Scientific Program

Conference Series LLC Ltd invites all the participants across the globe to attend 7th Annual Congress on Primary Healthcare, Nursing and Neonatal Screening Vancouver, British Columbia, Canada.

Day 1 :

Keynote Forum

Sam S Oh

UCSF, USA

Keynote: Make precision medicine socially precise

Time : 09:15-09:50

American Primary Healthcare 2018 International Conference Keynote Speaker Sam S Oh photo
Biography:

Sam Oh serves as the Director of Epidemiology at the UCSF Asthma Collaboratory, where he examines the effect of genetics and environment on asthma risk, severity, and response to medications. He is passionate about resolving difficult public health problems that affect underdog communities that are too often ignored in biomedical research. Racial and ethnic minorities currently make up 40% of the US population yet have been represented in only 4.4% of NIH-funded pulmonary research since 1993. Dr. Oh studies asthma, the most racially disparate common disease.

 

Abstract:

 

Most drugs and genetic tests are developed in populations primarily of European descent, but nearly 90% of the world's population is non-European. As the applications of genomic studies become more widespread, it is critical that the study populations used for genomic discoveries more closely resemble the populations on whom the results are applied. While the vast majority (>80%) of genomic studies have been conducted on populations of European descent, Europeans represent less than 15% of the world’s population. Significant problems with drug efficacy and genetic test accuracy can occur if their development is based on genetic patterns that occur more frequently among people of European ancestry. The generalizability of many drugs and genetic tests can be called into question. Since the results of these studies are used to inform policy and drug development, this mismatch in representation has the potential to lead to very poor outcomes. For example, genetic tests for serious diseases may not work in some populations (Manrai et al.), and medicines may fail to deliver their therapeutic effects (Wu et al.). Adopting a one-size-fits-all approach can be myopic. Diversity in biomedical and clinical research is an asset. Ignoring racial/ethnic diversity is a missed scientific opportunity and can translate to poor clinical outcomes.
 

Keynote Forum

Muhammad Ajmal Zahid

Kuwait University, Kuwait

Keynote: Prevalence of psychiatric morbidity in the primary health clinic attendees in Kuwait

Time : 09:50-10:25

American Primary Healthcare 2018 International Conference Keynote Speaker Muhammad Ajmal Zahid  photo
Biography:

Dr Zahid got his pre-medical education from Paharang, Faisalabad and obtained a Medical degree from King Edward Medical College, Lahore, Pakistan. He became a member, Royal College of Psychiatrists, UK, in 1985. He served as Assistant Professor, Department of Psychiatry, King Edward Medical College during 1986-1992; joined the Department of Psychiatry, Kuwait University in 1994, which he has Chaired since 2006. His areas of interest include Psychosomatic disorders, Violence against Medical Staff, and Psychotic Disorders. He has authored more than 35 publications in peer-reviewed, indexed, International journals and organized 11 International conferences. He is the recipient of a number of Research and Academic awards and author of two scales measuring Violence against medical staff and Somatic symptoms in the Psychologically distressed medical outpatients. He has made over 40 presentations in various International Conferences.

 

 

Abstract:

Statement of the problem: An extensive number of patients going to the essential wellbeing facilities experience the ill effects of the co-dismal mental issue.

Objectives: To estimate the prevalence of the comorbidity between common mental disorders (anxiety/depression/somatization) and common chronic physical illnesses among primary health care attendees and explore the relationship of comorbidity with the type of illness and socio-demographic characteristics.

Method: The Physical Health Questionnaires (PHQ-SADs) were directed to a randomized example of 1046 essential center participants in all the five governorates of the nation over a 5-month time frame. Physical diagnoses were ascertained by the attending physicians based on ICD-10 criteria.

Results: Of 1046 respondents, 442 (42.25%) had no less than one mental issue, while 670 (64.1%) had a physical ailment determination, viz: diabetes mellitus (37.01%), hypertension (34.18%), heart infections (7.2%) and non-chronic physical illnesses (9.4%). Physical comorbidity was significantly associated with older age, divorce, illiteracy, and poorer living conditions.34.4% (360/1046) had physical-mental comorbidity while 53.7% (670) % had physical-mental comorbidity; and of 376 without physical disease, 82 (21.8%) had no less than one mental issue (OR = 4.1, P < 0.001). The commonest comorbid mental disorders were somatization and the simultaneous presence of all 3 mental disorders. There was an increase in the prevalence of mental disorders with an increase in the number of physical illnesses, and increase in psychopathology scores with a number of physical comorbidities. Subjects with heart diseases and asthma consistently had higher psychopathology scores.

Conclusion: The findings call for the primary care physicians to be sensitive to the psychosocial context of patients who present primarily with physical conditions; more so for patients with multiple medical illnesses and social disadvantage.

 

American Primary Healthcare 2018 International Conference Keynote Speaker Sarah Gafforini photo
Biography:

Sarah Gafforini is the Head of Strategy, Population and Global Health at Marie Stopes Australia. She is also the Acting Head of MS Health, the Australian pharmaceutical company that pioneered the introduction of medication abortion in Australia. Sarah’s research, lobbying and management experiences over her career has strengthened her passion for ensuring women have choice and autonomy over their sexual and reproductive health. Her past research publications focus on various aspects of public health within the Australian health care system. She is currently completing a PhD on the introduction of a reproductive coercion screening tool in Australia through La Trobe University.

 

Abstract:

 

Statement of the Problem: Women are disproportionately affected by violence from male partners. Reproductive coercion is an often overlooked element of male partner controlling behavior and violence against women in Australia. It is essential that healthcare providers are aware of the challenges women can face in trying to control their own fertility. Clinician perspectives on reproductive coercion, its prevalence and talking to women about their experiences of reproductive coercion have not been assessed in Australia.
Methodology & Theoretical Orientation: This mixed methods study utilized semi-structured key informant interviews together with an electronically administered survey. Interviews were analyzed using thematic analysis. Frequency distributions and descriptive analysis were derived from the survey.
Findings: Participants were medical practitioners and nurses employed in one of 16 Marie Stopes Australia abortion clinics throughout Australia. Not all clinicians reported experiencing women having disclosed reproductive coercion however nurses were more likely to. Pregnancy coercion was more frequently disclosed than contraception coercion. Concealment of pregnancy was the most prevalent form of coercion followed by male partners threatening to leave a relationship if an abortion was not sought.
Conclusion & Significance: Reproductive coercion by male partners is a causal factor in the link between family violence, unplanned pregnancy, and abortion, with an unplanned pregnancy and abortion more likely to be associated with violence than planned pregnancies. This is the first study in Australia to explore clinician experiences of women disclosing reproductive coercion. Further research is required to explore women’s self-reported experiences of reproductive coercion and implications for future practice.

 

American Primary Healthcare 2018 International Conference Keynote Speaker Natasha Iyer photo
Biography:

Dr Iyer has spent the last 21 years working with and caring for her patients.  Her focus has always been on the individual.  She developed strong relationships with her patients, taking a keen interest in their lives, not just their medical problems. Dr Iyer has successfully completed her written and oral exams, and academic requirements towards the Advanced Fellowship in Anti-aging and Regenerative Medicine (ABAARM).

 

Abstract:

Statement of the Problem: From menarche to menopause, women experience hormone fluctuations and a variety of mental-emotional and physical symptoms that affect their quality of life, relationships and the ability to be productive. Other than hot flashes and night sweats, a common presenting complaint of women in the menopause is anxiety, and sleep disturbance. Other complaints like increasing fatigue, genitourinary symptoms, weight gain and low libido during menopause are often unexplained or ineffectively treated. The WHI, 10 years later; has confirmed concrete benefits to HRT for women. Should we be expanding our thinking and approach to HRT in younger and older women by looking at augmenting levels of progesterone and other hormones to treat women more comprehensively? Progesterone is a neurosteroid. Its metabolites have a significant positive effect on the brain and neurochemistry. Are we missing an important part of treating women adequately, when we think ‘no uterus-no progesterone’? Other hormones like DHEA and pregnenolone have data supporting the positive effects on menopausal women. From bone to mood, to anxiety and sleep: hormone replacement therapy needs a rethink beyond ‘hot flashes and bone’ and our traditional approach to estrogen only, and estrogen and progesterone with an intact uterus. More important too, is the distinction between progestin and progesterone, a critical difference to pay attention to in clinical practice.

 

Keynote Forum

Robert J Gatchel

University of Texas, Arlington, USA

Keynote: Prevention of oral diseases

Time : 12:00-12:35

American Primary Healthcare 2018 International Conference Keynote Speaker Robert J Gatchel photo
Biography:

Robert J Gatchel received his BA in Psychology, Summa Cum Laude, from SUNY at Stony Brook, and his PhD in Clinical Psychology in 1973 from the University of Wisconsin. He is also a Diplomate of the American Board of Professional Psychology. At the University of Texas at Arlington, Dr Gatchel is currently: A Distinguished Professor of the Department of Psychology, College of Science; the Nancy P & John G Penson Endowed Professor of Clinical Health Psychology; and the Director of the Center of Excellence for the Study of Health & Chronic Illnesses. He has conducted extensive clinical research in the area of pain, much of it continuously funded for the past 35 years by grants from the National Institutes of Health (NIH), National Science Foundation, and the Department of Defense. He was also the recipient of a prestigious Senior Scientist Award from NIH. Dr Gatchel has received numerous national and international awards associated with his research, most recently, the 2017 American Psychological Foundation’s Gold Medal Award for Life Achievement in the Application of Psychology.

 

Abstract:

In 2011, the influential Institute of Medicine (IOM) Report, Relieving Pain in America, highlighted the urgent need for the development of better methods for pain management because the ever-increasing costs with current treatment approaches cannot be sustained. Chronic pain is more common than the total number of individuals with diabetes, heart disease, and cancer combined! Musculoskeletal pain is the most common type of chronic pain; chronic low back pain is the most prevalent in this category. A lesser-known fact is that temporomandibular joint and muscle disorder (TMJMD) is also very prevalent, and ranks second only to low back pain. Treatment costs of TMJMD average $4 billion annually. The current presentation will review a number of NIH-supported clinical research studies on the early identification and intervention of “high risk” (HR) TMJMD patients that prevent the development of more chronic and costly disease states. During this presentation, four separate projects will be presented. The first will be a statistical algorithm that was developed to differentiate between acute TMJMD patients who were either at HR versus low-risk (LR) for developing chronic TMJMD problems. Drawing from these results, the second project evaluated whether an early biopsychosocial intervention program with HR patients would produce lower levels of pain at a one-year follow-up, relative to HR patients not receiving such care. The outcome data from that study revealed significantly more positive changes in the HR early-intervention group that in the HR non-intervention group. Finally, a just-completed study evaluated whether this early assessment and early intervention could be successfully utilized in the “real world” of dental clinics in the community. Again, the results were very clear in demonstrating that acute TMJMD patients who were administered early intervention showed significantly less chronic TMJMD disease indicators. This results clearly demonstrate that such an assessment/intervention program can be successfully employed with the general population in individual clinics.

 

Keynote Forum

Shabnam Das Kar

Better: A centre of complete living, Canada

Keynote: Women and cardiovascular disease

Time : 12:35-13:10

American Primary Healthcare 2018 International Conference Keynote Speaker Shabnam Das Kar photo
Biography:

Dr Shabnam Das Kar,  MD (OBGY), FMNM Websites Better Medical Centre Canada, MBBS & MD (OBGY) from India. Practicing as a Specialist in Functional & Metabolic Medicine at Better Medical Centre, Mumbai, India.  Director Medical Education at Better Medical Centre, Canada & India. Had worked as Consultant Obstetrician Gynecologist in 3 major hospitals in Mumbai, India.

 

Abstract:

Cardiovascular disease (CVD)–heart disease and stroke, is the biggest killer of women worldwide. More women die of CVD than breast cancer, yet the awareness about the unique risks of CVD in women is lacking. Many women affected by CVD die prematurely. Earlier it was thought that heart disease in women is the same as it is in men. However, in recent years gender-specific studies have highlighted the differences in heart disease in men and women. For example, Type 2 Diabetes Mellitus is a stronger predictor of risk for stroke and heart disease in women than men. Traditionally CHD has been associated with obstructive atherosclerosis in epicardial coronary arteries causing ischemia. However, in women, it has been found that some of them may have Cardiac Syndrome X, which is angina-like chest pain with evidence of myocardial ischemia in the absence of flow-limiting stenosis on coronary angiography. A greater proportion of women than men with myocardial infarction die of sudden cardiac death before reaching the hospital. Women with IHD have a poorer prognosis than men. Though many women with acute coronary syndrome present with chest pain, some may present with atypical symptoms like profound fatigue, pain in both arms, jaws, abdomen or breathlessness. Because of this, women sometimes delay in seeking treatment. Women have some unique risk factors associated with them because of their sex and gender. Some of these factors are: (a) Psychosocial stress is a bigger risk factor for heart disease in women than men. (b) Pregnancy-related complications like pregnancy loss, Pre-Eclampsia, Gestational Diabetes Mellitus Migraines (c) Women with PCOS have a higher lifetime risk of CVD compared to those without (d) Autoimmune conditions. More women than men are affected by autoimmune conditions. (e) Women, Sex Hormones, and CVD: Premenopausal women are protected against CVD because of higher levels of sex hormones than in post-menopausal women. The “timing hypothesis” of hormone replacement and the use of transdermal estrogen and oral micronized progesterone versus synthetic estrogens and progestin like Medroxyprogesterone Acetate (MPA) have dramatically changed our attitude towards hormone therapy. However, misinformation still abounds amongst patients and health care providers, resulting in many women being deprived of the benefits of hormone therapy. (f) Some cancer chemotherapy drugs are associated with increased risk of heart disease—the newly developing field of Oncocardiology. (g) Obstructive Sleep Apnea (OSA): OSA is associated with a high risk of CVD in men as well as women. Sometimes women are not screened for this because the presentation may be different in them. OSA in women has been misdiagnosed as fatigue, work-related stress, anemia, hypothyroidism or hypochondria. (h) Build awareness amongst women as well as their health care providers about the unique risks for heart disease and stroke in women. (i) Studies have shown that between 40 to 80% of stroke and heart disease can be prevented through lifestyle change. Through my presentation, I would like to build awareness about the unique features of women and CVD and draw attention to how we can help patients make small incremental changes to several risk factors, many of which fall below the radar. This can have a profound impact on managing the risk of CVD in women.