2nd World Congress on
Primary Healthcare and Medicare Summit

Biography:

Hiroshi Bando is a Physician with specialties in “primary care medicine, diabetes, life style-related disease and psychosomatic medicine”. He has more than 2000 Japanese publication articles, 30 books, 150 English medical publications, 800 lectures. He was the chairman of Annual Congress of 8th Japanese Primary Care Association (2017) and Editor of several medical journals on diabetes, endocrinology and metabolism. He has been the chairman of Shikoku Island division of Integrative Medicine Japan and was the chairman of annual Congress of 9^th Japanese Music Therapy Association (2009). He is also a pianist and won the silver prize in 3^rd European International Piano Concours in Japan (EIPIC) (2012). Furthermore, he has been an athlete in baseball, speed skating and athletics, and can run 100m for 13 seconds for half century. Thus, he continues to control the body and mind, which may become the reference for primary care medicine. 

Abstract:

In the 1960s, there was some dissatisfaction for the medical situation. They included increased depersonalization of medicine and fragmentation of care. Millis Report of 1966 was presented the recommendation for new medical system, which focuses not upon individual organs and systems but upon the whole man. After that, primary care medicine and family medicine were developed. On the other hand, in Japan, we have had a most respectable and well-known physician, Dr. Shigeaki HINOHARA (1911-2017). He had been working in St. Luke’s International Hospital, Tokyo, and been abroad in US. Then he came to know Sir Osler / Oslerism, and modern medicine at that time. After coming back Japan, he has changed the medicine in Japan. He has firstly introduced and developed in Japan, such as primary care medicine, annual medical checkups, health education system for many people, problem-oriented system (POS) for medical chart, education system for nurse and co-medicals, life style related disease, music therapy, New Elderly Association (NEA) movement and so on. Consequently, he has been called “The Father of Primary Care” and “The Father of Music therapy”. He lived up to 105 years with continuous activity, and his remarkable achievements have still lead many people. The author has majored in primary care medicine, music therapy, psychosomatic medicine, sports medicine, life style related disease and developed these activities with Dr. Hinohara for long. Recently, we have broaden Oslerism and Hinohara-ism through NEA and other opportunities. The author has been 1) physician, 2) pianist, 3) athlete, 4) essayist with more than 40 books and 2000 publications. In the key note speech, a variety of contents would be presented such as primary care, music therapy, anti-aging medicine, low carbohydrate diet (LCD), sports activities and others for the beneficial and positive effects for healthier body/soul/mind/spirit. 

Biography:

Abstract:

Hospice is a model of care that offers significant benefits to patients at the end of their lives, their families, and also to the primary care physicians (PCPs) who have diligently cared for their patients.  As comprehensive care physicians, PCPs can benefit from a strong understanding of hospice and palliative care.  Participants will understand the clinical appropriateness of a hospice patient to ensure a timely referral.  They will understand the relationship between the primary care physician and the hospice provider to ensure collaboration in care of hospice patients.  Finally they will understand how they can reimbursed for the services as they continue to care for patients on hospice.

Biography:

Demet Karadenizli, MD has her expertise and passion through health and wellness. Her COMPACTLY SRUCTURED Health Screening model allows a comprehensive systematic patient oriented and evidence based evaluation of the current medical status which gives a chance for executing all the diagnosis and risk factors simultaneously for each and every patient. She has built this model after eleven years of experience with four hospital implementations. Her previous background composed of teaching clinical skills to preclinical students and creating a geriatrics curriculum in a non-geriatrician faculty) as an assistant professor, and ruling a branch for “National study on Assesment of the Nature and Extent of Drug Abuse in Turkey” project; (Project No. AD/TUR/02/G02 UNODC-GAP/Turkey, 2002-2003, ANKARA)  These were the previous multidisciplinary projects she inspired in developing this compact model for health screening. This approach has approved itself with an international patient loyalty and early diagnosis rates which should be the key performance indicators for a comprehensive health screening.

Abstract:

Statement of the Problem: There is lack of a comprehensive algorithym in patient oriented health screening in accordance with an evidence based paradigm. The previous point of view has its own limitations. This approach has stable and flexible parts which allows customization and are all based on but not limited to highest level of evidence. This approach has proved its reliability by international patient loyalty, the early diagnosis rates, and the self, early diagnosis of a breast cancer of the doctor whom held the approach.

C: CUSTOMIZED ( Evidence based customization)

O: ORGANISED (pre and post process organisation scheme)

M: MATRÄ°X (multiple interrelated decision trees)

 P: PATÄ°ENT ORIENTED

A: ADULT

C: COST-EFFECTIVE  (clinically and financially)

T: TIME EFFICIENT (in terms of the process and the disease-free period )

L: LEGAL

Y: YEARLY

S: SYSTEMATÄ°C 

T: TRACKED (allows a patient to be tracked)

R: RESPONSÄ°BÄ°LÄ°TY SHARING (takes place between phisicians and the patient with an informed consent)

U: ULTIMATE ( A very high quality approach proves itself with international patient loyalty and early diagnosis rates for many cancers)

 C: COHERENT (between the other disciplines and the coaching)

T: TRAINING (necessary for everybody in the process)

U: UPWARDS (the patients’ health status moves upwards.)

C: CIRCLE (interrelated circles of sessions)

E: EVIDENCE BASED (relies on the highest evidence)

D: DIAGNOSTIC ACCURACY AND DÄ°VERSÄ°TY (allows concrete and  multiple diagnosis simultaneously)

The main success for COMPACTLY STRUCTURED Health Screening is  international patient loyalty and the early cancer diagnosis rates.

Biography:

Anna-Liisa Tamm (PhD) is the docent and head of Physiotherapy and Environmental Health Department at Tartu Health Care College (Estonia). She has studied several health issues (including vegetarianism, coffee consumption, bone health, physical activity) and she has also a patent “Mechanotherapeutic Device And Measurement Method” (for children with genu valgum).  She has organized several conferences in recent years (for example International Student Conference “Health in Our Hands”.

Abstract:

Statement of the Problem: Vegetarianism is an increasing trend in Western world and among other reasons that influence calcium level probably one cause of osteoporosis.  Aim of this cross-sectional study was to evaluate the impact of vegetarianism to bone mineral density (BMD) and blood vitamin D and calcium level, considering other influencing factors as age and gender. Methodology & Theoretical Orientation: Altogether 171 subjects were recruited to study: 103 adult omnivores (O; ♀=81; ♂=22) and 68 vegetarians (V; ♀=51; ♂=17) who did not eaten meat at least past two years. Total and regional (lumbar spine - L1L4; femoral neck - FN) BMD was measured with dual-energy X-ray absorptiometry. Calcium concentration was determined by BS-120 chemistry analyzer and vitamin D by ELISA. The t-test, univariate and multiple linear regression analysis were done. Findings: Results showed that V had considerably lower L1L4 (p=.045) and FN (p=.019) BMD, that was more different in men group; but in general women’s BMD in comparing to men was lower (total BMD p<0.001).  Results of univariate linear regression analysis show, that age and gender also had an effect on BMD; FNBMD: V vs O coef-.045; p=.028, female vs male coef-.08; p<.001; total BMD:  female vs male coef-.094, p<0.001; older vs younger coef.002, p=.004; L1L4BMD older vs younger coef.002; p=.038. After adjustment for age and gender the situation stay quite same. Calcium levels were mostly in recommended level (2,02-2,60 mmol/l) in both groups, but significantly higher in O group (p=.026). Vitamin D level was not differing in groups, but were below the recommended level in 43.5% and 35,1% of V and O participants, respectively. Conclusion & Significance: V had lower FNBMD, even vegetarianism was found to have a positive effect on calcium concentration.

Biography:

I was born in 1980 in Istanbul. I completed my undergraduate education at Florance Nigtingale School of Nursing of Istanbul University between 1997-2001. I studied at “The University of Salford” and “City Collages” Manchester in 2003 to study English. I completed my master's degree in Psychiatric Nursing at Marmara University. I am currently a PhD candidate at Marmara University. 2002-2017 I worked as a nurse in various positions in “Acıbadem Health Group”. In my 18 years of professional life, I gained experience in all processes of the hospital including emergency room, inpatient care, operating room, intensive care, endoscopy, training and management processes. Currently, I am working as a lecturer at Rumeli University Vocational School of Health Services. I am also the assistant director of the college.

Abstract:

This study is planned, as a descriptive and seeking relation, to investigate effecs of personality traits of interpersonel relations of doctors nurses and other health professionals of private hospital who has intensive interpersonal relations during work. For data collection Ä°nformation form which is based on literature is developed by researcher, Ä°nterpersonal Relations Scale, A Type Personality Scale are used and for data evaluation Chi-Square Test, Student’s T test, one way ANOVA,  post hoc further analysis test.  In the study, it was found that the A-type personality traits of the health workers benefited from the highest mid-level services in the sub-dimensions (30.990 ± 7.087), while the lowest average levels of social activities (6.827 ± 2.548) were found. The highest score average of the sub-dimensions of interpersonal relationships of health workers was found to be in “Feeder Relationship Style lard (32,207 ± 6,186).

 As a result of this study, first of all,  studies are provided to  know and recognize personality traits of health professionals, to motivate individuals “effective leadership” model is actualized, opportunity is given to workers  about education for adaptation to job and to be productive are suggested. Keeping guidance and psychological counseling effective and active this provides positive outcomes such as improving flexible programs which individuals personality make positive and health professionals take time of themselves, their families and their hobbies.

Biography:

Seda KARAMAN is a lecturer of Istanbul Rumeli University, Department of Physiotherapy. She completed her master’s degree at Izmir Demokrasi University. She  had been worked as a physiotherapist at pediatric rehabilitation department of Ministry of  Family, Labor and Social Services for two years. She took place in several conferences and forum about Health Science and Health Care Services with her papers and oral presentations such as “Evaluation of the Environment of Disabled People Living in Bolu: Preliminary Study”.  She attended “Intra-muscular Manual Therapy”, “Dry Needling (Trigger Point Therapy)” and “Cupping and Hirudotherapy” courses organized by AC-OMT and Dura Osteopathy Association.  She received “Space Therapy System Training” at 2019.

Abstract:

Statement of the Problem: Caregiving is a profession that requires physical effort and is also affected by psychosocial factors. Researchers have reported that the difficulties of caregiving adversely affect the quality of life associated with physical and mental health. The aim of the study was to investigate the low-back pain, depression and burnout levels among formal caregivers of elderly and children with disability.

Methodology & Theoretical Orientation: The study included 29 caregivers of disabled children and 26 caregivers of elderly. In the evaluation of low back pain, the part related to low back pain in the Standardized Nordic Musculoskeletal Questionnaire (SNMA) was used. Beck Depression Inventory (BDI) and Maslach Burnout Inventory (MBI) was used to assess depression and burnout levels respectively.

Findings: There was a significant difference between the two groups only for the frequency of pain (p=0.039). There was a significant difference in depression levels between the groups (p=0.001) and no difference in the burnout level of the among groups.

Conclusion & Significance: The caregivers involved in this study suffered from high low-back pain. Individuals in the elderly care group experienced pain for several days a week, while the disability care group had either continuous (almost daily) or rarely pain. In this study, the level of depression of the caregivers of disabled children was higher than the caregivers of elderly. Burnout levels of both groups were similar. It was found that both groups experienced moderate emotional burnout in the mean scores of emotional exhaustion and depersonalization subscale, but there was a high level of burnout in the personal accomplishment subscale. Physical and psychosocial problems experienced by caregivers can significantly affect the quality of care. In conclusion, early recognition, prevention and coping with problems affecting the physical and mental health of caregivers able to improve the quality of healthcare services.

Biography:

Abstract:

Background: Time and again evidence coming on development of multidrug resistant tuberculosis has emphasized focus on drugs, patients, their compliance and lab support. In our study we have tried to incorporate the role of health care providers as well, a major cog in the health system. We assessed their existing knowledge  , capacity building, and execution in terms of programmatic components.

Methods: The study was carried out in TB Sanatorium ITKI, Sadar Hospital Ranchi and RIMS Ranchi. The interview of various health personnel including SAHIYAs was taken using a semi-structured questionnaire based on programmatic management of multi drug resistant tuberculosis guidelines -2016.

Results: Among Doctors knowledge level was good compared to other health personnel which had mean value 7.33 (±2.79), laboratory technician 3.45 (±2.64), STS 4.67 (±1.59), Sahiya 2.1 (±0.73). Regarding capacity enhancement level all health personnel needed refresher trainings in which doctors got 4.67 (±1.58), laboratory technician 3.45±2.64, STS 1.72±0.34, and Sahiya 0.5±0.52. Specially sahiya needs training regarding MDR-TB because they are the connecting link between health system and community. Regarding execution level, Doctors got 1.86 (±0.74), laboratory technician 1.64 (±0.56), STS 1.64 (±0.56) and Sahiya (ASHA) 2.2 (±0.44). Sahiya were better than other health personnel at execution level.

Conclusions: Advocacy, communication, and social mobilization are important aspects of TB control, Policy makers and administrators should be sensitized for need of adequate and sustained funding for TB control to ensure quality capacity building. They need to provide continuous and quality training of staff at different levels and retention of trained staff and periodic reviews to identify gaps and take corrective steps.

Biography:

Josephine Ozioma Ezekwesili-Ofili is a lecturer and researcher in Pharmacological Biochemistry at the Department of Applied Biochemistry, Nnamdi Azikiwe University, Awka, Nigeria. She has special research interest in ethnomedicine and medicinal plant pharmacology and toxicology. She is also involved in validation of folkloric claims of medicinal plant action. She is a member of the Association of Scientific Investigation, Conservation and Utilization of Medicinal Plants of Nigeria (ASICUMPON) wherein she interacts with traditional healers and professionals with interest in curative and esoteric effects of plants. She is also a member of the Nigerian Fields Society. She has contributed a book chapter on African traditional medicine in herbal medicine.

Abstract:

Statement of the Problem: Primary Health Care (PHC) is provided for individuals within a community with a broad range of services from health promotion and prevention to treatment and management of acute and chronic conditions, especially in rural areas. The principles of PHC include accessibility, affordability and equity.  However, most parts of Africa still face shortage of basic health care. This inequity in health care delivery, coupled with low literacy, low income level and high cost of modern medicine, amongst others, are the major constraints to achieving the WHO mandate of health for all. People, therefore continue to rely on traditional medicine which is based on locally available resources, and cultural knowledge. This work investigated the extent and role of African traditional medicine in primary health care in selected African countries, including Nigeria. Methodology and Theoretical Orientation: The materials and methods used included books, journals, databases, interviews and questionnaires to primary healthcare providers, traditional healers and individuals in different communities. Findings: There was evidence of increased interest in herbal medicine among urban and rural dwellers due to improved scientific knowledge, promotional advertisements and trade fairs. Approaches differed according to region and cultural beliefs. Patronage of herbal medicine did not exclude the use of primary health care services where available, but very chronic illnesses were considered to be better handled by traditional healers. Conclusions and significance: Although Western medicine is generally accepted in Africa and can be accessed by many, it cannot completely replace indigenous health care but exists in tandem with it. Thus African traditional medicine remains central to the lives of many in both rural and urban areas. Due to the increasing popularity of traditional medicine, it is imperative that a healthy collaboration be established between the PHC practitioners and traditional healers, to augment primary health care services.  

Biography:

Alejandra Martínez has her expertise in molecular processes of tau protein in dementias. She stars her scientist formation since she was studying chemistry at UNAM in Mexico. After that, she continues her formation in one of the most prestigious investigation center in México, CINVESTAV, obtaining a PhD in cellular and molecular neurobiology. She is currently a professor at a prestigious university and collaborates with the National Brain Bank at CINVESTAV. The goal of her research is to find therapeutic targets for Alzheimer’s disease and other dementias. She also currently interested in studying the molecular mechanisms involved in mental disorders such as autism, attention deficit disorder, depression and stress. 

Abstract:

Dementia is a complex disorder of multifactorial etiology that results in alterations in health status changes in lifestyle. It is important to identify the risk factors at an early age, to prevent disease. Diabetes mellitus type 2 is the most common type of diabetes in which autoimmune antibodies appear to be the cause. In this type of diabetes, insulin resistance is observed, which limits the ability to respond to hormones, both endogenous and exogenous. In some cases, insulin resistance is a result of a lower number or a mutation of insulin receptors. These receptors are expressed in the central nervous system. When there is insulin resistance as in the case of diabetes mellitus type 2 or there is no insulin production as in the case of diabetes mellitus type 1, the pathways involved in the neuronal function are not activated. Therefore, some proteins involved in neuronal death such as tau, amyloid-ß, and å-synuclein are activated. These proteins will form intracellular and extracellular deposits, which are histopathological features of dementias such as Alzheimer’s Disease and Parkinson Disease. Neuronal death caused by the lack of insulin is one of the reasons why diabetes mellitus is a risk factor for dementia.

Biography:

Abstract:

Stroke is a common neurological and public health problem with high mortality and morbidity globally as well as Bangladesh. After stroke functional life becomes impaired and sometimes developed psychiatric symptoms. Due to lack of awareness and limited psychiatric services they don’t take psychiatric services when they developed behavioral, emotional, psychotic symptoms.

The aim of the study was to assess the psychiatric disorders after stroke patients in a tertiary care neuroscience hospital in Bangladesh.

This cross sectional study was done in the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from January 2017 to November 2018. Semi-structured questionnaire was used to obtain socio-demographic data and DSM V Diagnostic criteria were used to diagnose psychiatric disorders. Ethical issues were maintained accordingly.

Total 214 patients were referred to psychiatry department from inpatients and out patients department and out of them 120 were diagnosed post stroke depression, 49 developed anxiety disorders, 68 developed sleep disorders and 34 developed psychosis. Some patients had multiple diagnosis.

It was found that significant psychiatric co morbidity developed after stroke. So psychiatric assessment is needed every patient after stroke for proper management of the stroke patients. Further broad base study is need in this regard.

Biography:

Shahrul Rahman has expertise in internal medicine and also has an interest in research. Research conducted has appeared in several international journals. His experience in research is dedicated to the importance of the development of medical science so that they become more advanced.

Abstract:

Background: Benign Prostatic Hyperplasia (BPH) is an enlarged prostate gland caused by progressive hyperplasia of glandular cells or stoma cells from prostate tissues. BPH is a common problem that increased by age up to 40 years. The symptoms is termed as lower urinary tract symptoms (LUTS) that consist of voiding symptoms, which is straining to urinate, frequent urination, urinary hesitancy and retention. Beside that there are also other storage symptoms such as urgency, frequency and nocturia. Aims: The aim of this study is to know the characteristic of BPH patients in RSU Haji Medan from January – December 2015.

Method: Research design of this study is descriptive studies. Population all of the patients who diagnosed with BPH in RSU Haji Medan from January-December 2015. Sampling technique is using total sampling method. Research data was retrieved by taking the patient's entire medical record with BPH in RSU Haji Medan from January-December 2015.

Results: There are 84 person diagnosed with BPH. The highest age group is 60-70 years; consist of 34 people (40.5%). The most common  complaints of patients with BPH is being not able to urinate, consist of 42 people (50.0%). Common volume size of prostate is 40-60 grams which is 32 people (38.1%). The most common therapy is TURP, by 64 people (76.2%). The highest co morbidities is hypertension, consist of 20 people (23.8%).

Conclusion: The most patients with BPH in RSU Haji Medan were 60-70 years old, with the chief complaint is being not able to urinate, with common size of prostate volume is 40-60 grams, the most common therapy that been used is TURP and the highest co morbidities is hypertension.

Biography:

Halil Demir is a lecturer of Istanbul Rumeli University, Department of Medical Documentation and Secretarial.He has been conducting lessons about Medical Documentation, Administration of Healthcare Facilities, Writing Techniques in Healthcare and Ethics of Healthcare for 2 years. He participated in "Green Growth and Sustainable Development Forum" as a Turkish Delegate in France(Paris) OECD Centre(20-22 November 2017).He took place in several symposiums, conferences and forum about Health Science and Healthcare Management with his papers and oral presentations such as "Global Social Responsibility Levels of The Medical School Students, Attitudes of Health Care Vocational School Students on Patient Privacy, The Effects of Different Attitudes of Health Administrators on Institution Employees”in France, Bulgaria, Kosovo, Bosnia and Herzagovina). Currently, his paper which is entitled  "Social Gender Perceptions of Women Working  in the Healthcare Sector" was accepted by West East Institute for oral presentation at Harvard Faculty Club(Boston, U.S.A.) between 29 June and 02 August 2019.

Abstract:

In parallel with the growth in enterprises, productivity has also gained importance in recent years. As a result of evaluating the conditions that affect the performance of employees in positive or negative aspects, supportive practices such as motivation programs or improvement of conditions are taken into consideration in order to eliminate the situations causing negativity. Performance-based payment systems are one of the effective ones.

In particular, Health Services, which is more complex than other services, has gained great importance not only for the benefit of the institution but also for the patients who are users. Research into the quality of health care has provided evidence of widespread deficits, even in countries with extensive resources for healthcare delivery. In an intervention to improve quality, a proportion of institutions' wages is directly linked to the outcome of quality indicators. This mechanism is known as for Pay for Performance ”(P4P). It has found application in the private sector rather than the public sector. In our country, it is limited. The most successful institution is the Ministry of Health. Since 2003 in Turkey "Health Transformation Program" (SDP) with significant reforms to regulate the health care system is realized. Incentives for better performance in health care have a variety of modes and methods. It is designed to encourage employees to perform better and improve the results of their work. It may include monetary or non-monetary incentives and may be applied to consumers, individual providers or institutions.

One of these models is the Payment by Performance system. In this system, beneficiaries are compared with each other based on a series of performance indicators and those who reach a high level of performance are financially rewarded. Although there are many studies related to performance-based wage systems, there are still no sufficient and up-to-date studies on the field of health. This study has been presented by classification of comparisons with the literature review by reference to domestic and foreign literature, and it will also be of great benefit for such future researches.

Biography:

Oguz Ozyaral was born on 22 July 1956 in Istanbul. He completed his education in Istanbul University Faculty of Pharmacy in 1979.  He completed his Business Administration Specialization in 1988 at the Institute of Business Economics of Istanbul University.  He completed his Master's Degree in Microbiology at Marmara University Institute of Health Sciences in 1989 and was honored with high success by the Dutch Royal Academies GIS Institute.  In the same year, he completed his PhD studies in Istanbul University, Institute of Health Sciences, Department of Microbiology and received the title of Mik Doctor of Pharmaceutical Microbiology ”.  In April 2012, he was promoted to Associate Professor in the field of Mik General Microbiology, and as a Professor in Health Sciences Health Management in 2017.  He has 278 scientific studies and articles published in national and international platforms, 16 chapters in books and 1 printed book in English and 3 in Turkish. Her research interests include microbiology, environmental health, occupational health and safety, occupational hygiene and public health.  He served as program moderator and presenter for various National Radio and TV channels.  He has held administrative positions such as the Dean of Students, Director of Vocational Schools, Heads of Pharmaceutical Microbiology Department and Faculty of Pharmacy and Public Health Department and University Senator.   He is currently the Vice Rector of Istanbul Rumeli University and Director of the School of Health Sciences.

Abstract:

The importance of hospice care is increasing day by day.

The aim of the study is based on the preference of HOSPICE care as "Home Care Services". Therefore, structuring palliative care within Home Care Services is to prepare management models.

The association of Home Health Care and Home Care is part of Palliative Care as HOSPICE Services, conducted in the areas of home or institutional care. Many terminal cancer patients want to spend the last period of their lives at home. It should be possible to provide this service upon the request of the persons who meet hospital discharge criteria and who meet the criteria for receiving Palliative Care Service. The patient is referred to the Family Physician and / or Home Care Unit with epicrisis and care directives.In order to provide Palliative Care service to the patient, the appropriateness of the home and care conditions for the patient should be evaluated by the social worker and home care team and necessary arrangements should be made.

Service provision is unique and different for each individual. therefore, the objectives, intensity, frequency of care; patient's and family's needs, values, disease progression and process may vary according to the way. Necessary home visits are made within the scope of Home Care Services. Patient and family-centered care is provided. Patients receiving treatment such as chemotherapy or dialysis can continue treatment.The process focuses on patient comfort and care, with or without curative intervention. PB, also known as comfort care, is usually made up of doctors, nurses and other trained health care professionals, and a team from which the patient will receive the first therapeutic intervention in an institution such as a facilitated hospital, nursing home, elderly care home or extended care.

Palliative Care Programs are being prepared for the sustainability and effective implementation of these services to be provided to patients. In the structuring of home care of palliative treatment, doctors and nurses working primarily in the field of home care should specialize in this field. The PC and Home Care relationship models proposed in this study provide the ability of the patient to stay at home with the people whom he / she wants to be with, his / her personal belongings and pets. The patient tries to provide quality time with his family and relatives in the treatment and care processes.

Biography:

Ülle Parm is currently the Associate Prof at Tartu Health Care College; Research Fellow in Medical Microbiology at University of Tartu Institute of Biomedicine and Translational Medicine and Board member of the Estonian Society of Infection Control. She has instructed more than 100 students’ final thesis and has been the head of several research projects. The field of research has been different: development of neonatal microbiota; vaccination status and problems in Estonia; influence of vegetarian diet and coffee consumption to body composition, bone mineral density and metabolic syndrome; Lyme borreliosis in Estonia; occupation health by example of police workers and firefighters, and so.

Abstract:

adolescence period, the 15-years-olds have willingness to experiment and take high-risk decisions influencing their health. The aim was to establish availability and consumption habits of addictive substances (alcohol, tobacco products, and illegal narcotics) among the 9th grade students of Tartu.

Methodology & Theoretical Orientation: Anonymous questionnaire was conducted among 394 pupils from eight schools (80.1% of total sample size). Descriptive statistics and Pearson's correlation to find links between alcohol, tobacco, and illicit drug use was applied. Comparisons between groups for numerical values were made with t-test or Mann-Whitney test, non-numerical data were analyzed using χ2 test; p value of <0.05 was considered as significant.

Findings: Alcohol, tobacco and narcotics had been tried respectively by 76.4%, 39.9% and 15.7% of participants. Other soft alcohol drinks were consumed more than wine (p<0.001) and strong alcohol (p = 0.046), and strong alcohol was consumed more than beer (p=0.002). As median amount of alcohol and quartiles was zero, we can conclude that less than one quarter of students consume alcohol. Alcohol is mostly obtained from parents and friends; tobacco products from friends and acquaintances and illegal drugs from friends.

The reasons for alcohol and narcotics consuming are curiosity and having fun; tobacco was used at parties mostly. The use of tobacco correlates with consumption of alcohol (r=0.43; p<0.001) as well as with use of narcotic substances (r=0.4; p<0.001). The use of narcotics also correlates with alcohol consumption (r=0.24; p<0.001). The availability of alcohol is considered easy by 63.9% of pupils, while 51.5% and 27.7% for tobacco and narcotic drugs. Respectively, 14.9%, 26.9% and 26.6% of pupils noted that if availability of these substances would become more difficult, consumption would decrease.

Conclusion & Significance: Though several pupils have experienced the usage of illegal addictive substances the consumption is not frequent. 

Biography:

Irina Mozhaeva is a researcher at the University of Latvia. She holds a PhD in Economics (subfield – Econometrics) from the University of Latvia. Her research and publications focus on long-term care, health economics, social policies, labour market issues etc. She is an administrative data specialist and during the last decade has worked extensively with the Latvian and Estonian (individual level) administrative data, including health care data, social insurance, social assistance data, etc. As an expert she has participated in numerous World Bank and OECD research projects in Latvia and Estonia, e.g. „Estonia: Long-Term Care”, „Latvia: Active Ageing”, „Developing a Health System Strategy for Priority Disease Areas in Latvia”, “Connecting People with Jobs”, “Investing in Youth: Latvia”, “Latvia: Who is Unemployed, Inactive or Needy? An Assessment of Post-Crisis Policy Options”, as well as in other national level projects, including "Assessment for Elaboration of the Public Health Strategy 2014-2020" (commissioned by the Ministry of Health).

Abstract:

The pressures of population ageing stimulate policy-makers to look for cost-effective opportunities that would go in hand with greater efficiency, quality and better outcomes.

In this study, we analyze the efficiency of home health care services in reducing mortality, readmissions, and emergency visits during 365 days after the hospital discharge among the Latvian elderly patients aged 60 and above. This is the first comprehensive study on utility of home health care in the post-transition context.

The individual-level data used in this study have been collected specifically for the purposes of this project from various Latvian administrative data sources, including registers of the National Health Service, the Centre for Disease Prevention and Control, Oncology Register, Psychiatry Register, etc. The obtained data sets cover the observation period from 2014 to 2018.

In our study, we verify three broad hypotheses: home health care reduces the probability of readmissions and emergency visits during 365 days after the hospital discharge and increases survival among the discharged patients. These hypotheses are tested within the entire group of elderly patients, as well in specific subgroups, including oncology patients, patients with cardiovascular diseases, etc.

Patients who received home health care services are matched with the control patients discharged with "self-care" applying propensity score matching method. Regressions used to adjust for the observed patient characteristics include a wide set of control variables, including various characteristics of inpatient and outpatient care received, implemented manipulations, patient’s diagnoses, demographic characteristics, etc.

The obtained results propose that home health care after the discharge significantly reduces the probability of hospital readmission and death, however, the magnitude of these effects differs substantially between various patient groups. The obtained results are of particular importance for the development of the efficient health care models and value-based care plans.

Biography:

Abstract:

Background

Maternal mortality remains a public health concern; about 303,000 maternal deaths were reported in 2015 globally.  Each day, about 830 women were reported to die from pregnancy or childbirth related complications. In low and middle income countries including Tanzania maternal mortality are high. In Tanzania maternal mortality ratio is high at 556 deaths per 100,000 live births. Direct Health Facility Financing (DHFF) was introduced by the government of Tanzania in financial year 2017/18 with main goal of decentralize powers to primary health care facility in-charges and improve ownership among community.

Methods

Study utilized mixed method approach to capture information before and after implementation of DHFF 2016/17 before and 2017/18 after intervention. Data were collected before and after intervention. 20 IDIs were conducted with health care providers at 5 health facilities and 5 FGDs were conducted with Community health governing committee members in each study site.

Results

Increased number of pregnancy women delivered at health facilities from 1189 to 1589. An increased number of drugs necessary for maternal health such as folic acid from 8,800 to 20,000, Iron supplement from 23,800 to 39,900, Magnesium sulfate from 43 to 57, Sulfadoxine-pyrimethamine from 26,200 to 39,500 and urine deep stick for protein from 3,200 to 4,600. Furthermore, an increased number of medical equipment’s like BP machine from 7 to 13, weigh scale machine from 8 to 10, fetal scope from 7 to10 and deliveries kits from 24 to 73. Increased number of medical reagents like syphilis test from 2,390 to 8,568, urine deep stick for protein from 500 to 2,200 and MRDT from 1,250 to 8,800. DHFF has increased stakeholders involvement in facility planning, budgeting and purchasing of facilities drugs, medical supplies and medical reagents which facilitate provision of better maternal health services.

Conclusions

We recommend that, DHFF to be taught in health institutions, this will help to impart required skills and knowledge to health care workers and simplify its implementations.

Biography:

Abstract:

Objectives: Passive smoking describes the unintended exposure of non-smokers to tobacco smoke and is an important public health problem. In all over the world, 40% of children and 34% of non-smoker adults are exposed to cigarette smoke.  It has long been known that tobacco smoke has a detrimental effect on people who doesn’t smoke. We aimed to evaluate the knowledge of the patients and their relatives about the health problems occurred by passive smoking.

Materials and methods: Our study was applied with the volunteers from patients and their relatives in the outpatient clinics of Smoking Cessation and Chest Diseases. A questionnaire was used to evaluate the demographic characteristics and the knowledge of the patients and relatives about results of passive smoking . The questionnaire included 17 statements that included the definition and results of passive smoking. For participants some options were presented "I agree", ”I disagree“ or "I don’t know".

Results: 520 participants were included in the study. The mean age of the participants was 42,73 ± 15,40, 328 (63,10%) were male and 192 (36,90%) were female. 41,70% of the participants were smokers, 42,50% had never smoked, 15,80% had stopped smoking. Most participants (89,10%) knew the definition of passive smoking. Knowledge was high in some statements like passive smoking relation with heart disease, asthma, lung cancer, bronchitis, pneumonia, cardiovascular diseases and COPD. However, relationship between passive smoking and diabetes mellitus, dementia and sudden infant death were not known well. To the statements of “In infants of smokers, sudden infant death in sleep is more common” (p: 0.037) and “in children of smokers cough, sputum and wheezing are more common” (p: 0.005), agreement of smokers was less than who never smoked and than those who quit smoking. The majority of those who did not agree in the statement “Cough, sputum and wheezing are more common in the children of smokers” were male (p: 0.033).

Conclusion: In our study, the participants had known some of the harmless effects of passive smoking on health. Although the smoke-free airspace policy, which has been implemented for ten years in our country, has increased the public's awareness of the hazards of cigarette smoke; this is not enough. Therefore, people can be protected from the damages of passive smoking with the application of laws and increasing public awareness. Especially parents can take some protective measures for their children by the awareness of all passive smoking hazards.

Biography:

Abstract:

Purpose:

It has been observed an increased of participation of women in the medical profession over several countries worldwide over the past decades. This study aimed at addressing the of health workforce feminization among doctors in Oman and exploring the health system readiness in dealing with this phenomenon.

Methods:

Literature review was conducted to study the global trend of female’s participation in the medical profession. Furthermore, reports and records were reviewed regarding the human resources and gender of the health care workers, specifically the doctors in Oman.

Results:

Findings regarding the medical students showed higher number of females compared to males (64% females in 2015 compared to 54% in 2009). A similar trend was observed in the postgraduate students (61.5% of the graduated residents were females).

As for active workforce, the Ministry of Health statistics revealed that female doctors represent 42% of the total doctors compared to 27% in 1990. It increased 4% from 1990 to 2000, doubled to 8% from 2000 to 2010. The proportion of specialized female doctors reached 31% in 2015 compared to 21% in 1990. There also was gender variation among specialities. The proportion of female General Practitioners reached 50% in 2015 compared to 30% in 1990 (4% increase every five years).

Conclusions:

The feminization phenomenon in Oman requires more attention in order to assess the health system readiness of meeting the needs and accommodating the females' as the main care providers. The trend can have important consequences on future planning, given that women doctors differ from men in how they participate in the workforce. It may also potentially contribute to a shortage in supply due to difference in preferences and consequently affect the skill-mix and productivity. The cultural, social context and dimensions need to be explored; and feasible options to be provided for better planning.

Biography:

Abstract:

Individuals' health behaviors and health perceptions are regarded inseperable from each other. Communities having endeavored to maintain their cultural characteristics for centuries have passed down this on their health behaviors and strived for finding cures to their health problems in their cultural lives. The individuals’ beliefs about health, attitudes and behaviors, past experiences, treatment practices, in short their culture, play a vital role in improving health, preventing and treating diseases. Culture is influential at many levels in health, ranging from the formation of new diagnostic groups, to the diagnosis of disease to the determination of what is called a disease or not symptoms and disease cues. However, in almost all regions of the world,  wars, ethnic conflicts, repressive regimes, environmental and economic crises along with globalization have forced many people to abandon their country and migrate in their country or to immigrate other countries as refugees. As a result, multicultural populations comprised of individuals, families and groups from different cultures and subcultures are rapidly emerging all around the world. In order to improve the health behaviors of the community, cultural factors affecting health behavior and health care services need to be clearly recognised. Unless health care initiatives are based on cultural values,  it will be impossible to achieve the goal and the care provided will be incomplete and fail. Cultural differences and health beliefs have been recognized for many years as prior knowledge in practice. Despite that, cultural health care is unfortunately not part of a routine or common health practice. Knowing cultural beliefs related to health can enable us to build a framework for data collection in health care. In order for the societies to regulate health care that will meet the needs of different groups in terms of culture, all health team members must be equipped with the necessary knowledge and skills. The nursing profession, which plays an important role in the health team, is a cultural phenomenon. The patient's cultural values, beliefs and practices are an integral part of holistic nursing care. Transcultural nursing provides effective nursing care to meet the cultural needs of individuals, families and groups. The concept of "Transcultural Nursing" derived from the need to care for individuals in different cultures in nursing was first used by Madeleine Leininger in 1979. Transcultural nursing is sensitive to the needs of families, groups and individuals who are representatives of groups with different cultures in a community or socieity. This sensitive approach provides support for the individual in achieving the well-being and happiness. The aims of transcultural nursing are to provide sensitive and effective nursing care to meet the cultural needs of individuals, families and groups, to integrate transcultural concepts, theories and practices into nursing education, research and clinical applications, to improve transcultural nursing knowledge, and to incorporate this knowledge into nursing practice. The International Nurses Association (ICN) invited the nurses from the World Health Organization (WHO)  member countries to work on adaptable models to their communities at the 1989 Seoul Conference. Some of these models include ;

1. Leininger’s Sunrise Model
2. Narayanasamy’s ACCESS Model:
3. Giger and Davidhizars’s Transcultural Assessment Model
4. Purnell’s Model For Cultural Competence

Biography:

Faaiz Alhamdani finished his PhD in Newcastle University, UK in 2012. Part of his PhD project was qualitative study on patients’ experiences with blow-out fractures of the orbit. Since then he became interested in qualitative research methodologies. Beside his interest in qualitative research he is also interested in educational research and quality of life research, particularly in Oral and Maxillofacial Surgery. He works now as Vice Dean for Scientific Affairs, College of Dentistry, Ibn Sina University for Medical and Pharmaceutical Sciences, Baghdad-Iraq. He joined IADR 2010. From 2010-2016 he worked as Iraqi Division Secretary. On August 2016 he was elected as President of Iraqi Division. From 2012 he co-organized most of Iraqi Division (IAOR) events and in August, 2017 he was the main organizer and President of the 4^th IAOR Scientific Conference in Antalya Turkey. He is also member of The American Association for Advancement of Sciences.He is a writer, poet and fine art critic. He published 3 collections of poetry book and 4 books on fine art.

Abstract:

During the last 2 decades, the medical research underwent a gradual transition from purely quantitative research (post-positivist) to endorse qualitative research (interpretivist) paradigm. This article tries to shed a light on this transition and use fine art examples as analogy. For the sake of clarification it is important to explain some of the terms used in this article for readers whom their interest might be out of the scope of qualitative research or fine art. 

Biography:

Abstract:

Biography:

Consultant of  obstetrics and gynecology (1991), PhD (2002); Habilitated Professor of obstetrics and Gynecology, and Head of “Dr I Cantacuzino” Discipline of obstetrics and gynecology , at “Carol Davila” University of Medicine and Pharmacy, Bucharest (2016), President of   The Romanian  Menopause Medical Association (June 2019) with active involvement in women’s health research and care, from the entrance in the speciality., with focus on hormonal contraceptive methods, non-oral routes for menopausal hormone therapy, gynecological conservative surgery, besides maternal-fetal medicine.

Abstract:

Endocrine and neural senescence overlap in time, by  intertwined complex feedback loops. Women’s brain  is more prone to suffer  during life,  perimenopause is a ”critical period”, offering to the scientific and medical communities a  “critical window of opportunity” to delay the onset of brain aging and neurodegenerative diseases, Alzheimer’s disease(AD) being actually the most analyzed. Women’s brain exposure to estrogens from puberty during reproductive years is crucial for the  brain health in elder ages, different from populations. Depression associated to memory, learning, cognition disorders are present from earlier ages when hysterectomy with/without adnexectomy vs general population. The multifactorial  nature of women’s brain aging opens many hypotheses and tests in health research and practice.  AD is  characterized not only by Aβ oligomers, plus fibrils accumulation, but also by metabolic and inflammatory changes, with onset in transition, and early years of menopause. Animals models are helpful to sustain the still controversial results of human clinical  observational/randomized controlled trials. Deep analysis of endocrine, neural, metabolic pathways are giving new insights to the sequential view of Aβ-centric in AD pathogenesis, prevention and treatment from  perimenopause, for maintaining women’s neurological health, to maintain brain volume, proved to diminish. Estrogens, progesterone and androgens, with nuclear and membrane receptors, genes, and epigenetics, their connections to cholinergic, GABAergic, serotoninergic, and glutamatergic systems are involved in women’s brain normality or pathology through direct/indirect mechanisms of modulating/protecting plasticity, vessels net-work, fuel metabolism- glucose, ketones, ATP, insulin resistance, aging brain’s inflammation through  blood-brain-barrier disruption, and microglial aberrant activation, neural cell survival/loss, în myelination, and influences on congnitive processes. Estradiol protects the neurons from excytotoxic damage and increases neuronal survival. Progesterone with it’s 5α-reduced metabolite, allopregnanolone stimulates neurological and functional recovery, different from progestagens.  Androgens also exhibit a wide array of neuroprotective effects in motoneurons, including supporting cell survival, axonal regeneration, and dendritic maintenance.

Biography:

Abstract:

PURPOSE: To compare rates of positive bacterial growth in placental swab cultures done among women who received ampicillin prophylaxis at different timings after term PROM.


MATERIALS AND METHODS

Design: Matched Cohort Study

Setting: Department of Obstetrics and Gynecology at Southern Philippines Medical Center in Davao City, Philippines

Participants: One hundred twenty pregnant mothers at ≥37 weeks age of gestation, aged ≥18 years old who have a history of gross pooling of amniotic fluid and have a singleton pregnancy in vertex position and have no other infections and co-morbidities.

Methodology: A total of 120 patients consented and were included in the study.  These patients were grouped according to the onset of watery vaginal discharge up to the time where antibiotic was initiated.  They were then grouped in the 6^th hour, 12^th hour and 18^th hour group.  Blood tests such as WBC and CRP were obtained upon admission on these patients. Monitoring of maternal temperature and heart rate, fetal heart rate, monitoring for the occurrence of uterine tenderness and vaginal discharge were done.  After delivery, placental swab of the patients were submitted for culture and sensitivity.

Results: The mean age of patients belonging to the 6^th hour group is 25.4, 26 for patients in the 12^th hour group and 26.4 in the 18^th hour group.  Most of the patients were single with an OB Score of G1P0.  There were no significant differences in the age, civil status, gravidity and parity among the groups.  There were no significant differences in the clinical signs of intraamniotic infection (IAI) mentioned among the 3 groups.  There was no association between the occurrence of maternal infection based on WBC in the 3 groups.  However, more patients in the 12^th hour and 18^th hour  group have elevated WBC.  There is a significant association between CRP positivity and the 3 groups of PROM.  There are more patients in the 12^th hour group and 18^th hour group who showed a positive result for CRP.  For placental swab culture, there is no association between bacterial growth among the 3 groups.  Bacterial growth were observed in 27/40 (67.5%) of cultures in the 6H group, 31/40 (77.5%) of cultures in the 12H group, and 31/40 (77.5%) of cultures in the 18H group.  Across all groups, the five most common isolates were Escherichia coli, Staphylococcus hominis, Staphylococcus haemolyticus, Staphylococcus epidermidis, and Enterobacter cloacae.  In the 3 groups, the predominating bacteria was Escherichia coli.  This organism is 71% sensitive to Ampicillin and 100% sensitive to Amikacin, Amoxicillin/Clavulanic acid, Aztreonam, Cefepime, Cefotaxime, Cefoxitin, Cefuroxime, Ciprofloxacin, ertapenem, Imipenem   and Meropenem.

CONCLUSION: Among the 3 groups, there were no significant difference in their clinical signs of IAI.  However, laboratory parameters showed that there were more markers of infection seen on patients who received the antibiotic later.  Elevated WBC and bacterial growth in the placenta were higher in the 12^th hour and 18^th hour group, although not significantly different among the 3 groups.  There was also a significant difference in the CRP positivity among the 3 groups.  There were more patients who showed a positive CRP result on those who received the antibiotic later.  This study recommends that starting antibiotic earlier in the 6^th hour is beneficial. 

Biography:

Cem Yener is a specialist doctor in Department of Gynecology and Obstetrics. He is now working on Division of Perinatology at the Trakya University Medical Faculty, Turkey. His expertise is especially in high risk pregnancies, targeted ultrasound, chromosomal and congenital anomalies, amniocentesis, chorionic villus biopsy and cordocentesis.

Abstract:

Iniencephaly is a rare neural tube defect characterized by the presence of occipital bone defects at foramen magnum, fixed retroflexion of head, spinal dysmorphism, and lordosis of cervicothoracic vertebrae. Iniencephaly is in the same family of neural tube defects as spina bifida, but it is more severe. The frequency varies between 0.1-10 / 10,000. Most of the fetuses are female. Etiopathogenesis is not known. According to some sources, it has been associated with trisomy 13, 18 and monosomy X. AFP(alfa-feto protein) as a biochemical marker is generally increased. Here we present a 30 years old 19 weeks pregnant women that was  referred to our Perinatology Department. We detected polihydramnios, extreme retroflexion of the head, absent neck, low set ears and major cardiac anomaly on ultrasonography. We informed family and with family consent we terminated pregnancy (Image 1). In conclusion, iniencephaly is a neural tube defect with unknown etiopathogenesis. There is no standard treatment for iniencephaly since most infants rarely live longer than a few hours.  Medicine is based more on prevention using supplementation with folic acid.  Numerous studies have demonstrated that mothers can reduce the risk of neural tube birth defects such as iniencephaly by up to 70 percent with daily supplements of at least 4 mg of folic acid.  Pregnant women should avoid taking antiepileptic drugs, diuretics, antihistamines, and sulfa drugs, which have been shown to be associated with an increased risk of neural tube defects.  Maternal obesity and diabetes are also known to increase the risk for these disorders so prenatal care is important for these patients.

Biography:

Taniya Thapa, graduated as Masters in Nursing (Women’s health and Development) and Masters in Sociology with two and half years experience in clinical as Nursing In charge and two years experienced as Nursing Lecturer  and recently working as Lecturer in Chitwan Medical College approved by Tribhuwan University in Nepal. With the work experiences and skills attained so far has inspired for further career development with readiness to face with new challenges

Abstract:

Objectives: Pelvic organ prolapse is the descent of one or more of the pelvic structures from the normal anatomic location toward or through the vaginal opening influencing the quality of life of women particularly among adults and old women in developing countries. We aim to assess the awareness regarding pelvic organ prolapsed among women attending in a teaching hospital, Chitwan so that necessary awareness program could be recommended if found unsatisfactory.

Methods: A descriptive cross-sectional study was done among 110 women attending Gynae Gynaecology Outpatient Department of Chitwan Medical College Teaching Hospital, Chitwan who participated voluntarily in face to face interview that used structured questionnaire from 1st July to 5th August, 2018 selected using consecutive sampling technique. Data was analyzed using descriptive and inferential statistics like frequency, percentage, mean, standard deviation, chi-square and fisher exact test.

Results: Among 110 respondents the median age was 37.0 years, 31.8% were from the ages between 31-40 years. Majority of the respondents were literate, 47.3% were housewife, 51.8% had first child between the ages of 20-24 years, 46.4% had two children, 33.6% had abortion, 49.1% had heard about pelvic organ prolapsed from friends and relatives and 6.4% were diagnosed with pelvic organ prolapse and among the diagnosed 28.6% had received treatment, 65.5% were aware regarding pelvic organ prolapse and age of having first child was significantly associated with the level of awareness (p=0.002).

Conclusion: In conclusion more than half of the women were aware regarding pelvic organ prolapse. Further awareness program can be conducted at rural settings by Female Community Health Volunteers and health workers to enhance the awareness level regarding pelvic organ prolapse among women.

Biography:

ANOUA Adou Serge Judicaël is a Doctor in socio-anthropology and Assistant Professor in the Department of Anthropology and Sociology at the Alassane Ouattara University. He is a coordinator of the Laboratory of Studies and Research in Reproductive Health care Transition. He intervenes at the Basic School of the National Institute for Training of Health Agents of Bouaké, at the graduate cycle of the National Institute for Training of Health Agents of Abidjan and in Master of Health Community at the Continuing Training Center at Alassane Ouattara University. He has published several papers in journals and is an editorial board member. My domain of speciality is the socio-anthropology of health. The general problem that occupies my scientific reflection is the issue of Reproductive Health in rural Africa, particularly in Côte d'Ivoire. I also conduct research activities in the domain of community health and environmental health and nursing care.

Abstract:

Statement of the Problem: The epidemiological transition remains a major challenge for public health in Côte d'Ivoire. It stems from the medicalized vision of the health system. In fact, the action plans of the various national programs are in no way officially supported by any sociological support study. The reference structure for prevention remains the service of epidemiological surveillance. The implication of such an attitude is the fact of sociological resistance in the acculturative process. In this context, the human component is a dimension of importance. From this we deduce that this epidemiological monopoly underlying the public health approach in Côte d'Ivoire seems to us to be wrong. How to reduce this complex health situation? And how to get people to take charge of their own health individually and collectively? Intervention: Faced with these questions, we propose the establishment of a training system in health promotion anchored in lifestyle. It is a matter of guiding the different social strata of the population towards the adoption of the behaviors in favor of a general well-being, in addition to the control of their own health. It is in this context that the opening in 2014 of the community health training program at Alassane Ouattara University in Bouaké, meets a healthy wait. This stream recruits nurses, midwives and doctors. They are trained in theory and practice from a multidisciplinary perspective in order to establish the mechanism of behavioral change in the population. Results: The first promotion has just been released in 2018, with the Master's degree in Community Health. Conclusion: It is envisaged for these new graduates, the creation of a national network to maintain relations, strengthen the spirit of professional belonging and develop a framework for collaboration and exchange of experiences for improving skills.

Biography:

Abstract:

Background: management of critically ill patient in emergency department is a critical health status which requires standardized care policies and qualified skilled health providers to obtain good outcome of management. Objectives: To study nurse’s competences regarding management of critically  ill patients. Methods: A descriptive hospital-based study conducted at Emergency Department in Omdurman Military Hospital / Sudan during the period of September 2018 to December 2018. Sixty nurses working in emergency department were assessed for their knowledge, practices and attitude towards management of critically ill patients. The assessment was performed by using a questionnaire for knowledge and check list for practical skills. Results: Females represented (60%) of the total sample and most participants had experience of 1-5 years. The overall participant's knowledge for all the variables analyzed in this study revealed that 18 participants (30%) had poor knowledge in the emergency department which was considered alarming in caring for critically ill patients. Twenty eight   participants scored below (50%) for applying critically ill patient care. Also the participants showed positive attitude regarding management of critical ill patient in emergency department.

There was a highly significant association between level of knowledge and Educational level P.V ≤ 0.05, also Significant associated with Training course and Knowledge stated P.V ≤   0.05.

Conclusion: The study showed good knowledge, but generally nurses’ performance in the current study found low. Practical skills wasn't  compatible with participants’ knowledge.

Positive attitude was attined regarding management of critical ill patient in emergency department. 

Biography:

Bin Ghouth has experience in primary health care and research methodology and epidemiology. Bakramn has expierence in clinical practice especially in diabetic care, the other co-aithors are medical students participating in proposal development , data and specimens collection and data analysis. All of author and co-authors participating in writing and reviewing the final report and approve it. Hadramout University is an academic institution where the research conducted in its laboratories.

Abstract:

Statement of the problem: Patients with diabetes mellitus are at high risk of cardiovascular events because of abnormal lipid levels status. Dyslipidemia is common in patients with type 2 diabetes mellitus. However; in Yemen this issue was not yet addressed. The purpose  of this study is to determine the prevalence and patterns of dyslipidemia in patients with T2DM in Mukalla city, Yemen, in 2017. 

Methodology & Theoretical Orientation: A Cross-sectional study was conducted in a randomly selected eligible patients from the diabetic registry of the AL Noor Charity Center (ACC), Mukalla city in eastern Yemen during the period from May-July 2017. A well structured questionnaire and blood investigation for lipid profile and blood sugar were the tools of data collection from 120 randomly selected T2DM patients registered in the ACC.

Findings:  The prevalence of dyslipidemia in type 2 diabetic patients was 85%, prevalence of dyslipidemia in males was 86% while in females was 84% but the difference was not significant (P-value 0.4).  Regarding age group, BMI and duration of DM, there is no significant association exist with dyslipidemia. About half of the studied T2DM patients have high serum cholesterol level (52.5%), while 22.5% had low serum HDL- C levels and 39.2% had high serum triglyceride level, most of patients had serum LDL-C levels above normal range (67.5%), so the common patterns of dyslipidemia in this study were LDL-C followed by cholesterol.

Conclusion& Significance: High prevalence of dyslipidemia among type 2 diabetes mellitus in Mukalla city were observed and so the common patterns of dyslipidemia is LDL-C followed by cholesterol. This study recommended  screening of lipid profile among DM patients as these abnormalities may lead to development of cardiovascular diseases.

Biography:

Omotosho Tobiloba Oyejide Alex graduated from the Department of Nursing and Reproductive Health of the University of The Gambia in 2016 and is currently pursuing a masters degree in Community health nursing at the same institution. Presently working as a registered nurse at the only teaching hospital in The Gambia and as a graduate assistant with the University of the Gambia, he has developed interest in the areas of chronic disease management, health promotion and reproductive health.

Abstract:

Staterment of the Problem: Nurses are often the first point of contact for people seeking information on diabetes care and therefore have a major role in insulin administration. Inadequate knowledge of nurses on insulin treatment can cause errors and several adverse outcomes. It is therefore expected that nurses should have information about how insulin works, when and why insulin is needed. The purpose of this study was to determine the level of knowledge of insulin therapy among nurses in Edward Francis Small Teaching Hospital, The Gambia. Methodology: A hospital-based descriptive cross-sectional study was conducted among 127 randomly selected trained nurses using the EFSTH staff list as the sampling frame. Data were collected using a self-administered questionnaire. Data were analysed using IBM SPSS version 20. Findings: A total of 127 nurses participated in this study but 118 completely filled and returned the questionnaires making a total response rate of 93%. The mean years of experience of nurses was 3.86±4.051 years with a minimum of 1year (20.3%) and maximum of 23years (0.8%). Most of the nurses were females (n=66, 55.6%), had a diploma in nursing (n=75, 63.6%) and working at the surgical department (n = 47, 39.8%) respectively. The majority (n = 93, 78.8%) of them had never attended an in-service training on diabetes management. The majority of nurses rated their knowledge of diabetes as good (n = 72, 61%). General level of knowledge score on insulin therapy was low (n=88, 74.6%). There was a significant mean difference of the nurses’ years of experience in relation to their knowledge of sign and symptoms of hypoglycaemia (p < 0.05). Eighty-six (72.9%) nurses reported administering insulin injection in the arm while 4.2% (n=5) of them reported checking for expiry date prior to giving insulin injection. Conclusion: The nurses with more than four years of practice were more knowledgeable on the requirements of effective insulin administration than those with two years or less practical experience. Recommendations are made for the urgent need for an educational intervention on diabetes and insulin therapy for the nurses in EFSTH.

Biography:

Ignateva Lilya is a graduate student of the last year of study in KSMU. The doctor also runs a private practice as an orthodontist. Her research interests are focused on myofunctional disorders of the maxillofacial region in children. In addition to the scope of his scientific interests, the doctor constantly attends conferences and seminars in his profession and is also the speaker of these events.

Abstract:

Annotation. Many studies speak about the dependence of myofunctional disorders and the formation of occlusion pathology. Our study shows changes in the bioelectric activity of muscles during orthodontic treatment, and also shows the effect of orthodontic treatment on the change in electromyography.

Introduction. Recent studies allow us to rationally explain the complex pathogenetic mechanisms of dental anomalies and deformities, which have a multifactorial nature. It was found that myofunctional disorders are the most significant among postnatal factors affecting the formation of occlusion. It should also be noted that many researchers.

The aim of our study is the effect of orthodontic treatment on the bioelectric activity of muscles in the presence of combined pathology of dentoalveolar anomaly in children aged 9-12 years.

Experimental methods. Electromyographic study was performed using four-channel computer neuromyopathies analyzer "Synapsis" in dental equipment connected to the computer with the given software for the analysis of the obtained results.

Research result. Previously, three groups of children were recruited. The first group included 53 patients treated with the use of the device of functional action, the second-50 patients in whom the hardware treatment was supplemented by the use of a myofunctional simulator, the third – 34 patients using only the simulator.

Summary.Thus, according to the results of the evaluation of the values of the average amplitude of EMG potentials achieved after correction, it was found that the greatest decrease was observed in patients receiving combined treatment-using both the apparatus and the simulator.

 Thus, the greatest decrease in EMG potentials was expressed in the correction of VHF by a combination of hardware treatment and a simulator. The use of the simulator was accompanied by a moderate negative dynamics of EMG potentials, and with the isolated use of hardware correction, changes in indicators were practically absent.

Biography:

Abstract:

Behavioral change remains the back born for healthier lives of individuals bearing in mind the current situation where, lifestyle diseases are the leading cause of preventable morbidity and mortality. While governments are using substantial amounts of funds to treat diseases and ensure that children are immunized, change in behavior still has a great role in prevention of lifestyle diseases. Due to the cost involved in treating diseases as well as the consequences of the disease effects, prevention should be recognized as an approach of choice. Children are to be targeted in as far as behavioral change is concerned because they can learn new behaviours and adopt them to be part of their lifestyle. However, children first learn life skills and behaviors from their parents, later they learn from their peers. Hence, the role of parents, especially mothers in establishing early basic health practices is of great importance if we are to change the community towards the desired goals. Parents should be taught what is proper for them to pass the same to their children. Diseases have both direct and indirect impact on children and their ability to thrive in school. Poor health can lead to loss of school days and even if the child goes to school there will be poor focus and concentration. A sick child will not be able to feed properly and may end up being malnourished. It is a known fact that poor nutrition results in poor growth and development of a child hence poor learning ability. A sick child is also affected both psychologically and socially; additionally his/her self-image and confidence may be impaired. Educating parents, especially mothers on their children’s healthy desired behaviours may be cheaper than treating diseases which are due to lifestyles. Use of leaflets, pamphlets, short text messages as well as phone calls has proved to be effective in delivering health information to parents. Parents may not use the information to change their own behaviors, but if instructed to impart that information to their children, they often do so. When children are still at the age which allows learning new ideas, they can easily adapt newly taught behaviours. Once a considerable number of children in a particular society has learnt good behaviours, they can disseminate the knowledge to their peers and ultimately to the whole society. This can be a cost effective and sustainable means to prevent diseases through behavioral change while improving children’s well-being and school performance.

Biography:

Abstract:

Purpose. We aimed to assess the effect of pre-hospital statin administration on the concentration of inflammatory markers and matrix metalloproteinases (-1, -3, -9) in the serum of patients with ST-elevated myocardial infarction (STEMI).

Materials and methods. As part of a prospective cohort study, 175 patients with STEMI were consistently included. The average age of patients in the common group was 61.3 ± 8.4 years, among them there were 116 (66.3%) men and 59 (33.7%) women. Serum concentrations of interleukins (IL-6, IL-10, IL-12), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and matrix metalloproteinases (MMP) -1, -3, -9 (pg/ml), as well as blood lipid parameters were evaluated in all the patients on the 1^st and 12^th day of myocardial infarction. All the patients were divided into 2 groups depending on the statin intake at the pre-hospital stage: 136 (77.71%) patients without statins, 39 (22.29%) patients with statins.

Results. It was identified that in the group of patients (n = 39) who took statins for at least 7 days prior to the development of STEMI, significantly lower values of low-density lipoproteins were revealed [2.91 (1.31; 5.13) vs 1.34 (0.76; 9.77)], as compared to the patients without prior statin therapy. When analyzing the differences in the concentrations of the studied biomarkers in the groups of patients depending on the statin intake at the pre-hospital stage, significantly lower values of pro-inflammatory markers (IL-6, CRP, TNF-α), as well as MMP-9 were detected both on the 1^st and the 12^th day of STEMI development in the group of patients with pre-hospital statin intake. The concentration of IL-10 anti-inflammatory marker in the group of patients who was taking statins at the pre-hospital stage was twice higher than the corresponding values in the group of patients without statin administration.

Conclusion. The lack of pre-hospital statin administration in patients with STEMI is associated with the higher values of pro-inflammatory markers (IL-6, CRP, TNF-α), and MMP-9 during the in-hospital period.