Conference Schedule
Day1: May 28, 2018
Keynote Forum
9:30-10:15
Biography
Dr. Ana Rita Gonzalez graduated from the Johns Hopkins University with a Doctorate of Science in Health Policy and Management, and she holds a Masters in Health Services Administration and Certificate in Public Health. She is the President and CEO of Policy Wisdom LLC, in Florida, USA, an organization that works with governmental and non-governmental entities to shape policies on health, safety, and the environment. Elizabeth Fee holds a PhD in the History and Philosophy of Science from Princeton University, USA and is currently Chief Historian at the National Library of Medicine, National Institutes of Health, USA.
Abstract
Today, there is a 38-year age gap between countries with the lowest and highest life expectancy rates. A child born in Sierra Leone can expect to live for 46 years while a child born in Japan may expect to live for 84 years. Most people in health care and health policy would agree that health equity is a desirable goal, but can it ever be achieved? Historically, there have been repeated efforts to define health equity with questions whether it means equity in the delivery of health services or equity in health status – the latter being a great deal more difficult to measure, and to attain. To guide actions at the policy and programmatic level we first need to collect and analyze data on health equity.
We used World Bank data to make cross-country comparisons of inequality using absolute and relative equity measurements (differences and ratios). We used aggregate indicators, such as infant mortality rate and life expectancy to illustrate trends in health and income, and regions of the world as equity stratifiers. We know that between and within countries, there is an inequitable distribution of power, money, and resources. We find that the measures of health we selected – infant mortality and life expectancy -- mirror these economic and political inequities. The evidence points to the existence of extensive (and widening) social inequities in health. This poses a public health challenge of the highest order.
10:15-11:00
Ian Walton
Former General Practitioner and Chair of Tipton Care Organisation
Title: Project for the Evaluation of Asthma in TiptonSchools(PEATS)
10:15-11:00
Biography
Ian worked as a GP in Tipton in the Black Country for 30 years. In 2013 he was awarded Clinical Leader of the Year by the National Association of Primary Care for his clinical leadership role within the award winning Sandwell integrated mental health and wellbeing model which demonstrated major health gains through early intervention using a range of community based services.
He has retired from practice but continues to do voluntary work in mental health and wellbeing, whilst researching, writing and teaching primary care mental health and wellbeing.
Abstract
The UK has one of the highest number of child deaths in the developed world and many of these excess deaths have been attributed to asthma. (1) Confidential enquiries have suggested that avoidable factors still play a part in the majority of asthma deaths.(2) In 2015, 1468 people died of asthma, the highest levels for 10 years,
In 2001 the lead author heard positive anecdotes, from a local headmistress, of an education programme running in local primary schools for 5-10 year old asthmatics. Aware that the benefits of the programme would need to be evidenced for it to be mainstreamed and having the opportunity to do so as chair of a consortium of 8 local practices wishing to pioneer community medicine and employing one of the first community pharmacists in the country, together with a public health statistician and a local university’s primary care research centre he evaluated a re-run of the project
The research showed many interesting findings including,33% of children recorded as asthmatics in school, but not registered as asthmatic by their GP. Prescribing and compliance was also well below par. The educational programme did lead to improved management of the disease, improving appropriate inhaler use, which was sustained 12 months after the project.
Educating the child with asthma and their parents, must be a way forward in reducing unnecessary deaths and improving outcomes. |Dr Walton intends to discuss at his presentation how we might prove that investment in low cost courses, run by health trainers is effective.
11:15-12:00
11:15-12:00
Biography
Abstract
Chronic diseases require ongoing management by GPs (general practitioners). Thermobalancing therapy (TT) is a safe and reliable treatment option for chronic non-malignant urological conditions. The therapeutic Dr Allen’s Device (DATD) is the tool that performs Thermobalancing therapy. In essence, it charges off the body of the patient by accumulating the emitted body heat and using it to maintain the optimal temperature required to treat the affected organ over a prolonged period of time. Observational studies demonstrate high effectiveness of TT as a treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), benign prostatic hyperplasia (BPH) and kidney stone disease. The significant improvement in the quality of life of patients has also been observed.
The effect of TT with the use of Dr Allen’s Therapeutic Device (DATD) has been investigated in 45 men with CP/CPPS and 124 patients with BPH over a 6-month period. International Prostate Symptom Score (IPSS) and National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), prostatic volume (PV) were measured in groups who underwent TT and control groups of 45 and 124 men respectively that did not use TT. All parameters were compared. Five people who used DATD for kidney stones treatment were observed.
The results demonstrated high efficacy of TT, which decreased urinary symptoms in men with BPH from 14.3 to 4.95 (p< 0.001); and reduced pain score in men with CP/CPPS, from 10.38 to 3.58 (p < 0.001). TT reduced PV significantly in both treatment groups, from 45.16mL to 31.8mL (p< 0.001) and from 31.75mL to 27.07mL (p< 0.001) accordingly. In the control groups, no notable change in parameters was observed. The empirical evidence demonstrated that DATD dissolved small and large kidney stones in all patients.
It is therefore suggested that TT with DATD can be used in primary care as the first line treatment for these urological diseases. Moreover, TT with DATD is a safe and cost-effective solution. Integrating the innovative TT with DATD into standard medical practice can improve patient outcomes and reduce financial pressure on the healthcare system.
Tracks
- Healthcare, Services and Technologies | Healthcare and Patient Safety | Healthcare and Public Health | Healthcare and Nursing | Primary Care and Family Medicine | Primary Care and Community Health | Healthcare and Cardiology | Primary Care and Diabetes
Location: London, UK
Hossam Elamir
Qualit & Accreditation Directorate
Chair
Helen Bowman
NAET
Co Chair
Hossam Elamir
Qualit & Accreditation Directorate, Kuwait
Title: IMPROVING PATIENT FLOW THROUGH APPLYING LEAN CONCEPTS TO EMERGENCY DEPARTMENT
Biography
Dr Hossam Elamir holds a graduate degree in medicine and postgraduate degrees in quality and healthcare management. He worked in the National Guard Health Affairs (KSA) and the Specialized Medical Centres (Egypt), before joining the quality and Accreditation Directorate (Kuwait). He was appointed as the head of quality and accreditation office in one of the general hospitals for seven years, then a leader of a Technical Support Team which is covering a number of governmental hospitals. Dr Hossam is a Certified Professional in Healthcare Quality (CPHQ), a Certified Professional in Healthcare Risk Management (CPHRM), and a certified Healthcare Accreditation Professional by Accreditation Canada International.
Abstract
Emergency Department overcrowding (EDOC) and increased Length of Stay (LOS) have been key global issues for more than 20 years, as they have serious repercussions. No measurements have been done to assess the situation nationally. Expanding EDs and adding more beds have never succeeded in eliminating wastes and targeting the root causes of the problem. The paper used direct observation for seven days to collect patient flow data on ED patients at a secondary care hospital in Kuwait. It calculated wait times and services to identify the major causes of EDOC and increased LOS. Around one-third of the ED design capacity was utilized by 12% of the patients who stayed > 6 hours each. The wasted waiting time represents 56.2% of the aggregated LOS, which puts Lean management (LM) on the top of the process reengineering approaches suitable for improving overcrowding by reducing waste. Guided by the LM concepts, the paper proposes solutions that fall under three themes: ensuring effective triaging of all patients, reducing the total number of patients referred to observation room, and reducing maximum LOS and wait times in observation room. The selected solutions address the vital few causes of the EDOC and prolonged EDLOS.
Biography
Helen Bowman; Naturopath, Acupuncturist, Homeopath, NAET practitioner & instructor with qualifications in; Biomedical Sciences, Naturopathy, Toxicity, Detoxification, Fasting, Diet, Nutrition, Homeopathy, Herbal Medicine, Tissue Salts, Bach Flowers, Ear Acupuncture, Ear Candling, Chinese Diagnostic, Iridology, psychology, and clinicalresearch. With a career initially in university laboratory research in genetics, bacteria and viruses, then international gene research, gene sequencing and cell membrane transport. Next into clinics, surgeries and hospitals with GP's, and Consultants at the cutting edge of drug and medical device research, medical ethics & the side effects of drugs. Her international role included teaching doctor’s therapeutics, clinical research, medical ethics and methods of testing pharmaceutical medicines worldwide. From 2014-2016 headed up NAET Europe overseeing the NAET organisation, membership, teaching, and, instructor, practitioner and patient support in liaison with Dr Devi Nambudripad, and, since January 2017 is the Principal of the NAET Training Institute.
Abstract
Shijun Li
Division of Geriatric Cardiology, China
Title: RELATIONSHIP BETWEEN PROTEIN MALNUTRITION AND LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN THE HOSPITALIZED MIDDLE-ELDERLY MALE PATIENTS WITH PRESERVED EJECTION FRACTION
Biography
Dr. Shijun Li has been Graduated from Health Science Center of Peking University in China as Medical Doctor, with the specialties in Geriatric Cardiology. Later on he worked as post doctorate in section of cardiology, department of medicine, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden. Presently he has been working at Chinese PLA General Hospital in Beijing, China.
Abstract
Background: Left ventricular diastolic dysfunction (LVDD) provides incremental prognostic valuein the elderly population. It is unclear whether protein malnutrition is related to diastolic heart dysfunction in the hospitalized elderly male patients. Methods: A total of 199 male patients aged older than 50were recruited. Protein malnutrition was defined as serum albumin less than 35g/L. Laboratory tests for biochemical indicators, transthoracic echocardiography and anthropometric measures were performed at admission. Results: Patients with protein malnutrition was older than those with normal protein nutrition (P=0.003).The prevalence of LVDD was 67.4% in patients without protein malnutrition and 73.2% in those with protein malnutrition. In subgroup analysis for the patients aged more than 80 years old, the prevalence of LVDD in patients with and without protein malnutrition was still not significantly different. However, serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level was closely related to protein malnutrition in in-hospital middle-elderly male patients, and serum NT-proBNP level had a moderate value for diagnosing malnutrition. Conclusions: Protein malnutrition wasn’t related to LVDD, however it was related to serum NT-proBNP level in the hospitalized middle-elderly male patients with preserved left ventricular ejection fraction.
Biography
Dr. Khalid Ahmed Al-Anazi is currently working as Consultant and Chairman, Department of Adult Hematology and Hematopoietic Stem Cell Transplantation, King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia.
He graduated from the college of medicine, King Saud University (KSU) in Riyadh, in the year 1986. After passing his Boards in Internal Medicine, he trained in clinical hematology and hematopoietic stem cell transplant at King’s College Hospital, University of London, U.K. He has 4 year experience in internal medicine and 26 year experience in adult clinical hematology and hematopoietic stem cell transplantation (HSCT) at the Armed Forces Hospital, King Faisal Specialist Hospital and Research Center (KFSH&RC), King Khalid University Hospital (KKUH) and the College of Medicine, KSU in Riyadh and KFSH in Dammam, Saudi Arabia.
Abstract
The available therapeutic modalities for diabetes mellitus (DM) include: diet and lifestyle modifications, oral hypoglycemic agents, insulin injections and pancreatic islet cell transplantation. The efficacy of autologous hematopoietic stem cell transplantation (HSCT) in type 1 DM was first reported in the year 2007. Since then, several studies have confirmed not only the safety, but also the efficacy of autologous HSCT in both types of DM.
High-dose immunosuppressive therapy combined with infusion of hematopoietic stem cells (HSCs) downregulate the autoreactive T-cells, renew the immune system, improve the immune regulatory networks and ultimately induce insulin independence in type 1 DM. The increased C-peptide and the decreased HbA1C levels encountered in animal and human trials have shown that stem cell therapies can offer an effective treatment for type 1 and possibly type 2 DM. Recently, clinical trials in humans have utilized various forms of stem cell therapies including: HSCs, umbilical cord blood stem cells, embryonic stem cells as well as mesenchymal stem cells.
Our group at King Fahad Specialist Hospital in Dammam, Saudi Arabia has recently published the first world report of curing insulin dependent DM in a patient who received an autologous.
Jailan Gabr
Director, Kuwait
Title: USING PATIENT SATISFACTION SURVEY DATA TO IMPROVE AND MONITOR THE PATIENT CARE.
Biography
Jailan has been Graduated from Faculty of science , Biochemistry. of Kuwait university as Medical Lab Technologist., with the specialties including Microbiology, Diploma in Biochemistry from Alexandria university.. Later on she obtained her Master degree from Alexandria university, Egypt. Started working at Kuwait university as a project assistant. Presently he has been working at Kuwait Cancer Control Center, KCCC at Ministry Of Health as quality and safety officer in Cytology Laboratory. Where she worked for College Of American Pathologist , CAP and Canada Accreditation with UHN University Health of Network.
Abstract
Ana Rita Gonzalez
Policy Wisdom, LLC, USA
Title: Patient associations as promoters of people-centered treatment in Latin America
Biography
Dr. Ana Rita Gonzalez graduated from the Johns Hopkins University with a Doctorate of Science in Health Policy and Management, and she holds a Masters in Health Services Administration and Certificate in Public Health. She is the President and CEO of Policy Wisdom LLC, in Florida, USA, an organization that works with governmental and non-governmental entities to shape policies on health, safety, and the environment. Elizabeth Fee holds a PhD in the History and Philosophy of Science from Princeton University, USA and is currently Chief Historian at the National Library of Medicine, National Institutes of Health, USA.
Abstract
Biography
Department of Medical Laboratory Science, Rivers State University of Science and Technology Nkpolu, Port Harcourt, Nigeria.
Abstract
The hepatitis B virus (HBV) is a major cause of viral hepatitis which can lead to inflammation of the liver and its prevalent in the tropics such as Nigeria remains a huge public health concern. The prevalence of the hepatitis B surface antigen (HBsAg) which is a component of HBV was determined among indigenes of Ahoada East Local Government Area of Rivers State in the oil-rich Niger Delta Region. A total of 1000 randomly selected subjects from the Community Health Center Edeogha-Ekpeye, Community Health Center Ochigba, Comprehensive Health Center Ahoada, Ahoada General Hospital, Ula-upata, Ahoada Timber Market and Ogbo town were recruited for these study after due consent was obtained. Self and well-structured questionnaires were distributed to the respondents to also obtain their socio-demographic data and their blood samples collected for serological assay for HBsAg using the Acon HBsAg test strips. Nonetheless, 46.40% of the respondents were males and 53.60% were females. The total prevalence of hepatitis infection was 14% out of which 5.7% were males and 8.3% were females. Of those infected, 4.8% were within ages 25-34, 4% were within the ages of 15-24, 3.9% were within the 35-44 and 1.3% was within 45-54. However, in terms of the educational status, 6% of positive cases were those with the senior school certificate, 3.6% were those with the First School Leaving Certificate, 3.3% had no educational qualification, 1% were BSc holders while 0.1% were MSc holders. Nevertheless, in terms of the occupational status, 3.1% were students, 1.8% farmers, 1.7% applicants, 1.3% civil servants while 0.3 were fishermen. Furthermore, with respect to marital status, 7.5% were married, 4.9% were widowed while 1.6% were single. Among those infected, 13.4% of them knew the use of condoms could prevent HBsAg infection while 0.6% said they were not aware. Based on location, Ahoada General Hospital had a high prevalence of 47.14% of the total prevalence, Comprehensive Health Center Ahoada 13.57%, Ula-upata community 10%, Community Health Center Ochigba 8.57%, Community Health Center Edeogha-Ekpeye and Ogbo town 7.14% respectively and Ahoada Timber Market 6.43%. The studies show that marital status, age and occupation played a huge role in determining the prevalence. The need to strengthen the importance of health education especially in our rural communities to engender behavioral change among the weak and vulnerable subjects in our villages in Niger Delta cannot be over emphasized. It is strongly believed that continuous enlightenment and prompt diagnosis and treatment would help to reduce the epidemic trend in our society.
Alfiya Aminova
Medical University, Russia
Title: DETERMINATION OF AROMATIC CARBOHYDRATES IN THE BILE OF CHILDRENALFIYA AMINOVA
Biography
Abstract
Background: In sanitary unhealthy areas hepatobiliary disorder occur 3-4 times more than in relatively “clean”3 that is probably stipulated by the impact of big quantity of industrial toxicants on the liver. It is established that the part of environmental factors makes from 14 to 36% from all the possible causes of hepatobiliary diseases.
Aim & Objectives: To evaluate the clinical significance of a method for determining the aromatic hydrocarbons in the bile in children.
Methods/Study Design: During the study 303 children were examined with “Biliary dyskinesia” (K82.8) and “sphincter of Oddi dysfunction” (83.4) according to CD-10. The study group embraced 204 children in the age from 5 to 15 with hepatobiliary disorders, living in the area of refining complex impact. 99 children living in the sanitary healthy area were chosen for the control group. We have performed chemical testing of biological media (blood and bile) in a group of children (N = 45), using the developed chromatographic method, along with clinical and anamnesis, clinical laboratory and instrumental examinations.
Results/Findings: Thus, living in the area close to the source of hydrocarbons pollution impacts on the formation and evolution of hepatobiliary disorders in children. In those children who live in the area close to the source of hydrocarbons pollution benzene, toluene, xylene were detected in biological media (blood and bile). Exposure to aromatic hydrocarbons in children, the content of these compounds in the bile, may cause such patterns of biliary dysfunction as memory impairment and irritability in children, more pronounced symptoms of dyspepsia (food belching, vomiting after eating with bile, nausea and vomiting during while riding in the car and after a fatty meal, a tendency to thin stool, sclera subicteritiousness). Aromatic hydrocarbons contribute to the hypertonia of sphincter Oddi, intrahepatic cholestasis, gallbladder hypokinesia (benzene 0.007 + 0.001 and 0.0001 + 0.00001 and p <0.05), which is accompanied by enlargement of the right lobe of the liver, bile flow overtime.
Conclusion: The study results showed the adverse impact of the studied aromatic hydrocarbons on the condition of the hepatobiliary system, which induces the development of hypertonic-hypokinetic dyskinesia of the gallbladder and the development of intrahepatic cholestasis.
Simon Lovegrove
Director, UK
Title: THE DELIVERY OF HEALTH AND CARE SERVICES NEED TO BE MORE FLEXIBLE
Biography
Mr Simon Lovegrove has been in the health and care sector for over 30 years, from specialist hospital construction, to the management of hospitals, nursing homes and other resources. Since 2007, he has been more actively involved in the relationship of health and care in new city environments. He has worked with the Qatar Sovereign Fund’s property arm, Samsung C&T, and the Governments in the UK, Portugal, Hungary, Ethiopia, Libya, China, Vienam and the Philippines. He and his company MHealth maintain a research database through their work and the hospitals and institutions with which they work.
Abstract
Health and care are changing at an ever greater speed. There are a number of factors, the demographics, characterised by an ageing population, the increasing urbanistion, epidemiology through the growth of non-communicable diseases, many of which can be preventable to a greater or lesser extent, such as diabetes, better technologies and clinical techniques which are reducing the patient’s length of stay in hospital, informatics and digital technologies that allow more post-discharge options and overall better possibilities of monitoring the health of people. However, these do not all necessarily “pull in the same direction” nor are they precisely the same in the context of varying countries.
All too often the clinicians are frustrated by their inability to handle this as effectively as they wish. We need to change existing models of care, particularly the planning and implementation of physical assets and their management to better support front-line services.
The other “elephant in the room” is the inability of financial resources to keep up with the demand for ever greater services.
We as individuals must take greater responsibility for our health and we as planners and managers must stimulate ideas that can create a better environment for this to work.
Biography
Department of Medical Laboratory Science, Rivers State University of Science and Technology Nkpolu, Port Harcourt, Nigeria
Abstract
Background: Rainwater in most developing communities of the globe remains the major source of water for drinking, washing, bathing and cooking purposes but often times; its potability is often not tested and trusted, thus putting the general populace at risk of myriad of water-borne illnesses including those from bacteria, virus, parasite and fungi respectively. However, the growing world population has continued to put the scarcely available water resources at high demand, thus the need to secure the integrity of these very important natural resources cannot be over emphasized given it’s critical applications and usage in our everyday life and survival on earth.
Method: This study was aimed at carrying out bacteriological analyses of rainwater harvested and kept in two different atmospheric conditions within a period of 21 days. Rainwater samples from three different locations (Diobu, Trans-Amadi and Rumuolumeni) within Port Harcourt, Rivers State in Nigeria were harvested directly using pre-sterilized plastic bottles and transported to the laboratory for bacteriological analysis.
Result: Sample A which was the pre-exposed sample from Diobu had the highest mean bacterial load of 153 × 103 cfu/ml; sample C from Rumuolumeni which was kept in a darkroom for 21 days had a mean bacterial load of 115 × 103 cfu/ml while sample B from Trans-Amadi which was exposed to sunlight for 21 days had the lowest mean bacterial load of 29 × 102 cfu/ml.
Conclusion: The result show the presence of bacterial load in the sampled rainwater, and as such, contamination of rainwater can be reduced by varying the atmospheric condition by exposing it to sunlight for some period over time. Nevertheless, increasing the temperature of stored rainwater and any other water sample can help to reduce the number of microorganisms present as most of them are mesophiles and as such, cannot survive in environments with high temperature. It is therefore strongly suggested that this could be an alternative means of water purification and treatment, especially in the rural communities of low income setting with huge visible lack of infrastructure and basic scientific technology for water disinfection option. However, the routine application of the above approach could massively reduce the increasing trend of water wash, water base and water borne infection among rural inhabitants especially when they are used in synergy with other treatment options like ultrasound and chlorination in a reduce quantity.
Day2: May 29, 2018
Keynote Forum
10:00 - 10:45
Ana Pokrajac
West Herts Hospitals NHS Trust , UK
Title: HERTFORDSHIRE DIABETES EDUCATION, A STEP CLOSER TO INTEGRATION OF DIABETES CARE
10:00 - 10:45
Biography
Dr Ana Pokrajac is a consultant at the West Herts Hospitals NHS Trust. She is Diabetes UK National Clinical Champion for her contributions to diabetes care (co-founded Herts Diabetes Education Charity).
Ana is West Herts and Herts Valley CCG lead for diabetes and chronic kidney disease (CKD). She has special interest in complex diabetes and health-care system performance. She teaches medical students and junior doctors.
Ana’s National roles include: Association of British Clinical Diabetologists committee member, ABCD-Renal Association national guidelines-writing group and All Party Parliamentary Group for Diabetes.
Abstract
Hertfordshire has a 1.2 million NHS-registered population, 47,000 of them have diabetes. The model of care aims to provide 70% of care in primary care (General Practitioners (GPs)), 20% in intermediate care (Diabetes Nurse Specialists (DSNs)) and 10% in secondary (Consultants Diabetologists). The service is commissioned by 2 Clinical Commissioning Groups (CCGs) for 10 localities and provided by: 130 GP practices, 2 Acute Trusts and 1 Community Trust. There are 6 different IT systems used to record encounters with patients. The providers are guided by National Institute of Clinical Excellence (NICE) standards, but the quality of diabetes care is only measured by Quality Framework (QoF) points applicable to GP practices and by national diabetes audits of secondary care.
In 2013, we established an educational and networking event for all stakeholders in diabetes in Hertfordshire (patients, practice nurses, GPs, DSNs, podiatrists, dieticians, pharmacists, commissioners and consultants) to enable exchange of knowledge and experience and help standardisation of care. The Annual Hertfordshire Diabetes Conference has 2 keynote speakers, testimonials from patients, 6 workshops for the front-line staff and a lively debate on controversies in diabetes. The formal feedback has demonstrated >98% satisfaction 4 years in the row. The Conference has grown into Herts Diabetes Education Charity that is endorsed for Innovation by Diabetes UK.
Hertfordshire Diabetes Education is a unique platform for all stakeholders in the County used to share experience, learn together and agree on objectives: patient-centred care, standardisation of care delivery and education for all providers interacting with patients.
10:45 - 11:30
Debbie Wake
University of Dundee, UK
Title: MY DIABETES MY WAY – AN ELECTRONIC PERSONAL HEALTH RECORD: IMPACT ON CLINICAL OUTCOMS
10:45 - 11:30
Biography
Dr Debbie Wake is a Senior Lecturer and Consultant Physician at University of Dundee/ NHS Tayside (diabetes/ general endocrinology/ osteoporosis). Her research interests include informatics and new technology approaches to patient care, management and education. Further research interests include understanding associations between diabetes and psychiatric disease. Previous research experience is in the area of steroid metabolism in human obesity and diabetes (PhD- 2006) and clinical aspects of diabetes management.
Debbie coordinates the undergraduate teaching in diabetes and endocrinology at the University of Dundee, is programme director for the MSc Quality diabetes care programme and clinical lead for the PG cert/Dip/ MSc Diabetes Care, Education and Management, part of the Kuwait Scotland eHealth Innovation Network. She previously developed an online distance learning MSc programme in Internal Medicine (2011) for the University of Edinburgh and Royal College of Physicians.
Debbie also has an active role in public health communication. She is a regular contributor to radio health programming, was previously resident doctor on Scottish Televisions flagship show 'The Hour', and was a health columnist The Scotsman newspaper for many years. She developed and produced the first medical podcast series in the UK (Dr Pods Healthcast) in 2005, and has also produced and presented videos and webstreams for doctors.net and NES (NHS Education Scotland). She provides clinical support for the innovative mydiabetesmyway patient portal and website - where patients can access their own clinical data and find educational resources on-line.
Abstract
Background: My Diabetes My Way (MDMW) is the NHS Scotland website for people with diabetes and their carers. It consists of an interactive information website and electronic personal health record (ePHR) available to the 291,981 people with diabetes in Scotland. We aimed to analyse the impact of records access on clinical process outcomes.
Methods: We matched patients by age, gender, type of diabetes, duration, treatment and socioeconomic status. We analysed routinely collected clinical data on HbA1c, cholesterol, creatinine, blood pressure and BMI. Results were analysed in groups: type 1; type 2 on insulin; type 2 not on insulin.
Results: By September 2017, 15,575 people had logged in to access their records. 3,120 had 3+ years of follow-up since first login. There was a reduction in HbA1c in all active users (p<0.001), with type 2 patient not treated with insulin (n=1,599) showing most significant and sustained changes. The intervention cohort reduced from 60.5 to 54.1 mmol/mol (females) and 60.2 to 53.8 mmol/mol (males) within 1 year, while the matched cohort increased from 57 to 57.2 mmol/mol (females) and remained at 57.2 mmol/mol (males) during the same period. Intervention patients remained 2.9 mmol/mol (females) and 3.4 mmol/mol (males) below their matched counterparts after 3 years.
Conclusion: MDMW is an effective low-cost population-based self-management intervention. When extrapolated across a large population, MDMW may offer significant cost savings through reduction of long-term complications and treatmens. MDMW is currently being adapted to work with other clinical systems and conditions, with releases in Somerset and London during 2017.
11:30-12:15
Graham Ewing
CEO, Mimex Montague Healthcare Limited, UK
Title: Strannik is the first medical technology to incorporate an understanding of how the brain regulates the body’s function’.
11:30-12:15
Biography
Mr Ewing graduated from Northumbria University with B.Sc.Chemistry. In 2003 he started working with the Strannik technology. Over the period 2003-2018 he has authored ca 80 peer-reviewed medical papers and conference presentations in his efforts to illustrate the scientific and medical significance and value of the Strannik technology which was developed by Dr Igor Grakov. Mr Ewing is currently CEO Mimex Montague Healthcare Limited.
Abstract
Strannik cognitive software is based upon a mathematical model of how the brain regulates the autonomic nervous system and physiological systems. It comprises the screening technology Strannik Virtual Scanning (SVS) and the therapeutic modality Strannik Light Therapy (SLT).
SVS is a Point of Care technology which identifies the most destabilised physiological system(s), organ(s) and cellular morphology for each organ; provides a summary of the ca 15 pathologies in each of the 30 main organs; the extent of genotype and phenotype for each of the ca 15*30 reported pathologies; and the onset of pathologies from their presymptomatic onset.
Initial research has illustrated that SVS performs 2-23% more accurately than the range of diagnostic tests against which it was compared. Published peer-reviewed papers have illustrated the scope of SVS as an advanced screening technique which can more effectively screen the complex pathological correlates of all common medical conditions including diabetes, cardiovascular disease, alzheimer’s disease, migraine, raynaud’s phenomenon, etc. It has also been shown to be of value in a predictive capacity e.g. to illustrate susceptibility to heart attack, stroke, migraine, etc.
SLT uses the data from the Strannik test to define the parameters of a biofeedback-type technique which acts by re-establishing the coherent function of the autonomic nervous system and physiological systems.
Initial research has indicated a 75-96% level of effectiveness depending upon the nature of the condition to be treated. It has been shown to be particularly effective treating sleeping and breathing disorders, migraine, dyslexia, etc.
Tracks
- Healthcare and Environmental Health | Healthcare and Medicine | Healthcare and Nutrition | Primary Care and Diabetes | Healthcare, Services and Technologies | Healthcare and Patient Safety | Healthcare and Public Health | Healthcare and Cancers
Location: London, UK
Graham Ewing
CEO,Mimex Montague Healthcare Limited
Chair
Michaelene Holder March
Quality Assurance and Nursing and PELC Ltd
Co Chair
Michaelene Holder-March
Director of Governance, United Kingdom
Title: The cost and dearth of female sanitary products and its social and reproductive health implications
Biography
Mrs Michaelene Holder-March - RGN RM LLB(Hons) MSc, CMgr, AMBCS MIAEM MISQEM FinstAM Director of Governance, Quality Assurance and Nursing Partnership of East London Co-operatives (PELC) Ltd Becketts House - 2-14 Ilford Hill - Ilford - Essex - IG1 2FA
Abstract
Introduction
Pubertal development includes the onset of menstruation by young girls. Menstruation is a natural and beneficial monthly occurrence in healthy adolescent girls and pre-menopausal adult women. The age of menarche is getting as low as 8 years. Menstruation ceases at about the age of 45 - 55 years. This in effect means that females will bleed for about 2800 to 4000 days in their lifetime. This cuts across all income and ethnic groups. The financial burden and reproductive health effects on females have not become an issue until recently. Just as female issues such as infertility and urinary incontinence were not discussed publicly in years gone, menstrual problems and its effect on women are rarely discussed publicly at present. However, it is coming to the fore that there is a problem with how women manage the menstrual period. Period poverty has come into our language and it refers to the difficulty with affording sanitary protection. There are health and social implications of poor hygienic management of the menstrual period. These include absenteeism from schools, loss of self-esteem, infections, toxic shock syndrome among others.
Discussion
‘Period poverty’ hit the public consciousness in December 2016 following the release of Ken Loach’s hard-hitting film I, Daniel Blake. One scene, showed a struggling single mother caught stealing sanitary towels. This caught the conscience of the nation and food banks were flooded with donations of menstrual products. This has led to a national campaign calling for free menstrual products for children in receipt of free school meals.
Sanitary wears come in various forms and these include pads and tampons. They also come in different sizes and absorbent capacity. The cost of a pack of sanitary product is a drain on the pockets of women. It is estimated that a woman will spend about £20,000 in her lifetime for sanitary products. The cost implications of sanitary products push young girls and women to use alternatives such as rolled toilet paper, stuffed socks or pieces of cloth. This situation is worse in low to medium income countries but not exclusive to them.
Effects:
Social
One in ten girls in Africa misses school for the duration of her period each month.2 In March 2017, the media were full of reports of schoolgirls in Leeds, United Kingdom routinely missing school because they were unable to afford menstrual products. Children as young as 10 were choosing to stay at home to avoid the embarrassment of bleeding on their school uniform in front of their peers, because they were not adequately protected. They miss school every month because they cannot face the shame and fear of going to school using socks stuffed with tissues, old torn T-shirts or newspaper. In these families, menstrual products are an unattainable luxury. Embarrassed to go to school, absenteeism, will affect academic performance. This is likely to exacerbate the cycles of being uneducated, unemployable, poverty and inequality.
Health
In Bangladesh, infections caused from filthy, contaminated rags are rampant. Menstrual hygiene has been linked to high rates of cervical cancer in India. In the United States, where the economic and opportunity costs of menstruation for poor women have gone relatively undocumented, the problem hides in plain sight. That is, until there was a call for menstrual care to be treated as healthcare.
A systematic review of the available scientific literature was undertaken to ascertain the differing approaches to menstrual hygiene management (MHM) and its association with a wide range of health and psycho-social outcomes in lower income settings. 14 articles were identified which looked at health outcomes, primarily reproductive tract infections (RTI). 11 articles were identified investigating associations between menstrual hygiene management, social restrictions and school attendance. MHM was found to be associated with reproductive tract infections in 7 papers. However, methodologies varied greatly and overall quality was low.
Addressing the issue - advocacy
The provision of free or subsidised sanitary products will reduce the financial burden on teenagers who are not in employment as most of them will be students. Staying in school is essential in helping women in all countries achieve their full potential. Toilet papers are provided in public toilets for free. Placing vending machines in schools and other female toilet facilities for free sanitary products and reduction in the shelf costs will go a long way to alleviate and eliminate the exposure to period poverty
Conclusion
There is need to step up the discussion on the lack of access to quality hygienic sanitary products and to advocate for the provision of free sanitary products to young girls and students. The potential adverse reproductive health issues can result in infections and affect fertility. The costs of managing these disorders will place a strain on the cost of health care. Also important is the negative social impact on the dearth of sanitary products. There is a need for further scientific, qualitative and quantitative research, to ascertain the social and reproductive health impact of menstrual hygiene management.
13:00-13:30
Rotimi Jaiyesimi
Basildon University Hospital NHS Foundation Trust,UK
Title: The use of technology to reduce errors in clinical practice with a focus on electronic observations
13:00-13:30
Biography
Professor Rotimi Jaiyesimi - Associate Medical Director for Patient Safety and Consultant in Obstetrics and Gynaecology Basildon University Hospital NHS Foundation Trust Visiting Professor, Institute of Health Sciences, University of Sunderland
Abstract
Introduction
This presentation is based on the personal experience of the two authors in their roles to uphold patient safety. A patient's pulse, respirations, blood pressure, and body temperature are essential in identifying the patient’s baseline status and to detect any clinical deterioration. These vital sign monitoring is a fundamental component of nursing care. To be effective these parameters must be measured consistently and recorded accurately. Experience has shown that omissions or commissions in undertaking these tasks may result in adverse outcomes for patients.
Discussion
The measuring and recording vital signs fall within the tasks of nurses. Blood pressure, pulse and temperature measurements are to a large extent dependent on the use of digital equipment. The measurement of the respiratory rate is dependent on the nurse practitioner counting the chest excursions and using watches for a 30 – 60 seconds count. The latter comes across as a mundane task and there is evidence from clinical incident investigations that these are not recorded accurately. These figures are recorded in the observation chart.
The use, non-use or misinterpretation of this information became apparent when it became known that deteriorating patients were not being adequately identified in hospitals, not just in our own hospital setting but globally. In addition, many different observation charts to record routine physiological measurements were in use across the NHS. There was no standardised approach to the design of observation charts. This variation was an obstacle to standardised training, and engendered a lack of familiarity with clinical data recording when staff or patients relocated to different clinical areas or different hospitals. The Royal College of Physicians came up with the national early warning scores (NEWS) for adults in 2012 to bring about some standardisation.1 Each vital sign was allocated a figure depending on normalcy or variance from normalcy. Nurses were expected to undertake the summation of these values and record them on a pictorial chart that provided a panoramic view of consecutive readings. A score of 5 was set as a trigger for the nurses to call for medical evaluation of patients.
Investigations carried out in the authors’ clinical settings into adverse incidents have shown areas of errors dependent on human factors. These include nurses' failure to reliably measure, calculate, record, and interpret vital signs, failure to recognise the importance of vital signs (especially respiratory monitoring) and failure to escalate a deteriorating patient.
All too often physiologic abnormalities that develop up to 24 hours prior to death are either undocumented or unrecognized, as evidenced by a well-publicized case in which a patient died from haemorrhagic shock after major abdominal surgery, either because blood pressure was not monitored or changes in vital signs were not interpreted properly.
These ought to be the most reliable data in a patient's chart, but they are not. Abundant research indicates that vital signs are not consistently assessed, recorded, or interpreted. These lapses interfere with appropriate and timely interventions for deteriorating patients. All too often physiologic abnormalities that develop up to 24 hours prior to death are either undocumented or unrecognised, as evidenced by a well-publicised case in which a patient died from haemorrhagic shock after major abdominal surgery, either because blood pressure wasn't monitored or changes in vital signs weren't interpreted properly.
The future
The introduction of electronic early warning system eliminates the dependency on human factors and the move from paper-based records to automatically calculated digital recordings on portable electronic tablet devices.
Conclusion
The use of electronic observation tools will eliminate the dependency on human factors. New generation monitors are linked to the critical team and trigger when the defined threshold for trigger is crossed. The authors’ experience have shown a reduction in the number of missed deteriorating patients and a reduction in call out of the critical outreach team. This technological advancement has reduced errors in clinical practice and enhanced patient safety.
Biography
DR. Mohamed Fathy – PhD, MBA, FAIHQ, (CPHRM), MBBCH, Quality Management Director – Private Hospital – Royal Commission in Yanbu, Climax Healthcare Services Company Partner and General Manger. PhD in Hospital Management, Ashley University, USA, MBA , Brooklyn Park University NY,USA, 2013 , Diploma of Hospital Management, 2007 (Ain Shams University), Diploma in Total Quality Management in Healthcare, 2005 (AUC). He is a member of Fellow in American Institute of Health Care Quality (AHCQ) 2007. Participated in Various National and International conferences, He Graduated from School of Medicine MBBCh, 1997, and Certified Professional in Healthcare Risk Management (CPHRM) 2003,Risk Management Foundation of the Harvard Medical Institutions, he has Over 12 years as a health care executive ,Expertise in Patient safety, quality measurement and management.
Abstract
A definition for patient safety has emerged from the health care quality movement, Patient safety was defined by the IOM as “the prevention of harm to patients, healthcare system of care delivery that (1) prevents errors; (2) learns from the errors that do occur; and (3) is built on a culture of safety that involves healthcare professionals, organizations, and patients. Patient safety practices have been defined as “those that reduce the risk of adverse events related to exposure to medical care across a range of diagnoses or conditions. Many patient safety practices, such as use of simulators, bar coding, computerized physician order entries, and crew resource management, have been considered as possible strategies to avoid patient safety errors and improve health care processes. The types of errors and harm are further classified regarding domain, or where they occurred across the spectrum of health care providers and settings. The root causes of harm should be identified. Hospital should follow international patient safety goals in order to prevent medical errors such as miscommunication among caregivers, unsafe use of infusion pumps, and medication mix-ups. In 2002, The Joint Commission established its National Patient Safety Goals(NPSGs) program; the first set of NPSGs was effective January 1, 2003. The NPSGs were established to help accredited organizations address specific areas of concern in regard to patient safety. Patient safety is the cornerstone of high-quality health care.
Biography
Dr. Mostafa Sharif Azzam has been Graduated from University of Assiut, Egypt as Clinical Pharmacist (PharmD), He accomplished PhD degrees of Healthcare Management - High Claire University – USA by Jan 2018. Dr Mostafa, started his studies for Master’s of Infection Control in University of Essex – UK to be completed by the end of 2019,
He is a Certified Professional in Healthcare Quality (CPHQ) on March 2015 through National association of Healthcare Quality (NAHQ) - Chicago - USA.
Dr Mostafa Sharif was the Infection Control officer of Al Remaya Medical center – Egyptian Armed Forces from 2012 to 2014 then he started his role as a Healthcare quality Manager of one of the biggest chain of hospitals in Bahrain (Al Hilal Hospital) - JCI Accredited.
In October 2017, Dr Mostafa Sharif Established his own company for Healthcare Management & Consultancy (Positive) and became the Healthcare Quality Consultant of Al baraka Fertility Hospital.
Abstract
Healthcare Quality Management concepts and standards became an obligatory way of Healthcare Facility management relued and stated by the regulatory bodies all over the world. In GCC, especially in Kingdom of Bahrain, it is just started recently to take a place as an improvement roadmap for high quality of medical services and directly affecting the patient care standards and treatment plans.
Governmental & Private healthcare sectors realizes the importance of National Accreditation and how it can improve the overall services for external & Internal stakeholders. In 2017, National Accreditation process of Healthcare facilities started in Bahrain in line with huge change of the Healthcare running module in the country including a Comprehensive Medical Insurance program for citizens & expats, which generated a lot of Investments & business opportunities to be initiated and developed to reach the anticipated outcome of this changes.
Late start of this changes & regulations, uncovered deficiencies in Healthcare management practices and skills in both governmental & private sections, and here coming the role of healthcare quality experts and how they can minimize the transit stage of the healthcare revolution by guiding the existing, start-up and up-coming healthcare facilities to help in providing the best healthcare services & ensure the most appropriate implementation of patient care practices.