drink drving, drug-related offences and public disorder and there are health risks too. An entry into the criminal justice system occurs with arrest and detention within a police custody suite. With regards to alcohol-related offences, depending on the time of the arrest e.g., evening or during the night or the previous day would mean being charged with a court appearance the next day. Whilst there has been limited research to date concerned with reducing alcohol consumption amongst offenders arrested and/or detained in police custody suites, such settings offer a number of advantages integrating the UK National Health Service primary health care workers. Successfully delivered interventions within these settings have potential to interrupt hazardous drinking earlier than those that are offered later in the cycle of offending, such as within probation settings, police custody and magistrate courts as well as better health outcomes.
Ingrid Schusterova
Children University Hospital, Slovakia
Title: Importances of cardiovascular disease in primary healthcare
Time : 11:40-12:00
Biography:
I Schusterová is an Associated Professor and the Head of the Department of Paediatrics and Adolescent medicine, Children University Hospital, P J Š University in Košice, Slovakia. At the same time, she is the Head Physician in the tertiary center for valvular and congenital heart defects, Eastern Slovak Institute of Cardiac and Vascular Diseases. She took specialization exam from Adult and Pediatric Cardiology at National Institute of Cardiac and Vascular Diseases in Bratislava, Slovak Republic. After Graduation, she took part in Fellowship Training at Ottawa Civic Hospital, and later on performed research work in the area of cardiology at University of Ottawa in Canada. In the period from 11/1999 till 7/2004, she completed her training at Cardiologic department, II. Internal Medicine Clinic, General hospital, Vienna under supervision of Professor Dr Gerald Maurer. Later in 2005, she broadened her professional knowledge and skills at Cardiac Surgery Clinic, Kardiocentrum Universitätsklinik in Bad Oyenhausen, Germany. Her research interests focus on preventive cardiology, obesity, and disorders of lipid metabolism, atherosclerosis and their prevention in the pediatric age group.
Abstract:
The process of atherosclerosis begins already in childhood and its relationship to the presence and intensity of the known cardiovascular risk factors has been already proved. Expert panel on integrated guidelines for cardiovascular reduction in children and adolescents highlighted early identification of risk factors and their elimination, as they plays a key role in the prevention of CVS diseases. AHA definition of “CVS health” encompasses these parameters: tobacco use, BMI adjusted to the gender and age of a child, physical activity, score of healthy food, total cholesterol, blood pressure, fasting glycaemia. As an important part of primary prevention we perform screening program, examining the serum concentration of total cholesterol in 11 and 17 years old children and adolescents allover Slovak Republic by primary paediatricians. In case, total cholesterol level are higher than 5.4 mmol/l patients are refered to the specialist outpatient care department – pediatric cardiologist and endocrinologist. Selective screening is provided in population with high risk of CVS disease (with positive family history of CVS diseases, concentrations of cholesterol higher than 6.2 mmol/l, etc.) in specialised terciary centers for lipid metabolism disorders and preventive cardiology. Markers of subclinical atherosclerosis, increased Carotid Intima-Media Thickness (CIMT) assessed with ultrasound, endothelial dysfunction (reduced arterial dilation), and increased left ventricular mass with cardiac ultrasound are examined in the pediatric centers of preventive cardiology. The identification of children and adolescents with high risk and effective management of identified risk factors represents the key point in prevention of future CVD.
Gustavo H. Marin
National University of Central Buenos Aires (ESCS-UNICEN), Argentina
Title: Proposal to improve Primary Health Care effectiveness
Time : 12:00-12:20
Biography:
Gustavo H Marin is Doctor in Medicine; Magister in Public Health; Magister in Health Economics; Magister in Political Sciences; Post-doc in Public Health Assistance, Paris, France. He is the Former Director of Primary Health Care of Buenos Aires; Director of Scientific Research Commission, Buenos Aires, Argentina; PAHO Health International Leadership Fellowship; Head Professor of Health, National University of Central Buenos Aires, UNICEN, Argentina. He is the Author of more than 150 papers and books in Public Health Research.
Abstract:
Primary Health Care (PHC) has been an excellent theoretical strategy however, in practice, after more than 30 years from the proposal, health’s results and indicators are not the one expected. From Alma Ata to our days, the epidemiological approach of diseases has changed. Chronic illnesses such as hypertension and diabetes mellitus have replaced the infectious diseases as the major causes of morbidity and mortality worldwide. Our group has focused the absence of nominal responsibility and customization of the practices by the health team as one of the major drawbacks of the lack of success with PHC strategy. To demonstrate this point, we examined the impact of nominal and customized health care model in patients with diabetes and hypertension. 2,400 patients were included in a randomized study. Patients were assigned to a control group or to an intervention. Both groups received medication prescribed by health professional for free, but “control” group received the treatment on demand; while in the "intervention" group, a weekly regular contact by one of the member of the health team. A nominal responsibility of the patient was being then assigned to that team’s member. After 24 months of running this health care model, results showed 46% reduction in cardiovascular events and 62% decrease in hospital admissions due to events related to these diseases. We conclude that PHC strategy showed a substantial improvement of the goals when a nominal responsibility is assigned to a member of the health team in order to provide this care practices.
Muhammad Ajmal Zahid
Kuwait University, Kuwait
Title: Prevalence of psychiatric morbidity in the primary health clinic attendees in Kuwait
Time : 12:20-12:40
Biography:
Muhammad Ajmal Zahid has done his MBBS from King Edward Medical College, Lahore. He is working as a Professor; Faculty of Medicine in Kuwait University, Kuwait. He has attended many international conferences and organized many workshops. He has published nearly 30 abstracts in many reputed journals. He is an invited speaker to many conferences.
Abstract:
Background: A substantial proportion of primary clinic attendees suffer from psychiatric disorders and many of them are neither recognized nor adequately treated by primary clinic physicians. Objectives: To determine the point prevalence of, and identify risk factors for, depression, anxiety and somatisation disorder in the primary health clinics in the country. Method: The Physical Health Questionnaires (PHQ-SADs) were administered to a randomized sample of 1046 primary clinic attendees in all the five governorates of the country over a 5-month period. The descriptive data were computed with chi-square tests while the association of demographic characteristics with psychiatric disorders was determined with the logistic regression test. Results: 42.7% of our patients suffered from psychiatric disorders including depressive (22.9%), anxiety (17.7%), and somatisation (33.4%) disorder. Comorbidity between the three disorders was found in 20.4% of the sample; 11% had two and 10.4% had all three disorders. The Kuwaiti nationals, female gender, older age group subjects and those with lower level of education were more likely to suffer from psychiatric disorder. Limitations: The inter-rater reliability may have affected the results as a large number of physicians were responsible for administering the questionnaires. Moreover, the study did not include eating and substance-abuse disorders and the findings were limited to detection of somatisation, depression and anxiety disorders. Conclusions: In order to ensure timely provision of appropriate treatment, the primary care physicians need adequate information on different forms of presentation, and basic front line treatment, of the common mental disorders at the primary care level.
Litty Varghese
Seha Ambulatory Healthcare Services, UAE
Title: Barriers to adult immunizations and strategies to improve coverage
Time : 12:40-13:00
Biography:
Litty Varghese (RN; MSN) is working as A/Head of Nursing Education, AHS/SEHA, UAE. She has 34 years of experience in the field of PHC, UAE and has expertise as JCIA chapter lead and tracer team member, quality improvement coordinator, diabetic clinic project coordinator, community program organizer, nurse educator, newsletter editor and researcher. She holds Master’s Degree in Community Nursing, Post Graduate Diploma in Nursing Administration and obtained certification in Principles of Epidemiology and Biostatistics from CDC, Atlanta. With her continuance in excellent professionalism, she won the First Seha Best Employee Award 2012, the 3rd Best Abstract Award at The Pan Arab Hypertension Conference in Abu Dhabi Feb. 5-9, 2000 and actively participated in winning the following Awards: 2009 Arab Health Award for PHC Chronic Disease program; 2010 Arab Health Award for Nursing HR development.
Abstract:
Vaccination against childhood communicable diseases through the Expanded Program on Immunization (EPI) is one of the most cost-effective public health interventions available. Most causes of vaccine preventable illness among children are relatively uncommon due to high rates of vaccination and very effective vaccines. Adult vaccination is one of the most important tool for reducing morbidity and mortality not just in the elderly but in other members of the society by increasing herd immunity, reducing severe clinical outcome and helping in eradication of the disease. The immunization program overall has been very successful with kids. We are not doing so well with adults. Adults are recommended to receive vaccinations based on their age, underlying medical conditions, lifestyle, prior vaccinations and other considerations. Although provider recommendation is a key predictor of vaccination, more often clients report not receiving vaccine recommendations at healthcare provider visits. Other barriers for vaccinating adults include the cost of providing vaccination services, inadequate or inconsistent payment for vaccines and vaccine administration, and acute medical care taking precedence over preventive services. Despite these challenges, a number of strategies have been demonstrated to substantially improve adult vaccine coverage, including patient and provider reminders and standing orders for vaccination. Providers are encouraged to incorporate routine assessment of their adult patients' vaccination needs during all clinical encounters to ensure patients receive recommendations for needed vaccines and are either offered needed vaccines or referred for vaccination.
Tim Carr
Maharishi Ayurveda Association of Australia, Australia
Title: Personalized diet and lifestyle prescription in primary health care
Biography:
Tim Carr has completed his Medical degree from the University of Sydney in 1976 and Postgraduate studies at the MIU Institute of Ayur-Vedic Studies, Iowa, USA and the Gujarat Ayur-Veda University, Jamnagar, India in 1984-85. He has authored and co-authored several articles on the clinical applications of Maharishi Ayurveda. He was appointed as Expert Adviser on Ayurveda to Complementary Medicines Evaluation Committee, Therapeutic Goods Administration from 2002 to 2009. He is currently the President of the Maharishi Ayurveda Association of Australia.
Abstract:
Diet and lifestyle are recognized as the primary determinants of major chronic diseases. Primary health care physicians are ideally placed to advise patients about primary and secondary preventive measures. Compliance, however, is largely dependent on patients’ motivation. This can be improved by personalizing preventive advice, so that the recommended measures are more relevant to and compatible with the patient. Maharishi Ayurveda, the reconstruction of the ancient Vedic system of medicine, offers a systematic approach to adapt preventive advice to the patient. Central to this approach is the determination of the patient’s mind/body type and digestive capability. This is assessed through a short questionnaire and simple clinical examination. The mind/body type is indicative of the patient’s metabolic type and responsiveness to different food groups, exercise programs and daily routines. Knowing the patient’s digestive capability, however, is the first step in formulating the dietary advice. It is known that the products of digestion can alter gut flora and the integrity of the gut lining and in turn influence the body’s immunological and endocrinological responses. Dietary manipulation of the digestive function therefore can have a major impact on health outcomes. In this approach the patient also learns to monitor the effects of dietary and lifestyle changes and to modify them accordingly – and is thereby empowered to take more responsibility for his or her health. Clinical experience confirms that by personalizing diet and lifestyle prescriptions in this way and educating the patient to self-monitor the results, compliance with preventive advice is greatly enhanced.
Brendan Mitchell
Gold Coast University Hospital, QLD, Australia
Title: Medication adherence one month after hospital discharge in medical inpatients
Time : 11:35-11:55
Biography:
Brendan Mitchell completed a Bachelor of Science at the University in Queensland in 2010, and subsequently a Doctor of Medicine at the University of Melbourne, graduating in 2014. He is currently working as a resident medical officer at Gold Coast University Hospital in Queensland, Australia.
Abstract:
Background: The rate of medication non-adherence has been consistently reported to be between 20-50%. The majority of available data comes from international studies, and we hypothesized that a similar rate of adherence may be observed in Australian patients. Aims: To determine the rate of adherence to medications after discharge from acute general medical hospital admission, and identify factors that may be associated with non-adherence. Methods: A prospective cohort study of 68 patients, comparing admission and discharge medication regimens to self-reported regimens 30-40 days after discharge from hospital. Patients were followed up via telephone call and univariate and multivariate binary logistic regression used to determine patient factors associated with non-adherence. Results: A total of 27 of 68 patients (39.7%) were non-adherent to one or more regular medications at follow up. Intentional and unintentional non-adherence contributed equally to non-adherence. Using multivariate analysis, presence of a carer responsible for medications was associated with significantly lower non-adherence (OR 0.20 (0.05-0.83), p=0.027) when adjusted for age, comorbidities, chemist blister pack and total number of discharge medications. Conclusions: Non-adherence to prescription medications is suboptimal, and consistent with previous overseas studies. Having a carer responsible for medications is associated with significantly lower rates of non-adherence. Understanding patient’s preferences and involving them in their healthcare may reduce intentional non-adherence.
Trish Morison
Universal College of Learning, New Zealand
Title: When pregnancy is no longer the issue
Time : 14:40-15:00
Biography:
Trish Morison has completed a Master’s degree in Public Health. Her research was published in the New Zealand Journal of Primary Health Care. She has lectured in Anatomy, Physiology and Pharmacology for the last 14 years.
Abstract:
The rate of sexually transmitted infections amongst midlife and older heterosexual women in New Zealand is rising. Popular culture celebrates a heightened sexuality for this population group. However, depictions of sexually savvy ‘cougars’ are at odds with reality for many women. International literature highlights that these women are often ill-equipped to negotiate safer sex and condom use, instead focusing on pleasing men and attributing their silence to spontaneity. The study aimed to explore the enablers and barriers to safer heterosexual sex as perceived by midlife and older New Zealand women, who are re-partnering or in casual relationships. This qualitative study utilized Interpretive Phenomenology Analysis, supported by the theory of gender and power, to examine the gender-normative assumptions and behaviors in women’s accounts of unprotected sex. Eight single women aged 40-69 participated in individual, in-depth interviews. Analysis indicated that these women held misconceptions about STI transmission but had not sought educational material, nor discussed their sexual health with clinicians. Results highlighted women’s ambivalence about prioritizing safer sex, preferring to comply with partners’ wishes, particularly when under the influence of alcohol. Women described valuing their own pleasure and their distaste for condom use, but data emphasized that women predominantly aligned their choices with men’s preferences. This study highlights that midlife women are both ill-informed and vulnerable with regards to sexual health. Primary healthcare clinicians are well placed to provide education and sexual health advice.
Haw-Yueh Thong
Shin Kong Wu Ho-Su Memorial Hospital ,Taiwan
Title: Experience of Photopneumatic Therapy in Taiwanese Acne Patients
Time : 15:00-15:20
Biography:
Haw-Yueh Thong is Chief of the Cosmetic Center at Shin Kong Wu Ho-Su Memorial Hospital in Taipei, Taiwan ROC. After graduating from National Taiwan University College of Medicine, she completed an Internship in National Taiwan University Hospital. Her Residency was in dermatology at National Taiwan University Hospital and her Fellowship was in cosmetic dermatology at the University of California, San Francisco. She had worked closely with Professor Howard Maibach at UCSF. She is also a Graduate of Stanford University with a Master’s degree in management science and engineering, focusing on medical decision analysis. She has published numerous articles in professional journals and serves on many advisory boards and committees. Her interest in dermatology include acne vulgaris, cosmetic dermatology and filler injections
Abstract:
Acne is a disease of the pilo-sebaceous unit affecting both teenagers and adults. The treatment of acne is sometimes frustrating due to the emergence of antibiotic resistance, skin irritation and lack of novel therapy. Light and vacuum devices, also known as photo-pneumatic therapy, have been shown promising as a generally well-tolerated adjunctive treatment of acne vulgaris. We conducted a clinical study using such device to assess the efficacy and safety as an adjunctive treatment of acne in Taiwanese patients. Twenty patients received six sequential treatments every one to two weeks in the facial region. A 4×4 cm2 area on cheek was chosen as a control area and was not treated with photo-pneumatic device. Safety parameters and adverse events were recorded. VISIA Complexion Analysis System was used for image analysis on the improvement of four parameters, namely, pigmentation, pore reduction, redness and porphyrin levels. There was an overall improvement in pigmentation, pore size, redness and porphyrin levels on treatment areas. The treatment areas showed statistically significant improvement (p<0.05) in pigmentation and pore sizes compared with the control areas using paired samples T-test. Mild and self-limiting localized adverse events, mostly focal petechiae or mild irritation, were reported. Our study has demonstrated that photo-pneumatic therapy is an effective, safe and relatively well-tolerated procedure in Taiwanese acne patients.
Salwan Tariq Al-Ani
UIT Arctic University of Norway, Norway
Title: Symptoms, signs and biomarkers during exacerbations of asthma and COPD in primary care: Which findings are most strongly related to a drop in lung function?
Time : 15:20-15:40
Biography:
Salwan Tariq Al-Ani is a PhD student at the Arctic University of Norway since 2011; he is doing his research about asthma and COPD in primary care as a part time. He is working as a General Practitioner and community medicine Doctor in Fauske Municipality in the north of Norway. During the last 4 years, he published 2 articles about the exacerbation of asthma and COPD from his research and attended many scientific meetings and conferences like IPCRG, GRIN and Nordic congress and presented abstracts from his research in these meetings.
Abstract:
Background: Little is known about the association between lung function and other physiological changes with the clinical course of the exacerbation of asthma and COPD in primary care. The purpose of this study was to describe these changes and the association between them at the time of presentation. Aims: To describe the changes in symptoms, signs and biomarkers during acute exacerbation of asthma or COPD in primary care, and to identify which findings are most strongly related to a drop in lung function. Methods: Patients aged 40 years or more registered with diagnosis of asthma and/or COPD in the previous 5 years from seven general practice offices in Norway were identified, and 1111 patients were invited for baseline examinations. Those included were asked to contact their GPs if they experience exacerbations during the following year. Symptoms, chest findings, CRP, pulse oximetry and spirometry were registered both at baseline and during exacerbations. COPD clinical questionnaire (CCQ) was used to register the symptoms. Results: Of the 376 patients in stable phase included at baseline, 95 patients experienced one or more exacerbation during the study period. Of the 88 patients, who underwent spirometry during exacerbation, the FEV1 had dropped 10% or more in 36 patients (40.9%). Crackles recorded at exacerbation, but not at baseline and a drop in oxygen saturation of at least 2% to 94% or less were the findings most strongly associated with a 10% or more reduction in FEV1. Conclusion: Most respiratory symptoms and chest findings changed during the acute exacerbations of asthma or COPD, but chest signs, together with a decrease in oxygen saturation were much stronger indicators of a drop in lung function than were the respiratory symptoms.
Ahmad A Mirza
Taif University, Saudi Arabia
Title: Diagnosis and control of hypertension as indicators of the level of education and awareness among the relatives of medical students
Time : 16:20-16:40
Biography:
Ahmad A Mirza has completed his MBBS from Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia. Recently, he has been appointed as Demonstrator (Teaching Assistant) in Department of Surgery, Taif University. He has published 2 papers in reputed journals and currently, he is working on 7 ongoing researches. He has been attended and presented in many national and international conferences.
Abstract:
Education and awareness of patients play an important role in the early diagnosis and control of many diseases, including hypertension. We aimed to assess the level of education and awareness among the relatives of medical students, as indicated by the prevalence of undiagnosed and uncontrolled hypertension in this specific population. In this cross-sectional design, senior medical students were invited to interview their respective adult first-degree relatives for the following factors: age, body mass index (BMI), smoking and history of diabetes or any cardiovascular disease, as well as the existence of diagnosed hypertension. Subsequently, students were instructed to measure the blood pressure (BP) of their relatives twice with 5 minutes interval. In case if hypertension is detected (average systolic BP≥140 mmHg and/or average diastolic BP≥90 mmHg), relatives were analyzed either as undiagnosed or uncontrolled hypertension, according to the absence or existence of hypertension in their history, respectively. Comparisons between different sub-groups regarding demographic and clinical factors were made using Chi-Square test and a multivariate logistic regression was used to analyze these factors as predictors for having undiagnosed or uncontrolled hypertension. We included 770 relatives (36.4% females, 16.3% aged≥60) of 82 (57.7%) total students’ participations. Hypertension was detected in 246 (31.9%) relatives, with higher proportions in older (up to 56%, p<0.001), obese (43.2%, p<0.001) and non-diabetic subjects (47.4%, p<0.001) and no difference across gender (p=0.093), marital (p=0.712) or smoking status (p=0.555). The prevalence of undiagnosed hypertension in the total study population was 14.4% (111 cases); while that of known hypertension was 16.9% (130 cases), among which 61.9% cases of uncontrolled hypertension. Predictors for undiagnosed hypertension were age<40 (p=0.004), current smoking (OR=1.96; 95% CI [1.08, 3.58]; p=0.028), absence of diabetes (OR=3.45; 95% CI [1.96, 6.25]; p<0.001) and absence of other cardiac diseases (OR=8.33; 95% CI [2.33, 25.0]; p=0.001); while none of the investigated factors showed to be a significant predictor for uncontrolled hypertension. There is an insufficient level of awareness and education among the family members of medical students, as demonstrated by the high prevalence of both undiagnosed and uncontrolled hypertension. The typical profile associated with the lowest level of awareness in this specific population is that of the young smoker with no history of diabetes or cardiac disease. Healthcare professionals should have a significant contribution in raising the levels of awareness and education in their close circle.
Natalia Alexeeva
Stanford University Graduate School of Business, USA
Title: Virtual primary care-new models for guideline adherenace, efficiency and access
Time : 16:40-16:55
Biography:
Natasha Alexeeva is a serial entrepreneur and health care enthusiast. She spent past 5 years in top notch innovation teams and those endeavors got her to start friendly. Her background is in technology and entrepreneurship. She graduated with computer science degree and math minor from Moscow State University in Russia and attended Graduate School of Business at Stanford University where she co-founded and sold another company in electronic education.
Abstract:
Virtual primary care is the fastest growing market segment in health care. It is projected to reach 42% this year. This is compared to 7% growth of the Urgent Care and 14% growth for retail clinics. The market says it all consumers, physicians and healthcare organizations all over the world see the value in more efficient ways to deliver high quality care. There are two major models in delivering health over electronic medium: Syncherenous (video and phone) and asyncherenous (model that does not require real time interaction). Syncherenous models have been shown to be effective in mental health and clinician to clinicial communications. However, it delivers limited efficiency, since the time taken to assess someone’s health via a video visit is almost identical to the time needed to do the same in the office (23 minutes vs 25 minutes average). Asyncherenous healthcare delivery, on the other hand, creates efficiency as well as increases access and convenience. It relies on latest evidence based guidelines to collect information from the patient using sophisticated computer algorithsms and then serves it to the physician, so that they can access non-critical cases using clinical marginal capacity. Friendly is the market leader in asyncherenous communication. The unique approach is showing an average doctor visit reduced by a factor of 10. Physician documentation is reduced by 50%. Patient loyalty and satisfaction is much higher as compared to in-person visit.
Alzbeta Tohatyova
Pavol Jozef Šafárik University, Slovakia
Title: Ad36 infection can lead to overweight and obesity?
Time : 16:55-17:10
Biography:
Alzbeta Tohatyova is currently a PhD student at Medical Faculty, P J Safarik University in Kosice, Slovakia. Her research interests focus on pediatric cardiology and preventive cardiology.
Abstract:
Introduction: Ad36 is the first human adenovirus reported that causes obesity in experimentally infected animals and shows association with obesity in humans. More human studies, all over the world, are related to the relationship between Ad36 infection and obesity, and till now have not been explanatory, studies show contradictory results. Aim: The main aim of our study is to assess the association between Ad36 infection and obesity in high-school students from Eastern Slovakia. Methods: Two hundred and twenty-four randomly selected students (17.72±1.20 years of age, 120 female) from 7 high-schools in Kosice were included in the study. Subjects with secondary causes of obesity were excluded and none were taking medications or had a history of cardiovascular disease. In 224 healthy students, anthropometric parameters, fasting plasma glucose and insulin were measured. Ad36 antibody was detected by ELISA test. Results: No significant differences were found between Ad36 positive and Ad36 negative high-school students in prevalence of obesity (chi-kv: 1.91, p=0.16). Study found no significant differences between high-school students with and without IR in prevalence of Ad36 positivity (chÃ-kv: 0.66, p=0.41). We confirmed significant differences between Ad36 positive and Ad36 negative in normal weight high-school students (p<0.05, U=2221.50). We also confirmed the high prevalence of overweight and obesity in healthy high-school students (23.66%). Conclusion: The current study shows a possible association between Ad36 infection and the risk of development of obesity in normal weight children and adolescents. Our results do not support that any Ad36 adipogenic adenovirus effect on body composition is operating in human through an insulin-resistance-related mechanism. Further studies in different age groups of children and adults are required to elucidate this biological mechanism of such complex relationship.
Lamia K Alsenaidi
United Arab Emirates University, UAE
Title: Women’s knowledge and attitude towards pregnancy in a high-income developing country
Time : 17:10- 17:25
Biography:
Lamia K Alsenaidi is a 6th year Medical student in United Arab Emirates University/College of Medicine and Health sciences. She has published 2 papers in reputed journals and she is currently working in a new research about cancer awareness.
Abstract:
Objective: The aim of this study was to determine the knowledge and attitudes among women in a high-income developing country regarding pregnancy and antenatal care. Methods: Women who participated in the study were asked to complete a questionnaire. The questionnaire enquired about age, level of education, internet use, marital status and employment. It also included questions regarding their knowledge of ultrasound, the effects of sexual activity and other exercise during pregnancy, breast feeding and premature delivery. The collected data were subjected to statistical analysis using SPSS. Results: The total number of women included in this study was 205. A total of 115 women (56.1%) thought that the most important benefit of ultrasound was to discover fetal abnormalities. Only 75 (36.6%) thought that regular exercise was not harmful during pregnancy. Of the total respondents 116 (56.6%) of 205 thought that sex during pregnancy was harmful to the fetus or did not know. Age (P=0.001), marital status (P=0.001) and working status (P=0.005) were found to significantly affect their knowledge. Conclusion: Knowledge about pregnancy among Emirati women is low. There is a need for effective prenatal classes that focus on educating women about issues related to pregnancy and antenatal care.
Galya Ghalib Al Ghalib Alsharif
King Abdulaziz University Hospital, Saudi Arabia
Title: The benefit of pre- and post-operative instructions
Time : 17:25- 17:40
Biography:
Galya Ghalib Al Ghalib Alsharif has completed her MBBS from King Abdulaziz University Hospital. She is currently a medical intern.
Abstract:
Millions of people each year undergo surgery. Despite the development in the surgical field; patients remain in fear of the complications that may take place. 140 patients were randomly selected from the clinics at King Abdul-Aziz University Hospital, in Jeddah. A questionnaire was used to test their knowledge of the instructions before and after a surgery; ear nose and throat specialty in particular. Another questionnaire was given after educating the patients of the instructions in one of the surgical operations in this specialty. The aim is to educate the patients about these instructions in the event of undergoing any future operations. The result was: 64% of patients knew the existence of instructions before and after operations, while 36% didn’t know the existence of such instructions. The most known instruction by 86% was: to stop eating at midnight on the night of the operation. And the least known by 34% was: to stop taking Aspirin 7 days before the operation. The benefit rate from the explained instructions was 100%. 54% of these patients received only verbal instructions, while 10% received both verbal and on paper instructions and the remaining 18% of patients didn’t receive any instructions.
Christos Stefanou
Limassol General Hospital, Cyprus
Title: Electrical muscle stimulation: Essential in health and disease, in primary and secondary prevention
Time : 17:40- 17:55
Biography:
Christos Stefanou is an Internist and Intensivist in Limassol General Hospital ICU of Cyprus, where he is in-charge of the educational program and an Honorary Associate Professor of Medicine at St George’s University. He was ranked first class in his Medical School of Athens University and finished his fellowship at Evangelismos Hospital of Athens, Greece and his internship in the USA. He is a PhD candidate and researcher in the pathophysiology and regenerative properties of electrical muscle stimulation. He has also been the President of psychosocial support and health group of Cyprus Red Cross.
Abstract:
Electrical muscle stimulation (EMS) is just following the steps and evolution of exercise: one of the enormous accumulations of evidence about its possible medical benefits and high safety and feasibility profile. EMS is nearing inclusion at contemporary essential guidelines for health maintenance, primary and secondary prevention and rehabilitation, with a range of actions extending from healthy people to various categories of chronic patients. It appears to exert regenerative and reparatory effects on the endothelium, to mobilize endothelial progenitor cells; to favorably affect the microcirculation; to induce mesenchymal stem cell potentiation; to exert multilevel beneficial immune, metabolic and endocrine actions related to cytokine, hormonal, neural, anti-inflammatory and anti-oxidant modifications. By these pleotropic pathophysiologic mechanisms, it is evidenced that, EMS improves cardiovascular fitness and overall health; prevents ICU- acquired weakness or sarcopenia, pressure ulcers and venous thromboembolic disease; decreases pathological cardiac remodeling in heart disease, and sympathetic activity; alleviates dyspnea in malignancy or COPD; improves glucose metabolism in metabolic syndrome or diabetes patients; reinforces post injury neuroregeneration; improves spasticity, urinary/fecal incontinence, pelvic floor dysfunction, and chronic pain syndromes; enhances tissue perfusion; and assists in muscle reeducation. Further emerging applications relate to psychological health (such as depression); to post-surgical prevention of atelectasis and cough reinforcement; and to dysphagia in stroke or anorexia nervosa patients. Many applications of this endless list are FDA approved already. EMS needs to be considered as part of numerous medical conditions and any health-care professional needs to be aware of its indications.
Vijayalakshmi Gopalan Nair
University of Nizwa, Oman
Title: Influence of balanced diet on the nutritional status of the children between 1 to 3 years
Time : 17:55- 18:10
Biography:
Vijayalakshmi Gopalan Nair is a registered Nurse and Midwife with Master’s in Community Health Nursing Specialty in 2000. She has completed a Post-graduate diploma in Computer Application and pursuing PhD. She is currently working as Lecturer at College of Pharmacy & Nursing, University of Nizwa, Sultanate of Oman.
Abstract:
Aim: In the present study the researcher wanted to examine the nutritional status of children between 1 to 3 years (preschoolers). This study also wanted to investigate the improvement of weight and hemoglobin level through administration of balanced diet. Methods: One group per-test post-test design was adopted in the study. In pre-test nutritional assessment, dietary intake, anthropometric measurements and hemoglobin level of the children were assessed. The data collection was done for a period of 45 days. Physical assessment, nutritional assessment, dietary intake (pattern), nutritional deficiency diseases, anthropometric measurements like height, weight, head circumference, chest circumference, mid-arm circumference and hemoglobin levels were assessed. Education was given to the mothers on balanced diet and was demonstrated individually in their home setting on their menu planned for their children. After assessing, 30 children data were collected from their mothers. Results: The study findings revealed that among 96% of children there was a significant increase in the weight (from 0.5 to 1.2 kg), mid arm circumference and hemoglobin level (0.6 to 1.2gms dl). None of the child reported to have nutritional deficiencies. There was no significant difference in height, chest circumference and head circumference of the children. However, it has not increased to the ICMR recommended allowances. All the mothers perceived the importance of balanced diet and were able to prepare and feed the prescribed diet to their children comprised of rice, ragi, beef, egg, fish, milk, daal and vegetables including green leafy vegetables, roots and tubers and locally available fruits. Conclusion: The study brings to the attention that proper preparation and administration of balanced diet assures satisfactorial growth and development, prevention of infectious disease, nutritional deficiencies and thereby promoting well being of the children.
Jawahar Jay Kalra
University of Saskatchewan, Canada
Title: Quality care and patient safety: Global approaches to medical error disclosure
Biography:
Jawahar Jay Kalra, an educator, researcher, and quality health care advocate, is a Professor of Pathology in the University of Saskatchewan and has served as Head of the Department of Pathology and Laboratory Medicine. He is recognized for his many contributions as a clinical scientist, academic leader, and health system administrator. He has been a pioneer in establishing guidelines for thyroid-function testing, quality assurance program and contributed nationally and internationally in the area of total quality management. He has published extensively and is the author of the book “Medical Errors and Patient Safety: Strategies to reduce and disclose medical errors and improve patience safety.â€
Abstract:
Disclosure of an adverse event is an important element in managing the consequences of a medical error. We have previously reported the Canadian provincial initiatives encouraging open disclosure of a critical event and have suggested its integration into a ‘no-fault’ model. We reviewed and compared the various medical error disclosure initiatives across the globe (USA, Australia, New Zealand, and United Kingdom) to analyze the progress made in this area. In Australia, disclosure policy integrates the disclosure process with risk management analysis towards investigating the critical events. In New Zealand, in any adverse event, patients are rehabilitated and compensated through a no-fault state funded compensation scheme. The United States Joint Commission on Accreditation of Healthcare Organizations mandated an open disclosure of any critical event during care to the patient or their families’. Effective communication between health care providers, patients and their families throughout the disclosure process is integral in sustaining and developing the physician patient relationship. The Canadian provincial initiatives, though similar in content, remain isolated because of their non-mandatory nature on disclosure. In conclusion, the designing of an error disclosure policy requires integration of various aspects including bioethics, physician-patient communication, quality of care, and team-based care delivery. The complexities of medical error disclosure to patients present ideal opportunities for medical educators to probe how learners are balancing the ethical complexities involved in error disclosure. We suggest that a uniform policy centered on addressing errors in a non-punitive manner and respecting the patient’s right to an honest disclosure be implemented.
- Track 5: Primary Care Services
Track 6: Primary Care Pediatrics
Location: The Oberoi Dubai, Dubai
Chair
Tochi Iroku-Malize
Hofstra Northwell Health School of Medicine, USA
Co-Chair
Brian Littlechild
University of Hertfordshire, UK
Session Introduction
Kaye Ervin
The University of Melbourne, Australia
Title: Care giver distress in dementia in rural Victoria
Time : 10:15-10:35
Biography:
Kaye Ervin has been a registered nurse for over thirty years, practicing predominantly in rural Victoria. Her passion is aged care and the focus of her research interests for the past 6 years. She is a member of the rural health department, the University of Melbourne. She has published 20 papers in international peer reviewed journals and regularly presents her research at National and International forums.
Abstract:
Aim: The aim of this study was to explore the levels of stress, anxiety and depression of informal carers caring for someone with dementia in a rural setting. The study also sought to determine carer’s primary source of stress and their use of dementia specific services. Methods: Carers of people with dementia were recruited to complete a survey that incorporated the Depression, Anxiety Stress Scales (DASS) to measure carer emotional well-being. The survey also included the Neuropsychiatric Inventory Questionnaire (NPI-Q), which assesses the presence and severity of behavioural and psychological symptoms of dementia (BPSD) of care recipients and their effect on the carer. They were also asked through an open ended question what they found most stressful in their caring role and what services they utilised. Results: A total of 39 carers completed surveys. Almost half of the respondents reported levels of stress and depression in the moderate to severe range as measured on the DASS. BPSD exhibited by care recipients, such as agitation, anxiety, aggression and nocturnal disturbance, showed a relationship to the level of stress reported by the carer as measured with the NPI-Q. Despite 84.6% reporting use of the Aged Care Assessment Service and 61.5% reporting provision of printed information on the services available, less than half of the carers utilised commonly available support services. Only 46.2% received financial compensation for their carer role. The predominant source of stress reported was the unremitting burden experienced when caring for someone with dementia.
Mariely Lima
Escola Superior de Educacao de Paula Frassinetti, Portugal
Title: Dogs on the front line of care: Timely information for family physicians
Time : 10:35-10:55
Biography:
Mariely Lima completed her degree in Speech Therapy and PhD in Biomedical Sciences. She is an invited Professor at two Universities in Portugal, where she lectures Post-Graduate and Master’s courses and supervises academic research. She is a founding member of ÂNIMAS, a Portuguese association, accredited by the Assistance Dogs International, which implements dog-assisted interventions and educates assistance dogs. She has been responsible for a number of dog-assisted activities and therapy programs for individuals with different diagnoses. She has attended different conferences as an invited speaker and published a number of scientific papers in peer-reviewed journals with good impact factor.
Abstract:
Recent years have witnessed a surge of interest in the relationship between dogs and human health with a concurrent emergence of new and exciting ‘medical’ roles for these animals. Not only studies show that owning a pet dog can have prophylactic and therapeutic value, but that incorporating these animals into clinical practice, can have a number of benefits for different types of patients. Dogs can also fill the role of assistants for people with disabilities, bringing important physical, psychological and social positive effects for their handlers, and even be trained to alert to seizures in epileptic patients and to changes in blood sugar levels in diabetics. In light of this, a significant “push” is currently being made by a number of researchers to integrate dogs into mainstream healthcare, notably through family medicine. Data, however, suggest that family physicians do not explicitly enquire their patients about dog ownership and feel uncomfortable to discuss the benefits of acquiring assistance or alert dog, and recommend dog-assisted interventions. In this communication, a timely and comprehensive update on the scientifically stronger evidence supporting the positive effects of dogs for human health will be provided. With it, one aims at calling for the attention of family care practitioners on the clinical potential of pet dogs, namely as motivators for adherence to treatment plans and on the importance of ensuring their patients knowledge about the possibility of engaging in dog-assisted interventions and/or acquiring an assistance or alert dog.
Naser Salihu
University Clinical Center of Kosovo, Kosovo
Title: Unusual orbital trauma
Time : 11:10-11:30
Biography:
Naser Salihu finished his residency in Medical Faculty in Ljubljana. He has completed his PhD in Medical Faculty at University of Prishtina. His interests in ophthalmology are anterior segment surgery, oculoplastic surgery and ocular trauma. He has published a lot of papers in International Journals. He also is the president of Kosovo Association of Ophthalmologists and head of trauma department in Eye Clinic, University Clinical Center of Kosovo.
Abstract:
Every orbital trauma represents a serious condition, because in most of the cases is associated with face and head trauma. We represent an unusual case of 12 years old boy with multiple face trauma associated with bilateral globe avulsion and optic nerve transection. He was involved in a tractor accident while driving it. The first signs to be notice as a serious condition from the GP are bilateral globe luxation and acute loss of vision. In this situation we have to pay attention about these signs as they may be caused by fracture of midface and orbit. Because of the closely related anatomy between orbit and midface with brain and blood vessels, this kind of injury may be life threatening. This situation is an emergency which needs multidisciplinary approach. This case should raise awareness on preventing injuries caused by driving agriculture machines from children, especially in developing countries where these injuries are more often.
Belinda Pustina
University Clinical Center of Kosovo, Kosovo
Title: Life threatening eyelid infection after minor trauma
Time : 11:30-11:50
Biography:
Belinda Pustina was born in 1982 in Prishtina, Kosovo. She has started the residency in Ophthalmology in 2011 in University Clinical Center of Kosova, Eye Clinic and the PhD in Neuroscience in University Hospital Center of Tirana, Albania. During this time she participated in many trainings and congresses as active participant. She participated every year in training programs organized from ESCRS (European Society of Cataract and Refractive Surgery) and SOE (European Society of Ophthalmologists). She is now a national representative of Young Ophthalmologists in SOE (European Society of Ophthalmologists) and treasurer in KAO (Kosovo Association of Ophthalmologists). Interests in Ophthalmology are Cornea, Cataract and Refractive Surgery.
Abstract:
Eyelid infections usually are not an emergency in ophthalmology and this is the reason of misdiagnosing necrotizing fasciitis as one of the rarest disease after minor trauma of eyelids. Necrotizing fasciitis is a life threatening soft tissue infection characterized by necrosis of fascia and subcutaneous tissue. If diagnosis and treatment is delayed it can become fatal. It tends to occur in patients in which host defenses are compromised or in healthy individuals after trauma. In periorbital region is very rare because of the excellent blood supply in that area. We present a case of an old farmer female that had a minor trauma in her lower eyelid. First cutaneous anthrax of eyelids was considered in differential diagnosis, because of the contact of patient with animals. But, culture taken from the wound resulted positive for Streptococcus viridians. Treatment with Ceftriaxone + Penicillin was initiated immediately. Patient responded to intravenous antibiotics and after 2 days the edema began to regress. After 2 weeks patient was discharged from the hospital and the clinical outcome was good. Based in this case the treatment of early diagnosed and uncomplicated necrotizing fasciitis may be treated with conservative therapy only. Prompt diagnose from the GP and immediate start of the treatment may be lifesaving in this disease.
Kirti Katherine Kabeer
Apollo Specialty Hospital, India
Title: Post-traumatic long segment small bowel stricture – A diagnostic dilemma
Time : 11:50-12:10
Biography:
Kirti Katherine Kabeer has completed her MS in General Surgery from Mahatma Gandhi Medical College and Research Institute, Pondicherry, India and is currently working with Apollo Specialty Hospital, Chennai, India. This paper that we would like to present has already been accepted and published by the Journal of Surgical Science in 2014.
Abstract:
Delayed post-traumatic small bowel stricture is rare and differentiation from other more common causes of small intestinal stricture is difficult. Presentation may be delayed up to years after the injury. Very often the findings mimic those of other causes of long segment strictures such as Tuberculosis, Crohn's disease, lymphoma, etc. This study analyzes two cases of post-traumatic small bowel stricture, with different presentations and different therapeutic challenges. The literature on this condition is not well recognized and will be reviewed. Resection and reconstruction are diagnostic and therapeutic in patients who present with post-traumatic small bowel stricture, as inflammatory and neoplastic causes cannot be ruled out without histological diagnosis.
Samy Abd Elsamad Nasef
Pharos University, Alexandria,Egypt
Title: The effect of restricted diet with olive oil versus fish oil combined with endurance exercise on dyslipidemic females
Time : 12:10-12:30
Biography:
Samy Abd Elsamad Nasef is the Dean of Faculty of Physical Therapy, Pharos University, Alexandria. He is a PhD holder (1993) (channel emission between Cairo University and Indian University, USA). He is an Associate Editor of the Journal of Advanced Research, Cairo University and has published more than 30 papers in conferences and Journal of Physical Therapy, Cairo University.
Abstract:
Introduction: Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health, leading to reduced life expectancy and/or increased health problems. Lifestyle behaviors, including diet and exercise, are the cornerstone of weight control. Purpose: To compare between the effect of restricted calorie diet containing olive oil or containing fish oil combined with endurance training exercise on lipid profile in obese female. Subjects: Sixty obese females aged 20-40 years are included in the present study. Their Body Mass Index (BMI) ranged from (30:34.99). They were randomly divided into three groups (A, B and C) each group included twenty subjects. Methods: Group (A) included those on restricted calorie diet (1200 cal/day daily) containing olive oil (40.5 ml/day three times a week) and a program of endurance training exercise (moderate intensity 3 times/week), group (B) included those on restricted calorie diet containing fish oil (in form of 204 gram mackerel fish to supply the patient with 3.6 gram omega-3/day three times a week ) and a program of endurance training exercise as group (A) and group (C) included those on restricted calorie diet and endurance training exercise only. The biochemical changes in serum total cholesterol (TC), Triglyceride (TG), Low Density Lipoproteins cholesterol (LDL-C) and High Density Lipoprotein cholesterol (HDL-C) were measured at the beginning of the study and after twelve weeks. Results: Results showed a significant improvement in both lipid profile and weight in the three groups. Dyslipidemic females showed significant improvement in lipid profile of restricted calorie diet combined with exercise more than exercise alone where there was a challenge between group A and Group B in all measured items. Weight was significantly reduced in all groups but group c demonstrated a greater reduction compared with other groups. Conclusion: Restricted calorie diet with olive oil and fish oil, combined with endurance exercise had shown significant improvement in the blood lipid profile and body weight in obese subjects.
Nezla Duric
Helse Fonna Hospital, Norway
Title: ADHD children and adolescents: Long-term randomized controlled study
Time : 12:30-12:50
Biography:
Duric N S is Child and Adolescent Psychiatrist and Clinical Researcher at Helse Fonna Hospital in Norway. She obtained her Medical degree from the University of Sarajevo in 1980 after which she pursued specializations in ear, nose and throat from the Clinical University Center of Sarajevo (1988) and child and adolescent psychiatry from Mental Health Clinic Kristiansand, Norway (2001). She completed her PhD from the University of Bergen. She has published many articles in prestigious journals and has served as a scientific reviewer of repute. She has a long engagement as a member and leader of charity work.
Abstract:
ADHD is one of the largest groups in psychiatric health care for children and adolescents in Norway. Early recognition and diagnosis, proper organization and appropriate treatment have a positive effect on the self-esteem and development of the child as well as probable socioeconomic benefits for society. The need for mental health support for ADHD children is one of the upcoming issues and needs to address whether the detection and treatment can be given to primary health care (PHC). Different treatment approaches aimed at improving ADHD core symptoms have been assessed. Despite the beneficial effects of most treatment approaches, existing problems with those that do not respond well to treatment or have adverse drug reactions, call for alternative or complementary treatments. A randomized controlled clinical study was performed to explore the ability of PHC to identify ADHD symptoms and to evaluate the use of short and long-term efficacy of standard stimulant medication and neurofeedback as the single and multimodal treatment to treat ADHD in children and adolescents. The high referral rate and low incidence of ADHD-diagnosed children and adolescents at the Child Adolescent Mental Health Clinic demonstrated a need to improve the understanding of ADHD in PHC. Pre-referral screenings and additional screening guidelines in the community and PHC environments is recommended. Findings provide new evidence for the long-term efficacy of multimodal treatment of stimulant medication and NF. However, more research is needed to explore if multimodal treatment is suitable for ADHD children and adolescents with insufficiently response to single MED treatment.
Maysoun Al Rushood
Kuwait University, Kuwait
Title: Anaphylaxis management: Knowledge and practice among pediatricians
Time : 12:50-13:10
Biography:
Maysoun Al Rushood is an Assistant Professor at the department of pediatrics in Kuwait University. After graduating from Kuwait Medical School, she joined the pediatric residency program in McGill University in Montreal, Canada. She did further training in the specialty of pediatric allergy and clinical immunology in McGill University, Canada. She has the following certificates: The American Board of Pediatrics, The Canadian Board of Pediatrics and The Canadian Board of Allergy and Clinical Immunology. She is a member in many medical associations in the field of pediatrics and allergy and immunology, such as The American Academy of Pediatrics and The American Academy of Allergy, Asthma and Immunology. Her special interests are primary immunodeficiency and various allergic diseases as well as medical education. She is actively involved in research and teaching at the Faculty of Medicine besides her clinical work in the hospital.
Abstract:
Anaphylaxis is a serious allergic reaction that is rapid in onset and might cause death. It is fatal in around 1% of cases. Studies have shown that there is underuse of intramuscular epinephrine as a first-line treatment despite the international guidelines. It has been demonstrated that many pediatricians have difficulties in anaphylaxis diagnosis and management. My personal observation is that there is delay or failure to use IM epinephrine, which is lifesaving, in cases of anaphylaxis. This is the first study on anaphylaxis in Kuwait. The aim of which is to assess the knowledge on anaphylaxis management among pediatricians and pediatric emergency physicians and factors influencing their practice. The ultimate goal is to be able to provide appropriate tools (updated ER protocol, scientific days, and workshops) to improve patient care and outcome. This is a survey questionnaire that will cover aspects on management based on the international guidelines. The study population is going to be pediatricians in the wards, clinics, ER or PICU, where they might encounter anaphylactic reactions.
Ghada Mohammad Abu Shosha
Zarqa University, Jordan
Title: Perceived challenges of mothers having a child with Thalassemia major: A phenomenological study
Time : 13:10-13:30
Biography:
Lamia K Alsenaidi is a 6th year Medical student in United Arab Emirates University/College of Medicine and Health sciences. The expected date of her graduation is May 2016. She has published 2 papers in reputed journals and she is currently working in a new research about cancer awarness
Abstract:
Thalassemia is a genetic blood disorder that requires a life-long treatment of blood transfusion and chelating drugs. It poses a range of stressors and challenges for patients, their families, and health care team. Mothers are the primary caregivers and therefore, understanding their perceptions of having a child with thalassemia is very important. This study aimed to explore challenges of having a child with thalassemia major as perceived by Jordanian mothers. A descriptive phenomenological approach was used. Twenty three Jordanian mothers were selected purposefully from two major thalassemia treatment clinics in Jordan to participate in this study. Semi-structured, face-to-face interviews were used to obtain the participants' perspectives. Interview sessions were transcribed verbatim, and translated from Arabic to English. Data were analyzed using Colaizzi’s process of descriptive phenomenology. The study revealed that thalassemia has a significant impact on mothers' lives. Many forms of challenges associated with rearing children with thalassemia were illustrated using four major themes: “Psychosocial problems"," Financial problems", "Inadequate information", and “Disease consequences". Participants expressed their worries and fear resulting from the complications of the disease and its treatment. They voiced their needs for more information about the disease and managing the side effects of treatment. Therefore, nurses are advised to address the needs of mothers caring for children with thalassemia and to provide psychosocial support and sufficient information about the child's disease and its treatment.
Rosa Gimenez-Garcia
Hospital Rio Hortega, Spain
Title: Photodistributed hyperpigmentation induced by antihypertensive drugs: Two case reports
Biography:
Rosa Gimenez-Garcia is working as a Clinical Assistant in Hospital Universitario Rio Hortega, Valladolid, Spain and Associate Professor as Faculty of Medicine in Valladolid Spain. She done her residency 1981-1985. Hospital Clinico UNiversitario de Valladolid, DEPARTMENT OF DERMATOLOGY. Worked as Consultant Dermatologist in Hospital Clinico Valladolid and its area of health May 1985-Novembre 1987. Post of Clinical Assistant .Hospital Virgen Blanca" de León (Obtained through public competitive examination) 04-11-87 y el 06-11-90. Post of Facultativo Especialista de Ãrea (Clinical Assistant) (obtained through public competitive examination) "Hospital Rio Hortega" Valladolid 06-11-90- present.
Abstract:
Introduction: Drug-induced skin pigmentation is estimated to account for 10-20% of all cases of acquired hyperpigmentation. Antihipertensive drugs induced hyperpigmentation has been rarely described. Calcium channel blockers are commonly prescribed cardiovascular agents and have been associated with skin reactions in sun-exposed areas. No case of cutaneous hyperpigmentation associated with lercanidipine has been formally reported up to date. We present two cases of photo distributed hyperpigmentation induced by telmisartan- hydrochlorothiazide combination and lercanidipine. Case Reports: Case 1: A 79-year-old man was referred to us for evaluation of hyperpigmented lesions. He had been given telmisartan 80 mg and hydrochlorothiazide 12.5 mg daily for essential hypertension for 3 years and he has noticed hyperpigmentation and pruritus on sun exposed areas a few months after starting therapy. Discontinuation of the drug caused gradual reduction of photo distributed pigmentation. Case 2: A 68-year-old woman, with personal history of frontal fibrosing alopecia, presented to us with a 4 months history of photosensitivity (during the previous summer) and increasing pigmentation on her face. She had been given lecardinipine for essential hypertension for approximately 4 years. Physical examination revealed a dark-brown reticulated pigmentation on the malar area and superior eyelids. A skin biopsy specimen showed interface changes with vacuolar degeneration and pigmentary incontinence. Discussion: Drug-induced hyperpigmentation has been associated with many different types of medications, including anti-malarials, amiodarone, cytotoxic drugs, tetracyclines, heavy metals or psychotropic drugs (phenothiazines and imipramine). Clinical features are very variable with a large range of patterns, colors and distributions. The interval from the initiation of treatment through the onset of hyperpigmentation is markedly longer (even several years) than the intervals for other types of drug eruption. Antihypertensive drugs are very commonly prescribed. Photodistributed hyperpigmentation associated with diltiazem, a calcium channel blocker widely used in the treatment of cardiovascular disease, has been described. Oral mucosal and cutaneous hyperpigmentation associated with amlodipine, and telmisartan induced hyperpigmentation have been reported. Conclusions: Drug-induced cutaneous pigmentation, in particular with antihypertensive medications, must be considered in unexplained pigmented lesions, especially in the elderly. Cessation of the suspicious drug typically results in a gradual fading of the rash, although in some cases it never completely resolves.
Litty Varghese
Ambulatory Healthcare Services-SEHA, UAE
Title: Barriers to adult immunizations and strategies to improve coverage
Biography:
Litty Varghese; RN; MSN is working as A/Head of Nursing Education, AHS/SEHA, UAE. She has 34 years of experience in the field of PHC, UAE and has expertise as JCIA chapter lead and tracer team member, quality improvement coordinator, diabetic clinic project coordinator, community program organizer, nurse educator, newsletter editor and researcher. She holds Master’s Degree in Community Nursing, Post Graduate Diploma in Nursing Administration and obtained certification in Principles of Epidemiology and Biostatistics from CDC, Atlanta. With her continuance in excellent professionalism, she won the First SEHA BEST EMPLOYEE Award 2012, the 3rd Best Abstract Award at The Pan Arab Hypertension Conference in Abu Dhabi Feb. 5-9, 2000, and actively participated in winning the following Awards: 2009 ARAB HEALTH AWARD FOR PHC Chronic Disease program; 2010 ARAB HEALTH AWARD FOR Nursing HR development.
Abstract:
Vaccination against childhood communicable diseases through the Expanded Program on Immunization (EPI) is one of the most cost-effective public health interventions available. Most causes of vaccine preventable illness among children are relatively uncommon due to high rates of vaccination and very effective vaccines. Adult vaccination is one of the most important tool for reducing morbidity and mortality not just in the elderly but in other members of the society by increasing herd immunity, reducing severe clinical outcome and helping in eradication of the disease. The immunization program overall has been very successful with kids. We are not doing so well with adults. Adults are recommended to receive vaccinations based on their age, underlying medical conditions, lifestyle, prior vaccinations, and other considerations. Although provider recommendation is a key predictor of vaccination, more often clients report not receiving vaccine recommendations at healthcare provider visits. Other barriers for vaccinating adults include the cost of providing vaccination services, inadequate or inconsistent payment for vaccines and vaccine administration, and acute medical care taking precedence over preventive services. Despite these challenges, a number of strategies have been demonstrated to substantially improve adult vaccine coverage, including patient and provider reminders and standing orders for vaccination. Providers are encouraged to incorporate routine assessment of their adult patients' vaccination needs during all clinical encounters to ensure patients receive recommendations for needed vaccines and are either offered needed vaccines or referred for vaccination.
Mariamma Kuriakose
Malankara Orthodox Syrian Church Medical College, India
Title: Can Insects Transmit Hepatitis B virus?
Biography:
Mariamma Kuriakose is working as a Professor and consultant Physician at M.O.S.C Medical college, Kolenchery. She has done 3 major clinical and epidemiological studies in leptospirosis and published that in international journals and co-author of six journals on leptospirosis in international journals.
Abstract:
Hepatitis B virus is known to spread only through close contact with tissues or body fluids of an infected person either directly or indirectly. No known insect transmission of the virus has been reported in literature, although the virus has been found to survive in bed bugs for up to 6 weeks after feeding on infected hosts. But it has not been successfully transmitted in animal models. Two villages close to MOSC Medical College Hospital have shown an unusual clustering of hepatitis B cases for the last 3 years. Many of them do not have a likely route of exposure from analysis of patient history. They attribute the infection to bite from a blood sucking fly found in large numbers around their habitat. This study analyses probable routes of transmission of hepatitis B in these villages and seeks to investigate the possible insect transmission of the virus through the bite of the said blood sucking fly.
Madhusudan B Jani
Gujarat Adani Institute of Medical Sciences, India
Title: Rhythmic inversion exercise techniques: Healthier approach to hypertension
Biography:
Madhusudan B Jani completed his PhD from Medical College, Baroda which is affiliated to M S University of Baroda, Gujarat, India. He has teaching and research experience {MBBS, Dental, Physiotherapy, MSc (Medical)} of 34 years at Medical College, Baroda. His fields of research work are Exercise Physiology Applied to Health, COPD, Hypertension, PAD and Obesity. He has been a life Member of Indian Science Congress and Indian Journal of Physiology and Pharmacology. He is invited as a Guest Speaker at national conferences in India. Currently, he is working as a Professor of Physiology at Gujarat Adani Institute of Medical Sciences, BHUJ, Gujarat, India.
Abstract:
Inversion therapy has been around from a long time – inversion has been talked about since 400 BC when Hippocrates, the father of modern medicine, monitored patients being hung from a ladder in the interests of their health. Very recently, there has been a little interest in the West, in objectively documenting the effects on health, especially for the more advanced or esoteric practices, such as inversions. Inversion can act positively on the cardiovascular system, as blood flow in some parts aided, and in other parts challenged, which can lead to a mild cardiovascular workout. Regular inversion can have a positive effect in fighting varicose veins, and, as blood helps to infuse the brain, the increased oxygen it carries may have positive impact on maintaining brain function in later years. Those that swear by inversion and its benefits say that inversion therapy helps in correcting the imbalances affected by gravity. Because we spend most of our life sitting or standing, blood is pulled down into our lower body and our circulation progressively grows sluggish. Hanging upside down, reverses the blood flow temporarily, which allows more blood and oxygen to reach the brain. Pre and post rhythmic inversion exercise, on floor and under water, blood pressures were registered and concluded as healthier ways to control hypertension.
Geeta Ahlawat
Pt B D Sharma PGIMS Rohtak, India
Title: Airway management in emergency and trauma patients
Biography:
Geeta Ahlawat is a Graduate and Post-Graduate of Gujarat University, Ahmedabad, presently working as a Professor in Anaesthesiology and Critical care, Rohtak, Haryana. She has 26 publications to her credit and her areas of interest are innovations in the field of emergency and trauma, airway management and cardiac anaesthesia.
Abstract:
Airway management forms the vital component of treatment for emergency and trauma patients. A timely secured airway for injured patients is directly proportionate to the effectiveness of the treatment provided and hence the outcome achieved. Though a lot of advanced techniques have come up worldwide in this field, many are not available in emergency settings as well as in areas with only primary health care facilities especially in developing countries like India. I wish to correlate the best available options for airway management with primary health care settings in emergency and trauma patients in my talk.
Galya Ghalib Al Ghalib Alsharif
King Abdulaziz University Hospital, Saudi Arabia
Title: The Benefit of pre- and post- operative instructions
Biography:
Galya Ghalib Al Ghalib Alsharif has completed her MBBS from King Abdulaziz University Hospital. She is currently a medical intern.
Abstract:
Millions of people each year undergo surgery. Despite the development in the surgical field; patients remain in fear of the complications that may take place. 140 patients were randomly selected from the clinics at King Abdulaziz University Hospital, in Jeddah. A questionnaire was used to test their knowledge of the instructions before and after a surgery; ear nose and throat specialty in particular. Another questionnaire was given after educating the patients of the instructions in one of the surgical operations in this specialty. The aim is to educate the patients about these instructions in the event of undergoing any future operations. The result was: 64% of patients knew the existence of instructions before and after operations, while 36% didn’t know the existence of such instructions. The most known instruction by 86% was: to stop eating at midnight on the night of the operation. And the least known by 34% was: to stop taking Aspirin 7 days before the operation. The benefit rate from the explained instructions was 100%. 54% of these patients received only verbal instructions, while 10% received both verbal and on paper instructions, and the remaining 18% of patients didn’t receive any instructions.
Kaye Ervin
The University of Melbourne, Australia
Title: Care giver distress in dementia in rural Victoria
Time : 10:15-10:35
Biography:
Kaye Ervin has been a registered nurse for over thirty years, practicing predominantly in rural Victoria. Her passion is aged care and the focus of her research interests for the past 6 years. She is a member of the rural health department, the University of Melbourne. She has published 20 papers in international peer reviewed journals and regularly presents her research at national and international forums.
Abstract:
Aim: The aim of this study was to explore the levels of stress, anxiety and depression of informal carers caring for someone with dementia in a rural setting. The study also sought to determine carer’s primary source of stress and their use of dementia specific services. Methods: Carers of people with dementia were recruited to complete a survey that incorporated the Depression, Anxiety Stress Scales (DASS) to measure carer emotional well-being. The survey also included the Neuropsychiatric Inventory Questionnaire (NPI-Q), which assesses the presence and severity of behavioral and psychological symptoms of dementia (BPSD) of care recipients and their effect on the carer. They were also asked through an open ended question what they found most stressful in their caring role and what services they utilized. Results: A total of 39 carers completed surveys. Almost half of the respondents reported levels of stress and depression in the moderate to severe range as measured on the DASS. BPSD exhibited by care recipients, such as agitation, anxiety, aggression and nocturnal disturbance, showed a relationship to the level of stress reported by the carer as measured with the NPI-Q. Despite 84.6% reporting use of the Aged Care Assessment Service and 61.5% reporting provision of printed information on the services available, less than half of the carers utilized commonly available support services. Only 46.2% received financial compensation for their carer role. The predominant source of stress reported was the unremitting burden experienced when caring for someone with dementia.
- Symposium on Preventive cardiology and obesity, dyslipidemia
Location: The Oberoi Dubai, Dubai
Chair
Gillian Hood
Queen Mary, University of London, UK
Co-Chair
Marc Matthews
Mayo Clinic, USA
Session Introduction
Schusterova I
P. J. Šafárik University in Kosice, Slovakia
Title: Universal screening for hypercholesterolemia in children at 11- and 17 years of age: unique in Slovakia for 17 years
Time : 13:40-14:25
Biography:
Schusterová I is an Associate Professor and the Head of the Department of Paediatrics and Adolescent Medicine, Children University Hospital, P J Š University in Košice, Slovakia. At the same time, she is the Head Physician in the Tertiary Center for Valvular and Congenital Heart Defects, Eastern Slovak Institute of Cardiac and Vascular Diseases. She took specialization exam from Adult and Pediatric Cardiology at National Institute of Cardiac and Vascular Diseases in Bratislava, Slovak Republic. After Graduation, she took part in Fellowship Training at Ottawa Civic Hospital, and later on performed research work in the area of Cardiology at University of Ottawa in Canada. In the period from 11/1999 till 7/2004, she completed her training at Cardiologic Department, II. Internal Medicine Clinic, General Hospital, Vienna under supervision of Professor Dr Gerald Maurer. Later in 2005, she broadened her professional knowledge and skills at Cardiac Surgery Clinic, Kardiocentrum Universitätsklinik in Bad Oyenhausen, Germany. Her research interests focus on preventive cardiology, obesity, and disorders of lipid metabolism, atherosclerosis and their prevention in the paediatric age group.
Abstract:
Atherosclerosis begins in childhood. In adults, elevated non-HDL-cholesterol concentrations, low HDL-cholesterol concentrations, hypertension, smoking, diabetes, and obesity are associated with advanced atherosclerotic lesions and increased risk of clinically manifest atherosclerotic disease. These risk factors also are associated with early atherosclerosis in young persons. Control of these risk factors is the major strategy for preventing atherosclerotic disease. The current recommendations for the primary prevention of cardiovascular diseases in Slovakia include universal nation screening for hypercholesterolemia: national programmed routine examination of 11- and 17 years old children by primary pediatricians. The national universal screening in Slovakia was introduced gradually, and the referral rate to the tertiary institution reached its expected level only in 1998. Screening was gradually implemented throughout the whole country, reaching an estimated majority of 11 and 17-years-old children, approximately 1 million from 2004 until now. Data for the efficacy of a national universal screening for detection of familiar hypercholesterolemia are lacking. The universal screening for hypercholesterolemia together with familiar history and premature cardiovascular complicationidentified a disease- causing variant for familiar hypercholesterolemia. The long-range prevention of atherosclerosis and its squeal by control of the risk factors for adult coronary artery disease should begin in adolescence and young adulthood. Primary pediatricians play an important role in primary prevention of cardiovascular diseases, detection of familial hypercholesterolemia in a cohort of children with hypercholesterolemia. Clinic for preventive cardiology and lipid metabolism disorders focus on management and treatment of children with positive screening test result.
Tohatyova A
P J ŠUniversity in Košice, Slovakia
Title: Childhood obesity and obesity reduction program
Biography:
Alzbeta Tohatyova is currently a PhD student at Medical Faculty, P J Safarik University in Kosice, Slovakia. Her research interests focus on pediatric cardiology and preventive cardiology.
Abstract:
Over the past three decades the prevalence of overweight and obesity has increased substantially. Childhood obesity is an important public health problem and is of particular interest because of possible long-term associations with adult body weight status and morbidity. Obesity is associated with a shortened life expectancy mainly because of increased risk for cardiovascular disease and obesity related cardiomyopathy. However, a third of obese individuals never develop CV disease; and this group is called the metabolically “healthy” obese. Recent evidence suggests that not all obese persons are negatively affected by their body weight and that weight loss does not necessarily always improve health. Obese youth will live a longer portion of their life as obese and with chronic health conditions. Moreover, although weight loss in obese youth is associated with improved metabolic outcomes, weight management goals for this age group are more ambiguous than in adults. In our Children Faculty Hospital, the management of obesity includes hospitalization to exclude secondary causes of obesity, spa treatment and outpatients programs. Our highly specialized Clinic for preventive cardiology and lipid metabolism disorders, focus on individual and group outpatient therapy for obesity, and also on cardiovascular risk stratification in children and adolescent. Highly organized team of specialists is working on interdisciplinary outpatient program- “Obesity reduction program, School of Obesity”. This program is focused on the same sex groups of children and adolescent who are in the same range of ages. The goal of this program is to win the fight against obesity- prevention of cardiovascular disease associated with obesity, and treatment of childhood obesity by new ways. We confirmed that group outpatient therapy for children and their parents had significantly better results in body weight loss (p<0.05) compared to individual therapy during the childhood.
Biography:
Schusterová I is an Associate Professor and the Head of the Department of Paediatrics and Adolescent Medicine, Children University Hospital, P J Š University in Košice, Slovakia. At the same time, she is the Head Physician in the Tertiary Center for Valvular and Congenital Heart Defects, Eastern Slovak Institute of Cardiac and Vascular Diseases. She took specialization exam from Adult and Pediatric Cardiology at National Institute of Cardiac and Vascular Diseases in Bratislava, Slovak Republic. After Graduation, she took part in Fellowship Training at Ottawa Civic Hospital, and later on performed research work in the area of Cardiology at University of Ottawa in Canada. In the period from 11/1999 till 7/2004, she completed her training at Cardiologic Department, II. Internal Medicine Clinic, General Hospital, Vienna under supervision of Professor Dr Gerald Maurer. Later in 2005, she broadened her professional knowledge and skills at Cardiac Surgery Clinic, Kardiocentrum Universitätsklinik in Bad Oyenhausen, Germany. Her research interests focus on preventive cardiology, obesity, and disorders of lipid metabolism, atherosclerosis and their prevention in the paediatric age group.
Abstract:
Obesity causes chronic volume overload (increased preload) and dilation of the left ventricle (LV) of the heart. Hypertrophy LV itself as an adaptation to expanded intravascular volume determines the damage of the diastolic function LV especially by influencing later diastolic passive infilling. For persistent obesity they may of course result in systolic dysfunction and manifest heart failure while damaging the function of the myocardium correlates with body mass index and the duration of obesity. The clinical picture of the consequences of cardiomyopathy depends on the severity of the emerging cardiac changes, age, duration and severity of the obesity, as well as on associated diseases, which often accompany obesity (arterial hypertension, disorder in the metabolism of lipids and glucose, ischemic heart disease, sleep apnea syndrome, etc.). Studies of obese child patients indicate, initial signs of cardiomyopathy – changes of indices of diastolic and systolic functions, though they are clinically silent. Early structural and functional changes in the myocardium of obese children and overweight children represent a higher risk of clinical manifestation of this cardiomyopathy in early adulthood, and therefore they require increased vigilance of the pediatricians and pediatric cardiologists. In one of our study, we confirmed differences not only in LVM (p<0.001) and LVM index body height2.7 (p<0.05) but as well as the differences in left ventricle size (IVS (p<0.01), LVEDD (p<0.005), LVESD (p<0.05), PWTh (p<0.001)) and volumes include stroke volume (p<0.05) in spite of normal preserved systolic function in obese and overweight children. Increased LV mass in obese individuals is also a result of the increased amount of epicardial fat and fat infiltration of the myocardium. The thickness of epicardial adipose tissue (EAT) as measured by echocardiography represents an independent predictor of visceral adiposity. A very good positive correlation was found between echocardiographic measurements of EAT and MRI measurements, which represent the gold standard for assessing visceral fat mass. We confirmed significantly higher thickness of echocardiography EAT was found in overweight and obese adults and children (p<0.001). However, it requires the creation of a standardized examination methodology for children age, as well as the creation of certain reference values while considering the growth and development of children.
- Track 7: Community Primary Care
Track 8: Primary Healthcare Management
Track 9: Primary Care Epidemiology
Location: The Oberoi Dubai, Dubai
Chair
Fahad Alkherayf
University of Ottawa, Canada
Co-Chair
Brian Littlechild
University of Hertfordshire, UK
Session Introduction
Gulnaz Karatay
Tunceli University, Turkey
Title: Effect of scenario-based school based prevention program to the abilities of students to say
Time : 14:10-14:30
Biography:
Gulnaz Karatay is an Associate Professor in Public Health Nursing in the Tunceli University Health High School in Turkey. She completed her Master and Doctorate program from Hacettepe University Faculty of Health Science in Ankara, Turkey. Her academic background and work experience as a Nurse-Researcher has enabled her to develop a range of skills. Accordingly, she has been in Prato Hospital in Italy-Florence for 3 months and US-Wisconsin Madison University for 3 months. Her research focuses on motivational interviewing for smoking cessation, improving cognitive function of the elderly, prevention of substance use in adolescent period and women health.
Abstract:
Objective: To develop students' ability to say "No to Substances" in order to prevent substance use. Method: A pre- and post-test study design was used with a single group. All of the 8th graders (n=282) in 3 schools located in an Eastern Province of Turkey were included in the study; however, the study was completed with n=249 students, who responded to both pre- and post-tests. The scenario-based training, developed by the researchers, was applied school counselors for 4 weeks. For this purpose, a teaching booklet was prepared for the teachers as well as a supportive material in a comic book format for students. The scenarios were to improve adolescents' abilities to say "No" to substance offers, to prevent addictive substances, and to call for help if needed. The pre-test of the study was applied in November 20-25, 2015, and the post-test was applied in January 4-8, 2016. The data of the study were collected using personal information form, self-efficacy scale in protection against substance abuse for adolescents, and Rosenberg self-esteem inventory (ROSE). The obtained data were assessed using percentages, Chi-square, t-test and F-test in the SPSS software. Results: The average age of the students was 13.53±0.57. Of the students, 8.5% stated they tried smoking, and 25% stated that they used alcohol. The mean score in the self-efficacy scale in protection against substance abuse for adolescents was found to increase significantly (103.20±20.00) after the training compared to the situation before the training (92.11±17.08) (t=6.374, p=0.001). Similarly, the mean Rosenberg self-esteem inventory score was increased after the training (1.51±0.85) compared to the pre-training score (1.29±0.79), and the difference was statistically significant (t=2.828, p= 0.005). Conclusion: Short-term outcomes of the class-based scenario training were observed to be effective in the development of self-efficacy for substance abuse prevention.
Rosa Gimenez-Garcia
Hospital Rio Hortega,Valladolid,Spain
Title: Photodistributed hyperpigmentation induced by antihypertensive drugs: Two case reports
Time : 14:30-14:50
Biography:
Rosa Gimenez-Garcia is working as a Clinical Assistant in Hospital Universitario Rio Hortega, Valladolid, Spain and Associate Professor in the Faculty of Medicine in Valladolid Spain. She has completed her residency during 1981-1985 at Hospital Clinico Universitario de Valladolid. He worked as Consultant Dermatologist in Hospital Clinico Valladolid and its area of health from May 1985-November 1987. He obtained the Post of Clinical Assistant at Hospital Virgen Blanca" de León and at "Hospital Rio Hortega" Valladolid from 06-11-90 to present.
Abstract:
Introduction: Drug-induced skin pigmentation is estimated to account for 10-20% of all cases of acquired hyperpigmentation. Antihipertensive drugs induced hyperpigmentation has been rarely described. Calcium channel blockers are commonly prescribed cardiovascular agents and have been associated with skin reactions in sun-exposed areas. No case of cutaneous hyperpigmentation associated with lercanidipine has been formally reported up to date. We present two cases of photo distributed hyperpigmentation induced by telmisartan- hydrochlorothiazide combination and lercanidipine. Case Reports: Case 1: A 79-year-old man was referred to us for evaluation of hyperpigmented lesions. He had been given telmisartan 80 mg and hydrochlorothiazide 12.5 mg daily for essential hypertension for 3 years and he has noticed hyperpigmentation and pruritus on sun exposed areas a few months after starting therapy. Discontinuation of the drug caused gradual reduction of photo distributed pigmentation. Case 2: A 68-year-old woman, with personal history of frontal fibrosing alopecia, presented to us with a 4 months history of photosensitivity (during the previous summer) and increasing pigmentation on her face. She had been given lecardinipine for essential hypertension for approximately 4 years. Physical examination revealed a dark-brown reticulated pigmentation on the malar area and superior eyelids. A skin biopsy specimen showed interface changes with vacuolar degeneration and pigmentary incontinence. Discussion: Drug-induced hyperpigmentation has been associated with many different types of medications, including anti-malarials, amiodarone, cytotoxic drugs, tetracyclines, heavy metals or psychotropic drugs (phenothiazines and imipramine). Clinical features are very variable with a large range of patterns, colors and distributions. The interval from the initiation of treatment through the onset of hyperpigmentation is markedly longer (even several years) than the intervals for other types of drug eruption. Antihypertensive drugs are very commonly prescribed. Photodistributed hyperpigmentation associated with diltiazem, a calcium channel blocker widely used in the treatment of cardiovascular disease, has been described. Oral mucosal and cutaneous hyperpigmentation associated with amlodipine, and telmisartan induced hyperpigmentation have been reported. Conclusions: Drug-induced cutaneous pigmentation, in particular with antihypertensive medications, must be considered in unexplained pigmented lesions, especially in the elderly. Cessation of the suspicious drug typically results in a gradual fading of the rash, although in some cases it never completely resolves.
Manjula A Rao
Kasturba Medical College, India
Title: Assessment of emotional problems faced by people living with HIV/AIDS (PLWHA) and to study the need for family support to manage the emotional problems
Time : 14:50-15:10
Biography:
Manjula A Rao has completed her MPhil in Social Work from Coimbatore University and PhD scholar from the same University. She is working as a Counselor in Kasturba Medical College, Mangalore. She has 20 years experience in HIV field. She has presented 15 scientific papers in national and international conferences. She has published papers on HIV and received Best Paper Award in Practitioner Category. She is the Director of RUDES and ADHAR charitable trust. She is a national level master trainer for different organization and member of many organizations which works in welfare of the community.
Abstract:
HIV/AIDS is one of the most alarming social challenges faced by the people in the Universe. It has been described as the “most devasting epidemic humanity has ever known”. Human immunodeficiency virus (HIV) is a lentivirus that causes the infection and acquired immunodeficiency syndrome (AIDS). As on today the disease is fatal, but it is totally preventable. AIDS is the end result of a viral infection, caused by a group of viruses known as Human Immunodeficiency viruses. UNDP 2010 reports that India had 2.39 million people living with HIV at the end of 2009. The present study highlights the effect of emotional problems faced by the person with HIV and AIDS. HIV infection has a major impact on the mental health of the person which has a chance of causing cognitive impairment, mood and anxiety disorders, and even psychotic manifestations. Various psychological issues leading to manifestations among PLWHAs are acute-stress reactions, anxiety disorders, depression, mania, psychosis and neuro-psychiatric manifestations of HIV associated neurological illness. Testing for HIV is itself evokes a lot of anxiety. It is very general that most of them take lot of time to muster up courage to undertake the test. Not all will react in a positive way. The first reaction is anger, depression and failure to cope up with life. Suicidal thoughts will occur. At this time there is a need for proper counseling. Appropriate counseling or absence of any other social support can devastate an individual. They experience a lot of stress mentally as many emotional problems occur to them. To cope up with these stressors there should be a need for social support for which the PLHWHA could be able to tell them about the sero-status for moral, emotional and psychological support. Majority of our study population included males (52.2%) and rest are females (37.8%). Majority of them had primary (58.6%) and secondary (37.8%) level of education. 99.1% are infected through sexual contact. 38.7% of respondents receive support from spouse, and secondary family members. 95.5% respondents are satisfied with the support they get from family members. Most of our respondents (41.4%) always and sometimes (55.9%) get financial support for their medication, only 2.7% will never get support. 94.6% of respondents feel they have someone to listen their feelings and thoughts. 41.4% respondents get reminder to take ART medication from their family members. 81.1% of the respondents felt that they can always participate in family function. The present study highlighted the fact that adherence of ART treatment is better when family support is high.
Madhusudan B Jani
Gujarat Adani Institute of Medical Sciences, India
Title: Rhythmic inversion exercise techniques: Healthier approach to hypertension
Time : 15:10-15:30
Biography:
Madhusudan B Jani completed his PhD from Medical College, Baroda which is affiliated to M S University of Baroda, Gujarat, India. He has teaching and research experience {MBBS, Dental, Physiotherapy, MSc (Medical)} of 34 years at Medical College, Baroda. His fields of research work are Exercise Physiology Applied to Health, COPD, Hypertension, PAD and Obesity. He has been a life Member of Indian Science Congress and Indian Journal of Physiology and Pharmacology. He is invited as a Guest Speaker at national conferences in India. Currently, he is working as a Professor of Physiology at Gujarat Adani Institute of Medical Sciences, BHUJ, India.
Abstract:
Inversion therapy has been around from a long time – inversion has been talked about since 400 BC when Hippocrates, the father of modern medicine, monitored patients being hung from a ladder in the interests of their health. Very recently, there has been a little interest in the West, in objectively documenting the effects on health, especially for the more advanced or esoteric practices, such as inversions. Inversion can act positively on the cardiovascular system, as blood flow in some parts aided and in other parts challenged, which can lead to a mild cardiovascular workout. Regular inversion can have a positive effect in fighting varicose veins, and, as blood helps to infuse the brain, the increased oxygen it carries may have positive impact on maintaining brain function in later years. Those that swear by inversion and its benefits say that inversion therapy helps in correcting the imbalances affected by gravity. Because we spend most of our life sitting or standing, blood is pulled down into our lower body and our circulation progressively grows sluggish. Hanging upside down, reverses the blood flow temporarily, which allows more blood and oxygen to reach the brain. Pre and post rhythmic inversion exercise, on floor and under water, blood pressures were registered and concluded as healthier ways to control hypertension.
Biography:
Essam Mahran has completed his MD degree in April, 2010 from Cairo University. From that date, he is working as lecturer of Anesthesia and pain therapy in National Cancer Institute, Cairo University. He has published more than 5 papers in reputed journals and has active participation in many conferences including ESA, 2012 in Paris, European Congress of Airway Management, 2013 in Istanbul, WIP, 2014 in Mastricht and AOSRA, 2015 in Bangkok.
Abstract:
None Steroidal Anti-Inflammatory Drugs (NSAIDs) are analgesic, antipyretic and anti-inflammatory drugs. NSAIDs are commonly used drugs with more than 13 millions chronic users in USA with direct cost more than 2 billion dollars per year. They have serious side effects up to mortality representing 15th commonest cause of death in USA. The NSAIDs are present in the 3 steps of the WHO step ladder analgesic pattern. NSAIDs are classified according to their degree of selectivity on cyclo-oxygenase enzyme into non-selective drugs and newer Cox 2 selective NSAIDs. They vary in their potency, duration and elimination. Because of their CVS risks both Roficoxib and Valdicoxib are withdrawn from the market. GIT risks of gastric erosion and peptic ulcer are more with non selective NSAIDs. Renal side effects result mainly from vasoconstriction of afferent arteriole. Other side effects include allergy and prolonged labor. NSAIDs choice should be tailored to each patient according to his/her age and medical status. In hepatic patients paracetamol can be used in mild to moderate impairment with reduction of the maximum daily dose. In renal impairment NSAIDs, dose adjustments are made according to creatinine clearance. NSAIDs during pregnancy can result in early closure of fetal ductus arteriosus and preterm birth, So NSAIDs are contraindicated in 3rd trimester in France and their FDA approval is category D in third trimester and category C in first and second trimester. During lactation paracetamol, ibuprofen and diclofenac are safe. They vary in their pediatric doses. Celecoxib has also anti-cancer effect.
Anil Kumar Chhotalal Mithani
Omdurman Teaching Hospital, Sudan
Title: PHC Sudan- Knowledge exchange to improve primary healthcare outcomes from a Urologist’s perspective in Sudan
Time : 15:50-16:10
Biography:
Anil Kumar Chhotalal Mithani completed his MBBS from Alexandria University and obtained MD from China. He is carrying over 30 years of clinical experience and also worked as the Director of Government Hospitals. Currently, he is working as an Associate Professor at University of Bahri and Head of Urology at Omdurman Teaching Hospitals which has 600 beds and treat the maximum number of patients in Sudan. He attended Urological Conferences in Iraq, Egypt and many other countries. Also, he is the Treasurer of the Sudan Urology Association and the President of the Indian Community in Sudan.
Abstract:
The highly skilled Urologist Surgeons of Primary Health offer a comprehensive approach to urological care, including an array of treatments for urinary tract infections, prostate problems, bladder disorders, kidney and ureteral stones, urethral strictures, undescended testes, erectile dysfuntion, infertility, cancer of bladder, kidney, prostrate and testicular and all other conditions related to the genito-urinary tract system. Specialists provide primary health care expertise in health promotion, prevention and screening, and treating various conditions. Primary care providers play an important role in caring for cancer and metastasis. Sudan health system is based on the district health system approach, which emphasizes the principles of primary health care (PHC). Nevertheless, the decentralization of the public sector resulted in more deterioration of the PHC system particularly in rural and peripheral areas due to lack of financial resources and managerial capacities. The local health system act gave the responsibility of management of PHC level to the localities while, this was not accompanied by ensuring availability of sufficient financing resources to localities to run this function. We have carried out a study by coordinating with a few PHC authorities by creating awareness of the urological care and wish to share our findings and learn from other’s experiences.
Neeraj Bedi
Jazan University, Saudi Arabia
Title: Research ethics and regulatory reforms
Time : 16:25-16:45
Biography:
Neeraj Bedi is a highly experienced medical professional having 26 years of teaching, training, research and administrative experience in the field of Public Health/Community Medicine. He obtained his MD in 1986, MPH and MBA administrative qualifications. He is involved in Quality Assurance and Risk Management Activities related to the Hospital Management. He has been awarded WHO fellowships in “Hospital Administration” and “Management of Malaria Field Operations”. He has published 50 research publications and is a reviewer of many journals. Currently, he is working as full time Professor in Faculty of Public Health and Tropical Medicine, Jazan University, Saudi Arabia.
Abstract:
The medical research misconduct has become a big global problem. Research misconduct is being defined as the “Behavior by a researcher, intentional or unintentional that do not meet or fulfill the scientific and ethical standards”. The accurate data about research misconduct are not available except from countries like the USA, China and Germany. The research misconduct include fabricating the data, falsifying the data and plagiarism. The various irresponsible research practices are publishing research data more than once, non-disclosure of conflict of interest, selective reporting of data and inappropriate authorship. The most scrutinized literature for medical research misconduct was collected from different electronic sources including PubMed. About 19 references were found. 2% of scientists have been found to admit fabricating the data and 33% researchers were involved in different types of irresponsible research practices. There is no formal regulatory programs available to monitor the research projects in different countries. Few developed countries like the USA, Germany and China tried to develop programs which can monitor the medical research misconduct. There is a need to develop a regulatory system at national and institutional level to regulate the research activity to ensure that good ethical and scientific standards are practiced by medical researchers. All academic institutions must have teaching and training sessions for ethical issues to update the students and staff at regular periodical intervals. Similarly, the medical education curriculum for medical students must have the chapters on research ethics and good research practices to deal effectively with the research misconduct problem.
Kamar Tanyan
Mary Begg Clinic, Zambia
Title: Primary health care challenges in remote medical setting
Time : 16:45-17:05
Biography:
Kamar Tanyan has worked in a number of Middle Eastern and Arab countries (Tunisia, Lebanon, Saudi Arabia and Iraq) and therefore has a deep-rooted understanding of the challenges related to the primary healthcare industry in the region. She holds the international diploma in Humanitarian Assistance from Fordham University- New York and a Master’s degree in Disaster Medicine from University of Piedmont Orientale, Italy. In 2003, she actively contributed to the implementation of pre-hospital medical emergency care program in North Lebanon in collaboration with Lebanese Red Cross. She participated several times with military hospital medical team in the response to Hajj mass gathering in Saudi Arabia. In 2014, she joined a humanitarian mission in Iraq, as Health Project Manager in response to the Syrian refugees’ crisis. Managing a WHO and ECHO financed health programs including health programs design, implementation and monitoring, capacity building of local doctors to insure a better health care of this vulnerable population. Currently, she is the Chief Medical officer of remote hospital operated by an international mining company in Zambia, where she is confronted to all aspects and challenges of remote medicine as well as dealing with African epidemic diseases such as malaria, TB, HIV with minimal resources. Her current focus is the development of an emergency response planning guidelines in low setting resources.
Abstract:
Providing healthcare in remote locations means working without the level of medical support that most health professionals are used to have at their disposal. It requires a different mindset to that of an urban medical facility. Illnesses which can be easily managed in the urban setting may initiate a crisis at a remote health facility. Operating in resource-limited primary health care settings presents a multitude of health challenges especially in the third world such African countries. Remote healthcare professionals face major challenges, including a critical shortage of specialized health workers, poor state of health facilities and equipment; add to it the high burden of epidemic disease such as HIV/AIDS, malaria and TB. Remote medical practitioners require a broad range of competencies in several specialties, including emergency and critical care, primary care mental health, public health, occupational health, pharmacy, dentistry, health management and interpersonal skills. They are forced to utilize more basic physical examination skills, clinical impression and overall clinical experience. Likewise, not having necessary diagnostic testing, remote medical practitioners may feel the need to be more aggressive in treatment and act faster. Not having the luxury of being able to definitively assign a diagnosis to an illness, they may feel the need to cover the patient for the worse potential diagnosis as possible. Not only do these factors increase the risk of worsening illness or injury due to delays in diagnosis and treatment, they also confront remote medical clinicians to the key question “where responsibility for providing care starts and stops”? These issues have made providing higher standards of care in remote third world countries an infinite complex challenge. This presentation provides an oversight into some of the key issues facing the delivery of primary healthcare and doctors’ challenges in remote medical setting and describes the role remote primary health care professional can play in delivering a lifesaving care.
Pawlin Vasanthi Joseph
Nirmala College for Women, India
Title: Probability mapping to determine the spatial risk pattern of acute gastroenteritis in Coimbatore district, India, using geographic information systems (GIS)
Time : 17:05-17:25
Biography:
Pawlin Vasanthi Joseph completed her PhD in the field of Environment Management and Biotechnology from the Defense Research and Development Organization – Centre for Life Sciences, Bharathiar University, Coimbatore, India. She has published 10 papers in peer reviewed journals and has presented 14 papers in national and international conferences. Currently, she is the Head of the Department of Zoology at Nirmala College and Co-ordinates the Career Oriented Program in Vermitechnology and the Star College Scheme for strengthening of Life Sciences, Department of Biotechnology, Government of India.
Abstract:
Background: Maps show well the spatial configuration of information. Considerable effort is devoted to the development of Geographical Information Systems (GIS) that increase understanding of public health problems and in particular to collaborate efforts among Clinicians, Epidemiologists, Ecologists, and Geographers to map and forecast disease risk. Objectives: Small populations tend to give rise to the most extreme disease rates, even if the actual rates are similar across the areas. Such situations will follow the decision-makers attention on these areas when they scrutinize the map for decision making or resource allocation. As an alternative, maps can be prepared using P-values (probabilistic values). Materials & Methods: The statistical significance of rates rather than the rates themselves are used to map the results. The incidence rates calculated for each village from 2000 to 2009 were used to estimate λ, the expected number of cases in the study area. The obtained results are mapped using Arc GIS 10.0. Results: The likelihood of infections from low to high is depicted in the map and it is observed that 5 villages namely, Odanthurai, Coimbatore Corporation, Ikkaraiboluvampatti, Puliakulam and Pollachi Corporation are more likely to have significantly high incidences. Conclusion: In the probability map, some of the areas with exceptionally high or low rates disappear. These are typically small unpopulated areas, whose rates are unstable due to the small number of problems. The probability map shows more specific regions of relative risks and expected outcomes.
Mariamma Kuriakose
Malankara Orthodox Syrian Church Medical College, India
Title: Can insects transmit hepatitis B virus?
Time : 17:25-17:45
Biography:
Mariamma Kuriakose is working as a Professor and consultant Physician at M.O.S.C Medical college, Kolenchery. She has done 3 major clinical and epidemiological studies in leptospirosis and published that in international journals and is the co-author of six international journals on leptospirosis.
Abstract:
Hepatitis B virus is known to spread only through close contact with tissues or body fluids of an infected person either directly or indirectly. No known insect transmission of the virus has been reported in literature, although the virus has been found to survive in bed bugs for up to 6 weeks after feeding on infected hosts. But it has not been successfully transmitted in animal models. Two villages close to MOSC Medical College Hospital have shown an unusual clustering of hepatitis B cases for the last 3 years. Many of them do not have a likely route of exposure from analysis of patient history. They attribute the infection to bite from a blood sucking fly found in large numbers around their habitat. This study analyses probable routes of transmission of hepatitis B in these villages and seeks to investigate the possible insect transmission of the virus through the bite of the said blood sucking fly.
Christos Stefanou
Limassol General Hospital ICU of Cyprus
Title: Electrical muscle stimulation: Essential in health and disease, in primary and secondary prevention
Time : 17:45-18:00
Biography:
Christos Stefanou is an Internist and Intensivist in Limassol General Hospital ICU of Cyprus, where he is in-charge of the educational program; and an Honorary Associate Professor of Medicine at St George’s University. He was ranked first class in his Medical School of Athens University; and finished his fellowship at Evangelismos Hospital of Athens, Greece; and his internship in the USA. He is a PhD candidate and researcher in the pathophysiology and regenerative properties of electrical muscle stimulation. He has also been the President of psychosocial support and health group of Cyprus Red Cross.
Abstract:
Electrical muscle stimulation (EMS) is just following the steps and evolution of exercise: one of the enormous accumulations of evidence about its possible medical benefits and high safety and feasibility profile. EMS is nearing inclusion at contemporary essential guidelines for health maintenance, primary and secondary prevention and rehabilitation, with a range of actions extending from healthy people to various categories of chronic patients. It appears to exert regenerative and reparatory effects on the endothelium, to mobilize endothelial progenitor cells; to favorably affect the microcirculation; to induce mesenchymal stem cell potentiation; to exert multilevel beneficial immune, metabolic and endocrine actions related to cytokine, hormonal, neural, anti-inflammatory and anti-oxidant modifications. By these pleotropic pathophysiologic mechanisms, it is evidenced that, EMS improves cardiovascular fitness and overall health; prevents ICU- acquired weakness or sarcopenia, pressure ulcers and venous thromboembolic disease; decreases pathological cardiac remodeling in heart disease, and sympathetic activity; alleviates dyspnea in malignancy or COPD; improves glucose metabolism in metabolic syndrome or diabetes patients; reinforces post injury neuroregeneration; improves spasticity, urinary/fecal incontinence, pelvic floor dysfunction, and chronic pain syndromes; enhances tissue perfusion; and assists in muscle reeducation. Further emerging applications relate to psychological health (such as depression); to post-surgical prevention of atelectasis and cough reinforcement; and to dysphagia in stroke or anorexia nervosa patients. Many applications of this endless list are FDA approved already. EMS needs to be considered as part of numerous medical conditions, and any health-care professional needs to be aware of its indications.
- Track 2: Primary Care Medicine
Track 3: Family Medicine and Primary Care
Track 4: Quality in Primary Care
Location: The Oberoi Dubai, Dubai
Chair
Gillian Hood
Queen Mary, University of London, UK
Co-Chair
Ingrid Schusterova
Children University Hospital, Slovakia
Session Introduction
Brendan Mitchell
Gold Coast University Hospital, Australia
Title: Medication adherence one month after hospital discharge in medical inpatients
Time : 14:25-14:45
Biography:
Brendan Mitchell completed his Bachelor of Science degree at the University of Queensland in 2010 and subsequently Doctor of Medicine degree at the University of Melbourne, graduating in 2014. He is currently working as a resident Medical Officer at Gold Coast University Hospital in Queensland, Australia.
Abstract:
Background: The rate of medication non-adherence has been consistently reported to be between 20-50%. The majority of available data comes from international studies and we hypothesized that a similar rate of adherence may be observed in Australian patients. Aims: To determine the rate of adherence to medications after discharge from acute general medical hospital admission and to identify factors that may be associated with non-adherence. Methods: A prospective cohort study of 68 patients, comparing admission and discharge medication regimens to self-reported regimens 30-40 days after discharge from hospital. Patients were followed up via telephone call and univariate and multivariate binary logistic regression used to determine patient factors associated with non-adherence. Results: A total of 27 out of 68 patients (39.7%) were non-adherent to one or more regular medications at follow up. Intentional and unintentional non-adherence contributed equally to non-adherence. Using multivariate analysis, presence of a carer responsible for medications was associated with significantly lower non-adherence (OR 0.20 (0.05-0.83), p=0.027) when adjusted for age, comorbidities, chemist blister pack and total number of discharge medications. Conclusions: Non-adherence to prescription medications is suboptimal, and consistent with previous overseas studies. Having a carer responsible for medications is associated with significantly lower rates of non-adherence. Understanding patient’s preferences and involving them in their healthcare may reduce intentional non-adherence.
Lori Sanderson
Loma Linda University, USA
Title: Lifestyle change interventions for children and adolescents with diabetes or kidney disease
Time : 14:45-15:05
Biography:
Lori Sanderson completed her Doctoral degree in Public Health Education and Promotion. She also holds a Master’s degree of social work and is currently a Licensed Clinical Social Worker. She has worked as a Medical Social Worker for over 10 years now and specializes with children and adolescents who have been diagnosed with kidney disease and/or diabetes. She recently accepted a part-time position at eating disorder clinic in Claremont, CA. She has developed several programs to help the children with whom she works with. She is currently working to develop a non-profit organization in eating disorders.
Abstract:
The purpose of this research letter is to report on the availability of evidence-based interventions for promoting lifestyle change in children and adolescents with diabetes or kidney disease. References for this review were obtained using several electronic databases, including Ebsco Host, PsychInfo, Medline and CINAHL. Search topics included transplant adherence, diabetes adherence, kidney adherence, obesity and transplant, kidney disease, transplant noncompliance, renal failure, renal disease, chronic kidney failure, end-stage renal disease, obesity and diabetes, overweight and kidney disease, overweight and diabetes, overweight, treatment interventions and overweight, treatment interventions for obesity, children and obesity, growth chart, diabetes intervention, kidney disease intervention, obesity intervention, obesity and transplantation, obesity transplant intervention, motivational interviewing, physical activity level, physical activity, exercise intervention, body mass index measurement, body fat percentage, psychosocial issues of kidney disease, psychosocial issues of transplant, and coping with kidney disease. Search results included English language only and between the years 2000 and 2009. Very few lifestyle interventions have been shown to be effective for obese children or adolescents with diabetes and none for obese children and adolescents with kidney diseases. More research is needed to develop effective interventions for this vulnerable population.
Trish Morison
Universal College of Learning, New Zealand
Title: When pregnancy is no longer the issue
Time : 15:05-15:25
Biography:
Trish Morison has completed a Master’s degree in Public Health. Her research was published in the New Zealand Journal of Primary Health Care. She has lectured in Anatomy, Physiology and Pharmacology for the last 14 years.
Abstract:
The rate of sexually transmitted infections amongst midlife and older heterosexual women in New Zealand is rising. Popular culture celebrates a heightened sexuality for this population group. However, depictions of sexually savvy ‘cougars’ are at odds with reality for many women. International literature highlights that these women are often ill-equipped to negotiate safer sex and condom use, instead focusing on pleasing men and attributing their silence to spontaneity. The study aimed to explore the enablers and barriers to safer heterosexual sex as perceived by midlife and older New Zealand women, who are re-partnering or in casual relationships. This qualitative study utilized Interpretive Phenomenology Analysis, supported by the theory of gender and power, to examine the gender-normative assumptions and behaviors in women’s accounts of unprotected sex. Eight single women aged 40-69 participated in individual, in-depth interviews. Analysis indicated that these women held misconceptions about STI transmission but had not sought educational material, nor discussed their sexual health with clinicians. Results highlighted women’s ambivalence about prioritizing safer sex, preferring to comply with partners’ wishes, particularly when under the influence of alcohol. Women described valuing their own pleasure and their distaste for condom use, but data emphasized that women predominantly aligned their choices with men’s preferences. This study highlights that midlife women are both ill-informed and vulnerable with regards to sexual health. Primary healthcare clinicians are well placed to provide education and sexual health advice.
Dybesh Regmi
United Arab Emirates University, UAE
Title: Motivational interviewing- A necessity in medical education
Time : 15:25-15:45
Biography:
Dybesh Regmi is working as an Assistant Professor in the Department of Family Medicine at UAE University. He also holds a faculty membership at the Department of Family and Community Medicine at the University of Toronto. He completed his residency training in Family Medicine at McMaster University. He has been an examiner for the College of Family Physicians of Canada and was a peer assessor for the regulatory body in the province of Ontario.
Abstract:
Primary care is focused on prevention and adoption of healthy behaviors by the general population. A proven effective tool for patient behavior modification that has been utilized is Motivational Interviewing (MI). Compared to the trans-theoretical model which focuses on the stages of change, MI promotes personal desire for change within the patient. Such self-promotion of change is enhanced by the fact that the technique allows the patient to resolve doubts and identify barriers for change. Numerous studies have shown that MI is more effective than traditional method of giving advice to elicit behavior change particularly in weight loss, dyslipidemia and lowering of blood pressure. Furthermore, research indicates that techniques of MI are best taught by workshop sessions by experts who utilize MI within their primary care. The expert clinician asks open ended questions, assesses level of motivation and confidence and then tailors the interview accordingly. Ultimately, the expert determines the structure and direction of the interview, the patient is responsible for the change. Clerkship and residency programs should consider incorporating MI into their communication skills, thus enabling future primary care providers to be effective clinicians.
Haw-Yueh Thong
Shin Kong Wu Ho-Su Memorial Hospital, Taiwan
Title: Experience of photo-pneumatic therapy in Taiwanese acne patients
Time : 16:00-16:20
Biography:
Haw-Yueh Thong is Chief of the Cosmetic Center at Shin Kong Wu Ho-Su Memorial Hospital in Taipei, Taiwan ROC. After graduating from National Taiwan University College of Medicine, she completed an Internship in National Taiwan University Hospital. Her Residency was in dermatology at National Taiwan University Hospital and her Fellowship was in cosmetic dermatology at the University of California, San Francisco. She had worked closely with Professor Howard Maibach at UCSF. She is also a Graduate of Stanford University with a Master’s degree in Management Science and Engineering, focusing on medical decision analysis. She has published numerous articles in professional journals and serves on many advisory boards and committees. Her interest in dermatology includes acne vulgaris, cosmetic dermatology and filler injections.
Abstract:
Acne is a disease of the pilo-sebaceous unit affecting both teenagers and adults. The treatment of acne is sometimes frustrating due to the emergence of antibiotic resistance, skin irritation and lack of novel therapy. Light and vacuum devices, also known as photo-pneumatic therapy, have been shown promising as a generally well-tolerated adjunctive treatment of acne vulgaris. We conducted a clinical study using such device to assess the efficacy and safety as an adjunctive treatment of acne in Taiwanese patients. Twenty patients received six sequential treatments every one to two weeks in the facial region. A 4×4 cm2 area on cheek was chosen as a control area and was not treated with photo-pneumatic device. Safety parameters and adverse events were recorded. VISIA Complexion Analysis System was used for image analysis on the improvement of four parameters, namely, pigmentation, pore reduction, redness and porphyrin levels. There was an overall improvement in pigmentation, pore size, redness and porphyrin levels on treatment areas. The treatment areas showed statistically significant improvement (p<0.05) in pigmentation and pore sizes compared with the control areas using paired samples T-test. Mild and self-limiting localized adverse events, mostly focal petechiae or mild irritation, were reported. Our study has demonstrated that photo-pneumatic therapy is an effective, safe and relatively well-tolerated procedure in Taiwanese acne patients.
Ahmad A Mirza
Taif University, Saudi Arabia
Title: Diagnosis and Control of Hypertension as Indicators of the Level of Awareness Among Relatives of Medical Students
Time : 16:20-16:40
Biography:
Ahmad A Mirza has completed his MBBS from Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia. Recently, he has been appointed as Demonstrator (Teaching Assistant) in Department of Surgery, Taif University. He has published 2 papers in reputed journals and currently, he is working on 7 ongoing researches. He has been attended and presented in many national and international conferences.
Abstract:
Introduction: Patients’ awareness plays an important role in the early diagnosis and control of many diseases including hypertension. We aimed to estimate the level of awareness among the relatives of medical students by assessing the prevalence of undiagnosed and uncontrolled hypertension. Methods: In this cross-sectional designed study, a certain group of medical students were invited to interview their respective adult first-degree relatives for risk factors and take measurement of their blood pressure in adequate conditions. According to the absence or presence of hypertension in their history, relatives who were measured with elevated blood pressure were analyzed as undiagnosed or uncontrolled hypertension, respectively; while those who were measured with normal values of blood pressure were analyzed as normal or controlled hypertension, respectively. Comparative analysis of different parameters was carried out between these subgroups. Results: We included 770 relatives of 82 (57.7%) total students’ participations. The prevalence of undiagnosed hypertension in the total study population was 14.4% (111 cases). Among participants diagnosed previously with hypertension, 61.9% were uncontrolled at the time of the study. Predictors for undiagnosed hypertension were aged below 40, working at the present time in either governmental or private sectors, current smoking, absence of diabetes and cardiac diseases; while none of the investigated factors showed to be a significant predictor for uncontrolled hypertension. Conclusions: There is insufficient level of awareness among the family members of medical students, as demonstrated by the high prevalence of both undiagnosed and uncontrolled hypertension. The typical profile associated with the lowest awareness level is that of the young smoking employee with no history of diabetes or cardiac disease.
Natalia Alexeeva
Stanford Graduate School of Business, USA
Title: Virtual primary care-new models for guideline adherence, efficiency and access
Time : 16:40-16:55
Biography:
Natasha Alexeeva is a serial entrepreneur and health care enthusiast. She spent past 5 years in top notch innovation teams and those endeavors got her to start friendly. Her background is in technology and entrepreneurship. She graduated with computer science degree and math minor from Moscow State University in Russia and attended Graduate School of Business at Stanford University where she co-founded and sold another company in electronic education.
Abstract:
Virtual primary care is the fastest growing market segment in health care. It is projected to reach 42% this year. This is compared to 7% growth of the Urgent Care and 14% growth for retail clinics. The market says it all consumers, physicians and healthcare organizations all over the world see the value in more efficient ways to deliver high quality care. There are two major models in delivering health over electronic medium: Synchronous (video and phone) and asynchronous (model that does not require real time interaction). Synchronous models have been shown to be effective in mental health and clinician to clinician communications. However, it delivers limited efficiency, since the time taken to assess someone’s health via a video visit is almost identical to the time needed to do the same in the office (23 minutes vs. 25 minutes average). Asynchronous healthcare delivery, on the other hand, creates efficiency as well as increases access and convenience. It relies on latest evidence based guidelines to collect information from the patient using sophisticated computer algorithms and then serves it to the physician, so that they can access non-critical cases using clinical marginal capacity. Friendly is the market leader in asynchronous communication. The unique approach is showing an average doctor visit reduced by a factor of 10. Physician documentation is reduced by 50%. Patient loyalty and satisfaction is much higher as compared to in-person visit.
Alzbeta Tohatyova
Pavol Jozef Šafárik University, Slovakia
Title: Ad36 infection can lead to overweight and obesity?
Time : 16:55-17:10
Biography:
Alzbeta Tohatyova is currently a PhD student at Medical Faculty, P J Safarik University in Kosice, Slovakia. Her research interests focus on pediatric cardiology and preventive cardiology.
Abstract:
Introduction: Ad36 is the first human adenovirus reported that causes obesity in experimentally infected animals and shows association with obesity in humans. More human studies, all over the world, are related to the relationship between Ad36 infection and obesity, and till now have not been explanatory, studies show contradictory results. Aim: The main aim of our study is to assess the association between Ad36 infection and obesity in high-school students from Eastern Slovakia. Methods: Two hundred and twenty-four randomly selected students (17.72±1.20 years of age, 120 female) from 7 high-schools in Kosice were included in the study. Subjects with secondary causes of obesity were excluded and none were taking medications or had a history of cardiovascular disease. In 224 healthy students, anthropometric parameters, fasting plasma glucose and insulin were measured. Ad36 antibody was detected by ELISA test. Results: No significant differences were found between Ad36 positive and Ad36 negative high-school students in prevalence of obesity (chi-kv: 1.91, p=0.16). Study found no significant differences between high-school students with and without IR in prevalence of Ad36 positivity (chí-kv: 0.66, p=0.41). We confirmed significant differences between Ad36 positive and Ad36 negative in normal weight high-school students (p<0.05, U=2221.50). We also confirmed the high prevalence of overweight and obesity in healthy high-school students (23.66%). Conclusion: The current study shows a possible association between Ad36 infection and the risk of development of obesity in normal weight children and adolescents. Our results do not support that any Ad36 adipogenic adenovirus effect on body composition is operating in human through an insulin-resistance-related mechanism. Further studies in different age groups of children and adults are required to elucidate this biological mechanism of such complex relationship.
Lamia K Alsenaidi
United Arab Emirates University, UAE
Title: Women’s knowledge and attitude towards pregnancy in a high-income developing country
Time : 17:10- 17:25
Biography:
Lamia K Alsenaidi is a 6th year Medical student in United Arab Emirates University/College of Medicine and Health sciences. She has published 2 papers in reputed journals and she is currently working in a new research about cancer awareness.
Abstract:
Objective: The aim of this study was to determine the knowledge and attitudes among women in a high-income developing country regarding pregnancy and antenatal care. Methods: Women who participated in the study were asked to complete a questionnaire. The questionnaire enquired about age, level of education, internet use, marital status and employment. It also included questions regarding their knowledge of ultrasound, the effects of sexual activity and other exercise during pregnancy, breast feeding and premature delivery. The collected data were subjected to statistical analysis using SPSS. Results: The total number of women included in this study was 205. A total of 115 women (56.1%) thought that the most important benefit of ultrasound was to discover fetal abnormalities. Only 75 (36.6%) thought that regular exercise was not harmful during pregnancy. Of the total respondents 116 (56.6%) of 205 thought that sex during pregnancy was harmful to the fetus or did not know. Age (P=0.001), marital status (P=0.001) and working status (P=0.005) were found to significantly affect their knowledge. Conclusion: Knowledge about pregnancy among Emirati women is low. There is a need for effective prenatal classes that focus on educating women about issues related to pregnancy and antenatal care.
Galya Ghalib Al Ghalib Alsharif
King Abdulaziz University Hospital, Saudi Arabia
Title: The benefit of pre- and post-operative instructions
Time : 17:25- 17:40
Biography:
Galya Ghalib Al Ghalib Alsharif has completed her MBBS from King Abdulaziz University Hospital. She is currently a medical intern.
Abstract:
Millions of people each year undergo surgery. Despite the development in the surgical field; patients remain in fear of the complications that may take place. 140 patients were randomly selected from the clinics at King Abdul-Aziz University Hospital, in Jeddah. A questionnaire was used to test their knowledge of the instructions before and after a surgery; ear nose and throat specialty in particular. Another questionnaire was given after educating the patients of the instructions in one of the surgical operations in this specialty. The aim is to educate the patients about these instructions in the event of undergoing any future operations. The result was: 64% of patients knew the existence of instructions before and after operations, while 36% didn’t know the existence of such instructions. The most known instruction by 86% was: to stop eating at midnight on the night of the operation. And the least known by 34% was: to stop taking Aspirin 7 days before the operation. The benefit rate from the explained instructions was 100%. 54% of these patients received only verbal instructions, while 10% received both verbal and on paper instructions and the remaining 18% of patients didn’t receive any instructions.
Vijayalakshmi Gopalan Nair
University of Nizwa, Oman
Title: Influence of balanced diet on the nutritional status of the children between 1 to 3 years
Time : 17:40- 17:55
Biography:
Vijayalakshmi Gopalan Nair is a registered Nurse and Midwife with Master’s in Community Health Nursing Specialty in 2000. She has completed a Post-graduate diploma in Computer Application and pursuing PhD. She is currently working as Lecturer at College of Pharmacy & Nursing, University of Nizwa, Sultanate of Oman.
Abstract:
Aim: In the present study the researcher wanted to examine the nutritional status of children between 1 to 3 years (preschoolers). This study also wanted to investigate the improvement of weight and hemoglobin level through administration of balanced diet. Methods: One group per-test post-test design was adopted in the study. In pre-test nutritional assessment, dietary intake, anthropometric measurements and hemoglobin level of the children were assessed. The data collection was done for a period of 45 days. Physical assessment, nutritional assessment, dietary intake (pattern), nutritional deficiency diseases, anthropometric measurements like height, weight, head circumference, chest circumference, mid-arm circumference and hemoglobin levels were assessed. Education was given to the mothers on balanced diet and was demonstrated individually in their home setting on their menu planned for their children. After assessing, 30 children data were collected from their mothers. Results: The study findings revealed that among 96% of children there was a significant increase in the weight (from 0.5 to 1.2 kg), mid arm circumference and hemoglobin level (0.6 to 1.2gms dl). None of the child reported to have nutritional deficiencies. There was no significant difference in height, chest circumference and head circumference of the children. However, it has not increased to the ICMR recommended allowances. All the mothers perceived the importance of balanced diet and were able to prepare and feed the prescribed diet to their children comprised of rice, ragi, beef, egg, fish, milk, daal and vegetables including green leafy vegetables, roots and tubers and locally available fruits. Conclusion: The study brings to the attention that proper preparation and administration of balanced diet assures satisfactorial growth and development, prevention of infectious disease, nutritional deficiencies and thereby promoting well being of the children.
Rajni Nair(Video Presentation )
Metro-North Hospital Health Services, Australia
Title: Home is where health is
Time : 17:55-18:05
Biography:
Rajni Nair has completed her Master’s in Health Care Research from Griffith University, Australia and has publications related to "Extent and application of patient diaries in Intensive care unit in Australia". She has been the guest speaker in various conferences, like the Australian College of Critical Care Nurses and the Australian and New Zealand Intensive Care Society. She is the Nursing Director of Hospital in the Home service, in the Metro-North Health Services in Queensland. She has done extensive work in this sector, where active research is being conducted in “Hospital in the Home” and how the model would be effective to assist in patient journey in the field or Rehabilitation, Delirium, and more.
Abstract:
Hospital in the Home (HITH) involves the provision of acute, sub-acute treatments by health care professionals at a patient’s usual place of residence as a substitute for inpatient care received at a hospital. Patients are considered to be inpatient with preservation of medical governance. Most states and territories in Australia have HITH programs under which admitted patients are provided with hospital care in the home. The drive for HITH care in Australia has been due to rising health care costs increasing the need to reduce inefficient health care expenditure; growth in the demand of inpatient care in the context of limited public hospital bed supply; shifting demographics and population growth, hospital access issue, increased responsive to consumer preferences; and the development of portable hospital technologies, drugs delivery devices. The Metro-North HITH model of care has incorporated 4 tertiary hospitals, with care provision provided to patients in varied diagnosis related groups (DRG), with intravenous antibiotics, fluid management, wound management, blood transfusion, peritoneal dialysis and rehabilitation. Studies have shown that HITH is more beneficial when access block to hospitals is interjected, in Emergency Department. A pilot project conducted in one of the tertiary hospitals showed that the presence of a HITH nurse within the Emergency Department proved to be very effective and efficient in referring patients onto the HITH services. Other than the lesser waiting time for patient, outcomes were predominantly the portrayal of the efficiency in health services, cost savings, patient satisfaction, further referrals and less representation back to hospital.