Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 2^nd Annual Congress and Medicare Expo on Primary Care and General Pediatrics Phoenix, USA.

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Day :

Primary Care

Session Introduction

Roderick S. Hooker

Northern Arizona University, USA

Title: The Contributions of Physician Assistants and Nurse Practitioners in Primary Health Care

Biography:

Roderick S. Hooker is a health policy consultant with an interest in organizational efficiency. He spent two decades with Kaiser Permanente as a health services researcher, as a PA, and then moved to the University of Texas and the Department of Veterans Affairs in Dallas, Texas. Following the VA he became a Senior Director with The Lewin Group in Washington, DC, a health policy-consulting firm. He is a cofounder of the International Health Workforce Collaborative that meets biennially to discuss medical organizational economics. Over the past decade Dr. Hooker served as a consultant to the Ministry of Health in Ontario and New Brunswick. A similar consultancy was in Queensland and Scotland developing their PA corps. He is now retired and lives in Southwest Washington State.

Abstract:

After a half-century of development, the physician assistant and nurse practitioner are not only enmeshed in American culture but also deployed in 15 other countries. Their contributions to the delivery of primary health care is not only growing but serving as critical players able to backfill where scarce medical care delivery systems are present. The raison d’etre for their development was the shortage of generalists and the demands for health care services in underserved communities. What has emerged is a cadre of approximately 250,000 clinically active PAs and NPs that are providing a wide range of services within the full spectrum of North American communities – from Manitoba to The Virgin Islands. How they are utilized in primary health care and to what extent will be presented. Their economic and social contributions will be illustrated along with the benefits to physicians, medical teams, and the social stability of small communities. Growing evidence reveals that the presence of PAs/NPs in small and medium medical groups helps improve access, lower liability exposure, and malpractice rates, and reduce the likelihood of primary care physician burnout. The economics of PA/NP employment in primary care service delivery is only now being understood as significant. It is not enough to know that their wages are less than half of a family medicine physician, but their annual productivity matches that of a family medicine physician.

Peter D. Trice

The Innova Group, USA

Title: Starting From Scratch: Rebuilding an Ambulatory Care Network

Biography:

Peter Trice, a founder and vice president of the Innova Group, has spent more than 30 years developing his expertise in healthcare planning. As an industry leader in the integration of new concepts in healthcare strategy and clinical operations into hospital and health system design, Peter’s passion is finding creative data driven solutions to current obstacles to the delivery of effective healthcare. Mr. Trice is dedicated to improving the quality of care worldwide, project by project. His recent work has been in the Middle East, Latin America, the United States, Mainland China, Viet Nam, Singapore and most recently Brunei.

Abstract:

Our client, Reliant Medical Group (RMG), is a 250 provider medical practice. RMG has a long history of working in a risk model, has a mature relationship with electronic records, and has been continually improving and innovating over many years. There are over 20 sites of outpatient care, and the organization recognized that many of these were planned based on now-outdated operating methods, idiosyncratic preferences of the individual occupants and/or the configuration of the existing space. At the same time, more than half of RMG’s primary care facilities were under a master lease agreement that might not be renewed. This provided an unprecedented opportunity to redesign the distribution of care sites, envision new workflows and patient experience, and develop a built environment where form can truly follow function.

This session will present a case study on how RMG worked to:

• Develop an ideal geographic distribution of new and current sites of care that optimizes access, capital costs, operational costs and population health management goals

• Create standardized templates for an RMG “Medical Office Building of the Future,” including a common vision for end-to-end flow of patients, staff, and providers in the new facilities, space requirements to support (PCMH), lean operations, and virtual care

This session will present a case study on how a large multi-site medical group worked to:

• Develop an ideal geographic distribution of new and current sites of care that optimizes access, capital costs, operational costs and population health management goals

• Create standardized templates for a “Medical Office Building of the Future,” including a common vision for end-to-end flow of patients, staff, and providers in the new facilities, space requirements to support (PCMH), lean operations, and virtual care.

Jenny Mee

Federation University, Australia

Title: The challenges for business managers of home care services in meeting regulatory quality requirements in Australia.

Time : 11:35-12:05

Biography:

Ms Jenny Mee’s passion for caring and life-long learning as a nurse has lead her on a journey as a clinician, clinical educator, nurse manager (neurology), researcher and directing her own home care business. Jenny is currently a PhD candidate and works as an academic in nursing at Federation University (Victoria, Australia). Jenny holds a Master of Applied Science (Research), and has been serving as Faculty of Health board member at her university.

Abstract:

The ethical and political challenges facing home care provision is fraught with complexity, none more so than for those who conduct home care businesses. The gaps in the literature reveal that home care for-profit providers have not had a voice in Australia. The purpose of this research is to gather information about home care business in Australia and how owners/managers meet quality accreditation processes. The intent of the research is to provide a forum in which participants can share experiences and challenges with the wider home care governing and research communities about the business of home care. The research has implications for informing policy and practice relating to the recent changes in consumer directed home care that will improve service delivery. This has specific political and economic implications for Australia as the population ages and consumer directed home care packages are implemented. An inclusive analysis of the discursive events is an important starting point to inform consumer directed change and is vital for ensuring quality provision of home care services for the consumers. In addition it will provide insights into how consumer driven care can be provided universally with a focus on equity and inclusion. This presentation will explore the ethical considerations of inclusive practice for the project using a post structural framework.

Bettie Coplan

Arizona State University, USA

Title: How PAs and NPs Contribute to Chronic Disease Management in Primary Care

Biography:

Bettie Coplan is Clinical Associate Professor at Arizona State University in the School for the Science of Health Care Delivery where she leads the online MS degree program. She also serves as adjunct faculty for Northern Arizona University’s physician assistant (PA) program and practices clinically part-time at a medical respite center for patient’s experiencing homelessness. Ms. Coplan has been a physician assistant since 1999 and an educator since 2006. She is a leader in her profession and has published several articles addressing PA and primary care issues. In 2012, she received the national Physician Assistant Education Association Research Achievement Award.

Abstract:

The US health care system is facing complex challenges: an increasing and aging population, a paradigm shift from acute care to management of chronic disease, and impending shortages of physicians. Proposed solutions include greater reliance on team-based models of care delivery and creating environments in which health care professionals practice to the full extent of their education and training.1 Currently in the US, physician assistants (PAs) and nurse practitioners (NPs) contribute substantially to the provision of primary care services and chronic disease management, particularly in underserved communities where they often practice with little or no physician oversight.2 Nurse practitioners have full independent practice status in 21 states, and state laws that dictate PA practice generally allow for off-sight physician supervision. Research suggests that PAs and NPs can provide safe, high-quality care. In some settings, however, they may be underutilized. The main objectives of this presentation are to 1) review the recent literature on chronic disease management by PAs and NPs, 2) discuss the various roles NPs and PAs play in primary care, 3) examine barriers to PA and NP practice in primary care, and 4) discuss strategies for effective utilization of NPs and PAs going forward.

Leslie Zun

Chicago Medical School, USA

Title: Identificaiton and Treatment of Mental Illness in Primary Care

Biography:

Leslie S. Zun, M.D., M.B.A. is the System Chair of the Department of Emergency Medicine in the Sinai Health System in Chicago, Illinois and Chairman & Professor, Department of Emergency Medicine and a secondary appointment in the Department of Psychiatry at the Rosalind Franklin University of Medicine and Science/Chicago Medical School in North Chicago, Illinois. His background includes a medical degree (M.D.) from Rush Medical College and a business degree (M.B.A.) from Northwestern University's JL Kellogg School of Management. He is board certified in Emergency Medicine by the American Board of Emergency Medicine. Dr. Zun was a chief operating officer and acting chief executive officer for a 200 bed hospital in Chicago. Dr Zun’s research interests include healthcare administration, violence prevention and behavioral emergencies. His publications have addressed the administration of the hospitals and emergency departments, physicians’ bonus and incentive plans and quality improvement topics. He has presented his research and lectured on these topics both nationally and internationally. He is a board member of American Academy of Emergency Medicine and the President Elect for the American Association for Emergency Psychiatry. He is the chief editor of the Behavioral Emergencies for Emergency Physicians textbook and course director for the past five years for the National Update on Behavioral Emergencies conference.

Abstract:

Studies have demonstrated that up to 45% of adult patients and up to 40% of pediatric patietnes have undiagnosed mental illness. Undiagnosed mental illness impairs the evaluation and treatment of many medical disorders. Primary care is the front door to the diagnosis and treatment of patients with diagnosed and undiagnosed mental illness. This course will discuss the means to identify patients with mental illness, impact on their medical disorders and appropriate treatment. The course will feature common and uncommon mental illness that present to primary care.

Mary E. Oâ€™Keefe

UTMB School of Nursing, USA

Title: Providing Care to Wards of Texas Probate Courts

Biography:

Dr. O'Keefe is a lawyer (JD) and a registered nurse (RN), with a doctor of philosophy (PhD) in nursing and a licensed professional counselor (LPC). She has a certification as a Clinical Nurse Specialist in Psychiatric and Mental Health Nursing (CNS Psych/Mental Health) and has extensive training in alternate dispute resolution, including mediation and arbitration. Dr. O’Keefe is a Professor in the UTMB School of Nursing, Galveston, Texas, where she has been awarded the Constance Brewer Koomey Endowed Professorship in Nursing and is recognized as an University of Texas Distinguished Teaching Professor. She is also a Professor in the UTMB Graduate School of Biomedical Sciences, a Clinical Associate Professor in the UTMB School of Medicine, and a Visiting Professor in the Shantou University Schools of Medicine and Nursing, Shantou, China. Dr. O’Keefe has published a series of textbooks known as Nursing Practice and the Law: Avoiding Malpractice and Other Legal Risks. She has a pending publication entitiled Policy, Power, & Politics: Creating the Leadership Potential in Nursing Practice

Abstract:

The State of Texas has over 54,000 legally incapacitated individuals, designated as Wards of the Court. Wards lack the physical and/or mental ability to provide shelter, financial management or physical care and therefore placed under Guardianship. This presentation discusses the Interprofessional partnership involving undergraduate nursing students in four programs across the State of Texas who served as Court Visitors to Texas Probate Courts. Students assessed the Wards providing independent evaluation of their health status. This groundbreaking Interprofessional entry into the legal system provided students with clinical experiences in non-traditional venues while serving as a springboard for the other seminal clinical programs including Interprofessional Pediatric Advocacy Model and Drug Court Clinical Model. Mentoring among and between professionals in nursing education and the legal system will be presented for the following campuses. (A) UTMB-School of Nursing (SON) and Galveston Court: (1) the Court Visitor Program Model (CVP); (2) Mentoring of Court, Faculty & Students in Model implementation; and, (3) Mentoring in development of unique related clinical programs. (B) UTMB-SON and CPS: (1) the Interprofessional Pediatric Advocacy Model; (2) Mentoring of Court, Faculty, and Students in Model implementation. (C) Blinn College Associate Degree Nursing Program: (1) Mentoring of Court, Faculty and Students in Model Implementation, and, (2) Drug Court Clinical Model. (D) UTArlington-SON and Tarrant Court: Court, Faculty and Student mentoring process in the development of the CVP. (E) UTAustin-SON and Travis Court: Court, Faculty and Student mentoring process in the development of the CVP for a RN-BSN Public Health Nursing practicum course.

Primary Care Nurse Practitioner

Session Introduction

Freida Toler

Amarillo Medical Specialists, USA

Title: Females With Down syndrome: Lost opportunities in primary care

Biography:

Freida Toler completed her Masters in Nursing from West Texas A & M University in Canyon Texas. She is an AANP Certified Family Nurse Practitioner. She is currently employed by Dr. Biggs, MD as a Nurse Practitioner at Amarillo Medical Specialists. She works full time in Endocrinology. She is an officer in the local Panhandle Nurse Practitioner Association and has recently been voted as Nurse Practitioner of the year. She has published an article in JAANP. She has been a guest speaker for Panhandle Nurse Practitioner Association in the area of womens health.

Abstract:

Purpose: Nurse practitioners (NPs) need to be aware of the health disparities that exist between adult females with and without Down syndrome (DS). It is essential that necessary primary and preventive healthcare services are available to women with DS to maintain adequate health and quality of life, and reduce the occurrence of misdiagnosed or underdiagnosed treatable diseases.

Data sources Review of published literature, DS society reports, and U.S. government reports.

Conclusions: A lack of agreed guidelines for the screening of adult females with DS contributes to unmet health needs in primary care for this population. Adequate promotion of health in all persons with disabilities, including the specific needs of women with DS, will help prevent the development of preventable secondary disabilities. Research shows that health promotion, screenings, and preventive care are overlooked or ignored in the female population with DS. Barriers to this care were consistent with misconceived attitudes and beliefs about adults with DS and a lack of training for primary care providers in caring for persons with disabilities.

Implications for practice

Although much research is needed, there are some resources for NPs who provide care for this vulnerable population. Screening for preventable conditions, such as obesity, sexually transmitted infections, and sexual exploitation, can improve the quality of life for adult women with DS.

Tendai Nzirawa

Queens University Hospital, UK

Title: Does the intervention of a Community Neonatal Service, actually reduce hospital readmission? A case study of Nasogastric tube fed infant over a 12 monthsâ€™ period

Time : 12:05-12:35

Biography:

Tendai Nzirawa completed Undergraduate Diploma in Nursing studies (Adult) in 2005 (City University, London). Completed Bachelor of Science with Honours in Nursing Studies (Neonatal Care) in 2012 (City University, London). Currently, studying a Master of Science in Nursing Studies (Neonatal Care) London Southbank University, London. Since 2010, have been involved in setting up and running a Neonatal Parent Support group with other health professionals. Also in June 2015 set up a Down Syndrome Parent Support Group, run it with the assistance of two mothers who have children with Down Syndrome. In 2012, participated at the European academy of Pediatric Societies, Turkey (Poster Presentation) – The experiences of parents of infants on Home Oxygen.

Abstract:

Every year our neonatal unit discharges at least 6 infants on nasogastric tube feeding, in order to reduce length of stay and promote parent-infant bonding in a relaxed environment. Although, in 2015 one infant proved that the input of a community neonatal service can reduce length of stay, and also reduce readmission to the children’s ward. (According to The Code-Nursing and Midwifery Council, 2015 the infant name has been changed and will be referred as Summer). Summer was born in a level 3 hospital at full term and at examination was diagnosed with Laryngomalacia and severe hypotonic, Summer was transferred to a local level 2 hospital for continuity of care, however after a total of 2 weeks in hospital, a discharge planning meeting was done to discuss Summer’s discharge including parental teaching for nasogastric tube feeding. Throughout, the 12 months’ period that Summer received support from the community neonatal nursing team, Summer never attended A&E and also never was readmitted in the children ward. Summer’s case study has proved that by having a Community Neonatal Service would reduce length of stay and reduce hospital readmission. In conclusion, it is important to recognize that this can only be achievable when there are other health professionals to ensure that the focus of the care is based on the infant’s needs and unlimited parental support.

Joe Tabor

University of Arizona College of Public Health, USA

Title: Who Provides Primary Care in Arizona?

Time : 12:35-13:05

Biography:

Joe Tabor is an Assistant Professor and Nicholas Jennings is a doctoral candidate. Both authors have appointments in Community, Environment and Policy Department at the University of Arizona’s College of Public Health in Tucson.

Abstract:

Results from a community-level analysis of health providers show high spatial variability of the workforce data, greater susceptibility to data errors, and bias due to incorrect assumptions about the data.

Arizona has growing needs for primary care providers but information about the role and distribution is lacking. Primary care physicians, PAs, and NPs compared at zip code and county levels showed geographical maldistribution of professions that could influence the selection of preceptorship and residency training locations. County level comparisons between physician licensing board data and Health Professional Shortage Areas (HPSAs) data show a differential bias in magnitude and direction. State level comparisons underscore how a state such as Alaska can improve primary healthcare rankings by including physician assistants, nurse practitioners and certified nurse midwives. Spatial analysis of healthcare workforce and points of services will better inform policy development by federal and state governments, educational and professional organizations, and the private sector.

Luciana Merley Belmiro de Assis Borborema

Federal University of Tocantins (UFT)- Brazil

Title: Xerente people: observing on hypertension and health care.

Biography:

Luciana Merley Belmiro de Assis Borborema- Nurse , effective teacher of the nursing course of the Federal University of Tocantins . It operates in lines of research in child health , Emergency Department and Public Health

Abstract:

This study is aimed to know how Xerente people understand systemic hypertension and health care.

Method: field research with qualitative measures, ethnographic approach, with 29 hypertensive indigenous Xerente. The data was based on Leininger analysis, it proposes the ethnographic method for Nursing, which divides the analysis into four phases: First phase is to collect and documentation gathering of raw data. Second is consisted in the study of data which observes similarities and differences in statements and behaviors. Third was held and contextual analysis of patterns. Finally, the fourth stage are the issues, findings and relevant theoretical formulations being analyzed and synthesized.

Results: The power of indigenous people and their eating habits have undergone through changes over the years due to the contact with the city. The indigenous Xerente population does not perform any type of physical exercise in the villages. Much of the interviewees claim that they use the medicine prescribed by the doctor and also make use of plants as medicine.

Conclusion: The indigenous hypertensive recognizes the process of being ill in their body, however, the health care for the same needs to be related to their way of life at the village. It's concluded that the necessary provision in health care in a way that meets the needs of indigenous in respect to their cultural values, through the inclusion of indigenous services and conducting health education activities, it is critical the training of professionals working with indigenous health.

Primary Care Management

Session Introduction

Maha A. Al Turki

King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia

Title: Hospital Food Services; Dealing with Cultural Influences on Food Consumption Patterns

Time : 12:05-12:35

Biography:

Maha A. Al Turki obtained a Master of Medical Sciences in Human Nutrition in 2006 and PhD of Human Nutrition in 2014, both from the University of Sheffield/UK. Upon her return to Saudi Arabia, she joined King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh as an Assistant Professor of Clinical Nutrition. In her pursuit of academic excellence she is currently studying for a Master Degree of Medical Education at KSAU-HS. At present, she is holding a position of Assistant Dean at the College of Applied Medical Sciences at KSAU-HS.

Abstract:

Diet and nutrition play an important role in promoting recovery from different illnesses. Patient's nutritional status often deteriorate during hospitalization; a study has shown that nutritional status was declined in 29% of well-nourished patients during their hospital stay1. Besides health reasons and hospital environment2, food habits and preferences are one of the important factors affecting food intake of hospitalized patients. Food habits are the main aspect of many cultures, and cannot therefore be easily changed, or else it will affect food intake and meals pattern. Saudi people from different distinct regions eat different foods and have different food habits. The food ingredients, type, cooking methods and preservation techniques vary among these regions.

Hospitalized patients often find it difficult to adjust, from their traditional food, to a standard hospital menu. This may result in reducing intake of food and increasing risk of malnutrition. One major step in promoting good nutritional care in hospitals is to ensure that hospital menus take into consideration patients’ needs and preferences. Moreover, patients should be involved in planning their meals and choosing their food items in order to customize their dietary plan to accelerate recovery from illness and reduce the length of hospital stay.

In my presentation I will discuss the difficulties that some patients admitted to King Abdulaziz Medical City (KAMC)/Riyadh may face with food presented to them. I will also discuss the methods that are used by the hospital Food Service department to assess patient satisfaction with the food available (e.g. tray assessment method), and how these methods can be used to explore the reasons for low food consumption of some patients. Moreover, I will present the results and examples of tray assessment process for hospitalized patients over two weeks. The process of dealing with patients to fulfil their dietary requirements and preparing meals in accordance with their tradition and preference will also be discussed.

Satish Chandrasekhar Nair

Tawam Hospital, UAE

Title: Primary Care Practice Based Research and Learning â€“Global Experience

Biography:

Dr Satish Chandra is the Director for Medical Research at Tawam Hospital- Johns Hopkins Medicine International in Al Ain UAE. He has Bch.Med and later PhD, faculty of Medicine from the USA. He has authored more than 54 papers in international scientific peer-reviewed publication besides 2 book chapters on Molecular Medicine and Genetic Susceptibility of Diseases (Mary Ann Liebert, NY). He is involved as an investigator for clinical trials, chairs the ethics committee and continues to teach medical residents. He is currently the associate clinical professor, college of medicine, UAE University

Abstract:

Compared with other health care settings, primary care is unique in the breadth of its scope, being concerned with a range of patient health issues and human needs. Primary care providers respond to physical and emotional health concerns of diverse populations, providing and coordinating care across the lifespan. Many patients present with multiple health concerns and other psychosocial, family, or cultural issues requiring attention. This broad scope of practice contrasts with what some see as the highly specialized nature of medical and intervention research, driven by a focus on single, tightly defined diseases or clinical situations. The clinical practice guidelines and educational programs are often developed with single diseases in mind and sometimes overlook socioeconomic and cultural differences in populations. This disconnect forces primary care providers to assess the applicability of research findings and interventions to the “real-world” patients in their own practice settings. This study focusses on the factors important to close the gaps to enable primary care and advanced care to be integrated through a research platform to generate better outcomes for patients.

Zachary Hartsell

Wake Foret School of Medicine, USA

Title: Effectively benchmarking both financial and non-financial metrics for physician assistants and nurse practitioners practices

Biography:

Zachary Hartsell completed his physician assistant training at Touro College in 1998. He has worked in emergency medicine, cardiology, and hospital medicine. Mr. Hartsell has been working in both clinical and administrative roles at academic medical centers for the last 15 years. Most recently he worked as the Director of PAs at Wake Forest Baptist Medical Center and oversaw the workforce transformation and optimization of over 300 NPs and PAs. He is currently pursuing his doctorate in health administration at A.T. Still University with an emphasis in leadership development. Zachary regularly speaks both nationally and internationally on topics related to workforce optimization and development of NPs and PAs. Mr. Hartsell also serves on the editorial board of the Journal of the American Academy of Physician Assistants.

Abstract:

The rise of value-based care has created a system of greater accountability from providers in regards to cost, quality, and effectiveness. While many different frameworks and benchmarking models for physician productivity exist, there are few models that can be correctly measured nurse practitioners (NP) or physician assistants (PAs) true value. As a result, many NPs and PAs are inadequately represented and often invisible in the reporting and finance system. This inability to accurately track NP and PR performance creates uncertainty and tension with budget development, as the NP or PAs true value may be undervalued or counted against physician performance. With the increase utilization of NPs and PAs several benchmarking tools have become available, but these tools suffer from poor sensitivity and specificity towards the NP or PAs actual work performed. This presentation will introduce a benchmarking tool aimed at accurately capturing data on the wRVU production of NPS and PAs. Focus will aim at introducing the challenges with the current benchmarking system and the description of a reproducible predictive modeling tool to determine the expected revenue generation of NPs and PAs. The presentation will highlight the challenges in utilizing and developing financial benchmarking tools for NPs and PAs with a focus on understanding local/specialty practice patterns. The presentation will also introduce a nonfinancial incentive model focused on quality and patient satisfaction developed specifically for PAs. Finally, a review of the proper and improper application of shared visits will be discussed.

At the end of this presentation, participant should be able to

Describe the challenges with using existing physician focused productivity benchmarking tools in the analysis of NP or PA practice.
Explain the different types of nonfinancial quality metrics that capture the productivity of NPs and PAs most accurately.
Apply shared visits in the appropriate setting and situation to maximize reimbursement and efficiency.

Primary Care Epidemiology

Session Introduction

Mbuyiselo Douglas

Human Sciences Research Council, South Africa

Title: The Perceptions and Knowledge of Boys Regarding Deaths and Complications Related to Traditional Male Circumcision

Time : 13:50-14:20

Biography:

Dr. Mbuyiselo Douglas was awarded an AusAID, Nelson Mandela Scholarship to study Master of Public Health degree at Curtin University in Western Australia which he obtained in 2004. He graduated PhD in Health Sciences at Walter Sisulu University. He has been a senior lecturer and an acting head of department. He has published 5 papers in accredited journals and was also coordinating Ubuntu Bethu Circumcision Project at Nyandeni in the Eastern Cape Province funded by AIDS Foundation South Africa (AFSA). He is now on a three year contract for post-doctoral research fellowship at Human Sciences Research Council in South Africa.

Abstract:

Every year there are reported deaths of AmaXhosa male circumcision initiates, especially in the region of Pondoland in the Eastern Cape, a province in South Africa. These deaths are in particular due to complications such as dehydration, sepsis and gangrene. The primary purpose of the study was to explore the perceptions and knowledge of boys about the underlying determinants related to circumcision deaths and complications. A qualitative approach with exploratory and interpretive components was followed. A simple random sampling was used to select 3 focus group discussions with 36 circumcised boys. A purposive sampling was used to select 10 key informants for semi-structured interviews. One question was asked from the participants: Why boys are dying in the circumcision initiation schools? The Tesch’s eight steps data analysis method was used. The data was organised and prepared for analysis by first transcribing the interviews verbatim and then translating the transcriptions. Four overall themes were developed during data analysis:

(1) Unskilful and inexperienced traditional practitioners; (2) Assaults and torture in the initiation schools; (3) Restriction of fluids and food; (4) Action that should be taken to prevent the problem. The inexperienced and unskilful traditional practitioners were identified to be the main cause of the problem. The preventive action was recommended to empower the target groups and thereby protect the children.

Innocent Emmanuel KONGO

University Libre of Kinshasa - DRC

Title: Access to health care in the Democratic Republic of Congo: Major challenge for the poor (case report).

Time : 14:20-14:50

Biography:

Innocent Emmanuel KONGO has completed his graduation at the age of 27 years from University Libre of Kinshasa and is International Master Studies from Sao Paolo Institute of Public Health. He was the director of Medical staff service of CARITAS organization. He has published more than 15 papers in reputed journals and has been serving as an editorial board member of repute. The Libyan Board of Medical Specialties and Jamaharya Medical Revue, DRC Epidemiological Revue, He is actually CEO of CAMPUS of HEALTH DRC NGO working in partnership with the Ministry of Health, The Ministry of Gender, Family & Child and The Christian Church in DRC.

Abstract:

General situation of hospitals and health care

Access to health care is a universally human rights established and recognized internationally, regionally and nationally by several legal instruments including the Universal Declaration of Human Rights, the International Covenant on Economic Social and Cultural Rights, the African Charter on Human Rights and peoples and the Constitution of 18 February 2006 in the Democratic Republic of Congo.

The best quality of health care depends on several parameters: political, cultural, demographic, security, socio - economic. In order to improve the health sector, the Congolese Government had, in the legislature from 2006 to 2011, placed health in five priorities project of the Democratic Republic of Congo. [ 1 In the context of reaching the completion Point, the Democratic Republic of Congo received from the international financial institutions to reduce its debt by 12.3 billion US dollars.] The CAMPUS of HEALTH -NGO and its allies were compelled to launch the investigation in difference’s hospitals. To do this, We’ve sending investigators to collect lots of data relevant to the preparation of this report with patients, doctors, nurses and the public.

Quality in Primary Care

Session Introduction

Daniel Tekie Ghebreselasie

University of Gezira, Sudan

Title: Risk factors of Non-Communicable Diseases among Population in Wad- Medani City, Gezira State, Sudan (2013)

Biography:

Daniel Tekie Ghebreselasie is an Eritrean Citizen, graduated his Medical studies and earned Degree of Doctor of Medicine from Latin America school of Medicine (ELAM), Cuba in 2009 at the Age of 26. He has recently completed his Masters studies in field of community medicine from University of Gezira, faculty of medicine in March, 2015. He is currently pursuing his PhD studies in field of Community Medicine at the University of Gezira, Sudan. As young junior doctor, he is always interested in research and publications. He has published three original articles in Gezira Journal of health science as lead author and presented an article in the Gezira first international Family & community medicine conference, under the theme“ Partnership & Integration towards comprehensive health care for families and communities” 26-28th, March, 2015, Wad-Medani city, Sudan. In Addition He has also Co-Authored an article in Journal of Eritrean Medical Association. He is so much interested in medical researches focusing mainly on Non-Communicable diseases.

Abstract:

The burden of non-communicable diseases is on the rise in middle and low income countries on top of the existing infectious diseases. Recently in Sudan NCDs accounted for a total of (44%) of the overall mortality. Moreover, the distributions of the specific risk factors are not systematically identified in the country, which hinder the designing of appropriate preventive and control strategies. The objective of this study was to describe the distribution & prevalence of risk factors for non-communicable diseases. This is a descriptive cross-sectional analytic community based study conducted from October to December, 2013 in Wad-Medani city, Gezira State, Sudan. In this house to house survey, data was collected using structured questionnaires, anthropometric measurements & Blood pressure apparatus. A total of 380 individuals of age 30 years & above were selected for the study by stratified proportional random sampling technique. Data was analyzed using SPSS for Windows version (16.0). The distributions of the various categories of risk factors were identified. The prevalence of smoking for males & females were (18.4%) & (0.3%) respectively, alcohol consumption (3.9%), only among males, consumption of fruits and vegetables below adequate level (72.9%), physical inactivity (75.0%). This study showed Cigarette /tobacco use & personal documented history of NCDs were associated and was found highly statistically significant (p-value <0.005). Similarly there was a statistical significance between association of physical activity with both age & educational level (p-value of 0.003 & 0.011) respectively. Mean systolic & diastolic blood pressures were 135.5 mmHg & 85 mmHg respectively for both sexes. The prevalence of hypertension was (29.7%) on physical assessment for both sexes.

Based on BMI criteria, (1.6%) were underweight, (35.5%) were overweight and (22.6%) were obese & (0.8%) were severely obese. The prevalence of central obesity measured by waist circumference revealed that almost a quarter (24.7%) and above half (51.5%) of study participants were having an increased and a substantial increased values respectively. In this study, association between physical inactivity and central obesity was found statistically significant (p-value=0.002). This study also found statistically significant association between personal and family history of NCDs (p-value=0.00).In conclusion, the magnitude of risk factors for non-communicable diseases is considerably high in the study population.

Tendai Nzirawa

Queens University Hospital, Essex, UK

Title: The past, present and future of the community neonatal nursing

Time : 12:35-13:05

Biography:

Tendai Nzirawa completed his Undergraduate Diploma in Nursing Studies (Adult) in 2005 (City University, London) and Bachelor of Science with Honours in Nursing Studies (Neonatal Care) in 2012 (City University, London). Currently, she is pursuing her Master of Science in Nursing Studies (Neonatal Care) from London Southbank University, London. Since 2010, she has been involved in setting up and running a Neonatal Parent Support Group with other health professionals. In July 2016, she won the Tony Fuller Cup- Clinical Audit Competition and in August 2016, she received the best poster award for presenting at the 6^th World Nursing and Healthcare Conference, London.

Abstract:

Reviewing the data of the current community neonatal service in North East London over the past six years, there is political evidence of moving more hospital based services into community. In 2014, our trust closed level one special care baby unit and moved all neonatal services to the level two hospitals. The recent internal audits has shown the increase in early hospital discharge from the neonatal unit, increased home visits and increase in more complex babies being followed up by the community neonatal nurses. Reviewing all this evidence, the question would be what does the future hold for our pre-term and complex babies? Where our health care resources should be increased in terms of follow up in the community?

General Pediatrics

Session Introduction

Asma Javed

Mayo Clinic, Rochester MN, USA

Title: The honest hairy truth about PCOS: What your teenage patient wants to know but is afraid to ask?

Time : 14:50-15:20

Biography:

Asma Javed, MD has completed her Medical School degree in Pakistan at Aga Khan University. She then completed Residency in Pediatrics at Mayo Clinic, Rochester MN followed by Pediatric Endocrinology Fellowship training at Mayo Clinic, Rochester MN. She is currently on staff at Mayo Clinic and speaks frequently at regional and national meetings on topics related to Women’s Health.

Abstract:

The overall purpose of the proposed activity would be to discuss evidence based guidelines for the diagnosis and management of PCOS in light of the most common complaints adolescents with PCOS present with. Current controversies in management of young females with PCOS will be highlighted using a case based discussion format. At the end of the session, participants will be expected to: Understand the concept of morphing PCOS phenotype across stages of life and the role of prenatal (fetal) programming to early childhood obesity and premature puberty in the development of PCOS; work through a number of cases highlighting common complaints the adolescent with PCOS presents with such as hirsutism and acanthosis nigricans and provide best practice advice including new treatment modalities available to address hirsutism and acanthosis nigricans and; discover current controversies in PCOS evaluation such as ‘mass screening’ for complications such as glucose intolerance and ‘pan androgen testing’.

Global Primary Care

Session Introduction

Lori Sanderson

Loma Linda University, USA

Title: Barriers and Facilitators of Physical Activity and Unhealthy Eating for Children Diagnosed with Kidney Disease or Diabetes

Time : 13:05-13:35

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 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:

Over eighty nine percent of children diagnosed with type 2 diabetes are considered obese or overweight (19). Childhood obesity is associated with an increased risk of kidney disease and the progression to and mortality of kidney disease (33). Most hospitals consider patient education as sufficient to helping this population to increase their physical activity and healthy eating (3,4,14). Without identifying the barriers to successful weight loss or successful increase in physical activity and health eating, this population will remain stagnant in their efforts to change. The purpose of this article is to identify the barriers of physical activity and healthy eating for patients with kidney disease or diabetes. A systemic literature review was conducted to identify the barriers of weight management for children and adolescents who have been diagnosed with kidney disease or diabetes. Upon identifying the barriers, the facilitators, which aim to improve health, can be established. Studies were found using pubmed, academic search premier, and the global internet. Search criteria included obesity rates for children, obesity rates for children with kidney disease, obesity rates for children with diabetes, physical inactivity rates for children, physical activity rates for children with kidney disease, physical activity rates for children with diabetes, unhealthy eating rates for children, unhealthy eating rates for children with kidney disease, unhealthy eating rates for children with diabetes, risk factors for children to acquire diabetes, risk factors for children to acquire kidney disease, barriers to healthy eating for children with kidney disease, barriers to healthy eating for children with diabetes, barriers to healthy eating, barriers to exercise, barriers to exercise for children with kidney disease, and barriers to exercise for children with diabetes. Although not all of the barriers were from research studies of patients with kidney disease or diabetes, there were multiple barriers which occurred in more than one study. These comprised lack of time, physical or personal appearance, lack of social support, lack of motivation, lack of money, weather, fatigue, and lack of access to exercise facilities for physical activity. Lack of time and cost of healthy food were both identified in at least two articles. Patient education alone is not sufficient to helping this population to increase their physical activity and healthy eating. Investigators must first understand what prevents the population from increasing their physical activity and healthy eating, so that they can develop and test potential solutions (facilitators) to the problem. More research is needed to identify barriers among specific populations such as children with diabetes or kidney disease, and to understand why many barriers differ among various populations. More research is also needed to identify and test facilitators to healthy eating and physical activity. Without identification of barriers and the facilitators to change, morbidity and mortality statistics of children with diabetes or kidney disease will continue to increase.

MÃ³nica Carrasco-GÃ³mez

National Institute of Public Health in Mexico

Title: The Role of Health Inequality in the Maternal Health Services Provided by Public Institutions in Mexico

Biography:

Mónica Carrasco-Gómez has completed his PhD at the age of 31 years from National Institute of Public Health in Mexico. She is Professor of National Council for Science and Technology attached to CIESAS-Sureste, a public research center in Mexico. She has published more than 3 papers in reputed journals.

Abstract:

This work aims to determine the role of inequality in the provision of maternal health services among five regions in Mexico (northwest, northeast, central, the Mexico City-State of Mexico re- gion and the south). We consider the most important service providers corresponding to the main health institutions in Mexico (IMSS, ISSSTE, SESAS, IMSS-Oportunidades). Therefore, a cross-sec- tional prospective study was conducted to analyze eight intervention packages (Prenatal Care, Syphilis, Influenza, Obstetric Urgent Care, HIV in pregnancy, delivery care, neonatal care and ac- cessibility) offered by the Maternal and Perinatal Health (MPH) program. A quantitative analysis demonstrates low to marginal performance of the MPH program in three regions (South, Mexico City-State of Mexico and the Northwest) and marginal in two other regions (Central and Northeast). Furthermore, four of the intervention packages presented the lowest performance in the South (Prenatal Care, Syphilis, Influenza and Obstetric Urgent Care), as did the average of the total of the MPH packages. The performance of HIV in Pregnancy package was marginal in the Southern and Mexico City-State of Mexico regions and Neonatal Care was low in the Northwest. The assessment of the MPH intervention packages allows us to identify their strengths and weaknesses. This in- formation allows us to identify similarities and differences among the geographical regions in or- der to describe and analyze the strengths, weaknesses, opportunities and threats in the current system and hence to improve the decision making regarding the Maternal and Perinatal Health Programs in Mexico. The results suggest that a homogenization has taken place in terms of the low quality of the services.

Litty Varghese

Ambulatory Healthcare Services, SEHA, UAE

Title: â€œ Challenges to Immunizing women of reproductive age and strategies to improve coverageâ€

Biography:

Litty Holds Master degree in Community Nursing, and have 33 years’ experience in the field of Primary Health Care, UAE, as Education Coordinator, School screening program coordinator, Vaccination coordinator, Chair of NPC committee, Nursing Quality Improvement Coordinator, Auditor, ISO certification coordinator, JCIA Chapter lead(PFE and PCI), JCIA Steering committee member & Tracer team member, Infection control Steering committee member, Infection control JCIA Chapter lead, Diabetic clinic project coordinator, Community program organizer, Newsletter editor & Researcher and participated in various committees in the departmental, District and National level. Having expertise in the field of developing PPG, Best Practice Guidelines, and Competency Framework.

She was involved in teaching vaccination in all levels of HCP including Faculty of Medicine UAE University in the Residency program.

With her dedication and hard work she earned,

Abstract:

Vaccine-preventable infectious diseases are responsible for significant maternal, neonatal, and young infant morbidity and mortality. Changes in the immune response in pregnant women – which are thought to occur in order to allow the woman to tolerate the semi-allogeneic foetus – may interfere with the development of the specific immune response to pathogens. These immunological changes may alter the susceptibility of the woman and the foetus to certain infectious diseases (1) and increase the risk of more serious outcomes.

All women of reproductive age should get the recommended immunizations. Any immunizations prior to pregnancy are recommended, this includes all childhood and adolescents immunizations.

Maternal immunization provides important health benefits for pregnant women and their infants. Pregnant women and their babies are at increased risk for influenza-related complications, including premature labor and preterm birth. Additionally, pertussis outbreaks continue to occur in the United States with infants at highest risk of severe illness, including hospitalization and death. However, immuniza¬tion coverage among pregnant women is suboptimal. Clients report concerns for the safety of vaccines and not receiving vaccine recommendations at healthcare provider visits.

Department of Health and Human services recommendation includes Assess the immunization status of each patient, Recommend the indicated vaccines to each patient, Administer any necessary vaccines or, if you do not stock the vaccine, refer the patient to a provider or location that can vaccinate the patient, Document the vaccinations that your patient is given, ideally in your state or local immunization registry.

Strategies include Maximize obstetrical care provider recommendation and administration of recommended maternal immunizations; enhance communication to address the safety and effectiveness of immunizations during pregnancy, focus efforts to improve financing for immunization services during pregnancy, postpartum etc.

Health care providers play a crucial role in helping keep pregnant women and their newborns healthy. Assuring your patients are protected by recommended vaccines is key.

NOELLA MARIA DELIA PEREIRA

BAI JERBAI WADIA HOSPITAL FOR CHILDREN, MUMBAI

Title: Postnatal lactational counseling and neonatal weight pattern

Biography:

Noella Pereira has completed her D.C.H. and D.N.B. at the age of 32 years from the University of Mumbai and the National Board of Examinations, New Delhi respectively. She has been an Assistant Professor in Pediatrics for over two years at the Bai Jerbai Wadia Hospital for Children, in Mumbai, an academic centre of excellence for training post graduates. She has been awarded the Best Poster award for her research paper at Pedicon 2013 – a National Conference for Pediatricians and has published 5 papers in reputed international journals. She has even peer - reviewed an article for an international journal.

Abstract:

Objective: To compare the impact of postnatal lactational counseling on the weight gain and frequency of mixed feeding in full term neonates.

Design: Observational study.

Setting: Mother-infant pairs were observed in the maternity section of a multispecialty general hospital in Mumbai during two time periods.

Participants: 260 mothers who delivered a full term, healthy, appropriate for gestational age neonates with a birth weight >2.2 kg.

Methods: During the period from 18th November 2007 to 4th March 2008, 126 mothers received unstructured verbal encouragement to maintain breastfeeding from the maternity staff. During June 2008 to 16th December 2008, 134 mothers were counseled about breastfeeding by the pediatric residents and nurses with the help of charts, literature and verbal advice. They were supervised and helped during the first feed and subsequently until discharge.

Main outcome measure: Weight gain (g/kg/day) of neonate at 28 days of life.

Results: The mean (SD) weight gain was significantly higher in the counseled group in comparison to historical control group [9.2 (4.5) g/kg/d vs. 7.9 (5.1) g/kg/d; P=0.03]. Mixed feeding occurred less frequently in [RR 0.36, 95% CI 0.13, 0.98; P=0.046] the counseled group (5/134) as compared to control group (13/126).

Conclusions: Postnatal lactational counseling leads to higher weight gain, and lesser chances of mixed feeding in the neonatal period.

Primary Healthcare in USA

Session Introduction

David K. Jones

Boston Universityâ€™s School of Public Health, USA

Title: Primary Healthcare in USA

Biography:

David K. Jones is an Assistant Professor in the Department of Health Law, Policy and Management at Boston University’s School of Public Health. His research examines the political and policy issues surrounding the ACA’s implementation. He is working on a book about how states made decisions about what type of health insurance exchange to establish. His work has appeared in the New England Journal of Medicine, The Journal of the American Medical Association, The Journal of Health Politics, Policy and Law, and The American Journal of Public Health among other places. He has been cited in media outlets such as the New York Times, the Washington Post, and the Wall Street Journal. He is a part of multiple organizations focused on developing and disseminating research on the ACA. Dr. Jones is the winner of Academy Health’s Outstanding Dissertation Award for his doctoral thesis completed at the University of Michigan.

Abstract:

2016 is an important transition year for the debate over health reform in America. By the time a new president takes office in January 2017, it will have been nearly seven years since the enactment of the Affordable Care Act (ACA). What comes next—whether we build on the law or dismantle it—will largely depend on the results of this November’s elections. I will discuss what is at stake with this election, including what the leading candidates from the two parties say they will do if elected. I will address how these changes are likely to affect primary care providers. I will also present results from a study examining how state leaders have made decisions about whether or not to extend the ACA’s temporary increase in Medicaid reimbursement levels for primary care providers.

Dr William Alazawi

Queen Mary University, UK

Title: Practical strategies to risk-stratify patients with abnormal liver function in primary care: focus on non-alcoholic fatty liver.

Biography:

Dr William Alazawi is a Reader and Consultant Hepatologist at Queen Mary, University of London and Bart’s Health NHS Trust. He has recently been involved in the production of Primary Care Liver Disease Guidelines.

He leads a research programme into liver disease that encompasses basic science, translational research and clinical investigation. He has published widely and is a reviewer for a number of leading journals. He was awarded the Physician-Scientist Fellowship of the European Association for the Study of the Liver and has recently been awarded a New Investigator Research grant from the Medical Research Council.

Abstract:

Liver function tests are frequently performed in primary care and abnormalities are detected in approximately 1 in 6 cases. It can be difficult to know the cause of the abnormalities, how to manage the patient further and in particular who should be referred to a hepatologist. The most common cause of chronic liver disease is non-alcoholic fatty liver (NAFL). This represents a spectrum of disease that ranges from simple fatty infiltration into the liver, through inflammation, scarring and eventually cirrhosis with complications such as liver cancer and liver failure.

This presentation will discuss the prevalence and risk factors for NAFLD and give an evidence-based practical approach to the investigation and management of patients with these abnormalities. This will be linked to the risk-stratification tools that can be used in primary care to identify patients at risk of disease progression and the management of these individuals. It will also highlight the treatment options and future therapeutics in the field.

Rosamar Torres

UCLA School of Nursing, USA

Title: Perceived prenatal care benefits in late adolescent latinas born in the United States

Time : 15:20-15:50

Biography:

Rosamar Torres completed her PhD in Nursing from The University of Texas at Austin. She competed her Post-doctoral training at University of California, San Francisco, School of Nursing. She is currently an Assistant Professor at University of California, Los Angeles, School of Nursing. Her clinical background is in Pediatric and Neonatal ICU nursing.

Abstract:

In an effort to understand latinas’ inadequate use of prenatal care (PNC) services, research has centered on exploring perceived barriers to access/utilization and has focused on latinas overall without accounting for age or birth country. Therefore, little is known about the perceived benefits of PNC utilization in late adolescent latinas. This retrospective study included 54 latinas that were recruited from online blogs, discussion forums, and groups geared towards pregnant teens and/or latinas. Eligibility criteria were: Born in the U.S.; between 18-21 years; ≤12 months postpartum and; uncomplicated pregnancy and delivery. Perceived PNC benefits were measured by the Better Babies Survey (BBS). A majority (95%) of participants perceived timely (1^st trimester) and adequate (≥12 visits) PNC as important. However, only 56% of the sample entered PNC in the 1^st trimester, and over 90% of the sample obtained inadequate PNC. There were no statistically significant differences in BBS scores between participants with timely or late PNC or with adequate or inadequate PNC. A logistic regression determined that BBS scores predicted timely entry into PNC, χ²(3)=13.38, p=.004. A multinomial regression determined that BBS scores did not predicted adequate, intermediate or inadequate PNC utilization (p=.51). This study reveals that late adolescent latinas have positive opinions of PNC and they believe that it is important for healthy pregnancy/delivery outcomes, and are aware of the appropriate timing and utilization of care. However, this population likely faces multiple access and utilization barriers beyond their control.

Primary Care: Fitness and wellness

Session Introduction

Eva Stephens

University of Texas, USA

Title: A Descriptive Study: Weight Management Practices of Members of A Professional Nurses Association trying to lose weight

Biography:

Dr. Eva Stephens, Associate Professor, Director of Nursing Education Track, University of Texas Medical Branch, Galveston, Texas, School of Nursing. Earned Doctorate Degree Nursing, Case Western Reserve University, Cleveland, Ohio , Masters Science Nursing, Howard University, Washington, DC , Bachelor Science Nursing , Texas

She has over 36 years of professional nursing experience, 20 years as a Board Certified Family Nurse Practitioner encompassing nursing education and clinical practice. Her research has focused on the health consequences and management of obesity among Nurses, African American women and people of color.

Abstract:

Obesity has reached pandemic levels. A critical challenge today is improving the health behaviors of those providing care to the general public. Nurses as health promoters & role models of healthy lifestyles are in a unique position to combat this global problem.

This descriptive quantitative study sought to describe the weight management practices of members of a professional nursing association who were trying to lose weight.

Questions were adapted from the Behavioral Risk Factor Surveillance Survey. In addition, the HealthStyles survey was used along with one additionally inserted question.

Twenty percent of the nurses’ loss weight, average change in weight +2.88 pounds (SD=7.67), maximum individual weight loss -21.50 pounds. Weight loss was greatest during consecutively held meeting & non-holiday seasons. ANOVA revealed no significant differences in weight change among normal weight, overweight & obese participants after the peer-led interventions (F (2,26)=.402, p =.673. Pearson Product Moment analysis revealed a moderate, but statistically significant correlation between the numbers of meetings attended by the participant & weight loss (r=-.370,p.044).

A small percentage of the nurses moved from the obese classification into the overweight status, thereby improving their health. Over 60% attempted to lose weight by combining dietary & exercise strategies. Thirteen percent met the recommended guidelines of the American College of Sports Medicine (ACSM) 60-90 minutes of physical activity guidelines to lose weight.

Luke Allen

University of Oxford, UK

Title: Data driven healthy weight services and the global context

Biography:

Luke completed his medical training at Bristol University (UK) in 2012 and worked as a hospital doctor before undertaking a Global Health MPH at Harvard in 2014. He currently works as a global health researcher at Oxford University alongside consultancy work for the WHO. He is retiurning to clinical practice next year as a primary care trainee.

Abstract:

The English National Childhood Measurement Programme aims to establish the Body Mass Index (BMI) of approximately 1m school children every year. Data from this rolling initiative is used to inform the healthy weight services provided in the primary care setting across England. Data are also used to allow analysis of trends in growth patterns, and for as a vehicle for engaging children and families on matters of healthy weight. This national programme that feeds into regional service planning is an excellent model for countries aiming to extend health coverage through better surveillance and strategic use of data. The model also provides cautionary lessons, as disadvantaged groups with the highest prevalence of obesity can be systematically excluded from data-collection: Schools for children with special needs are often exempted and BMI is an inappropriate measure of healthy weight in children with certain disabilities. Means for identifying and overcoming these barriers are discussed, along with the broader use of epidemiological surveillance in service of universal health coverage. The political economy of the British health system is discussed in reference to other models of provision around the world.

Ayedh A. Alhajri

Royal College of Surgeons in Ireland, Ireland

Title: Attitudes of Paediatricians and General Practitioners in Diagnosing Hypertension in Children

Time : 14:15-15:15

Biography:

Ayedh Alhajri is a first class honour medical student at the Royal College of Surgeons in Ireland and he is expected to graduate in May 2018 with MB, BCh, BAO, LRCP and LRCSI at the age of 25. He is a research assistant at Kuwait University, Faculty of Medicine, Department of Pediatrics. He is the founder of Kuwait Medical Students Team in Ireland which is functional since April 2014. He has contributed in two papers about pediatrics so far.

Abstract:

Introduction: Hypertension is a major long-term health condition and it is the leading cause of premature death among adults throughout the world. Based on the use of ≥95th percentile to define hypertension, it would be expected that the prevalence of hypertension in children would be approximately 5%. Paediatric hypertension is considered as an under-diagnosed problem worldwide. This survey study was conducted to explore the extent of this issue in Kuwait.

Subjects and Methods: A questionnaire, having a brief case history of a child with increased blood pressure was prepared. The case history was followed by 15 true/false/I do not know questions directed to the attending physician. The questionnaire also solicited information on the physician’s current position and the length of his/her experience. The questionnaire was distributed to general practitioners working in 15 primary health care centers; all health districts in Kuwait were included. The same questionnaire was distributed to pediatricians working in the six main hospitals in Kuwait. Only assistant registrars and registrars were included. The questionnaire was collected in person from all participants of both groups.

Results: A total of 127 physicians responded to the questionnaire. The responders were 69 (54%) male physicians and 58 (46%) female physicians. 44 (34.6%) of the responders were general practitioners and 13 (10.2%) were family medicine physicians working in polyclinics throw-out the country (group A). 70 (55.2%) of the responders were paediatricians working in the six main hospitals in Kuwait. In terms of years of experience 20 (15.7%) of participants have 5 years or less, 35 (27.6%) have 5 to 10 years and 72 (56.7%) have more than 10 years of experience. No statistical significance in the responses of both groups except in two questions (Q2 and Q11, p values are 0.025 and 0.0038 respectively). Q2 and Q11 reflect the knowledge of proper paediatric cuff size and proper method of diagnosing hypertension in children respectively.

Conclusion: Our results suggest that paediatric hypertension is likely to be under-diagnosed by general practitioners due to lack of both knowledge and clinical skills in measuring blood pressure. This mandates an extensive education programmes to train general practitioners.

Chiyori HAGA

Okayama University, Japan

Title: Child care providersâ€™ perceptions of chil-drenâ€™s lifestyles and risk factors for obesity: A focus group study

Time : 14:45-15:15

Biography:

Chiyori HAGA has completed her PhD in 2012 from Yamanashi University and worked there as an assistant professor. She is associate professor at Okayama University Graduate School of Health Sciences. She has conducted some cohort studies about health promotion for both children with and without disabilities. She has been serving as an editorial board member of International Journal of Nursing & Clinical Practice.

Abstract:

Child care providers’ perceptions of chil-dren’s lifestyles and risk factors for obesity: The lifestyles of insufficient sleep and skipping breakfast have been pointed out as the problems on child-hood lifestyle since 2008. If the nurses have not had health guidance for parents in spite of knowing these associations, they would not grasp the recent situation on childhood lifestyles. This suggest that the nurses who will have a health guidance for childhood should interview not only parents, but also childcare providers. Therefore, this study attempts to understand child care providers’ perceptions of remarkable children’s lifestyles and discusses potentially successful strategies of cooperation among child care providers, parents, and health professionals for health promotion and the prevention of obesity in preschool children. We conducted 6 focus group discussions consisting of 34 child care providers employed by private and public child care centers, and a public kindergarten in Japan. Systematic thematic analysis was conducted to generate themes to address the study questions. Our results indicate that what the focus group participants discussed with felt mainly into the 3 different kinds of points: “Concerns of Child Care Providers Regarding Parental Attitudes about Nutrition and Nurture,” “Tensions Between Parents and Child Care Providers,” and “Current Obesity Prevention Activities and the Role of Child Care Profession-als.” Child care providers needed a system to demand helps from public health nurses in guiding parents would be effective in pre-venting childhood obesity.

Hasan Mohammed Al-khaldi

The Hashemite University, Jordan

Title: Enhancing the Olympic Values in the Physical Education Faculties in the Jordanian Universities from the Point of View of the Teaching Staff Members

Biography:

Dr. Hasan Al Khaldi has completed his PhD in physical education specialized in sport management, He has worked in al Hashemite University in Jordan as assistant professor. He was chair of sport administration and training Department, He was chair of sport rehabilitation department. He published more than 17 articles in field of sport administration, training and health. Beside that he has worked as fitness instructor in FIFA, AFC, JFA

Abstract:

De Coubertin expressed the importance of values like honor, a better world, competing is more important than winning, sound mind in healthy body, sportsmanship and brotherhood.

The IOC has translated those values into the defination of Olympism as a found in the Olympic Charter.

This study aimed to investigate the level of enhancing the Olympic Values of the teaching staff members in the Physical Education Faculties in the Jordanian Universities. The sample consisted of (94) members from (4) Jordanian Universities.

A questionnaire was developed in order to achieve the purpose of this study which consisted of (20) items for enhancing the Olympic Values. The indications of questionnaire's validity and reliability were confirmed. The results indicated that the level of enhancing the Olympic Values of the teaching staff members in the Jordanian Universities was high, and there were no differences with statistically significance in the level of enhancing the Olympic Values of the study sample individuals according to the : gender, the academic rank or the universities.

Olympic Values such as Joy of Effort, Fair Play, Respect for Others, Pursuit of Excellence and Balance of Body, and Mind and Character come from the fundamental principles of the Olympic movement , Researchers indicted that The Olympic values that are directly related to the life of the children, students and athlete, it can help the individual's character building, through better search itself, both in sports activities, such as in everyday actions. The study provides a first-of-its-kind to assess the status of Olympic Values and to prevent student from psychological problems such as violence, stress and burnout in the Jordanian Universities and middle east

Lifestyle Disorders

Session Introduction

Joni K Roberts

University of Mississippi Medical Center, USA

Title: Understanding Access to Care: Lessons from a Malawian study

Biography:

Joni K Roberts completed her Doctorate from Loma Linda University and is currently a Clinical and Community-Based HIV/AIDS Research Training (CCRT) Fellow for 2016-2018 at Brown University. She is an assistant professor at the University of Mississippi Medical Center, where she serves as the Health Education Curriculum Coordinator. Roberts is a certified health education specialist, with research interests in maternal and child health, sexual health, adolescent health and global health issues concerning accessibility and barriers to health care. She brings a passion for community engagement, and as a result, frequently volunteers for professional organizations both locally and internationally.

Abstract:

According to healthy people 2020, approximately 25% of Americans do not have primary care physician or a health center for regular services, this same number of people also lack health insurance. The debate of access to health care has long surrounded around health insurance coverage, costs associated with care and transportation. However, access to health care is much more perplexed than insurance coverage, fees and transportation. A recent study accessing barriers to care among pregnant urban women in Malawi, identified contributors to the access to health care problem beyond insurance, costs and transportation. Malawi is considered the poorest country in the world and has universal health care for all residents at all government health facilities. In spite of full coverage of care, Malawi continues to see an underutilization of services among its citizen’s especially pregnant mothers. Roberts, J., et al., identified three main barriers to accessing care among pregnant women: 1) culture, 2) patient-provider relationship and 3) facility systemic operations. This paper discusses these barriers and identifies ways to use this knowledge to improve health care access for all.

Joyceline NtohYuh

University of Oldenburg, Germany

Title: Socio-Cultural construction of HIV/AIDS Stigma among African Migrant Women in Lower Saxony, Germany.

Biography:

Joyceline Ntoh Yuh is a Feminist and Ph.D candidate in the University of Oldenburg, Germany. She holds an MA in Women & Gender Studies from the ISS Erasmus University Netherlands. Her research interest includes HIV/AIDS related stigma, gender issues, Sexual and Reproductive health. Since 2006 she took keen interest in the field of HIV/AIDS were she researched on the impact of HIV on Agriculture affecting mostly women with the UN FAO Gender unit,mainstreaming HIV policies in UNFFE Uganda,HIV stigma & child bearing in Cameroon and currently facilitates workshops with MA students in the area of Gender, Migration & HIV/AIDS(Health).

Abstract:

An estimate of 80,000 people are living with HIV in Germany with 4,400 sero-positive persons in the State of Lower Saxony which counts amongst the high HIV prevalence states in Germany. Yet, many sexually active people do not know their HIV status. In so doing, HIV-related stigma stands a major barrier in seeking VCT especially within the African communities. Gender and culture play a significant part in the aftermath of the infection. Women are more likely to be blamed for the transmission of HIV compared to men. All these complicate the disclosure of infection and prevention of HIV transmission. HIV prevention efforts are slowed down by societal and cultural factors that largely lead to stigmatization of infected individuals.

The current research therefore examines the socio-cultural constructions of HIV stigma and dilemmas as African-migrant Women struggle to cope with the challenges posed by HIV/AIDS in their day to day lives. The social context of HIV-related stigma is reflected in negative behaviors including discrimination, denial, secrecy and self-blame. Most HIV infections are through heterosexual transmission, a mode of transmission closely linked to promiscuity and the resultant HIV-related stigma. The complexity surrounding HIV-related stigma cannot be ignored considering the fact that, it is layered amongst other stigmas such as gender and promiscuity (Skinner & Mfecane, 2004). Intersectionality is an ideal framework for analyzing complex health inequalities that occurs among HIV-infected subgroups especially African Women whose experiences are different from their male counterpacts. Multiple factors often precipitate stigmatization experiences and their social identities at the individual level such as being female, ethnic minority, low economic status which interlocks with oppressive forces at the macro level e.g classism or sexism which creates social injustice. It is vital to examine the underlying aspects creating and re-enforcing HIV-related stigma in order to design culturally sensitive intervention. Thus, redefining HIV/AIDS from the social perspective which created stigma in order to eradicate it.

Dinkar Sahal

ICGEB, INDIA

Title: Confluence of Biological Inspiration and chemical intuition in search of Novel Drugs Against Malaria

Time : 16:10-16:40

Biography:

Dinkar Sahal’s laboratory epitomizes a vibrant atmosphere for both design and discovery of novel antibiotic peptides and antimalarial drugs. The foundations for understanding the mechanisms of action and discovery of the origins of potency, synergy among antibiotics and broad spectrum of action of antibiotic peptides has been laid in his laboratory. Likewise discovery of novel drugs against drug resistant malaria is a major passion of his laboratory. He has published more than 75 papers in reputed journals and has been serving as a Reviewer and an Editorial Board Member of different journals.

Abstract:

The parasite that causes malaria has been tormenting mankind for a long time and the image of a child dying of malaria every minute continues to haunt us even today. Our handling of malaria for the last hundred years has taught us that the malaria parasite which relishes riding on the invertebrate mosquito vector to fly from one vertebrate victim to another vertebrate host is not easy to control. Its ancient heritage appears to have taught the parasite to emerge with heightened vengeance whenever we have challenged it with either ill equipped vaccines or misused drugs. Today’s malaria parasite is well equipped to conquer almost all antimalarial drugs through resistance and we have miles to go before we have credible vaccines against malaria. While it is true that our best drugs against several diseases including Malaria have been gifts of Nature, it is equally true that synthetic medicinal chemistry has played a commendable role in chiselling and tweaking Nature’s pharmacophores to enhance potency, decrease toxicity and making drugs affordable for the poorest of the poor. My talk will illustrate the ethos of my laboratory which is to study marine organisms, medicinal plants, Cyanobacteria and endophytic fungi for new drugs against Malaria. Towards this mission, we are using high through put fluorescence based microtiter plate assays to culture the malaria parasite in human red blood cells and to examine the effects of potential drugs on the growth of the parasite. On finding hits, we subject natural extracts to activity guided high resolution chromatographic separation to isolate highly purified compounds against Malaria. Working in close association with “chemical collaborators” we then determine the chemical structures of Nature’s pharmacophores and validate the same through chemical synthesis. While the pursuit of discovering novel antimalarials is continuing, we are currently engaged in fine tuning of a natural antimalarial for optimum medicinal properties and drugability.

Solmaz Fakhari

Tabriz University of Medical Sciences, Iran.

Title: Adjustment of Preoperative Fasting Guidelines for Adult Patients Undergoing Elective Surgery

Time : 16:40-17:10

Biography:

Dr Solmaz Fakhari is an assistant Professor of anesthesiology, and is an academic member of department of anesthesiology at the Tabriz University of Medical Sciences (TUMS), IRAN, since 2011. She qualified in general medicine (1993-2000) and specialty in anesthesiology (2005-2009) at the TUMS, with getting the second score in iranian board certification in anesthesiology in 2009. She qualified in palliative care medicine in 2011 after participating in 18 month long period fellowship program at TUMS. She experienced the working in ophthalmic, gynecologic and orthopedic anesthesia and pain medicine fields, and collaborated in many research, nine of them were published in medial journals.

Abstract:

The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice. The aim of this study was to evaluate the adjustment of preoperative NPO time with fasting guidelines in adult elective ophthalmic surgeries in a university educational ophthalmology hospital in Tabriz, Iran. Methods: In 3 months period, this descriptive study was conducted on 250 patients who scheduled for elective eye surgery. The investigator interviewed with patients before beginning of anesthesia and evaluated fasting duration for heavy meal, light meal and clear liquids and his or her satisfaction from NPO time and also investigated which staff recommended NPO time before anesthesia induction.

Results: Fasting duration from heavy and light meal and clear liquids was 14.31 hours (8 - 23 hours), 12.46 hours (6 - 21 hours) and 11.54 hours (3 - 18 hours), respectively, that was not consistent with ASA guidelines. The discontent of the patients from prolonged NPO time was 60.8%. The most complaint was thirsty (42%). Ward nurses were the personnel who had the primary role in patients fasting time period (47.6%). Conclusion: Preoperative fasting duration for heavy and light meal and clear liquids for elective ophthalmic surgery in this teaching hospital was very long and not consistent with ASA guidelines

Primary Care : Healthcare technology

Session Introduction

James McMorran

Oxbridge Solutions Limited and Coventry and Rugby Clinical Commissioning Group, UK

Title: 20 years of GPnotebook: from a medical student project to a national and international resource

Biography:

Dr James McMorran BM BCh PhD DCH DRCOG FRCGP. James is a Coventry General Practitioner and GP Advisor to the UK NHS Screening Committee.

James trained in medical informatics before winning a Pre-Clinical Adviser’s Scholarship to study medicine at Oxford University. During his medical degree he was awarded a Foulkes Fellowship and a Hobson Memorial Scholarship.

He graduated from Oxford University in 1993 and completed house jobs in Oxford and Warwick before undertaking his general practice training in the Mersey Region. He is the Community Clinical Lead for Coventry and Rugby Commissioning Group. He has a specialist interest in diabetes and works as a GP with Specialist Interest in a community clinic receiving referrals from fellow GPs in his locality. He is a GP Advisor to the UK NHS Screening Committee and takes a role in helping develop UK based screening in areas such as diabetic eye screening and abdominal aortic aneurysm screening.

Abstract:

GPnotebook (www.gpnotebook.co.uk) is a computerised reference resource that has been developed over more than two decades. It is a database that now contains over 2 million words of clinical information and over 27 000 index terms.

The original idea for the database began in the canteen of John Radcliffe Hospital in 1990 while James McMorran, a first year Oxford University clinical student, was writing up his medical notes. Instead of writing notes in longhand he wrote his notes in ‘mind maps’ of packets of information linking different concepts and conditions in a two-dimensional representation of clinical knowledge.

GPnotebook is regularly used by doctors, particularly GPs in the UK. Access to GPnotebook is free and unrestricted to medical students (via validation of their University email address) and doctors and medical students in developing countries (validation via Facebook). During the a 12 month period, 11.5 million unique users accessed pages on GPnotebook. Of those who logged into personal accounts, 30 621 users were GMC accredited clinicians working in the UK and of these, 18 719 GMC accredited doctors using the site described themselves as GPs.

Evgeny A. Yumatov

National Research University, Russia,

Title: : "INFORMATION MEDICINE" - the control and prevention disorders of the vital functions of a human in everyday conditions".

Biography:

Yumatov Evgeny A. MD, Doctor Med. Sci., Professor, academician of International Academy of Sciences (ICSD/IAS), Corresponding member of the Ukrainian Academy of Technology & Cybernetics.

The Chief Researcher Scientific Research Institute of Normal Physiology P.K. Anokhin.

Professor in chair of the General Radio Engineering Department of National Research University «Moscow Power Engineering Institute».

Major research interest: neurophysiology, neurochemistry, physiology of emotions & emotional stress, medical instrument-making. Scientific pedagogical activities in the field of normal physiology, biophysics, social psychophysiology.

He is the author of more than 300 scientific publications, and author and co-author of 14 monographs and of a number of manuals. He has 9 patents for his inventions. Awarded an I.M. Sechenov Medal, P.K. Anokhin Medal, Medal of All-Russia Exhibition Center, and Gold I.P. Pavlov Medal of International Academy of Sciences, Diploma di Merito European and Gold Medal of the Eurochambres for his contribution to fundamental scientific and applied research activity.

Abstract:

The mankind has invented a lot of technical and electronic devices to monitor the work of industries and their production. However the most vital functions of a man are out of physiological control and protective signaling. A man self is unable objectively to control the state of his vital physiological functions. Untimely medical help is a fatal factor which often becomes the cause of death.

The new direction – "Information medicine" was offered for the prevention of disturbance of the vital functions of the person in real everyday life and timely of health care. New concept of medical instrument was developed – the information-household microprocessor equipment for protection of life and human health in every-days-life and at work. This direction and developed medical devices have been supported and approved by the Presidium , General Meeting and Plenum of the Russian Academy of Medical Sciences and have been highly appreciated by leading Russian and foreign experts.

Practical realization of the specified concept was creation and patenting of a number of original devices of the security alarm system of the vital physiological functions of the person (“Guards of Health”).

Original instruments for individual continuous control of physiological functions gives alarm when first objective signs of disorders in vital physiological functions appear during day-time or sleep at night. A warning signal will make it possible and timely to take some reasonable actions to normalize a disordered physiological parameter and so to prevent further development of the serious dysfunction.

Further development of "Informational medicine" has wide prospects. Undoubtedly, the new class of devices for monitoring and the security alarm system of violations of physiological functions in everyday life will extend.

Primary Care Services

Session Introduction

Harmandeep Kaur

Panjab University,India

Title: An observational study and targeted preventive care of Female Sex Workers (FSW), Men (MSM), Transgender (TGs), and Injecting drug users (IDUs) in India

Time : 15:15-15:45

Biography:

Harmandeep Kaur has completed her Bachelor’s in Anaesthesiology from Govt Medical College And Hospital (GMCH), Chandigarh, India. She is now doing research in Panjab University, Chandigarh. She has published more than 15 papers in reputed journals and has been serving as an editorial board member of repute

Abstract:

AIDS is a severe immunological disorder caused by the retrovirus HIV, resulting in a defect in cell-mediated immune response that is manifested by increased susceptibility to opportunistic infections and to certain rare cancers. It is transmitted primarily by exposure to contaminated body fluids, especially blood and semen.

An observational study was conducted on randomly selected Female Sex Workers (FSW), High risk men who have sex with men (MSM), and transgender (TGs),Injecting drug users (IDUs) in the year 2015-16 in Chandigarh, Punjab, and Nepal.

The activities mainly includes STI services, Condom use, Behaviour Change Communication (BCC) through peer and outreach, Building enabling environment, Ownership building in the community, Linking prevention to HIV related care and support services. These activities are provided through ICTC, mobile ICTC, ART centres, network clinics and dispensaries. These activities are carried out as per the guidelines of NACO.

It can be concluded as the TI project focuses on FSWs to provide them preventive, promotive and curative facilities against HIV/AIDS

Rabaa K. Al Momen

Prince Sultan Military Medical City, KSA.

Title: Patient Enablement in Chronic Diseases in Primary Health Care, Riyadh City, KSA

Time : 16:05-16:35

Biography:

Dr. Rabaa K Almomen, is a consultant and trainer family physician. Worked in the training of family physicians and research for many years. Interested in doctor -patient communication skills teaching, quality improvement and patients safety, evidence based medicine and women health care. Conducted and published research in the areas of interest.

Abstract:

Chronic diseases continue to cause high morbidity and mortality in Saudi Arabia. Patients severing from diabetes mellitus, hypertension and associated complications have recently increased and most of these patients find it extremely difficult to understand or cope with their illness. The objective of this study is to determine the level of patients’ enablement in chronic disease and its predictors. Methods: A community based cross-sectional study was conducted between December 2014 and January 2015. Six hundred and four (604) Patients attending the Chronic Disease Clinic in Alwazarat Health center were randomly selected to participate in the study. Patients aged 18 years and above, who willingly agreed to participate, were included in the study. Self-reported questionnaire was used to determine patient level of enablement. Descriptive statistics such as mean and median were calculated and binary logistic regression was employed to determine the predictors of patient’s enablement to chronic disease.

Results: Our results show that five hundred and sixty five (565) out of (604) patients participated in the study with 86.6% response rate. Type 2 diabetes mellitus affecting 40.65% while hypertension affecting 37.79% of the patients in Al wazarat health center. Patient’s enablement to chronic disease was very low and ranged between 2.41 and 1.53 out of 5.0. Binary logistic regression shows that age (male: OR; 0.84, 95% CI, 0.72 - 1.04, female. OR; 1.04, 95% CI 0.88 - 1.39), marital status (male: OR; 0.72, 95% CI 0.54 - 1.11, female: OR 1.01; 95% CI 0.82 - 1.29), patient educational level and number of problems discussed with physician and consultation length between male patients and their physician were statistically significant and correlated with patients enablement to chronic disease (P < 0.05).

Conclusion: This study shows that patient’s enablement in chronic disease is very low but constitutes an important arm in patients care management. It should be considered as a measurable patient outcome from healthcare services. More prospective studies on this important topic are highly recommended.

Primary Home Care

Session Introduction

Qamarunissa Muhabat Khan

Aga Khan University Hospital, Pakistan

Title: Clinical Presentation of Ovarian Tumor

Time : 16:35-17:05

Biography:

Dr. Qamarunissa Muhabat Khan has been Graduated from Chandka Medical College, Larkana Pakistan as MBBS doctor. Later on she obtained his post-graduation in obstetrics and gynecology from Isra University Hospital Hyderabad and passed FCPS examination from College of Physician and Surgeons Pakistan (CPSP) and then started working at The Aga Khan Maternal and Child Care Centre, Hyderabad , Pakistan as Consultant.

Abstract:

Background: Ovarian tumor is one of the most common gynecological tumor seen in females. In Pakistan, it is the 2nd most common cause of death in women malignancies after breast tumor. It is often called the “silent killer” because the disease is not often detected until it reaches an advance stage.

Objective: The aim of this study was to determine the frequency of various clinical presentations of ovarian tumors by age and stage that could lead to early diagnosis.

Methodology: A case series study has been conducted in the department of Obstetrics & Gynecology at Isra University Hospital, Hyderabad. Data were obtained by history, detailed symptoms, Physical examinations and relevant investigations. Then diagnosis is confirmed by ultrasound or laparotomy and histopathology.

Results: In my study majority of women i.e. 37 (38.1%) belonged to age group >60 years while 17 (17.5%) belonged to <30 years. Regarding the duration of symptoms i.e. 18 (18.6%) women had symptoms of less than 6 months while 42 (43.3%) women had symptoms for more than 1 year. Majority of women i.e. 47 (48.5%) were nullipara while 21 (21.6%) were multipara. Abdominal mass seen i.e. 43 (44.3%) in women while 19 (19.6%) had increased urinary frequency, while 19 (19.6%) were asymptomatic. 77 (79.6%) patients had benign tumor while 20 (20.6%) patients had malignant ovarian tumor.

CONCLUSION: Ovarian malignancy is a serious disease affecting women of all ages. The women having history of malignancy in family should screen regularly specially in old age. So, it is concluded that for prognosis and patient survival, early detection and treatment is mandatory, which may reduce mortality.

There is need to increase awareness of population. Detail physical examination and appropriate investigations should be carried out in every patient presenting with gynecological problem.

Mahin Yazdani Zonouz

Tabriz University of Medical Sciences, Iran

Title: Depression in adolescent students, Tabriz, Iran

Time : 17:05-17:35

Biography:

Mahin Yazdani Zonouz is a Registerd Nurse of Faculty of Nursing & Midwifery at Medical Sciences University of Tabriz. She has completed her MS in Mental Health & Psychiatric Nursing of Medical Sciences. She has presented four articles in international conference. She has more than 25 years of experiences as a Nursing Instructor in Clinical Nursing Education.

Abstract:

Introduction: Depression is the most common mental disorders and a serious health problem in the world. It causes social, educational and biological problems in adolescents. Physiological changes during adolescence cause mental distress and make them more prone to depression. So, early diagnosis and treatment is very important.

Aim: Aim of this study was to examine depression in adolescent students and effects of related factors in schools of Tabriz, Iran.

Materials & Method: Data was gathered through the center of epidemiological studies depression scale for children from 903 adolescent students, including 455 boys and 448 girls who were selected by multi-stage cluster sampling. Data were analyzed by SPSS software/PC.

Results: The results showed that depression is a common event among adolescents. It was more in girls. There was correlation between depression and some factors such as: increased age, school and family problems, life events and self-concept of adolescents (p<0.05).

Conclusion: It is necessary that parents, primary healthcare centers and healthcare teams should pay more attention to risk factors of depression in adolescents.

Hamid Yahiya Hussain

Dubai Health Authority, UAE

Title: An Audit of Screening for Depression among asthmatic, hypertensive and Ischemic heart diseases patients at primary health care setting in Dubai ,UAE, 2015

Biography:

Dr. Hamid Yahiya Hussain is a senior specialist community and Family medicine, Dubai Health authority. Senior specialist public health, preventive services center, primary health care / Dubai health authority. Professor at Dubai residency training program/ Community and family medicine/ Arab Board for health specializations.

Director of school health and educational institutions in Dubai / Government of Dubai / Dubai / UAE. Senior specialist family medicine / primary Health care centers DHA/ Dubai, Senior specialist at preventive services center/ primary health care / DHA/ Dubai. Enrolled with different international organization, UNICEIF, WHO, ICRC, IOM and others as programs manager and expert.

Worked as environmental expert ant ministry of environment, Iraq. Worked as training consultant, researcher, and programs manager at ministries of health and higher education and scientific research in different Middle East and North Africa region. Supervised more than 20 PhD thesis, 10 MSc thesis, achieved about publishing of 120 research work and contribute to CDC textbook on Ethics in Public Health

Abstract:

Background: Doctors of primary health care should always been trained to screen for depression among their asthmatic, hypertensive and cardio-vascular patients. The mild to moderate cases of depression can be screened, diagnosed and managed at the primary care level unless it is severe with suicidal ideation or resistant to treatment after 12 months of follow up, in that case it has to be referred to the hospital.

Objectives: To study the proportion of asthmatic, hypertensive and ischemic heart patients who are screened for depression. To study the percentage of those who are suspected to have depression according to PHQ 9 tool out of those who are screened .To identify actions taken when suspecting a case of depression among asthmatic hypertensive and ischemic heart patients.

Results: The study revealed socio-demographic distribution of study sample, e.g. As age group 50-59 and 60+ were the highest groups 29.6% and 30.8 respectively, female were more than male 57.5%, UAE nationality were about 77.2% comparing with expatriates, 85.8% of the study population were Married, about 32.0% of the sample were having higher education, and 54.1% were having no work. The study showed that 86.4% of the sample were having hypertension compared to 8.7 asthma and 3.2% IHD, the study revealed that about 6.6% of sample who screened for depression were diagnosed as depression . 2.4 % of depression cases were mild depression and similar were moderate. The study revealed that about 40.5% of assigned health care provider was committed to carry out screening for depression among NCD patients at primary health care facilities settings while almost 60% were not.

Conclusion: An operational gap while applying screening of depression among NCD patient at Primary health care facilities by health care providers has been significantly figured out, lack of training, lack of awareness and weaknesses of auditing culture were among the main reasons behind. Training of health care providers, creating a culture of auditing at institutional and individual level and empowering adherence to standards, guidelines will be the effective strategies to increase percentage of conducting screening for depression among asthmatic, hypertensive and ischemic heart patients, and subsequently increase the percentage of those who will receive treatment and improve their treatment outcomes.

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Title: Primary Healthcare in USA

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