10^th World Congress on Healthcare & Technologies July 17-18, 2017 Lisbon, Portugal

Biography:

Josh has more than 10 years of leadership experience in a vast variety of settings. Most recently, Josh has been responsible for the implementation of Patient-Reported Outcomes throughout the University of Utah’s ambulatory clinics. Prior to this, Josh spent a year as an IT Project Manager at Metlife where he was responsible for several high impact projects. Josh also spent over 8 years in the Air Force as an F-15E WSO and AC-130U Navigator and began his career as a high school math teacher in New Jersey. Josh holds a BS in Mathematics from Virginia Tech, a MS in Aeronautical Science with a Space Studies specialization from Embry-Riddle Aeronautical University and an MBA in Finance from Arizona State University. Josh is also currently enrolled in a Ph.D. program within the Population Health Sciences division within the School of Medicine at the University of Utah. He hopes to graduate in 2019.

Abstract:

Aim: The implementation of Patient Reported Outcomes (PROs) to screen for mental health conditions has traditionally used a manual process of paper and pencil with little standardization throughout a Healthcare System. Patients are typically screened when a provider identifies them as at risk; many patients are not screened. As we move forward into an era of health technology, we can leverage this capability to provide a standardized health outcomes assessment using PROs for mental health screening to all patients.

Methods: We currently administer the PROMIS Depression v1.0 instrument as part of a standard PRO assessment to all patients. PRO assessments are either completed at home or in clinic with a tablet computer. We customize the time between assessments to minimize patient burden, while maximizing relevant data for clinicians. The PHQ-9 is still used as a manual screening process within primary care and mental health. ICD-10 codes identified patients diagnosed with depression; anti-depressant prescriptions identified treated patients. Patients with a PROMIS score of ≥65 or PHQ-9 score of ≥15 were identified as at risk for depression.

Results: Since September 2016, 205,813 unique patients have been seen at the University of Utah Health System. Of the 33,484 (16.3%) patients screened using PROMIS Depression in an automated electronic process, 2,312 were identified as at risk for depression. Of the 6,039 (2.9%) patients screened using the PHQ-9 in a manual process (2.9%), 2,212 being identified as at risk for depression Compared to the manual process, the automated process identified more patients at risk for depression and not diagnosed (982 vs 402) and at risk for depression and not treated with medication (852 vs 226).

Conclusions: The use of an automated PRO platform for mental health screening enables a clinician to identify patients at risk that may have otherwise gone unidentified. Our automated platform screened more unique patients than a manual process in the same time frame. The implementation of the automated process is implemented in just under 70% of our total health system’s appointments. By implementing automated PROs, we hope to identify our total population of patients at risk for mental health conditions.

Biography:

Domenico Mastrangelo has completed his degree in Medicine and Surgery on October 26th, 1979, at the age of 24. He then specialized in Haematology in 1983 Oncology in 1987, Clinical Pharmacology in 1990 and Ophthalmology in 2010. His experience is in the fields of hematological/oncological epidemiology and laboratory, cell biology, molecular biology. He published more than 100 papers in reputed scientific journals, including chapters in highly reputed scientific books in the fields of ocular oncology, clinical oncology, cancer cell biology, and hematology. He is presently Senior Scientist at the Department of Medical, Surgical, and Neurological Sciences of the University of Siena, Italy.

Abstract:

Background: Vitamin C (ascorbic acid) is an essential nutrient with a number of beneficial functions, for the organism, among which it is worth mentioning its antioxidant activity and its role in the synthesis and stabilization of collagen. The anticancer/anti leukemic properties of Vitamin C are also known since at least 1969, even though the interest in Vitamin C as a potential anticancer molecule has only recently revived, thanks to experiments performed on human tumour cell lines in vitro.

Material and Methods: We used human tumour cell lines derived from retinoblastoma (Y79), uveal melanoma (C918, and OCM1) and human myeloid leukaemia (HL60, K562, U937, NB4, Nb4-R1, and NB4/As) exposed to different concentrations (in the order of magnitude of the millimoles) of the sodium salt of Vitamin C (sodium ascorbate). To evaluate cell viability before and after exposure to Vitamin C (sodium ascorbate), we used a standard flow cytometer and morphological/cytochemical methods, to further characterize the biological events produced by the exposure to the nutrient.

Results: All the cells used in our experiments showed apoptosis, autophagy, autoschizis, and still other forms of cell death degeneration after 1-2 hours exposure to millimolar concentrations of Vitamin C (sodium ascorbate). The apoptotic/cytotoxic effect of Vitamin C showed a peak at around 3 millimoles although Y79 cell lines appeared to be more sensitive than the rest of the cell lines tested.

Discussion: There are at least seven different pathways, through which Vitamin C in high concentration may be cytotoxic for cancer cells. The most commonly accepted cause of cell death, after exposure to millimolar concentrations of Vitamin C is considered the production of H2O2, consequent to the oxidation of the nutrient to dehydroascorbate (DHAA) and subsequent reduction to ascorbate, but other mechanisms, such as the downregulation of hypoxia inducible factor (HIF) are also involved.

In this experience with a variety of human tumour cell lines, we have showed that Vitamin C kills very efficiently different cancer cell, in vitro, being, at the same time, completely harmless for normal cells. The data reported herein imply that Vitamin C in high concentrations, such as those that can be reached by intravenous injection of the nutrient, represents a very promising, natural molecule in the routine treatment of different cancers.

Biography:

Jenny works as a project implementation lead for the University of Utah Health Professional Data and Analytics team. She oversees the training and implementation of the patient-reported outcomes project throughout the University’s health care system. Jenny has a strong interest in community health, improving patient quality of life, and serving Utah’s vulnerable populations through improved access to health care. Her master’s thesis focused on health care accessibility for low income women in Utah and improvements needed from the health care system and state. Jenny holds a bachelor’s degree in public health from Brigham Young University and a dual master’s degree in health care administration and public administration from the University of Utah.

Abstract:

Objective: The use of Patient Reported Outcomes (PROs) to screen for mental health has traditionally been implemented through a manual process of paper and pencil with little standardization throughout a Healthcare System. Patients are typically screened when the provider identifies them as having a need; many patients are not screened. As we move forward into an era of health technology we can leverage this capability to provide a standardized health outcomes assessment using PROs for mental health screening to all patients. We investigate the rate of identification of depressive symptoms in patients before and after deployment of a standard technology-based screening.

Methods: The University of Utah has over 1 million ambulatory visits per year with over 400,000 unique patients. We currently administer the PROMIS Depression v1.0 instrument as part of a standard PRO assessment to all patients. We customize the time between consecutive repeated PRO assessments based on specialty preference to minimize patient burden, while maximizing relevant data for clinicians. Collected data resides within the electronic health record and is displayed in tabular and normalized graphical forms. We used ICD-10 codes to identify patients diagnosed with depression and anti-depressant prescription to identify treated patients. Summary statistics were generated using R (Version 3.3.2).

Results: At the end of year one, 48,926 patients were seen in practices that used the automated PROs and 16,046 unique patients were screened using an automated PRO platform. These patients generated 22,042 observed scores. A concurrent manual process of screening using the PHQ-2 or PHQ-9 was also used during this timeframe. In these practices, XXXX patients were seen. The PHQ-2 screened 2,543 unique patients with 2,904 scores and the PHQ-9 screened 7,289 patients generating 11,814 scores. There were 911 unique patients who received the automated PRO platform using PROMIS Depression and the PHQ-2 or PHQ-9. Of the patients screened, 1,297 were identified as at risk using the automated PRO platform, which accounts for 1.37% of the 94,488 eligible patient visits. With the manual process, 2,926 were identified as at risk, but this accounts for just 0.7% of the 408,926 eligible patient visits. When comparing the automated platform (PROMIS Depression) to the manual process (PHQ-9), the instruments agreed on the screening results 78% of the time. 66.4% of the patients identified as at risk for depression using the PROMIS Depression or using the PHQ-9 did not previously have a diagnosis of depression or prescription for an antidepressant.

Conclusions: The use of an automated PRO platform for mental health screening enables a clinician to identify patients at risk that may have otherwise gone undetected. Our automated platform was able to screen more unique patients in the same time frame as compared to a manual process even with implementation of the automated process in just under 50% of our total clinics’ appointments. By implementing PROs in all clinics, we hope to identify our total population of patients at risk for mental health issues.

Biography:

Fernando Pimentel-Santos is a clinician scientist, focusing his work on understanding the challenges of early diagnosis and personalized therapy in axial Spondyloarthritis through genetic and –omic approaches. Fernando completed his Ph.D. in 2012 at the NOVA Medical School, NOVA University of Lisbon. Fernando is member of international research consortia for Spondyloarthritis, The International Genetics of AS (IGAS) and The Ibero-American Registry of Spondyloarthritis (RESPONDIA). He is also full member of Assessments Spondyloarthroarthritis International Society (ASAS). Fernando has published over 35 papers, with first or senior author publications in in peer-reviewed journals indexed to PubMed/Medline. Invited referee for several journals and associated Editor of Acta Reumatológica Portuguesa and Frontiers in Medicine. He was awarded with several scientific grants.

Abstract:

Background: Targeting humoral immunity has been proved effective in several inflammatory rheumatic diseases (IRD). Though clinical trials have shown some efficacy of B-cell depletion in ankylosing spondylitis (AS), results are less convincing. Other studies have revealed an association between mutations and expression of immune regulatory genes suggesting a B-cell dysfunction in the development and progression of AS. Yet, there is still lack of data describing B-cell subsets in AS, how these compare to other IRD and an evaluation of B cell compartment homeostasis in the pathophysiology of this disease.

Objective: To assess and compare the immature, naive and antigen differentiated subsets of peripheral B-cell compartment in AS with those in healthy controls (HC) and other IRD.

Methods: Patients (pts) with AS, RA and SLE according to respective classification criteria were included in this study. Pts under biologic DMARDS were not included. Sociodemographic and clinical variables were recorded. Blood samples were collected for quantification of inflammatory markers (ESR and CRP), immunoglobulin serum levels and assessment of B-cell immature transitional stages and mature subsets by flow cytometry. Mann-Whitney and Fisher´s exact test were used for comparison of AS with other groups.

Results: Overall, 60 pts and 12 HC were included. All patient groups presented similar and rather low levels of inflammation, as measured by CRP, ESR and immunoglobulins, in addition to a decreased lymphocyte count by comparison with HC. There were no differences in the B-cell counts between AS pts and HC, and both groups had inturn higher B-cell counts than RA and SLE pts. Regarding B-cell subsets, the immature transitional compartment of AS pts was found in normal range, but not in the RA and SLE groups. In fact, the latter presented a significant decrease in all transitional cell maturity stages (T1-T3). The next step in B-cell differentiation is mature naïve cells, also found in normal levels in AS and decreased in RA and in particular in SLE. AS pts presented slightly higher counts of CD27+IgD+ MZ-like and class able to switch memory cells with reference to HC and these cell numbers were found to be low in RA and even more decreased in SLE pts. Switched memory CD27+IgD-B-cells were reduced in all patient groups, however, only SLE pts presented highly decreased cell levels.

Conclusions: We found that while a severe dysfunction is present in the homeostasis of the B-cell compartment in RA and in particular SLE pts, which are lymphopenic in both immature and mature B-cell compartments, it appears that AS pts are not affected in the same way. At this stage, functional studies appear to be necessary in order to identify differences in key mechanisms of B cell development and differentiation that play a role in the aetiology and progression of these inflammatory rheumatic diseases. Our first results, however, establish that pathophysiological mechanisms involving B-cells clearly differentiate AS from RA and SLE.

Biography:

Lutfi A. Jaber is one of the foremost experts in the field of consanguinity and the problems associated with consanguineous marriages. This is still a major problem in many countries in the Middle East and Asia and Professor Jaber has studied it intensively and written many articles about the issue. As a pediatrician who is Director of a busy pediatric clinic in a large Arab town in Israel and who also works in the Department of Neurology at a large tertiary children’s hospital, he sees first-hand every day the consequences of these marriages as the various illnesses among the children he treats. He is also a Professor in the Sackler Faculty of Medicine, Tel Aviv University, Israel. By teaming up with colleagues in the Department of Genetics at a local tertiary medical centre, he also contributes to on-going research into the genetic conditions that result from consanguineous marriages.

Abstract:

Statement of the Problem: The risk among children of first-cousin parents for severe congenital malformations and genetic diseases is 2.7 times higher than that of children born to unrelated parents. To reduce the number of babies born with these conditions, in addition to reducing the rate of consanguineous marriages an important factor is the willingness of families to agree to termination of pregnancy (TOP) when prenatal tests have established beyond doubt that the foetus is affected.

The purpose of this study is investigating the attitudes of Israeli Arab women with children with severe congenital defects to prenatal testing and termination in future pregnancies and the impact of inclusion of a Moslem cleric or physician on the decision-making process.

Methodology & Theoretical Orientation: We investigated how many of 250 women (50% in consanguineous marriages) with babies with severe congenital anomalies had undergone prenatal testing and how many had refused recommended TOP; ascertained why they refused TOP, and investigated whether they would have changed their decision had they been able to talk to a Moslem cleric or a Moslem doctor.

Findings: The main recommended tests that were done are carriers of thalassemia, late ultrasound, triple test and early ultrasound. Thirty-five percent refused to consider TOP at all, 22% agreed, and 35% agreed provided it was carried out prior to 120 days gestation. Of those who refused, 50% did so on religious grounds and in 30% the reason was unclear. When we asked those who had refused whether the addition of a Moslem religious cleric to the committee would cause them to change their opinion, 46% said it would, but only 28% said they would change their mind if a senior Moslem physician were added.

Conclusion & Significance: Severe congenital anomalies resulting from consanguinity continue to cause major problems and additional strategies are required to reduce these.

Recent Publications

1. Al-Matary Abdulrahman and Jaffar Ali (2014) Controversies and considerations regarding the termination of pregnancy for Foetal  Anomalies in Islam. BMC Medical Ethics Feb 5;15: 10.
2. Jaber Lutfi and Halpern Gabrielle J. (2014) Consanguinity – its Impact, Consequences and Management. Bentham e Books.
3. Gitsels-van der Wal JT, Manniën J, Gitsels LA, Reinders HS, Verhoeven PS, Ghaly MM, Klomp T, Hutton EK. (2014) Prenatal screening for congenital anomalies: exploring midwives' perceptions of counseling clients with religious backgrounds. BMC Pregnancy Childbirth Jul 19 ;14:237.
4. Basel-Vanagaite, L., Taub, E., Halpern, G.J., et al. (2007)Genetic screening for autosomal recessive nonsyndromic mental retardation in an isolated population in Israel.European Journal of Human Genetics, 15, 250-253.
5.  Ahmed S. , Atkin K., Hewison J., et al. (2006) The influence of faith and religion and the role of religious andcommunity leaders in prenatal decisions for sickle celldisorders and thalassaemia major. Prenatal Diagnosis, 26, 801-809.

Biography:

Felipa de Mello-Sampayo was the coordinator of the project PTDC/EGE-ECO/104157/2008, entitled "Health and Economic Growth". Under this project, she developed and published two key papers related to a dynamic stochastic model for the optimal timing of a treatment switch, and applied to problems in medical decision taking Gastrointestinal Stromal Tumor (GIST) and HIV. The first, entitled "The Timing and Probability of Treatment Switch under Cost Uncertainty: An Application to Patients with Gastrointestinal Stromal Tumor", Value in Health, 2014, Vol. 17, and the second entitled "HIV patients' decision of switching to second-line antiretroviral therapy in India, Aids Care, 2015.

Abstract:

Research has been limited on the effect of quality on the elderly despite their rapidly increasing share in medical spending. We exploited the spatial variation of medical spending and use in the US, employing a spatial regression design. A focus of the study was whether and to what extent medical spending varies by service type. We addressed the question by using Medicare data that contain accurate and detailed spending information for nearly all medical services provided.

Methods: Using Medicare regional data, we first examine the impact of the heterogeneous effects of the quality of care on elderly’s Medicare spending at the aggregate level. We then delve into details and examine whether the quality effects are heterogenous by service type. We use advances in Geographically Weighted Regression (GWR) to estimate what can be thought of as spatially moving clusters of structural covariations. We also employ spatial regression models that likewise relax the assumption of spatial independence.

Findings: We find that at the aggregate level poor quality of the healthcare increases Medicare spending (SMS) and thus costs per beneficiary. Second, quality effects are heterogeneous, and their impact varies both spatially and by the type of medical service. In particular, Clinics and Ambulatory Surgical Centers services stand out for their high positive effect of hospital readmissions, a proxy for poor quality of continuity of care. We also find that poor quality of continuity of care decreases the use of Outpatients Dialysis Facilities, Physician Procedures, and Tests. Lower quality in terms of primary care access decreases the spending in Ambulatory Surgical Centers, Evaluation and Management Services, Physician procedures, Imaging, and Drugs. Third, we find that the effect of health risk status on medical spending differs by treatment type.

Conclusions: Reducing geographic variation in healthcare spending would not necessarily improve the overall quality of medical practice. Reducing payments to high-spending areas and increasing payments to low-spending areas reduces spending variation but the results on the quality of care will be ambiguous, since we found the quality effects to be heterogeneous both spatially and by services.

Recent Publications

1. Moscone, F., Knapp, M. and Tosetti, E. (2007a), `SUR model with spatial effects: an application to mental health expenditure.', Health Economics 16, 1403 -08.
2. Moscone, F., Tosetti, E. and Knapp, M. (2007b), `Mental health expenditure in England: a spatial panel approach.', Journal of Health Economics 26, 842 -864.
3. Fukushima, K., Yamamoto, S. and Lizuka, T. (2016), `Patient cost sharing and medical expenditures for the elderly.', Journal of Health Economics 45, 115 -30.
4. Rettenmaier, A. J. and Wang, Z. (2012), `Regional variations in medical spending and utilization: a longitudinal analysis of US Medicare population.', Health Economics 21, 67 -82.
5. Skinner, J., Chandra, A., Goodman, G. and Fisher, E. F. (2008), `The elusive connection between health care spending and quality.', Health Affairs, Web Exclusive p. 119 -23.

Biography:

Maria Jose Merino Plaza is a Pharmacist specialized in Clinical Analysis, responsible for the clinical analysis laboratory of Doctor Moliner Hospital, a medium stay Hospital in Valencia, Spain since 1994 Master in Quality Management. Since 2010 she is responsible for quality of the center and is very committed to the exciting topics related with Job Satisfaction and Patient Safety Culture. At the moment she is conducting her Ph.D. on Quality of Care and Patient Safety in a Hospital of medium stay Hospital in collaboration with the University of Granada, Spain. Among her professional competences can be highlighted the management of multidisciplinary human teams, the definition and implementation of quality management mechanisms and the high analytical, relational, interpersonal, organizational and empathy skills.

Abstract:

Statement of the Problem: Recently, more importance has been given to the human factor and the organizational climate due to their influence on the motivation of the professionals and the improvement of performance. Some studies indicate that job satisfaction may be related to patient safety.

Aim: To evaluate the relationship between Safety Culture and Job Satisfaction in a medium-stay hospital, showing the relationships between the dimensions that define both constructs and identifying the dimensions with the greatest impact on both variables.

Methodology & Theoretical Orientation: Cross-sectional study conducted in 2015, using the Basque Health Service Job Satisfaction Survey and the Spanish version of the "Hospital Survey on Patient Safety" questionnaire (Agency for Healthcare Research and Quality). Result Variables: High Job Satisfaction and High Degree of Perceived Security (score ≥75th percentile).

Predictor Variables: Socio-demographic characteristics and perception of the evaluated dimensions. The association between variables was quantified by adjusted Odds Ratio and the 95% Confidence Interval.

Findings: The mean Job Satisfaction was 7.21 (SD = 2.01) and the mean of Perceived Safety was 7.48 (SD = 1.98). The 75th percentile of the distribution in both cases was 9. The socio-demographic variables had little significance, while a positive perception of many of the considered dimensions was associated with high perception of the result variables. In the data analysis were obtained multiple significant correlations and cross-relations between the dimensions that define both constructs, as well as between the degree of satisfaction of the dimensions considered and the outcome variables.

Conclusion & Significance: The dimensions that define Work Satisfaction and Safety Culture present cross-relationships with each other and with the outcome variables, indicating that both constructs are related. These results reinforce the idea that if an adequate climate is created and Job Satisfaction increases, health workers improve their performance and increase Patient Safety.

Recent Publications

1. Merino-Plaza MJ, Carrera-Hueso FJ, Roca-Castelló MR, Morro-Martín MD, Martínez-Asensi A, Fikri-Benbrahim N. Relación entre la satisfacción laboral y la cultura de seguridad del paciente. Gac Sanit. 2017; In press
2. Merino-Plaza MJ, Carrera-Hueso FJ, Castillo-Blasco M, Martínez-Asensi A, Martínez-Capella R, Fikri-Benbrahim N. Evolución de la cultura de seguridad del paciente en un hospital de media-larga estancia: indicadores de seguimiento. An. Sist. Sanit. Navar. 2017; 40: 43-56
3. Merino-Plaza MJ, Carrera-Hueso FJ, Arribas-Boscá N, Martínez-Asensi A, Nebot-Sanchez MC, Fikri-Benbrahim N.  Job Satisfaction evolution in a Medium-Stay Hospital: Variables related an monitoring indicators. Cad Saude Publica. Under review.
4. Merino-Plaza MJ, Carrera-Hueso FJ, Arribas-Boscá N, Martínez-Asensi A, Trull-Maravilla E, Fikri-Benbrahim N.  Burnout en el personal de un Hospital de crónicos. Rev Saude Publ. Under review.
5. Sensibilidad del medio XG  para  el  aislamiento  de  Salmonella, Shigella y Yersinia. Publicado en la Revista Enfermedades infecciosas y microbiología clínica 1996; 14 (6): 72-73

Biography:

Virginia Montero Campos is microbiologist and Clinical Chemistry. She has experience in industrial microbiology and environmental microbiology and has a Ph.D. in Natural Sciences. In her doctorate she specialized in environmental toxicology, experiences that join with the investigation of diseases related to the environment. She is a member of the International Medical Geology Association (IMGA). According to this scope of study she has related the high incidence of gastric cancer of Costa Rica with environmental factors specific to her country. She is currently investigating the relationship between Mesoamerican Nephropathy and geographic and environmental variables of a very specific area of her country

Abstract:

Helicobacter pylori (H. pylori) are bacteria considered to be present in half of the population and it is a public health problem worldwide. Most patients infected with H. pylori show no clinical symptoms; nonetheless, approximately 10% to 20% of these patients will develop peptic ulcers and 1% will develop gastric cancer. The International Agency for Research on Cancer has classified H. pylori as a Group 1 carcinogen, recognized as the only bacteria capable of producing cancer. Samples of drinking water (n = 44) from aqueducts with chlorination treatment in selected areas with high prevalence of gastric cancer were analyzed in Costa Rica. Samples of drinking water from Panamá (n = 44) from aqueducts supplying untreated water for human consumption in the province of Chiriquí were also analyzed. The molecular marker of H. pylori, glmM, was used and to optimize the Real Time PCR (qPCR) technique, annealing temperature, concentration of primers and probe were standardized; also, by analyzing different standard curves, the best reaction conditions that allowed detecting and quantifying the gene were determined. The LightCycler® 480 II (LC480II) equipment from Roche Diagnostics GmbH was used, as well as the Absolute Quantification Analysis by means of the Second Derivative Maximum Method. In the case of the samples from Costa Rica, it was determined that 79.5% were positive for H. pylori; removing outlier high average, quantification of bacteria was determined in 3.6 × 103 copies/100 mL. For Panamá it was determined that 86% of the samples were found positive for the presence of H. pylori; removing outlier high average quantification of bacteria was determined at 3.3 × 102 copies/100 mL. The difference in values between the aqueducts in both countries revealed an environmental distribution of the bacteria of epidemiological interest in each case.

Recent Publications

1-Montero V, Arias S, Valdés B, Jarquin M (2015). Quantitative Detection of Helicobacter pylori by Real Time PCR in Drinking Water—Environmental and Public Health Risk Significance. OJMM 5(3): 118-127.

2- Montero V, Hernández A, Camacho J (2014). Culture and Molecular Identification of Helicobacter pylori in Drinking Water from Areas of High and Low Incidence of Gastric Cancer in Costa Rica. OJMM 4(4): 261-269.

3- Montero V, Puente Allen (2016). Continuous-Flow Removal of Arsenic in Drinking Water by Filtering down through Fe₃O₄@SiO₂ Magnetic Composite. JWARP 8(5): 619-630.

4- Montero V, et al (2011). Hallazgo de la bacteria Helicobacter pylori en agua de consumo humano y su relación con la incidencia de cáncer gástrico en Costa Rica. Tecnología en Marcha 24(3) 3:14.

5- Montero V, Quesada J, Ledezma A, Sandoval JA (2010). Determinación de arsénico en abastecimientos de agua para consumo humano de la provincia de Cartago, Costa Rica. Acta Med Costarric 52(2): 96-101

Biography:

Nada M. Madi is Assistant Professor in the Department of Microbiology, Faculty of Medicine at Kuwait University where she has been a faculty member since January 2015. She completed her Ph.D. and MSc. At Faculty of Medicine, Kuwait University and her undergraduate study at Faculty of Science, Kuwait University. Her research interest lies in the area of developing advanced techniques in viral diagnostics such as metagenomics approach for the detection of viruses causing different diseases such as respiratory tract infections and gastroenteritis. Currently, she works as Quality Control Manager and a member of the Health and Safety Committee at the Faculty of Medicine.

Abstract:

Clinical manifestations of human herpes virus 6 (HHV-6) have not been clearly defined, and the role of HHV-6 in human disease among infants and children in Kuwait remains to be fully elucidated. A retrospective study covering the period between 2008 to 2014 was conducted on infants and children aged one month and five years. Blood and CSF samples from infants and children who presented with symptoms suggestive HHV-6 infection were subjected to PCR test for HHV-6. Results showed that 9.3% (n=42) of infants and children were positive for HHV-6. Fever was the most noticeable symptoms, presented in 50% (n=21) of the patients. Also, neutropenia was highly associated with HHV-6 infection, where it presented in 35.8% (n=15) of infants and children. Our results provided valuable information about the clinical outcome of HHV-6 infection among infants and children in Kuwait.

Recent Publications

1. Madi N, Al-Qasser M, Abdul Khalik D, Edan R, Al-Nakib W. Clinical Utility of Viral Load Management of CMV Infection in SOT Patients in Kuwait. Transplant Proc. 2015 Jul-Aug; 47(6):1802-7.

2. Chehadeh W, Al-Qaseer M, Albaksami O, Altawalah H, Suhail Ahmad, Madi N, John SE, Al-Nakib W. Phylogenetic analysis of HIV-1 subtypes and drug resistance profile in treatment-naïve people from Kuwait. J Med Virol. 2015 Sep 14; 87(9):1521-6.

3. Madi N, Al-Tawala H, Abdul Khalik D, Al-Nakib W.A Relatively High Number of Pregnant Women in Kuwait Remain Susceptible to Rubella: A Need for an Alternative Vaccination Policy. Med Princ Pract. 2014; 23(2):145-8.

4. Madi N, Al-Tawalah H, Al-Nakib W. Clinical Presentations of HHV-6 Infection in Infants and Children in Kuwait:  A Retrospective Study. AIM. 2014; 4: 1088-11094.

5. Al-Tawalah H, Madi N, Al-Qaseer M. Prevalence of blood-borne viruses in the dialysis unit, Mubarak Al-Kabeer Hospital, Kuwait. KMJ. 2014; 47(1): 30-32.

Biography:

Cristina Gomes has her expertise in poverty and inequalities, and particularly in policy evaluation of public policies to improve health, education and wellbeing. She adopts triangulated methodologies, combining quantitative and qualitative approach to evaluate policies on poverty, wellbeing, health and education from an integrated framework.

Abstract:

Statement of the Problem: Racism in Brazil is structural, reflects more than four centuries of slavery and it is reproduced in institutions and civil society, in daily and family life. After 13 years promoting the inclusion of black population in public services this research evaluates the implementation of the National Policy for Integral Health of Black Population in health services in the municipality of Camacari, State of Bahia, Brazil.

Methodology & Theoretical Orientation: A triangulated methodology was applied, including a quantitative Survey, participant observation, in-depth interviews and focal groups with workers of public and private health services. The questionnaire included the staff profile: socio-demographic, family and work conditions, and their perceptions, attitudes and practices on racism and race inequalities and policies.

Findings: The workers recognize that racism exists in Brazil. However, their speeches indicate the predominance of a modern or subtle type of racism, based more on social prejudices than on color, mainly among high school professionals, such as physicians, nurses social workers, etc. Less educated workers, like technicians, receptionists and watchmen present higher proportions of prejudices based on color, or traditional racism, compared to the more educated workers.

Conclusion & Significance: The results adhere to the cultural approach on racism as ideology (Miles and Brown, 2003), associated to the level of education. However affirmative policies are rejected by most workers regardless of their level of education. Recognizing that racism, inequalities and injustices exist does not allow people to assume a commitment to act collectively to compensate or eliminate the effects of these injustices in their daily life or work, or to support actions to promote real equality.

Recent Publications

1. ALENCAR, José A.  Ponha-se no seu lugar: Resenha de DANIEL, G. Reginald. Machado de Assis – Multiracial identity. Philadelphia: The Pennsylvania State University Press, 2012, 330p.   Fundação Casa de Rui Barbosa Rio de Janeiro (RJ), Brasil. Machado de Assis em linha, Rio de Janeiro.  v. 6, n. 11, p. 134 - 139, junho 2013.
2. ARAÚJO, Carla L. F. (2010) O quesito cor/raça em formulários de saúde: a visão dos profissionais de saúde. Revista Enfermagem - UERJ, v. 18, n. 2, p. 241-246.
3. ARAÚJO, Edna M. (2009) A utilização da variável raça/cor em Saúde Pública. Interface-Comunicação, Saúde, Educação, v. 13, n. 31, p. 383-394, 2009.
4. Bonilla-Silva, Eduardo, (2006) Racism without racists : color-blind racism and the persistence of racial inequality in the United States / Eduardo Bonilla-Silva.—2nd ed.
5. BOYLE, Kevin. (2005). Dimensions of Racism. Proceedings of a Workshop to commemorate the end of the United Nations Third Decade to Combat Racism and Racial Discrimination. New York and Geneva. OHCHR and UNESCO
6. BRASIL. Ministério da Saúde (2007). Política nacional de saúde integral da população negra. Brasília. Editora do Ministério da Saúde.
7. BRASIL. Ministério da Saúde (2005). A saúde da população negra e o SUS: ações afirmativas para avançar na equidade. Brasília: Editora do Ministério da Saúde.
8. CEBES. (2013) Saúde em Debate. Rio de Janeiro, Revista do Centro Brasileiro de Estudos em Saúde.  v. 37, n. 99, out/dez
9. MILES R, BROWN M (2003) Racism. Routledge Taylor and Francis Group. London and New York. 2^nd ed.
10. OSORIO, Rafael Guerreiro. (2003) O Sistema Classificatório de “Cor ou Raça” DO IBGE. Texto para discussão 996, IPEA. Brasília.

Biography:

Zohra is a Researcher at Nuclear Research Center of Draria - Algeria since 1998. She is a rigorous analyst in Neutron Activation Analysis; who is interested in the improvement of public health, she works on the analysis of medicinal plants from her country: Natural product, compared with chemical drugs, efficient, cheap. But Crude product, composition not harmless, his work contribute to bring people’s attention on what they take and she researches for new Path to Treatment and Healing and try to creates a Natural Health Products Ingredients Data base ( HNPID)- Algeria with a team of scientists.

Abstract:

Seven elements have been determined using neutron activation analysis technique usually quite for herbs analyses. The essential elements found in Aristolochia Longa in this work may be potentially correlated with their therapeutic effect. However there is a need to investigate the toxic composition of Bereztem. It is clear the people using this plant especially the cancer patients in association or not with another therapy for economic considerations and or hope of cure should pay attention because the aristolochic acid contains. This acid is Very dangerous. The aristolochic acids Nephropathy (NAA) called also Chinese plants Nephropathy NCP is a diseases identified for the women having followed a Chinese slimming diet in 1992 , and a new American study reveals that this Acid is more carcinogen than the tobacco. When The Aristolochic Acid extracted from a medicinal plant is traditionally used in China to cure some diseases, the arthritis and the other inflammations. Dr. Selda and his colleagues show the direct toxicity of the Aristolochic acid on the human gene TP53 (gene suppressor of cancer).

Methodology & Theoretical Orientation: The medicinal plant Aristilochia Longa is collected from Taourirt Aden Algerian village situated in Kabylia region Northern Algeria. The root was washed extensively in distillated water as to remove superficial dust. The dry and hard form of this part was ground in a steel mortar; the fine powder obtained was prepared for neutron Activation Analysis.

Findings: it is possible to separate the useful from the toxic fractions of plant, instead to banned the use of herbal remedy containing acid Aristolochic. Five elements were quantified in certified AIEA standards IAEA-V10 and IAEA-SL1 for checking the accuracy of our procedure. It was noteworthy the most of the values obtained from this work are in good agreement with the certified values. The Z-score values for all elements were |Z|<3, which means that the results obtained are acceptable. the elemental concentrations obtained from this work shows the usefulness of using INAA for the elemental determination, the La, K, Br, As are present at trace levels and the Cr, Sb was found at minor level and Na at the major level.

 Recent Publications

1. Cherif H.S,  F. Said et al (2009) Identification et  caracterisation de Quelques Composés chimiques chez  Aristolochia Longa.nr.3- 4 : 71- 72. 
2. Jean-pierre Cosyns (2004) Aristolochic Acid-and ochratoxin A- DNA adducts: possible markers of Balkan endemic nephropathy and associated urotherial tumors Medicine and Biology 11,N°1 : 1- 4.
3. Chung-Hsin Chen et al (2012) Aristolochic acid –  associated Urotherial cancer in Taiwan PNAS  /may 221 / 109 / n° 21 : 8241-  8246.
4. Jian Qing Yu, Zhi Xiong Liao et al (2007) Composition ,  Antimicrobial  activity and  cytotoxicity of essential  oils from Aristolochia   mollissima : Environmental  Toxicology and Pharmacology 23 : 162-167.
5. Bachir et al. (2012) Aristolochia Longa aqueous extract triggers the mitochondrial pathway of apoptosis in BL41 Burkitt’s lymphoma cells : International Journal of Green Pharmacy  : 45-49.

Biography:

Sankalp Dwivedi is working as professor in surgical discipline in the Department of general surgery MMIMSR Mullana-Ambala-India. He is also the Dean academic affairs and co-chairman central research cell as well as secretory post graduate board of study in MM Institute of medical sciences and research, Mullana India. His areas of interest are hepatobiliary surgery, acute care surgery and trauma apart from general surgical practice. Being the leader in academics he is engaged in various institutional academic and research programmes. To quench the desire to learn more and contribute something in surgical sciences and evolution he is regularly organizing and participating in the workshops related to these skills. Dr Dwivedi is engaged in teaching and training programs as in charge academics central research cell and critical care division.

Abstract:

Problem of Statement: Intra-Abdominal Hypertension (IAH) is defined as a sustained elevation of Intra-Abdominal pressure (IAP) of greater than 12 mm Hg that may sometimes reach to the dangerous level in cases of acute abdomen especially in abdominal trauma. Therefore an early initiative for treatment of IAH warrants serial monitoring of IAP. Our study was designed with an objective to measure IAP using intra vesicular pressure monitoring in conditions predisposing to abdominal compartment syndrome (ACS).

Methodology: 30 patients of suspected IAH with acute abdomen were selected randomly. IAP was measured at 0hr, 8hr, and 16 hours. The relevant data like demographics, diagnosis on admission, APP (MAP-IAP), APACHE II; ICU stay, hospital stay and mortality were taken.

Findings: There was male preponderance (2.33:1 and IAH 61.9%) in our study. Majority (46.7%) of patients were admitted with perforation peritonitis with significant abdomen distention (96.7%). IAH was observed in 60% of cases and ACS (IAP≥20 mmHg) was noted only in 10%. The mean IAP was 14.73±2.83 (P =0.92) in IAH group and was 19±2.98 (P=0.74) in ACS group whereas the mean APP was 53.60 ±11.01 (P =0.92) in IAH group and 39±11.43 (P=0.97) in ACS group. Majority (47.6%) observed high APACHE II score (>20). Mean APACHE score in ACS group (27.3 ±10) was higher with higher mortality rate 58.3±31.94 as compared to IAH group (20.4±6.04, mean mortality 34.78±18.25). Finally medical therapy (100%) and surgical therapy (midline laparotomy 86.7%) was offered in majority.

Conclusion and Significance: Raised IAP leading to IAH and ACS is a hidden threat to the surgical abdomen. For early prompt diagnosis & prediction of mortality, IAP and APP monitoring are effective.

References

1. Manu Malbrain; Abdominal compartment syndrome; F1000 Medicine Reports 2009, 1:86
2. Dariusz Onichimowski^1,2, Iwona PodliÅ„ska¹, Sebastian Sobiech¹, Robert Ropiak³ Measurement of intra-abdominal pressure in clinical practice;  Anaesthesiology Intensive Therapy, 2010,XLII,2; 96-101
3. D. Turnbull1*, S. Webber2, C. H. Hamnegard3 and G. H. Mills2 Intra-abdominal pressure measurement: validation of intragastric pressure as a measure of intra-abdominal pressure British Journal of Anaesthesia 98 (5): 628–34 (2007)
4. Jens Otto*1, Daniel Kaemmer1, Marcel Binnebösel1, Marc Jansen1, Rolf Dembinski2, Volker Schumpelick1 and Alexander Schachtrupp1; Direct intra-abdominal pressure monitoring via piezoresistive pressure measurement: a technical note; BMC Surgery 2009, 9:5
5. Malbrain ML, Deeren DH. Effect of bladder volume on measured intravesical pressure: a prospective cohort study. Crit Care 2006; 10(4): 98.
6. Zhao-Xi Sun, Hai-Rong Huang, Hong Zhou; Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis; World J Gastroenterol 2006 August 21; 12(31)
7. Jens Otto, Daniel Kaemmer, Marcel Binnebösel, Marc Jansen, Rolf Dembinski, Volker Schumpelick and Alexander Schachtrupp Direct intra-abdominal pressure monitoring via piezoresistive pressure measurement: a technical note; BMC Surgery 2009, 9:5
8. Jian-cang Hong-chen Kong-han Qiu-ping Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians J Zhejiang Univ-Sci B (Biomed & Biotechnol) 2011 12(2):156-162

Biography:

Kazuhiro Esaki has been graduated from college of science and technology, Nippon University with master degree of 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 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 for 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 at the Tokyo City in Japan.

Abstract:

Generally, for quality improvement of an organization management, TQM (Total Quality Management) is used worldwide and recognized. However, contents of activity are various, and it is very difficult for organization to define the whole assessment scope of TQM. However, 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 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. In the previous study, we suggested the concept of TQM matrix and new framework of TQM.

Also, in the previous study, we suggested the view point of three dimensional unification value models for evaluating quality of system. Above assumptions, the aim of this presentation is to propose the “Common Management Process” based on the consideration of TQM matrix and view point of three dimensional unification value models for Personal Management.

Recent Publications

1. K. Esaki (2016) Common Management Process of new TQM based on the Situation Analysis，Intelligent Information Management，vol.8，no6，pp.181-193
2. K. Esaki (2016) Application of Framework of New TQM to Healthcare, Journal of Nursing & Healthcare，vol.1，Iss1, pp.1-8
3. K. Esaki (2015) Target Entities of Total Quality Management based on the new TQM and Three Dimensional Unification Value Models，Intelligent Information Management，vol.7，no2，pp.70-79　
4. K. Esaki (2013) General Frame Work of New TQM Based on the ISO/IEC25000 Series of Standard，Intelligent Information Management，vol.5，no4，pp.126-135
5. K. Esaki (2013) Three Dimensional Integrated Value Models Based on ISO/IEC9126 System Quality Model，American Journal of Operations Research，vol.3，no.3，pp.342-349　
6. K. Esaki (2013) Introduction of System Quality Requirement and Evaluation Method Based on the Three Dimensional Integrated Models，44th annual conference Proceedings of Southwest Decision Sciences Institute，pp.481-489　

Biography:

Immanuel is the Assistant Professor of Health Policy at the Mohammed Bin Rashid School of Government, Formerly the Dubai School of Government. He has a Doctor of Philosophy Ph.D. in Health Services: Leadership from Walden University, USA. He has published over 51 publications in peer-reviewed journal articles peer-reviewed international conferences, policy briefs and reports, co-authored books and book chapters thus far. His research interest is in public policy, education healthcare management & leadership, maternal & child health, nutrition, and quality management.

Abstract:

According to the WHO, the maternal and child mortality rates in the United Arab Emirates are the lowest in contrast to the other 21 countries within the Middle Eastern region. Therefore, the UAE is seen as a best practice in the region for lowering mortality rates and improving the overall Maternal and Child Health (MCH) through policy-making. In working towards the lowering of the mortality rates, WHO mandated for the adoption of the policies and strategies. Ten countries within the Middle East are struggling with the adoption of the policies and strategies towards improving Maternal and Child Health (MCH). The research agenda is to provide an overview of the health policy-making process in the UAE with the use of the Andersen Model. The paper understands how specific MCH policy issues recommendations are designed to carry out such a course of action through health policy development as examples to positively influence the policy-making processes of the struggling countries. The policy-making process in the UAE includes 5-stages: Preparation; Formulation; Adoption/Legitimization; Implementation; and Evaluation. The study uses a quantitative research design approach with ANOVA and regression analysis of health professionals’ demographic factors, including nationality working experience and education, on their involvement in the MCH policy-making processes. The results of the analysis determine which demographic factors influence the policy-making process within the UAE and reflect how these factors can help and better understand those struggling countries within the Middle Eastern region.

Recent Publications

1. Moonesar, I.A. (2016). UAE Health Professionals Policy Involvement on Maternal and Child Health. Oxford Women's Leadership Symposium. University of Oxford, United Kingdom.
2. Moonesar, I.A. (2016). UAE Health Policy Impact in Maternal & Child Health Care. Volume 43. Mohammed Bin Rashid School of Government: Dubai, United Arab Emirates. DOI: 10.13140/RG.2.1.3616.9363.
3. Moonesar, I.A. (2015). A Conceptual Analysis on the United Arab Emirates Public Health Leadership Theory- Part 1. Volume 40. Mohammed Bin Rashid School of Government: Dubai, United Arab Emirates. DOI: 10.13140/RG.2.1.1923.5043
4. Moonesar, I.A. (2015). A Conceptual Analysis on the United Arab Emirates Public Health Leadership Theory- Part 2. Volume 41. Mohammed Bin Rashid School of Government; Dubai, United Arab Emirates. DOI: 10.13140/RG.2.1.5069.2320
5. Moonesar, I.A. (2015). UAE National Agenda: Healthcare in addressing Obesity among the Youth. Volume 42. Mohammed Bin Rashid School of Government: Dubai, United Arab Emirates. DOI: 10.13140/RG.2.1.2120.1128
6. Balakrishnan, M. S. & Moonesar, I.A. (2015). General Electric: How GE worked to transform oncology Healthcare in the Kingdom. Emerging Markets Case Studies Collection. 5(3), Emerald Group Publishing, UK. http://dx.doi.org/10.1108/EEMCS-03-2015-0037
7. Moonesar, I.A. (2015). The Role of UAE Health Professionals in Maternal and Child Health Policy (Doctoral dissertation, WALDEN UNIVERSITY) ProQuest.
8. Moonesar, I.A. (2013). U.S Public Health Policy: A Current Briefing. Chartridge Books Oxford: UK. ISBN-10: 1909287865 & ISBN-13: 978-1909287860.
9. Moonesar, I. A. & Vel, P. (2012). Patients' perception on prenatal care management at Trinidad & Tobago. Management Sciences, 2(3), 63-74.
10. Kemp, L.J., Moonesar, I.A. & Al Banna, S. (2011). Noor Dubai Foundation: Managing Blindness In Developing Countries, Emerging Markets Case Studies Collection. 1(4), 1-13, Emerald Group Publishing, UK. ISSN: 2045-0621. DOI: 10.1108/20450621111190214.

Biography:

Manisha Bhatt Dwivedi is working as professor anaesthesiology, in the department of anaesthesiology and critical care MMIMSR Mullana-Ambala-India. Her areas of interest are airway management, life support programs and neuromuscular monitoring. To quench the desire to learn more and contribute something in these areas she is regularly organizing and participating in the workshops related to these skills and is engaged in teaching and training programs as in charge simulation laboratory, central research cell and in charge critical care division.

Abstract:

Problem of Statement: Securing definitive airway traditionally requires placement of endotracheal tube which has got some undesirable effects like eliciting sympathoadrenal stress response, requirement of muscle relaxants and inevitable apnoea. To overcome these effects Laryngeal Mask Airway was invented. It is such an innovation in the field of airway management that has led to drastic reforms in the traditional aspects of general anaesthesia. Its placement is possible without relaxants. This implies that this method minimizes apnoea time or even prevents apnoea. It reduces the degree of atelectasis and offers various other advantages. In this study we compared the combination of propofol-butorphanol with propofol-fentanyl for Laryngeal Mask Airway insertion without using muscle relaxant and allowing the patient to resume spontaneous ventilation and apnoea time, recovery time and sedation scores were compared.

Methodology: Hundred patients scheduled for elective surgeries were randomly divided into two groups of 50 each. As coinduction drug Group F received fentanyl and Group B received butorphanol. In both the groups induction was achieved with I/V propofol and LMA was placed. Apnoea time, recovery time and sedation scores were noted and analysed statistically.

Findings: As compared to group F apnoea time was significantly less in group B and recovery time was significantly more in group B. In group B statistically postoperative sedation was significantly higher than in group F at 1/2 hour, but clinically, majority of the patients were responding to verbal commands. At 1 hour no significant difference in sedation were noted and none of the patients were deeply sedated at 2 hour in both the groups.

Conclusion and Significance: Propofol-butorphanol combination is a safer alternative to propofol-fentanyl combination because of decreased apnoea time and various advantages of maintaining spontaneous ventilation. Sedation score and recovery time though higher with butorphanol group, was clinically within acceptable limit.

References

1.  Ghafoor H, Afshan G,  Kamal R. General Anesthesia with Laryngeal Mask Airway: Etomidate vs Propofol for Hemodynamic Stability. Open J Anesthesiology 2012;2:161-5

 2. Yousef GT,Elsayed KM .A clinical comparison of ketofol (ketamine and propofol admixture) versus propofol as an induction agent on quality of laryngeal mask airway insertion and hemodynamic stability in children. Anesth Essays Res  2013 ;7(2):194-9

3.  Ramaswamy AH, Shaikh S. Comparison of dexmedetomidine-propofol versus fentanyl-propofol for insertion of laryngeal mask airway.Journal of  Clinical Pharmacology 2015 ; 31(2);217-20

4.Pournajafian A,Alimian M ,Rokhtabnak F,Ghodraty M,Mojri M.Success rate of airway devices insertion:Laryngeal mask airway versus supraglottic gel device.Anaesth Pain Med march2015;5:e22068

5. Sirian R,Wills J.Physiology of apnoea and the benefits of preoxygenation. Contin Educ Anaesth Crit Care Pain 2009; 9 : 105-108.

6.Ziyaeifard M,Azarfarin R,Ferasatkish R,Dashti M.Management of difficult airway with laryngeal mask airway in a child with mucopolysaccharidosis and mitral regurgitation:A case report.Resp Cardiovasc Med 2014;3:e17456

Biography:

Milena Stevanovic works as a doctoral candidate at KU Leuven. Her research aims at providing architects and engineers with a quantitative sustainability assessment method for healthcare facilities. Throughout her research, she is collaborating with VK Architects & Engineers; a company specialized in healthcare projects where she contributes to a better decision-making throughout different project phases. Her expertise in evaluating the sustainability of healthcare facilities lies in focusing on an integrated assessment of economic, environmental and performance aspects, i.e. in combining the Life Cycle Assessment (LCA) and Life Cycle Costing (LCC) analysis.

Abstract:

The predicted increase of population and life expectancy of people have resulted in a growing demand for healthcare facilities. Consequently, this need has led to a growing interest in the way hospital buildings are designed and operated. Current urge to decrease the negative impacts of the building stock around the world has also resulted in the encouragement of the healthcare construction industry to implement the sustainability principles in its practice. Nonetheless, as medical preconditions, such as hygiene or patient safety, often prevail over any other in hospitals, these facilities have been slower than other corporations in integrating sustainable technologies. Over the past two decades, efforts have been made to facilitate the sustainability assessment within hospital settings by using a quantitative approach, based on a life cycle thinking perspective. The analyses were often applied on the medical packaging, waste management or surgical equipment. However, a holistic sustainability evaluation on the scale of the hospital building, as well as an appropriate quantitative assessment method are still lacking to date. To overcome this gap, an attempt has been made to apply a screening life cycle assessment (LCA) and life cycle costing (LCC) on the new general hospital Sint-Maarten in Mechelen. This study allowed for gaining better insights into the environmental impacts and financial cost of a hospital building in Flanders. The outcomes of the study are seen as valuable inputs for the development of a hospital sustainability assessment method that would facilitate building practitioners’ decision-making throughout the project phases.

Recent Publications

Biography:

Elodie Vandenbergh is a neuropsychologist. She is currently writing a thesis on the cognitive processes involved in prescription comprehension in older adults and patients with Parkinson’s disease. By adopting an experimental approach, she aims two objectives: To enrich existing models of procedural document’s processing by taking into account user’s characteristics, and to identify the prescription designs that are the most adapted for different older adult cognitive profiles.

Abstract:

Statement of the Problem: If following a medication prescription is a complex task for standard adults, it is often a too complex task for many older adults. Because they are generally prone to complex polypharmacy, may suffer from cognitive, motor, or sensorial decline, and are faced with a standard prescriber-patient communication, elderly people encounter supplementary difficulties. These factors could partially explain why they are frequently non-adherent. Specific tools are needed to analyze the exact nature of these difficulties. Our objective is to present such a tool, that we are developing in a multidisciplinary project, the CONSIGNELA project.

Methodology & Theoretical Orientation: CONSIGNELA-Appli-R-1.0 is an application designed to study in real time older patient’s and parkinsonian patient’s behavior while consulting and understanding fictive medication prescriptions on tablets and touch-screens. It can display the same prescription in different formats (textual or tabular), and can simulate virtual and interactive pillboxes that can be filled by pressing, in a given order, different objects represented on the screen. It automatically stores the beginning, duration and end of every patient’s action while he/she is consulting the prescription, and is filling the pillbox.

Conclusion & Significance: Preliminary results of a pilot study carried out with young adults showed that our application is operational. The next phase will consist in using it alone, or coupled with an eye-tracking device, to study cognitive processes and visual strategies of older non-impaired people and patients with Parkinson’s disease interacting with fictive prescriptions. CONSIGNELA-Appli-R will be of particular interest for understanding why impaired and non-impaired older patients may encounter difficulties with some prescription designs.

Recent Publications

1. Bainbridge J L, Ruscin J (2009) Challenges of treatment adherence in older patients with Parkinson’s disease. Drugs Aging 26: 145‑155. http://doi.org/10.2165/0002512-200926020-00006
2. Beckman A G K, Parker M G, Thorslund M (2005) Can elderly people take their medicine? Patient Education and Counseling 59: 186‑91. http://doi.org/10.1016/j.pec.2004.11.005
3. Kheir N, Awaisu A, Radoui A, El Badawi A, Jean L, Dowse R (2014) Development and evaluation of pictograms on medication labels for patients with limited literacy skills in a culturally diverse multiethnic population. Research in Social and Administrative Pharmacy 10: 720‑730. http://doi.org/10.1016/j.sapharm.2013.11.003
4. Malek N, Grosset D G (2014) Medication adherence in patients with Parkinson’s disease. CNS Drugs 29: 47‑53. http://doi.org/10.1007/s40263-014-0220-0
5. Morrow D G (2015) Technology-Based Support for Older Adult Communication in Safety Critical Domains. Psychology of Learning and Motivation - Advances in Research and Theory (Vol. 64). Elsevier Ltd. Http://doi.org/10.1016/bs.plm.2015.09.008
6. Morrow D G, McKeever S, Chin C, Madison A, Davis K, Wilson E, Kaiser D, Wolf M, Conner-Garcia T, Graumlich J (2012) An EMR-based tool to support collaborative planning for medication use among adults with diabetes: A multi-site randomized control trial contemporary clinical trials 33: 1023-1032.
7. Tandy C, Bamford L (2010) Medication compliance aids. European Geriatric Medicine 1: 314–316. http://doi.org/10.1016/j.eurger.2010.07.013
8. Si P, Koo K N, Poon D, Chew L (2012) Knowledge of prescription medications among cancer patients aged 65years and above. Journal of Geriatric Oncology 3: 120‑130. http://doi.org/10.1016/j.jgo.2011.12.004
9. Vandenbergh É, Heurley L, Hainselin M, Quaglino V, Beldame S (2015, Septembre) Prescriptions présentées sur tablette chez des adultes âgés. Poster présenté au 56ème Congrès de La Société Française de Psychologie. Strasbourg, France.
10. Wanderley G M P, Abel, M H, Barthès  J P, Paraiso E C (In press) An Advanced collaborative environment for software development. Systems, Man, and Cybernetics (SMC).

Biography:

Malvika Sharma is currently enrolled in a three-year post-graduate program in Community Medicine at Maulana Azad Medical College one of the top medical colleges of India. She has been involved in multiple departmental projects in various fields such as environmental pollution and mental health. The current study is a part of Master’s Thesis and pertains to adoption of mobile phone technology for modification of risk-factors of non-communicable diseases.

Abstract:

Introduction: The rising trend of non-communicable diseases (NCDs) has led to a “dual burden” in low and middle-income (LAMI) countries like India which are still battling with high prevalence of communicable diseases. Insufficient physical activity is one of the behavioural risk factors responsible for development of NCDs. Mobile phone technology is viewed as a promising communication channel that offers the potential to promote behaviour change among vulnerable populations. An advantage of mHealth interventions is that they can be delivered to many individuals in a cost-effective manner and in a shorter time.

Methods: A community-based “Before-and-After” Intervention study was conducted on 400 subjects, over a period of one year in Barwala village, Delhi, India. A mHealth intervention package consisting of weekly text messages and monthly telephone calls addressing lifestyle modification for behavioural risk factors of NCDs was given to the intervention group, compared to no intervention package in control group. Primary outcome of the study was the change in level of physical activity. Secondary outcomes were change in physiological risk factors (BMI and blood pressure) and metabolic risk factors (Fasting blood glucose, total cholesterol, LDL and HDL cholesterol). The study was registered with Clinical Trials Registry of India (CTRI/2017/03/008264)

Results: Physical activity was found to increase significantly in intervention group as compared to control group (60.7 MET-mins week vs 0.3 MET-mins/week). The proportion of participants engaging in insufficient physical activity (<600 MET-mins/week as per WHO recommendations), decreased by 6% in the intervention group while it remained constant in control group. BMI, blood pressure, fasting blood sugar and HDL cholesterol level also showed significant difference in the intervention group as compared to controls.

Conclusions: The study demonstrated the usefulness of mHealth for health promotion and lifestyle modification at community level in a LAMI country. With the growing burden of NCDs in the community, such cost effective and innovative measures will be needed that can easily reach the masses.

Biography:

Yoichiro Sato received a Philosophy of Doctor degree in Education from Human Movement Science course at Hokkaido University, Japan, in 2016. His main areas of research are in biomechanics and motor control as it relates to activities of daily living such as walking and sit-to-stand motion in healthy young adults, as well as biomechanics and prevention interventions of the fall in the elderly. He currently researches biomechanics of walking in healthy young adults using experiments and model simulations. Furthermore, he started an investigation into the biomechanics of the single leg standing in healthy young and elderly, which was supported by Grants-in-Aid for scientific research expenses. These studies would contribute to the wellbeing of the elderly.

Abstract:

As the central nervous system controls whole-body motion, which involves multi-joint movement, certain problems regarding the number of variables controlled by the central nervous system arise (i.e., the “degree of freedom problem”). The central nervous system solves these problems, not by controlling joint movements, but rather by controlling only the task-dependent center of mass (COM) position of the whole body. Although uncontrolled joint movement should be organized in a coordinate manner to form the task-dependent COM position, it is unclear how the law joint coordination is organized. In the present study, we aimed to clarify the shape of joint coordination by elucidating the mutual relationship between the COM trajectory and joint movement during whole body motion. Downward squatting motions with five trunk angles were recorded by using a 3-D motion analysis system in eight healthy men. The trunk, thigh, and shank angles relative to the vertical line were calculated. Furthermore, the COM coordination in the sagittal plane was calculated using those angles. The COM trajectory showed an approximately vertical path in all trunk conditions, suggesting that the form of the COM trajectory depends on a motor-task. In addition, the COM vertical path suggests that the COM trajectory is constrained by biomechanical dynamics and minimum muscle torques. The shank angle decreased with an increase in the trunk angle, whereas the thigh showed a constant angle. This result suggests that the shank and trunk angles form the COM vertical path and the thigh angle adjusts the COM height. These findings demonstrate that the joints are organized into a lawful coordinative structure to make up the task-dependent COM trajectory. The present findings can contribute to improving motor abilities in healthcare activity and effectiveness of activity of daily living.

Recent Publications

1. Sato Y, Nagasaki H, Yamada N (2016) Joint coordination organizes to form the task-dependent trajectory of the body center of mass. J Behavioral and Brain Science 6: 1-8.
2. Mattos D, Schöner G, Zatsiorsky VM, Latash ML (2015) Task-specific stability of abundant systems: structure of variance and motor equivalence. Neuroscience 310: 600-615.
3. Sadeghi M, Andani ME, Bahrami F, Parnianpour M (2013) Trajectory of human movement during sit to stand: a new modeling approach based on movement decomposition and multi-phase cost function. Experimental Brain Research 229: 221-234.
4. Wu YH, Latash ML (2014) The effects of practice on coordination. Exercise and Sports Sciences Reviews 42: 37-42.
5. Yamasaki HR, Nakamura U, Nagasaki H (2014) Temporal optimality of a via-posture on trajectory during sit-to-stand and back-to- sit movements. J Biomedical Science and Engineering 7: 387-396.

Biography:

Nareerut Pudpong was awarded Diploma in Nursing Science and Midwifery (equivalent to BSc) from Boromrajonani College of Nursing, Lampang, Thailand. She obtained the Master of Public Health from Curtin University of Technology, Western Australia, and Doctor of Philosophy in Public and Environmental Health from London School of Hygeine and Tropical Medicine, UK. After graduation she worked as an instructor at Sirindhron College of Public Health, Chonburi, and later on a researcher at the International Health Policy Program (IHPP), Ministry of Public Health. Presently, she is a technical officer, Quality Development and Promotion Division, Healthcare Accreditation Institute (Public Organization), Thailand.

Abstract:

The Healthcare Accreditation Insitute played a vital role in facilitating the self-assessment process to determine Thailand’s situation on patient safety by using the country self-assessment tool of the WHO SEARO. Series of consultative meetings among concerned stakeholders and experts (such as academic insitutions, healthcare professional councils, and the Ministry of Public Health) to verify the actual situation with respect to six strategic objectives (SOs) were carried out in a 4-month period (Jun-Sep 2016). Results revealed that strengthening quality of medical care/services through intervention programes (SO5) was in a “Good to Excellent” level with a room for improvement in “safe medication”. While Thailand had done reasonably “Good” for improving structural systems to support quality and efficiency of patient safety at all healthcare levels (SO1), establishment of effective system to rigorously assess the nature and scale of adverse events (SO2) is a critical area that needs more attention. Thus, the national goals are set to improve Thai health systems that provide trusted, high-quality of care, and safety, which are accessible for everyone. The patient and personnel (2P) safety policy has been adopted and strategic plans will be released and expected to be implemented nationwide. The national policy, which focuses on not only patient safety, but also personnel safety, appears to be the uniqueness of Thailand. In addition, the monitoring and evaluation system will also be needed to ensure the compliance, monitor its progression, and inform future policy intervention designs to be fitted with the country context and sustainable in the long run.

Biography:

Marwa Ibrahim was graduated from Faculty of medicine from Alexandria University, Egypt as Medical Doctor 2005, with the specialties including Tropical Medicine, Hepatology, gastroenterology and infectious diseases with 3 years of residency in Alexandria main university hospitals as an intern of tropical medicine gastroenterology 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 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 end of treatment.

Results: 30 naïve patients with HCV genotype 4 and 20 relapsers (10 non cirrhotic and 10 cirrhotic patients) were enrolled. Cirrhosis was diagnosed on ultrasound basis. 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. Rash and jaundice were noticed in one patient.

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.

Recent Publications

[1] Mohlman, M.K., Saleh, D.A., Ezzat, S., Abdel-Hamid, M., Korba, B., Shettyia, K., et al.(2015) Viral Transmission Risk Factors in an Egyptian Population with High Hepatitis C prevalence. BMC Public Health, 15, 1030.http://dx.doi.org/10.1186/s12889-015-2369-y

[2] Breban, R., Doss, W., Esmat, G., Elsayed, M., Hellard, M., Ayscue, P., et al. (2013) Towards Realistic Estimates ofHCV Incidence in Egypt. Journal of Viral Hepatitis, 20, 294-296. http://dx.doi.org/10.1111/j.1365-2893.2012.01650.x

[3] Gower, E., Estes, C., Blach, S., Razavi-Shearer, K. and Raza, H. (2014) Global Epidemiology and Genotype Distribution of the Hepatitis C Virus Infection. Journal of Hepatology, 61, S45-S57.http://dx.doi.org/10.1016/j.jhep.2014.07.027

[4] Maasoumy, B. and Wedemeyer, H. (2012) Natural History of Acute and Chronic Hepatitis. Best Practice & Research Clinical Gastroenterology, 26, 401-412. http://dx.doi.org/10.1016/j.bpg.2012.09.009

[5] Gomez, E.V., Bertot, L.C., Rodriguez, Y.S., Gonzalez, A.T., Perez, Y.M. and Garcia, A.Y. (2014) The Natural History of HCV-Related Cirrhosis and Its Temporal Progression across the Different Clinical Stages. Hepatology International,8, 527-539. http://dx.doi.org/10.1007/s12072-014-9565-1

Biography:

Parvena Meepradit works as lecturer at Burapha University. She has expertise in evaluating the potential health hazards and passion in improving the workplace. Her open and contextual evaluation model based on responsive constructivists creates easy and economical pathways for improving work condition. She has built this model after a year of experience in research, evaluation, and teaching both in the University and other workplaces.

Abstract:

Statement of the Problem: The common musculoskeletal disorders (MSDs) including low back pain or injury. Researchers have reported that the majority of the low back problem comes from heavy, frequent, or awkward lifting. The NIOSH lifting equation has been designed to assist in the identification of ergonomic solution for reducing the MSDs associated with manual lifting. The purpose of this study is to find the effects of NISOH lifting equation for preventing low back pain.

Methodology & Theoretical Orientation: Measuring the variable data about the manual lifting conditions as follows: the NIOSH lifting equation both the origin and destination with include the weight of the object lifted, the distance from the wrist in a horizontal line, the distance from the wrist in the vertical line, moving distance of the hands, the angle of the shoulder from usual posture, the frequency of lifting per minute, and the way of holding the object. The lifting index (LI) was analyzed by dividing the Recommended Weight Limit (RWL) with the object weight. If the LI < 1.0, the present object weight or lifting procedures does not have any affect to workers’ health. If LI > 2.0 but does not exceed 3.0, is shows that the present manual lifting task risk to cause the low back pain symptoms, and is LI > 3.0, it shows the worst case handle lifting. It causes low back injury.

Findings: The work station redesigns were conducted training for workers on bringing the load closer, raising the height of objects placed to reduce the vertical distance, and moving the origin and destination of lifting closer together to reduce the angle twist. The final result was found the lifting index was safer (LI < 1.0).

Conclusion & Significance: NIOSH lifting equation guidelines are easy and economize expenses to improve working conditions. However, it should conduct training properly and combine with the other ergonomic tools.

Recent Publications

1. Meepradit P (2016) The prevalence and risk Factors of musculoskeletal disorders among migrant labors in Thailand. Archives of Current Research International 3 (2): 1-7.
2. Thetkathuek A, Meepradit P (2016) Work-related musculoskeletal disorders among workers in as MDF furniture factory in eastern Thailand. International Journal of Occupational Safety and Ergonomics: 1-11.
3. Thetkathuek A, Meepradit P, Jaidee W (2016) Factors affecting the musculoskeletal disorders of workers in the frozen food manufacturing factories in Thailand. International Journal of Occupational Safety and Ergonomics. Dec. 14: 1-19.
4. Meepradit P, Sunee N, Chantrasa R (2015). The application of NIOSH lifting equation to prevent musculoskeletal disorders risks. Journal of Biosciences and Medicine. 3 (3): 39-44.
5. Wano S, Meepradit P (2012). The work methods improvement for decreasing the risk of hand and arm injuries of strip booth operators in a surgical glove factory in Rayong province. In The 8^th National Scientific Conference and the 4^th International Scientific on Occupational and Environmental Health (pp. 250-255). Hanoi: Vietnam.