10^th Asia Pacific Global Summit on Healthcare March 12-14, 2018 Singapore

Mayumi Hashimoto has been actively involved as a Technical Advisor on Nursing and Midwifery Education System and legal framework for human resources for health in low-middle income countries

Background: The Ministry of Health of the Government of Laos established the Guidelines for the Scope of Nursing Practice in 2007, held national dissemination seminars frequently in 2008 and set up a committee to implement the guidelines in public central hospitals in 2013. Objective: To explore the effectiveness of the guidelines for the scope of nursing practice for nursing leaders that has been implemented at hospitals in Laos. Method: A qualitative, exploratory, descriptive research design was used. Data were collected through semi-structured interviews conducted with 13 clinical nursing leaders (five nursing directors, five members of nursing departments and three chief nurses) in 2016. Inductive data analysis was performed using a modified grounded theory approach. Findings: Five categories and 10 sub-categories were identified regarding the effectiveness of the guidelines for the scope of nursing practice. The analysis revealed that clinical nursing leaders faced difficulties in implementing the guidelines at hospitals because of a lack of nursing competency and inadequate understanding of the scope of nursing practice by medical doctors; however, they could cope with the situation flexibly. The implementation process cultivated the nurses’ awareness of the nursing profession as typified by their identity as a nurse, encouraged them to develop their professional way to work, such as by organizing training and meetings by themselves and helped them transform their relationships with medical doctors into professional partnerships. The nursing leaders also described their ideas of professional nursing in Laos. Conclusion: These findings suggest that the guidelines affected not only the scope of nursing practice at hospitals, but also the awareness of nursing leaders regarding the nursing profession and their relationships with medical doctors. Although some difficulties were seen among clinical nursing leaders in implementing the guidelines at hospitals, overall, the implementation process enhanced nursing practice in Laos.

Hyunsung Ban is currently an MS candidate in the Department of Clothing and Textiles at Yonsei University. Her research interests include application of emerging technologies to design and product development, functional apparel design for active ageing population and functional, expressive and aesthetic attributes of wearable technology

Recently, there has been a rapid increase in the aging population due to the increase in lifespan of humans resulting from the improvements in living standards and health care technology. Especially, the baby boomers, which currently comprise 15% of the Korean population, will become part of the ageing population in about 10 years and will exert strong influences in many areas of society as the new mainstream. This generation is greatly concerned about health care, especially to prepare for elderly age and their demands of efficient health management are constantly increasing. Owing to this current trend, there is a consistent increase in demand for smart sportswear for health management and improving exercise efficiency, among middle-aged people. Recently, body signal measuring sensors have been implemented in sportswear to measure the body signals of the wearer (muscle activity and heart rate) during exercise and give feedback to the wearer so that the exercise quality can be improved. These requirements and technology have led to the development of smartphone application connected sportswear, which have received considerable attention from middle-aged people. This research analyzes consumers’ needs and explores solutions for the design and product planning of smart fitness wear for middle-aged people that improves the efficiency of walking exercise based on their needs. For this purpose, this study examines the existing researches in literature related to wearable technology and the current development of smart wear technology and conducts in-depth interviews of 6 and survey of 150 middle-aged consumers who exercise by walking. Based on these positive data analyses, we have sign-posted design and product planning for smart sportswear in order to improve the efficiency of walking exercise performed by middle-aged people

Tang Phua Hwee is a Pediatric Radiologist with interest in neuroimaging. She has graduated from National University of Singapore and did her basic and advanced radiology training in various hospitals in Singapore. After obtaining her FRCR and Masters in Diagnostic Radiology, she spent 6 months in University of California, San Francisco learning the finer points of pediatric imaging, including pediatric neuroimaging and fetal imaging. She has also done a Mini-Fellowship in Neuroradiology at Cincinnati Children’s Hospital Medical Centre and a Visiting Fellowship at Athinoula A Martinos Center for Biomedical Imaging. She had also completed the Khoo Clinical Scholar’s Program and is currently conducting research on non-invasive methods of tissue assessment as well as optimizing MR imaging for children with her collaborators from ASTAR and Duke-NUS.

MRI scan frequently exceeds half an hour and young children have difficulty keeping still for such long periods. Images are non-diagnostic and marred by motion artifact when children or adults move during the scan. Vendors have created ultrafast sequences which propose to be able to scan the brain in a very short imaging time of 5 minutes compared to our standard MRI brain protocol which has an imaging time of 14 mins. In this prospective study, children scheduled for MRI brain underwent both the ultrafast MRI as well as standard MRI protocol. The presence of artifacts on each set of scans for the children were compared across the T1, T2, FLAIR, DWI and SWI sequences in both protocols and statistical significant differences were calculated using chi square test. Out of 30 children, who had MRI brain scan, 13 (43%) of the ultrafast scans were non-diagnostic due to artefact. For the rest of the 17 scans, the diagnoses made on ultrafast scans were similar to the diagnosis made on the standard MRI scans. Artifacts seen on the ultrafast T2 and FLAIR images were statistically significantly more than those present on standard MRI. Time taken to carry out 30 standard MRI brains is 30×14 mins=420 minutes. Time to carry out 30 ultrafast MRI brains is 30×5=150 minutes. Even after factoring time required to carry out supplementary standard brain MRI to supplement the 43% of ultrafast imaging with non-diagnostic MRI=150 minutes + (13×14 minutes)=332 minutes, ultrafast MRI provides time saving compared to standard protocol for all (which is 420 minutes). Ultrafast MRI is effective and saves time even with some scans having artifacts and requiring supplementation with standard MRI brain.

Pan Yen-Chu has graduated from Da-Yeh University, Taiwan in Master of Health Enterprise Management. Currently Pan Yen-Chu is working at St. Martin De Porres Hospital as a Chief Nursing Officer in Surgical Intensive Care Unit engaged in clinical management and teaching.

Background: Diabetes is a global, chronic disease that has been recognized as an important health issue in many countries. The prevalence rate of diabetes is very high in Taiwan that poses a serious threat to the health of people. Patients’ physical and psychosocial factors all have an impact on the treatment result. However, this issue has not been extensively discussed in previous research. Aim: The purpose of this study was to investigate the effects of socio-psychological factors on the care outcomes of type-2 diabetes. Method: The study is a descriptive and correlation design; used structured questionnaires collected data from a large regional teaching hospital located in southern Taiwan. Instruments included a basic information form, Social Support Scale, Chinese version of Perceived Diabetes Self-Management Scale, Chinese version of Patient Health and Depression Questionnaire, Perceived Stress Scale, and Health-related Quality of Life Scale. Data were coded and analyzed using SPSS 22.0 software for Windows. The analysis methods included descriptive statistics, independent-sample t-test, one-way ANOVA, Pearson product-moment correlation, multiple linear regression, and binary logistic regression. The sample consisted of 133 patients. In this sample, women constituted the majority; most patients are married, aged between 60~69, having elementary education as highest level of education, and economically independent. Majority patients were diagnosed of the disease over the last 5~10 years. Results: Results showed that among the diabetes patients, depression was significantly negatively related to social support (r=-0.27, p<0.05), psychological distress was significantly negatively related to social support (r=-0.21, p<0.05), psychological distress was significantly positively related to depression (r=0.85, p<0.01), quality of life was significantly negatively related to depression (r=-0.64, p<0.01) and psychological distress (r=-0.59, p<0.01). Conclusion: Continuous outcome variables were analyzed using regression analysis. Results indicated that depression and economic independence jointly explained 32.1% of variance in the physical aspect of quality of life (27.9% by depression and 4.2% by economic independence). Depression and psychological distress jointly explained 61.3% of variance in the psychological aspect of quality of life (59% by depression and 2.3% by psychological distress). Economic dependence on others explained 3.1% of variance in the number of hospital stays. Depression explained 3.7% of variance in the number of emergency department visits. Education level explained 4.3% of variance in the number of complications. Categorical outcome variables were analyzed using binary logistic regression. Results showed that education had a significant effect on average glucose level over the last year (p>0.03). Depression had a significant effect on both the last HbA1c level (p<.05) and average glucose level over the last year (p>0.03). Results of this study suggest that when providing clinical care to diabetes, nurses should also consider the effects of socio-psychological factors on the care outcomes and provide necessary counseling and treatment of depression to enhance the effectiveness of care.

Sung Ming Chi is currently working at St. Martin De Porres Hospital as a Chief Nursing Officer in Surgical Intensive Care Unit engaged in clinical management and teaching

in today's workplace, and individuals are required to meet or fulfill the responsibilities of work or family roles. However, the development and popularization of information technology, resulting in the work and family roles and time of the division of the increasingly blurred trend, although technology can create benefits, but also under pressure. Such as instant messaging and other technologies are all ubiquitous features, coupled with the network system, but also regardless of time and place to transmit messages. Purpose: This study examine the impact of work stress, job conflict and stress effects, and further explore the effect of communication with the instant messaging software using intelligent mobile devices to work with job stress and workplace conflicts. Method: This study is intended to pressure theory and work-family conflict model, coupled with the technical pressure to do the relevant factors. The data analysis method was used to model the structural equation modeling, and SPSS and Smart PLS were used as the main statistical analysis tools to verify the causal relationship between the variables in the research model. Results: (1)The work pressure will "positive correlation " affect the work-family conflict(r＝.609, p＜.001). (2)Technology invasion will "positive correlation" affect the work-family conflict(r＝.264, p＜.001). (3)Work-family conflict "negative correlation" affects job satisfaction(r＝ -.541, p＜.001). (4)Work-family conflict "negative correlation" affects family satisfaction(r＝-.440, p＜.001). (5)Work-family conflict will be "negative" affect the physical and mental health( p＜.001). Conclusion: With the development of information technology and network technologies, had to using instant messaging software such as mobile phones after get off work continued, which not change personal life, but also increases the load of work. Correct use of information technology to improve work efficiency, we should also plan after get of work standby mechanism and jobs. It is suggested that enterprises should review their information technology supportive policies to avoid overtime of work and affect the quality of life and the physical and mental health.

Alvin Atlas is presently a PhD candidate at the University of South Australia, School of Health Sciences under a scholarship grant from the Capital Markets Cooperative Research Centre (CMCRC) and the Australian Health Service Alliance (AHSA). His PhD research is about understanding the impact of health literacy on the use of elective surgery in private hospitals. Currently, he is affiliated with the International Centre for Allied Health Evidence as a Research Associate/Biostatistician

Aim: Patients require skills and supports to make considered decisions about their health care choices, risks and benefits and possible outcomes. The aim of this scoping review is to describe the range and nature of available research regarding sources of information that patients’ access to inform their decisions about elective surgery. Methodology: The search and reporting were conducted using the adapted framework by Arksey and O’Malley. Six scientific literature databases were searched: Medline, PubMed, CINAHL, Academic Search Premier, EMBASE and SCOPUS; focusing solely on elective surgery information sources oriented to patients. Web searches for grey literature were also conducted in Google, South Australia Department of Health, Commonwealth Department of Health and My Aged Care. Included literature was described by National Health and Medical Research Council hierarchy of evidence and data was extracted on country and year of publication, type of literature, who provided it and any information on end-users. Result: A pool of 1010 articles was reduced to 13 after screening for duplicates and non-relevant studies. Information sources were categorized by type and how information was presented. Face-to-face exchanges were the most likely source of information prior to elective surgery (46% studies), followed by e-learning (23%), printed information (23%) and multimedia (8%). The face-to-face category included information provided by physician/general practitioners/specialists and family and friends. Printed information included brochures and pamphlets, e-learning consisted of internet sites or videos and the use of multimedia included different mixed media format. Conclusion: The information patients used to inform their decision to undergo orthopedic elective surgery is highly variable. Face to face interaction with the medical personnel as the most common source of health information raises some possible issues on information that could be biased and dependent on what healthcare providers choose to share.

Chukwudebelu Victor is a Registered Nurse, obtained his Nursing Diploma and Practice License before he moved to Philippines for an academic advancement. He has published many books including research tittles

Immunization is a way of creating immunity to certain diseases by using small amount of a killed or weakened microorganism that causes the particular disease. Child immunization is designed to protect infants and children in the early life, when they are most vulnerable and before they are exposed to potentially life-threatening diseases. In order to improve immunization coverage, factors such as mothers’/caretakers’ practices are known to contribute to the success or failure of the immunization program. A qualitative phenomenological type of research design was employed in the study to determine mothers’ practices before, during and after immunization. The study was carried out in Carlatan, City of San Fernando, La Union. The researchers made use of an interview guide and a small group discussion as a method of accurate data collection tool on 15 participants. The participants were mothers who had children under 1 year old. The study showed that mothers engage in several practices before, during and after immunization such as observing daily routine, relaxation, massage and hot compresses. With regard to practices for their children, mothers’ practices include breast feeding, cooling, use of anti-pyretic and hot compresses. This helped the researchers to draw a conclusion that the participants have good immunization practices. The researchers recommend that mothers should continue to breastfeed their infants before, during and after immunization, mothers should use warm compress instead of hot or cold compress so as to avoid reducing the immunization potency and researchers should conduct further studies on the health benefits of these practices.

Kang Meng Feng has graduated from Institute of Information Management in Chung Cheng University, Chiayi, Taiwan in 2017 and received Bachelor of Science degree in Nursing from Chang Gung University of Science and Technology, Chiayi, Taiwan in 2008. Kang Meng Feng is currently working at St. Martin De Porres Hospital as a Chief Nursing Officer in Surgical Intensive Care Unit engaged in clinical management and teaching

The incidence of pressure ulcer is one of the essential indicators of clinical care. Even many scholars and experts have aimed to prevent the adverse event of pressure ulcer, but the high incidence of hospitalized pressure ulcer was unfortunately commonly found in clinical practices. Therefore, identifying the risk factors and implement preventive interventions of pressure ulcer to avoid wound, pain, surgical treatment, prolonged hospitalization, infection, mortality and health expenditure increasing become more critical. We found that the Braden scale, Norton scale, Gosnell scale and Waterlow scale were broadly used for risk evaluation of pressure ulcer. However, these scales were established by the criteria of various patients and applicability or usability of the caring system. In this study, we use three classifiers of data exploration technology includes decision tree, logistic regression, and random forest to create the prediction model for hospitalized patients with a pressure ulcer. A total of 11838 medical records of hospitalization were collected and analyzed in 30 sets of training samples, and following with a 10-fold cross-validation was conducted to verify the performance of these prediction models. The results revealed that the sensitivity of the decision tree, logistic regression, and random forest were 79.94%, 75.81% and 84.48%, respectively. It demonstrated that the random forest has better classification efficiency of constructing a predictive model. We also found that the predictive factors for impaired skin integrity, systolic pressure, poor expression. Basel scale and micro vascular filling time greater than 2 seconds are the most influential risk factors for pressure ulcers. This study provides the critical risk factors to caregivers for patient physical assessment to predict pressure ulcer incidence of hospitalized patients and to implement preventive actions in clinical practice. Overall, these findings enhance the improvement of the medical care quality and service

Bonnie McRae has interest in orthopedics, trauma and sports medicine. She is passionate about the improvement of healthcare through the implementation of virtual clinic models, patient self-care pathways for minor injuries and the use of audits to observe peaks in trauma presentations to hospitals in order to enable adequate resource allocation. She is also involved in the education of junior medical staffs and holds Academic title at Griffith University, University of Queensland and is an Orthopedic Group Tutor for the University of Edinburgh

Introduction & Aim: Supracondylar humeral fractures are the most common elbow injury occurring in the pediatric population, accounting for 55-80% of all elbow fractures and 3-18% of all pediatric fractures. They occur most commonly due to a fall from play equipment or furniture. This study aims to determine if any relationship exists between supracondylar humeral fractures and any temporal or injury characteristics. It was hypothesized that an increased incidence of supracondylar fractures would be observed in summer months and on weekends. Method: All patients <18 years of age with an isolated distal humerus supracondylar fracture between 2004 and 2014 were included in this study. Patient demographics and fracture characteristic data were collected. Hypothesis testing was performed to assess for any statistically significant relationship between fracture incidence and temporal or injury characteristics. Patients were then divided based on their management (conservative vs. operative) and hypothesis testing was performed to determine whether any difference existed between the management groups with regards to temporal and injury characteristics. Results: No statistically significant association was noted between fracture incidence and gender, laterality, or day/month/season of injury. Time of injury and presentation to the Emergency Department demonstrated significant results, with highest incidence in the afternoon hours (12:00-17:59). Conclusion: Unlike previous international studies, no significant difference was noted between day/month/season of injury and incidence of supracondylar fracture. This is thought to be likely due to the difference in climate between Australia and other countries.

Chridtian Adam L. Espiritu is fourth year medical student from the University of Northern Philippines College of Medicine coming from different undergraduate degrees but with a common interest in pursuing Public Health research. Chridtian Adam L. Espiritu by Dr. Leslie Asuncion a Cardiologist and mentored by Dr. Dalvie Casilang

International students are vulnerable group of students because of several factors including language and culture barriers. With their growing presence, local officials are getting more concerned if their basic needs are met in the community. This study aims to determine the health status of international medical students of the University of Northern Philippines (UNP) as a tool for authorities to develop programs that can provide support for their health needs. The study showed relatively poor physical health, with 57% of the students have Body Mass Index (BMI) which are under or above the normal values. The study shows a high incidence of hospitalization over the last year (13.7%). Thirty-one percent of the respondents reported to have at least 1 chronic, permanent or recurrent illness with eye problems such as impaired vision and myopia (4.8%), as the most reported. The depression level was measured using the Goldberg Depression Screening Test and showed that 52.9% may have depression; 17.8% possibly mild, 5.8% borderline, 12.9% mild to moderate, 10.1% moderate to severe, and 5.8% severe. Finally, the stress level measured using Cohen’s perceived stress test showed 31.7% have low stress level, 57.3% have moderate stress level and 10.4% have high perceived stress.