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Plenary Talks

Abstract

Objectives The aging of Japanese economy has been rapidly proccing and its population also started declining, and these phenomena are more noticeable in the less populated areas. Medical expenditures also have been increasing sharply, and the strengthening and promotion of telemedicine is mandatory.To reduce medical expenditures, shifting patients from medical institutions to their houses has been emphasizing and homecare becomes more important. In these circumstances, the new guideline on online clinic (online diagnosis) issued in March 2018aims to support this change and promote telemedicine. This study aims to analyze how online clinic transform Japanese patient healthcare and telemedicine further based on filed research on clinics and regional Medical Associations. Online clinic Online clinic (online diagnosis) is DtoP telemedicine which utilizes IT such as smartphones and tablets for real time diagnosis including medical treatment, informing its results, and prescription.Doctors at clinics can monitor patients for 24 hours or patients can send their biodata to doctors. Similarly by telepharmacy, pharmacists support patients at home to take medicine properlyand advise their families. Online clinic is thus complementary toface-to-face diagnosis, and it promotes efficiency of medicine, prevent of chorionic diseases and serious condition. The data obtained via the online clinic can be shared with other doctors and made fully to treat patients. Accordingly it reduces medical expenditures. Current issues of online clinic and obstacles for further implementation Since March 2018, more than 1,000 clinics have been implementing which is smaller than expected. The less popularity is summarized as follows: (1) diseases applied to online clinic are chronic such as diabetes, hypertension, and strokes, and other disease such as tele-psychiatrist, pediatrics, atopic dermatitis, and allergic rhinitiswhich are supposed to be more effective than face-to-face diagnosis are excluded; (2)although the reimbursement of online clinic from public medical insurance is firstly admitted,it is about JPY700 (USD6.40) per month per patient, which is the same as current telephone diagnosis. This is far smaller than promoting online clinic; (3) restructuring current medical system to promote telemedicine, since the incumbentsystem is too robust in all aspects; and (3) benefits of online clinic are not observable and its cost-benefit analysis is required.

Biography

Professor Masatsugu Tsuji Ph.D. Faculty of Economics, Kobe International University,and Professor Emeritus of Osaka University.Received B.A. from Kyoto University in 1965; M.A. from Osaka University in 1967; and Ph.D. in Economics from Stanford University, US.in 1976. He is currently professor of Kobe International University. His serves include visiting professors of Carnegie Mellon University, US and National Cheng Kung University, Taiwan; Board of Director, International Telecommunications Society; Editorial Board, Journal of International Society of Telemedicine and eHealth, and Smart Homecare Technology and TeleHealth; coordinator of e-Health Economics, ISfTeH. Current research focuses on economic evaluation of telemedicineand e-Healthusing econometric methods, and the applicationsof ICT for innovation inmedicine, telecommunications, and other industry. He has been consulting the Japanese Government and local governments for implementing telemedicine projects.

Speaker
Dr. Masatugu Tsji / Kobe International University, Japan

Abstract

As the IDF warns, diabetes mellitus (DM) is becoming a global issue. In Japan, the increase in dialysis patients especially due to diabetic nephropathy has become a social issue. Therefore, the prediction and prevention of the onset of DM as primary prevention are more important than the treatment for the prevention of its severity as third prevention. Recently, we developed the AminoIndexLifestyle-related Disease Risk Screening (AILS)to screen for the risk of lifestyle-related diseases by multivariate analysis of plasma free amino acid concentrations between lifestyle-related disease patients and healthy controls. In this study, we determinedwhether this AILS could screen for the risk of developing DM.The subjects were 7,703 people who took a health check-up as Ningen Dock without DM in the first year. Based on the AILS formula, when the specificity for developing DM within four years is 40%, the value is 5.0, and a specificity of 80% corresponds to a value of 8.0. The minimum and maximum values are 0.0 and 10.0, respectively. In addition, AILS values are classified as Rank A, for values lower than 5.0, Rank B, for values from 5.0 to less than 8.0, and Rank C for values of 8.0 or higher. The higher the AILS values, greater the risk for developing DM within four years. From 7,703 subjects, 215 (2.5%) persons developed DM, that in, DM occurred in 3,008 to 12 persons (0.4%) in rank A, 3,091 to 96 persons (3.1%) in rank B, and 1,604 to 107 persons (6.7%) in rank C. Assuming the odds ratio of rank A is 1.0, rank B is 8.0 (95% confidence interval 4.4 to 14.6), and rank C is 17.8 (9.8 to 32.5).These results which the risk of developing DM can be predicted by AILS level, may suggest that AILS prevents the onset of DM by lifestyle modification intervention according to AILS level, and that AILS may play a novel role in DM medical care.

Biography

Minoru Yamakado is Dean and Professor, Department of Nursing, Ashikaga University and Special Adviser, Health Care Center, Mitsui Memorial Hospital. He received his Medical Doctor’s degree from Department of Medicine, University of Gunma in 1972. After he was a Resident of Mitsui Memorial Hospital, 1972~1974, he was a Medical Staff, Department of Internal Medicine, Mitsui Memorial Hospital, 1974~1978 and a Medical Staff, Department of Internal Medicine, University of Tokyo School Of Medicine, 1978~1981. After receiving his PhD degree from University of Tokyo in 1981, he joined Professor PJ Mulrow’s Laboratory of Hypertension at Medical College of Toledo, Ohio, USA as a research fellow, 1981~1983. After returning Japan, he was a Chief Staff of Center for Kidney Diseases, 1983~1991, Director, Department of Preventive Medicine , 1991~1994, Director, Health Screening Center, 1994~2012, and Special Adviser of Health Screening Center of Mitsui Memorial Hospital from 2012. He is appointed Dean and Professor, Department of Nursing of Ashikaga University from 2014. His specialty is preventive medicine and hypertension. His board certifications are Fellows of Japanese Society of Internal Medicine, Councilor of Japanese Society of Anti-aging Society, Honorable Councilor of Japanese Society of Nephrology, Japanese Society of Endocrinology, Japanese Society of Atherosclerosis, Japanese Society of Obesity and Members of Internal Society of Nephrology and American Society of Hypertension.

Speaker
Dr. Minoru Yamakado / Ashikaga University, Japan

Abstract

Background: The main process used to pasteurize human milk is the low-temperature, long-time Holder method (HOLDER and recently investigated, the high-temperature, short-time method. Both processes lead to an appropriated inactivation of vegetative forms but are ineffective versus the bacterial spores. Research Aims/Questions : Find a method accomplish two main objectives: inactivation of all pathogens, including spores, and preservation of the activity of milk components. Design/Methods: Recently, a novel approach of the High Hydrostatic Pressure processes have been developed by HPBioTECH. We compared the effect of Human Milk treatment on the same samples (raw Human milk, Holder and our novel High Hydrostatic Pressure) on vegetative and spores forms of pathogens and on bioactive components (Lipase activity, Immunes proteins). Results: a) Pathogens destructions: two main microbial strains have been selected: Staphylococcus aureus (as reference for the vegetative forms) and Bacillus cereus (as reference for spores). This research led process adapted to the a) microbial decontamination of 6 log., either for Staphylococcus aureus or Bacilluscereus, b) Human Milk bioactive components: the main components of human milk is preserved. Activity of the lipase after this treatment (close to 80%) and that of several additional components (α-lactalbumin: 96-99%: Casein: 98-100%, Lysozyme :95-100%; lactoferrin: 93-97%; sIgA: 63-64%). Conclusions: this novel high Hydrostatic process generate microbiologically safe human milk could potentially result in important benefits for preterm infants: (i) improved assimilation of human milk, leading to daily weight and (ii) improved resistance to infections(iii) to avoid discarding 10% of contaminated by Bacillus Cereus human milk collected.

Biography

Claude Billeaud received his MD degree from the Medical University of Bordeaux ( France) in 1979 after a graduation in human cytogenetics (1976). He then studied pediatrics and has been the Clinical Assistant Director of Bordeaux University in the departments of Pediatrics, Neonatology and Intensive Care since 1983. He currently serves as a pediatrician in the neonatal unit at the Children’s Hospital of Bordeaux, as a scientific manager of Bordeaux-Marmande human milk bank, as a lecturer and head of research (HDR : Habilitation to direct research) in neonatal nutrition at the Medical University of Bordeaux. His particular interest in research led him to graduate in Biology and Health (1988, Bordeaux), be awarded a master in statistics applied to clinical research ( 1991, Montreal) and complete a PhD in nutrition and food science (2000, Bordeaux). Along his career he has often been invited as a guest professor specialised in nutrition and neonatology in various universities abroad ( Montreal, Corrientes in Argentina). Over the last 35 years, he has been an active member of different scientific organisations, either French, European or American, specialised in perinatal medicine (neonatology, pediatrics and nutrition). In this instance, he has served as the President of the Association for Pediatric Education in Europe (A.P.E.E) since 2008 and behalf APEE he is Member of European Academy of Paediatrics (EAP). He has also been very involved in the French human milk banking association (ADLF) for more than 10 years, sharing his academic knowledge focused in nutrition and his long clinical experience in neonatology. He is currently carrying out several researches on the composition of human milk. As an expert in nutrition and perinatal medicine, he is also the author and co-author of numerous scientific publications.

Speaker
Dr. Claude BILLEAUD / CIC Pédiatrique 1401 CHU Pellegrin .Bordeaux France

Keynote Talks

Abstract

Homelessness is still a major problem in Canada with especially damaging effects in rural and northern communities. Saskatchewan experiences higher rates of homelessness than the national average (e.g., one in five residents are homeless or at risk of homelessness; Canadian Centre for Policy Alternatives, 2015). Leaders in this domain (e.g., National Centre for Excellence in Homeless Services, Housing First, etc.) agree that increased collaboration between academia, existing service providers, and community leaders is vital to ensuring existing and upcoming initiatives are well coordinated, effective, and efficient. Our team received a SSHRC Partnership Engage Grant to conduct participant action and community capacity building research in Prince Albert. Included within this project were a series of focus groups and a full day event at which we communicated results of the focus groups and elicited follow-up responses through private interviews. The purpose of this research was to enhance the ability of PrinceAlbert to respond to homelessness by stimulating discussions and mutual collaboration between academic researchers, community leaders, social agencies, front-line workers, and the homeless population. The specific goals of this partnership are: 1) for all parties to develop a better understanding of the needs and potential supports for the local homeless population; 2) to develop a greater awareness of the challenges and advantages that community agencies experience when providing supports and programming; 3) to improve each parties' capacity for participatory action research. We are now applying for a SSHRC Partnership Development Grant to address the primary areas identified through our first study. Specifically, we intend to hire a community coordinator to: 1) act as a central contact person to improve the coordination of services across partner agencies; 2) to expand the use of HelpSeeker, an interactive mobile application and website, within Prince Albert; 3) to develop and administer life skills courses to those who are homeless or at risk of homelessness.

Biography

Acting Assistant Dean, Professor in College of Nursing, University of Saskatchewan. Research Team Member, Principal Investigator on numerous and Co-principal Investigator on multiple research projects. Adjunct appointment at Prince Albert Parkland Health Region (2009-2010). Associate Dean, Executive Team, University of Saskatchewan (2005-2010). Saskatchewan Health Research Foundation, “Strengthening Inter-Professional Ethics Education Practices of Nursing and Social Work Professionals in Saskatchewan: Deepening Understandings of Ethical Issues and Early Indicators”.

Speaker
June anonson / University of Saskatchewan, Canada

Abstract

Meditation is an ancient method of healing originated from India. It refers to the practice of intentionally bringing one’s attention to present-moment in a non-judgmental manner, with an attitude of acceptance and openness to internal and external experiences. We have previously found that meditation showed good effect on relieving of anxiety, depression and sleep disorders. We also found that intractable hallucinations and delusional symptoms scores were significantly reduced after an eight-month meditation training on chronic schizophrenia patients. To further clarify the effect of meditation on residual symptoms of schizophrenia, we recently have carried out a randomized controlled clinical study, in which 60 patients with chronic and refractory schizophrenia were randomly assigned to receive meditation or general education. Multimodal data, including scale assessment, EEG, nuclear magnetic, and biochemical data were collected at baselines, 3 months and 8 months post meditation. We have found that compared with education group, 3-month meditation significantly improved positive and negative symptoms in patients, in which the improvement of delusions, hallucinations, and social withdrawals were most pronounced. In addition, after meditation, patient's cognitive function improved significantly. We will further track the effects of long-term meditation on mood, cognition function, physiological function, and EEG and nuclear magnetics. What’s more, we also revealed the effect of long-term meditation on cardiovascular protection. We profiled and validated plasma proteome remodeling by long-term meditation (19.12±7.7 year) across 125 Tibetan Buddhists and matched controls. Remodeled proteome patterns indicated reduced cardiovascular risk.

Biography

Donghong.Cui, Professor and PI of the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, CNH. Executive director of Shanghai Key Laboratory of Psychotic Disorders. Director of Bio-Bank. She received Ph.D. from Fudan University, China and pursued postdoctoral training in Yale University, USA. She serves as the Standing Committee Member and secretary general of the Chinese Society of Neuroscience& Psychiatry (CSNP), the President of the neuromodulation Union of CSNP, and the President of Shanghai Institute of Integrated Medicine, etc.Her research interests focus on Pathogenesis of Psychiatric disorders and precision medicine; mechanism of meditation.She published more than 60 academic papers in reputed journals such as , , etc.

Speaker
DongHong Cui / Shanghai Jiao Tong University , china

Abstract

Chronic conditions and autoimmune disorders, acquired later in life, manifest due to a triad of factors - genetic susceptibility, a broken body barrier and one or more environmental triggers. A common instigator in the environmental factors group is dietary proteins. Specific food protein antibodies, for example, alpha-gliadin-33, cow’s milk casein and spinach aquaporin, have been shown to cross-react with human tissues, while food lectins and agglutinins have an affinity for binding to human tissues. Both cross-reactivity and binding can contribute to autoimmune reactivity as seen in chronic disorders. We have shown that 64% of patients with IgG reactivity to wheat gluten family proteins, 73% of patients with IgG + IgA reactivity to dairy family proteins, an average of 63.75% of patients reacting to one or more food aquaporins, and an average of 73.62% of patients with specific lectin/agglutinin antibody reactivity, had IgG + IgA reactivity to one or more self-tissues. Thus, food may be a contributing factor to a patient’s illness. Dietary interventions, when elevated food antibody levels are detected, may be considered as part of full-spectrum treatment protocols for patients with chronic clinical conditions.

Biography

Jama Lambert is a graduate of the University of Oregon. She has spent thirteen years under the mentorship of Aristo Vojdani, renowned microbiologist and immmunologist. She has co-authored multiple peer-reviewed publications, as well as six book chapters and has edited medical books. She has presented original research at the last two International Congresses on Autoimmunity and has lectured, or presented posters, at medical conferences. She is currently the Vice President, Education at Cyrex Laboratories, LLC and is working towards a PhD in Public Health and Nutrition.

Speaker
Jama Lambert / Cyrex Laboratories, USA

Abstract

One of the tenets of Palliative Care is the care of patients and their family members as the unit of care. Health providers often seek information about the patient from family members, and expect them to provide a complex caregiving role, without understanding their readiness, willingness, and ability to assume the role. Family caregivers can become at-risk for serious health issues, given the physical, cognitive, emotional, and social stress associated with the caregiving role. As caregiving extends over time, caregivers are at greater risk for mortality, yet they remain a vulnerable population neglected by health professionals. As illustrated through a case study, this presentation will address the complex role of family caregivers, as both health team members and second order patients. The importance and components of family assessment will be discussed, as well as multi-faceted interventions needed balance the burdens and benefits of family caregiving and protect caregiver’s health and well-being.

Biography

Deborah Witt Sherman, Ph.D., APRN, ANP-BC, ACHPN, FAAN is a Professor at Florida International University and has a prestigious career in education, research, clinical practice, and leadership. Shewas funded by the Soros Foundation to develop the first palliative care nurse practitioner program in the United States. She received the Hospice and Palliative Care Nurses Associations’ “Leading the Way Award” and the “Lifetime Achievement Award in Palliative Care Nursing” from MD Anderson Cancer Center inTexas. Dr. Sherman is co-editor of the award-winning textbook, “Palliative Care Nursing: Quality Care to the End of Life,” and has over 100 publications.

Speaker
Deborah Witt Sherman / Florida International University, USA

Sessions:

Chronic Diseases and Healthcare

Abstract

Ligament injury is worldwide common pathology, and the rehabilitation cost rises to billions dollars annually. Ligaments are a connective tissue made up by cells (fibroblasts) that release and maintain the extracellular matrix, their function is guarantee joint stability, proprioception and loads transfer during body movement.When tissue is injured due to an overstress, the collagen fibers are broken. This event induces a sequencial stages: inflammatory, proliferative, and remodeling phase. Therapeutic ultrasound is frequent agent used in physiotherapy to treat the ligament injuries. Nevertheless, its efficacy is still controversial for clinical use, and scientific evidence to support its impact at the cellular level in ligaments is limited. The aim of this study was to determine whether pulsed ultrasound treatment every 24 hours for five days at 1.0 MHz with two different intensities 1.0 and 2.0 W/cm2 increases (1) type I, type III collagen, and fibronectin synthesis using and ELISA assay and (2) cell proliferation through MTS assay by cultured fibroblasts explanted from knee collateral lateral ligament of rat growing as monolayers. We showed collagen average was increased 94% for both treatment groups and fibronectin was increased 73% at low intensitiy and 40% at high intensity. We found that cell proliferation was increased 10% at low intensity, and decreased 13% at high intensity with significant differences among groups (p< 0.05). In summary, this work argued that pulsed therapeutic ultrasound might be used to stimulate cells to improve the ligament healing process.

Biography

Rosy Cárdenas is finishing her PhD from Universidad Nacional de Colombia. She is the leader of Clinical Movement Laboratory, of the School of Medicine and Health Sciences at Universidad del Rosario. She researchs in the Rehabilitation Science Research Group at Universidad del Rosario and in the Tisssue and Organ Mechanobiology Research Group at Universidad Nacional de Colombia. She has published 8 papers in reputed journals.

Speaker
Rosy Paola Cárdenas-Sandoval / Universidad Del Rosario, Colombia

Abstract

eHealth service is a fast growing concept to accelerate efforts towards reaching United Nations Sustainable Development Goals target date of 2030. Bangladesh Government and several development organizations have been implementing telemedicine and mHealth program. During its commercial and technical piloting of eHealth programs, it was identified that direct interaction and real time information dissemination is crucial for the mothers to change their behavior. Considering these facts, in 2015, Grameen Intel developed COEL, a smart wellness wearable bangle that provides pre-recorded Mobile Alliance for Maternal Action (MAMA) messages for maternal health in local language, on a preferred time and with less effort and understandable way. Based on the trial data, it was found that, most of the rural expecting mothers have a requirement of information either for nutritional facts or status of the unborn child or health & hygiene or preparation in the final stage and COEL could deliver the information to the target audience at right time. It can also alert the presence and level of indoor air pollution particularly carbon monoxide during cooking. COEL is targeted to rural and peri- urban mother who usually doesn’t get adequate health care services and information during pregnancy. It speaks about 80 pregnancy wellness messages. Currently we have been disseminating health and nutritional messages to pregnant women and mothers of children under 2 years via text messages and voice calls through Nobo Jatra project of World Vision. COEL can ensure that the target audience will not miss any disseminated information or messages, as the bangle speaks in local language. User can use this bangle while engaging in every day to day household activity. Data regarding messages delivery and CO detection stored in the Bangle and while connected, it automatically transferred to cloud server, from where data management and monitoring can be done.

Biography

Dr Md. Abdul Alim has completed MPH from National Institute of Preventive & Social Medicine, Bangladesh and Master of Science from Nagoya University Graduate School of Medicine, Japan. He is the deputy program manager of National Nutrition Services under Institute of Public Health Nutrition of Bangladesh government, an apex body that woks for nutrition in the country. He has published a significant number of scientific papers in reputed journals and has been serving as an editorial board member of three international journals.

Speaker
Md. Abdul Alim / Institute of Public Health Nutrition, Bangladesh

Abstract

Improved health and nutrition of children has a positive impact on his or her education and community development. Healthy and well-nourished children stay in school longer than malnourished children; they learn more and become healthier and more productive adults. In Bangladesh, both malnutrition and micronutrient deficiencies remain significant problems that limit children’s potential to succeed in school. Among school-aged children, 32% are stunted, 70% are underweight, 13% are wasted, 55% are anemic and 34% have iodine deficiency. Bangladesh government introduced “Little Doctors” concept in 2010 to control soil-transmitted helminthes (STH) when STH infection rate among school children peaked at 80%. This innovative program selects 5 students from each class of 3rd, 4th and 5th gradae a total 15 in number to as “Little Doctors.” They assist their teachers on health promotion days and help their classmates learn about STH and how to prevent infection. They also distribute dewarming tablet among non-school children on de-worming days. The current objectives of “Little Doctors” are to increase the status of health, hygiene, and nutrition among school students as well as their families. According to government guidelines, there are 15-21 members of the “Little Doctors” in each primary school. A Hygiene teacher leads this team. “Little Doctors” program is design to prevent and treat the causes of ill health that affect children’s ability to learn, while creating a safe and supportive school environment that promotes healthy behaviors. Simple interventions such as regular deworming, micronutrient supplementation and hand washing with soap can prevent children to be anemic, and can prevent diarrheal diseases and pneumonia. Promoting healthy behaviors through school, is a very effective way of improving the health of the entire community today and in the future, as these children become parents themselves. In the school, there is a Hygiene Corner for “Little Doctors” equiped with weighing scale, height board, eye chart, hand washing and poster with nutritional messages, emergency primary medical equipment boxes etc. to measure monthly height, weight and eye check-up and demonstration of hand washing and counselling. Here the members of the “Little Doctors” deliver health-related messages and play a role in health care. “Little Doctors” has already proved a cost effective and successful program which is to be scaled up in the country.

Biography

Dr Md. Khalilur Rahman has completed MPH from the University of Dhaka, Bangladesh. He worked in different positions of Bangladesh government at sub-district, district and central level. Currently he is the director of Institute of Public Health Nutrition of Bangladesh government, an apex body that woks for nutrition in the country.

Speaker
Md. Khalilur Rahman / Institute of Public Health Nutrition, Bangladesh

Sessions:

Pharmaceuticals and Healthcare

Abstract

The aim of my presentation is to report the development of a new pharmacoclinical concept for the development of new analgesics able to alleviate acute and chronic pain and to be devoid of the side effects of morphine (MO). This approach is based on the existence of a physiological endogenous opioid system (EOS) constituted by neuropeptides essentially the two pentapeptides enkephalins (Met-ENK and Leu-ENK) which stimulate two G-proteins coupled receptors (7TMGPCR) called mu (MOR) and delta (DOR) present on free nerve endings in skin, muscle, articulation and spinal and brain structures constituting the somatosensory system. The two ENKs have the same affinity and efficiency than MO but their life-time is very short because they are cleaved by two zinc metallopeptidases neprylisine (NEP, CP10) and aminopeptidase N (APN, CD13) called enkephalinase. Our strategy was therefore to design dual enkephalinase inhibitors (DENKIs) to block completely the inactivation process leading to an exaltation of the ENKs signalling occurring strictly on synapses activated by painful events or by various stressful or depressive disorders in contrast to the ubiquitous activation occurring with MO [1]. Among the DENKis two molecules have been selected, PL37 and PL265. Both are prodrugs of two different chemical series of DENKIs, a disulfide series and an aminiphosphinic series respectively. These compounds protect in vivo the enkephalins released during physical and psychic painful events after i.v. and /or oral routes. Moreover, PL265, orally administered does not cross the blood brain barrier, leading to pure peripheral antinociceptive effects. Tested on animal models of pain, these molecules are highly efficient in protecting the enkephalins released during all types of pain, acute and chronic pain, inflammatory and ocular injury, migraine, post operative nociception, or neuropathy, without all the drawbacks induced by exogenous opioids such as MO, i.e. tolerance, dependence, respiratory depression, constipation, hyperalgesia and allodynia. Moreover they are efficient to regulate mood and particularly affective disorders and depressive illness. Preclinical studies of PL37 and PL265 in animal and human have shown the absence of toxicity. Clinical Phase 2 for PL37 in neuropathic pain (capsaisin test and diabetic neuropathy) has demonstrated the efficacy of this innovative approach. The effects of DENKis were shown to be greatly enhanced by their associative with various drugs acting on other mechanisms of pain control than by opioid. This could be used to present or attenuate the « crisis » occuring in USA and other countries by use of morphine derivatives.

Biography

Bernard P. Roques earned degrees in pharmacy and pharmacology at René Descartes University, Paris, France, and a Ph.D in Physical Chemistry at the Ecole Polytechnique, where he was Assistant Professor 1970-1976, and then Professor of Pharmacochemistry at René Descartes University and Director of the Departement de Pharmacochimie Moléculaire et Structurale associated with the Centre National de la Recherche Scientifique (CNRS) and Institut National de la Santé et de la Recherche Médicale (INSERM) from 1976-2001. During this period he designed Stagid® the first antidiabetic agent with long duration of action still on the international market. His laboratory designed the first DNA polyintercalators, in addition to discovering potent and selective agonists of the -opioid receptor and subsequently demonstrating their potential interest as antidepressants. In 1980, he developed selective inhibitors of enkephalin-inactivating enzymes, one of them Tiorphan® being on the market as antidiarrheal agent very convenient for infants and proposed the concept of dual inhibitors DENKisfor the complete protection of enkephalins and its extension to metallopeptidases involved in cardiovascular diseases. B.P. Roques is author of more than 500 publications and 30 patents. At present, his laboratory specializes in the development of inhibitors of the zinc metallopeptidases involved in peptide metabolism, which are of potential interest in analgesia, cardiovascular field, neurodegenerative processes, migraine, glaucoma and cancer. Among international awards, B.P. Roques has received the Charles Mentzer Prize from the Medicinal Chemistry Society (1994), the INSERM Academy of Sciences Award (1994), the G. Witter/V. Grignard Prize from the Gesellschaft Deutscher Chemiker (1996), the Galien Prize of Pharmaceutical Research (1977) and the Rudinger Award from the European Peptide Society (2000), the Founder’s Award from the International Narcotic Research Committee. He is member of the French and European Academy of Sciences. Now Scientific Director of the start-up company Pharmaleads founded by him in 2001, B.P. Roques has participated to the development and commercialization of : i) new methods for the detection of very low concentration of botulinum toxin usefull in bioterrorism oversight and in treatment of neurological diseases and wrinkles attenuation; ii) Fluofast, a universal substrate library for proteases and phosphatases. Two DENKIs, PL37 and PL265 are now I clinical trials and PL37 now found efficient in phase 2 to treat neuropathic pain and activation, retina pain and migraine.

Speaker
Bernard P. Roques / University Paris Descartes, Paris

Sessions:

Mental and Physical Health

Abstract

The primary mental health care (PMHC) problems form 60% among PHC patients, mostly depression and anxiety. These disorders interfere with the chronic cases control. Majority of them are miss-diagnosed. The PHC physicians are not well prepared in their training as PMHC providers (WHO/Wonca Report 2008, 2017). Goal: Empower the attendees through training on a new efficient patient interview called “5-steps patients’ interviewfor MH care providing in PHC”. - Step-1 Suspected stage: when patient should be interviewedand suspected asa MH ill patient: frequent visits and uncontrol chronic physical diseases. - Step-2 Screening stage: 1. ICEaim is to identify the hidden agenda. 2. Impacton sleep, performance, relationship, aim is stress present? a. Sleep: -“Early insomnia” happen in mild case - “is it interrupted”?moderate case - Late insomnia; mostly severe. - Do you have a prolong sleep?happen in atypical depression. b. Performance:marked decline usually occurs in moderate case. c. Relationship:isolation or problem-maker, mostly occurs in a severe case. - Step-3 Scoping stage: Patient needs to be served in PHC OR referred to hospital - Step-4 Diagnostic stage: Need one major criterion > 2 weeks. Depression: sad mood or loss of interest. Anxiety: anxious tens mood or fear worry. - Step-5 Management stage Cases with moderate- severe level in the impact questions, think in antidepressant medication except 2-cases: Incooping with life events, action is to apply narrative therapy as the first step. Secondly, side effect of medication, stop medication and follow-up and reassess.

Biography

Dr. Al-Khathami is a Consultant Family and Community Physicia Vice-chair Wonca-Working Party Group on Mental Health-EMRO. Director of the Primary Mental Health Initiative Program-MOH Saudi Arabia. Dr. Al-Khathami served his main research work addresses Mental Health and Family Medicine, has several publications in indexed journals. He has been as speaker at national and international conferences. He obtained themaster’s degree in medical education from Cardiff University-UK in 2010. Also, Diploma in Total Quality Management from American University in Cairo 2012.In 2018 obtained Master primary MH care from Nova-Lisbon. Dr. Khathami have considered as a key person in the PMHC field in his region. Also, a senior trainer in the training of the trainers (TOT) courses. Recently, He has published a book in the TOT field.

Speaker
Abdullah D. Al-Khathami / King Fahad Hosp. of the University, Saudi Arabia

Abstract

The etiology of autoimmune disease is multifactorial, including genetic, environmental, hormonal, and immunological factors. Nevertheless, the onset of autoimmune disorders remains enigmatic (Tabl 1). Physical and psychological stresses have been suggested in the development of autoimmune disease, since numerous animal and human studies demonstrated the effect of stressors on immune function. Moreover, many retrospective studies had found that a high proportion (up to 80%) of patients reported uncommon emotional stress before disease onset. Recent reviews discuss the possible role of psychological stress, and of the major stress-related hormones, in the pathogenesis of autoimmune disease and presume that the stress-triggered neuroendocrine hormones lead to immune dysregulation, which ultimately results in autoimmune disease by altering or amplifying cytokine production. However, there is no evidence based research to support this concept. Unfortunately, not only does stress cause disease, but the disease itself also causes significant stress in the patients, creating a vicious cycle. Recent reviews discuss the possible role of psychological stress, and of the major stress-related hormones, in the pathogenesis of autoimmune disease. It is presumed that the stress-triggered neuroendocrine hormones lead to immune dysregulation, which ultimately results in autoimmune disease, by altering or amplifying cytokine production. The treatment of autoimmune disease should thus include stress management and behavioral intervention to prevent stress-related immune imbalance. Different stress reactions should be discussed with autoimmune patients, and obligatory questionnaires about trigger factors should include psychological stress in addition to infection, trauma, and other common triggers. Keywords: Physical and psychological stresses, autoimmune disease, trigger factors. This work was supported by research grant number 175041 for 2011 – 2020, and by research grant number TR 32040 for 2011-2020, issued by the Ministry of Science of the Republic of Serbia.

Biography

Ljudmila Stojanovich received her Ph.D. in Medicine, with the thesis “Neuropsychiatric manifestations in patients with Systemic Lupus Erythematosus” in 1999. She is the scientific director in the Bezhanijska Kosa, University Medical Center of Belgrade University, where she is currently a Full Research Professor. She is an author of three monographs and of about 250 articles on various aspects of Autoimmune Rheumatic disorders, published in international and domestic journals and in conference proceedings. She is in Editorial Boards (Editorial Boards LUPUS (LONDON). /Reviewer in the “CURRENT CONTENSTS” or “Science citation index”, like LUPUS REWIEWER DATABAS, Cellular and Molecular Neurobiology.

Speaker
Ljudmila Stojanovich / University Hospital Medical Center, Serbia

Sessions:

Womens Healthcare

Abstract

Background: In North America, there are approximately 30 million women in the menopausal age range of 40-54 years. Since menopause can be a time of changes, women may be interested in receiving information regarding menopause and management of associated symptoms such as hot flashes, mood instability and vaginal dryness. Although there are ways to alleviate these symptoms, many women, due to their limited knowledge related to menopause, are not aware of these treatment options nor able to determine which options would be best for them. Many healthcare providers fail to identify women who may present with menopausal symptoms, thus failing to offer them treatmentsto alleviate these symptoms. Methods: We developed at the Miami VA healthcare system, a project called the“My HealtheVet to Enable AndNegotiate for Shared decision making” or MEANS project, an unblinded non-randomized pilot project, to deliver an educational intervention program surrounding the management of menopause. The project identified female veterans of perimenopausal and menopausal age (45 to 60 years) at three VAHealth Systems (VAHS) – Miami, Orlando, and West Palm Beach. The six-month intervention provided educational resources on menopause andshared decision making (SDM) through the MyHealtheVet electronic portal system to women in the Miami VAHS only. Following the intervention, data regarding patient knowledge and use of the MyHealtheVet portal was collected. The project compared the impact of the MEANS intervention on patients at the Miami VAHS to women veterans of the same age who did not receive this intervention across the three VAHS sites. Results: At the initiationand conclusionof the study, participants completed a test assessing their knowledge of menopause. This test was scored out of 18 points, with a higher score indicating a higher level of knowledge. At the beginning of the intervention, the average score was 14.7 with a standard deviation of 2.4. Following the intervention, the average score increased to 15.8 with a standard deviation of 1.8.Along withknowledge tests, women were asked to rate their perceived understandingof menopausal symptoms and the associated treatment options. Women rated their knowledge to be higher following the intervention, suggesting that the MEANS project increased participants’ confidence in their understanding of menopause. In addition, the MEANS project increased understanding of Shared Decision Making (SDM), and increased use of the MyHealtheVet portal among participants. Conclusions: These findings are promising and suggest that an educational intervention could be effective in increasing women veterans’ access to treatment for the symptoms of menopause.

Biography

Stuti Dang is an experienced geriatrician and researcher, and the Associate Director for Implementation and Outcomes Research in the Geriatrics Research Education and Clinical Center (GRECC) at the Miami VA Healthcare System. She has been a PI or co-investigator on multiple projects funded by the VA, NIH, and DOD for implementing care models that leverage technology for high need veterans with complex chronic conditions and their caregivers. She has extensive expertise in caregiver issues, care coordination, and telehealth interventions for chronic disease management in the elderly. She seeks to understand the needs and need gaps of frail, older, high-need high-risk veterans and their caregivers to allow aging in place. In the past, Dr. Dang has worked to develop successful telemedicine approaches, supplemented with evidence-based innovative interventions for better management of patients with chronic conditions and their caregivers. Her funded technology projects strive to establish usability and utility of various technologies including home telehealth, video, mobile, and web-interventions, in different settings, including home based primary care. Her projects are designed with the intent to empower patients and their caregivers to become informed partners in their health care, by helping them increase their problem-solving ability and by providing them needed resources.

Speaker
Stuti Dang / University of Miami Miller School of Medicine, USA

Abstract

The psychological cannon highlights on a new paradigm shift from the traditional models such as the bio-psychosocial model to disease and treatment to the inculcation of spirituality (Bio-psychosocial-S) in holistic treatment plan. Breast cancer is the second leading malignancy in Ghana and appears to be on the ascendency in recent times. Emerging studies have documented increasing diagnosis among premenopausal women which conflicts with previous findings. However, an attempt to handle the disease has been crippled with logistic and structural challenges. Breast cancer patients have adopted various strategies over the years in attempt to cope with the structural challenges inherent in the diagnosis, treatment and post treatment plan. Using qualitative research methodology, twelve participants were conveniently sampled and interviewed. This preliminary study explored views and perceptions of breast cancer patients on breast cancer and how they have coped with the condition. Results were analyzed using Interpretative Phenomenological Analysis (IPA) to explore how participants make meaning of their experiences. Findings showed that socio-cultural factors play an integral role in participants’ interpretations of the disease and this also informed the culture-specific coping ties which were employed respectively. Implications for psychological models, treatment, and research are discussed.

Biography

Dr Yvonne Otubea Otchere is a lecturer/researcher and an alumni of the University of Ghana. Currently, she is a lecturer at Lancaster University Ghana. Her research has primarily focused on understanding the African sexuality, Breast Cancer, masculinity and neuropsychological functioning in typical and atypical populations. Dr Otchere’s research concerns are focused on specifically dissecting the layers of the African sexuality. She is known to be one of the avid African scholars documenting on gender roles among homosexual men in Ghana. With funding support from Global Research Challenge Fund, she is currently involved in landscape projects such as the use of technology/apps in mental health among Men who Sleep with other Men (MSM) in Ghana. Her teaching interests include social behaviour, brain and behaviour, understanding organisational psychology, sexuality, understanding psychological assessments, Psychology of religion and spirituality in the African context. As part of her earnest zeal for research work and social responsibility, she serves as the treasurer for the Ghana Psychological Association.

Speaker
Yvonne Otubea Otchere / Lancaster Uni Ghana, Ghana

Sessions:

General Practice & Hospital Management

Abstract

The regional medical information network connects medical institutions in the region to share residents’ medical records including images of x-ray and endoscopy, diagnosis, history of treatment, medication. It promotes the efficiency of providing medical care and the reduction of medical expenditures by preventing double medical checks or medications. In the age of big data or AI, the medical networks become more important in all aspects. This paper is based on field research on regional medical information networks in Japan, and compares them in terms of their objectives, information systems, economic foundations, and effects on medical institutions, medical doctors, and patients. The cases include Ajisai (Hydrangea) Net, Nagasaki, Himawari (Sunflower) Net in Okayama, and Oshidori (Swan) Net in Shimane are included.The issues of Japanese regional medical networks this study found are (i) connectivity and (ii) utilization. (i) Most of information networks in Japan are based on either “ID-Link” of NEC and “Human Bridge” of Fujitsu. But two do not integrate each other, since their structures are different. (ii) Medical data from the networks is not stored and medical institutions do not make fully use of information obtained from the network to promote efficiency such as reducing manpower and costs. The sizes of Japanese networks are too small to be big data and data is not stored. This is obstacles to utilize data for prevention of diseases. This study proposes how to integrate networks to produce big data and how to utilize the big data for solving medical issues of regions.

Biography

Professor Masatsugu Tsuji Ph.D. Faculty of Economics, Kobe International University,and Professor Emeritus of Osaka University.Received B.A. from Kyoto University in 1965; M.A. from Osaka University in 1967; and Ph.D. in Economics from Stanford University, US.in 1976. He is currently professor of Kobe International University. His serves include visiting professors of Carnegie Mellon University, US and National Cheng Kung University, Taiwan; Board of Director, International Telecommunications Society; Editorial Board, Journal of International Society of Telemedicine and eHealth, and Smart Homecare Technology and TeleHealth; coordinator of e-Health Economics, ISfTeH. Current research focuses on economic evaluation of telemedicineand e-Healthusing econometric methods, and the applicationsof ICT for innovation inmedicine, telecommunications, and other industry. He has been consulting the Japanese Government and local governments for implementing telemedicine projects.

Speaker
Masatsugu Tsuji / Kobe International University, Japan

Keynote Talks

Abstract

Healthcare organizations store, maintain and transmit huge amounts of data to support the delivery of efficient and proper care. In recent years, rapid growth of information and communication technologies and increasing pressures for reducing health care costs, improving health care quality, ensuring patient safety and reducing medical mistakes have led to increasing use of computerized health information systems in healthcare organizations. However, the advances in information and communication technologies have caused health information to be confronted with new security and privacy threats. As a result, many healthcare organizations aim to upgrade the security of their information systems to protect their databases against unauthorized access. Security is an important issue when dealing with information, particularly in the health care settings where the nature of information is critical and confidential. Although implementing absolute security is impossible, a security plan is necessary to attain an appropriate or a reasonable level of information security in different organizations. A Hospital Information Management System is a computer system designed to manage all the aspects of a hospital's operations such as clinical, administrative, and financial activities. Information systems and computers are the most important assets in each organization that must be protected due to the value of information. In this condition, system design, workload, education and training of staffs and readiness and acceptance of information and communication technologies are important factors for organisations. In order to achieve success and sustainability by increasing quality, continuity, safety and efficiency in health care services, it is very important to understand the factors that affect the level of readiness.

Biography

Assist. Prof. Dr. Pınar Kılıç Aksu is a Dentist and an expert in Health Care Management. She has her Msc and Phd degrees on Health Care Management. She is Head of the Health Care Management Department in Yeditepe University and also works as Administrative Coordinator in Yeditepe University Dental Hospital. She is interested in Information Security and Patient Pivacy especially.

Speaker
PINAR KILIC AKSU / Yeditepe University, Turkey

Abstract

Egypt is among the world top 10 countries in diabetes prevalence. It is the first country among the MENA region. Healthy lifestyle education and support help people with diabetes to improve health outcomes. Many physical and psychological barriers can hinder patients to follow a healthy lifestyle. This study aimed to examine the effect of lifestyle modification educational sessions in helping Egyptian patients to overcome main barriers of diabetes self-management through improving nutritional behaviors, physical activity, medication compliance, and blood glucose monitoring. A cohort study included 205 patients with type 2 diabetes. Baseline assessment of patients' lifestyle behaviors and barriers using personal diabetes questionnaire of Louisville University, with both anthropometric and blood glucose assessment. Interventional lifestyle health education was provided weekly through multiple integrated techniques, followed by post-intervention assessment to evaluate the effect of the health education sessions. Statistical analysis was done to identify any statistically significant difference before and after the health education intervention. There was a significant improvement of the post education mean scores of the studied behaviors when compared with the pre education scores of the participants’ behaviors (p <0.001). There was also a significant reduction in the barriers facing patients to diabetes self-management including nutritional barriers (P<0.001), medication compliance barriers (P <0.001) with a percent change (43%), physical activity barriers (p <0.001), and blood glucose monitoring (p <0.001) with a percent change (44%).There was a statistically significant positive correlation between improvement of medication compliance (P=0.027), blood glucose monitoring(P=0.045), and glycated hemoglobin of the study participants

Biography

Prof. Dr. Ammal is Prof. of Public Health and Preventive Medicine/ head of Community Medicine Research Dept./ National Research Centre of Egypt./ Regional Board member for the Eastern Mediterranean of the World Hepatitis Alliance. She has been hired as preventive medicine and behavioral change advisor since 1997 for many international agencies in Egypt; She has published 59 papers in reputed international journals. Her primary interest lies in promoting behavioral change for families in rural communities through community based approaches aiming at their development and mobilization.

Speaker
Ammal Mokhtar Metwally / National Research Centre, Egypt

Abstract

By 2013, Western countries received roughly 130 million immigrants, with women consisting of more than half the immigrant population. This demographic change highlights the importance of cultural sensitivity and its role in clinical practice. The impact of cultural diversity in the delivery of quality health care is undeniable.Sociocultural differences, e.g., ethnicity, race, and language proficiency, are just a few factors to consider. Furthermore, these differencesdirectly influence a woman’s perspective, behavior, belief, and value incurrent multicultural societies. A true understanding of a woman’s cultural differences is required to establish effective clinician-patient communication and to improve quality of care. Through applied and innovative understanding, it is possible to continue the integration of diversity in women’s health management and establish standards of care for this vulnerable population. Standards to considermay include availability of personalized care, cultural respect, informed consent in medical decision-making and medical procedures, understanding of sexual orientation, use of interpretive services, and regard for all birth rituals and faith-based concerns. The purpose of this presentation is to: • Define cultural diversity in women’s health • Identify obstacles in cross-cultural care • Introduce sensitive models to care for women from other cultures

Biography

Soheyl Asadsangabi studied Midwifery in Iran and completed herDoctoral study (DNP) as a midwife from Vanderbilt University. She has been practicing midwifery since 2004 in private and academic settings. As a woman from another culture and a clinician who provides care for a diverse population her focus is on cross cultural women’s health care. She is currently an Assistant Professor at Vanderbilt School of Medicine.

Speaker
Soheyl Asadsangabi / Vanderbilt University Medical Center, USA

Sessions:

Medication Safety

Abstract

The question addressed in this research study was, “Is there a difference in medication adherence for African American women diagnosed with unstable high blood pressure from a community health clinic setting who monitor their blood pressure daily and use the OnTimeRx® smartphone application versus those who use the Omron BP786 monitor?”The Stroop Color and Word Testwas administered pretest to screen for cognitive deficits which may interfere with the participants’ ability to operate the equipment used in this research study. After achieving t-scores of 30 in all three test areas, the participants were consented and randomized into one of two study conditions (treatment group or control group). Throughout the study, all participants were contacted on a weekly basis for follow-up and to answer study-related questions. Handouts were provided as a secondary measure to augment verbal instructions. After 28-days of data collection, medication adherence was measured with the Morisky Medication Adherence Scale-8. In this post-test (only) study, all 67 participants who completed the study submitted their blood-pressure values to the primary investigator; and all 31 treatment-group participants submitted their compliance (adherence) scores. Results suggested the treatment group demonstrated significantly better medication adherence than the control group (Mann-Whitney U=393, p-value=0.037); and, the estimated marginal means of the treatment group’s systolic blood pressure was significant (p-value-0.002). These findings suggested smartphone technology can have a positive influence on high blood pressure management.

Biography

Dr. Monroe completed her PhD at Texas Woman’s University. As a previous staff-nurse, she has worked in the field of cardiovascular nursing since 1991. She has worked as nurse educator since 2007. Currently, she is a clinical assistant professor at PVAMU-CON. She has published previously on this same topic; and serves on the editorial board of a nursing journal.

Speaker
Vanessa D. Monroe / Prairie View A&M University-College of Nursing (USA)

Sessions:

Addiction Disorders & Health care

Abstract

In connection with a change in the lifestyle of a person, energy requirements for fats have decreased due to a decrease in physical exertion.On the contrary, there is a predominance of intellectual and operator types of activity, which are provided by the energy of glucose (the brain uses only glucose as a source of energy).This led to the development of an energy imbalance - a deficiency of one energy source (glucose) against the background of an excess of another (fat).The body is trying to ensure the functioning of the brain due to the supply of glucose with food, but at the same time an excess amount of food is supplied, which contributes to the development of obesity.Brain activity can also be achieved by increasing transport or increasing blood pressure, but this increases the risk of developing hypertension. In the liver, fat oxidation provides energy for the process of gluconeogenesis, and when there is a shortage of substrate or amino acids for gluconeogenesis (for example, during fasting or type 1 diabetes), the need for ATP energy decreases and fat oxidation during the acetyl-CoA phase is blocked.Two molecules of acetyl-CoA are condensed with the formation of acetoacetate, which is then converted into hydroxybutyrate and acetone, i.e. developing ketosis, which is a threat to life.Therefore, the body protects itself from the development of ketosis (adaptive response) through the secretion of the hormone insulin, which prevents the release of fat from the depot to the circulation. However, an increase in insulin also has an adverse effect (in particular, hypoglycemic coma), so the body protects itself against insulin through the development of insulin resistance, which leads to the development of diabetes. In response to insulin, the synthesis of fats increases and their oxidation decreases, leading to the development of dyslipidemia. This deadly quartet (obesity, hypertension, diabetes, and dyslipidemia) has been called metabolic syndrome (MS). For the prevention and treatment of MS, it is necessary in the phase of physical and mental activity or in the post-adsorption period to increase the body's supply of glucose energy, which can be achieved through the use of a specialized product for feeding obese individuals (Certificate of Grant of Patent GB 2496119 22 January 2014). This product also improves the interface between lipid oxidation and the process of gluconeogenesis, which prevents the development of ketogenesis. Thus, in addressing the issues of prevention and treatment of MS, it is necessary to use the metabolic approach in conjugating the processes of formation and utilization of ATP energy, which we proposed as a conceptual metabolic model developed taking into account the carbon skeleton transport during the absorptive and postabsorptive periods.

Biography

Emil Mukhamejanov - doctor of medical sciences, professor. In 1964-1972, I worked in the Institute of Physiology, responsible for the regulation of muscle contraction. In 1974-1991, I worked in the Institute of nutrition, responsible for the regulation of energy metabolism and metabolic diseases. Developed metabolic model of balanced diet coupled with effects of toxic compounds, physical activity and dietary factors. Has developed specialized nutrition products for athletes and for the prevention and treatment of metabolic diseases. Currently working in the Scientific Center of anti-infective disorders, develop approaches of reducing the negative impact of drugs. I participate in a grant (JSC National Medical University named after S.Asfendiarov) for the study of polymorphism in diabetes mellitus. I am a scientific consultant at International Institute of Gerontology, Almaty

Speaker
Emil Mukhamejanov / LLP SPA-SKY Production, Almaty, Kazakhstan

Abstract

PCOS-Polycystic Ovarian Syndrome is a metabolic disorder that effects the hormones and endocrine system. This disorder affects so many young girls and women, it is said that 1 in 10 women of childbearing age have it and may not know it. Symptoms range from infertility, being overweight, cardiovascular issues, acne, unwanted hair, etc. Many specialized medical providers can treat PCOS patients but the beginning starts with Ultrasound imaging and lab work for diagnosis. Ultrasound provides images of the ovaries to understand if cysts are present.

Biography

Keshena has a Bachelor’s of Science in Radiology Technology. She has worked as a Radiology Technologist for over 7 years now. She has experience in a variety of positions including leadership. She is also a respected independent author publishing a part memoir, part informational nonfiction book about her journey with PCOS(polycystic ovarian syndrome) called “I Kept My Smile, From A Girl To A Woman With: PCOS”. Her passion is self-love, patient care, raising awareness for PCOS, and to support and encourage women and young girls with PCOS to be fearless and take control. She is also a motivational speaker and has written publications in her career field and the PCOS community.

Speaker
Keshena Patterson / Houston Texas USA

Abstract

The mineral waters have long been used for prophylaxis and treatment of human beings. The value of mineral waters considerably depends on pH salt composition. Recently, there has been a significant amount of interest in drinking green tea, contributing to reduce the levels of free radicals i.e. reactive oxygen species (ROS) which have a negative impact on the biological structures of the body. ROS can come from the environment and be formed by the body itself, with 90% of our energy machine – mitochondria. However, abnormal accumulation of ROS promotes degeneration of mitochondria, which is an important reason for the development of many diseases, particularly in old age, when there is reduced the number of natural anti-oxidant Coenzyme Q10 (CoQ10).Supplementation of products with CoQ10 has a positive impact in a number of metabolic diseases, especially those with a high energy demand (heart, liver, kidneys). However CoQ10 refers to fat soluble compounds, it is poorly absorbed into these tissues. We used light (chrome) effect technology during the extraction of dietary compounds from 189 herbs at a wavelength of 490 nmc. This has contributed to enhancing hydrophilic properties of extractable compounds and it turned out that CoQ10 became a water soluble, thus increasing its ability to penetrate into the cells.In a small quantity of extract was added into the mineral water (under the Almaty) and it was called SPA- SKY – Source of Heaven. Efficiency in the use of mineral SPA-SKY water was assessed in the clinic of the Institute of Cardiology and Internal Diseases and it is concluded that when using this mineral water cholesterol and levels of oxidative stress in particular malonic dialdehydeis decreased. Thus, mineral water SPA-SKY has a high prophylactic and curative effect and can be used for individuals with metabolic diseases and to preserve the health of elderly individuals.

Biography

Diaz Shakenov 1997, birth. With 2016, student faculty of food manufactures Almaty technological University Almaty, Kazakhstan. In 2015-2016, graduated from the school of Economics, Bydgoszcz, Poland. He is currently Director of LLP «SPA-SKY Production». In 2016 He participated in 21-St International Congress ""Apislavia"" Almaty with the report " "Evaluation of the prospects of the use of table water enriched with antioxidants to correct functional State of the organism"".

Speaker
Dias Shakenov / LLP SPA-SKY Production, Almaty, Kazakhstan

Sessions:

Chronic Diseases and Healthcare

Abstract

Frequent hospitalizations for COPD exacerbations is associated with poor prognosis and increased mortality. To address this, a multidisciplinary task force was formed to develop a multi-pronged approach designed to decrease future readmissions in this population. The group was comprised of a Physician, Nurse Practitioner, Respiratory Therapist, Pharmacist, Social worker, a Case Manager, and a Home Health provider. The group met weekly and each specialist had a role in monitoring patients using a COPD standardized care plan. Evidence-based interventions were developed which started at admission and continued through discharge. The care plan was based on an average length of stay of five to seven days. Interventions included expert consultation with a pulmonologist, evidence-based diagnostics for the population, specific pharmocologic and medical treatments, physical therapy evaluation and treatment, assessment of nutritional needs, a psychosocial evaluation, tailored patient teaching, aggressive discharge planning and a home care needs assessment. Readmission risk was calculated using a risk assessment model based on four criterion; the number of inpatient visits within the past six months, the number of unique medications started on hospital day one, insurance status, and the Rothman Index; a validated clinical tool that creates a composite number based on key nursing assessments, vital signs and laboratory values which are predictors of deterioration and poor outcomes in the hospital setting. Those patients with a calculated readmission risk greater than 50% were placed on the standardized care plan. In a cohort of 400 patients between 2015 and 2017, the relative risk for readmission was reduced by 15% using the strategies outlined in the care plan.

Biography

Elena Ruocco completed her training in Family Primary Care at Pace University, New York and was awarded an MSN in Nursing. She later completed Post Master’s work and received a certificate as an Adult, Geriatric, Acute Care Nurse Practitioner from the University Health Science Center in Houston Texas. She is dual certified by the American Nurses’ Credentialing Center as an FNP, and AGACNP. In her 28 year career, she has held a variety of professional positions and distinctions ranging from clinical research, direct patient care, management, as well as numerous leadership and academic engagements.

Speaker
Elena Ruocco / Houston Methodist Hospital, Texas, USA

Abstract

Purpose: Hypertension is one of the leading causes of mortality in Indonesia, there is a significantly increasing trend in annual hypertension prevalence in Indonesia. Hypertension is one of the most common diseases in NTB, the prevalence of hypertension measured based on blood pressure in NTB is 1,523,574 (32.4%), it is higher than the national rate (1,255,537 (26.7%) of 4,702,389 people). The highest prevalence of hypertension in Mataram City is in Cakranegara Primary Care, there are 724 people with hypertension in this primary care working area. The purpose of this study is to determine the average number of patient’s hypertension rate at Cakranegara Primary Care before and after given muscle relaxation techniques. Method: This study uses "Quasi Experiment Design" with control group as comparison. The population in this study are 724 hypertension patients and 27 patients as sample based on inclusion and exclusion criteria. Results: The results of this study indicates that the T-test calculation using Quasi Experiment Design shows the difference of average of hypertension rate before and after given progressive muscle relaxation technique. It is 10,306 mmHg in intervention group and 1,425 mmHg in control group. The p-value in the intervention group is 0.000 that is smaller than α = 0.05 and the p-value of control group is 0.431 that is greater than α = 0.05. Conclusion: From this study, we can conclude that there is a difference of hypertension rate between intervention and control group. We hope this progressive muscle relaxation technique can be used as an appropriate alternative or complementing treatment to control Hypertension rate.

Biography

Dedy Arisjulyanto is one of the postgraduate students of Public Health Universitas Gadjah Mada, he has expertise in overcoming non communicable diseases with complementary therapy and adolescent reproductive health , this research was conducted directly in the community and analyzed it by quantitative way and various theoretical references, this research became a very good recommendation in overcoming hypertension problem in world

Speaker
Dedy Arisjulyanto / Universitas Gadjah Mada, Indonesia

Sessions:

Disease diagnosis &Long term care

Abstract

Backgrounds:The risksof Ovarian Malignancy Algorithm (ROMA) and Human epididymis protein 4 (HE4) appear to be thepromising predictors of epithelial ovarian cancer (EOC).However, conflicting results have been obtained in the diagnosis process when we compare ROMA, HE4,and CA125. Methods:The databases (MEDLINE/PUBMED, EMBASE, Web of Science, Google Scholar, the Cochrane Library and ClinicalTrials.gov) and full texts bibliographies were searched for relevant abstracts. EOC predictive value of ROMA was systematically evaluated, and the predictive performance of ROMA, HE4,andCA125 were compared within the same population. In this meta-analysis, the pooled sensitivity, pooled speci¬ficity, pooled AUC, pooled p-value of each tumor marker as well aspooled number of patients and healthy individuals were calculated. Result:Based on meta-analysis of 9 studies, thetotal sample sizewas obtained,785 patients and 667 healthy individuals. The overall estimates of ROMA for EOC predicting pre-menopausalwomen with 95% CI were86.9 sensitivity, 085.52 specificity, and 0.9 AUC. ROMA for EOC predicting pre-menopausalwomen was90 sensitivity, 80.84 specificity, and 0.9 AUC.The overall estimates of Ca125 and HE4 for EOC predicting with 95% CI were as follows; sensitivity (84.5 and 80.37), specificity (83.8 and 88.45), and AUC (0.85 and 0.87). Conclusion:Thismeta-analysishighlighted that ROMA can help distinguish EOC fromthebenign stage in post- menopausal women. ROMA is less specific but more sensitive than HE4. Both ROMA and HE4 are more specific than CA125 for EOC prediction. CA125 has a higheraccuracy for diagnosis than HE4 for EOC. ROMA is a good predictor to replace CA125, but its utilization requires further exploration. Biography Haniyeh Bashizadeh-Fakhar has completed his PhD at the age of 35 years from ShahidBeheshti University of Medical Sciencesand She studies onexpression proteomics on cancer in Proteomics Research Center.She is assistant professor in medical azad university. He has published more than 15 papers in reputed journals .Most of them are in proteins expressionin cancer(such as ovarian,breast,cervix)

Biography

Haniyeh Bashizadeh-Fakhar has completed his PhD at the age of 35 years from ShahidBeheshti University of Medical Sciencesand She studies onexpression proteomics on cancer in Proteomics Research Center.She is assistant professor in medical azad university. He has published more than 15 papers in reputed journals .Most of them are in proteins expressionin cancer(such as ovarian,breast,cervix)

Speaker
Haniyeh Bashizadeh-Fakhar / Islamic Azad University, Chalous, Iran

Sessions:

Womens Healthcare

Abstract

Background: Morbidity associated to iron deficiency anaemia in pregnancy is increased in the presence of sickle cell anaemia. Iron supplementation in pregnant sicklers in a bid to resolve iron deficiency anaemia is recommended only after laboratory confirmation of iron deficiency. However, the greatest burden of sickle cell disease is seen in low and middle income countries where equipment for measuring body iron indices are unavailable. Discussion: Sickle cell anaemia is an inherited disorder of haemoglobin synthesis characterized by life-long severe haemolytic anaemia. People with sickle cell anaemia are at increased risk of iron overload from haemolysis and recurrent multiple transfusions. Iron overload a complication of sickle cell disease, which is more often in thalassemias is given undue fear in sickle cell anaemia especially in patients with no recent transfusion history. About a third of the haemolysis in sickle cell anaemia is intravascular, and the resulting excess iron is lost in urine. This may lead to a negative iron balance and iron deficiency. There is little evidence of iron overload in pregnant sicklers, and iron deficiency may be more common than suspected. Even when iron overload does occur in a condition called siderosis, the deposited iron is irreversible and thus cannot be reused by the body in case of susceptibility to iron deficiency. More so, in pregnancy there is an increase in the body’s iron requirement by about 1000-1200 mg which is usually not met by dietary intake. Iron supplements could be given to pregnant sickler, caution should however be taken in patients with history of recurrent transfusion. Conclusion: Anaemia is a common and feared complication in pregnancy. The co-existence of iron deficiency anaemia and sickle cell anaemia worsens prognosis of pregnancy. Iron overload a possible complication of sickle cell anaemia is related to multiple transfusions. The urinary losses from intravascular haemolysis and increased dietary requirement in pregnancy predispose even pregnant sicklers to iron deficiency anaemia. Iron supplements should thus conveniently be given to pregnant sicklers with no history of recurrent transfusions.

Biography

Dr Desmond Aroke is a physician at the Cameroon Ministry of Public Health. He is the founder and former coordinator of the Nkwen Baptist Health Center Sickle Cell Clinic. He is cofounder and current president of “GREEN FINGERS” a non-governmental organization involved in the fight against sickle cell disease

Speaker
Desmond Aroke / Health and Human Development Research Group, Douala, Cameroon

Sessions:

Surgical Care Safety

Abstract

BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists. We hypothesized that the use of Robot Physician’s (RP) in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 220 +/- 80 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 150 +/- 55 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for patients with AML (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 20 % compared with the prerobot era, and there was an ICU cost savings of KD2.2 million attributable to the use of RP.

Biography

Dr. Alisher Agzamov has completed his MD in 1981 from Tashkent University, USSR and postdoctoral PhD studies from Moscow University, USSR in 1991. During 1992 – 1998 He was a Senior Consultant Cardiac Anaesthesioligst of the Europen Cardiac Surgery Programme and Professor of Anaesthesiology of the University of Zambia and University Teaching Hospital, Lusaka, Zambia; From 1998 till up to date He is the Senior Consultant Anaesthesiologist fo the Department of Anaesthesiology & ICU, Kuwait Cancer Control Center ( KCCC), Ministry of Health, Kuwait City, Kuwait. He has published more than 750 papers in reputed journals and has been serving as an editorial International board member of reputable Anaesthesia and Intensive Care Journals. His main Scientic interest in fileds for Anaesthesia and ICU Management Surgical and Medical ICU Oncology Patients. His using extensively Robots Physians in ICU Management of Oncology ICU patients.

Speaker
Alisher Agzamov / Department of Anaesthesiology, Kuwait City, Kuwait

Sessions:

Pediatric & Geriatric Patient Safety

Abstract

Background A patient diagnosed to have pneumonia and put on empirical antibiotics but did not show the expected resolution is a common problem faced by the clinician. Data regarding the use of ciprofloxacin in children with non-resolving pneumonia are scarce. The aim of this study was to evaluate the effect of ciprofloxacin therapy in pediatric patients with non-resolving pneumonia. Methods All pediatric patients with non-resolving pneumonia who received ciprofloxacin treatment in the pulmonary department of Al-Rantisy Specialized Pediatric Hospital (a tertiary care centre) in Gaza, were included in this retrospective study. Patients received ciprofloxacin 10 mg/kg IV twice daily. Patient demographic data, clinical symptoms recorded, sputum culture findings and ciprofloxacin therapeutic outcome were gathered. Data were analyzed using computer software SPSS version 20. Results 57 patients with non-resolving pneumonia (mean age 3.4 years [range 2 month to 8 years] ) were included in this study. 36 (63%) patients were males and 21 (37%) patients were females. Fever (74%) and cough (89.5%) were the most common symptoms. Positive culture was obtained in 42 (73.6%) patients while 15 (26.4%) patients showed negative results. The most common organism isolated in the positive cultures was Pseudomonas aeruginosa (26/42 [62%]). Among the study sample, 23 (40.4%) patients received ciprofloxacin as empirical therapy and 34 (59.6%) patients received this drug depending on culture sensitivity results. There was a significant decrease in body temperature levels at day 1, 2 and 3 of ciprofloxacin treatment (P <0.001). Overall, ciprofloxacin was effective in the treatment of 53 (93%) patients of the present study. Only 4 (7%) cases showed resistant to this therapy. The mean length of hospital stay was 7.5 days. No side effects were reported during the course of this study. Conclusion Data of the present study suggest that ciprofloxacin is effective and safe , including as initial monotherapy, for the treatment of pediatric patients with non-resolving pneumonia.

Biography

Mohammed Kamel El-Habil is a Palestinian-born and has been a consultant pharmacist, lecturer and publisher. Over the past sixteen years, he worked in a wide varity of pharmaceutical services in both the private and general sectors. Now he is working as adirector of Pharmacy, Al-Rantisy Specialized Pediatric Hospital, Gaza, Palestine. He earned his master degree in clinical pharmacology from college of pharmacy, Al-Azhar university Gaza with excellent grade in 2008. Mohammed has published many journal articles on topics of pharmacology, toxicology and therapeutics. His recent article entitled: " new antiepileptic drugs in children with epilepsy " was published in journal of Al-Azhar university-Gaza (natural Science). Additionally, he has participate in multiple conferences and workshops. He always seeks the best hoping to provide safe and cost-effective pharmaceutical care to enhance the quality of patient life

Speaker
Mohammed K. El-Habil / Al-Rantisy Specialized Pediatric Hospital,Egypt

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