Day 2 :
Keynote Forum
Anil K. Mandal
Mandal Diabetes Research Foundation, USA
Keynote: Control of D-glucose preserves renal function in patients with diabetes
Time : 9:30-10:00
Biography:
Anil K Mandal has completed his graduation from Calcutta National Medical College and is a Diplomat of the American Board of Internal Medicine. He is the author of many books and articles on research in Diabetes and Kidney Disease. He is a two time Fulbright Scholar to India and Visiting Professor to 24 countries where he has lectured on diabetes, high blood pressure and kidney disease. He began the Mandal Diabetes Research Foundation for the prevention and treatment of diabetes based on his knowledge that diabetes is the most common cause of kidney failure worldwide. He is dedicated in helping diabetic patients live a good life and not to enter dialysis.
Abstract:
We previously reported that D-glucose is a strong predictor of renal function change in diabetes. This study is an expansion of a previous study but with longer duration. Data was compared between first and last visits. 85 diabetic patients were treated with a combination of glargine or detemir with regular or fast acting insulin for 26.3±24.6 (SD) months. Blood pressure was controlled by beta blockers, calcium channel blockers, sympathetic inhibitors or a combination, and chlorthalidone in resistant cases. Angiotensin Converting Enzyme Inhibitors and Receptors Blockers (ACEI/ARB) were excluded in order to reduce the risk of acute and chronic renal failure. Objectives were to determine if this paradigm of treatment prevents progression of diabetic nephropathy. Fasting (F) and 2 hour Post-Prandial (2hPP), glucose, Serum Creatinine (Scr) and estimated Glomerular Filtration Rate (eGFR); hemoglobin A1c (HbA1c); and Sitting Systolic and Diastolic Blood Pressure (SBP) were recorded for the first and last visits. Mean Blood Pressure (MBP) and differences (d, 2hPP-F) were calculated for glucose, Scr, and eGFR. Parameters between first and last visits were compared using a paired t-test adjusted for age, gender and duration of treatment with p<0.05 considered significant. No significant differences were found between first and last visits for F and 2hPP glucose, F and 2hPP Scr, and F and 2hPP eGFR, and HbA1c. D-glucose, sitting SBP and MBP were significantly lower at last when compared to first visit. Combining of visits, D-glucose and HbA1c showed a direct and positive correlation with dScr. Changes in post minus pre-treatment values were significantly correlated positively between HbA1c and FBG, 2hPPG or D-glucose. In conclusion, the current study emphasizes the importance of control of D-glucose (2hPP-F) with insulin in preserving renal function in diabetes when ACEI/ARB are not used.
Keynote Forum
Neelam Doshi
Bond University, Australia
Keynote: Ebola: Facts, myths and challenges
Time : 10:00-10:30
Biography:
Neelam Doshi is a locum staff specialist in Microbiology at the Gold Coast University Hospital, where she is active in laboratory and clinical teaching across the continuum of medical learners. She also is designated as Associate Professor of Pathology at the Bond University Medical School, Gold Coast. She has both domestic and international medical training and work experience including India, UK & Saudi Arabia. She trained as a General Pathologist in India in 1994, then specialised as a fellow in Microbiology & Virology in UK/Australia. She was the Clinical Lead Consultant for Infection Prevention and Control at Stockport NHS Foundation Trust hospital, UK and played a key role in developing laboratory and infection control protocols for the UK NHS Influenza Emergency Preparedness in 2010.
Abstract:
Ebola viral disease (EVD) is a re-emerging, zoonotic, viral hemorrhagic disease. The Ebola outbreak of West Africa in 2014-15 is the largest till date, affecting the metropolis as well as rural lives, in addition to that of health care professionals. The cardinal components to prevent EVD include early recognition, prompt diagnosis, dissemination dynamics, quarantine of cases, contact tracing, active surveillance, safe burials, infection prevention practices including PPE and societal education. All the above were challenged significantly in this outbreak. What started as a regional medical emergency rapidly evolved into an international catastrophe. Coordinated global efforts to strengthen the health care systems in resource-poor regions, along with public health education and community engagement were the prime factors which mitigated its impact. Favourable new vaccine and pharmaceutical interventions could be a breakthrough in combating this fatal and neglected tropical disease. The keynote will be an interactive session, exploring the past, present and future of Ebola viral hemorrhagic disease.
- Healthcare and Chronic Diseases
Chair
Anil K Mandal
Mandal Diabetes Research Foundation, USA
Co-Chair
Neelam Doshi
Bond University, Australia
Session Introduction
YeonsooJang
Yonsei University, South Korea
Title: The relationships of perceived fatigue, cortisol, and cytokine in Koreans with chronic hepatitis B
Time : 10:30-10:55
Biography:
Yeonsoo Jang is an Assistant Professor in Yonsei University, College of Nursing, Seoul, South Korea. She is interested in researches related to clinical symptoms and self-management behaviors of patients with chronic diseases.
Abstract:
The purpose of this study was to examine the relationship of perceived fatigue, cortisol, and cytokine in patients with HBV. The severity of fatigue was measured with the revised Piper Fatigue Scale among 143 subjects, and the cortisol and cytokine levels were measured using the serum samples of the subjects. The revised Piper Fatigue Scale consisted of 22 numerical items. A descriptive analysis was performed to determine the subjects general and disease-specific characteristics; the correlation of the level of fatigue, the serum cortisol level, and the serum cytokine (IL-6 and TNF-α) were examined using Pearson’s correlation coefficient; and quantile regression analysis was used to estimate the changes in the cortisol and cytokine levels, depending on the fatigue level.The mean score of overall fatigue was moderate. There were no statistical differences of serum cortisol, IL-6, TNF-α level by fatigue groups. The overall fatigue score increased as the cortisol level decreased, it was significantly negative correlation (r = -0.178, p = 0.031). The overall fatigue score increased as the IL-6 and TNF-α level increased. However, it was not statistically significant. TNF-α was only significant as a predictor on fatigue. The cortisol level depending on fatigue in cognitive/mood was significant in the 70th, 80th, 90th quantile which were severe levels of fatigue. The IL-6 level depending on fatigue in overall and cognitive/mood were significant in 90th quantile. Cortisol, IL-6 and TNF-α were related with perceived fatigue, particularly, in cognitive/mood dimension in patients with HBV. This suggests that the fatigue patterns of patients with HBV are related to mental and mood states and physical responses such as cortisol and cytokine are correlated with their nature of fatigue. In clinical, the intervention to manage fatigue should be developed based on the characteristics of fatigue in patients with HBV.
Jianqian Chao
Southeast University, China
Title: The long-term effect of community-based health management on the elderly with type 2 diabetes by the Markov model
Time : 11:10-11:35
Biography:
Jianqian Chao is currently working in the university as a Professor at School of Public Health, Southeast University China. His major research fields are public health, social medicine, health administration and hospital management. Recent researches focus on the elderly health management, project evaluation, community health service. The rapid increase in the elderly population not only greatly influences the development of the social economy, but also poses significant challenges to health care in China. Health management has been looked upon as a way to deal with these challenges. We evaluated the effects of community-based health management on the health of the elderly and conducted the evaluating methods research.
Abstract:
The aim of this study was to assess the long-term effects of community-based health management on elderly diabetics using a Markov model. A Markov decision model was used to simulate the natural history of diabetes. Data were obtained from our randomized trials of elderly with type 2 diabetes and from the published literature. One hundred elderly patients with type 2 diabetes were randomly allocated to either the management or the control group in a one-to-one ratio. The management group participated in a health management program for 18 months in addition to receiving usual care. The control group only received usual care. Measurements were performed on both groups at baseline and after 18 months. The Markov model predicted that for every 1000 diabetics receiving health management, approximately 123 diabetics would avoid complications, and approximately 37 would avoid death over the next 13 years. The results suggest that the health management program had a positive long-term effect on the health of elderly diabetics. The Markov model appears to be useful in health care planning and decision-making aimed at reducing the financial and social burden of diabetes.
Anil K. Mandal
Mandal Diabetes Research Foundation, USA
Title: Control of d-glucose Preserves Renal Function in Patients with Diabetes
Biography:
Dr. Anil Mandal is a native of India and a naturalized citizen of the United States . He graduated from Calcutta National Medical College and is a diplomate of the American Board of Internal Medicine. He is the author of many books and articles on research in Diabetes and Kidney Disease. He is a two time Fulbright Scholar to India and Visiting Professor to 24 countries where he has lectured on diabetes, high blood pressure and kidney disease. Dr. Mandal began the Mandal Diabetes Research Foundation for the prevention and treatment of diabetes based on his knowledge that diabetes is the most common cause of kidney failure worldwide. Dr. Mandal’s conviction are that, in the office, patients come first and in the home, children come first. He is dedicated to helping diabetic patients live a good life and not enter dialysis.
Abstract:
We previously reported that dglucose is a strong predictor of renal function change in diabetes. This study is an expansion of a previous study but with longer duration. Datawascompared between first and last visits. Eighty five diabetic patients were treated with a combination of glargine or detemir and regular or fast acting insulin for 26.3 ± 24.6 (SD) months. Blood pressure was controlled by beta blockers, calcium channel blockers, sympathetic inhibitors or a combination, and chlorthalidone in resistant cases. Angiotensin converting enzyme inhibitors and receptors blockers (ACEI/ARB) were excluded in order to reduce the risk of acute and chronic renal failure.Objectives were to determine if this paradigm of treatment prevents progression of diabetic nephropathy. Fasting (F) and 2-hour postprandial (2hPP), glucose, serum creatinine (Scr) and estimated glomerular filtration rate (eGFR); hemoglobin A1c(HbA1c); and sitting systolic and diastolic blood pressure (SBP) were recorded for first and last visits. Mean blood pressure (MBP) and differences (d, 2hPP-F) were calculated for glucose, Scr, and eGFR. Parameters between first and last visits were compared using a paired t-test adjusted for age, gender and duration of treatment with P<0.05 considered significant. No significant differences were found between first and last visits for F and 2hPP glucose, F and 2hPP Scr, and F and 2hPP eGFR, and HbA1c.dglucose, sitting SBP and MBP were significantly lower at last compared to first visit. Combining both visits, dglucoseand HbA1c showed a direct and positive correlation with dScr.Change in post minus pretreatment values weresignificantly positively correlated between HbA1c and FBG, 2hPPG or dglucose. In conclusion the current study emphasizes the importance of control of dglucose (2hPP-F) with insulin in preserving renal function in diabetes when ACEI/ARB are not used.
Carl Johan Jakobsen
Aarhus University Hospital, Denmark
Title: Risk prediction and management in cardiac surgery
Biography:
Vice-president 2001-2004, President 2004-2007, Past president 2007-2010 of European Association of Cardiothoracic Anaesthesiologist. Honorary memberships of Association Latinoamericana de Anestesiólogos Cardiotorácicos 2005 and European Association of Cardiothoracic Anaesthesiologists 2015. Heart Group of National board of Health (1997-2011); Danish Heart Registry (1997-2011); Advisor to the National Health Insurance system (2007-2012); Speciality advisor in Anaesthesiology to the National board of Health (2012-till ).More than 150 publications mostly in international journals. Co-author of more than 75 free presentations. Received several prizes. Author of book chapters: Anaesthesia and monitoring in cardiothoracic surgery. Anaesthesia for the cardiac patient in non cardiac surgery.
Abstract:
The short time outcomes from cardiac surgery has changed dramatically during the last decades. Despite an increasing elderly population and more complex surgery the 30-day mortality has in many institutions been halved the last 10 years, but the one-year mortality remains. Risk prediction systems like the EuroSCORE is a valuable tool in control of the quality of cardiac surgery, but the validity of the risk score for the individual patient may be questioned. Further most scoring systems only take the patients preoperative state and the intended surgery into consideration, and hardly handle the procedure and perioperative complicating factors. Thus we have very poor tools to predict the longer term mortality. The presentation is based on cohort studies of more than 25.000 patients handling and evaluating different factors in an attempt to isolate factors with independent impact on postoperative complications and survival. The studies demonstrate that both co-morbidity and age has great impact on 30-day mortality. In longer time outcomes the impact of co-morbidity seems less, while the impact of age increases together with perioperative intervention I.e. use of inotropes and vasoconstrictors, use of haemostatic drugs and blood transfusion. Except that age in elderly people has an important role in survival the unequal developments in short and longer term mortality are not readily explained.
Keerti Jain
National Institute of Pharmaceutical Education and Research, India
Title: Dendrimers: Anti-angiogenic nanomaterials for treatment of cancer
Biography:
Dr. Keerti Jain is currently working as Lecturer at Department of Pharmaceutics in NIPER, Raebareli, INDIA. She earned her B. Pharm., M. Pharm. (with merit position and Honors Division) and Ph.D. from Department of Pharmaceutical Sciences, Dr. H. S. Gour Central University, Sagar, INDIA. Dr. Jain is author of more than 30 international manuscripts in peer reviewed-high impact journals, including publications in Progress in Polymer Science (Elsevier) and chapters in international books. She has been recipient of several prestigious grants, fellowships and awards. Her research interests include Dendrimers, Quantum Dots, Nanoparticles and CNTs based drug delivery systems, Anti-angiogenic activity of Dendrimers, and Pharmaceutical Nanotechnology.
Abstract:
Formation of new blood vessels from pre-existing blood vessels i.e. angiogenesis play crucial role in the metastasis and growth of tumor, and hence inhibition of neo-vascularization could be a lucrative approach in the successful treatment of cancer. Numerous preclinical investigational studies showed that the combined treatment of cancer with angiogenesis and chemotherapy/radiotherapy could result in improved outcomes as compared to chemotherapy and/or radiotherapy. In this regard we could postulate that the designing of a nano-material with anti-angiogenic activity and potential to deliver anticancer drug selectively to cancer cells may emerge as a promising therapeutic approach for treatment of cancer. Dendrimers represent a well defined three-dimensional macromolecular structure synthesized in a step-wise controlled manner with nearly mono-disperse polymeric architecture. Some dendrimer molecules including poly-L-lysine (PLL) dendrimers, poly-arginine dendrimers with glycine core, poly(propylene imine) (PPI) dendrimers with surface arginine groups have shown intrinsic anti-angiogenic activity in previous reports including from our laboratory. Particularly PLL dendrimers have been investigated thoroughly for anti-angiogenic activity and showed reduced vascularization, significant reduction in apoptosis/necrosis of tumor tissue and moderate regression effect on tumor growth equivalent to commercially available antiangiogenic agent, Avastin (anti-VEGF antibody bevacizumab) without significant toxic effect on non-cancerous tissues. In this presentation I will enlighten the progress made in design of anti-angiogenic dendrimers, dendrimers as nano-carrier for delivery of anticancer drugs and future possibilities to improve treatment strategies for cancer via two pronged attack on cancer with anti-angiogenic dendrimers and chemotherapeutic agents including reports from our laboratory and other laboratories as well.
Carl Johan Jakobsen
Aarhus University Hospital, Denmark
Title: Risk prediction and management in cardiac surgery
Biography:
Vice-president 2001-2004, President 2004-2007, Past president 2007-2010 of European Association of Cardiothoracic Anaesthesiologist. Honorary memberships of Association Latinoamericana de Anestesiólogos Cardiotorácicos 2005 and European Association of Cardiothoracic Anaesthesiologists 2015. Heart Group of National board of Health (1997-2011); Danish Heart Registry (1997-2011); Advisor to the National Health Insurance system (2007-2012); Speciality advisor in Anaesthesiology to the National board of Health (2012-till ).More than 150 publications mostly in international journals. Co-author of more than 75 free presentations. Received several prizes. Author of book chapters: Anaesthesia and monitoring in cardiothoracic surgery. Anaesthesia for the cardiac patient in non cardiac surgery.
Abstract:
The short time outcomes from cardiac surgery has changed dramatically during the last decades. Despite an increasing elderly population and more complex surgery the 30-day mortality has in many institutions been halved the last 10 years, but the one-year mortality remains. Risk prediction systems like the EuroSCORE is a valuable tool in control of the quality of cardiac surgery, but the validity of the risk score for the individual patient may be questioned. Further most scoring systems only take the patients preoperative state and the intended surgery into consideration, and hardly handle the procedure and perioperative complicating factors. Thus we have very poor tools to predict the longer term mortality. The presentation is based on cohort studies of more than 25.000 patients handling and evaluating different factors in an attempt to isolate factors with independent impact on postoperative complications and survival. The studies demonstrate that both co-morbidity and age has great impact on 30-day mortality. In longer time outcomes the impact of co-morbidity seems less, while the impact of age increases together with perioperative intervention I.e. use of inotropes and vasoconstrictors, use of haemostatic drugs and blood transfusion. Except that age in elderly people has an important role in survival the unequal developments in short and longer term mortality are not readily explained.
- Work Shop
Location: 11:35-12:35
Session Introduction
Allison Wiseman
School of Health Sciences- University of Surrey, UK
Title: Peer assessed medicines management OSCE for student nurses, a strategy to enhance safe medicines management practice
Time : 11:35-12:35
Biography:
Allison Wiseman is a qualified Nurse with 20 years of experience in Intensive Care and was awarded a Doctorate of Clinical Practice in 2015. She has worked in Higher Education for the last 16 years firstly as a Lecturer, Practitioner and now as a Senior Teaching Fellow at the University of Surrey, UK. She is the Director of Studies for BSc & MSc professional practice and Lead for Recognition of Prior and Certificated Learning. Her area of expertise is Interdisciplinary Simulation in Healthcare to promote safe practice. She has presented her work on simulation internationally and has published in peer reviewed journals.
Abstract:
Safe medicines management is a priority nationally and internationally. Professional and regulatory bodies such as the Nursing & Midwifery Council (NMC) mandate safe medicines management for pre-registration students and registrants. Evidence highlights medicines management adverse events continue to raise despite quality assurance initiatives such as medicines management competency assessments of registrants and students. Similarly student nurses are involved in medicines management and adverse events under the supervision of their mentors. Educators have dual responsibility with placement providers to deliver safe and efficacious learning experiences. The PAMMO was designed to develop student nurse’s medicines management skills and knowledge, including error identification, problem solving, decision making, assessment and feedback in a safe and supported learning environment. Phase 1- evaluated the inter-rater reliability of student nurses PAMMO criterion referenced and global scores of safety. Phase 2- identified what informs student’s global scores of safety design and a mixed method exploratory sequential study which evaluates Peer Assessed Medicines Management Objective (PAMMO), as a structured clinical examination for student nurses. Results revealed that phase 1- criterion assessing five rights of medicines management demonstrates the exact agreement (Cohen’s kappa 1.0), global scores demonstrated poor reliability (Cohen’s kappa 0.02) and phase 2- students judgment making fell within two theoretical frameworks in which firstly, social constructivism where assessments were based upon their learning on theoretical and practical basis and views on safe care and secondly, the cognitive continuum- nine modes (Standing, 2010) based on five modes of judgment making. Finally it was concluded that PAMMO may offer educators a cost effective and efficacious way to develop students’ safe medicines practice.
- WorkShop
Session Introduction
Amber McCall
Augusta University, Georgia
Title: Nursing’s next generation: Innovative nursing education for Millennials and Generation Z
Time : 13:45-14:45
Biography:
Amber McCall is an Assistant Professor at Augusta University’s College of Nursing. She earned her BSN from the Medical College of Georgia, PhD from Georgia Health Sciences University, and FNP certification from Georgia Regents University. Prior to academics, she worked in the intensive care/medical-surgical units and hospice/palliative care. She currently teaches in AU’s Clinical Nurse Leader Program and Nurse Practitioner Programs. She has experience in clinical, simulation, lab, and lecture. She uses innovative teaching strategies for student engagement, including new-edge technology and interactive lectures. She was recipient of the 2014 AACN Novice Faculty Excellence Didactic Teaching Award.
Abstract:
An anticipated world-wide nursing shortage has been well-documented. Nursing educators report multiple generational differences among current students and seasoned faculty. This trend will likely continue to unfold as digital natives, fully equipped with mobile learning wants and needs, and seek to become nurses. Thus, updated and innovative teaching methods are needed in nursing education with efforts to engage Millennial and Generation Z nursing students. The objectives of this presentation/workshop is to discuss the mindset needed for innovative teaching success, for views that are easy-to-duplicate examples of innovative teaching methods used in simulation environments, skills lab, clinical (or hands-on learning), lecture/didactic content delivery, online courses, and for research/practice and to provide templates and facilitate processes to help attendees to brainstorm and create their own innovative teaching resources.
- Healthcare Case Studies
Session Introduction
Thiwawan Thepha
University of Aberdeen, UK
Title: The facilitators and barriers to exclusive breastfeeding in Northeast of Thailand
Time : 12:35-13:00
Biography:
Thiwawan Thepha is a PhD candidate of University od Aberdeen, School of Medicine and Dentistry. She is a Lecturer at Department of Midwifery, Khon Kaen University Thailand. She is running project about exclusive breastfeeding for six months in Northeast Thailand. She has an experience of more than 10 years about midwifery and breastfeeding and would like to share and exchange her experience in order to develop exclusive breastfeeding situation, especially in Thailand.
Abstract:
The six month exclusive breastfeeding (EBF) rate in the Northeast of Thailand has significantly decreased while in other regions of Thailand it has not. It is unknown what the cause of this decrease was or what could improve the situation. The aim of this study was to identify perceived barriers and facilitators to six month EBF in Northeast Thailand of the main stakeholders, namely breastfeeding mothers. Six focus group discussions comprising of 30 participants were conducted. The eligibility criteria for participants in the focus groups was Northeastern-Thai mothers aged 20 to 40 years with children aged between four and six months and currently breastfeeding their children. The participants were recruited through self-selection sampling from Khon Kaen Hospital, Num-phong Hospital and private hospitals in Khon Kaen, Thailand. Thematic analysis was employed to analyse the data. Three themes were identified: knowledge and belief, environment, and support. Most mothers mentioned that knowledge about the advantages of breast milk and how to produce breastmilk were facilitators to six month EBF. Relating to the support theme, the use of social media emerged as a facilitator of six month EBF. The identified facilitators and barriers can inform the development of relevant intervention(s) to improve the six month EBF rate in the Northeast of Thailand, as well as in other countries.
Jessica Covino
Bond University, Australia
Title: Analysis of paediatric bone growth in children from isolated populations
Time : 14:45-15:10
Biography:
Jessica Covino has recently completed her graduation and currently, she is a research student at Bond University. She has interest in the analysis of female growth parameters, and in particular, bones development and formation.
Abstract:
This study aims to identify variations in growth parameters in the metacarpal (MTC) bones of young females living in Papua New Guinea (PNG) and Australia. X-Rays of the left hands were taken annually over five years from juveniles living in three regional areas of PNG, and Australia. There was a significant difference in growth between females living in coastal regions compared to the highlands in PNG, with coastal females being taller and heavier. The length, cortical thickness, width and diaphysis lengths were larger in coastal residents for the second and third MTCs. There were fewer differences between coastal females and Brisbane females. All comparative measurements were different between highlands and Brisbane populations. In regards to longitudinal growth, annual increases in female stature between 8-17 years old and anthropometrical measurements were apparent in height (4.19±1.72) and weight (3.95±2.21). The second MTC also increased in length (0.24±0.16), width (0.04±0.03) and diaphysis length (0.25±0.15), while the third MTC increased in length (0.23±0.14), width (0.04±0.04) and diaphysis length (0.21±0.14). There were associations between anthropometric measurements and development of MTCs. Correlations were observed (n=53) between stature, and the second (r=0.96, P<0.01) and third (r=0.829, P<0.01) MTC length. In addition, there was significant elongation associated with height in both the second MTC (r=0.829, P<0.01) and third MTC (r=0.784, P<0.01). A female juvenile’s height can be determined through metacarpal length, width and diaphyseal length, with an appropriate degree of accuracy. The metacarpals demonstrated consistent growth throughout development and can be used as a measure to determine stature, although regional differences in growth need to be taken into consideration.
Ramesh Kumar
Chulalongkorn University, Thailand
Title: Impact of medical waste management trainings intervention for improved behaviors of hospital workers in Pakistan
Time : 15:10-15:35
Biography:
Ramesh Kumar is a public health professional with sound expertise in Health Systems Dynamics especially health systems governance and policy planning concerning hospital management, infection control, environmental and occupational health, human resources in health, RH, health policy, hospital management, administration, strategic planning, financing, reforms and capacity building. He demonstrated an exceptional understanding of different public health facets such as hospital management, human resources for health, maternal & child health, reproductive health, social marketing of health, social determinants of health, and health systems analysis. He is carrying a diverse experience of research, advocacy and service in public health and been involved in qualitative as well as quantitative analysis and research works. He has worked in various projects on health systems, HRH, environmental health, RH, quality of care, health education, promotion and communication for international and national public health and social development organizations. He has worked as Consultant (team leader) with World Health Organization, UN Organizations, GHWA, USAID and WHO/EMRO. His flagship work on hospital infection control, hospital waste management and human resource for health has become a cutting edge in the field. His research work is extensively disseminated through more than 50 peer reviewed publications in both national and international indexed journals. He has vast teaching and research supervision experience for undergraduate and postgraduate public health, health policy and management graduates.
Abstract:
Objective: The aim of this study was to evaluate the sustainability and effectiveness of training as an intervention to improve the knowledge, attitude and practices of hospital workers on health care waste management. Method: We conducted this quasi-experimental study in two tertiary care teaching hospitals in Rawalpindi in October 2013. Training, practical demonstrations and reminders on standard waste management were given to 138 hospital workers in one hospital and compared with 137 workers from the control hospital. We collected data 18 months after intervention through a structured questionnaire to assess the impact of the intervention. We used paired t-test to compare the scores on knowledge, attitude and practices at baseline and first follow up and final impact assessment. Chi square test was used to compare group variables between intervention and control groups. Results: After 18 months since intervention the mean scores on knowledge attitude and practices differed statistically significantly since baseline and intervention group had statistically significantly better knowledge positive attitudes and good health care waste management practices (p<0.001). Health care and sanitary workers in intervention group scored statistically significantly higher (p<0.001). Conclusion: Trainings of health and sanitary workers on health care waste management guidelines were sustainable among the intervention group after 18 months which shows the positive impact of our intervention. It is recommended that the trainings as intervention be included in the overall policies of the public and private sector hospitals in Pakistan and other similar settings.
Soumya Guha
Safdarjung Hospital, India
Title: A unique case of right cervical aortic arch with anomalous left common carotid artery and absent right common carotid artery
Time : 15:35-16:00
Biography:
Soumya Guha is working as a General Surgeon at Safdarjung Hospital and Sr - Rml Hospital. He is currently pursuing a super speciality residency program in Cardiothoracic Vascular Surgery. He has published many articles on his research in national and international journals.
Abstract:
Introduction: Cervical aortic arch is a rare anomaly where-in the ascending aorta arises normally from the left ventricle and extends in such a fashion that the aortic arch is situated high in the neck on either side. This anomaly should be suspected in any child exhibiting a pulsatile swelling in the neck. Case commentary: An 8 year old child presented with a pulsatile swelling on right side of neck since birth. CT angiography revealed right sided cervical aortic arch at C4-C5 level. The left common carotid artery arose from ascending aorta at D4 with the right external and internal carotid arteries originating separately from cervical arch. The right and left sub-clavian arteries arose from descending aorta at D1 and D4 respectively. Discussion: Although most patients with cervical aortic arch are asymptomatic, some have dysphagia from oesophageal compression and respiratory distress from tracheal compression. There are many anatomical variations in cervical aortic arch. What makes this case unique is that apart from the presence of right cervical aortic arch, 2 additional oddities in the form of abnormal origin of the left common carotid artery from ascending aorta and absence of right common carotid artery are noted. Conclusion: To our knowledge, this is the first report of right cervical aortic arch with this unique anatomy where there is an anomalous left common carotid artery and absent right common carotid artery.
Reza Chaman
Yasuj University of Medical Sciences, Iran
Title: Breast cancer trend in Iran from 2000 to 2009 and prediction till 2020 using a trend analysis method
Time : 16:00-16:25
Biography:
Reza Chaman is the Head of Community Medicine Department at Yasuj University of Medical Sciences. He has 12 years of Teaching Experiences in Universities. He has published/Translated more than 10 books. He has published more than 70 research papers and presented his research in 36 national and international conferences. He is a part of 57 investigations and Research Projects as Investigator or Cooperator.
Abstract:
Background: Breast cancer is the most common cancer in women worldwide with a rising incidence rate in most countries. Considering the increase in life expectancy and change in lifestyle of Iranian women, this study investigated the age-adjusted trend of breast cancer incidence during 2000-2009 and predicted its incidence to 2020. Materials & Methods: The 1997 and 2006 census results were used for the projection of female population by age through the cohort-component method over the studied years. Data from the Iranian cancer registration system were used to calculate the annual incidence rate of breast cancer. The age-adjusted incidence rate was then calculated using the WHO standard population distribution. The five-year-age-specific incidence rates were also obtained for each year and future incidence was determined using the trend analysis method. Annual percentage change (APC) was calculated through the joinpoint regression method. Results: The bias adjusted incidence rate of breast cancer increased from 16.7 per 100,000 women in 2000 to 33.6 per 100,000 women in 2009. The incidence of breast cancer had a growing trend in almost all age groups above 30 years over the studied years. In this period, the age groups of 45-65 years had the highest incidence. Investigation into the joinpoint curve showed that the curve had a steep slope with an APC of 23.4% before the first joinpoint, but became milder after this. From 2005 to 2009, the APC was calculated as 2.7%, through which the incidence of breast cancer in 2020 was predicted as 63.0 per 100,000 women. Conclusions: The age-adjusted incidence rate of breast cancer continues to increase in Iranian women. It is predicted that this trend will continue until 2020. Therefore, it seems necessary to prioritize the prevention, control and care for breast cancer in Iran.
Aslinna Bte Abdul Jabbar
KK Women’s & Children’s hospital, Singapore
Title: An exploratory survey on current hospitalisation experiences and future ideas on an adolescent (teenage) only ward
Biography:
Aslinna bte Abdul Jabbar is a nurse with 30 years’ experience working in KK Women’s & Children’s hospital. She is a Nurse Clinician, qualified midwife with BHSc (Nursing) and MHSc (Education). She joined Adolescent Medicine Service in 2008 and won merit award for her poster on ‘Role of Resource Nurse in Adolescent Sexual Health’ in KKH annual Scientific Meeting in Singapore Y2011. She received second prize for her oral presentation on ‘HPV Education & its Effect on Knowledge & Potential Vaccination Uptake among Teenagers in Singapore’ in Alexandra Health Forum in conjunction with AH Nursing Fest 2014.
Abstract:
The medical opinions for adolescent during his or her hospital stay by healthcare professionals differ each day. It does not contribute to the consistency of treatment required for this specific group of patients. Adolescents have developmental characteristics and health care desideratum that are quite distinct from those of children and adults. They are unique both in the nature of their problems and as reluctant consumers of traditional health services. Providing developmentally appropriate health care to adolescents presents a number of challenges. Not only must health care providers be professionally skilled and knowledgeable, but they must also be sensitive to how threatening and confusing health care systems can appear to vulnerable adolescents. It is not possible to effectively plan, implement or evaluate programme of care for adolescents without consulting the experts – adolescents themselves! Aims A Singapore children hospital is conducting a needs assessment and patients’ experiences survey to find out: (1) health care service for adolescents and (2) in relation to the current children wards, adolescents’ experiences of environment. Methods A descriptive research with a cross sectional sample size of 200 will be used. All inpatient adolescents between 12 and 16 years of age, during a one-year period will be enrolled in this research. A self-administered questionnaire will be used. Conclusion Descriptive data analysis will be conducted. The results of the survey, which would be used to improve the quality of some of services offered to adolescents and their families, will be presented.
Ibrahim Awad Eljack
Al-Baha University,Saudi Arabia
Title: The prevalence of Hymenolepis nana among preschool children of displacement communities in Khartoum state, Sudan: 
A cross-sectional study
Biography:
Ibrahim Awad Eljack Ibrahim is Assistant professor of Family and Community Medicine Al-Baha University Faculty of Medicine, Saudi Arabia. He was the Director of Department of Organizations and Voluntary Agencies, Khartoum State Ministry of Health, Sudan during 2012- August 2013. He was also the Director of Planning Department and Deputy Director of Primary Health Care General Directorate, Khartoum State Ministry of Health, Sudan , Responsible for Planning, Quality management, Researches, Training and Monitoring and Evaluation activities for the Primary Health Care in Khartoum State, Ministry of Health, 2008-2012.
Abstract:
Summary Background: Hymenolepis nana is among the most common intestinal parasitic infections causing a public health threat in poor communities in Sub-Saharan Africa. The present study was conducted to determine the prevalence of H. nana infections and associated risk factors among preschool children of displacement communities in Khartoum state, Sudan. Methods: A cross-sectional survey was conducted in May 2013 in displacement camps, Khartoum state, Sudan. A simple random sample of preschool children from the displacement camps, aged between 1 and 5 years, were included. Information was collected by presenting a questionnaire and taking 500 fresh stool specimens, which were examined microscopically for the presence of eggs, using direct saline and formal-ether concentration techniques. Results: The prevalence of H. nana was determined to be 32.6% (163/500), 95% CI (28.5% e36.9%). Infections of H. nana were more prevalent among males than females, and this association was statistically significant (P < 0.001, OR Z 2.125, 95% CI Z 1.452e3.108). H. nana infections were significantly prevalent among the older age group (2.6e5.0 years) (P < 0.001, OR Z 2.909, 95% CI Z 1.914e4.420). Approximately 76.7% of infected preschool children had diarrhea and it was significantly associated with H. nana infection (P < 0.001, OR Z 9.45, 95% CI Z 6.10e14.64). None of the preschool children had access to a clean water supply. No significant association was found between use of latrines and infections of H. nana (P Z 0.56, OR Z 0.880, 95% CI Z 0.73e1.763). Conclusions: There was a high prevalence rate of H. nana infection among preschool children of displacement camps in Khartoum state, Sudan. Being male, aged between 2.6 and 5.0 years, and having diarrhea were identified as important risk factors for H. nana infection. Measures including health education, environmental hygiene, water supply and treatment should be taken into account to reduce the high prevalence of H. nana.
Atif Malik
M.D. American Spine, USA
Title: Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Retrospective Study
Biography:
Atif Malik, M.D., grew up in Houston, Texas, where he obtained his Bachelor of Science degree at the Houston Baptist University. Graduating with Cum Laude honors in Fine Arts, Biology and Chemistry, Dr. Malik went on to finish his Medical Degree from St. George’s University School of Medicine. Dr. Malik completed his residency training in Physical Medicine and Rehabilitation at Baylor College of Medicine where he was then chosen to serve as Chief Resident. He then went on to sub-specialize by completing an Interventional Pain Fellowship from Harvard Medical School at Beth Israel Deaconess Medical Center in Boston. He further trained in percutaneous and endoscopic spine surgery under world renowned spine surgeon, Dr. Thomas Hoogland of the Alpha Klinic in Munich, Germany and fellowship trained in advanced spinal surgical technique developed by Wooridul Hospital in Soul, Korea. Dr. Malik has been one of the first physicians to educate and train endoscopic spine surgeons in the United States in a bloodless and minimally invasive technique to preserve normal disc tissue. As one of the of the original founders of Spine PulseTM treatments, Atif B. Malik, MD, has dedicated his practice to the advancement of minimally invasive spinal surgery and endoscopic spine surgery. Additionally, he has served as a spinal consultant to numerous companies related to minimally invasive spine products and has also been involved in the development of intradiscal transplantation of stem cells and platelet-rich plasma, laser thermodiscoplasty, percutaneous and endoscopic discectomy / foraminotomy, and the use of laser, radiofrequency and bipolar technology. He is an advocate of redefining the algorithm for the treatment of degenerative spinal disorders and the preservation of spinal segmental motion using minimally invasive techniques. Furthermore, he has authored peer-reviewed research journal articles, scientific abstracts, reviews, and book chapters in the field of pain and spine medicine.
Abstract:
Participants Adults with chronic (≥6 months), moderate-to-severe nascent lumbar discogenic pain that was unresponsive to conservative treatment including spinal injections. Methods Participants received 2 cc of intradiscal PRP using standard diskography technique. Data on pain, physical function, and participant satisfaction were collected at 2 week, 3 months, 6 months, and 1 year. Main Outcome Measures Oswestry Disability Index (ODI), , and Visual Analague Scale (VAS) for pain were used. Results Data were analyzed from 18 patients (11 men, 7 women; mean age 38.2 years-old) who had completed 1 year follow-up. No patient showed adverse events, significant increase in pain for more than 2 weeks or new MRI changes. For patients who received autograft with PRP, the mean VAS improved by 4.9 points (p < 0.01), and mean ODI improved by 29 points (p < 0.001). Conclusion Participants who received intradiscal PRP showed significant improvements in VAS and ODI at 3, 6 and 12 months post injection. Although these results are promising, further studies are needed to define the subset of participants most likely to respond to biologic intradiscal treatment based on anatomic classification system.
- Poster Presentations
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 has completed his graduation in Medical studies and earned Degree of Doctor of Medicine from Latin America School of Medicine (ELAM), Cuba in 2009. He has recently completed his Master’s in the field of Community Medicine from University of Gezira. He is currently pursuing his PhD studies in the field of Community Medicine at the University of Gezira, Sudan. As a young Junior Doctor, he is always interested in research and publications. He has published three original articles in Gezira Journal of Health Sciences as lead author and presented an article in the Gezira first International Family & Community Medicine conference, under the theme “Partnership and integration towards comprehensive health care for families and communities”, Wad-Medani city, Sudan. In addition to that, he has also co-authored an article in Journal of Eritrean Medical Association. He is so much interested in medical researches focusing mainly on NCDs.
Abstract:
The burden of Non-Communicable Diseases (NCDs) 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 and prevalence of risk factors for NCDs. 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 and blood pressure apparatus. A total of 380 individuals of age 30 years and above were selected for the study by stratified proportional random sampling technique. Data was analyzed using Statistical Package for the Social Sciences (SPSS) for Windows version (16.0). The distributions of the various categories of risk factors were identified in which the prevalence of smoking for males and females were (18.4%) and (0.3%) respectively, alcohol consumption (3.9%) only among males, consumption of fruits and vegetables below adequate level (72.9%) and physical inactivity (75.0%). This study showed cigarette/tobacco use and 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 and educational level (p-value of 0.003 & 0.011) respectively. Mean systolic and diastolic blood pressures were 135.5 mmHg and 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 and (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 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 NCDs is considerably high in the study population.
Eric Boateng
International University of Japan, Japan
Title: Impact of NHIS free maternal healthcare policy on utilization of maternal care services in Ghana
Biography:
Eric Boateng, is a student (Japan Development Scholarship Fellow on Health Policy) pursuing Master’s in International Development Programme at the Graduate School of International Relations, International University of Japan. The above abstract is from proposal on a research he intend to conduct in fulfilment for the award of Master’s Degree at the International University of Japan.
Abstract:
The National Health Insurance Scheme (NHIS) free maternal healthcare programme was introduced in July 2008 to help Ghana meet Millennium Development Goals (MDG) 4 and 5 which are to reduce child mortality and improve maternal health. Under the NHIS programme pregnant women are to receive free full package access to antenatal, prenatal and postnatal care. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and child birth by three-quarter between 1990 and 2015. In the period 2007-2012 Ghana had reported maternal mortality ratio of 450 deaths per 100,000 live births (this figure was estimated at 350 deaths per 100,000 by UN agencies/World Bank in 2010). The Government of Ghana declared maternal mortality a national emergency in 2008, developing the MDG Acceleration Framework with the aim of improving maternal health and giving it the level of urgency required. It is in line with this that the government of Ghana through NHIS introduced the free maternal healthcare programme in July 2008 to give all pregnant mothers free full package access to antenatal, prenatal and postnatal care. This study thus seeks to assess the impact of NHIS free maternal healthcare policy on utilization of maternal care services in Ghana after six years of implementation of the policy. The study is intended to improve policy formulation and assist the NHIA to evaluate the impact of the free maternal healthcare policy based on utilization of maternal care services as a measurement of success (or failure) in improving maternal health in Ghana.
Ibrahim A Eljack
Al-Baha University, Saudi Arabia
Title: The prevalence of Hymenolepis nana among preschool children of displacement communities in Khartoum state, Sudan: A cross-sectional study
Biography:
Ibrahim A Eljack is Assistant Professor of Family and Community Medicine, Al-Baha University Faculty of Medicine, Saudi Arabia. He was the Director of Department of Organizations and Voluntary Agencies, Khartoum State Ministry of Health, Sudan during 2012- August 2013. He was also the Director of Planning Department and Deputy Director of Primary Health Care General Directorate, Khartoum State Ministry of Health, Sudan, responsible for planning, quality management, researches, training and monitoring and evaluation activities for the primary health care in Khartoum State, Ministry of Health, 2008-2012.
Abstract:
Background: Hymenolepis nana is among the most common intestinal parasitic infections causing a public health threat in poor communities in Sub-Saharan Africa. Aim: The present study was conducted to determine the prevalence of H. nana infections and associated risk factors among preschool children of displacement communities in Khartoum state, Sudan. Methods: A cross-sectional survey was conducted in May 2013 in displacement camps, Khartoum state, Sudan. A simple random sample of preschool children from the displacement camps, aged between 1 to 5 years, was included. Information was collected by presenting a questionnaire and taking 500 fresh stool specimens, which were examined microscopically for the presence of eggs, using direct saline and formol-ether concentration techniques. Results: The prevalence of H. nana was determined to be 32.6% (163/500), 95% CI (28.5% e36.9%). Infections of H. nana were more prevalent among males than females, and this association was statistically significant (P<0.001, OR Z 2.125, 95% CI Z 1.452e3.108). H. nana infections were significantly prevalent among the older age group (2.6e5.0 years) (P<0.001, OR Z 2.909, 95% CI Z 1.914e4.420). Approximately 76.7% of infected preschool children had diarrhea and it was significantly associated with H. nana infection (P<0.001, OR Z 9.45, 95% CI Z 6.10e14.64). None of the preschool children had access to a clean water supply. No significant association was found between use of latrines and infections of H. nana (P Z 0.56, OR Z 0.880, 95% CI Z 0.73e1.763). Conclusions: There was a high prevalence rate of H. nana infection among preschool children of displacement camps in Khartoum state, Sudan. Being male, aged between 2.6 and 5.0 years, and having diarrhea were identified as important risk factors for H. nana infection. Measures including health education, environmental hygiene, water supply and treatment should be taken into account to reduce the high prevalence of H. nana.
Jeong-Soo Kim
Pukyong National University, Korea
Title: Socialization experiences of Korean physically disabled adults in public welfare program
Biography:
Jeong-Soo Kim has completed his PhD from Ewha Womans University (2011) in Seoul. She is currently working as an Associate Professor at Pukyong National University in Busan, Korea.
Abstract:
This study was to describe and understand the experiences of the physically disabled adult attending in public welfare program. The interview data were collected from 9 persons and analyzed by using descriptive phenomenology of Colaizzi. The procedural steps described the phenomenon of interest, collected participants' descriptions of the phenomenon, extracted the meaning of significant statements, organized the meanings into the clusters, wrote exhaustive descriptions and then incorporated data into an exhaustive description. The finding in 129 re-statements, 63 constructed meanings, 41 themes, 15 theme clusters, and 6 categories were deduced. The 6 categories were ‘life patterns exclusive health’, ‘powerlessness in physical disability’, ‘living with acquaintances helps’, ‘motivated positively’, ‘seeking to be holistic health’, and ‘sense of accomplishment’. The study identified that social welfare program for the disabled need necessities for health learning and economy for their future in success. Therefore, we suggest that there may be a need for supplying professional program for their health and welfare.
Maitali Ganesan
General Hospital, Singapore
Title: Nurses’ perceptions in providing patient education for patients with chronic kidney disease in Singapore: A descriptive qualitative study
Biography:
Maitali G has 10 years of experience working in one of Singapore's highly regarded medical institutions, The Singapore General Hospital. On the third year of her tenure as a Nurse she was offered by Ngee Ann Polytechnic, Singapore to pursue her Diploma in Health Sciences, where she graduated and attained Diploma with merit which is awarded by the educational institution only to those with outstanding academic performance. She was also in the Director's list consecutively for three years from 2008 to 2010 for five semesters. She was recognized by SINDA for her outstanding performance in attaining Diploma in Health Science (Nursing) and was awarded the prestigious SINDA Excellence Award.
Abstract:
Background: Nurses play an important role in implementing medical and nursing educational interventions for Chronic Kidney Disease (CKD) patients as to reduce or prevent complications of the disease. With increasing number of CKD patients both locally and globally, it contributes to increased healthcare utilizations. Even though current literature suggested that appropriate nursing management and patient education are required to meet specific demands of patients with CKD; limitations of evidence and literature had demonstrated on the aspects of nurses’ challenges with regards to the process delivering patient education. Aims: The aim of the study is to explore and understand nurse’s perceptions in respect to patient education for CKD in Singapore. The research questions were directed towards understanding of patient education process, identifying barriers and facilitators of patient education and both nurses and patient’s perceptions of patient education. Methods: A qualitative descriptive design using semi-structured face to face interview was conducted to gather contextual data. Sample sizes of 20 registered nurses working in a renal ward setting at one of tertiary hospitals in Singapore were recruited until saturation is reached. The participants were selected using purposive sampling technique and were based on inclusion and exclusion criteria. The interview process lasted for 20 to 60 minutes and was audio-taped. Audio-taped interviews were transcribed in English. Thematic analysis was employed. Results: Nurses have a key role in implementing medical educational interventions for Chronic Kidney Disease (CKD) patients while employing effective management strategies to reduce or prevent complications of the disease. The main central concerns were knowledge level, self confidence level, and time availability with their patients. Conclusions: These results enable healthcare professionals to understand the significance to maintain and improve patient education and management for patients who are clinically diagnosed with CKD. In addition, it would also provide an understanding of expectations, clinical expertise, challenges, difficulties and scope of practice of renal ward nurse. As limited evidence from current literature was noted on the essential components of patient education, this study would give an opportunity to identify the core teachings that should be implemented. It could also be a good basis for policy-making in hospitals. It could be a guide for future studies such as education for other chronic conditions or educational program interventions.
Shu Ting Yen
National Cheng Kung University Hospital, Taiwan
Title: Correlation of Injury Severity Score and Average Length of Stay
Biography:
Shu Ting Yen has completed her Master’s degree from I-Shou University. She is now the registry staff of trauma team in National Cheng Kung University Hospital and published trauma related manuscripts during the past 4 years.
Abstract:
Objective: The purpose of this study was to determine trauma patient length of stay (LOS) and the association between LOS and trauma patient demographic and clinical characteristics. Methods: This was a retrospective study. We ascertained the differences and correlations between gender, age, injury severity score (ISS), surgical status, and intensive care unit (ICU) stay and LOS among trauma patients admitted to a Tainan medical center in 2013. Results: The ISS was significantly correlated with ICU stay and LOS. The ICU stay and LOS in patients with extremely severe trauma (ISS≧25) who underwent surgery were significantly longer than any other group. In addition, the ICU stay and LOS increased by 0.496 and 0.656 days per incremental increase in ISS. The ICU stay and LOS of patients who underwent surgery were 3.432 and 3.12 days longer than patients who did not have surgery. Conclusions: The ISS in trauma patients who underwent surgery was a major predictor of ICU stay and LOS. The results of this study can serve as a reference for managing LOS of trauma patients in medical centers.