Scientific Program

Keynote Talks

Abstract

Errors are a recurring fact of health care organizational life and can potentially yield either adverse or positive consequences. Although we have learned much about errors in specific research areas across specific organizational contexts, we know little about how multifaceted forces in organizations, especially when they contradict each other, might affect the pathways of errors in organizations. In this talk I will present an integrative approach to errors by summarizing conceptual foundations and empirical findings of my studies. I will focus on three dimensions: namely (1) levels of analysis – the degree to which errors are attributed to the individual (e.g., individual employee) or collective actors (e.g., teams, units); (2) temporal dynamism – the degree to which organizational emphasis is put before, during, and afteran error occurs; and (3) priority – the degree to which conflicting priorities are assigned to error coping strategies. I will present my research findings onhow to reduce the underlying causes and negative consequences of errors while promoting positive outcomes and learning benefits in organizationsand specifically in health care.

Biography

Eitan Naveh is an associate professor at the Faculty of Industrial Engineering and Management, Technion–Israel Institute of Technology,where he received his D.Sc. in quality assurance and reliability. Last year a visitor scholar in Harvard School of Public health.His research interests include mainly two streams of organizational research: errors in organizations; and linkage between innovation and quality. Applying an interdisciplinary approach that combines aspects of behavioral sciences and engineering he has contributed to the understanding of errors, innovation, and quality by revealing the hidden tensions resulting from multiple priorities situations and exploring their consequences. He mainly studies research and development teams in hi-tech companiesand medical teams in medical centers.His research has been published in the Academy of Management Journal, Journal of Applied Phycology, Journal of Management, Journal of Operations Management, Management Science, and other leading academic journals.

Speaker
Eitan Naveh / Technion - Israel Institute of Technology
Israel

Sessions:

Abstract

Globally, about 10% of maternal deaths are due to preeclampsia-eclampsia (PE-E). Antepartum low-dose aspirin prophylaxis costs less than USD $25. Primary prevention of PE-E with aspirin and calcium can half the incidence of PE-E. Antepartum low molecular weight heparin combined with low-dose aspirin prophylaxis can half the incidence of early onset PE-E and small for gestational age fetuses. However, PE-E prophylaxis is not routine. Therefore, magnesium sulfate secondary prevention of eclampsia remains the globally recommended intervention. In 2016, the PE-E checklist was presented as a continuous quality improvement (CQI) tool facilitating appropriate antepartum PE-E screening, prophylaxis and maternal care from the first trimester through the postpartum fourth trimester inter-partum interval. Subsequently, the role of low-dose aspirin in PE-E prophylaxis has been confirmed by randomized controlled trial. Meanwhile, studies to improve PE-E screening continue. CQI PE-E checklist implementation and appropriate PE-E prophylaxis provide clinicians and healthcare systems an opportunity to achieve Millennium Development Goals 4 and 5, reducing child mortality and improving maternal health.

Biography

Oroma Nwanodi graduated from Meharry Medical College of Nashville, Tennessee in the United States of America as a Medical Doctor in 2001. She specialized in Obstetrics and Gynecology at The University of Massachusetts and Maimonides Medical Center. In 2016, she completed the Doctor of Health Science program at A. T. Still University, Mesa, Arizona. In 2017, she obtained American Board of Physician Specialties certification in integrative medicine. She has practiced in California, Minnesota, Missouri, New York, and Wyoming. She has published more than 30 papers in reputed journals and serves as an editorial board member of repute

Speaker
Oroma Nwanodi / Obstetrics and Gynecology Locum Tenens
USA

Abstract

The paper will outline how a conceptual model of ward safety has been devised and outline plans to test the model in complex clinical placement settings. The aim is to further determine and better understand the complex workplace culture and organisational culture interplay that can impact on staff, patient and organisational outcomes in terms of quality care provision and safety measures. To date, no studies have examined inpatient clinical wards as individual ‘units’ within a wider organisational structure as an attempt to understand the complex interface of a safety culture; investigating patient safetyfrom workplace through to organisational level. Neither hasthe linkbetween workplace safety culture and how this relates directly to patient outcomes been well articulated. Therefore, this is a unique, comparative, case study-based approach, designed to identify differences between wards within its host NHS Trust/organisation, performing under NHS requirements regarding patient safety. Second, this study will provide a more comprehensive theoretical understanding of how at team, leader and organisation level, psychological capital may affect culture and how this affects patient outcomes at ward level in an organisation. As a consequence, this study may help to explain why some wards within an organisation are ‘safer’ than others. Third, this research will provide further clarity on the complex constructs that contribute to a climate of patient safety in complex workplace settings

Biography

Professor Sally Hardy has undertaken previous work around transformational change and workplace cultures of effectiveness.

Speaker
Sally Hardy / London South Bank University
United Kingdom

Abstract

The paper will outline how a conceptual model of ward safety has been devised and outline plans to test the model in complex clinical placement settings. The aim is to further determine and better understand the complex workplace culture and organisational culture interplay that can impact on staff, patient and organisational outcomes in terms of quality care provision and safety measures. To date, no studies have examined inpatient clinical wards as individual ‘units’ within a wider organisational structure as an attempt to understand the complex interface of a safety culture; investigating patient safetyfrom workplace through to organisational level. Neither hasthe linkbetween workplace safety culture and how this relates directly to patient outcomes been well articulated. Therefore, this is a unique, comparative, case study-based approach, designed to identify differences between wards within its host NHS Trust/organisation, performing under NHS requirements regarding patient safety. Second, this study will provide a more comprehensive theoretical understanding of how at team, leader and organisation level, psychological capital may affect culture and how this affects patient outcomes at ward level in an organisation. As a consequence, this study may help to explain why some wards within an organisation are ‘safer’ than others. Third, this research will provide further clarity on the complex constructs that contribute to a climate of patient safety in complex workplace settings.

Biography

Dr Louise Terry is an Associate Professor specializing in law and ethics within complex clinical settings. All work at the School of Health and Social Care at London South Bank University

Speaker
Louise Terry / London South Bank University
United Kingdom

Abstract

The paper will outline how a conceptual model of ward safety has been devised and outline plans to test the model in complex clinical placement settings. The aim is to further determine and better understand the complex workplace culture and organisational culture interplay that can impact on staff, patient and organisational outcomes in terms of quality care provision and safety measures. To date, no studies have examined inpatient clinical wards as individual ‘units’ within a wider organisational structure as an attempt to understand the complex interface of a safety culture; investigating patient safetyfrom workplace through to organisational level. Neither hasthe linkbetween workplace safety culture and how this relates directly to patient outcomes been well articulated. Therefore, this is a unique, comparative, case study-based approach, designed to identify differences between wards within its host NHS Trust/organisation, performing under NHS requirements regarding patient safety. Second, this study will provide a more comprehensive theoretical understanding of how at team, leader and organisation level, psychological capital may affect culture and how this affects patient outcomes at ward level in an organisation. As a consequence, this study may help to explain why some wards within an organisation are ‘safer’ than others. Third, this research will provide further clarity on the complex constructs that contribute to a climate of patient safety in complex workplace settings.

Biography

Marie Culloty is Associate Professor for Adult Nursing at London South Bank University, and undertaking her PhD from which this paper has been based

Speaker
Marie Culloty / London South Bank University
United Kingdom

Abstract

Chronic heart related diseases are a major public health issue (prevalence 2% and 8% for >65 yrs) and is the leading cause of hospitalization for people >65 yrs. Compared to hospital-based management of patients, home monitoring embraces a patient-centric self-management alternative system. Early detection of cardiac rhythm disorders allows for timely intervention and prevention of serious conditions such as stroke and repeated falls. The REAFEL project has two aims. First to research, design, and implement a telemedicine sensor platform that enables for remote monitoring of patients, providing automated alerts and reminders to the patient and clinicians. The goal is to provide a home monitoring solution that is applicable for any general practitioner (GP) and Cardiology department for remote live monitoring and review of health data for optimizing the diagnosing and treatment of a potential critical heart rhythm disorders. The second aim is to reorganize and improve the diagnostic process of heart rhythm disorders in frail elderly patients by using this telemedicine setup. Timely diagnosis may prevent repeated falls with adequate pacemaker treatment and medical adjustments. Likewise, strokes related to atrial fibrillation can be prevented with adequate anticoagulation, where the latter amount to 81 mDKK in the Capital Region of Denmark alone. The sensor can be provided by the patients’ general practitioner (GP) or by the home nurse. This will ensure that frail patients who need cardiac rhythm assessment but do not show up for testing due to burdensome outpatient clinic assessments can be tested. These patients are particularly prone to repeated falls and to strokes related to cardiac arrhythmia, that can receive adequate specialized evaluation with the REAFEL model.

Biography

Helena Domínguez, MD, PhD, is Consultant Cardiologist at the Hospital of Bispebjerg-Frederiksberg since 2014, and Associate Professor in the Institute of Biomedicine of the Health Faculty, University of Copenhagen. Her research covers translational science in two main areas: i) vascular function, with special focus on insulin resistance, and ii) use of eHealth technologies to improve patient management, with special focus on frail elderly, heart failure and atrial fibrillation. Teaching responsibilities: Lung and Heart Physiology, and Electrocardiography and Echocardiography exercises for medicine students. Postgraduate courses target PhD students within the area of vascular insulin resistance and methods to study vascular function

Speaker
Helena Dominguez / Hospital of Bispebjerg
Denmark

Abstract

Substantial increase in the number of ageing European population is one of the most pressing challenges that the society is facing today, especially providing cost effective, high quality medical and healthcare services for all citizens. One of the prime impetuses is to ensure that the elderly can live longer and independently at their home with minimal support. Recent advancements in information and communication technologies and the use of assistive technologies (ATs) and assistive devices (ADs) enable the aged individuals to perform their day-to-day functions that might otherwise be difficult or even impossible. Atrial fibrillation (AFIB) is a condition affecting a large part of the elderly (+60 years) population. It is a leading risk factor for stroke. With increasing prevalence of AFIB patients worldwide, there is a need for effective ways for early diagnosis and treatment. Up to 80% of related strokes can be prevented by early detection and treatment of AFIB. This necessitates the need for state-of-the art intelligent algorithms for early and Automatic AFIB Detection (AAFD), as they are crucial to efficiently prevent other more severe cardiac complications. Such systems will certainly benefit the socioeconomic burden, and enhance the life quality of patients. Several methods with varying success have been developed for the AAFD, which rely on the R-R irregularities (RRI), or the absence of P-waves, or combinations of both in the electrocardiogram (ECG) signals. With the growing fields of machine learning and artificial intelligence, in REAFEL, novel method(s) for real-time AAFD is being developed, which consists: (i) ECG pre-processing – Data segments are filtered to minimize noise and baseline wanders using state-of-the art algorithms, (ii) Feature extraction/selection, (iii) Classification & Validation - ECG segments are classified into AFIB or non-AFIB and validated against the gold-standard, and (iv) the system testing on real-time ECG data - collected using a heart rhythm monitor, the C3 device, developed by Cortrium ApS.

Biography

Speaker
Sadasivan Puthusserypady / Technical University of Denmark
Denmark

Abstract

The ubiquity and connectivity of smartphones have opened up new opportunities in eHealth. We are now able to harness mobile devices to screen, diagnose or support the clinical management of a variety of acute or chronic conditions: We can now also leverage our smartphones and a plethora of wearables to unravel new clinical evidence for better understanding ofdisease and health. In this talk, we will discuss the challenges and opportunities in designing and conducting smartphone-based clinical studies by relating specifically to our participation as a cross-disciplinary team inthe Stanford Medicine X / Withings Precision Research Challenge 2017. We present the design, implementation and initial results of a pilot study aimed at leveraging the potential of consumer-grade smartwatches and sleep trackers to determine the long-term preventative effect of daily physical activity against the progression of cognitive decline in people suspected of suffering from Mild Cognitive Impairment (MCI). We hypothesized that increased levels and varietyof physical activity(e.g. walking, cycling, etc.) undertaken byindividuals showing signs of MCI mightprevent the progression of cognitive decline and via the promotion ofbetter quality of sleep. At this stage, our study includes 54 participants. The pilot-phase of the study started in June 2017 and is scheduled to end in January 2018. We plan on presenting some of our initial results during the workshop.

Biography

Danish Technical University (DTU), Nanotech, Copenhagen, Denmark Engineering Systems, Department of Management Engineering, Technical University of Denmark.

Speaker
Francois Patou / DTU Management Engineering
Denmark

Abstract

Background Unintended pregnancy rate is rising nowadays especially in adolescents. Birth rate of adolescent in Thailand was higher than Asia - Pacific regions. Health literacy is one important influencing factor of unintended pregnancy. Exploring health literacy factors for preventive behaviors toward unintended pregnancy is essential to reduce unintended pregnancy in adolescents. Objectives The research aims to examine the health literacy for preventive behaviors toward unintended pregnancy among female college students in Chon Buri Province, Thailand Method A cross-sectional analytical research was conducted during February-May 2017. Multistage sampling was utilized to recruit 418 female college students from 18 faculties in Chon Buri's universities. Chon Buri was reported as the highest adolescent birth rate in Thailand. The self-administrative questionnaire which composed of; 1) personal factors 2) health literacy on preventive behaviors toward unintended pregnancy 2) behavior to prevent unwanted pregnancy was applied to collect the data. Cronbach’s alpha coefficient of the behavior to prevent unwanted pregnancy was 0.89. Descriptive statistic was used to analyze in term of number, percentage, maximum, minimum, and standard deviation. Association was analyzed by Chi-square. Results The female college students who had age average twenty year old. Two – fifth of them have boyfriend/ girlfriend. A half of them had hugging and kissing experience, and nearly one – third had sexual intercourse. The finding shown that 78.2% had moderate and poor level of health literacy. Of those there was third-fifth who had poor access to health information and health service to prevent unwanted pregnancy, seventh-tenth who had poor cognitive health to prevent unwanted pregnancy, and communication skill in enhance skills to prevent unwanted pregnancy, third-fifth who had poor decision skill in choosing appropriate practice to prevent unwanted pregnancy and self-management to prevent unwanted pregnancy, and third-fifth who had poor media and information literacy to prevent unwanted pregnancy. Half of them had appropriate behavior. Analysis using chi square revealed that cognitive health to prevent unwanted pregnancy (p = 0.001), decision skill in choosing appropriate practice to prevent unwanted pregnancy (p ≤ 0.001), self-management to prevent unwanted pregnancy (p ≤ 0.001), media and information literacy to prevent unwanted pregnancy (p = 0.008) were significantly associated with preventive behaviors toward unintended pregnancy among female college students considered at p-value ≤ 0.05. Conclusion This study presented that female college students had poor health literacy on preventive behaviors toward unintended pregnancy which may lead unintended pregnancy. Therefore, there is empty room to construct strategies and program to increase health literacy on preventive behaviors toward unintended pregnancy. Also, this issue should set as a general education course for all female college students.

Biography

Speaker
Saowanee Thongnopakun / Chulalongkorn University
Thailand

Abstract

Mass Drug Administration (MDA) of mebendazole tablets in developing countries has addressed infection by Soil-Transmitted Helminthiases (STH) over the last years. We quantify the public health benefit of 6-monthly MDA in13 million Vietnamese children from 2006 to 2011. This is compared to the cradle-to-graveenvironmental impact of the pharmaceutical supply chain, which also has an effect on Human Health, e.g. through emissions of fine particulate matter. Building on a published model structure by Montresor et al. (2013) we developed a more stable treatment progression.The morbidity by STH is split up in three STH infections: Hookworm, Ascaris lumbricoides and Trichuris trichiura. For each worm, four levels of intensity of infection were included: none, light, medium and heavy. The treatment effect on patients was quantified inDisability-Adjusted Life Years (DALYs). To do that, we quantified the STH-related anaemia and wasting compared to the general population, supported by literature review. Environmental sustainability analysis through Life Cycle Assessment was also quantifiedinDALYs. Compared to ‘No Treatment’, five-year maintenance treatment avoided 143,959 DALYs (83.80% reduction) for Hookworm, 34,029 DALYs (84.64% reduction) for Ascaris lumbricoides and 26,263 DALYs (87.61% reduction) for Trichuris trichiura. The Human Health impact associated with environmental resource use and emissions of the pharmaceutical supply chain of mebendazole was 11 DALYs. A sensitivity analysis verified the results. Anaemia was the most sensitive parameter, even with the most conservative assumptions, the public health benefit of the Mass Drug Administration avoided significantly more DALYs than those associated with the pharmaceutical supply chain

Biography

Speaker
Sam Debaveye / Ghent University
Belgium

Abstract

Radiationtherapy (RT) planning and delivery have changedsubstantially over the last three decades, startingwiththeintroduction of three-dimensional (3D) treatment planning in the 1980s, followedbyintensity-modulatedRT (IMRT), stereotacticablativeradiotherapyand image-guided RT (IGRT), with a substantialcomplexity in the planning and delivery process. The evaluation of these potentially error-pronetechniques in clinical trials with RT requirescarefulandthoroughqualityassurance (QA) programs, whichthe EORTC has pioneeredsincethe 1990s. QA in RT (QART) is defined by all of those procedures that ensure consistency of the RT prescription and the safe fulfillment of that prescription with regard to the dose to the cancer and organs at risk (OARs), minimization of exposure of personnel, and patient monitoring aimed at determining the results of treatment. The practice of QA includes the environment in which care is delivered (structure), how operational standards are maintained (process), and what is achieved for patients (outcome). A QA program is aimed at defining the range of acceptable deviations, detecting potential causes for larger deviations, and developing mechanisms of action for correction and prevention of these deviations. The goal is to reduce variability and uncertainties related to the different steps of treatment planning and actual patient irradiation, including but not limited to patient positioning, correct beam delivery output and precise dose delivery to the cancer. Interest in the quality of clinical trials in radiation oncology has increased in parallel with the growing complexity of RT techniques, associated cost of studies and increased numbers of patients accrued to trials. Only the results of well-conducted studies with a documented QA program in which patients are treated in a technically optimal fashion can be considered credible. Optimal RT is pivotal in the interpretation and reliability of trials, ensuring that potentially practice-changing results are regarded as robust, definitive and generalizable. Specific considerations of QART in a multicentre research setting include: • determination of protocol ambiguities that may affect treatment delivery; • education of sites in RT-specific trial guidelines; • promotion of consistency between centres; • ensuring sites meet minimum technical and personnel requirements; • ensuring accuracy and integrity of data; • estimation of inter-patient and inter-institutional variation; and • identification and correction of flaws in study design. Variations in compliance with protocol treatment can decrease therapeutic effectiveness that may lead to loss of tumour control and/or increase RT-induced toxicity. Such deviations may ultimately contribute to negative clinical trial results. In this presentation, RT deviations/violations will be presented for a number of tumors including brain and head and neck cancers. The association between sub-optimal QA and patient’s outcome will be detailed.

Biography

Speaker
Damien Charles Weber / Paul Scherrer Institute
Switzerland

Abstract

In 2004, the Brazilian Federal Government introduced the “Brazilian Popular Pharmacy Program”, as an alternative means to facilitate access to medicines, aiming to extend this access to more patients and regions, and also, to reduce family expenditures, mainly for popular class families, who are users of the private health system, but have difficulties buying medicines in the regular market. The Popular Pharmacy Program is focused on the distribution of low cost essential medicines, for the treatment of non-communicable chronic diseases, such as diabetes, hypertension, asthma, cholesterol and others. It is based on a copayment model, in which the cost of medicines is partially paid by the government, while the consumer pays the difference. At first, it was based on distribution by government pharmacies. In 2006, the government innovated towards a growth strategy, grounded on partnership with private retailers, operating through a reimbursement system by the Ministry of Health. In 2011, the government established the free of charge distribution of medicines with priority, for the pathologies of diabetes, hypertension and asthma. Recently, the government had to close public pharmacies. This analysis contributed to identifying the scope and limitations of the Program, as an alternative means of access to medicines in Brazil. Data were obtained by means of bibliographic and documentary research and were complemented by interviews with the stakeholders. Although the Program was considered important as an alternative means, operational and strategic improvements are suggested, making this Program more efficient to facilitate the access of medicines to the Brazilian population.

Biography

Silvia Rebouças Pereira de Almeida holds a Doctorate degree in Social Sciences from PUC University in São Paulo, Brazil, where she also completed her Masters in the field of Administration and Planning. She has worked as a professor at Mackenzie University, in the field of Management Information Systems. She holds a bachelor’s degree in Business Administration from Fundação Getúlio Vargas, where she intends to start a Postdoctorate in the field of Public Policies, comparing the Brazilian model of access to essential medicines in São Paulo, Brazil, with those of other countries with national health systems, such as England and Portugal

Speaker
Silvia Rebouças Pereira de Almeida / Pontifícia Universidade Católica de São Paulo
Brazil

Abstract

Background: Hypertension (HT) was a leading cause of worldwide death. Most of patients havepoorly-controlled blood pressure and were risk to be CVD. Exploring characteristics, self-management behaviours, health literacy, and hypertension evaluation of lifestyle and management knowledge (HELM)of them results in launching out appropriate strategies to control hypertension. However there was few research which explore poorly-controlled hypertension patients’ demographic in urban community of Thailand. Objective: 1.Toexplore characteristics, self-management behaviours, health literacy, and hypertension evaluation of lifestyle and management knowledge of poorly-controlled hypertension in urban community. 2. To study association between HELM and self-management behaviours. 3. To study association between health literacy and self-management behaviours. Method:This was a cross-sectional study. Two catchment areas of primary care unit (PCU) in the center of Muang district, NakhonRatchasima, Thailand were purposively selected as a study area due to a high number of population and a high prevalence of HT.The selection criteria were as following: age 30–70 years, registered patient, diagnosed essential HT with the average blood pressure (BP) of last two visits >140/90 mm Hg, lived in the responsible area at least 1 year, willing to participate in this research, and can communicate and write effectively in Thai. The sample size was 120.The 1029 were as eligible samples and their code number were randomized by computer software.Then the poorly-controlled hypertension patientsgot information and 119 patients decided to be participant with sign on inform consent. The questionnaire with characteristics, lifestyle and management knowledge (KR-20: 0607), health literacy (Cronbach's Alpha part 1: .960, part 2: .861), and self-management behaviors(Cronbach's Alpha: .881) was used to collect data by interviewing during August 2017-September 2017. Descriptive statistic, chi - square tests and linear regression were used. Result:The poorly-controlled HT had the average age 60.91 years olds, waist circumference 92.53 cm., years with HT 9.35 years, and types of drug treatment 3.95. There was female 62.2% of, married 55.5%, primary school 68.1%, enough income without saving money 46.2, unemployment 37.0, universal coverage scheme 87.4%, non-smoking 96.5%, nonalcoholic drinking 75.2%, and treatment by drug 100%. The co-morbidity were dyslipidemia 62.2%, diabetes mellitus 51.7%, Osteoarthritis 12.6%, kidney disease 10.9%, and cerebrovascular accident 3.4%. For hypertension evaluation of lifestyle and management knowledge, they had good level 26.1%, moderate level 36.5%, and poor level 37.4%. In term of literacy and potential, one-fourth had good level of talk to other understandable, hearing voice clearly, daily activities ability, and going out by her/himself ability.Only one-tenth had good level of writing message for other to understand,reading comprehension seeing things clearly. Their health literacy average score was 7.8 and 8.0 of 10 for experience sharing item and self-observation item respectively. One-third did good self-management behaviours regularly. There was no significantly association between HELM and self-management behaviours. However, there was significantly association only items self-observation of health literacy and self-management behaviours(P-value=.037). Conclusion:The characteristics of the poorly-controlled HT patients was elderly, ten years HT, low education and 4 drugs treatment. Their self-observation health literacy significantly related to self-management behaviours. This result suggest that increase health literacy about self-observation is important strategy to increase self-management behaviours resulting in HTcontrol. This lead to decrease morbidity and mortality of HT patients.

Biography

Speaker
Sawitree Visanuyothin / Maharat Nakhon Ratchasima Hospital
Thailand

Abstract

Theoretically, one of the fundamental goals of the healthcare system is the treaty that every citizen is not in danger of being impoverished by using health services. However, it is observed that often people become poor as a result of poor health. Moreover, the increase of private health expenditure calls into question the effectiveness of both the healthcare system and the public health policy in protecting people from poverty. Our empirical findings of the research turn out that middle-income or low-income households tend to spend more, as a percentage of their income, on health services compared to higher-income households. Actually, the low-income households are mainly burdened with inflated private spending, which has devastating effects on their income. This fact leads 'health policy makers' to adopt policy interventions in order to establish equal acess to health care, but often in an ineffective way. It is underlined that private spending does not need to be too high to become catastrophic for the households. There is no agreement among the researchers on setting the threshold of catastrophic health expenditure. It is claimed that the rates of catastrophic costs (out-of-pocket) range from 5% to 20% of households' total income. However, surveys converge on the finding that private expenditure ceases to be catastrophic since it ranges below 15% of total health expenditure. According to the available data, it is proven that in most European countries direct health expenditure is between 10% and 30% of total health spending and even higher in the poorest countries.

Biography

Angeliki Moisidou has completed her PhD from the Department of Social Administration and Political Science, Democritus University of Thrace, Greece. She has participated in many research projects in the field of social policy under the auspices of the World Health Organization, the University Mental Health Research Institute and the Observatory of Economic and Social Developments of the GSEE Labor Institute. Research interests: social policy, public health, health expenditure, health inequalities, health care systems, long-term care, non-governmental organizations, maternal and child health, quantitative analysis of empirical data, indicators of inequalities.

Speaker
Angeliki Moisidou / Democritus University of Thrace
Greece

Abstract

Malaria is one of the most contagious diseases which is still a public health problem in the world including Indonesia. The prevalence of malaria in Indonesia in 2013 is 6.0 percent, with malaria endemic areas spread from east to west. Statistical data describes Lampung as an endemic area with the highest point in Sukajaya Lempasing village, Pesawaran. The high incidence of malaria in the village is caused by the lack of optimal role of society to eradicate malaria due to lack of knowledge about malaria. Therefore, in 2017 we did a research to provide counseling about malaria to assess the effect of increased knowledge of society against the emphasis of malaria incidence. The counseling results were analyzed by the qualitative and quantitative approach. The qualitative analysis result (based on observations and interviews) indicate that all participants get more knowledge about malaria. The quantitative analysis result is done by Saphiro Wilk test to assess the data normality and the P value: 0,003 (before) and 0.000 (after). Based on the results obtained, the data has abnormal distribution so that nonparametric related-sample Wilcoxon test is conducted to assess the relationship between counseling and knowledge improvement. The result of nonparametric related-samples Wilcoxon test obtained P value: 0,00, the value is smaller than α (0,05) so it can be interpreted that there is a correlation between counseling with the improvement of community knowledge. After malaria examination is done there is a decrease of malaria incidence that indicates the relationship between society's knowledge with malaria incidence.

Biography

Angga Hendro Priyono is one of student in Faculty of Medicine, Lampung University, He is a Secretary of Student Representative Council in his University. He has published more than five papers journal and serving as an editorial board member. He has done more than three community services on public health scope in three different villages. Because of the devotion, the village can explore the existing resources in the village and can be utilized optimally by the local community.

Speaker
Angga Hendro Priyono / Medical Faculty of Lampung University
Indonesia

Abstract

Gambling is a growing and lucrative industry in Australia and around the world. Recent reports and reviews into the industry in Australia have highlighted the cost of gambling to Australian citizens and its impact upon our society more generally. For example, it is estimated that up to 40percent of gambling losses are incurred by people with serious gambling problems gambling disorder or gambling addictions and whilst it is accepted that up to 3% of the population are at high to moderate risk of having a gambling disorder, up to 10 other people are adversely affected by each addicted gambler. There are numerous strategies being employed in an attempt to mitigate problem gambling in our community ranging from public health and media based strategies to face to face psycho-therapies and on-line treatments and support, but the issue is not going away. As the industry grows and gambling practices are migrated to the on-line environment, more and more people are feeling the impact of the industry and becoming susceptible to the adverse effects of it. Gambling and problematic gambling behaviour in particular can be highly destructive of family and community life and lead to extreme emotional and social problems and even suicide. Any strategies that can be implemented to ease domestic tensions will be positive influences for reducing domestic violence. This paper outlines some treatment strategies that have been shown to be successful in the treatment and management of problematic gambling; strategies that, if more broadly applied, could help to mitigate social and domestic disharmony and violence. If more people could be encouraged to seek help currently less than 5percent of people with gambling problems seek help for their problem to overcome the stigma associated with their gambling addiction, this would be a positive step in ameliorating increasing rates of domestic violence.

Biography

We will Update soon

Speaker
Peter Harvey / Flinders University
Australia

Abstract

The American healthcare system is now engaged in a robust inquiry of how to integrate evidence of the impact of the social determinants of health (SDOH) into clinical standards of care. The most significant of these activities is the expansion of medical billing codes to include social risk factors that serve to facilitate or impede optimal health outcomes. These activities have spurred debate on the efficacy of healthcare systems to effectively intervene with social risk factors. The concept of household-centered care posits that the smallest unit of care should not be an individual, but the household unit. As such, care should consider the interplay in medical and social risks that are managed at the household level to predict health and social service seeking behaviors. Inter-professional teams conduct household visits to address medical, legal, and social barriers. Mitigation of social risk factors is accomplished through strategic partnerships with more than 160 community organizations, use of lay health workers and the development of health information technologies. The objective is to build resiliency among households by assisting them in achieving goals that will exceed basic survival and prevent repeated reliance on safety net services. Currently, Florida International University College of Medicine is implementing this approach longitudinally with 1100 households in medically underserved communities throughout Miami Dade County. A pilot study reported that emergency department usage by households participating in the household-centered approach was reduced by 50% between 2010 and 2012.

Biography

Dr. Luther Brewster’s background is in community development; he has worked both in the private and public sectors. Since beginning his career in 2003, Dr. Brewster has held academic and research positions at the City University of New York and the University of Michigan, Ann Arbor, Michigan. He served as consultant for the expansion of the 125th Street business improvement district in Harlem, New York and the Arsenal, F.C. Emirates Stadium housing regeneration project in London, England. The focus of Dr. Brewster’s work is on the identification and correction of health risks created by programs and policies that typically are not viewed as having a relationship to health. He has a consistent track record of implementing grassroots strategies to address community concerns. In 2005, Dr. Brewster joined Florida International University FIU as faculty in the Robert Stempel College of Public Health and Social Work. In March 2008, he became faculty at FIU Herbert Wertheim College of Medicine to lead the development of the community-based initiatives. As Founding Chief of the Division of Policy, Research and Community Development and the Community Director of Green Family Foundation NeighborhoodHELP™ Health Education Learning Program, Dr. Brewster oversees the development of a broad network of community partners and the recruitment and retention of households for the Green Family Foundation Medicine and Society community-based educational activities. He is also co-Founder of the FIU-Aetna Health Policy Analysis Academy, a joint venture with the Pardee RAND Graduate School to develop healthcare ‘value propositions’ for strategies aimed at addressing the social determinants of health. In July 2010, Dr. Brewster was a recipient of the prestigious Marshall Memorial Fellowship through the German Marshall Fund, which brings together Americans and Europeans to increase understanding and to build transatlantic networks among the political, media, business, and nonprofit communities. He is a member of the Accreditation Council for Graduate Medical Education Review Committee for Thoracic Surgery, Chair of Miami Homes for All and board member of Health Foundation of South Florida in Miami, Florida.

Speaker
Luther Brewster / Herbert Wertheim College of Medicine
USA

Abstract

Background: Obesity has a stranglehold on America. In spite of priority funding and numerous programs around the country to curb obesogenic behaviors, no downward trend has been observed nationally. In fact, adult obesity rates have stabilized over 2009 to 2012, but at levels that have doubled over the last 35 years, with the average American 24 pounds heavier today than in 29160. The Tulane Prevention Research Center (PRC) has been working to achieve its mission, the prevention/reduction of overweight and obesity in the Greater New Orleans area, for more than 12 years. Purpose: To present the many activities of the PRC that have improved the environment and promoted positive policy change within our community, with input from community partners. Examples of these activities are: evaluating new bike lanes for increases in active transportation, facilitating joint use agreements, promoting physical activity by building walking paths, addressing access to healthy food by policy change. Methods and Results: These PRC activities will be described, along with some impressive results. Discussion: The importance of environmental and policy implications for the prevention of obesity will be reviewed, along with recommendations for how we might proceed as a nation to healthy weight for the population.

Biography

Carolyn Johnson, PhD, FAAHB, LPC, NCC, is trained as a behavioral psychologist providing behavioral science expertise to a wide range of health-related studies. Her focus has been behaviors that affect physiological systems, such as diet, physical activity, smoking and sexual behaviors. She has been PI, Co-PI, and Investigator on NIH-funded multisite and single site studies, as well as research and training grants funded by DHHS and HRSA, and the State of Louisiana. Evaluation is one of her strengths, especially process and outcome evaluation. She has been Director of the PRC for six years and is Director of the Center of Excellence in Maternal and Child Health, as well as Chief of the Section of MCH in her department.

Speaker
Carolyn Johnson / Tulane University School of Public Health
USA

Abstract

Background:The Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program was designed to improve the management of acute changes in condition in NHs and reduce potentially avoidable hospitalizations(PAH) and EDvisits. In a randomized, controlled implementation trial involving 264 NHs the strategies used for training and implementation support employed showed no effect on hospitalization outcomes; 85 NHs with no prior INTERACT use demonstrated significant reductions in PAH, but no other outcomes. Objective:To determine if changes in use of INTERACT were associated with reductions in hospitalizations, PAH, and ED visits during a 12-month implementation trial. Methods:This was a secondary analysis of data from the randomized controlled trial involving 200 NHs from both the original intervention and control groups that reported their degree of INTERACTuse before and after a 12-month implementation period. Degree of use was based on self-reported use of two INTERACT core tools (SBAR and Stop and Watch). NHs were categorized based on changes inINTERACT useduring the implementation period. Outcomemeasuresincluded changes in all-cause hospitalization rates, and rates of PAH and ED visits. Results were adjusted for NH and patient factors that could influence hospitalization rates. Results:34 NHs reported consistent low or moderate use (Group 1), 65 NHs reported increasing from no or low use to moderate or high use (Group 2) and 100 NHs reported consistent moderate or high use or decreases in use (Group 3). Group 1 NHs showedsignificantly greater decreases in the rate of all cause hospitalizations, PAH and ED visits compared to the 34 NHs that had low or moderate use at baseline and 12 months. Group 3 NHs showed significantly greater decreases in ED visits than Group 1. Conslusion:Increasing INTERACT use from no or low use to moderate or high uses was associated with greater decreases in hospitalization outcomes, regardless of whether they were in the intervention or control group. These findings confirm previous results in a non-randomized trial in 25 NHs, and suggest that motivation and capacity to improve may be more important than the training and implementation support provided in this study.

Biography

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Speaker
Bernardo Reyes / Florida Atlantic University
USA

Abstract

Delays in diagnosis due to low Breast Cancer awareness are widespread in Brazil maybe owing to ineffective strategies to raise attention on early identification means. As a proxy of collective interest in BC screening (BCS), we analyzed the evolution of monthly accesses to BC and BCS web pages in National Cancer Institute website along 48 months. Methods: log files analyzers were used to built a time series (2006-2009) of BC and BCS monthly means, which oscillations were studied by analysis of variance (ANOVA). Results: significantly increasing accesses to BC and transient “attention peaks” were found. Enlargement in BC/BCS differences along all period were caused by increasing accesses to BC and decreasing/minor and stable oscillations to SBC pages. These results are consistent with previous reports on increasing interest to BC contrasting with indifference on BCS. In the context of an exploratory study, some aspects should be discussed: the weakness of a "prevention culture"; lack of confidence in health system and screening programs; “celebrity effect” in the context of media framing; collective perception of risks heightened by perception of social vulnerability. The findings suggest that culture-tailored communication strategies would be necessary to inform Brazilian people about BCS. Future research is needed to study social perceptions and constructions on BC topics.

Biography

Will Update It Soon

Speaker
PAULO R. VASCONCELLOS-SILVA / Oswaldo Cruz Foundation
Brazil

Abstract

Background: Migration of doctors from India to UK has been a known occurrence since post-colonial era. WHO has expressed concerns on migration of medical professionals from resource limited countries to developed countries as it can impair public health performance of source countries. Aim: To explore factors influencing migration of Indian doctors to UK through qualitative one to one semi-structured interviews. Methods: 12 one to one semi-structured interviews were conducted with 6 male and 6 female Indian doctors who have been working in UK for between three to ten years, identified through snowball sampling. Thematic analyses was conducted to explore emerging themes explaining influencing factors for migration. Results: The desire to seek post graduate and higher specialist training among doctors, unequal and highly competitive post graduate training opportunities in India, unethical practices in private healthcare, marriage with UK settled person and poor work life balance in India acted as major push factors for migration of doctors to UK. Higher specialisation opportunities, surplus jobs, accommodative health system and better work life balance acted as major pull factors for migration. Most doctors expressed non-recognition of UK training in India and lack of government support as major deterrent factors for returning to India. Conclusion: Migration of doctors from India to UK is a complex phenomenon which is driven by inherent system differences and doctors seeking better opportunities abroad. It is also culturally facilitated by colonial relations and can be a potential augmented human resource bank for India if government policies accommodate them into their health system.

Biography

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Speaker
Venkateshwaran Sivaraj / Liverpool University
United Kingdom

Abstract

Domestic violence is a traumatic experience for women. Since it is widespread and causes great harm, we should embark on finding a solution for controlling the same in society. Comprehending the meaning of domestic violence will help us in searching for a way to aid these women in confronting and reducing this phenomenon in society. This study is aimed at understanding the meaning of the lived experiences of domestic violence in Iranian women. This study was a phenomenological research with a hermeneutic approach. Participants in this study consisted of women who had experienced domestic violence in the city of Gonabad. Participants were selectively targeted and interviewed to a point of saturation. Finally, eight participants were studied by in-depth,open and unstructured interviews. Data analysis was performed based on the interpretation technique of Van Mannen's Content Analysis. The women described lived experiences of domestic violence in five main themes of tolerance, withdrawal, confusion, disregard and sin or self – blaming. The researchers found that these women view domestic violence as a complex and harmful phenomenon that has its roots within specific frameworks of the Iranian community. Similar findings have also been cited in different qualitative studies.

Biography

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Speaker
Nazanin Shamaeiyan Razavi / Tehran University of Medical Science
Iran

Abstract

Background: Proper disposal of human excreta remains a challenge especially in low income countries including Ethiopia. About 80% of the disease burden is related to poor sanitation and hygiene in the country. Cognizant of challenges, health extension program has been widely implemented longer. Latrine facility coverage of study area was higher but its utilization remained lower. Level of latrine utilization and factors associated with latrine utilization of the study area were not known. Therefore, evidences were required to show the current situation of latrine utilization in the study area. Objective: The main objective of this study was to assess level of latrine utilization by households and associated factors in Aneded District, East Gojam Zone, Northwest Ethiopia. Methods: A community based cross-sectional study was conducted from March 8 to April 9 /2014. Semistructured questionnaires and simple structured observation checklist to confirm evidences were data collection tools. Data was analyzed using SPSS version 16. Possible associations were assessed using logistic regression, and strength of association was measured using odds ratio at p-value <0.05 and 95% confidence interval. Result: The response rate was 99.8%, and the mean age of head of households was 39.25(± 12.56 SD). The level of latrine utilization in rural community of Aneded district was 63%. Significantly associated factors for latrine utilization in the district were the following: Clean latrine facility (AOR: 4.1, 95%CI [1.7,10.0], bad latrine facility (AOR: 0.2, 95% CI[0.5,0.9]), presence of children in the household (AOR: 2.5, 95%CI [1.0,6.0]), traditional hat latrine facility (AOR: 7.4, 95%CI [1.1, 49.0]), and age of families (AOR: 9.1, 95%CI [1.8,45]). Conclusion and recommendation: Latrine utilization in the study area was far from expected national target of 100% in MDGs. Not all constructed latrine facilities were used. Factors such as bad latrine facility and cleanliness of latrine facilities still need additional efforts. Health education should be given intensively to communities focusing on behavioral change communication, and good status and cleanliness of latrine facilities to improve its utilization

Biography

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Speaker
Tenaw Chanie Gessesse / Ethiopia

Abstract

Object: It is to examine the status of poor and non-poor women for taking pap smear ın accordance wıth Health Improvement Model and the factors affecting these. Method: This descriptive study was conducted with 30-65 age group of women in Narlıdere Region of İzmir Province between the dates of September 2014 and May 2015. Sample of this study consisted of a total of 121 women, 52 being poor and 69 being non-poor. Independent variables of the study are poverty, education and social insurance and dependent variable is taking pap smear test. Data are collected with Socio-Demographic Features Information Form, Health Improvement Model and Health Improvement Plan Clinic Assessment Form. Absolute poverty measurement was performed to determine poor women. In assessment of the data, numbers, percent distributions and chi-square tests are used. Findings: When socio-demographic features of women attending the study are examined, it is found that average age is 42 ± 9.30 and 32.2% are primary school graduate and 95.9% are married. 92.6% of women have social insurance and only 38.8% take pap smear test regularly. There is a statistical significance between poverty and education level and taking pap smear test while there is no statistical significance between pap smear taking and social insurance. When perceptions relating to taking pap smear test according to health improvement model for women it is found that 66.7% poor women do not know the benefit of the test while 48.3% regard the test as unnecessary and 84.4% are hesitant about overcoming the obstacles to be encountered on taking the test. 23.1% poor women feel good for taking the test, 19.3% have a person each desiring her to take the test and 84.6% do not have any support. It is determined that 46% poor women think the test is beneficial for early diagnosis and 62.2% have no obstacle for taking the test and 68% are hesitant about overcoming the obstacles. The ratio of people feeling good when taking the test is 84%, there is one person desiring the subject to take the test in the family for 63% and friends for 55% provide social support. Poor women choose public hospital for taking pap smear test while non-poor women more preferably want to go university hospitals. Conclusion: Pap smear testing is increased as income status and education level increase and the perception of women on taking pap smear test changes. Poor women should be informed about the pap smear test and cervix cancer risk factors by arranging education programs and perceptions of women relating to the pap smear test should be improved positively.

Biography

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Speaker
Feryal IflazoÄŸlu / Turkey

Abstract

Introduction: Purchasing and installing new equipment should be based on epidemilogical data and population (patients) needs. In reality it was more closer to a „rule of thumb“ and was dependant on relations between the current administration and hospital CEO-s. In 2014, we came into the Cabinet and decided to change that practice. Materials and methods: Most common used equipment and procedures were analysed. We gathered the data on number of machines (CT, MR, ultrasound etc.) and procedures made, including number of specialists working in every Hospital. The analysis was performed in period from Aug 20114 and July 2015. Data were presented to hospital CEO-s primarily, and than shared with public media. Results: Seventeen different analyses were done, including interventional cardiology, gastroscopy, colonoscopy, cataract surgery, cardiac ultrasound, MSCT and MRI procedures. Collected data showed a great variation between the hospitals inside the same category (there are four categories of hospitals in Croatia related to number of beds and complexitiy of procedures done). Within the same hospital category, variation in equipment usage and number of procedures was up to 150 -200 %. Conclusion: In 2014 we have started with initial and simple performance measurement of hospital services. Confrontation of hospital CEO-s with maesured performance resulted in average increase of number of procedures and more efficient equipment usage. This resulted in 11 percent increase of number of services for 2015 compared to 2014. Furthermore, 2015 was the first year with positive financial result of the whole public health system, according to positive results in Croatian acute hospitals.

Biography

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Speaker
Dragan Korolija-Marinic / University surgical clinic
Croatia (Hrvatska)

Abstract

Modern contraceptive methods are an integrated part of family planning which purpose is to help individuals and families take control over their reproductive health and needs. Family planning influence population dynamic and economic development as emphasized by the Sustainable Development Goals. However, the use on modern contraceptives has been very low in many developing countries including Ghana as compared to developed countries. Considering the tremendous contribution of women in national productivity, this study seeks to determine the modern contraceptive prevalence rate and to investigate factors affecting their utilization among female traders in their fertility age in Ghana. A cross-sectional descriptive study was carried out at the La-Nkwantanang Madina Municipality market in the Greater Accra Region. By means of a convenience sampling technique, 306 consented participants were interviewed on-site. The findings of the study revealed that the modern contraceptive prevalence rate was 26.1%. The level of awareness was almost universal (96.4%). Contraceptive use was found high among married women (56.3%) and with some form of educational attainments. Again, most contraceptive users were found between 25-34 years (41.2%). Injectable (43.8%) was the most commonly used method among modern contraceptive users followed by pills (25%) and IUD (12.5%). Among all participants, 36.3% were practicing covert contraceptive use. None of the socio-demographic factors investigated were found to be significantly associated with the use of modern contraceptives. This study has demonstrated needs in education on the benefits of modern contraceptives, provision of these methods near market places and for further research among this subpopulation.

Biography

Dr. Ebeny Francois TEMGBAIT CHIMOUN has completed a Doctorate in Dental Surgery from University of Dakar, SENEGAL and a Master of Public Health from ENSIGN College of Public Health, Ghana. He is the co-founder and director of health innovation at Check Health Services, a Healthcare management company in Ghana. He has extensive experience in public health in deprived communities in West and Central Africa

Speaker
Ebeny Francois TEMGBAIT CHIMOUN / CHeCK Health Services
Cameroon

Abstract

Strongyloides stercoralis is the causative agent of strongyloidiasis which affects an estimated 370 million people worldwide. The parasite is distributed around the world, being primarily prevalent in low socioeconomic status communities. S. stercoralis has a complicated lifecycle, including free-living and parasitic phases. A parasite has a unique ability to autoinfect inside a human through the parthenogenesis (asexual reproduction) leading to a chronic infection. Chronic infections are often asymptomatic; however in immunosuppressed and/or immunocompromised people, or when coupled with corticosteroid treatment, the disease usually becomes hyperinfected and/or disseminated (uncontrolled lethal spread of the larvae into the internal organs from the gastrointestinal and respiratory organs) with an 85% mortality rate. Currently, there are only two types of drugs against strongyloidasis, associated with several issues including the inability to prevent reinfection, potential resistance development (shown in animal studies), and adverse side effects. It is, therefore, essential to look at environmental sources of the parasite aiming to prevent the infection. Dog strongyloidiasis is also caused by the same species, S. stercoralis of an animal origin with up to 50% worldwide prevalence. It is known that human S. stercoralis strains can infect dogs in laboratory settings (dogs have to be immunosuppressed to maintain infection). Increasing evidence is suggesting that S. stercoralis could be a potential zoonotic pathogen. There is currently limited number of genetic studies that looked at the DNA of human and dog S. stercoralis. More molecular studies from different geographical locations are required to provide insight into the potential for cross infection.

Biography

Meruyert Beknazarova has completed her Bachelor of Environmental Health and Masters of Environmental Health from Flinders University, Adelaide. South Australia. She is currently undertaking her PhD looking at the environmental control measures of a human parasitic nematode, Strongyloides stercoralis. She has published 3 papers (1 paper is in press) in reputed journals in the S. stercoralis field research.

Speaker
Meruyert Beknazarova / Flinders University
Australia

Abstract

In the Current Study 60 Patients of Tamak Shwas have been selected randomly divided in two groups. The patients showing classical symptoms of Tamak Shwas such as Shwaskruchhrata (Dyspnoea), Kasa (Cough), Ghur-Ghurak Shabda (Wheezing or Rhonchi) During night, Kasten Shleshma Moksha (Difficult in Expectoration), Kasten Bhashya (Difficult in Expectoration), Anidra (Insomnia) etc. were included in this study. For the present study we were given Krishnadi Choorna orally. It reduces Respiratory Rate effectively & increases Expansion of Chest, Breath Holding Time, and Peak Expiratory Flow Rate & Sustained Maximal Inspiration which was highly significant statistically as compared with Tab. Deriphyllin. 0ut of 30 patient included in Group A none patients showed total relief in symptoms, 7 patients were markedly improved (50 to 75%), 21 patients were improved (25 to 50%), 2 patients were unchanged (less than 25%). Out of 30 patient included in Group B none patient showed total relief in symptom, 3 patients were markedly improved (50 to 75%), 26 patients were Improved (25 to 50%), 1 patients were Unchanged (less than 25%). At the end of the study it was found that Krishnadi Choorna in Group A is more effective than in Group B

Biography

Will update soon

Speaker
Bhairav B. Tawshikar / Ashvin Rural Ayurved College
India

Abstract

Health equity continues to be pursued by Kenya government as progress towards achieving Universal health coverage. This has been realized through the provision of a strong, efficient and a well-run health system with sufficient capacity of well-trained, motivated health workers and enhanced health care financing. This is evidenced in the various policies, strategies and legal framework including devolution of health care to county governance units. In the paper, an empirical review is provided showing how these initiatives have impacted on equity as a key component of universal health care. These are in terms of access, quality of care including availability of drugs and other pharmaceutical supplies, distribution of health resources, among others. Both primary and secondary data were collected with secondary data collected from published documents and reports, while primary data was collected through in-depth interviews with key stakeholders. The analysis reveals government commitment towards universal coverage through increased revenue allocation in absolute terms, investment in both health infrastructure and personnel. There however exist equity concerns that include uncoordinated and unplanned investment in health resources; stock-outs of drugs and other medical supplies, inadequate skilled and skewed distribution of the health workers, catastrophic health spending, limited solidarity in the financing of health care. Other concerns include inadequate and dilapidated health infrastructure, skewed distribution of health resources, disease burden, and differences in health outcomes across the country. Various recommendations were made including political will towards health care financing, development of a comprehensive health sector investment plan, revising and implementing the infrastructural norms and standards; fast tracking the enactment of Health Act. Other recommendations include enforcement of standards in the public health sector with respect to infrastructure, human resource, skills and supplies, and finally, enhance the pharmaceutical management information system.

Biography

Speaker
Timothy C. Okech / United States International University-Africa
Africa

Abstract

Many developed countries have experienced in implementing computerized laboratory information systems in order to deliver high quality, accurate and timely reports to the patients. This study was conducted to strengthen the availability of Pap smear laboratory reports done at the Well Woman Clinics(WWCs) conduct at the Medical Offices of Health(MOHs) in Kalutara district in Sri Lanka. Objectives of this study were to describe the current practice of pap smear reporting at the MOHs in Kalutara district, to develop and implement a software on computerized pap smear laboratory reports entering system at the National Institute of Health Science (NIHS) cytology reporting laboratory and MOHs and to assess the effectiveness of the intervention. This was an institutional based experimental study consisting of pre and post assessments with an intervention to the identified gap. This study was conducted at the Well Woman Clinics conduct at the MOHs in Kalutara district as well as at the National Institute of Health Sciences (NIHS) laboratory doing pap smear reporting in Kalutara district. A community survey was conducted to collect data on issues faced by women on Pap smear testing. The results showed, the low utilization of WWCs. The percentage of Pap smear reports received to the WWCs was low (67.2%). Most of them (n= 102, 77.3%) had received 03 month later and only about 24, 18.2% had received the Pap smear report within one month. The web based Pap Smear Information System (PSIS) was developed and implemented as a solution. The mean overall score for user satisfaction on PSIS was 48.5 (SD ±1.41). The accuracy of the reports generated by the PSIS was 100%. The PSIS was easy to use, generated Pap smear reports timely and easily.

Biography

Ayanthi gained MBBS from the Faculty of Medical Sciences, University of Sri Jayawardhanapura Sri Lanka in 2002. Since 2004 Ayanthi worked as a Medical Officer. Ayanthi has gained MSc and MD in Medical Administration from the Post Graduate Institute of Medicine, University of Colombo, Sri Lanka. She has published four papers in reputed journals. Her study interests are on electronic health information systems and to develop and integrate electronic health information knowledge in to the public health in order to deliver quality health care to the public. Since 2016 Ayanthi worked as deputy director of National Institute of Health Sciences which is the premier training institute for public health staff in Sri Lanka.

Speaker
Dellabada Batawalage Ayanthi Saranga Jayawardena / Ministry of Health
Sri Lanka

Sessions:

day 2

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Abstract

Introduction. Cervical cancer (CC) is one of the most common cancers among women in Poland. In many European countries, cancer occurs less frequently thanks to the effective prevention and greater health awareness of women. In Poland, the structure of morbidity and mortality CC is in the individual regions varied. Unfortunately, at the background of the country Lubuskie in the last ten years it ranks as the head of the statistics in terms of morbidity and mortality CC. Factor necessary but not sufficient to initiate the process of cancer of the cervix is HPV. Other factors include: chronic inflammation of the vagina, early initiation of sexual life, many births, age, cigarette smoking, immune deficiencies and low socio‐economic status of women. Preventive measures include in particular smear tests and vaccinations against HPV. Establishment of research. A comprehensive analysis of the problems of preventive medical examinations for the early detection of CC based on a retrospective analysis of the results of Pap tests from two different areas of the region Lubuskie, taking into account the following factors: socioeconomic status, place of residence, age of patients, the number of births and the organizational structure of medical entities performing a Pap test. Purpose of research. Holistic assessment of surveyed women in the context of their Pap smear result and to provide opportunities to optimize preventive medical examinations for early detection of CC. Research material. Medical documentation cytology Provincial Hospital in Zielona Gora and Private Cytodiagnostic Laboratory in Zielona Gora. Analysis of the subject to evaluate the effectiveness of Pap tests for the presence of changes as cervical intraepithelial neoplasia and CC. The analysis included 127 626 cytological expertise in the years 1985‐2015. Results. Changes in the organizational structure of the Regional Hospital in Zielona Gora as a result of the introduction of the reform of the healthcare system have contributed to a decline in the number of performed Pap tests. More irregularities a higher degree of cytological found in patients admitted to the clinics with a contract with the National Health Fund (NHF), than private clinics that do not have this contract. Comparative analysis showed a greater number of high‐grade abnormalities in patients from the border area. CC cases were reported in patients after the 60‐year old white, while small irregularities and a high degree of observed in younger patients. Most abnormal Pap test results were observed in patients who have given birth at least twice. In patients taking hormonal contraception frequently been observed in the image cytological changes small and large degree. Conclusions. 1) Possibilities for optimization exist primarily in a holistic approach to prevention in the field of early detection of RSM. 2) When constructing programs on state health policy should take into account the specific socio‐economic in the border region Lubuskie province. 3) Prevention programs RSM should be continued in older women. 4) Improve the impact of prevention can be achieved through the introduction of a central system of medical information, which are collected the results of cytology patients clinics with a contract NHF and private offices that do not have this contract with the NHF.

Biography

Hanna Giezowska, M.D., is an adjunct lecturer of immunology in the General Medicine Department at the University of Zielona Góra in Poland. She received her PhD degree in Public Health at the Medical University in Poznan. She graduated from Medical University in Poznan in a faculty: laboratory medicine. After studies she worked in the hospital in Zielona Góra where she did research in the field of autoimmunology and cytological diagnostics. In her work she is concerned especially with cervical cancer. She is a specialist in clinical analitics and medical cythomorphology and a member of the Polish Society of Laboratory Medicine

Speaker
Hanna Giezowska / University of Zielona Góra
Poland

Abstract

Water consumption with a high degree of mineralization has a negative effect on the body's functional condition, causing various pathologies. Some studies have demonstrated the direct link between water quality, including the degree of hardness and its mineralization, and morbidity through osteoarticular diseases. The aim: The aim of the research was to identify changes at the radiological level in people who consume water of high hardness. Materials and methods: The sample group consisted of 880 people diagnosed with osteoarthritis, residents of the Republic of Moldova who used drinking water with a total hardness higher than 28ºG. The people were evaluated during the years 2009-2012. Results: Radiographic changes characteristic of osteoarthritis were observed in 806 (91.6%) individuals. Radiological signs were observed earlier than clinical ones, but their frequency increased with age. The results of the radiological examinations of people who have consumed water with a high level of hardness have shown the following: the articular space in 646 (73.4%) of people was narrowed and 234 (26.6%) widened. In the cortical bone, bone destruction was found in the form of subdural cysts - 88 (10.0%) and erosions - 11 (1.2%) cases. Bone destruction through specific cysts and erosions has evolved along with bone proliferation, which is a productive neoformation that transcends articular surfaces. The impact of the disease on the axial skeleton was manifested by the presence of osteophytes in 125 (14.2%) patients, and in 137 (15.6%) cases by narrowing of the space. Coxfemoral joints have been implicated in moderate lesions, characterized by insignificant and definite local narrowing of the articular space in 189 (21.5%) and, respectively, in 66 (7.5%) people. Conclusion: The data certify that radiological signs are common in osteoarthrosis, their detection being pathognomonic in the case of a diagnosis of osteoarthritis.

Biography

Elena Ciobanu from 2002 to the present is Assistant professor, Department of Hygiene general, State Medical and Pharmaceutical University Nicolae Testemitanu, Chisinau, Republic of Moldova. In 2012 she received her Doctor Diploma in Hygiene with National and International qualification Doctor of philosophy, on thesis Hygienic assessment of the environmental impact on rural population morbidity trough osteoarthritis. In 2008 she received her License Diploma of Hygienist on thesis Hygienic evaluation and sanitary surveillance in occupational hygiene. In 2002 she received her Masters Degree Diploma Certificate in Business Administration, University of Nantes, France on thesis Nosocomial diseases in urology department. In 2002 she received her Diploma Hygienist epidemiologist, delivered by State Medical and Pharmaceutical University Nicolae Testemitanu of Republic of Moldova. She has published more than 80 papers in reputed journals, proceedings of the international and national conferences, scientific university bulletins and annals and was as an organizing member of one international conference

Speaker
Elena CIOBANU / State University of Medicine and Pharmacy
Moldova

Abstract

Methods: In a prospective, multicentre, longitudinal observational study, all patients already on the ICU at 0:00 on 4 November 2013 and all patients admitted to a participating ICU between 0:00 on 4 November 2013 and 2359 hours on 1 December 2013 were included. The patients were followed up for the occurrence of severe sepsis or septic shock (SEPSIS-1 defnitions) during their ICU stay. Results: A total of 11,883 patients from 133 ICUs at 95 German hospitals were included in the study, of whom 1503 (12.6 %) were diagnosed with severe sepsis or septic shock. In 860 cases (57.2 %) the infections were of nosocomial origin. The point prevalence was 17.9 % (95 % CI 16.3–19.7).The calculated incidence rate of severe sepsis or septic shock was 11.64 (95 % CI 10.51–12.86) per 1000 ICU days. ICU mortality in patients with severe sepsis/septic shock was 34.3 %, compared with 6 % in those without sepsis. Total hospital mortality of patients with severe sepsis or septic shock was 40.4 %. Classifcation of the septic shock patients using the new SEPSIS-3 defnitions showed higher ICU and hospital mortality (44.3 and 50.9 %). Conclusions: Severe sepsis and septic shock continue to be a frequent syndrome associated with high hospital mortality. Nosocomial infections play a major role in the development of sepsis. This study presents a pragmatic, affordable and feasible method for the surveillance of sepsis epidemiology. Implementation of the new SEPSIS-3 defnitions may have a major effect on future epidemiological data

Biography

Speaker
Christian Byhahn / Denmark

Abstract

Non-communicable diseases (NCDs) are the fourth burden of diseases affecting South Africa after HIV/AIDS, Injuries and other infectious diseases. While many strategies undertaken to address the disease have not succeeded, the primary health care (PHC) re-engineering is believed to be a solution. This study was initiated to examine the ways through which the approach has worked. A desktop search of existing literature was conducted. A total of 57 documents were retrieved, of which only 17 met the inclusion criteria. Content analysis was conducted to analyse the data. Findings revealed that there is a lot to be done and a myriad of minimum requirements are to be met prior to implementing the PHC re-engineering in South Africa. Adopted strategies have to be accompanied by a change of culture that incentivizes system-wide planning and implementation to achieve desired outcomes and maximize strategic partnerships. Without necessary decision-making space, human and material resources, PHC Managers cannot provide quality services; hence, putting re-engineering PHC at risk of failing before it has taken off the ground. There is, therefore a need to fully integrate NCDs into the re-engineering of primary healthcare in South Africa with the view to increasing community-based prevention, screening, and self-management care, including rehabilitation, palliative care and referrals as per the WHO innovative model for chronic care. A concluding remark suggests that PHC re-engineering strategy is essential but not sufficient condition to achieve improved health outcomes for people in South Africa, and that a lot more is still required for this innovation to be functional

Biography

Dr Ganzamungu Zihindula has completed his PhD from the University of KwaZulu-Natal, Durban South Africa, and currently on his postdoctoral studies at Mandela School of Medicine, University of KwaZulu-Natal, Durban campus, South Africa. He is a research coordinator of a project called “Health through Faith” – at Africa Health Research Institute (AHRI), formerly known as Africa Centre for population health. He has published more than 12 papers in both international and national journals, 3book chapters and presented at more than 30 scientific conferences both locally and internationally

Speaker
Ganzamungu Zihindula / Africa Health Research Institute- AHRI
South Africa

Abstract

Objective: The aim of this study was to assess the risk of HIV infection among the seasonal labour migrants of mid- terai region of Nepal. Methodology: Analytical cross-sectional study was conducted to assess the risk of HIV among seasonal Labour migrants of three VDCs from three district(Mahottary,Sarlahi and Rautahat) of mid Terai Region of Nepal which is the transition point for seasonal migrants going to India. The study population was the male migrants of mid-Terai region visiting the study area who give oral consent and show interest to participate. 333 seasonal labor migrants’ men aged between 18 to 47 years who went to India for work for at least three months and have returned home within the last three years was selected purposively. Closed ended structured questionnaire and direct interview method was used in the study.analysis of data was done by using SPSS, Version 16. . Univariate analysis was done at first of all the variables and then bivariate analysis was done using binary logistic regression analysis to see the association between different variables with dependent variables. Results: The findings found that majority of migrants were 15-25 age group which accounts for the 69.4% of the total participants and most of the respondents were found Disadvantaged dalit caste group which accounts for the 60.96 % of the total participants whereas 3.9% of participants were upper caste as well minority religious group. Majority of the participants were Hindu which accounts 84.7% and other were Muslim, Buddhist and Christian (15.3%). About 42 percent of the participants had their sexual intercourse onset at the age less than 18 years of age. The majority of the Migrants were found to be married, i.e. 86.49 percent. Among those that had sex with women 42.68 percent ever had sex with Female sex Worker (FSW) and rest 57.33 percent had no sex with FSW in abroad It was reported that 61.25 percent ever had sex with FSW in Nepal among them those who had sex with FSW 79.59 percent of the participants used condom during last sexual contact with FSWs in Nepal whereas 20.41 percent of the participants had not used condom. About 27.27 percent of the participants had sexual contact with the male partner whereas 72.73% had reported never had sexual contact with male partners. 53.22 % used condoms when having sexual contact with the male partners and 46.77 did not used condom. Among total respondents, 23.7 percent migrants were at risk of HIV and 76.3 percent migrants did not at risk of HIV. The risk of HIV in age group distribution found that, age group of 26-35 years was found to be 3.40 times higher in risk than 36-45 years. Similarly the risk of HIV was 4.643 times higher among age group 15-25 years as compared to 36-45 years. Among them Disadvantage Dalit caste had more risk than Upper caste. Similarly illiterate had more risk than Literate. In distribution of risk of HIV unmarried had high than ever married. Conclusion: The Study showed that seasonal migrants of mid-terai region have increased vulnerability to HIV. The unmarried labor worker and disadvantaged caste group were in the higher risk of facing HIV infection. It is necessary to design better service delivery focusing on these areas and need to explore the real situations of labor migrants.

Biography

Speaker
SATYA NARAYAN YADAV / National Health Foundation
Nepal

Abstract

Patients who present at the Emergency units require specialized care including access to beds in a timely manner. This study was aimed at developing a model to determine the optimal number of beds required for zero delay probability at the emergency wards of the Benue State University Teaching Hospital (BSUTH), Makurdi, Benue state Nigeria. The study used the M/G/C/C model for bed optimization at the emergency wards. Data on arrivals, length of stay and number of beds for each of the wards covering three years: 2014, 2015 and 2016 was obtained from the medical records dept. The average arrive rate, λ and average length of stay, E[B] were used to determine the delay probability and the other performance measures. The delay probabilities at the current bed capacities were 0.11, 0.069, 0.023 and 0.011 for the male, female, paediatric and gynaecology emergency wards respectively. The number of beds required for zero delay probabilities for the male, female, paediatric and gynaecology emergency wards are 16, 14, 14 and 6 respectively instead of the current number of beds: 8, 8, 9 and 4 respectively. The hospital would need to increase the number of beds across the emergency wards in order to have zero delay probabilities. The queueing model should be carried out at regular intervals across the wards and should be part of the management decision making processes in BSUTH.

Biography

Dr Ishaku Bako is a Public Health Physician with more than 15 years experience. He is currently a senior lecturer and Head of the department of Epidemiology and Community Health with the Benue state University and Consultant Public Health Physician with Benue State University Teaching Hospital, Makurdi, Nigeria. His research interests include medical statistics, risk taking behaviours and infectious disease control. Dr Bako has published a number of papers in peer reviewed journals and presented papers at local and international conferences

Speaker
Ishaku Ara Bako / BEnue State University
Nigeria

Abstract

Injecting drugs is major driver of human immunodeficiency virus (HIV) infections in Nepal. The aim of the study was to estimate the HIV prevalence and to examine factors associated with it among people who inject (illicit) drugs (PWID) in Nepal. The present study was based on data secondary to Integrated Biological and Behavioral Surveillance (IBBS) surveys of PWID in Nepal from 2002 to 2015. A χ2 test was used to determine significant risk factors for HIV infection. A logistic regression model was used to identify the most important determinants for HIV infection. We included cross-sectional data from 7,073 PWID in the surveys from 2002 to 2015 in this retrospective observational study; among these 1,257 (17.8%) had tested HIV positive. The prevalence of HIV infection showed a sharp decrease from 2002 (68%) to 2015 (6.2%). After adjusting each factor for the confounding effects of other factors, year, region, age, education, and duration of injecting drugs were significantly associated with HIV (P < 0.001). Prevalence of HIV infection was highest for the following factors: year 2002, Kathmandu Region (30.5%), aged ≥30 years (32%), illiterate (28.5%), and injecting drugs >10 years (35%). HIV infection shows a steady decreasing trend, but the number of cases remains high. The factors strongly contributing to HIV were advanced age, Kathmandu region, low educational achievement, and longer duration of injecting drugs. Intensified and focused programs are needed to reduce the HIV in the region focusing on its associated risk behaviors.

Biography

Dr. Sampurna Kakchapati, Public Health Researcher with a research experiences in the area of HIV/AIDS, Tuberculosis, Malaria, Non-communicable disease, Nutrition, Family planning, Reproductive and Sexual Health. He obtained Postdoctoral in Research Methodology from Prince of Songkla University (PSU), Thailand. An eminent scholar in the field of Public Health and Research, extensive experiences in conducting and leading a variety of health and medical research projects and surveys in Nepal and aboard for more than eight years. He had published more than 20 papers in international peer reviewed journals

Speaker
Sampurna Kakchapati / Prince of Songkla University
Nepal

Abstract

Introduction: Early-life conditions influence organ growth patterns and their functions, as well as subsequent risk for non-communicable chronic diseases in later life. A limited number of studies have determined that in Bangladesh, kidney size relates to its function among children as a consequence of the maternal and postnatal conditions. Objectives: The present study objectives were to determine early-life conditions in relation to childhood kidney size and to compare their influences on kidney function. Methods: The study was embedded in a population-based prospective cohort of 1067 singleton live births followed from fetal life onward. Kidney volume was measured by ultrasound in children at the age of 4.5 years (range 45-64 months), and the estimated glomerular filtration rate (eGFR) was assessed at the age of 9 years (range 96-116 months). Results: The mean (standard deviation) kidney volume of children at 4.5 years was 64.2 (11.3) cm3, with a significant mean difference observed between low-birth-weight and normal-birth-weight children (p < 0.001). Multivariable model showed, changes in status from low-birth-weight to normal-birth-weight children, with kidney volume increases of 2.93 cm3/m2, after adjusting for child’s age, sex, maternal age, and early pregnancy BMI, and socioeconomic index variables. The eGFR in low-birth-weight children was 5.55 mL/min/1.73m2 less than that in normal-birth-weight children after adjustments. Conclusion: Low birth weight leads to adverse effects on kidney size and function in children

Biography

Speaker
FARZANA FERDOUS / University of Tsukuba
Japan

Abstract

The recruitment and retention of health personnel is a challenge for maternal and newborn health (MNH) in Mwanza, Tanzania. Appallingly, the Tanzania Demographic Health Survey(TDHS) 0f 2015/2016 indicated that maternal mortality rate had increased from 432 to 556 per 100,000 live births, and human resources for health is at only 3.3 Nurses and 0.62 Medical Doctors per 10,000 people. As one response to these gaps in care, the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDEC) aims to institutionalize Community health Workers (CHW) services in 75% of the country’s districts by 2020. As a part of the IMPACT Project, the Aga Khan Development Network is working closely with the MoHCDEC on maternal and neonatal health. Through the project’s baseline survey, we assessed CHW coverage for pregnant women in Mwanza Region. Methods A cross-sectional household survey was administered in August 2017 in six of Mwanza Region’s eight districts. Households were selected via two-stage cluster sampling: first, cluster sampling of villages proportionate to the number of households per village; second, households were randomly sampled from each village based on household lists. Women age group 15-49 in a household were eligible, 30 villages were sampled in total and 1,476 households were sampled, 1,312 (88.7%) of which were successfully interviewed. Results Of the 1612 women eligible for interviewing, 1176 (73.0%) were interviewed. Only 124 (10.5%, 95% CI [8.7-12.3]) women ages 15-49 had ever been visited by a CHW. 36 (3.1%, 95% CI [1.3-4.9]) of the pregnant women had been visited by a CHW in the month preceding the survey. Conclusion In keeping with reported challenges in health personnel recruitment and retention, the prevalence of CHW visits to pregnant women in Mwanza remains low. Implications for Policy or Practice: The IMPACT Project plans to strengthen community-based maternal and newborn care by implementing an evidence-based, 2 care-group (CG) model that covers 80% of the region’s districts. Recruited and trained CHWs will work with the CGs to deliver an integrated package of health education on Antenatal care, knowledge of danger signs, and referral services that can reach households at a greater scale than CHWs alone in order to contribute to reduction of maternal and newborn mortalities in Tanzania. Ethics: The baseline survey was approved by National Institute for Medical Research (NIMR) (Certificate Number: NIMR/HQ/R.8a/Vol.IX/2517. The research was registered and Tanzania Commission for Science and Technology (COSTECH) certificates were provided to all researchers. Conflict of interest: The author declares no conflict of interest Acknowledgement: Acknowledge the IMPACT project staff and the communities and health workers of Mwanza Region, the MoHCDEC, Regional and District Medical Offices, multiple AKDN agencies

Biography

Speaker
Micheal Angel Mugerwa / Aga Khan Health Services
Tanzania

Abstract

Background: Association of raised serum ferritin levels with breast carcinoma is a well-established fact on account of iron enhanced free radical mediated estrogen induced carcinogenesis. Previous literatures report variations in serum ferritin levels with menopause, especially indicating its association with metabolic syndrome in post-menopausal women. Seldom has any study focused upon influence of age and menopausal status towards serum ferritin level determination in breast cancer patients. Therefore this study was carried out to assess the impact of age and menopausal status over serum ferritin levels in patients with breast cancer and in healthy females; and their comparisons. Methods: Estimation of serum ferritin was carried out in patients with breast carcinoma and healthy females. Objective: Age-wise and menopausal status-wise grouped numerical data were analyzed through intra- and inter-group comparisons. Results: Higher serum ferritin levels were observed in all age groups as well as pre-menopausal and post-menopausal groups of breast cancer subjects than their respective groups among healthy subjects. No particular age or menopausal status-wise pattern could be identified among cases as well as healthy controls. Conclusions: Serum ferritin levels abide no obvious influence of age or menopausal status in breast cancer patients as well as post-menopausal women devoid of metabolic syndrome. The present study reiterates the possible role of iron in breast carcinogenesis. Key words: Breast cancer, Serum ferritin, Menopause, Metabolic syndrome

Biography

Dr. Snehankar Kalita has completed his MBBS from Assam Medical College and Hospital, Dibrugarh, a premier Institution of the Northeastern part of the state of Assam, India and Postdoctoral studies from the Department of Biochemistry of the same Institution. He is currently working as a Demonstrator Faculty in the Department of Biochemistry, Jorhat Medical College and Hospital, Jorhat, another premier Institution in Assam, India. He has published a few papers in reputed journals and has completed his Fellowship in Diabetology from Apollo Hospital in association with the Royal Liverpool Academy, UK

Speaker
Snehankar Kalita / Assam Medical College and Hospital
India

Abstract

Pharmaceutical purchases (medicines) are the key cost driver for the health care system, being second only to the compensation of employees in terms of the health budget high expenditure items It is undisputed fact that medicines are essential for the treatment of diseases and illnesses despite this fact, according to World Health Organization estimation, 1.7 billion people nearly one third of the world population have inadequate or no access to essential medicines. The purpose of this study was to develop a framework for provision of essential medicines for the district health services. A qualitative descriptive, exploratory and contextual action research design was followed. The data collection was conducted through site visits and semi structured interviews targeting the responsible pharmacists who were purposively selected on the basis of their expert knowledge and experiences from the eight of the nine provinces of the Republic of South Africa which is a developing country with limited resources for provision of healthcare services. The study found that there was no standardised framework for provision of essential medicines for the District Health Services. Based on the site visits conducted and action research findings a proposed Framework covering the selection, procurement, warehousing, distribution and management support components for provision of essential medicines for district health services was developed and subjected to national pharmaceutical experts and district health services managers review and critique.

Biography

Dr Sibusiso Zuma has a Doctor of Literature and Philosophy in Health Studies UNISA. Currently employed as a Technical Advisor to the South African Department of Health. He has published papers on essential medicine provisioning and management. He is an action research practitioner with special interest on Supply Chain Management.He is a member of the Board of Directors for the Council of Health Services Accreditation in Southern Africa

Speaker
Sibusiso Memory Zuma / UNISA
South Africa

Abstract

Introduction: The project meets the demands of WHO, PAHO and the Ministry of Health, which have pointed to INTERPROFESSIONAL HEALTH EDUCATION and COLLABORATIVE PRACTICE IN HEALTH CARE as strategies that, in addition to being innovative, can play a significant role in facing the challenges, which not only Brazil, but several countries face, in reality, health. The WHO reports that INTERPROFESSIONAL EDUCATION IN HEALTH AND COLLABORATIVE PRACTICE IN HEALTH CARE can be important tools in reducing the global health crisis. General Objective: To investigate in the work of the health network teams elements of health training / intervention proposed by the Ministry of Health and other International Health Bodies (PAHO, WHO) as important in reducing the global health workforce crisis. Specific Objective 1-Map the health network of the 02 states / regions involved in the project; Steps / Actions: -Search next to the official sites, official documents of the 02 states the organization of the health network; -Provide documentary research identifying the structures of the current teams: composition, number of professionals, professional category, time of action in health. Specific objective 2 - To know and analyze the professional formation of the teams and their consonance with the perspectives of Interprofessional Health Education and Collaborative Practice in Health Care, Steps / Actions: - Conduct documentary research on professional training, curriculum type, training area, type of internships, training practices, teamwork, skills and competences building based on the concepts of Interprofessional Health Education and Collaborative Practice in Health Care; - To carry out the mapping of the professional formation in health of the members of the teams taking as premise the concepts of Interprofessional Education in Health and of the Collaborative Practice in the Attention to Health - - Identify in curricula and training actions and activities that focus on the relationships among workers, exchange of technical knowledge, decision making, skills developed, learning and education processes based on the concepts of Interprofessional Health Education, Collaborative Practice in Health Care. Methodology: In order to better understand the object of study, it was sought to use mixed methods research that aims at combining quantitative and qualitative approaches, using the strengths of each one of them. The interdisciplinary nature has also contributed to the formation of research teams composed of individuals with different methodological interests and approaches. The combined use of quantitative and qualitative approaches provides more insights with their combination than separately and enables a greater understanding of research problems (CRESWELL, 2010). The research locus of this project is the health network equipment located in 02 Brazilian states. Results: The research is running and up to now we can present as results: -Interactive network among the groups of researchers of the institutions involved constituted -Continuous training and information processes for students and health workers articulated and flow of relationships between universities involved Conclusions: In the consolidation of the SUS, as well as other public policies, the fragility of the appropriation of rights and guarantees of rights must be revealed, as it results in superficial, biased concepts that make it impossible to guarantee these rights. One possibility of realizing this densification is in the participation of the communities, in the strengthening of these collective subjects through social participation. This entails the participation of different actors in the achievement of the right of all in an interdisciplinary perspective, participating, training, creating other scenarios for collective practices, educating, performing management activities, participating in the construction of "networks" of diverse relationships, their intersections in guaranteeing the right to health.

Biography

Speaker
Maria Isabel Barros Bellini / Pontificia Universidade Catolica Do Rio Grande Do Sul
Brazil

Abstract

Aims:A Geriatric Depression Scale (GDS-15) short-form has been commonly performed as a standard questionnaire to assess geriatric depression symptoms globally. The objective of this study was to examine the validity and reliability of the Indonesian version of the GDS-15 in nursing home setting. Methods:Thirty elderly nursing home residents in two districts in Yogyakarta province, Indonesia aged 60 years and above were recruited in this study. Computation of Content Validity Index for Items (I-CVI) with three expert raters and Pearson’s correlation analysis were used to determine validity instrument. Computation of I-CVI ≥0.78 considered as having excellent content validity. Pearson’s correlation items-total score was set at a p-value <0.05. Multiple-item construct measurement was assessed to by using Cronbach’s alpha with cut-off point 0.7 to test the internal consistency for reliability. Results: The study found that Pearson’s correlation items-total score was significant at the 0.05 level (p-value <0.05) with I-CVI computation was 1.00. Internal consistency for the entire questionnaire was good with Cronbach’s alpha = 0.80. Conclusions:The GDS-15 Indonesian version was valid and having excellent content validity. This instrument was also reliable to assess the depressive symptoms among Indonesian elderly particularly in the nursing home setting.

Biography

Will update soon

Speaker
Bayu Anggileo Pramesona / College of Public Health Sciences
Thailand

Abstract

Cardiovascular diseases(CVDs) are the leading cause of morbidity and mortality globally including India. CVDs are preventable to a great extent, however effective primary prevention necessitates the prediction of cardiovascular risk. The cross sectional study was done in a tertiary health care setting of Northern India. A total of 402 adults attending medicine and allied OPDs were screened for 10 year cardiovascular risk by using World Health Organization and International Society of hypertension (WHO/ISH) risk prediction charts. Inclusion criteria of the study was presence of hypertension and all those with known history of any fatal or nonfatal cardiovascular event were excluded. JNC 7 criteria was used to diagnose hypertension. The results revealed that the prevalence of diabetes was 31.8% among study subjects. Mean systolic and diastolic blood pressure was 140.1/88.1mmHg and 135.1/85 mmHg in men and women respectively. Cardiovascular risk profile of the subjects showed that 60.9% of the subjects had low 10 year cardiovascular risk. It is concluded that the WHO/ISH risk prediction charts are easy to use in routine OPD basis for screening the patients for cardiovascular risk. The high percentage of people in moderate (21.9%) and high risk(17.2%) categories also warrants the need of the strategies to improve the awareness and promote healthy lifestyle to reduce the risk of cardiovascular diseases. However the study had certain limitations as the assessment was done in patients attending OPDs of the tertiary health care setting, so the screened population may not reflect the true community prevalence

Biography

Speaker
Kavita / National Institute of Nursing Education
India

Abstract

Cardiovascular diseases (CVD) are the leading cause of death in the EU. CVD includes angina pectoris, acute myocardial infarction (AMI), coronary insufficiency (unstable angina), and CHD deaths. The majority of CVD is caused by risk factors that can be controlled, treated or modified, such as high blood pressure, cholesterol, overweight/obesity, tobacco use, lack of physical activity and diabetes. However, there are also some major CVD risk factors that cannot be controlled, such as age, gender and family history. In addition to the major risk factors, a series of other risk correlates have been identified. Their presence may denote greater risk than revealed from summation of the major risk factors. Their quantitative contribution and independence of contribution to risk, however, are not well defined. Therefore, they are usually not included in global risk assessment. This does not mean that they do not make an independent contribution to risk when they are present. A sizable body of research supports an independent contribution of each. Their relation to CHD is more complex than that of the major risk factors. In some cases, they are statistically correlated with the major risk factors; hence, their own independent contribution to CHD may be obscured by the major risk factors. In other cases, their frequency in the population may be too low for them to add significant independent risk for the entire population; in spite of this, they could be important causes of CHD in individual patients. Since Rosahn in 1937 [1], a number of studies around the world [2-9] have indicated that weather plays an important role in the onset of CVD. The short-term effect on both CVD morbidity and mortality has been evaluated through various analyses [10-22]. Several researchers focused their attention on AMI, which is a common CVD disease that requires emergency medical treatment. The impact of ambient temperature on AMI morbidity has received less attention recently[23], while the influence of seasonal variations on the incidence of AMI has been well examined. Fewer studies are available on the influence of individual meteorological parameters on AMI [24,25], although a statistically significant effect of ambient temperature on AMI risk has been constantly reported [26-28]. Preventive efforts should target each major risk factor. Any major risk factor, if left untreated for many years, has the potential to produce CVD. Even though these other risk factors are not recommended for inclusion in absolute risk assessment, their exclusion from this function should not be taken to imply that they are clinically unimportant. Their role in evaluation and management of patients at risk deserves some consideration.

Biography

Doctorate degree in Environmental Protection form The Biotechnical Faculty of the University of Ljubljana.Bachelor’s degree in Health Education from The Faculty of Education and the College of Health Studies of the University of Ljubljana. Currently working as an assistant professor at Nursing Department, Faculty of Health Sciences in the University of Ljubljana.Conducted a national study that establish the basis of the doctoral thesis. Main results were reported in an article titled Influence of Daily Individual Meteorological Parameters on the Incidence of Acute Coronary Syndrome (International journal of environmental research and public health2014.The researchwas incorporated in a systematic review and meta-analysis titledAmbient temperature and risk of cardiovascular hospitalization: An updated systematic review and meta-analysis (The Science of the total environment 2016. Continue to explore the delay effects and as a co-author published an article tiled Immediate, lag and time window effects of meteorological factors on ST-elevation myocardial infarction incidence (Chronobiology international, 2018.Extended the field of research analysing the relationship between particulate matter pollution and acute coronary syndrome incidence.

Speaker
Mirjam Ravljen / University of Ljubljana
Slovenia

Abstract

Low back pain (LBP) has become a growing public health problem in adolescents, presenting a relatively high prevalence during school age. Several studies verified the prevalence of annual LBP in the world and the values varied between 13% and 51%. In southern Portugal, 966 adolescents were evaluated, aged between 10 and 16 years and the results revealed that 15.7% of students had LPB at the present time, 47.2% had experienced it in the last year and 62.1% had lifetime prevalence of LBP (Minghelli et al., 2014). LBP represents a significant negative impact, being commonly associated with the demand for health care, medication use, increasing absenteeism and with a decrease in quality of life. Because of that, the presence of LBP can lead to very high economic consequences, both due to direct financial costs and due to absenteeism. Several factors may be involved in the pathogenesis of LBP, such as genetic, psychosocial, physiological, anthropometric and environmental, among them ethnicity, age, sex, smoking, obesity, physical activity practice, sedentary activities such as television watching and computer use, adoption of wrong postures and incorrect transportation and excess weight in school backpacks.Minghelli et al. study found that students who sit with the spine incorrectly positioned presented 2.49 (95% CI: 1.91-3.2, p<0.001) greater probability of having LBP, and students using improper positions for watching TV or playing games have 2.01 (95% CI: 1.55-2.61, p<0.001) greater probabilities compared to those who adopted correct postures. Physiotherapy in the school healthfield emerges with the objective of promoting knowledge and health conditions in this specific area of LBP and postural changes, optimizing the technical and personal skills of teachers and students, and developing individual and collective health potential. The performance of the Physiotherapist in schools should involve a salutogenic approach in order to create in schools a stimulating environment of creativity and a critical sense, and not just an intervention aiming at changes in risk factors. Empowerment, capacity and motivation must be given so that adolescents and the entire school community are responsible for their own health choices.

Biography

Speaker
Beatriz Minghelli / Research in Education and Community Intervention
Portugal

Abstract

Widespread contamination of arsenic in Bangladesh has been jeopardizing the health of millions of people. Toxicity with arsenic in drinking water has occurred in many countries of the world causing people to be afraid of this hazardous health problem. This cross sectional study was done to assess the level of knowledge awareness and practice regarding arsenicosis among the community health care providers of Bangladesh in four Districts in Chandpur, Nilphamari, Jessore and Lalmonirhat. 210 community health care providers were interviewed by a structured questionnaire and were selected using purposive sampling. The study period was January 2014 to December 2014 This study suggests that refresher training will help them increase knowledge, awareness and practice about arsenicosis. Majority (77.6%) community healthcare providers’ age group was 31-40 years. Most (80.9%) respondents were female and the remaining male. Regarding educational status, the majority of respondents (76.2%) had passed H.S.C level. The study revealed that 69% of respondents had knowledge about arsenic while 31% did not know about arsenic. All (100 %) respondents knew that the red mark tube well was the source of arsenic contaminated water in Bangladesh. Regarding knowledge about arsenic contaminated districts, majority (71.4%) respondents had knowledge, while 28.5% did not. The study revealed that the majority (71.4%) respondents had knowledge about signs and symptoms of arsenicosis and 28.5% did not. Regarding knowledge about red and green mark tube well, 88.1% respondents knew the meaning of red and green tube well while 11.9% respondents did not. In this study most (95.3%) community health care providers attended the arsenicosis patient. 23.8% respondents thought that arsenicosis is a communicable disease and 23.8% said that arsenicosis is a hereditary disease. 71.2% respondents said that arsenicosis is a preventable disease while 28.2% said that it is a not preventable disease. The study showed that all (100%) respondents said that red labeled tube well cannot be used for cooking and drinking and green labeled tube well can be used for this purpose. Most (90%) respondents practiced to advice arsenicosis patients to avoid drinking the red mark tube well water. Regarding practice of medication in pregnant women, 52.3% respondents advised patients not to take Vitamin A,E and C, while 47.7% respondents advised to take these vitamins. Concerning practice of arsenic kit test, all (100%) respondents did not know how to operate arsenic kit test

Biography

Speaker
Md Mobin Ul Islam / Rangpur Medical College
Bangladesh

Abstract

Background: Musculoskeletal injuries (MSKI) constitute a major socio-economic and public health burden and threaten the organisational effectiveness of armed forces globally. Analysis of injury Surveillance is fundamental to designing prevention strategies. Aim: To evaluate five years inter-regimental MSKI patterns and training outcomes in British Infantry recruits. Methods: Retrospective analysis of 4777 MSKI reported from 12501 recruits, over five consecutive training years (1st April 2012-31th March 2017), from the Parachute Regiment (n= 1910), Line Infantry (n= 7799), Guards (n= 1834) and the Gurkha Regiment (n= 958). Results: The five year cumulative incidence varied between the training regiments; 66.49% (95% CI: 64.39-68.62), 38.17% (95% CI: 35.97-40.42) 33.29% (95% CI: 32.22-34.31) and 22.03% (95% CI: 19.42-24.65) for Parachute, Guards, Line, and Gurkha respectively. Overuse injuries were most frequently observed whilst the most common site for all types of injury was the knee. Significant difference was found (p <0.01) in the incidence of all MSKI between phases 1 (< week13) and phase 2 (week 13-26) of training. 42.1% of the total injuries occurred within the first eight weeks of training. Significant differences were observed between recruits successfully completing training at the first attempt (p <0.01); 37.0% (Parachute), 53.1% (Guards), 64.6% (Line) and 98.42% (Gurkha). Conclusions: The range in both incidence of MSKI and training outcomes across the four training Regiments, suggests that MSKI represents a substantial challenge the British Army. A requirement exists to thoroughly investigate the content and delivery of training in order to design effective injury prevention strategies.

Biography

Dr Jagannath Sharma trained at Curtin University, Perth Australia and has completed his PhD from Teesside University, UK. He is responsible for clinical management and undertaking formal research in musculoskeletal medicine using DEXA and HR-PQCT. His clinical and research interests include epidemiology on training injuries, risk factors, treatment and prevention of musculoskeletal injuries. He has published over 22 journal and conference papers and his work has been cited widely in link: https://scholar.google.co.uk/citations?user=AoSmE54AAAAJ&hl=en.

Speaker
Jagannath Sharma / Manchester University
UK

Abstract

Background: Maternal mortality remains a major public health challenge worldwide. Postnatal care is important to treat any complications arising from the delivery, as well as to provide the mother with important information on how to care for herself and her child. Hence, postnatal care is the most crucial intervention for improving maternal and child health. Methods: A community based cross sectional study was conducted in Afar National Regional State during February 2016. A multistage cluster sampling was employed to select 1152 women who gave birth in the two years preceding the survey. Data were cleaned, coded and entered into EpiData version 3.02, and were exported to SPSS version 20 statistical package for analysis. The Hosmer-Lemeshow goodness-of-fit with enter procedure was used to test for model fitness. Results: Three hundred eleven of the study mothers (27.7%) who gave birth in the last two years preceding the survey had attended at least one postnatal care follow up. Women who attended antenatal care visit [AOR: 3.41; 95% CI (2.48, 4.71)], who mentioned at least one pregnancy danger sign [AOR: 1.47; 95% CI (1.04, 2.08)] and who gave birth at health facility [AOR: 2.71; 95% CI (2.01, 3.67)] were more likely to utilize postnatal care service. On the other hand, women who reported pastoralist as their occupation were associated with lower odds of postnatal care service utilization as compared to those who had other occupational status [AOR: 0.60; 95% CI (0.437, 0.831)]. Conclusion: This study showed that nearly three women in every eleven had attended at least one postnatal care visit. Therefore, strengthening pastoralist-based maternal health facilities could be important to improve postnatal care service utilization in Afar Regional State

Biography

Professor, Department of Public Health, College of Medical and Health Sciences, Samara University, Ethiopia

Speaker
Surender Reddy / Samara University
Ethiopia

Will be updated soon...


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