Day 2 :
University of Florence, Italy
Time : 09:00-09:35
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.
Background: Hunger has often components that are conditioned by time, social behavior and sight of food. Blood glucose concentration (BG) is a biomarker of current energy availability and of hunger.
Objectives: Investigating whether energy per meal reduction may allow BG to fall to low levels, when feeding behavior is (mostly) unconditioned and can be recognized.
Methods: Subjects of the experimental group (trained; n = 80) were trained to ignore meal times and to pay attention to their earliest sensations of hunger or discomfort, so to measure glucose (blood glucose,BG) with a glucometer for two weeks. The control group was untrained; n = 78). After 7-week, all subjects were asked to estimate their preprandial BG that was simultaneously measured through a glucose autoanalyzer.
Results: Estimated and measured glycemic values were found to be linearly correlated in the trained group (r = 0.82; p = 0.0001) but not in the control (untrained) group (r = 0.10; p = 0.40). Fewer subjects in the trained group were hungrier than those in the control group (p = 0.001). The 18 hungry subjects of the trained group had significantly lower glucose levels (80.1 ± 6.3 mg/dL) than the 42 hungry control subjects (89.2 ± 10.2 mg/dL; p = 0.01). The estimation error of the entire trained group (4.7 ± 3.6%) was significantly lower than that of the control subjects (17.1 ± 11.5%; p = 0.0001).
Conclusion: Patients could be trained to accurately estimate their blood glucose and to recognize their sensations of initial hunger at low glucose concentrations.
Democritus University of Thrace, Greece
Keynote: Health prevention and health promotion via the lens of political science: A private or societal issue?
Time : 09:35-10:10
Costas Dikeos holds a PhD from Edinburgh University (1992), has worked as teaching fellow at the Department of Social Administration since 1998 (now an assistant professor). His teaching and research experience cover Health Policy and Politics, History of Welfare and Political Theory of Healthcare Management
Health Promotion and Health Prevention are important factors in health care and therefore health care policy, politics and management. They assist in (a) achieving a healthy that is sound and robust life and (b) cost reduction. However, critique has been raised against health promotion as an individual (-istic) matter as it has to do with personal behaviour and attitudes (exercise, diet, smoking), whereas social issues and choices of political factors (infrastructure, working conditions, access to primary care, spare time enough for exercise, access to information concerning promotion etc.) may prevail as causes of illness, whilst these causes are socio-political. Similar points may be raised against health prevention mainly in the form of primary prevention as far as individual(-istic) choices in life-style are under question (possibly leading towards libertarian ideology), and secondary prevention as far as health-care infrastructure and services and accessibility to them are under question.
Therefore, we need to follow at least two paths:
a. Health promotion and health prevention in view of general social inequalities and inequalities in health in particular (e.g. ‘Black Report’ 1979, ‘Health Inequalities’ Davey-Smith 2003, and ‘Inequalities in Health’ Gordon et al) and
b. Health promotion and health prevention in view of more theoretical approaches examining them as a matter between libertarian and socialist political theory and argumentation and neo-liberal and social-democratic policy options (e.g. J. S. Mill’s classical works, ‘Health Medicine and Society’ by Kennedy and Kennedy 2010, ‘Major Thinkers in Welfare’ by Vic George 2010, alongside key works of Pinker and Titmuss).
Rockford Gastroenterology Associates, USA
Keynote: Does anesthesiologist-directed sedation afford superior deep cannulation rates and procedural outcomes for ERCP in the community setting
Time : 10:10-10:45
Tewani received his combined Bachelor of Arts in the Medical Sciences and Medical Degree at Boston University. He completed residency in Internal Medicine, fellowship in Gastroenterology and Hepatology, and advanced fellowship in Advanced Endoscopy at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Massachusetts. He also completed the Program in Clinical Effectiveness at Harvard School of Public Health and Brigham and Women’s Hospital in Boston, Massachusetts, and an International Observership at Asian Institute of Gastroenterology in Hyderabad, India. He joined Rockford Gastroenterology Associates and University of Illinois College of Medicine-Rockford in Rockford, Illinois, during 2014.
The study aimed to compare outcomes by sedation class in community patients undergoing index endoscopic retrograde cholangiopancreatography (ERCP). The aim of this presentation is to summarize the findings of the study, comparing gastroenterologist directed sedation (GDS) with anesthesiologist directed sedation (ADS), with a focus on rates of successful cannulation, sedation failure, and procedural failure. The primary endpoint of the study was defined as successful deep cannulation of the intended target duct. Sedation failure was defined as agitation or airway compromise prompting termination of ERCP. Reasons for procedural failure included surgically altered anatomy, luminal obstruction, and technical failure. A total of 1079 patients was included from May 2005 to May 2011, 90% utilizing GDS and 10% requiring ADS. Case complexity was defined by the grading system proposed by the working party of the ASGE Quality Committee. Cannulation success rates were similar between the two groups. There were no statistical differences between sedation groups in procedural or respiratory adverse events. Technical failure was the predominant basis for deep cannulation failure in both groups. Agitation and airway compromise accounted for failure to achieve deep cannulation similarly in both groups. The need for reversing agents was lower, but similar in both groups. There was no statistical advantage in deep cannulation success rate of complexity grade in either sedation class. Excellent procedural outcomes and low adverse event rates were achieved using GDS, a more accessible and cost-effective method in a community-based setting.
Linköping University, Sweden
Time : 11:05-11:40
Carina Berterö graduated from University of Jönköping as a registered nurse, continuing with a bachelor degree, adding a diploma in education and then a master's degree in surgical and medical care at Linköping university. In 1996 she obtained her PhD from Linköping University, with the thesis: Living with leukaemia: Studies on quality of life, interaction and caring. She is a Professor in Nursing Science at the Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden. Her research area includes palliative care, oncology nursing, health and well-being, nursing/caring theory and empiric nursing, concepts, women issues and genus aspects.
Breast cancer is the most common type of cancer among women, the risk of breast cancer increases with age, it is most common after the age of 50, but reports have been published showing an increase in the incidence and mortality in young women i.e. < 40 years of age. Young women use blogs on the internet to describe their experience with breast cancer. Blogs represent an untapped source of knowledge for health care professionals. The purpose of this qualitative, exploratory study was to interpret and describe how a breast cancer diagnosis and its’ treatment affect these women’s life situations and how they manage their new situation. These women need social support and networks to share personal stories and experiences, but also to discuss disease issues. This social support could be found within writing personal blogs about their breast cancer experience. This blogging activity, could be seen as online health resources and can promote good health. There is some kind of healing effect due to expressive writing, leading to online support as blogging. Even though some of the women knew that they would not manage they continued writing blogs and at the end of life their family or friends wrote the blogs. It was important to inform each other, strengthen each other and share the experiences with other interested persons around. Sometimes the blogs were a source for validating information received from health care professionals. This is useful information for us health care professionals to include in our actions.