Day 13 :
- Primary Healthcare | Primary Care Medicine | Primary Home Care | Global Primary Care
Biography:
After an “Unsurvivable Plane Crash” in 1991, I dedicated my life to serving others with empathy. After the crash and resulting 3-year series of 16 operations to rebuild my legs, I earned my medical degree in the British Commonwealth (MBBS) plus MEd and PhD in kinesiology. I then directed and 12 clinical studies over eight years which led to 20 publications and being chosen as a Fellow of the American College of Sports Medicine. My empathy came from being obese when I started medical school and I first developed the treatment plan for myself, 18 years ago, (my BMI was > 32 and is now < 26). I’m blessed to have over 50 publications (including four books) and the interdisciplinary protocols I employ has helped my patients drop a total of 2,000kg (mean -14kg and -23% Body Fat).My protocols and the research behind it are in my latest book “The Overweight Cure.”
Abstract:
The first step to reducing obesity is to eliminate the causes which must be accomplished for permanent, overweight cure. The “know causes” can include consuming foods such as High Fructose Corn Syrup and TBHQ (Tertiary butyl hydroquinone) which has been shown in research to lower the metabolism for days while the phenol toxin is being eliminated.1 A simple nutritional assessment is needed to empower this elimination of numerous know causes.
Hidden causes of the overweight disease can include endocrine imbalances, and recently it has been estimated that 75% of the US population has sub-acute food allergies which correlates to the 73% [populations of Americans who are overweight (BMI >26).2,3 Food allergen testing for obesity reduction is best done with the broad leukocyte reaction testing (Cell Science System labs in Florida, Germany, and Australia). Testing of all 250 food and variants (i.e. egg yolk separately from egg white) has shown significant benefits even with no other treatments.
A recent comparison study examined Food Allergen Elimination alone vs. Combined Treatment (Food Allergen Elimination plus evidence-based protocols for metabolic acceleration.3) There was a significant difference for all subjects (P < 0.0001) and there was also a significant difference between the two subject categories (P < 0.0001).
The combined treatment included the PAN-5 method that includes eating a single Portion-size meal or snack (< 2 cups) five times a day,3-5 performing an Aerobic-surge, 2-minute exercise five times a day, 3,6,7 and consuming a Natural or raw food five times a day within the <2 cup portion size.3,8 The combined treatment group showed a 75% greater weight loss (-12.4Kg), 80% greater fat percentage reduction (-5.4%), and 70% greater BMI reduction (3.6).3
A retrospective analysis of the subjects in that study have shown over $2000 mean saving is total, annual health care expenses when comparing the 12 months before obesity reduction to the 12 month duration (after reaching BMI <26). The savings came from eliminating chronic GI conditions, curing Type II Diabetes mellitus, reducing osteoarthritis, reducing the frequency of upper respiratory infections, and changing the instance and severity of other conditions.9
Food allergen eliminations have been used in the treatment of migraine headaches, irritable bowel syndrome, and other conditions for decades. There is significant evidence that hidden food allergies may be one meaningful cause of the growing obesity epidemic and this can be treated in primary care by eliminating food allergens and teaching the PAN-5 system, so that patients may achieve the overweight cure. The Cell Science System ALCAT testing allows primary care clinicians to test all 250 foods for a small fraction of the cost of isolated IgE or IgG testing of only 40 foods.
Biography:
Pornchai Chanyagorn has been working for more than ten years in applying ICT and embedded systems to improve quality of medical and nursing care. His works focus on design a system to support standard clinical practice without increasing cost of healthcare services. Examples of his works are an automatic FiO2 mixture control for premature infant, an electronic Kardex to prevent medication error in IPD, an activity reminder system to reduce pressure injury, an emergency operational and convergence communication system for Mobile Stroke Unit. He has his expertise in requirement engineering, process analysis & design, and system analysis & design.
Abstract:
Statement of the Problem: Healthcare providers are always seeking for innovation based on engineering and information technology to improve care quality, manage risk, and reduce service cost. To develop this kind of innovation requires understanding of complex requirements including medical safety, patient privacy, patient pathology, clinical standard practice guideline, resource constraint, and change resistance. When requirements are unclear or unmanaged, a design can be too complicate to build or too expensive to maintain. A requirement engineering framework helps reducing under-clarification and promoting a viable design for healthcare technology related innovative system. The purpose of this study is to present a framework of requirement engineering in developing innovative systems for emergency healthcare and IPD care services.
Methodology & Theoretical Orientation: An adaptive requirement engineering framework based on conventional SDLC and agile model was utilized during requirement gathering and development of two systems: Mobile Stroke Unit and Preventing pressure ulcer in immobilized patients. The systems were implemented and tested in compliance with functional and non-functional requirements acquired and confirmed by the framework to understand its performance and validity.
Findings: In case of a Mobile Stroke Unit (MSU), the framework reduces time of design and implementation by 30% and supports objective of MSU in which the total time of CT scan + diagnosis by Cerebrovascular neurologist + rt-PA administration must be within 3.5 hours from onset. In pressure ulcer prevention, the framework provides a cost-effective system to support a clinical nursing practice guideline of 2-hour repositioning, promote patient-nurse relationship and reduce cases of pressure ulcer.
Conclusion & Significance: An engineering requirement framework is important for healthcare technology related innovation. The framework is usually under-recognized. This study recommends that the framework shall be implemented in all processes of innovation development.
Biography:
Peni Hausia Havea is a recent PhD graduate on Climate Change. His research looks at the impacts of climate change on livelihoods, health and well-being – a mixed method approach. His passion to improve health and well-being of those who are displaced because of climate change and/or disasters caused by natural hazards has prompted him to pursue this topic on climate change and diplomacy. This research is the first ever to be conducted on climigration in Australia amongst Pacific Islanders. It is hoped that by the end of this research, Australia will consider climigration as a priority for the nation. It should be because the ‘Crown’ states that “any measures to respond to climate change should support the development of an effective global response to climate change.”
Abstract:
Statement of the Problem: One of the reasons people are migrating to Australia because of climate change. However, despite the Climate Change Act (2011) gives strategic direction to respond to this issue the literature reveals that relatively little is known about climigration. Consequently, this research aims to narrow this research gap and conduct empirical research on climigration amongst Sydney-based Pacific Islanders aged 25 to 75+ in NSW. The overall aim of this study is to provide a better understanding about how Australians of Pacific descent perceive climigration in Australia for the people of the Pacific.
Methodology & Theoretical Orientation: This mixed method research will be designed using a mixed method approach named Concurrent Convergence Parallel Triangulation Design (CCPTD). Concurrent because both studies (QUAN & QUAL) will be conducted at the same time frame. Convergence as it will be merged. Parallel in the sense both studies will be equally weighted and triangulation for employing a multi-methodological approach. The general ‘theoretical orientation’ (e.g. hypothesis to be tested) of the study is to prove to Australia that climigration will bring prosperity rather than a disaster.
Findings: The data analysis will be conducted using SPSS, R, python, Tableau, Minitab, Stata and QGIS. There are eight objectives to be achieved in this study. Each of which is to prove that climigration is significant for Australia because it brings prosperity instead of a disaster. This study is mandated to support the message from the ‘Crown’.
Conclusion & Significance: Results from this research will be used to propose a climigration policy to the State Government of New South Wales and a framework as to how this policy will be part of its first ever climate change visa or climate refugee visa by law by 2030 and beyond before making this as universal immigration law.
Neeraj Bedi
Bundelkhand Medical College, India
Title: Cancer Awareness Campaigns and Primary Healthcare- Gulf Council Countries
Biography:
Prof. Dr. Neeraj Bedi is a highly qualified and experienced Public Health/Community Medicine professional. He has obtained his Doctorate in Community Medicine from India and Masters’ in Public Health from Manchester Metropolitan University, United Kingdom along with MBA in Healthcare and Hospital Management. His special interest are Healthcare Quality and Patients’ Safety. He is having a vast 28 years of teaching, training, research and administrative experience in Community Medicine/Public Health. He has published more than 100 research papers in local, national and international journals of repute. Presently working as Professor/ GMC, Bhopal, India and Head of Department, Epidemiology, Faculty of Public Health and Tropical Medicine, Jazan University, Saudi Arabia
Abstract:
Gulf Council Countries (GCC) citizens are expected to have 25,000 new Cases per year by 2035, which is 180 % Higher than in 1998. The Early Detection and Treatment of Cancer increases Cure by 95% for Breast, Prostate, and Thyroid cancers. And Modern Advanced Means are able to detect triggers for colon and cervical cancers years before they occur. To prevent and control cancers awareness Campaign are organized in GCC region. The campaigns are based on Facts that 40 % of Cancer Cases can be prevented by following a Healthy Lifestyle, and more than 40 % of Cancer Patients could recover if detected by early- Screening. In Saudi Arabia incidence is 24485 with more than 10518 deaths annually carrying a huge economic and resources burden. Breast cancer is number one cancer in females while in males Non-Hodgekins lymphoma. The other cancers are leukemia, lungs, liver etc. Pre-mature deaths due to risk of dying from cancers before the age of 75 is 12.1% in both sexes. 30-50% of all Cancer Cases are Preventable. The Prevention is the most ‘Cost-effective’ long-term strategy for the control. The National policies and programmes focus on to raise awareness, reduce exposure to cancer risk factors and to ensure that people are provided with the information and support they need to adopt ‘Healthy Lifestyles.’ Tobacco and alcohol use , Physical Inactivity, Dietary Factors, Obesity , Overweight and infections are important modifiable risk factors. Screening is an important tool in Primary healthcare to prevent and control the cancers.
- Primary Healthcare Management | Primary Healthcare and Public Health | Primary Care and Nutrition
Session Introduction
Agbenin Andrew
University of Calabar, Nigeria
Title: An Evaluation of Home Management of Malaria by care givers of under-five children in Calabar South Local Government Area of Cross River State, Nigeria
Biography:
Abstract:
Zilberman Uri
Barzilai Medical University Center, Israel
Title: The Prevalence of Molar Incisor Hypomineralization among children in Jewish and Arab population in Israel
Biography:
Dr' Zilberman received his DMD degree in 1983 from Hebrew University, Jerusalem, and his PhD degree in 2000 on basic dental science of dental anthropology. Specialized in pediatric dentistry from 1990 and treated children and adolescents for the last 38 years. Dr' Zilberman is the head of the Pediatric Dental Unit at Barzilai Medical University Center, a unit recognized for specialization in pediatric dentistry since 2007, and today there are 6 seniors and 9 residents in the clinic. Senior lecturer at the Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva. Teaches course on Pathophysiology of the Oral Cavity for fourth year pharmacology students. Dr' Zilberman published more than 50 research papers and chapters in pediatric dentistry and dental anthropology. His main interests are new dental procedures and devices for pediatric dentistry, hereditary disorders and their effect on tooth development, and the use of biomimetic materials in pediatric dentistry, like Glass-Ionomers Cements. He developed new dental procedures and a patented new dental device for pediatric dentistry
Abstract:
Purpose: To describe the prevalence and features of hypo mineralized enamel in molar incisor hypo mineralization in Jewish and Arab children, in south and north regions of Israel, and to present a sequential approach to management.
Methods: The children were examined by residents in pediatric dentistry. The examinations were performed at schools, using a headlamp, wooden tongue depressor and a dental mirror.
Results: The percentage of MIH in the Jewish children was 17.1%, and in the Arab children was 18%. The percentage of MIH in the younger age group (6-10Y) was higher in comparison with the old age group (10-16Y) in the Jewish boys and girls and in the Arab boys groups. The percentage of HSPM was 2.7% in the Jewish population and 1.9% in the Arabs with no differences between boys and girls.
Conclusion: The MIH prevalence is increasing in the Israeli population. In the young group the degrees were demarcated opacities and in the older group the degrees were atypical amalgam or composite restorations. The dentists treating the young children are using restorative methods that are not suitable for hypo mineralized molars. The treatment of MIH molars should be focused on remineralization of the affected enamel, using Glass-ionomer restorative materials.
Narentharen Selvarajah
Fellowship of the Royal Australian College of General Practitioners, Malaysia
Title: Case of a High Risk Pregnancy: A holistic management approach of Ventricular Septal Defect at Rural Primary Care
Biography:
DR Narentharen had completed his double degrees of MB BCh BAO & BMedSci(Hons) at the age of 25 years from the National University of Ireland and obtained a Post Graduate Diploma in Sports Medicine from the International Olympic Committee in 2016. He is currently in the Family Medicine residency programme where he is a candidate for the Fellowship of the Royal Australian College of General Practitioners (FRACGP). He has published multiple papers in reputed journals and has presented at numerous international conferences.
Abstract:
Maternal congenital cardiac abnormalities increases maternal morbidity and mortality.
We present a 36-year-old gravida III para II with ventricular septal defect diagnosed at 11 years of age. No surgical repair was done due to her poor socioeconomic background and she defaulted follow up. She presented at 14 weeks period-of-amenorrhea(POA) with breathlessness and pedal oedema. Vital signs were normal with a grade 3 pan-systolic murmur.
She had microscopic hypochromic anaemia with a haemoglobin of 8.3 grams per desiliter. Echocardiography showed a peri-membranous outlet ventricular-septal-defect measuring 0.5cm with a left to right shunt and moderate tricuspid regurgitation with moderate pulmonary hypertension.
Patient was managed by a multidisciplinary team. Her health seeking behaviour improved after constant aggressive counselling. She had no significant failure issues, blood pressure remained within normal limits and foetal growth parameters matched gestation age throughout the pregnancy. With optimization, haemoglobin remained stable above 12. Serial echocardiography did not show progression of disease. No abnormalities on detailed foetal ultrasound at 22 weeks of POA. Social services contributed financial aid and home care nursing team ensured compliance to treatment.
Patient was transferred to a tertiary cardiac centre for induction-of-labour at 37 weeks POA. She delivered a healthy baby boy(Apgar score 9,10) with a birth weight of 2.4kg via spontaneous-vaginal-delivery at 37 weeks and 2 days POA. She was discharged home well three days later.
Skillful pre-conception counseling and holistic management throughout pregnancy by a multidisplinary team becomes an essential component of the care of pregnant women with cardiac disease.
Shikha Kukreti
Indian Institute of Public Health Delhi, India
Title: Knowledge attitude practices of Accredited Social Health Activist (ASHAs) regarding nutritional screening and nutritional care of under five children in urban poor settlement of Delhi
Biography:
Shikha Kukreti born and brought up in Kotdwara, Uttarakhand, India. Shikha Kukreti is a Dental Surgeon who have recently completed Master of Public Health from Indian Institute of public health Delhi. Shikha Kukreti have a 5years of work experience and recently she has joined a project as a Research Assistant in ADRI Patna title “Public mental health system assessment in Bihar”
Abstract:
Background: India has a high burden of child undernutrition and 45 % of childhood deaths can be attributed to malnutrition. NHM envisioned ASHA as health activists in the community who creates awareness on health and its social determinants. Under the Delhi State Health Mission, ASHAs are provided training on child feeding practices and care as per ASHA modules.
Objectives: To assess the knowledge, attitude and practices of ASHAs in nutritional screening and nutrition care of children under 5 years in urban poor settlements of Delhi.
Methodology: A cross-sectional study was conducted among 67 ASHA workers selected from four primary urban health centers of south-east and south district of Delhi. Mixed method approach was used where quantitative data was collected using an interviewer administered questionnaire and qualitative data was collected using an in-depth interview conducted with the medical officer and ANM and focus group discussion with mothers of under-five children.
Results: The overall attitude of ASHA was good regarding nutritional care and nutritional screening. 65 percent ASHAs had knowledge of nutritional care and screening while 62 percent ASHAs practiced nutritional care and screening of under-five children and there was a significant association between total practice and knowledge scores of ASHAs (p<0.00). The qualitative finding suggested that although an adequate amount of training regarding infant and young child feeding and nutritional screening was provided to ASHA worker, certain challenges and motivational factors influenced their practices.
Conclusion: Present study shows that though ASHAs had the right attitude, their overall knowledge and practice level had gaps regarding nutritional care and screening of under five children. This is a crucial component as ASHAs are grassroots level functionaries who are in close proximity to the community and have an important role in protection, promotion and support to the nutrition of the children within the community.