Day 2 :
University of Siena | Italy
Time : 09:00-09:40
Domenico Mastrangelo has completed his degree in Medicine and Surgery on October 26th, 1979, at the age of 24. He then specialized in hematology in 1983, Oncology in 1987, Clinical Pharmacology in 1990, 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. Presently he is a Senior Scientist at the Department of Medical, Surgical, and Neurological Sciences of the University of Siena, Italy.
The selective anticancer properties of Vitamin C are known since at least four decades. However, only recently in vitro studies have shown that Vitamin C, in high enough concentrations, can efficiently and selectively kill a number of different human tumor cell lines, and these data have been confirmed in experimental animal tumor models.
The first human clinical trials, revealed that high doses of Vitamin C administered by intravenous injection, are not only very well tolerated, but substantially improve the quality of life of patients with clinically advanced cancer. However the clinical evidence of the effectiveness of Vitamin C in fighting off cancer, is still controversial.
The present chapter outlines the importance of Vitamin C for a number of physiologic functions, within the human body and shows that there is a solid rationale for its use in the routine treatment of cancer, either alone or in combination with conventional treatment.
Oregon Health & Science University | USA
Time : 09:40-10:20
Gail M. Wolf is a nurse educator and reading researcher who works at Oregon Health & Science University. Wolf’s focus is on public health, leadership, and the connection between literacy skills, and health. Wolf’s research on early literacy shows the connection between early childhood literacy, later adult literacy, and living a productive, healthy life. Wolf has spent decades teaching preschool children to read. She has presented her work at the National Institute for Healthcare Advancement’s Health Literacy Conference in 2010, and 2013. Wolf is currently writing up her research results with bilingual, Latino teachers and First Grade Hispanic children on early biliteracy.
Statement of Problem: Poor early literacy can be viewed as a chronic disease process that is a public health concern. Data shows children’s failure to develop simple word decoding skills in early years is linked to future poor reading, school dropout teen pregnancy, low self-esteem, entrance into crime, and life-long poor health. Letter-sound knowledge is needed for word decoding development; however questions remain on what types of letter-sound knowledge help children decode simple words.
This study investigated the differences in mean number of consonant-vowel-consonant (CVC) words decoded between two groups of children, a letter-sound reading group and non-letter-sound reading group. Children aged 4 to 6 in both groups attempted to decode a variety of simple words such as tan, sit, hen, pig, dot, and fun.
Analysis determined word decoding differences existed between the two groups. The letter-sound reading group had a significantly higher mean in number of CVC words decoded compared to the non-letter-sound reading group. The study informs the teaching approaches needed to improve early decoding skills showing letter-sound reading ability is an important step for learning to decode simple consonant-vowel-consonant words. Further, promoting early literacy, promotes life-long health, well-being, and living a productive life.
- Wolf, G.M. (2016). Letter-sound reading: Teaching preschool children print-to-sound processing. Early Childhood Education Journal, 44(1), 11-19. doi: 10.1007/s10643-014-0685-y
- Wolf, G.M. (2014). Differences in Mean Number of Consonant-Vowel-Consonant Words Decoded between Letter-Sound Readers and Non Letter-Sound Readers. Open Journal of Nursing, 4, 409-450. doi: 10.4236/ojn.2014.46047
- Wolf, G. M. (2015). Selected to present at Oregon’s Statewide Head Start Early Childhood Specialist Conference: April 9, 2015, Redmond, Oregon at Eagle Crest Resort. Bend, Oregon. Presentation is dissemination of National Institute of Health (NIH) grant research data results of early literacy and impact on health.
- Wolf, G.M. (2013). Selected to present at National Institute of Healthcare Advancement’s (IHA) 10th Annual Health Literacy Conference. Irving, California. Poster on Innovations in Reading Instruction the connection between early literacy and living a productive, health life.
- Wolf, G.M. (1998). The three ingredient reading program: You can teach your child to read. Mesa, AZ: Blue Bird Publishing. [2nd edition in process, 2017].
St. Elizabeth University of Health and Social Work | Slovakia
Time : 10:20-11:00
Miron Sramka studied at Faculty of Medicine of Charl´s University in Prague. He worked as research worker at Institute of Pharmacology of Czechoslovak Academy of Science. He worked as Department head at Department of Stereotactic and functional Neurosurgery from Faculty of Medicine Comenius University, Bratislava. Miron Sramka worked as a Professor at University Public Health and Social Work St. Elisabeth; He acts as head of Clinic of Stereotactic Radiosurgery. He is the member of the European executive committee for stereotactic and functional neurosurgery. New diagnostic methods: Spinal cord stereotaxy, Transplantation of brain tissue by the Parkinsonism and Hungtington’s chorea, Method of MR guided stereotaxy, Stereotactic radiosurgery of melanoma of eye, Virtual 3D printing by radiosurgical operation of head in collaboration with Dr. Ruzicky (Dean of the Faculty of Informatics PEU) showed the possibilities of 3D printing used in order to decide which modality surgery is most appropriate for the patient in order to maintain the highest quality of life after surgery.
A new Virtual Reality device has given new possibilities for a 3D imagination in the planning and treatment of various diseases. 3D printing method helps determine which surgery or modality radiation is optimal. 3D printing technology helps to make of prostheses, assistive devices, production of hearing aids, prostheses, nose, ears, eyes, teeth, breast reconstruction of bone substitutes. Method of 3D printing cells (bioprinting) also helps in treating skin injuries and regenerative medicine in which the patient's stem cells form filling printers. We used the 3D printers especially for tumor irradiation near the critical structures for better imagination during the planning treatment at radiosurgery. In this case we can better visualize for neurosurgeons some 3D objects of interest. The history of Virtual Reality (VR) began in the 90s of the last century. Technology Research Company Gartner forecasted mass use of VR after 2010. Company Oculus Rift designed prototype Oculus Rift DK in 2010 and later in 2013 Oculus Rift VR. Company HTC with Valve Corporation announced their virtual reality headset HTC Vive in 2015 and was distributed in 2016, which is the second most widely used VR model today.
Both models Oculus Rift VR and HTC Vive we have successfully implemented in the projects focused on the mapping natural curiosities. The experiences of these VR devices we now apply for neurosurgical planning in which we use software system TomoCon and our NeuroVR system. We used 3D printing in neuro-oncology with radiosurgical planning performance. With the 3D model printing, we increased the accuracy of the therapeutic dose and at the same time we calculated the lowest dose to risk structures. 3D printing method helps determine which modality radiation is optimal. For operations of the eye’s melanoma we created a set of 3D physical models of the eye and tumour.
- Šramka M et al. (2016) The possibilities of 3D printing in Surgery. Health in social work. 3:15-20.
- Šramka M, Ružický E (2016) Possibilities in 3D Printing by Radiosurgical Operations. Journal of Biosciences and Medicines, 4:18-22.
- Furdova A, Sramka M, Chorvath M, Kralik G, Krasnik V, Krcova I, Waczulikova I (2014) Stereotactic radiosurgery in intraocular malignant melanoma – retrospective study. Neuroendocrinol Lett 1:28–36.
- Ruzicky E, Šramka M (1995) Mathematical methods using CT and MR images for stereotactic neurosurgery. Molecular and Chemical Neuropathology 25:247–254.
- Ružický E, (2015) Formalization of user interaction with virtual expert resource of knowledge type via ontological modeling. Information technology applications. 1:33-43.
- Healthcare Management | Healthcare Innovation | Healthcare Services | Healthcare Technology | Digital Health
Location: Vasco de Gama 1
University of Siena | Italy
Gail M Wolf
Oregon Health & Science University | USA
MMIMSR | India
Title: Quick assessment of intra-abdominal pressure for better decision making in cases of acute abdomen in rural setup
Time : 11:20-11:50
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.
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.
- Manu Malbrain; Abdominal compartment syndrome; F1000 Medicine Reports 2009, 1:86
- Dariusz Onichimowski1,2, Iwona Podlińska1, Sebastian Sobiech1, Robert Ropiak3 Measurement of intra-abdominal pressure in clinical practice; Anaesthesiology Intensive Therapy, 2010,XLII,2; 96-101
- 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)
- 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
- Malbrain ML, Deeren DH. Effect of bladder volume on measured intravesical pressure: a prospective cohort study. Crit Care 2006; 10(4): 98.
- 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)
- 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
- 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
HOSEI University | Japan
Title: Common management process based on the TQM matrix and three dimensional unification value models
Time : 11:50-12:20
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.
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.
- K. Esaki (2016) Common Management Process of new TQM based on the Situation Analysis，Intelligent Information Management，vol.8，no6，pp.181-193
- K. Esaki (2016) Application of Framework of New TQM to Healthcare, Journal of Nursing & Healthcare，vol.1，Iss1, pp.1-8
- 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
- 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
- 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
- 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
MBRSG | UAE
Time : 12:20-12:50
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.
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.
- Moonesar, I.A. (2016). UAE Health Professionals Policy Involvement on Maternal and Child Health. Oxford Women's Leadership Symposium. University of Oxford, United Kingdom.
- 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.
- 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
- 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
- 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
- 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
- Moonesar, I.A. (2015). The Role of UAE Health Professionals in Maternal and Child Health Policy (Doctoral dissertation, WALDEN UNIVERSITY) ProQuest.
- Moonesar, I.A. (2013). U.S Public Health Policy: A Current Briefing. Chartridge Books Oxford: UK. ISBN-10: 1909287865 & ISBN-13: 978-1909287860.
- Moonesar, I. A. & Vel, P. (2012). Patients' perception on prenatal care management at Trinidad & Tobago. Management Sciences, 2(3), 63-74.
- 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.
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.
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.
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
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
KU Leuven | Belgium
Time : 14:05-14:35
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.
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.
- Stevanovic, M., Allacker, K., and Vermeulen, S. (2017) Evaluating the hospital building sustainability: Applying a screening LCA and LCC to the new general hospital in Mechelen, paper submitted and accepted for PLEA 2017 conference, Edinburgh, United Kingdom
- Stevanovic, M., Allacker, K., and Vermeulen, S. (2017). Hospital building sustainability: the experience in using qualitative tools and steps towards the life cycle approach. In Procedia Environmental Sciences.
- Stevanovic M., Allacker K., Vermeulen S. (2016). Assessing the hospital building sustainability: The experience in using qualitative tools, DS²BE, 28-29 April 2016
- Stevanovic M., Allacker K., Vermeulen S. (2015). A review on requirements and existing qualitative tools for designing sustainable large-scale healthcare facilities: a case studiy in the context of Flanders: Vol. 1. CISBAT 2015 (pp. 511-516) Ecole Polytechnique Fédérale de Lausanne (EPFL)
Universite de Picardie Jules Verne | France
Title: CONSIGNELA-Appli-R-1.0: A research tool for studying in real time electronic medication prescription comprehension in older adults and patients with Parkinson’s disease
Time : 14:35-15:05
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.
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.
- 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
- 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
- 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
- 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
- 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
- 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.
- Tandy C, Bamford L (2010) Medication compliance aids. European Geriatric Medicine 1: 314–316. http://doi.org/10.1016/j.eurger.2010.07.013
- 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
- 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.
- 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).
Maulana Azad Medical College | India
Time : 15:05-15:35
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.
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.
Poster Presentations 15:55-16:10 @ Infante Hall
Hokkaido University of Science | Japan
Time : 16:10-16:40
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.
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.
- 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.
- 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.
- 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.
- Wu YH, Latash ML (2014) The effects of practice on coordination. Exercise and Sports Sciences Reviews 42: 37-42.
- 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.
The Healthcare Accreditation Institute | Thailand
Title: Thailand self-assessment on patient safety situation: A key contribution to the establishment of national patient and personnel (2P) safety policy
Time : 16:40-17:10
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.
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.
Alexandria University | Egypt
Title: A real life study on treatment of Egyptian patients with HCV genotype IV with simeprevir and sofosbuvir
Time : 17:10-17:40
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.
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.
 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
 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
 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
 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
 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
Burapha University | Thailand
Title: The application of NIOSH lifting equation to prevent musculoskeletal disorders risk: The case study in Thailand
Time : 17:40-18:10
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.
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.
- 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.
- 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.
- 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.
- 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.
- 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 8th National Scientific Conference and the 4th International Scientific on Occupational and Environmental Health (pp. 250-255). Hanoi: Vietnam.