Day 1 :
Keynote Forum
Roberto Pinelli
Keynote: Long-term results of accelerated trans-epithelial cross-linking for keratoconus with osmotic riboflavin solution (ParacelTM)
Time : 09:10-09:40
Biography:
Roberto Pinelli graduated in Medicine and Surgery at the State University of Milan, and specialized in Ophthalmology. He trained in refractive surgery with Dr Michael Gordon at the Vision Surgery Laser Center in San Diego, the United States (currently the Gordon-Weiss-Schanzlin Vision Institute). In 2013 he undertook a new project in the Canton of Ticino, SERI Switzerland Eye Research Institute in Lugano, an eye surgery and ophthalmology research institute and care centre for visual defects and all kinds of eye diseases. Until 2014, he was a lecturer in corneal pathology and refractive surgery techniques at the ESASO, European School for Advanced Studies in Ophthalmology in Lugano. An ophthalmology and eye surgery specialist with the FMH (Swiss Medical Association), he has pioneered leading-edge surgery and innovation in ophthalmology, including P-Curve for presbyopia correction, osmotic transepithelial corneal cross-linking for the treatment of keratoconus, and the ParaCel eyewash. He was invited to join the exclusive International Intra-Ocular Implant Club (IIIC) for surgeons founded by Sir Harold Ridley. In 2009-10, in view of his groundbreaking research activity in the field of refractive surgery and the science of vision, he was invited to join the executive committee of the world’s most prominent ophthalmology association, the American Academy of Ophthalmology (ISRS/AAO). Currently a member of the Scientific Advisory Board of Biosyntrx (Colorado Springs, Colorado), a biotech company operating in the field of ophthalmology, and the Medical Advisory Board of Avedro (Waltham, Massachusetts), a leading company in the calibration of instruments and devices for eye pathologies.
Abstract:
Aim: The aim is to present the long-term results of accelerated transepithelial cross-linking (CXL) for keratoconus with osmotic riboflavin solution. Methods: Patient with progressive keratoconus had accelerated transepithelial CXL. Visual and refractive outcomes and the endothelial cell density /ECD) were evaluated preoperatively and postoperatively. Results: Thirty-five patients were examined unilaterally; postoperatively 35 eyes were evaluated at 3 months, 6 months, 1 year and 2 years form the treatment. No intraoperative or postoperative complications occurred. The mean uncorrected distance visual acuity improved significantly form 1.12 ± 0.60 logMAR preoperatively to 0.68 ± 0.49 logMAR at the last follow up and the mean corrected visual acuity form 0.37 ± 0.25 logMAR to 0.09 ± 0.15 logMAR, respectively. The mean steep and the mean flat keratometry readings decreased significantly form 54.71 ± 5.26 diopters (D) and 46.82 ± 3.29, respectively, preoperatively to 46.82 ± 3.69 D and 44.93 ± 3.61 D, respectively, at the last follow-up. The mean corneal astigmatism improved significantly from -6.75 ± 4.38 D preoperatively to -2.50 ± 3.10 D at the last follow-up. No significant ECD alteration occurred. Conclusion: Accelerated trans-epithelial CXL was effective and safe in keratoconic patients over a long-term follow-up.
Keynote Forum
Joan Prat
Keynote: Ophthalmologic biomarkers in pediatric psychiatric diseases
Time : 9:40-10:20
Biography:
Joan Prat has completed studies in Medicine (Autonomous University of Barcelona) and Ophthalmology in 1991. From 1991 to 2002 he worked in orbital diseases in Bellvitge Hospital (Barcelona) and later became the Head of Department of Pediatric Ophthalmology in Hospital Sant Joan de Déu de Barcelona until today. He has innovated in eyetracking both in research and development of medical devices for pediatric use and has been attending conferences in WCPOS and EPOS. He is now the Director
of Master’s degree in Pediatric Ophthalmology in Barcelona University and President of Spanish Society of Ocular and Orbital Plastic Surgery.
Abstract:
Psychiatric disorders are usually evaluated through different specific methods such as interviews, questionnaires or family references. The lack of known biomarkers is an important problem to have an objective diagnosis, that is why researchers have been studying the presence of ocular signs associated to several psychiatric disorders in the last two decades. Ocular motility alterations have been found using eye-tracking devices consisting on infrared video cameras and a computer vision software. Schizophrenia has been the most studied disorder, characterized by some defects in smooth pursuit movements. Patients can not follow a target in a medium velocity and have more frequent compensatory and intrusive saccades. Convergence defects and abnormal patterns of scene scanning have been observed, too. Other physical observations are thick retinal venules and thin retinal nervous fiber layer with OCT. These biomarkers can be used to identify adolescents with risk to present psychotic disorders, due to these alterations can appear earlier. Other disease well documented in children is the attention deficit hyperactivity disorder (ADHD). The characteristic failure of inhibitory systems of ADHD seems to produce abnormalities in saccades, specifically in antisaccades. Likewise, an improvement of saccades has been observed after treatment with amphetamines. One of the most important advances are related with early diagnosis of autism (ASD). In visual preferences test, ASD toddlers show preference to look at geometric images instead of faces and other social images, contrary to well-developed children. Moreover, several studies including 6 to 24-month children show a correlation between the performance of the test and the presence and severity of the disorder. In conclusion, the study of ocular biomarkers by noninvasive eye-tracking techniques in psychiatric disorders can help to obtain an early diagnosis, a better categorization and a better treatment. We encourage pediatric ophthalmologists to collaborate with mental health professionals in eye-tracking diagnosis of psychiatric diseases.
- Primary Care| Nursing Care| General Practice and Cardiology | Family Practice
Location: SERI, Switzerland
Chair
Helen Senderovich
University of Toronto, Canada
Session Introduction
Heike Schutze
Australian Health Services Research Institute
Title: Using unnounced standardised patients as a quality improvement tool to improve primary care
Biography:
Heike Schütze is a Lecturer and Research Fellow at the University of Wollongong. Her research interests include health services research, Aboriginal and Torres Strait Islander health, indigenous health, health inequity, translational research, and the prevention and management of chronic disease.
Abstract:
Aim: To improve the quality and appropriateness of targeted care in general practice for Aboriginal patients using unannounced standardised patients (USP).
Methods: This research was a mixed-methods multiple-site case study. USPs from the local Aboriginal communities anonymously attended general practices. Data from these visits were combined with data from focus groups, clinical records audit, interviews and surveys with practitioners and staff, and best practice guidelines, and were used to develop a tailor-made intervention to improve the acceptability and appropriateness of care provided to Aboriginal patients in general practice.
Findings: Most practices improved their Indigenous-status identification processes and provided more acceptable and appropriately targeted care to their Aboriginal patients. The use of USPs as a quality improvement tool was acceptable to providers and staff and provided the local Aboriginal communities a voice regarding the care they received.
Implications/Conclusions: USPs provide direct patient feedback whilst overcoming many of the inherent biases found in other research methods. Using USPs from the local Aboriginal communities ensured relevance with their priorities and was central to the uptake of the intervention. The method can be adapted as a tool for improving access to primary health care to other minority and marginalised populations.
Recent Publications:
Schütze H;Pulver LJ;Harris M, 2016, 'The uptake of Aboriginal and Torres Strait Islander health assessments fails to improve in some areas', Australian Family Physician, vol. 45, pp. 415 - 420
Schtze H;Rix EF;Laws RA;Passey M;Fanaian M;Harris MF, 2012, 'How feasible are lifestyle modification programs for disease prevention in general practice?', Australian Journal of Primary Health, vol. 18, pp. 129 - 137, http://dx.doi.org/10.1071/PY10106
Harris MF;Fanaian M;Jayasinghe UW;Passey ME;McKenzie SH;Davies GP;Lyle DM;Laws RA;Schütze H;Wan Q, 2012, 'A cluster randomised controlled trial of vascular risk factor management in general practice', Medical Journal of Australia, vol. 197, pp. 387 - 393, http://dx.doi.org/10.5694/mja12.10313
Denney-Wilson E;Fanaian M;Wan Q;Vagholkar S;Schütze H;Harris M, 2010, 'Lifestyle risk factors in general practice: Routine assessment and management', Australian Family Physician, vol. 39, pp. 950 - 953
Helen Senderovich
University of Toronto, Canada
Title: Integrated end-of-life care in advanced congestive heart failure: where are we now? 2015 update
Biography:
Helen Senderovich is a physician at Baycrest Health Science System with practice focused on Palliative Care, Pain Medicine and Geriatrics. She is an Assistant professor at the Department of Family and Community Medicine, and Division of Palliative Care at the University of Toronto who actively involved teaching medical students and residents. She has a broad international experience and a solid research background. Her research was accepted nationally and internationally. She is an author of multiple manuscripts focused on geriatrics, patient’s centered care, ethical and legal aspect of doctor patient relationship, palliative and end-of-life care.
Abstract:
Introduction: Congestive heart failure (CHF) is an increasingly prevalent terminal illness in our globally aging population. Despite optimal medical management, the reality of a poor overall prognosis for CHF is seldom communicated to patients and/or their families. There is an evolving evidence base suggestive that in patients with end-stage CHF, palliative care consultation can improve heart failure symptoms and address spiritual/emotional needs of both patients and caregivers. Despite this evidence, palliative care services remain woefully underutilized by patients with CHF.
Objective: To articulate specific challenges to accessing and implementing palliative care based on available literature and formulate recommendations for practice.
Methods: We performed an extensive literature review of all articles pertaining to end-of-life care for patients with CHF over the past 20 years. Recommendations for practice were made based on primary quantitative/qualitative research as well as expert opinion.
Results: Accessing palliative care services for patients with CHF remains a challenge for several factors including prognostic uncertainty, pervasive misconceptions in both the general public and healthcare providers around what palliative care is, and, unique to CHF, difficulty recognizing when a patient is suitable for referral. We identified key gaps in the delivery of appropriate care to patients with CHF, which included education to abolish current misconceptions, as well as addressing prognosis and goals-of-care effectively. To improve access to – and benefit from – palliative cares, a team-based approach is essential and a movement towards concurrent palliative care delivery alongside active medical therapy needs to be established.
Conclusion: Heart failure is a terminal illness that affects a significant portion of the population that is only increasing in size. Despite growing evidence that palliative care has a role in improving symptom control and overall quality of life in patients with CHF, a multitude of challenges exist and this ultimately hinders access to appropriate palliative care services. As the evidence base continues to grow, education to abolish pre-existing misconceptions and a movement towards team-based palliative care delivery concurrent with traditional medical management will likely improve access to, and benefit from, palliative care services for patients suffering from CHF.
Recent Publications:
Helen Senderovich; New Insights in Clinical Medicine The Role of Exercises in Osteoporotic Fracture Prevention and Current Care Gaps. Where Are We Now? Recent Updates DOI: 10.5041/RMMJ.10308
Shaira Wignarajah; Helen Senderovich Overcoming the challenges associated with symptom management in palliative care DOI: 10.21037/apm.2016.11.05
Evan J. Lilly Helen Senderovich Palliative care in chronic obstructive pulmonary disease Journal of critical care http://dx.doi.org/10.1016/j.jcrc.2016.05.019
Heike Schutze
Australian Health Services Research Institute, Australia
Title: Patient, oncologist and gp views about cancer follow-up care in general practice
Biography:
Heike Schütze is a Lecturer and Research Fellow at the University of Wollongong. Her research interests include health services research, Aboriginal and Torres Strait Islander health, indigenous health, health inequity, translational research, and the prevention and management of chronic disease.
Abstract:
Aim: To explore cancer survivors, their oncologists and general practitioners (GP) views about GPs taking a more active role in ongoing follow-up monitoring and care.
Methods: Collective instrumental case study of cancer survivors (patients), their general practitioners and oncologists. Patients were eligible if they had completed their active treatment for breast or colon cancer and had no current evidence of reoccurrence. Semi-structured interviews were conducted face-to-face or by telephone. Respondents were asked their views on the specialist hospital-based model for cancer follow-up care and their views on their GPs taking a greater or leading role in follow-up care. Thematic analyses within and across-cases were performed in Nvivo version 10. Researcher triangulation was used to refine the coding framework and emergent themes; source triangulation and participant validation were used to increase credibility.
Results: Fifty six interviews were conducted (patients 22, oncologists 16, GPs 18), with 19 cases involving patient, their GP and one or more of their oncologists. Within-case analysis (patient-specialists-GP) highlighted the importance of specialist cancer knowledge, the psychosocial aspect of specialist care, and the need for GPs to have an interest in and time for cancer follow-up care. Across-case analysis indicated that a staged, shared care team arrangement with both GPs and specialists flexibly providing continuing care would be acceptable for most.
Conclusions: Collaborative care of cancer survivors may lessen the load on specialist oncology clinics. The findings suggest that building this model will require early and ongoing shared care processes. This may be facilitated by shared electronic care plans involving patients, oncologists and GPs.
Recent Publications:
Schütze H;Pulver LJ;Harris M, 2016, 'The uptake of Aboriginal and Torres Strait Islander health assessments fails to improve in some areas', Australian Family Physician, vol. 45, pp. 415 - 420
Schtze H;Rix EF;Laws RA;Passey M;Fanaian M;Harris MF, 2012, 'How feasible are lifestyle modification programs for disease prevention in general practice?', Australian Journal of Primary Health, vol. 18, pp. 129 - 137, http://dx.doi.org/10.1071/PY10106
Harris MF;Fanaian M;Jayasinghe UW;Passey ME;McKenzie SH;Davies GP;Lyle DM;Laws RA;Schütze H;Wan Q, 2012, 'A cluster randomised controlled trial of vascular risk factor management in general practice', Medical Journal of Australia, vol. 197, pp. 387 - 393, http://dx.doi.org/10.5694/mja12.10313
Denney-Wilson E;Fanaian M;Wan Q;Vagholkar S;Schütze H;Harris M, 2010, 'Lifestyle risk factors in general practice: Routine assessment and management', Australian Family Physician, vol. 39, pp. 950 - 953
Melanie Koeller
College of Medicine, Germany
Title: Maintaining nursing care quality clinical care guidelines for cystic fibrosis - outpatient and inpatient
Biography:
Melanie Köller works as a Childrens Nurse since 1997. In 2006 she graduated from the University of Applied Sciences Bielefeld as a Certified Nursing Pedagogue. Her experience in the field of Cystic Fibrosis care covers nearly 16 years in one of the greatest special clinic of rehabilitation on the Island of Amrum. Since 2014 she is in the board of the Care Committee of the Mukoviszidose e.V.. She has published several posters for the German Congress for CF in Würzburg about salutogenesis, history of caring CF in Germany and the advantages of rehabilitation by CF.
Abstract:
The Care Committee of the Mukoviszidose e.V. (Chairwoman C. Meyer, University of Tübingen, College of Medicine) has drawn up a completely revised version of the german guidelines to ``Care in Cystic Fibrosis''. It addresses all nursing staff concerning children, adolescents or adults with cystic fibrosis (CF) either in an inpatient and outpatient setting or for rehab clinics. Since the first edition of the German Guidelines to Care in Cystic Fibrosis which had been published in 1998 the guidelines are being revised regularly. The information material evolves along with the increased life expectancy of cystic fibrosis patients and improved quality of life which is described by CF patients and is observed by the therapeutic CF team. The treatment of secondary diseases like CFDR (CF related diabetes) which comes along with an increased life expectancy has been added over the years. Therefore, it is essential that within such a complex disease pattern, professional experience of care staff who worked in specialized CF care centers (50+ patients per year) for many years has been made available for other nursing staff or beginners. This is especially important in the context of the heterogeneous characteristics of this disease. In many cases it can be often seen that the quality of the care for CF patients depends on the know-how and experience of the interdisciplinary therapists team. Moreover, it depends also on the knowledge which the patient him-/herself have gathered over the years and, of course, its relatives especially parents or partner.(Up
Melanie Koeller
College of Medicine, Germany
Title: Maintaining nursing care quality clinical care guidelines for cystic fibrosis - outpatient and inpatient
Biography:
Melanie Köller works as a Childrens Nurse since 1997. In 2006 she graduated from the University of Applied Sciences Bielefeld as a Certified Nursing Pedagogue. Her experience in the field of Cystic Fibrosis care covers nearly 16 years in one of the greatest special clinic of rehabilitation on the Island of Amrum. Since 2014 she is in the board of the Care Committee of the Mukoviszidose e.V.. She has published several posters for the German Congress for CF in Würzburg about salutogenesis, history of caring CF in Germany and the advantages of rehabilitation by CF.
Abstract:
The Care Committee of the Mukoviszidose e.V. (Chairwoman C. Meyer, University of Tübingen, College of Medicine) has drawn up a completely revised version of the german guidelines to ``Care in Cystic Fibrosis''. It addresses all nursing staff concerning children, adolescents or adults with cystic fibrosis (CF) either in an inpatient and outpatient setting or for rehab clinics. Since the first edition of the German Guidelines to Care in Cystic Fibrosis which had been published in 1998 the guidelines are being revised regularly. The information material evolves along with the increased life expectancy of cystic fibrosis patients and improved quality of life which is described by CF patients and is observed by the therapeutic CF team. The treatment of secondary diseases like CFDR (CF related diabetes) which comes along with an increased life expectancy has been added over the years. Therefore, it is essential that within such a complex disease pattern, professional experience of care staff who worked in specialized CF care centers (50+ patients per year) for many years has been made available for other nursing stuff or beginners. This is especially important in the context of the heterogeneous characteristics of this disease. In many cases it can be often seen that the quality of the care for CF patients depends on the know-how and experience of the interdisciplinary therapists team. Moreover, it depends also on the knowledge which the patient him-/herself have gathered over the years and, of course, its relatives especially parents or partner.(Up
Biography:
Abdia Naidoo Graduated from Somerset Hospital (Cape Town and Coronation Hospital) Johannesburg women and childrens hospital including Durban University of Technology and The University of Stellenbosh South Africa with the folowing qualifications: Registered nurse and Midwife,Community Health Nurse with the specialties of HIVand AIDS Management. She was employed by Dfid to manage an HIV/AIDS Health and Wellness Program on the remote Island of St Helena South Atlantic Ocean and was awarded multiple achievments awards with her work both locally and internationally.
Abstract:
The individual,the family and the community all forms a part of a complete and integrated system. As a community health nurse and practioner I observed on a daily basis how patients were treated by health practioners only for a disease or ailment without seeing the person in a holistic way or as a whole person. Patients were often misdiagnosed or seemingly not satisfied when they were seen as just another patient with an ailment and not as an individual who had muliple facets to their lives besides being a patient.
I started changing my own attitude towards patients when treating my patients and clients as a whole person. I developed a programme called the Whole Person Wellness Model and used this model to change certain behavious and attitudes when treating the individual patients.
The aim of this presentation/workshop is to create more awareness for health nurse pratitioners and health service providers to treat patients with a more authentic wholistic view and approach and treat persons with a disease or ailment with an holistic and wholesome approach in order to effect a more complete health and wellbeing out come.
- General Practice and Public HealthPrimary Care| Nursing Care| General practice and palliative care
Location: SERI, Switzerland
Chair
Joan Prat
Hospital Sant Joan de Deu de Barcelona, Spain
Co-Chair
Ashraf Armia Balamoun
Al Watany Eye Hospital, Egypt
Session Introduction
Norita Hussein
University of Malaya, Malaysia
Title: The effects of preconception interventions on improving reproductive health and pregnancy outcomes in primary care: a systematic review
Biography:
Norita is a Senior Lecturer in the Department of Primary Care Medicine at the University of Malaya, Malaysia. She received her PhD in 2016 from the University of Nottingham, United Kingdom. Her thesis focused on preconception assessment of genetic risk in primary care setting. Her special interest is primary care genetics especially developing strategies to improve genetic risk assessment among the reproductive women. She is also involved in the teaching and training of the postgraduate Master of Family Medicine at the University of Malaya.
Abstract:
Background: Reproductive health and pregnancy outcomes may be improved if reproductive risk assessment is moved from antenatal to preconception period. Primary care has been highlighted as an ideal setting to offer preconception assessment, yet the effectiveness in this setting is still unclear.
Objective: To evaluate the effectiveness of preconception interventions on improving reproductive health and pregnancy outcomes in primary care.
Method: MEDLINE, CINAHL, EMBASE and PsycINFO databases were searched from July 1999 to end of July 2015. Only interventional studies with a comparator were included.
Results: Eight randomized controlled trials were eligible. Preconception interventions involved multifactorial or single reproductive health risk assessment, education and counselling and the intensity ranged from brief involving a single session within a day to intensive involving more than one session over several weeks. Five studies recruited women planning pregnancy. Four studies involved multifactorial risks interventions; two were brief and the others were intensive. Four studies involved single risk intervention, addressing folate or alcohol. There was some evidence that both multifactorial and single risk interventions improved maternal knowledge; self-efficacy and health locus of control; and risk behaviour, irrespective of whether brief or intensive. There was no evidence to support reduced adverse pregnancy outcomes. One study reported no undue anxiety. The quality of the studies was moderate to poor.
Conclusion: The evidence from eligible studies is limited to inform future practice in primary care. Nevertheless, this review has highlighted that women who received preconception education and counselling were more likely to have improved knowledge, self-efficacy and health locus of control and risk behaviour. More studies are needed to evaluate the effects on adverse pregnancy outcomes.
Recent publications
Hussein N, Weng SF, Kai J, Kleijnen J, Qureshi N. Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD010849. DOI: 10.1002/14651858.CD010849.pub2.
Hussein, N., Kai, J., Qureshi. N., 2015. The effects of preconception interventions on improving reproductive health and pregnancy outcomes in primary care: A systematic review. European Journal of General Practice. (In Press.)
S.S.L. Wong, C.J. Ng, S.M. Liew, N. Hussein. Effectiveness of a colour coded HbA1c graphical record in improving diabetes control in people with type 2 diabetes: A randomized control trial. Diab Res Clin Pract (2011), doi:10.1016/j.diabres.2011.11.001
Robson, NMH.,Aziz, N., Abdul Aziz, AF., Mohamed, M., Othman,S., Hussein, N. 2008. The need for Good Clinical Practice in health care research. South Africa Family Practice. In press.
Avi Benov
Meir Medical Center, Israel
Title: Evaluating patients in sepsis using Compensatory reserve measurement; a prospective clinical trial
Biography:
Avi Benov has been working as a Physician in Meir Medical Center. He is also part of Tel-Aviv University, Israel. He is also part of Israel Defence forces
Abstract:
Background: Sepsis, one of the major health system concerns worldwide, is characterized by changes in organ function, morphology, cell biology, biochemistry, immunology and circulation that can lead to low blood perfusion, multi-organ failure, and death. It is a leading cause of morbidity and mortality, accounting a third of hospital deaths. Sepsis has several levels of severity ranging from self-limited disease to severe sepsis and septic shock. The evaluation of a patient's condition is routinely performed by a number of objective criteria including vital signs as well as laboratory tests. The compensatory reserve measurement (CRM) represents a new paradigm that measures the total of all physiological compensatory mechanisms, using noninvasive photoplethysmography to read changes in arterial waveforms. This study aim was evaluating the applicability and the predicting value of the CRM during sepsis.
Methods: Study patients included prospectively enrolled patients with proven laboratory and / or imaging diagnosis of infectious disease hospitalized in department of Surgery. All of them were evaluated with CRM, hemodynamic and laboratory measurements. Waveform data were postprocessed by an algorithm to calculate the CRM, measured on a scale of 1 to 0, with 1 indicating fully compensated and 0 indicating no reserve, or decompensation. Those values were measured throughout hospitalization.
Results: During the study period, data were prospectively collected from 100 patients. Subjects were hospitalized from October 1, 2016 to December 30, 2016. Of the 100 patients enrolled, 84 patients were not septic. The remaining 16 patients were in sepsis (SOFA score > 2), six of which were in septic shock. Groups had similar in age and gender, and statistical differences were wound in disease distribution when septic patients had higher incidence of mesenteric events and peri-appendiceal abscess (p=0.02). When Non-septic patients were compared to control patients, statistical differences were found only in CRP (P<0.0005), SOFA score (p<0.0005) and CRM (p<0.0001). When septic patients were compared with those in septic shock, differences were found in HR (p=0.03), SOFA score (p=0.01) and CRM (p=0.03). The remaining measurements did not show any significance among groups.
Conclusions: A novel computational algorithm that recognizes subtle changes in PPG waveforms can quickly and non-invasively discern which patients are in sepsis or in septic shock with high sensitivity and specificity in acutely sick patients.
Recent Publications:
1.Avi Benov Elon Glassberg Yitshak Kreiss Roy Nadler Role I trauma experience of the Israeli Defense Forces on the Syrian border DOI: 10.1097/TA.0000000000000377
2.Avi Benov Elon Glassberg Yitshak Kreiss Roy Nadler Tranexamic acid at the point of injury: The Israeli combined civilian and military experience DOI: 10.1097/TA.0000000000000325
3.Avi Benov Elon Glassberg Yitshak Kreiss Roy Nadler Intravenous access in the prehospital settings: What can be learned from point-of-injury experience DOI: 10.1097/TA.0000000000000723
Judith Barreintos
National Institute of Paediatrics, Mexico
Title: Adaptation and validation of a hospitalized pediatric patients fall risk assessment instrument
Biography:
Judith Barrientos Sánchez has her experience in evaluation and passion for improving the health and well-being of the pediatric patient. She worked as a pediatric nurse in the clinical area for 20 years. She studied master's degree and is currently Coordinator of research in the area of management, clinic, and managed care. She is in charge of the development projects of students of nursing, as well as professionals interested in developing derivative works of the needs of the practice. She works in conjunction with the network of ENEO-UNAM research institutions and national institutes of health, pediatric research network and international network of nursing in child health, developing projects that improve care through evidence.
Abstract:
Introduction: A significant number of patients who attend health institutions have a risk of fall anytime during their hospitalization. Taking care of these patients requires diverse interventions and clinical assessments. Objective: To adapt and validate a hospitalized pediatric patient fall risk assessment instrument. Methods: The J. H. Downton instrument was adapted and validated. Specificity and sensibility tests, negative and positive predictive value, and Kuder-Richardson (KR) and ROC curve analysis internal consistency were all assessed using the SPSS® v. 15 and Epidat® 3.1 statistics programs. Results: KR internal consistency of 0.92, specificity of 99.4, PP of 99.56, and PN of 81.52 with a confidence interval of 95% were obtained. Conclusions: Validated scales such as the St. Thomas have good sensibility and specificity values (93% and 88%), but this scale is adapted for elder patients. The validated scale of this study had better sensibility and specificity values than two other hospitalized pediatric population scales: the Humpty Dumpty and the CHAMPS, suggesting that the modified H. Downton scale is highly sensible and specific to predict hospitalized pediatric patient fall risks.
Recent Publications
1. Factores de riesgo para lesiones no intencionales debido a caídas en los niños de 0–6 años de edad: una revisión sistemática. [En internet] 2006 [Consultado 10 Marzo 2013]. 12(6): 378–381. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564414/
2. Aranda M. Morales J. Canca J. et al. Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis. BMC Health Serv. Res [En internet] 2013 [Consultado 12 Abril 2013]. 13: 122. Disponible en: http://1.usa.gov/HN1R5Y
3. Estrategia de prevención, detección y actuación ante el riesgo de caídas. [En internet] [Consultado 24 Septiembre 2012] Disponible en: http://www.slideshare.net/observatorioseguridad/estrategia-de-deteccin-prevencin-y-actuacin-ante-el-riesgo-de-cadas
4. Joint Commission/JCR Reviewers. Front line of defense second. Edition Improving Health Care Quality and Safety 2007; pp. 73–86.
5. Campos P. Cánceres C. Protocolo De Evaluación Del Riesgo Y Prevención De Caídas En El Huap. Unidad de Calidad y Seguridad del Paciente. 2010
6. Urruela M. Gómez AE. Iglesias AC. Valtierra M. González Y. Caídas en un hospital de agudos: características del paciente. Rev Mult Gerontol. [En internet] 2002 [Consultado 20 Septiembre 2012]; 12(1):14-18. Disponible en: http://dialnet.unirioja.es/servlet/articulo?codigo=261097
7. Tapia VM. Prevención de caídas, indicador de calidad del cuidado enfermero. Revista Mexicana de Enfermería Cardiológica. 2003; 11(2): 51-57.
8. Mora M C, Ramírez B I .Optimización de las medidas de prevención de caídas durante la hospitalización del paciente. Revista de Enfermería. [En internet] [Consultado 4 Julio 2012]. Disponible en: http://encolombia.com/medicina/enfermeria/Enfermeria9306Optimizacion.htm
9. Complejo Hospitalario Universitario de Badajoz. [En internet] [Consultado 4 Noviembre 2012] Disponible en: http://www.areasaludbadajoz.com/datos/enfermeria/escalas/ESCALA_de_DOWNTON.pdf
10. Salameh F, Cassuto N, Oliven A. Una herramienta de evaluación de riesgo de caída simplificada para pacientes hospitalizados en servicios médicos. [En internet] 2008 [Consultado 24-04-13]; 2:125-9. Disponible en: http://www.microsofttranslator.com/bv.aspx?from=&to=es&a=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F18432025
Aisha Sehari
Tripoli University, Libya
Title: Disseminated intravascular coagulation with clinical and laboratory evaluations of paediatric patients with acute gastroenteritis admitted at Gharyan Central and Teaching Hospital, Libya
Biography:
Aisha Sehari has been graduated from Tripoli University in January 1981 as Medical Doctor (MBBCh), with the specialties and Diploma in pediatric (DCH) from the same University. Later she obtained post-graduation from Alexandria University and got Master degree and Doctor of pediatrics (MD) in pediatric gastroenterology. Aisha started working at government university hospitals in Tripoli (Al khadra, Salahdin and Algala children hospital) and Gharrian teaching hospital where she has continued her research. Also she joined royal hospital for sick children (Glasgow) and Alexandria University Children hospital during her post graduate study. Presently she is working at Tripoli University, Medical College, and pediatric department as assistant professor and helping Gharrian medical college in the teaching program once per week.
Abstract:
Globally, acute gastroenteritis is an ailment that is very common among children during their first 3 years of life at which they will most likely experience about 1 to 3 acute diarrheal illnesses that can generate complication such as dehydration and disseminated intravascular coagulation. The diagnosis itself and its accompanying complications can be easily identified though proper clinical and laboratory evaluation. The purpose of this study was to identify evidences of disseminated intravascular coagulation (DIC) and correlate with other clinical or laboratory tests related to other complications of acute gastroenteritis (AGE) such as dehydration and some metabolic imbalances. Almost all of pediatrics patient who are severely dehydrated, suffering from hypernatremia and with hyperammonemia are with evidences of DIC. Moreover, some of the variables found to be significantly associated with positive and strong relationship while some are not.
Recent Publications:
1.June II Atombio Kiblasan Badridden F.A. Abufayed Aisha A. Sehari Kaltoom Mhana Analyzing the learning style and study habit of students in the faculty of nursing of Al Jabal Al Gharbi University, Gharyan, Libya DOI: 10.5430/cns.v4n2p48