7th World Congress on Healthcare & Technologies September 26-27, 2016 London, UK

Biography:

Anna-Maria Saarela is a senior research lecturer, a facilitator of the Future Food RDI Hub Finland and FP7-project manager at Savonia University of Applied Sciences. Anna-Maria has competence in international projects, food product development, consumer behavior and multidimensional research approaches. She developed a method verbal analysis protocol combined with wireless audio-visual observation in real-life settings. Anna-Maria has over 16 years’ experience in educating, supervising thesis (> 50), carrying scientific projects with industry and academia. Anna-Maria is an active writer and has published several scientific peer-reviewed papers.

Abstract:

For the majority, health and nutritional issues are important food selection criteria. The aim was to study a real-life setting in collecting data and simultaneously to examine consumers purchasing behavior from the nutrition knowledge perspective when selecting food for weight management. The subjects were obtained by collecting 1000 questionnaires in November- December 2009 at the K-Citymarket Kolmisoppi, Kuopio. The subjects (n=36, age 18-65) were selected to represent consumers of varied experience in weight management. The shopping experiment of subjects was studied using verbal analysis protocol combined with wireless audio-visual observation, nutrition surveys and interviews in the K-Citymarket in April-May 2010. The subjects received the same shopping list twice. During the first round, they were asked to select a product they usually buy and during the second round, a product they would use for weight management. According to the verbalizations and quantified results obtained from nutrition knowledge survey, there was a wide variation of nutrition knowledge among consumers. Also the level of nutrition knowledge was related to a total energy reduction in products selected and in order of product’s selection time. Weight management oriented consumers were not a homogenous group. There were different sub-groups who appreciated and followed different food selection practices in a supermarket setting. Orientations for food selection from the weight management perspective varied whilst taste-, price- and knowledge-oriented perspectives dominated in food selection. Therefore, it is essential to understand and give support for different consumer segments for providing them more successful weight management outcomes in a long run.

Biography:

Marie-Christine Dubé completed her PhD in physiology and endocrinology from University Laval in 2006. Since then, she has been working in diabetes research at CHU de Québec-University Laval. She has published more than 20 papers in reputed journals.

Abstract:

We investigated the effect of 24 weeks of treatment with Liraglutide 1.8 mg combined with basal/bolus insulin regimen on fat distribution in overweight subjects with type 1 diabetes. In a double-blind, cross-over fashion, participants (n = 15) were assigned to insulin + placebo or insulin + Liraglutide for 24 weeks including a one-month titration period. Measures of fat distribution (waist and hip circumferences, skinfold thickness, percentage of body fatness, abdominal and mid-thigh computed tomography scans) were obtained in 15 overweight participants under the baseline, Liraglutide and placebo conditions. Paired t tests were used to compare the changes in metabolic and anthropometric parameters. With Liraglutide, all markers of fat distribution decreased clinically and significantly. BMI decreased since 30.5 ± 0.9 to 28.5 ± 1.0 kg/m2, waist and hip circumferences each decreased by about 3 cm. The sum of skinfold thickness decreased from 220 ± 45 to 176 ± 12 mm. Percentage of body fat went from 33.2 ± 1.6 to 31.3 ± 1.8% (all p < 0.05). Total and subcutaneous adipose tissue decreased significantly (p < 0.0005), decrease in visceral adipose tissue was of borderline significance (p = 0.057). With Liraglutide, changes in VAT from baseline were correlated with changes in insulin sensitivity. The addition of Liraglutide to basal/bolus insulin therapy for 24 weeks in overweight participants with type 1 diabetes significantly improved fat distribution and related metabolic parameters. Longer term studies evaluating clinical endpoints will be required to further document the role of GLP- 1 agonist therapy in type 1 diabetes.

Biography:

Gunnar Johansson is a Professor of Health Sciences at Halmstad University, Sweden. He defended his doctoral thesis on diet and cancer at the Karolinska Institute 1990.

Abstract:

There is substantial evidence that vegetarians have lower incidence of coronary heart disease, but there is a debate as to why this is the case. The objective of the study was to explore whether a shift from a mixed diet to a lacto-vegetarian diet would lead to a decrease in risk for coronary heart diseases indicated by surrogate markers. Twenty volunteers participated in the study (4 men and 16 women, mean age 44 years, range 27-61) from a town in western Sweden. Clinical examinations were performed, blood samples were drawn and dietary survey, i.e. repeated 24-h recalls were carried out before (0 months) and 3, 6 and 12 months after the shift from a mixed diet to a lacto-vegetarian diet. A dietician educated the volunteers with regard to the vegetarian diet regimen, organized and taught the vegetarian cooking courses. The dietary change leads to an increase in the intake of total carbohydrates and fibre and a decrease in fat, protein and sucrose. The coronary heart disease risk markers, body weight, body mass index, systolic and diastolic blood pressure, total cholesterol and low-density lipoprotein cholesterol decreased significantly. To conclude, there was a decrease in disease risk markers. The main finding in this study is that there was a weight loss, sustained for one year, without any recommendation to decrease the energy intake or any focus on weight reduction.

Biography:

After multiple researches specialized in Adolescentology and Midwifery, Kaori Watanabe studied Public Health at Akita University Graduate School of Medicine and Faculty of Medicine. Currently, She is conducting the study on Adolescent Behavior Theory (particularly, sexual behavior and awareness) and Social Capital (defined as “networks together with shared norms, values and understandings that facilitate co-operation within or among groups”) that has been rarely addressed before in the world.

Abstract:

We aimed to reveal the association between cognitive, social capital and sexual awareness among high school students in Ho Chi Minh City. We conducted a questionnaire-based survey and a cross sectional study in late 2014, with 2,051 eleventh graders in Ho Chi Minh City. We assessed basic attributes, sexual knowledge, sexual awareness, sexual experience of peers, cognitive social capital such as a sense of community belonging, and Rosenberg Self-Esteem score. After multiple logistic regression analyses on sexual awareness were performed assigning trivalent Rosenberg Self-Esteem score, sexual knowledge, and sexual experience of peers as independent variables (model 1), followed by analysis adjusted for cognitive social capital (model 2). Of all participants, 45.8% in males and 49.4% in femaless correctly answered on sexual knowledge, 47.6% of males and 28.3% of females accepted premarital sex, 60.0% of male and 65.0% of females knew peers with sexual experience, and 78.1% of males and 79.1% of females agreed with a sense of community belonging. When multiple logistic regression analyses performed, in model 1, sexual awareness was significantly associated with Rosenberg Self-Esteem score in female. In model 2, above association disappeared, but significant association was found between sexual awareness and cognitive social capital in both sexes. The Vietnamese conservative, traditional culture seems to be similar to the concept of cognitive, social capital and it is considered to have influenced sexual awareness of high school students in Ho Chi Minh City. Cognitive, social capital is significantly associated with sexual awareness among high school students in urban areas.

Biography:

Lephart has a Ph.D. in Physiology from the University of Texas Southwestern Medical Center, Dallas, Texas, USA. He is Professor of Physiology/Developmental Biology and Neuroscience in the College of Life Sciences at Brigham Young University, Provo, Utah, USA. His research interests include: Estrogen Production via Aromatase Cytochrome P450 and The Biochemistry and Endocrinology of 5-Reductase. His main research interests examine Polyphenolic Molecules as Anti-aging agents in Dermal, Neuro-Endocrine and Reproductive areas with over 100 peer-reviewed publications.

Abstract:

Polyphenolic molecules found in plants are utilized currently for improving prostate health. The botanicals with the highest recognized profiles are Resveratrol and the isoflavonoids. Prostate health is compromised with aging, especially beginning in the mid-40s, when testosterone levels decline and estrogenic hormonal actions increase along with enhanced expression of the prostatic 5α-reductase enzyme that result in prostate enlargement commonly known as benign prostatic hyperplasia (BPH). There is a linear increase in BPH incidence with increasing age in men over 60 years old. Approximately 1 in 5 men with BPH had a clinical event (prostatectomies), within 1 year of initiating treatment for BPH. The symptoms of BPH include nocturia, incomplete emptying, urinary hesitancy, weak stream, frequency and urgency that negatively impact the quality of life. Current pharmaceuticals are somewhat effective, but can have serious side effects. Interest in complementary and alternative medicines (CAM) for BPH has increased during the last two decades. CAM agents include polyphenolic compounds such as Resveratrol and the isoflavonoids. Resveratrol is effective in vitro, but, in vivo administration presents efficacious challenges. Genistein was first thought to be responsible for improved prostate health, however, since the equal hypothesis was proposed in the late1990s, there has been increased focus on this isoflavonoid molecule. This presentation will briefly review Resveratrol and some isoflavonoid molecules where clinical studies have shown improvement of BPH symptoms in men using standardized laboratory biomarkers and survey indexing parameters. Clearly there is an opportunity for an efficacious and cost-effective approach for the treatment of BPH with botanicals.

Biography:

Marta Sánchez Menán received her medical degree from the Universidad Autonoma of Madrid, where her specialist field of study was Public and Community Medicine. She later earned her Ph.D. in medicine (cum laude) from the same university, after which she began work at Hospital Universitario Gregorio Marañón, furthering her research pursuits. For the last 11 years she has worked as Medical Director in several hospitals belonging to the Quirónsalud Group. Sanchez Menan currently occupies the position of Medical Director at Hospital Universitario Infanta Elena, where her investigations are focused on different topics concerning health-care management.

Abstract:

Introduction: We have developed a new tool that allows communication between care professionals. This tool leverages new technologies to enable effective, rapid communication between primary-care doctors and hospital’s specialists.

Objectives: The objectives are to provide more agile and faster communication between health professionals, enabling on-line consultation. This new method of communication seeks to avoid unnecessary hospital referrals in some cases. The maximum response time established for the system is two working days. The information provided by both professionals is recorded in both EMR systems.

Material and Methods: An analysis of all e-consultations was carried out. Cases in which a question or other consultation was resolved and where it was recorded in the system that, barring other problems or systems, the patient did not require hospital referral, were considered to be instances in which specialist consultation had been avoided.

Conclusions: A total of 610 e-consultations have been carried out. The department that has received the highest number of consultations is radiology, with 230 (37.7%). The second highest number of e-consultations were seen in in geriatrics, at 97 (15.9%) consultations. The average response time was 2.07 calendar days. Specialist visits were avoided in 201 (32.95%) of all cases/e-consultations. In 30 (4.9%) cases this system has been shown to be a quick and agile means of communication between physicians. It improves the efficiency of our health-care system by reducing the number of patients referred to the hospital.

Biography:

Ahmed Mohamed Arif Kensarah has been Graduated from Cairo University, Egypt as a Medical Doctor. Later on he obtained his post-graduation from Royal College of Surgeons in Edinburgh with subjects F.R.C.S. Ed and then started working at King Abdul Aziz University, Department of Surgery, where he has continued his research. Presently he has been working at Al Mashfa Hospital in Jeddah.

Abstract:

Aim: The aim is to evaluate foot Charcot's neuroarthropathy in diabetics in at tertiary hospitals in Jeddah (KSA). The study is a retrospective one, completed at the Surgical Department of King Abdulaziz University Hospital from 2005 – 2015 inclusive (64 patients in 11 years, mean age 61.75 years with male/female ratio 4:1.). The study items were: patient demography, exact presenting symptoms, duration, type of diabetes present, presence of a history of trauma, deformity, ulcer, peripheral vascular disease, obesity, hypertension, and history of previous surgery. Decumented had also been the exact site of involvement (mid, hind or fore-foot) and any given treatment.

Results: Pain was reported in 25%, numbness 12.5%, deformity 23.4%, discharge 73.4%, and difficulty in walking in 12.5%.. Eleven percent of patients reported a history of trauma. Majority of patients (68.8 %) had their diabetes of the no-ninsulin dependent type lasting > 10 years. It was fully controlled in 21.9%.

Other Findings: Nephropathy 46.3%, neuropathy 59.4%, retinopathy 40.6%, cardiomyopathy 48.4% and vasculopathy in 56.3% of cases. Charcot arthropathy involved forefoot in 65.5%, midfoot 4.7% and hindfoot/ankle in 21.9% of cases. Insult present as proven by x-ray as: subluxation 40.6%, dislocation 54.7%, disorganization 42.2%, bone resorption 23.4%, osteomyelitis 14.1%, fractures 50%, and in 39.1%. Three quarters of patients required some sort of amputation, while debridement was sufficient for the rest.

Conclusions: Charcot joint in the feet of diabetics poses great challenge in management. Emphasis should be given for early detection and prompt treatment, to be tailored according to the lesion.

Biography:

Doblin Sandai obtained his PhD in Medical Sciences; Molecular Medical Mycology at the Institute of Medical Sciences, University of Aberdeen, Scotland, United Kingdom in 2011. He is a senior lecturer in Infectomics Cluster, Advanced Medical and Dental Universiti Sains Malaysia Bertam, Penang. He teaches the subjects such as Fungus Infection Related to Organ and Tissue Transplantation, Biological Insults on Cells; Mycology, and Host Defenses in Oral Cavity for postgraduate students in MSc (Mixed mode), Master of Medicine (Medical Specialization) and MSc (Dentistry) program. He is also supervising postgraduate full research PhD and MSc candidates in research related to the molecular pathogenicity of Candida albicans, diagnostic testing of natural products, enhancing the resistant strains of Candida species to the anti-fungal drug treatment. He has published more than 20 papers, book and book in a chapter in a variety of local and international journals.

Abstract:

Candida albicans is an opportunistic pathogen that causes candidiasis in humans. In recent years, metabolic pathways in C. albicans have been explored as potential antifungal targets to treat candidiasis. The glyoxylate cycle, which enables C. albicans to survive in nutrient-limited host niches and its Key enzymes (e.g., isocitrate lyase (ICL1), are particularly attractive antifungal targets for C. albicans. In this study, we used a new screening approach that better reflects the physiological environment that C. albicans cells experience during infection to identify potential inhibitors of ICL. Three compounds (caffeic acid (CAFF), rosmarinic acid (ROS), and apigenin (API)) were found to have antifungal activity against C. albicans when tested under glucose-depleted conditions. We further confirmed the inhibitory potential of these compounds against ICL using the ICL enzyme assay. Lastly, we assessed the bioavailability and toxicity of these compounds using Lipinski’s rule of-five and ADMET analysis.

Biography:

Andreas FETTE has been graduated from the University of Mainz, Germany as Medical Doctor in 1993. Later he specialized in Surgery and Pediatric Surgery after many years of training in several pediatric surgical training centers worldwide. In 2009 he obtained his professorship from the University of Pecs, Medical School, Hungary. He has a great interest in child safety and child protection issues. Presently he is working as a consultant pediatric surgeon in the Black Forest area.

Abstract:

The ongoing globalization and constantly increasing world wide mobility within the pediatric community in the past, in coincidence with the actual refugee crisis situation, are putting new demands on our pediatric surgical health care systems, worldwide. Why ? Because, they are forcing us pediatric surgeons not only to pay attention on our best medical and surgical performance, like in the past, quite contrary, they are forcing us to pay even more attention to "new"psycho-socio-medical aspects like finance, rehabilitation, socialization & integration, culture, management & logisitics, health education and language skills. Quite unpleasant, but nevertheless important "new'' aspects, we pediatric surgeons did not hear so much about during our training so far. But, such aspects nowadays do have a major impact on the medical-surgical course and recovery of our individual patient. Therefore, they might be considered as a "Post Traumatic Stress Disorder (PTSD)-like syndrome" in the near future and treated accordingly. Then, solving this problem as soon as possible, would be essential for the future survival of any of our health care systems in the world.

Biography:

Parijat De is a Consultant Physician in Diabetes, Endocrinology, and Lipid Metabolism at City Hospital, Birmingham since January 2003 having trained as a Specialist Registrar in Wales. He has sub speciality interests in Adolescent diabetes, Insulin Pump, Telemedicine and Diabetes renal disease. He is involved in research and projects involving a variety of disease areas in diabetes and both undergraduate and MRCP training. He has also initiated various community based integrated diabetes initiatives in Sandwell & West Birmingham CCG (amongst the first such in the UK) which now forms part of the award winning DICE model of diabetes care delivery adopted throughout the CCG. He is currently the clinical lead in Diabetes, Endocrinology and nephrology in SWBHT.

Abstract:

In Sandwell and West Birmingham Hospitals NHS Trust, diabetes prevalence is high with a large ethnic minority population. Social deprivation is significant and compliance is a major stumbling block in the achievement of diabetes and Blood Pressure (BP) targets. Given the above, we took the opportunity to become part of the West Midlands Academic Health Science Network Integrated Care Flo Exemplar project via Simple Telehealth/Flo (STH/Flo) mobile phone texting service. Our aims were to improve adherence to BP treatment via engaging patients in their own health through text reminders and regular encouragement, and determine the clinical and cost effectiveness of this simple, yet unique method of virtual clinical consultation.

Since April 2015:

100 patients have enrolled for BP monitoring

26 for blood glucose and insulin reminder

Results:

Medications have been adjusted (added new agent or increased dose) in 27/100 (27%)

46/100 (46%) patients have been discharged with good BP control preventing 107 outpatient appointments (saving £11,663 vs. £2,329 Flo associated costs)

Total savings £9,334

High patient satisfaction & increasing usage

Improved utilisation of manpower resources and healthcare professional time – thus clinically and cost effective model of care delivery recognising the importance of supporting patients outside of face-to-face care to improve outcomes.

Flo’s use continues to grow at SWBHT, 5 new teams are ready to join (Pharmacy, Respiratory, Paediatric Diabetes, Haematology and Occupational Therapy). This simple Telehealth technology can be easily replicated in any NHS Trust or CCG, as has been shown within our own Trust.

Biography:

Marwa Ibrahim was Graduated from Faculty of medicine, Alexandria University, Egypt as Medical Doctor 2005, with the specialties including Tropical Medicine, Hepatology, gasteroenterology and infectious diseases with 3 years of residency in Alexandria main university hospitals as an intern of tropical medicine, gasteroenterology and Hepatology and Master degree in tropical medicine from the University of Alexandria 2010. Later on she worked as an assistant lecturer of Tropical medicine, Faculty Of Medicine, Alexandria University Egypt 2010-2014 till she obtained her MD from University of Alexandria in non surgical treatments of hepatocellular carcinoma and then started working as a Lecturer Of Tropical Medicine, Alexandria University, faculty of medicine, Egypt 2014-till now as well as University co-supervisor on fever hospital center for treatment of hepatitis C, where she has continued her research.

Abstract:

Treatment with a combination of the nucleotide polymerase inhibitor sofosbuvir and NS3A (non-structural protein 3A) protease inhibitor simeprevir resulted in high rates of sustained virological response in chronic hepatitis C Genotype 4.

Methods: We conducted a real life study on Egyptian patients coming to the tropical medicine department clinic at El Mery main university hospital from February 2015 to February 2016 for treatment naïve and treatment experienced patients with chronic HCV genotype 4, including cirrhotics and non cirrhotics. Naïve(cirrhotics and non cirrhotics) and relapsers (non cirrhotics) received nucleotide polymerase inhibitor sofosbuvir and NS3A inhibitor simeprevir once daily for 12 weeks and 24 weeks for relapse cirrhotic patients. The primary end point was a sustained virologic response at 12 weeks after the end of treatment. An informed consent was obtained from each patient at the beginning of the study (Real life study: a study on Egyptian patients when the drug was available in the market).

Results: 30 naïve patients with HCV genotype 4 and 20 relapsers (10 non cirrhotic and 10 cirrhotic patients) were enrolled. Patient inclusion criteria: Naïve patients are those who tested positive for HCV RNA by PCR and had no experience to HCV treatment; Relapsers are those who tested positive for HCV RNA by PCR and had a previous treatment for HCV. Cirrhosis were diagnosed on ultrasound basis. Mean age was 53.57 ± 10.682 years old in naïve patients and 48.30 ± 5.100 years old in relapsers. Median baseline HCV RNA was 360,069 IU/mL for naïve patients and 1,245,000 IU/mL for relapsers; using Fib4 20% of naïve patients were F3-F4, while 40% of relapsers were F3-F4. Degree of fibrosis was confirmed by fibrotest in relapsers. Upon treatment of patients with sofosbuvir and semiprevir once daily for 12 weeks and 24 weeks only to cirrhotic relapsers, end of treatment PCR was negative in 100% in all groups including cirrhotics and non cirrhotics. Primary end point (SVR 12) was achieved in 100% of all patients. Second end point (SVR 24) was achieved in 96.6% of naïve patients; SVR 24 for non-cirrhotic relapsers was achieved in 100% of patients and in 90% of cirrhotic relapsers. One patient had transient total bilirubin elevations without increased ALT (alanine aminotransferase) or AST (aspartate aminotransferase). One patient developed cutaneous rash.

Conclusions: Once daily sofosbuvir and simeprevir for 12 weeks provided high rate of sustained virological response among treatment naïve and treatment experienced patients with HCV genotype IV.

Biography:

Nada Alharbi has completed her Masters in Public Health: Health Systems and Quality Management from King Saud Bin Abdulaziz university in affiliation with Liverpool School of Tropical Medicine. She is a patient Safety Speculaist at KFSH&RC, Certified Patient Safety officer, Certified Professional in Healthcare Quality and a lean-six sigma certified. She also has 2 certifications in formal training and education. Very Passionat about Patient Safety and advocacy.

Abstract:

Providing a safe health care starts with improving the culture of patient safety. KFSH&RC understands this very well, thereofre, has invested in a major project in assessing the hospital staff perception on the culture of patient safety. The 2015-2016 Patient Safety Culture survey utalizing the AHRQ assessment tool was condcuted over a year long period in collaburation with an American consultencay company. The project included bulidng a survey adminstration & analytical portal , this collaburation helped in assuring that the survey was annonamous. For the first time, the hospital had measured its safety culture, climate at the unit level, including clinical and non-clinical areas with a 56% repoonse rate. The Survey results were correlated with Patient Satisfaction surveys and staff satisfaction scores, moreover, the results were correlated with units voluntary reported events. Additionally, for the first time the results were drilled down to the unit level. The results were, then revealed in a 4 hour debriefs session by the consultancy agency, the hospital positive reponse to culture of patient safety 12 composites were compared to international results. As a result, Major improvements actions underwent by the hospital executives and quality division. Just culture program, Event reporting campaign and a good catch program to name a few. Almost three months later a pulse check was conducted with additional customised questions by end users, which revealed a slight improvement, however, still the jurney is far from over.

Biography:

Ravi Shankar is regarded as an eminent oncologist and having experience of visiting renowned cancer hospitals around the world, is presently working as a senior consultant and a clinical oncologist at Queen's NRI Institute of Oncology. He was Gold medalist in MBBS and has done his Post Graduation MD in Radiation Oncology from a prestigious institute CMC, Vellore 1997, passed a DNB examination in year 2001. He is becoming a European certified medical oncologist in 2010 by passing ESMO examination, and passed MRCP in medical oncology from Royal College UK September 2013. He is the first Indian to become the Fellow of ESTRO in 2013 after successfully completing the examination in Geneva Switzerland.

Abstract:

Chemotherapy for cancer treatment has been one of the major medical advances in the last few decades. However, the drugs used for chemotherapy have a narrow therapeutic index, with varied toxicities ranging from nausea to life threatening anaphylactic reactions, and often the responses produced are unpredictable. In contrast, targeted therapy that has been introduced in recent years is directed against cancer-specific molecules and signaling pathways and thus has more limited nonspecific toxicities. Discoveries important for survival, proliferation, and metastasis of different cancer cells combined with technological advances have produced agents that target proteins or genes critical in the neoplastic process. Tyrosine kinases are an especially important target because they play an important role in the modulation of growth factor signaling. Targeted therapies are of various types like tyrosine kinase inhibitors, monoclonal antibodies and conjugated antibodies. In this article we would like to mention about the improvement in treatment options, increase in response to treatment to various solid tumours as well as patient compliance to the treatment with targeted therapy especially Tyrosine Kinase Inhibitors (TKIs) and monoclonal antibodies (mab).

Biography:

Zheng Cai-Mei has been graduated from Medical University of Yangon, Burma as Medical Doctor. She attained the specialties including Internal Medicine and Nephrology from the Taipei Medical University, Taiwan. Now, she has her PhD study in Graduate Institute of Medicine, Taipei Medical University, Taiwan, where she continued her research. She is now working as a Nephrologist at Shuang-Ho Hospital, Taipei Medical University, and as Lecturer in Nephrology, Internal Medicine Department at Taipei Medical University.

Abstract:

The rapidly increasing number of patients with ESRD has become a worldwide medical catastrophe. Growing incidence of diabetes mellitus (DM) with the severe consequence of DN is the major reason for this widespread increase. DN, affecting more than one-third of patients with type 1 DM and up to 25% of all patients with type 2 DM, is an extremely common complication of DM that strongly contributes to patient morbidity and mortality. Traditionally, metabolic and hemodynamic factors are the main causes for renal lesions in patients with type 2 DM, while DN has been considered as a nonimmune disease. However, recent studies have shown that chronic inflammation is associated with the development and progression of type 2 DM, implying that immunologic and inflammatory mechanisms may play a significant role in the disease process. Characteristic findings of DN are hypertrophy of glomerular structures, thickening of basement membranes, and accumulation of extracellular matrix (ECM) components. Increased infiltration of monocytes/macrophages, activated T lymphocytes, as well as augmented expression of inflammatory cytokines in the kidney have also been found in patients with DN. The purpose of this review is to bring together current information concerning the role of cytokines in the development and progression of DN. Specific emphasis is placed on the potential interaction and contribution of these cytokines to kidney damage. In addition, gene polymorphism of cytokines and therapeutic strategies targeting of cytokines in the treatment of DN are reviewed.

Biography:

Oroma Nwanodi graduated from Meharry Medical College of Nashville, Tennessee in the United States of America as a Medical Doctor in 2001. She specialized in Obstetrics and Gynecology at The University of Massachussets and Maimonides Medical Center. Later on she obtained specialization in integrative holistic medicine. She has practicized in California, Missouri, Minnesota, and Wyoming. She is currently a Doctor of Health Sciences candidate at A. T. Still University, Mesa, Arizona, in the United States of America

Abstract:

Obstetrical simulation dates from the Paleolithic period. Gynecologic simulation has its origins in the 1920s Link box trainers. By improving maternal-fetal outcomes, obstetric simulation secures mankind’s existence. In turn, improved maternal-fetal outcomes create a need for gynecologic surgery, and therefore, gynecologic simulation. Given this dynamic, gynecologic simulation may be an afterthought that has yet to attain a validated place in medical education and professional practice. The objectives of this review article are to assess the scope of simulation in obstetrics and gynecology, identify simulation’s weaknesses and strengths, review barriers to simulation growth in obstetrics and gynecology, and present a route forward. A previous Google scholar and Google Internet search phrased “simulation obstetrics gynecology”, performed on yielded 29 references from 2001 to 2015. A PubMed search on December 19, 2015, terms “simulation obstetrics gynecology, found 12 relevant, non-redundant articles. Additional Google scholar hand search on December 19, 2015 yielded 8 articles to complete topics. Post-Halstedian apprenticeship based medical training guarantees an ever-increasing role of simulation in obstetrics and gynecology training. Patient safety, healthcare quality, and healthcare provider credentialing concerns assure the future of simulation in obstetrics and gynecology professional practice. Given positive association with neonatal outcomes, medical student interest in obstetrics, and obstetrics team building, obstetrics simulation has proven itself. Gynecologic simulation needs to address fidelity, reliability, and validity concerns to secure an enduring position in gynecologic education and professional practice.

Biography:

Nor Ezleen Qistina Ahmad has been graduated from National University of Malaysia (UKM), as researcher with specialities in Biochemistry. Later on she obtained his post-graduation from National University of Malaysia with subjects Molecular Medicine and then started working at Universiti Kuala Lumpur, Institute of Medical Science Technology (UniKL-MESTECH) where she has continued her career as academician and researcher.

Abstract:

Crab allergy is one of a major cause of food-induced anaphylaxis, however the allergens are not well characterized. This study sought to analyze food allergy pattern in young adults with food allergy and subsequently identify the protein profiles and effects of heating (cooked) on the most popular crab species consumed in Malaysia, the blue swimmer crab (Portunus pelagicus). Data were obtained and analyzed from questionnaires distributed among 91 allergy subjects aged 18-32. Total serum IgE and crab’s allergen concentration from 14 subjects with recent symptoms were measured to confirm their allergy. Most of the subjects were allergic to shrimps (74%), followed by crabs (55%) and squids (53%). A significant relationship was found between crab allergy subjects and asthma (p<0.05). A positive correlation was found between seafood allergy and itchy symptoms (p<0.05). Subjects with high (>5 k[IU]/L) level of crab allergen are 20% and 30% subjects with moderate level of crab allergen (1 – 4 k[IU]/L) .The size of proteins for heated and raw Portunus Pelagicus were compared between fresh and frozen condition by using SDS-PAGE. Proteins ranging from 28 to 188 kDa were found in raw and heated crab with some differences observed in both heated fresh and frozen extracts. As a conclusion, seafood allergy shows the highest frequency in young adults with positive correlation with asthma and itchy symptoms. Protein profiles of fresh and frozen raw Portunus pelagicus exhibit a little difference in their size. Further investigations are needed to determine whether it contributes to the symptoms of allergy..

Biography:

Kathleen F. Hudson currently teaching and clinicals at the Longview University Center, University of Texas at Tyler. She has many years of experience with clinical, management, education and research. She has worked in medical and intensive care units; been an Educator of critical care units, Director of critical care units, university lecturer in Australia and Texas, completed research in Australia and the United States. Her current interests are student engagement, coping, evidence-based practice.

Abstract:

Aim: To depict the complex phenomena of coping involving the stressors, influencing factors, and responses of coping via a mid-range theory

Background: This model expands previous models creating a more complex and comprehensive description than previous work, and connects the stressors to responses, some adaptive and some maladaptive.

Design: Model includes components of initial stressors, key critical coping influencing factors, and various types of coping responses as a response to either healthy or unhealthy responses.

Results: This model portrays a comprehensive overview of the complex and multifaceted concepts of coping, including temporary, effective, and destructive coping responses. A list of key influencing factors is presented to assist with highlighting possible factors that can influence the overall potential adaptive (healthy) or maladaptive responses (unhealthy).

Conclusion: This model can be used for education, clinical, and research applications.

Biography:

Susumu Mukai has been graduated from Chiba University as Medical Doctor, with the specialities including Oto-Rhino-Lryngology and Cervico-Facial Surgery. Diplome in Lalyngology from Keio University. Later on he obtained his post graduation from Otorhinolarynglogy et Chirtgie Cervico-Facial of Université de Montpellier with subjects on mechanism of the larynx and then started working in the Yamato City Hospital where he continued OLR and CF surgeries. Presently he has been working at the Yamato City.

Abstract:

Background: Historically frenotomy was performed at newborn babies’ baptism for a healthy breastfeeding over many centuries. Although it was necessary for nursing babies, its application was denied subjectively without clinical observation since the early 20th century. As a result solutions for breastfeeding and breast problems are confused now. The causes of confusions result from:

1) The majority of babies (93.6%) have ankyloglossia.

2) Ankyloglossia is accompanied by deviation of the epiglottis and larynx (ADEL).

3) There were strong relationship between tongue and respiration.

4) The relationships between the tongue and respiration were ignored;

5) Various symptoms and signs of ADEL were ignored; and, above all,

6) There has been no standard of healthy breastfeeding.

Methods: In healthy breastfeeding, the baby opens its eyes wide and latches onto the mother’s breast with a wide mouth. It masticates the breast milk when it bites the areola and nipple and gobbles up the milk that gushes out. The movements of the jaws during masticating the milk are observable by the movement of both the temporal muscles and the ears. We studied changes in breastfeeding and mothers’ breasts before and one month after the operations for ADEL by standards for healthy breastfeeding and breasts.

Results: With regard to suckling, before the surgeries 24% of babies opened their eyes during breastfeeding, after surgeries 76% opened eyes while nursing. 30% of the babies correctly latched onto the mother’s breast with. After surgeries 84% properly latched on. 73% of the babies had calluses on the upper lip before surgeries, and no calluses were observed after surgeries. 27% of babies before surgeries moved the jaws during breastfeeding, but after surgeries 88% moved the jaws while nursing. White debris was on the dorsum tongue in 70% of babies prior to surgeries. After surgeries 22% was with debris. 67% of mothers experienced nipple pain before their babies’ surgeries while 6% had pain after the surgeries. 73% of mothers had palpable breast masses, after the surgeries 25% had palpable masses. Flattened nipples were observed in 55% of mothers before surgeries, 7% had after surgeries. 23% of mothers having breast pain before the surgeries, 4% had breast pain after the surgeries. Mastitis was from 9% to 1% after surgeries.

Summary: Remarkable improvements in breastfeeding and in mothers’ breasts were achieved after their infants operations for ADEL. These results indicate the necessity of surgical interventions in babies with ADEL.

Biography:

Kazuhiro Esaki has been graduated from college of science and technology, Nippon University with a master degree of s electronics in 1978. Graduation thesis: Scattering of Plane Electromagnetic Waves by Conducting Rectangular Cylinders. From 1978, he started working in Mitsubishi Electric Information systems Co., Ltd. and assigned to software development project of a process computer system of atomic power plants and continued his research. He has been graduated from the Tottori University with doctor degree of Social Systems Engineering in 2001. And also, he has been registered to Japanese Registered Engineer ( Service Management professional ) at 2002. On the other hand, he is working on developing the techniques (SQuaRE) for quality requirements and evaluation of system and software product for a long time in ISO/IEC JTC1 SC7WG 6 (software and systems engineering, working group six) from 1988. Presently he is working at the HOSEI University in the Tokyo City in Japan.

Abstract:

In recent years, the method of TQM (Total Quality Management for organization) is widely recognized. However, contents of assessment criteria's are various, and it is very difficult to define the whole management scope of TQM. On the other hand, it is very important to define the whole target entities of quality management about TQM because the lack of important target entities may cause significant risk of loss in the future. In the previous study, we have proposed the "new framework of TQM" of assessment for a total quality management of organizations based on the original development concepts of "TQM matrix" and the "Three Dimensional Unification Value Models". On the other hand, organization is defined as a kind of system based on the definition of ISO/IEC 15288: System life cycle process. Above assumptions, the aim of this presentation is to introduce the possibilities of application of "new TQM framework" to Healthcare of personnel as a unit of organization.

Biography:

Ehsan Sheybani earned BS, MS, and PhD in Electrical Engineering from UF, FSU, and USF respectively. His main research area has been applications of communication, signal processing, and data analysis. He has been involved in teaching, practicing, researching, and consulting applications of DSP in technology, system analysis, and data sciences for the past 20 years. He has a long list of publications and research grants including projects with NASA, NSF, NIH, DoD, DEd, and industry partners. Currently he serves as a faculty at the University of South Florida.

Abstract:

Noise (from different sources), data dimension, and fading can have dramatic effects on the performance of biomedical wireless sensor networks and the decisions made at the fusion center. Any of these parameters alone or their combined result can affect the final outcome of a wireless sensor network. Total elimination of these parameters could be damaging to the final outcome, as it may result in removing useful information that can benefit the decision making process. Several attempts have been made to find the optimal balance of parameters, their location, and how to remove them. Experts in the field agree that it is more beneficial to remove noise and/or compress data at the node level. We have developed computationally low power, low bandwidth, and low cost filters that will remove the noise and compress the data so that a decision can be made at the node level. This wavelet-based method is guaranteed to converge to a stationary point for both uncorrelated and correlated sensor data. This is mainly stressed so that the low power, low bandwidth, and low computational overhead of the biomedical wireless sensor network node constraints are met while fused datasets can still be used to make reliable decisions.

Biography:

Celia Caldas had her graduate degree in Nursing Science from Rio de Janeiro State University in 1982, her master's degree in Collective Health from the same University in 1993 and the PhD in Nursing Science from Federal University of Rio de Janeiro in 2000. Celia Caldas is an Associate Professor in Nursing Science at the Nursing Faculty (under graduate and graduate programs), and at the Medical Sciences School Graduate Program, Rio de Janeiro State University, Brasil. Her research area includes Gerontological Nursing, Family Care, Health and well-being, Nursing/caring theory and empiric nursing, concepts, elderly social issues and community care aspects.

Abstract:

Background: Understanding life transitions are important to help people to achieve their develop-mental needs. No studies have examined the patterns of responses to life transitions, eliciting the experiences of growing old of retired Brazilian older adults.

Aim: To identify and describe the patterns of responses to life transitions of retired Brazilian older adults.

Design: Using a theoretical perspective of transition as a guide, a qualitative, secondary narrative research design was in-corporated to obtain data from 11 interviews.

Method: Initial data collection took place during a broader study on the influence of people's working life history. Eleven autonomous and independent persons, 64 -82 years old, were interviewed at a geriatric outpatient unit in Rio de Janeiro to obtain their perceptions of old age. The secondary, narrative holistic-content analysis focused on the patterns of responses to life transitions. Results: The first turning point was a childhood event and the next was their first job. The third turning point was moving to another place/house or an-other city, the fourth starting a family, and retirement was the last turning point.

Conclusions: While older people may feel environmentally disconnected throughout life, their patterns of response, together with the available resources and prevention/interventions influence the transition process. Health Promotion actions are needed at vulnerable points during the transition process, thereby facilitating the health outcomes.

Biography:

Hiroshi Morimoto was graduated from the Mathematical Institute of Nagoya University. He was first employed by Nagoya University as a pure Mathematician. Then he explored many fields like a "rolling stone", through the field of global climate change and the analysis of big data. Finally he reached the field of bioweather, working as a professor of the same university.

Abstract:

The weather is known to affect human health. Facing global climate change and the coming of aging populations, the relations between weather and health are of increasing interest. Many studies have shown that changes in weather have been associated with the incidence of stroke and ischemic heart disease. However, the links still remain unclear. While the auto-regression models have been used so far, new technologies are urgently needed for the solution of the links. The aim of this presentation is to propose new approaches based on a new trend of informatics. For example, the "Entropy" is a main notion representing the amount of information. This notion will be presented as a useful method to determine which meteorological element (such as temperature) is associated with the incidence of disease. The "association analysis" is useful to give light to a new pattern of the relation of weather and health. Other methods, such as "Self-organized map" or "Hidden Markov Model" will be also presented. "Self-organized map" is one of well reached technique of data mining. It can be used for forming overviews of multivariate data sets and for visualizing them on a graphical map displays. "Hidden Markov Model" is a general statistical modeling technique that describes a probability distribution over an infinite number of possible sequences.

Biography:

Mario Ciampolini has been graduated from The University of Florence, Italy as Medical Doctor, with the specialties including Internal Medicine, Social and Community Medicine and Diploma in Pediatrics from the National University of Florence. Later on he obtained his post-graduation from National University of Florence and then started working at The University of Florence where he has continued his research. Presently he is retired from the year 2000.

Abstract:

Background: We attempted to train two diabetics as we suggested in the first abstract.

Objective: Diabetic people are different in this: they do not develop any hunger sensation after meal suspension.

Methods: We tried to implement this training in two obese, diabetic adults out of two consecutive recruitments. The two subjects consumed meals devoid of fats and carbohydrates (Very Low Energy Diet, VLED) for 6 to 12 months.

Results: At recruitment two diabetic subjects (out of two) showed a BMI of 39 and 33 and did develop neither a BG decline to 76.6 ± 3.7 mg/dL nor any hunger sensation after 2-days eating suspension. Both subjects lost 13%-20% of their body weight and recovered 76.6 ± 3.7 mg/dL of BG and hunger sensations before one – three meals a day, i.e.: went off diabetes.

Conclusions: Diabetes develops for inveterate conditioned intake (when previous energy intake has not been fully exhausted before meals), excessive fattening, excessive post-absorption emission of fatty acids from fatty tissues, permanent loss of BG decline to 76.6 ± 3.7 mg/dL and permanent loss of physiological signals of hunger. A healthy, non-diabetic life may be recovered from a painless loss of 20% body weight (No fats, no carbohydrates) and may be maintained by implementing IHMP at reappearance of hunger sensations. This means accurate energy intake planning instead of hunger endurance.

Biography:

Oroma Nwanodi graduated from Meharry Medical College of Nashville, Tennessee in the United States of America as a Medical Doctor in 2001. She specialized in Obstetrics and Gynecology at The University of Massachussets and Maimonides Medical Center. Later on she obtained specialization in integrative holistic medicine. She has practiced in California, Missouri, Minnesota, and Wyoming. She is currently a Doctor of Health Sciences candidate at A. T. Still University, Mesa, Arizona, in the United States of America.

Abstract:

In the United States, upon resident work hour restriction implementation, obstetrics and gynecology residents’ gynecologic surgery volume decreased and operative time per cesarean delivery increased. High volume surgeons can have clinically significantly lower complication rates than low volume surgeons, p < .001. Decreasing surgical volumes and increasing operating time raise the question of procedural patient safety in teaching institutions. Some institutions are turning to international rotations in resource-limited nations to increase residents’ surgery volume, possibly doubling the monthly surgical volume. As resource-limited nations need to train and increase their indigenous health care workforce, surgical skills simulation is ethically preferable to training high-resource nation residents in resource-limited nations. A medical and surgical skills simulation center (SSC) implementation is a workplace, continuous quality improvement (CQI) project that can benefit multiple facility departments and community organizations. Stakeholder preparedness must be evaluated before embarking on a CQI project. Anonymous brainstorming contributes to the CQI project selection. There is a preferred strategy for incorporating an SSC into an obstetrics and gynecology department. Staff, space, systems, supplies, science, success, support, and sustainability will come into play at different stages of SSC implementation. Once operational, the SSC must undergo CQI to optimize effectiveness. Continuous quality improvement plan-do-study-act cycles are recommended at least as frequently as equipment upgrades.

Biography:

Jasenka Gajdoš Kljusurić has been graduated, finished her Master's degree and Doctorate at the Faculty of Food Technology and Biotechnology/University of Zagreb. She graduated the MBA program in the field of Agribusiness (ICA). Application of different measuring and modelling methods in fields as Nutrition, Food Science and Food Technology are the topics she investigated in more than 60 published scientific papers. Presently she has been working at the University of Zagreb in Croatia where she teaches Modeling and optimization in nutrition and the basis of measurement methods in food science.

Abstract:

Medical plants as a source of bioactive components are investigated as medicinal plant extracts. A range of spectrophotometric, conductivity, near infrared spectroscopy and chemometric analyses were undertaken as a mean of determining the bioactive quality of 6 widely spread medicinal plant extracts from botanically distinct origins (Lemon balm, Sage, Lavender, Garden Thyme, St. John's wort and Marigold). Spectrophotometric determination of polyphenols and antioxidant capacity was performed. To determine the antioxidant capacity, two methods were used, the broadly used DPPH method and the Briggs- Rauscher method. BR method is performed at pH 2, which is similar to that of the fluids of the main digestive process (human stomach), giving in vitro information on antioxidant activity under "real digestion conditions". Conductivity and total dissolved solids and a NIR spectrum (NIRs) record for each medical plant extract were recorded. Chemometric techniques were used to establish the relationship between a technological method, as NIR spectroscopy, that was coupled with all determined, analytical parameters (total phenols, antioxidant capacity, conductivity and TDS). Partial least squares regression (PLSR) was used to evaluate the relationship between NIRs and bioactive and conductivity properties of medical plants to be able to predict the properties based on the NIR spectra of the medical plant extracts. The results showed high correlation confirming the suitability of NIR analysis for determination and quantification (RPD>3) of polyphenols, antioxidant capacity, conductivity and TDS in medicinal plant extracts.

Biography:

Pier-Luc Turcotte has completed his occupational therapy undergraduate studies at Université de Sherbrooke and is now pursuing a master’s degree in community health sciences at the Research Centre on Aging of the University Institute of Geriatrics of Sherbrooke. He received scholarships from the Fonds de la recherche du Québec – Santé (grant no. 31662) and the Canadian Occupational Therapy Foundation. His research is focused on fostering community practices that promote the wellness of older adults through improving their social participation.

Abstract:

Participation in fitness and social activities are key determinants of successful aging and enables older adults to stay in their homes and be integrated into the community. Although meeting participation needs involves older adults, their caregivers and health care providers, little is known about their respective viewpoints. This study thus explored the perceived, met and unmet participation needs of older adults having disabilities as seen by the older adults themselves, their caregivers and healthcare providers. A qualitative multiple case study consisted of conducting 33 semi-structured interviews in eleven triads, each composed of an older adult, his/her caregiver and a healthcare provider recruited in community health settings in Canada. Interview transcripts and reviews of clinical records were analyzed using content analysis and descriptive statistics based on thematic saliency analysis methods. Participation needs reported by each triad included all domains of participation. Needs related to daily activities, such as personal care, nutrition, and housing, were generally met. Regarding social activities, few needs were met by various resources in the community and were generally limited to personal responsibilities, including making decisions and managing budgets, and some community life activities, such as going shopping. Unmet needs were mainly related to social activities, involving leisure, other community life activities and interpersonal relationships, and some daily activities, including fitness and mobility. This study highlights the complexity of older adults’ participation needs, where fitness and social activities were mostly unmet although important. Properly assessing and addressing these needs is thus necessary to improve older adults’ health and well-being.

Biography:

Julia Bobek has completed a Master in Healthcare Management (University of Applied Sciences FH JOANNEUM) and in Healthcare, Policy, Innovation and Management (University of Maastricht). She is currently working as a project manager at the Gesundheit Österreich GmbH, which is the Austrian Public Health Institution, and working on her dissertation on Health Economics on the topic of hospitals’ performance measurement. She has worked on a number of national and international research projects (e.g. for the European Commission) on public health and health service provision.

Abstract:

In its recently adopted conclusion on open, data-intensive and networked research as a driver for faster and wider innovation, the European Council calls for action regarding the identification of sectoral priorities for research and innovation with the greatest potential for social and economic benefits in the data economy. The European Council is also emphasising the importance of the digital economy and recognizes its high potential as well as the need for a strong data value chain in Europe. Accordingly, both the European Council and Member States are willing to set the necessary steps to enhance data innovation, especially in the light of the exponential increase of data, highlighting that making data discoverable, accessible, assessable, reusable and interoperable is the key to innovation. Following this, CHAFEA / DG SANTE commissioned a study on “Big Data in Public Health, Telemedicine and Healthcare”. The study aims to identify applicable examples of use of Big Data in Health and develop policy recommendations for their implementation in the European Union. In order to validate and refine the policy recommendations that were developed together with an expert group in the course of the study, the recommendations are presented and discussed at different European conferences. The comments and discussion during these conferences will be recorded in writing and will be taken into account for the final version of the policy recommendations.

Biography:

Alexandre Fabricio Martucci went to medical school from 2001to 2007 - School of Medicine, Universidade Federal do Paraná– UFPR, Curitiba/PR, Brazil, started his Post-graduating training program (Residency) in Anesthesiology at Hospital Santa Casa de Ribeirão Preto - SP – Brazil. In 2013 completed his Master Degree in Anesthesiology at the Department of Anesthesiology, UNESP: Dissertation “Assessing renal function after myocardial revascularization surgery using dexmedetomidine” and in 2016 completed his PhD in Anesthesiology at the Department of Anesthesiology, UNESP, in association with University of California San Diego: Thesis “Microvascular findings and acute kidney function and toxicity following administration of hemoglobin based oxygen carriers”. Today he is Adjunct Professor at Universidade Federal de Goiás, Jataí-GO, Brazil.

Abstract:

Introduction: The increase of 0.3mg/dL in serum creatinine defines the term acute kidney injury (AKI) and is associated with higher incidence of postoperative mortality in patients undergoing coronary artery bypass grafting surgery (CABG). Clinical studies regarding the influence of dexmedetomidine (DEX) on renal function are scarce. We evaluated the LRA in postoperative of patients submitted to CABG with and without cardiopulmonary bypass (CPB) under anesthesia with DEX.

Method: In this retrospective study it was made serial analysis of serum creatinine (SCr) until 48h after the surgery of 286 patients undergoing CABG under DEX to evaluate the incidence of AKI. We tested the homogeneity among groups, evaluating patients separately for the use of CPB and DEX. Each patient was evaluated with respect to their blood concentration of creatinine in the preoperative and postoperative: early, 24h and 48h. In each period, it was compared the creatinine concentration with a creatinine concentration preoperatively. If at least in one of the periods this comparison showed increased creatinine ≥ 0.3mg/dL, the patient was classified as having AKI. It has also assessed the risk of AKI in patients with preoperative blood creatinine changed: values between 1.1 to 2.0mg/dL for females or 1.3 to 2.0mg/dL for men) compared with patients with normal creatinine concentration.

Results: The results were homogeneous for weight, age and creatinine concentration altered to 2.0mg/dL preoperatively. Patients who used DEX and underwent CPB had a higher incidence of AKI, with p = 0.043. Among those who were not undergoing CPB, there was a higher incidence of AKI after DEX, but with p = 0.066.

Conclusions: The use of intraoperative DEX increased the incidence of AKI in the postoperative myocardial revascularization in patients undergoing CPB.

Biography:

Heba Alqurashi is a final year PhD student from Brunel University, with an MSc degree from Imperial College London, in International Health Management and a BSc in Health Information Management and Technology from King Faisal University, Saudi Arabia. She is a lecturer from Najran University and a member of the Saudi Health Information Organization. Interning in different quality and information technology departments of different hospitals exposed her to how quality is adopted in hospitals, which endorsed her passion in the area of healthcare management specifically accreditation, quality and performance improvement.

Abstract:

The purpose of this research is to capture the multi-dimensional aspects of integrated health care delivery, to provide valuable evidence of the impact of hospital accreditation programs for performance management, as an effective external assessment scheme and to focus specifically on how following international accreditation standards and maintaining high quality of care improves performances. This research is concerned with the issue of hospitals being overwhelmed by patients as a result of the aging population, increase in chronic diseases and unhealthy lifestyles, which require appropriate management of hospital time and resources. It also addresses the lack of evidence regarding how accreditation, quality of care and performance management are interlinked, specifically in the context of Saudi Arabia, while also arguing that following national and international standards are enablers for achieving performance improvement and high quality care in Saudi hospitals. Quality management is a requirement to minimize the time people stay in hospitals and improve the efficient delivery of health care services. On the other hand, accreditation is an international mean to ensure quality of care and performance improvement. While performance improvement is mainstream in many fields, it is underdeveloped, yet highly pertinent to the healthcare sector in order to improve patient care. The study findings suggest that accreditation is directly linked to performance improvement and is essential for the quality of care in hospitals and staff regular involvement with accreditation results in acceptability of accreditation. It also suggests that management commitment and governmental support are essential for the adoption and implementation of accreditation.

Biography:

Odara Maria de Sousa Sá has been Graduated from UNINOVAFAPI University, PhD and Master in Pediatrics and Pediatric Sciences at the Federal University of São Paulo. Improving the MD. ANDERSON / Pediatric Oncology. Currently is Editor of Health magazine Coordination Focus, coordinator of graduate nutrition Clinical and functional College St. Augustine (FSA) and professor of Nutrition FSA course. Has experience in Nutrition, with emphasis on Oncologic and Functional Clinica. Presently he is working at the in the Sao Paulo City.

Abstract:

Glycine is a simple nonessential amino acid with potential immunomodulatory and anti Inflammatory effects in model animals including Oral Mucositis (OM); however, the mechanisms involved are not well understood. The aim of this study was to investigate the mechanisms of action of Glycine on chemotherapy- induced oral mucositis, as related to effects on collagen expression and inflammation.A hamster cheek pouch model of oral mucositis was used by all animals receiving intraperitoneal 5-fluorouracil, followed by surface irritation. Animals were randomly allocated into two groups and treated with a glycine 5%, or no supplemented. Clinical severity of mucositis was assessed by two blinded examiners on D7. Buccal pouch, tissue was harvested from all animals on day 7. Collagen was qualitatively and quantitatively evaluated after picrosirius staining. The density of the neutrophil infiltrate was also scored. The reduced severity of mucositis in the Glycine group was accompanied by a decrease in the number of neutrophils and an increase in the proportion of mature collagen as compared to the control group. The total quantity of collagen was significantly higher in the control group at the day 07 time point, as compared to the Glycine , with a more prolonged inflammatory response in the control group This study supports two mechanisms of action for Glycine in reducing mucositis severity. The increase in collagen organization in response to the Glycine group indicates that Glicine promotes wound healing. In addition, Glycine also appears to have an anti-inflammatory effect, as evidenced by the reduction in neutrophil infiltrate.

Biography:

Pierre Luc Pace is currently reading for Doctor of Medicine and Surgery at the University of Malta. His interests include Sports medicine, bionic limb prostheses as well as research in stem cells, specifically iPSCs and their applications in cartilage regeneration and repair. He is co-author of the paper ‘Stem Cells: Daddy or Chips?’ published in SCRIP in 2016 and book Stem Cells N’ Arthritis published in 2016 by Lambert. He also enjoys rugby, writing music and spending time with his family.

Abstract:

Arthritis is a debilitating disease, often causing a substantial liability for the patient’s livelihood, making daily physical activity, an agony. This brief review discusses a collection of some of the most recent and relevant discoveries involving stem cells (SCs), to repair and regenerate cartilage defects both in the acute and chronic stages of osteoarthritis (OA), as well as rheumatoid (RA) and the system is juvenile idiopathic arthritis (sJIA).

Biography:

Ahmadreza Zarifian is a medical intern at Mashhad University of Medical Sciences (MUMS) and is currently completing his practices for Medical Doctorate. With special interest in medical and clinical research, he has collaborated several studies and authored a handful of papers and publications in the fields of Internal Medicine, Cardiology, Surgical Techniques, Orthopedics, and Social and Community Medicine. He was chosen as the premier student researcher of the MUMS for 3 consecutive years (2013-15). Presently, he has been working as the head of Research Projects Unit at Student Research Committee of MUMS for 3 years.

Abstract:

Background & Objective: Median sternotomy and resternotomy is the standard surgical approach for coronary artery bypass grafting (CABG) as well as valvular and congenital heart disease. Unlike advancements in cardiac surgical procedures, there seems to be a lack of innovation in sternal closure techniques. Several techniques have been suggested for sternal closure including wiring, interlocking, plate and screws, and bone cementation, but none of them achieved widespread acceptability. Moreover, wiring and plating techniques are associated with serious post-operative complications, especially in high-risk patients. The aim of this study is showcasing the most difficult challenges with resternotomy in a patient with a history of previous cardiac surgery that was closed with biologic bone cements.

Case Report: Herein, we present the case of a 56-year-old woman with a history of previous sternotomy for mitral and aortic valve replacement, which was closed using biologic bone cement due to her osteopenic sternum. She was referred to an emergency department with dyspnea, 4 years after her operation. Later evaluations revealed a massive thrombosis at the mitral valve. Therefore, she underwent emergent cardiac surgery with a very difficult resternotomy under femoral cannulation support.

Conclusion: Resternotomy in patients with previous sternotal closure using Kryptonite bone cements or calcium phosphate cements (CPC) is safe and can be done similar to other cardiac reoperations. Ostensibly, the reoperation in these patients does not increase the risk of bleeding, morbidity, or mortality.