Day 1 :
Keynote Forum
Mayer B Davidson
Professor, Charles R Drew University, USA
Keynote: Comparison of insulin dose adjustments by primary care physicians and endocrinologists
Biography:
Mayer B Davidson is a Professor of Medicine at Charles R Drew University and the David Geffen School of Medicine at UCLA. He has been caring for diabetic
patients for 50 years. He was the Past President of the American Diabetes Association (1997-1998) and the Editor-in-Chief of Diabetes Care (2002-2006). He has
received the Outstanding Physician-Clinician in Diabetes Award from the American Diabetes in June 2016. He is also the Chief Medical Officer of Insulin Algorithms
Inc.
Abstract:
Primary care physicians (PCPs) are reluctant to start/intensify insulin. Two possible reasons are lack of time or (perceived)
and lack of ability. To test the latter, we developed 20 simulated cases based on patients’ meter downloads and assigned the
following insulin regimens: 3 basal insulin alone, 4 basal-bolus, 6 self-mixed-split, 5 premixed, 1 with U-500 regular insulin
and 1 with delayed responses to NPH insulin. The insulin dose adjustments of 9 PCPs and 9 endocrinologists were compared
to a Gold Standard (GS). The senior author has taught house staff, nurses, physician assistants and clinical pharmacists how to
adjust insulin doses for 50 years. A registered nurse (not an NP) taught these principles and supervised by PCPs who referred
patients to her lowered HbA1c levels of 111 taking insulin at referral from 11.0% to 7.3%. These computerized principles
served as the GS against which the PCPs and endocrinologists were compared. In 162 instances where the GS did not make
dose changes, the PCPs and endocrinologists also did not, 53% and 49% of the time, respectively. In 396 instances where the
GS did make dose changes, both groups did 67% of the time. The mean unit difference from the GS was significantly (P<0.01)
less with PCPs (-1.2) than with endocrinologists (-5.1). In conclusion, the abilities of PCPs to adjust insulin doses are like
endocrinologists suggesting that time constraints are a major barrier. Utilizing reports generated by these computerized insulin
dose adjustment algorithms after meters are downloaded in the office or remotely will save PCPs time and face-to-face visits if
done remotely. The latter telemedicine approach is economically feasible because of a CMS monthly fee of $42.
Keynote Forum
Walter Eichendorf
Deputy Director General of the German Social Accident Insurance (DGUV) and Director of DGUV’s prevention division
Keynote: Establishing a culture of prevention
Biography:
Walter Eichendorf has studied Physics and Mathematics. He was the Head of Statistical Department from 1983, Director of Public Relations from 1989, Deputy
Director General since 1998. Since 2007, he is Deputy Director General of the German Social Accident Insurance (DGUV) and Director of DGUV’s prevention
division. In addition, he is President of the German Road Safety Council (DVR). In the International Social Security Association (ISSA) he is Vice President of both
the Research Section and the Prevention Culture Section.
Abstract:
As digitalization continues, work forms and locations will change. Promoting a culture of prevention in companies
and organizations can encourage greater self-responsibility for one’s own safety and health at work, as well as support
the leadership and motivation of employees. Raising awareness of safety and health as important values for all people, all
organizations and for society as well as integrating safety and health into how we think and act will become crucial. Safety and
health must become the benchmark for all our actions. If safety and health become a mandatory established as values in every
school pupil, student, employee, employer and manager they can act as a benchmark for all their actions. Individuals would
be empowered to automatically make those values an important factor in all their thoughts and actions. At that point safety
and health could be seen to represent values that are both actively lived and perform a beacon function. This would represent
the completion of a significant process of cultural change. Therefore the DGUV has decided to start a ten-years-campaign to
promote the culture of prevention in Germany which will be launched on October 18, 2017. The target groups will range from
young children to elderly people. The evolution of a culture in which safety and health are firmly established as integral, lived
values requires companies and institutions to adopt a holistic approach spread across six fields of action. The six fields of action
are leadership, communication, participation, error culture, social climate/organizational climate and prevention which are
as an integral part of all tasks. The latter field has a special role to play as it is ideally to influence all other fields of action. The
conceptual concept will be presented as well as the communication structure of the campaign.
Keynote Forum
Ann Mitchell
Professor of Nursing and Psychiatry at the University of Pittsburgh School of Nursing
Keynote: Screening, brief intervention and referral to treatment for at-risk substance use: Nurse practitioners poised to make a difference in primary care settings
Biography:
Ann M Mitchell is a Professor of Nursing and Psychiatry at the University of Pittsburgh School of Nursing. She has served as Project Director (PI) on three HRSA-
funded projects related to screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use and is currently funded by SAMHSA
to integrate SBIRT education into the Nurse Practitioner curriculum, addressing substance use across the lifespan. Lastly, she is working with the CDC on two
projects to incorporate Alcohol Screening and Brief Intervention (Alcohol SBI) into nursing practice with the ultimate goal of preventing Fetal Alcohol Spectrum
Disorders (FASD).
Abstract:
Background: Alcohol and other drug use and misuse are public health problems resulting in high healthcare and societal
costs. This presentation will review the implementation of a screening, brief intervention, and referral to treatment (SBIRT)
program across multiple groups of advanced practice students to reach vulnerable populations at risk. Policy support for
SBIRT utilization comes from the US Preventive Services Task Force, the American Nurses Association, the American College
of Surgeons, the Joint Commission, and the Centers for Medicare and Medicaid. Outcome results, after the incorporation
of SBIRT into three advanced practice graduate nursing school curricula, including knowledge, skills, and attitudes will be
presented.
Methods: A mixed-method approach was used to measure the effects of education and curriculum infusion of SBIRT into
three advanced practice graduate nursing school curricula. Pre-to-post attitude surveys of nursing students towards working
with individuals who use alcohol or other drugs were measured as well as knowledge and skills post-training.
Results: SBIRT education positively influenced participants’ attitudes towards working with individuals who use alcohol or
other drugs. SBIRT education had the most pronounced significant effect on indicators of role security, including role adequacy
and role legitimacy (p<0.05) across all programs. Effects on indicators of therapeutic commitment, including motivation
and role support varied depending upon the program. Knowledge surveys indicated a significant increase in post-training
knowledge of SBIRT across all programs and participants’ skills were satisfactory post-training.
Conclusions: Nurse practitioners are in an ideal position to have a positive impact on patient care and patient outcomes
through the incorporation of screening for alcohol and other drug use, and when appropriate to provide a brief intervention
or a referral for further assessment or treatment.
- Primary Healthcare | Nursing | Mental Primary Healthcare Management | Dental Primary Care | Primary Womens Healthcare |Primary Healthcare Nursing | Primary Healthcare: Individualised Care | Primary Healthcare in Psychology
Location: PLAZA I
Chair
Muhammad Ajmal Zahid
Chairman, Kuwait University
Co-Chair
Walter Eichendorf
Deputy Director General of the German Social Accident Insurance (DGUV) and Director of DGUV’s prevention division
Session Introduction
Kwabena A. Kyei
Head (Chair) of the Department of Statistics at the University of Venda, Thohoyandou
Title: Accessing health care services by students at the university of venda, thohoyandou, South Africa
Biography:
Kwabena A Kyei is statistician & demographer, having a bachelor’s degree in Mathematics (with Statistics) from the University of Science and Technology,
Kumasi, Ghana, a master’s degree from Universite Catholique de Louvain, Louvain-la-Neuve, Belgium and a doctoral degree in Demography from the University
of Pretoria, Pretoria, South Africa. I have been a lecturer in statistics and demography at the university for over twenty-five years. I am currently the Head (Chair)
of the Department of Statistics at the University of Venda, Thohoyandou. I have published over thirty-seven articles in accredited journals, covering topics on
unemployment, childhood mortality, breastfeeding, profitability in banking, etc. and spanning through areas in economics, demography and primary health care. I
also did post-doctoral studies in actuarial science & biostatistics
Abstract:
South African youth experience obstacles related to accessing age-specific health care services. School-based health centers
provide youth-friendly services tailored to meeting the healthcare needs of young people. Are there obstacles preventing
students from accessing healthcare services? The study aims to assess the level of awareness regarding the University of Venda
(UNIVEN) campus health services and to determine the availability and acceptability barriers experienced by students in
accessing the campus health services. Five hundred and thirty-four respondents drawn from all the residences in the University
campus and comprising students from all the schools and levels were sampled using two stage sampling. Questionnaires were
administered face-to-face to respondents. The validity and reliability of the study was ensured. Ethical considerations, such as
informed consent, right to privacy, and no-harm to participants, were observed and addressed. The results from data analysis
indicated that the average age of the study population was 21.85 years with almost all the respondents (95%) being aware of
the existence of a health clinic in the University campus. However, only 63% had gone for consultation at the clinic. Awareness
of the clinic’s services appears to be poor. HIV counselling and testing was the most known service, while minor illnesses’
management was the most utilised service (48%). Barriers experienced by the respondents were related to waiting times and
opening hours of the clinic, with only 33% and 39% respectively, describing them as ideal. The study provides evidence that
although University health services may be provided at no cost, students still experience barriers in accessing them. Effective
measures are needed to increase students’ awareness of the clinic’s services and to shorten waiting times and improve clinic
opening hours.
Imran Ali
Assistant Professor, Jamia Millia Islamia (Central University), India
Title: Nano anti-cancer drugs: Hope for future
Biography:
He is a world recognized academician and researcher. He completed his Ph.D. from Indian Institute of Technology Roorkee, Roorkee, India. Prof. Ali is known
globally due to his great contribution in anti-cancer and chiral drugs development and water treatment. He has published 350 papers in reputed journals including
papers in Nature and Chemical Reviews. He has also five books published by Marcel Dekker, Inc., USA; Taylor & Francis, USA; John Wiley & Sons, USA; John
Wiley & Sons, UK; Elsevier, The Netherlands. His citation is 112000 with H index 46.
Abstract:
Routine chemotherapy for cancer treatment has several side and toxic effects. Recently, a new approach of nano anti-cancer
drug has been developed and only few drugs are available in the market today. The unique features of these drugs are
targeted action on cancer cells only without any side effect and, hence, called magic drugs. The important molecules used
for preparation of nano anti-cancer drugs are cisplatin, carboplatin, bleomycin, 5-fluorouracil, doxorubicin, dactinomycin,
6-mercaptopurine, paclitaxel, topotecan, vinblastin and etoposide etc. The most commonly used materials for preparing nano
particles carriers are dendrimers, polymeric, liposomal, micelles inorganic, organic etc. The proposed lecture will comprise
the-of-art of nano drugs in cancer chemo-therapy including preparation, types of drugs, mechanism, future perspectives etc.
Lauren Madere Hoel
University of Texas Health Science Center, USA
Title: The changing landscape of urological management in women
Biography:
Lauren Madere Hoel has been a Registered Nurse for 35 years and a Nurse Practitioner for 18 years. She brings a wide variety of practice experience to the
Department of Urology, Pediatric HIV Research and Clinical Care, Cardiology, Allergy and Immunology, Nephrology and joining the Urology Department in May of
2014. She has been a volunteer for the National Alliance on Mental Illness for 3 years.
Abstract:
In the recently published Primary Care update on urinary tract infection, the American Urological Association estimated that
over 150 million UTIs occur annually worldwide, with an estimated healthcare cost of over $6 billion. There are a variety
of diagnoses associated with urinary tract symptoms that may occur in the absence of bacterial infection. In the interest of
healthcare cost savings there have been some recommendations to avoid UCX and just treat UTI based on sex and urine dipstick.
Primary healthcare providers will continue to evaluate and manage the clear majority of UTIs in the outpatient population.
Providers should be armed with the knowledge of emerging trends in UTI diagnosis and treatment. This presentation seeks to
explore these trends and identify the tools needed to direct cost effective, yet population protective, management of outpatient
UTIs in women throughout the lifespan. Providers need to consider whether testing is indicated or not. Selecting a treatment
regimen should be carried out with consideration of culture specific pathogen results as well as complicating patient factors and
the suspected, vs proven, site of illness. Highlights of this presentation include associated issues such as up to date antibiotic
stewardship recommendations, current trends in pathogen resistance and recommendations regarding testing, management
and where appropriate, referral for urological evaluation with Subspecialty services.
V Rama
Asst Professor in the ECE Dept., NIT, Warangal
Title: Early detection of Cardiac disorder using artificial intelligence
Biography:
Mrs. V. Rama obtained her B.Tech in Electronics and Communication Engineering from JNTU, Kakinada and M. Tech. (E&I) from NIT, Warangal. Pursuing Ph D
from NIT, Warangal under the guidance of Dr.C.B.Rama Rao. She has been working as Asst Professor in the ECE Dept., NIT, Warangal for 18 years. Her area of
research is Bio Medical Signal Processing. She has published no. of papers in national and international conferences and Journals.
Abstract:
In the modern industrialized countries every year millions of people die due to cardiac disorders. India has highest incidence
of heart related diseases in the world. The WHO’s world statictics report 2016 shows that the life expectancy in India was
68.3 years. If no initiative is taken to check this most predictable and preventable among all chronic diseases, life expectancy
may further decrease. The main aim of this work is to enable the clinical doctors to diagnose cardiac disorders using computer
based analysis as the manual analysis is tedious and time consuming task. Early detection of cardiac disease is of paramount
importance for saving the life of patients. Electrocardiogram (ECG) is an important bio-medical signal representing the
electrical activity of the heart. A significant amount of work has been done in the past to identify cardiac disorders. All the
developed linear algorithms considered that the ECG signal as stationery. But on observing the fact that ECG is non-stationery.
It has been duly noted from Maedeh Kiani Sarkaleh (2012) paper in which the author has successfully classified 10 files,
which include both normal and two types of cardiac disorders and produced results with an accuracy of 96.5%. However, this
paper concentrates on developing novel feature extraction scheme using nonlinear signal processing technique and supervised
learning technique to improve classification accuracy of cardiac arrhythmias. The proposed system aims at classifying Normal
Sinus Rhythm (NSR) and 4 types of Cardiac arrhythmias-Sudden Cardiac Arrest (SCA), Ventricular Tachycardia(VT),
Ventricular Fibrillation(VF) and Cardiac Ischemia(CI). Daubechies wavelet transform (db4) 6-level decomposition technique
is used for extraction of ECG features. Finally these features are fed to Multi-Layer Perceptron Neural Network classifier.
The classification accuracy obtained is 100% and its computation time is only 0.28 seconds. Selection of optimum number of
features is essential to improve classification accuracy. The feasibility of all the above proposed method has been tested using
benchmarked MIT-BIH database and the performance of MLP classifier has been evaluated in Waikato Environment for
Knowledge Analysis.
Zeeshan Haider
Cyprus International University, Cyprus
Title: The impact of work place stressors on work quality of nurses in health care sector. Case study of private medical institutions in the (TRNC)
Biography:
Zeeshan Haider has his experience in passion and evaluation for the betterment of health care and other issues. His constant support, critical and indispensable
help of constructive comments and suggestions have contributed to the new pathways for healthcare improvement. Work related element of life in a medical care
environment has become an important aspect in the modern world.
Abstract:
In the Nursing work place of present world, stress is leading to be a one of the major and serious threat in health sector.
Among the people related to the health care professional, Nurse’s stress has a negative effect on their work quality, work
health and ability to do. Various studies have been discussed in the past time to predispose the contact of work place stressors
on work quality of Nurse. Most of the studies focused on the work place stressors and their relationship between work related
quality of life of Nurses that how stressors can affect the work quality of Nurses and what are the reasons or is there any
negative or positive relation between stressors and work quality. This study seeks to analyze the impact of work place stressors
among nurses in their work quality. If the stressors that alter the task quality of Nurses work more comfortable and relaxed.
The main findings suggest that there is a symbolic negative relationship of job place stressors with work nature and aspect of
Nurses. The result discloses that the frequencies of job place stressors have an eloquent contact on work quality of Nurses and
there is a statistically expressive negative linear contingency within job related element of life and Nurses stress. In health care
organization, designing and creating work to be more important and meaningful in their performance and in the manner at
which their contributions are acknowledged.
Zeeshan Haider
Cyprus International University, Cyprus
Title: The impact of work place stressors on work quality of nurses in health care sector. Case study of private medical institutions in the (TRNC)
Biography:
Zeeshan Haider has his experience in passion and evaluation for the betterment of health care and other issues. His constant support, critical and indispensable
help of constructive comments and suggestions have contributed to the new pathways for healthcare improvement. Work related element of life in a medical care
environment has become an important aspect in the modern world.
Abstract:
In the Nursing work place of present world, stress is leading to be a one of the major and serious threat in health sector.
Among the people related to the health care professional, Nurse’s stress has a negative effect on their work quality, work
health and ability to do. Various studies have been discussed in the past time to predispose the contact of work place stressors
on work quality of Nurse. Most of the studies focused on the work place stressors and their relationship between work related
quality of life of Nurses that how stressors can affect the work quality of Nurses and what are the reasons or is there any
negative or positive relation between stressors and work quality. This study seeks to analyze the impact of work place stressors
among nurses in their work quality. If the stressors that alter the task quality of Nurses work more comfortable and relaxed.
The main findings suggest that there is a symbolic negative relationship of job place stressors with work nature and aspect of
Nurses. The result discloses that the frequencies of job place stressors have an eloquent contact on work quality of Nurses and
there is a statistically expressive negative linear contingency within job related element of life and Nurses stress. In health care
organization, designing and creating work to be more important and meaningful in their performance and in the manner at
which their contributions are acknowledged.
- Primary Healthcare | Nursing | Mental Primary Healthcare Management | Dental Primary Care | Primary Womens Healthcare |Primary Healthcare Nursing | Primary Healthcare: Individualised Care | Primary Healthcare in Psychology
Location: PLAZA I
Chair
Muhammad Ajmal Zahid
Professor of Psychiatry, Faculty of Medicine, Kuwait University.
Co-Chair
Walter Eichendorf
Deputy Director General of the German Social Accident Insurance (DGUV) and Director of DGUV’s prevention division
Session Introduction
Walter Eichendorf
deputy director general of the German Social Accident Insurance (DGUV) and director of DGUV’s prevention division
Title: Vision Zero: A worldwide strategy
Biography:
Dr Walter Eichendorf studied physics and mathematics. He was the head of statistical department from 1983, director of public relations from 1989, deputy director
general since 1998. Since 2007, Eichendorf is deputy director general of the German Social Accident Insurance (DGUV) and director of DGUV’s prevention division.
In addition he is President of the German Road Safety Council (DVR). In the International Social Security Association (ISSA) Eichendorf is Vice President of both
the Research Section and the Prevention Culture Section.
Abstract:
Vision Zero is the vision of a world without occupational accidents and work-related diseases. Its highest priority is to
prevent fatal and serious work accidents and occupational diseases. Vision Zero is the goal of a comprehensive culture
of prevention. The German Road Safety Council and the German Social Accident Insurance (DGUV) firmly embedded the
goal of shaping working and living environments in such a way in their prevention strategy that nobody is killed or so severely
injured or ill for work reasons that they suffer permanent damage. However, in order for Vision Zero to become a reality one
day, prevention must always be realigned to this goal. This broad and networked approach requires everyone in society to get
involved.The basic maxims are: Life is not negotiable; people make mistakes; tolerance limits are the physical load limits of
humans and people have a basic right to a safe working environment. If life is not negotiable and people make mistakes, then
it is ethically unacceptable to pay for a mistake with a loss of life or a serious injury. Vision Zero is a strategic, comprehensive
and qualitative approach where objectives are formulated and agreed upon; which is geared towards risks and hazards and;
which takes into consideration all the circumstances behind accidents at work and on the road, occupational diseases and
work-related health hazards. The goal of zero accidents might seem difficult, but it is the only ethically correct goal that we
must work on in the future. Vision Zero provides a strategy to achieve this. Under Vision Zero, safety and health at work are
values that companies, organizations and society appreciate and strive for.
Shirley Gutkowski
CEO and Primary Practitioner at Primal Air, LLC, USA
Title: Improving breathing with a novel use of Xylitol
Biography:
Shirley Gutkowski, RDH, BSDH practiced Clinical Dental Hygienist from 1986 to 2003 when she focused her energy on product research, writing and speaking. She
is the 2008 Alumna of the Year Marquette University School of Health Science in Dental Hygiene, a recipient of the Leadership Award from the World Congress of
Minimally Invasive Dentistry, and 2006 – 2007 President of the Wisconsin Dental Hygienists’ Association. Her podcast Cross Link Presentations highlights notables
such as Patrick McGowan (author of The Oxygen Advantage and premier Buteyko instructor), Dr. Kevin Boyd (Darwinian Dentist), Gill Rapley (author of Baby Led
Weaning), Dr. Allison Hazelbaker, Dr. Mike Nelson (metabolic flexibility) and others. As the science continues to point to correlations between oral and systemic
health, the function of the nasal airway is also under scrutiny. She has published extensively on these topics. She is a featured speaker on the upcoming The
Functional Oral Health Summit.
Abstract:
Epigenetic changes in the shape of the face have modified the airway leading to changes in breathing, like mouth breathing.
Mouth breathing in children has consequences leading to decreased nasal volume and dental malocclusions. Allergy
profiles have also increased over the last century topping 15 million Americans today improving the odds for mouth breathing
and its consequences. Allergy symptoms often include a sinus component that may be relieved, reduced, or eliminated using
a saline nasal spray complimented by xylitol. The mechanism of action, recommended usage, and safety profile of this novel
functional ingredient are discussed.
Yayehyirad Yemane Adinew
Lecturer at the Department of Midwifery College of Health Sciences, Mizan-Tepi University
Title: Assessment of the associated factors, management and complications of uterine rupture at mizan-tepi university teaching hospital, mizan-aman town, bench-maji zone, snnprs, south west ethiopia, 2016/17. A case control study
Biography:
Yayehyirad Yemane has completed his primary and secondary education in Jijiga town, Ethiopia. He has completed his Bachelor of Science in Midwifery from
University of Gondar, Ethiopia in July 12 -2012, and then started working as Head of the Department in Department of Midwifery College of Health Sciences,
Mizan-Tepi University for one year. Then, he joined his Master’s education at Mekelle University in September 2-2013. He graduated from Mekelle University with
the specialty of Master’s in Clinical Midwifery in February-03-2016. Currently, he is working as Lecturer at the Department of Midwifery College of Health Sciences,
Mizan-Tepi University.
Abstract:
Background: Uterine rupture is tearing of the uterine wall during labor or delivery and rupture of a previously or already
unscarred uterus is more often than not a catastrophic event resulting in death of the baby, extensive damage to the uterus and
sometimes even maternal death from blood loss. The overall incidence of uterine rupture is 1 in 2,000 deliveries. In developing
countries, uterine rupture is more prevalent or common and is a serious or common problem.
Objective: To assess the associated factors, management and complications of uterine rupture in Mizan-Tepi University
Teaching Hospital, Mizan-Aman town, Bench-Maji Zone, SNNPRS, south west Ethiopia, 2016/17.
Methodology: A hospital based unmatched multi-factorial case-control study/consider was employed from 1st October - 30th
October 2016. The required sample size gave us a total of 352 delivery charts by considering case to control ratio of 1:4 of
these 71 were delivery charts with uterine rupture and 281 were delivery charts without uterine rupture which were selected
by using lottery method. Data was retrieved using pre-tested and structured data extraction format from operation notes,
delivery registers and patients cards documented from 2013-2015 G.C. Using SPSS version 20 software, descriptive statistics,
bivariate and multivariate logistic regression analysis was done and p-value <0.2 and <0.05 were considered as significant
during bivariate and multivariate logistic regression analysis respectively. AOR with 95% CI was used to control for possible
confounders and to interpret the results.
Result: From 1st January 2013 up to 31st December 2015 there were a total of 9878 deliveries from these 71 cases of uterine
rupture were recorded giving an incidence of 1 in 139 deliveries. Predisposing factors for uterine rupture were no antenatal care
(AOR 4.08 95% CI 1.924-8.651), labor duration > 18 hrs (OR 2.769; 95% CI 1.231-6.226), parity ≥ 5 (AOR 6.16; 95% CI 2.886-
13.148), having obstructed labor (AOR 2.714 95%; CI 1.228-5.720), no use of partograph (AOR 2.248, 95% CI 1.049-4.817).
There were 7 maternal deaths due to uterine rupture during the study period giving a mortality rate of ~ 0.07%.
Conclusion: Uterine rupture still remains one of the major causes of maternal and newborn morbidity and mortality. The
prenatal mortality for both case and controls is high in Mizan-Tepi University Teaching Hospital.
Biography:
Ermias Sahale finished MSc in clinical midwifery and working as Lecturer at Mizan-tepi university, Ethiopia.
Abstract:
Introduction: Labor pain is the most severe pain that a woman ever has to face. Pain relief in childbirth is subject to many
social and cultural modifiers, which continue to change. Delivery of the infant into the arms of a conscious and pain-free
mother is the most exciting and rewarding moment in maternal care services. Developed nation give emphasis on continuous
labor support, but in developing country pain is neglected especially managing labor pain. In a country like Ethiopia with low
institutional delivery managing labor pain can help as an incentive to enhance institutional delivery rate.
Objective: The main purpose of this study is to assess practice of labor pain management methods and associated factors
among skilled attendants in all Tigray region general hospitals.
Method: Institutional based cross sectional study design was carried out at all general hospitals in Tigray regional state from
October 01-30, 2016. All skilled attendants who were working at labor ward were included in the study. Data was collected by
interviewer-administered, pretested and structured questionnaire. The data were entered by Epi- info version 7 then analyzed
using SPSS for windows version 20. Descriptive analysis was done and logistic regression analyses were also used to see
the association of dependent and independent variables. Finally odds ratio and 95% confidence interval were computed to
determine the strength of association.
Result: This study found out that the practice of labor pain management methods was 43.3%, which is only non-pharmacologic
methods and practice of pharmacologic method was nil. Multivariate logistic regression showed professionals positive attitude
for labor pain management [AOR=2.242, 95% CI=(1.242-4.048)] and high level qualification [(AOR=2.876, 95% CI=(1.29-6.39)]
were statistically associated with practice of labor pain management methods.
Conclusion & Recommendation: This study revealed poor practice of labor pain management methods. Positive attitude and
highest qualification found to be significant predictor of practice of labor pain management methods. So there is a need to
build attitude and knowledge of skilled attendants towards good practice of labor pain management and further studies should
be done from mother satisfaction point of view.
Larry Lumor Gotah
Head of Department of the St. Karols School of Nursing in Ghana
Title: Perceptions of male infertility among men in the Accra metropolis, Ghana
Biography:
Larry Lumor Gotah has completed his Mphil Nursing degree at the University of Ghana Legon and has 12 years of Nursing experience. He is the current Head of
Department of the St. Karols School of Nursing in Ghana. He has made his first oral presentation at the first MDS LANCET student conference and yet to publish
a paper on his Master’s thesis.
Abstract:
The concept of male infertility appears to be shrouded in secrecy. This study explored the perceptions of male infertility
among men in the Accra metropolis. The Common Sense Model of illness representation (CSM) was used as an organizing
framework. Purposive sampling was used to recruit 14 men. The men were interviewed for 30 to 45 minutes. All interviews
were audio- taped and transcribed verbatim and thematic content analysis was conducted. Four main themes emerged from
the data (illness representation, coping, health outcomes and unmet needs of men with infertility). Out of these, three themes
were consistent with the CSM while one new theme emerged from content analysis. Findings revealed, men with infertility are
perceived to experience stigmatization, divorce and financial crisis with infertility treatment. The men perceived that Ghanaian
men are pressured to marry and produce children. Failure to conform to the society’s expectation was perceived to result in
stigmatization and in some instances, infertile men are perceived to commit suicide if they fail to respond to this obligation.
Men with infertility are also perceived to engage in risky habits like alcoholism and multiple sexual partners as strategies to cope
with infertility. Child adoption as an option for coping with male infertility is perceived to be a stigmatized concept in Ghana.
Poor health outcomes such as hypertension and madness are beliefs associated with male infertility. In conclusion, nurses need
to understand the perceptions the society hold about men with infertility and pay attention to how these perceptions influence
health service accessibility.
Addisu Alehegn Alemu
Lecturer in Mizan Tepi university, Ethiopia
Title: Magnitude and associated factors of primary cesarean section among mothers who gave birth between September and August, 2016 G.C in Suhul general hospital, Tigray, Ethiopia
Biography:
Addisu Alehegn Alemu has completed his Msc from Mekelle University College of Medicine and Health Sciences. He is a Researcher and Lecturer in Mizan Tepi
university, Ethiopia. He has published more than 3 papers in reputed journals
Abstract:
Background: Cesarean section is a lifesaving medical intervention. Its share in decreasing maternal mortality and morbidity
rates are immense, it is also an indicator of maternal health services quality of a country. However it is associated with many
complications compared with vaginal deliveries. The rising rate of CS is a global concern and it ranges between 12 and 86% in
developed and middle-income countries and between 2 and 39% in developing countries. Unjustified prior caesarean section
and decreasing trial of labor after caesarean section are among the reasons for its increment. A woman after a primary cesarean
has only 10% chance of a vaginal birth for sub sequent deliveries. In Ethiopia rate of caesarean section is increasing ranging
from 8 to 37% in the urbanized region. However, rate and factors leading to primary caesarian section are not addressed well.
Objectives: To asses magnitude and associated factors of primary cesarean section among mothers who gave birth between
September and August 2008 E C in Suhul general hospital, Tigray, Ethiopia.
Methodology: Retrospective cross sectional study from September 19 to October 20, 2009 E C(Ethiopian calendar)was
conducted in Suhul general Hospital. The data entered into EPI-Info version 7 and exported to SPSS version 20 for cleaning,
editing and analyzing. Logistic (bi-variable and multi-variables) logistic regressions were used to examine associations between
outcome and independent variables.
Result: The rate of primary CS in this study was 20.2%.Fetal distress 26 (32.2%), cephalopelvic disproportion 15 (17.3%).
Mothers who had been augmented were 3.14 times more likely to undergone primary CS than who hadn’t been AOR(95%CI)=
3.14(1.497,6.571) and mothers who had pregnancy induced hypertension were 3.10 times more likely to undergone primary
CS than those who hadn’t AOR, 95%CI =3.10(1.230,7.829).
Conclusion & Recommendation: The magnitude of primary cesarean section in this study is high. Gestational age and
augmentations, pregnancy induced hypertension and birth weights were associated factors. Objective decision for nonreassuring
fetal heart beat pattern should be practiced to reduce the magnitude of primary caesarean section
Cris Renata Grou Volpe
Teacher at the University of Brasilia -UNB, Master of Health Sciences University of Sao Paulo
Title: Nursing diagnoses associated of depression indices and capacity mental in elderly people in a geriatric ambulatory clinic of Brazil
Biography:
Cris Renata Grou Volpe is currently working as a Teacher at the University of Brasilia -UNB, Master of Health Sciences University of Sao Paulo. She has completed
her PhD in Nursing at the Graduate Nursing Program (UNB). She has experience in nursing, with emphasis on fundamental nursing, medical and gerontology
acting on the following topics: nursing in adult health and elderly, medicine, nursing in public health, semiotics and nursing process.
Abstract:
The present study aimed to identify the most prevalent nursing diagnoses in elderly patients in a geriatric outpatient clinic in
the Federal district, Brazil, according to NANDA Taxonomy II relating them to the depression and mental scales. This is a
descriptive, observational study of 40 elderly people over 65 years attended at the geriatric clinic. Data collection took place in
March 2010 for 60 days. The scales of EDG and MEEM were used. The Pearson's chi-square was used for associations and the
significance level of p<0.05. The Geriatric Depression Scale (EDG) and the Mental State Mini Exam (MMSE) were used. This
study was approved by the Ethics Committee of the Health Department of the Federal District. The most prevalent nursing
diagnoses were: Disturbed sensory perception; decreased cardiac output; impaired dentition; impaired memory; risk of falls
and insomnia. The indexes of depressive symptoms by EDG were 35% and the cognitive alterations by the MEEM were 60%.
There is a significant association between social isolation, risk of loneliness, chronic sadness and hopelessness in relation to
the depression indexes demonstrated by the scale. SDs significantly associated with cognitive impairment by MMSE were poor
knowledge and impaired memory. Older people tend to have cognitive deficits and depressive symptoms, especially older ones,
and dependence on how much wings activities of daily living. The most prevalent related factor with impaired memory was
excessive environmental changes and poor cognition was cognitive.
Miho Tonai
professor from Nursing Assessment Division, Department of Basic Nursing, Oita university of Nursing and Health Sciences, Japan
Title: Perceptions of nursing students and nurses assessed using an eye movement observation device
Biography:
Miho Tonai is working as professor from Nursing Assessment Division, Department of Basic Nursing, Oita university of Nursing and Health Sciences, Japan
Abstract:
Aim: The present study aimed to determine the ways to improve observation and assessment abilities during basic nursing
education by defining differences in the perceptions of symptoms and subsequent actions between nursing students and nurses
at the bedside.
Methods: Ten junior and 10 senior students at a nursing school and nine qualified nurses wore a device that tracks eye
movement. The nurses and students assessed symptoms in a simulation of a patient complaining of fatigue and perspiration in
a mock hospital room. They were then questioned about what they perceived as the most important issue and how they would
deal with it.
Analysis: The main areas observed included the face, a drip injection device, the bed surroundings, the feet and the areas of the
body that were perspiring. The ratio of the amount of time taken to assess each item to the total duration of observation was
calculated. Responses to the questions were classified as observations, impressions, hypotheses, verification and judgments.
Results: Among the participants, 43.9%, 50.9% and 57.6% of junior and senior nursing students and qualified nurses,
respectively, spent most of the time observing the face. Significantly more nurses than students observed the feet, whereas
significantly more junior students spent time observing other areas (p=0.02). The answers to the questions indicated that other
than the face, most participants in all groups paid more attention to other areas. Significantly more qualified nurses than junior
students included responses classified as judgments (p=0.01), and the nurses reached conclusions based on their observations.
Discussion: The objectives of the visual assessment of the patient was not clear to the nursing students, whereas the qualified
nurses considered various possible causes of the symptoms, actively observed them, consistently judged the level of urgency
and prioritized the need for assistance.
Naoko Arakawa
Assistant Professor at the College of Life and Health Sciences at Chubu University.
Title: Validity and usability of templates for a tablet-type database system created for community health nurses in Thailand
Biography:
Naoko Arakawa is a Registered Nurse and a Public Health Nurse who currently works as an Assistant Professor at the College of Life and Health Sciences at Chubu
University. She is also pursuing her PhD on Fundamentals and Clinical Nursing at the Nagoya University Graduate School of Medicine. The research theme of
her Doctoral thesis is to promote work efficiency and effective use of data by developing a database system for community health nurses in developing countries.
She has acquired a Grant-in-Aid for Young Scientists from the Japanese government for her work on the research theme. She is interested in Nursing Informatics,
particularly practical work using the Nursing minimum data set and the development of database systems.
Abstract:
Background: Community Health Nurses (CHNs) in Thailand are the key players in the health promotion and follow-up for
rural residents with chronic diseases. Our previous study showed there were major six target groups: diabetes, hypertension,
stroke, maternity, neonate and tuberculosis among them. However, because CHNs were recording residents’ information using
paper-based formats, they could not well utilize data collected from the residents.
Purpose: The purpose of the study is to develop an easy to use database system that could directly input data from residents
using a tablet device and examine its validity and usability.
Methods: Through five rounds of reciprocal development processes with CHNs who worked at a health-promoting hospital
in rural Northern-east Thailand, we revised designs, structures and data-entry format of a tablet-type database system for the
six target groups. In the final study, we asked four CHNs to use our system in their daily activities for five months to evaluate
the usability.
Results: Four CHNs who participated in this trial, collected data from 101 patients. Most of the data were collected from
diabetes patients (n=64) and 65% had suffered nerve damage in the peripheral nervous system. CHNs provided education to
patients on diet (94%), exercise (91%), curative medicine (78%), self-control (45%), sleep (42%) and stress management (35%).
CHNs could notice the detailed statistical trends for the first time, whereas previously they had just impressions through their
activities.
Conclusion: Our system can provide better information easily that could show the attributes of residents with chronic disease.
Further, it would help to describe the daily community health activities, which were not described before this system was used.
We also expect this system to help CHNs’ decision making to improve quality of community health.
Natsuki Nakayama
Associate Professor in the Nagoya University Graduate School of Medicine.
Title: Daily activity improves heart rate variability and sleep quality in patients with mild hypertension and/or stable angina pectoris
Biography:
Natsuki Nakayama has graduated from Nagoya University, Nagoya Japan. She is a registered Nurse, who currently works as an Associate Professor in the Nagoya
University Graduate School of Medicine. Her research interest includes preventions of diseases such as cardiovascular disease, gastrointestinal motility and
autonomic nervous activity.
Abstract:
Some studies have evaluated that sleep and physical activity are involved in cardiovascular prognosis. The objective of
this study was to evaluate the potential role of daily activity in heart rate variability (HRV) at sleep periods and clarify
relationships between daily activities and sympathovagal balance. We conducted this study as a nonrandomized, prospective,
six-month study in 42 patients with hypertension and/or stable angina pectoris. Daily activity was measured by the active
meter and HRV was evaluated by the Holter 24-hour ambulatory electrocardiogram at the start of the study (BASE) and after
6 months (6MoA). Heart rate, HRV parameters, such as low-frequency (LF), high-frequency (HF) and LF/HF ratio were
calculated 1 hour (1After), 3 hours after sleep onset (3After) and 1 hour before awaking (1Awake). The active mass at 6MoA
increased in 26 patients (active group), while it decreased in 16 patients (inactive group). LF/HF ratio of 1Awake was higher the
inactive group than active group at BASE. LF/HF ratio during sleep, 1After, 3After and 1Awake in inactive group were higher
than active group at 6MoA. LF and HF were significantly increased at 1Awake in active group from BASE to 6MoA. There
was significant increase in HF at 3After in active group, and in LF/HF ratio at 1After in inactive group. There was significant
increase in LF at 1Awake in inactive group. The decrease in active mass changed HRV outcomes with increased LF/HF ratio at
all sleep periods. These findings suggest that the increase of daily activity improves sleep quality.
Sachiko Deguchi
currently she is teaching at Kitasato University.
Title: Status and issues of Japanese psychiatric hospitals; Based on the hearing from nursing directors
Biography:
Sachiko Deguchi has her expertise in Mental Health and Psychiatric Nursing. She has completed her PhD in Psychiatric Nursing and currently she is teaching at
Kitasato University. For the past 20 years, she has conducted the hearing on the Japanese people concerning their war-time experiences on how their experiences
affected their lives after the war. Now she and her colleague are working research activities to form the effective support system for nursing staff of continuing
education of psychiatric hospitals.
Abstract:
In Japan, over 90% of the psychiatric hospitals are private hospitals where there are long stayed patients and have problems of
social hospitalization and revolving door etc. The psychiatric nursing staff has various educational background and many of
them are mid- career recruited workers and the employee turn-over rate is higher than general practice nurses. So the directors
of nursing have been facing difficulties of career education. To clarify the difficulty of continuous learning, the needs of nurses,
learning and to give some suggestions on the continuing education, we interviewed five directors of nursing service department
at five different private psychiatric hospitals. As a result, we have found out they understand that the base of nursing care’s
quality depends on the continuing education supported by staff. So, they have been working together with the back office on a
trial -and –error bases. They are looking for the way to succeed in continuing education, while experiencing difficulties. On the
other hand, due to the various social backgrounds of nursing staff at private psychiatric hospitals, there is the limit to conduct
conventional top-down education. They should rather have the bottom –up type learning-support programs. Moreover, it was
suggested that it is important to support the directors of nursing as well as to maintain effective tie -up between the specialists.
Kefyalew D Gizachew
Lecturer in Debre Berhan University, Ethiopia
Title: Prevalence and associated factors of common mental disorders among pregnant women in Debre Birhan Town, North Showa Zone, Amhara region, Ethiopia, 2014
Biography:
Kefyalew D Gizachew has his expertise in evaluation and treatment in improving the mental health wellbeing. He serves as a Lecturer in Debre Berhan University,
Ethiopia since October, 2015. He previously worked as a Midwife in primary health care settings and in Debre Berhan Referral Hospital, Ethiopia. He served as a
Mental Health Professional Specialist in Debre Berhan Referal Hospital.
Abstract:
Introduction: In low- and lower-middle income countries about one in six pregnant women are experiencing antenatal
common mental disorders (CMD).
Objective: To assess prevalence and associated factors of common mental disorders among pregnant women in Debrebirhan
Town, North Showa Zone, Amhara region, Ethiopia, 2014.
Methods: Community based cross-sectional study was employed among 569 study subjects. Data was collected using faceto-
face interviews with Amharic version of Self Reporting Questionnaire (SRQ-20) from seven selected kebeles. Kebeles
were selected by simple random sampling and individuals were selected using cluster sampling. Crude Odds Ratio (COR)
and adjusted Odds Ratio (AOR) was analyzed using bivariate and multivariable logistic regression analysis and the level of
significance for association was determined with 95% CI and at P- value < 0.05.
Result: A total 557 study participants were completed the interview and the prevalence of antenatal common mental disorder
was found to be 45.2%. Loss of loved one (AOR=1.97; 95% CI: 1.19-3.27), history of chronic medical illness (AOR=6.57; 95%
CI: 2.17-19.94), Unwanted pregnancy (AOR=2.13; 95% CI: 1.15-3.95), nulliparity (AOR=8.71; 95% CI: 1.58-47.94), one or less
ANC consultations (AOR=0.22; 95% CI: 0.08-0.64), two-three ANC consultations (AOR=0.30; 95% CI: 0.11-0.83) and current
obstetric complications (AOR=4.45; 95% CI: 2.21-8.99) were important factors significantly associated with antenatal common
mental disorder.
Conclusion: The prevalence of antenatal common mental disorder (CMD) was high in this study that shows antenatal CMD
is significant public health issue that requires a great emphasis. So, early screening and intervention for antenatal CMD should
be integrated in primary health care and antenatal care service settings.