Scientific Program

Day 1 :

Keynote Forum

Celina Afenir

Loma Linda University Children Hospital, USA

Keynote: Shared Leadership: Creating a Space for Truth to Empower, Engage and Strengthen Relationships

Time : 10:00-10:40

Biography:

Celina Afenir is an inspirational and motivational executive with a focus on a truth leadership approach. She has a proven record of success in strategic, organizational, operational, and fiscal management of the Children's Services, specializing in Neonatal Intensive Care Unit and Pediatrics Unit for major healthcare organizations within the United States Pacific Southwest and Northwest (California, Arizona, Oregon and Washington States). She has a BSN, MBA/Healthcare Management and is currently pursuing a PhD (Doctoral in Performance Improvement Psychology) at Grand Canyon University. She was a co-presenter at the 2016 National Association of Neonatal Nurses 32nd Annual Education Conference on the topic of Innovative Family Centered Care Bundle: One Hospital's Journey of Working with Family and Staff to Significantly Improve Communication and Patient Experience in the NICU. She is currently the Director of Patient Care Services NICU Loma Linda University Children’s Hospital California USA.

Abstract:

Background: Based on employee rounding, the NICU leadership team identified the need of the NICU frontline staff members to be encouraged and empowered to make decisions on initiatives, changes, projects and performance improvements.  There is a perception of inconsistent follow through from leadership team on issues, concerns, and suggestions regarding opportunities for improvement.  As a result, historical employee engagement survey participation has been less than 50% and engagement results were below standards. Purpose: The NICU Practice Council was developed to represent the unit-based aspect of the shared governance model in healthcare. The frontline staff members are empowered to identify barriers to clinical practice, improve processes and/or workflow by partnering with the leadership team to help remove identified barriers and facilitate resources. The NICU Practice Council has the responsibility and accountability to establishing and maintaining the standards of evidence-based practice which describe and guide the care provided.  

Keynote Forum

Thubi H.A. Kolobe

The University of Oklahoma Health Sciences Center, USA

Keynote: Robotic and sensor technology: Can we change brain development and functional outcomes in young children with brain insults?

Time : 10:40-11:20

Biography:

Thubi H.A. Kolobe is the Jill Pitman Jones professor of physical therapy in the Department of Rehabilitation Science at the University of Oklahoma Health Sciences Center. Her research in early identification of children with or at risk for disabilities, efficacy of robotics in the early mobility of young infants, cultural and environmental influences on development, and measurement has been funded by foundations and federal agencies such as the National Institutes of Health. She is a co-developer of the Test of Infant Motor Performance for preterm infants, a norm-referenced test that is used worldwide and has been translated into several languages. Dr. Kolobe has served as chair of the Research Committee of the Section on Pediatrics, chaired a task force to develop a research agenda for the American Physical Therapy Association's Section on Pediatrics, served on a recent task force to revise the research agenda for the American Physical Therapy Association, and has been appointed to serve on the Scientific Review Committee for the National Institute of Child Health and Human Development, National Institutes of Health. Dr. Kolobe has extensive clinical experience in pediatrics and community-based interventions. Over the past 30 years, her roles in this area have ranged from direct patient care in various settings, clinical education, and staff development, to program consultation. Her consultation roles have focused largely on program evaluation and development for community-based programs that serve children and families with disabilities and on funded undergraduate and graduate training programs. She serves on the Evaluation Committee for the Oklahoma SoonerStart program, a statewide early intervention program funded through the Part C program of the Individuals with Disabilities Education Amendment Act of 2004. She holds a Ph.D. in pediatric physical therapy (with a minor in family therapy) from Hahnemann University.

Abstract:

Brain insults occurring pre-, peri-, post-natally, or during early infancy have lasting negative impact on functional independence. Many of the neuromuscular problems, educational disparities, and societal participation limitations seen in older children and adults can be traced back to infancy. The period of infancy is also associated with dramatic changes in development and high synaptic connections in the brain further compounding the complexity and neurological sequelae following early brain insults. On the other hand, neuroplasticity research suggests that this period also offers the best opportunity for introducing targeted interventions that are likely to optimize development. The challenge for neurologists and rehabilitation professionals worldwide has been in determining or developing interventions that are effective, can be provided in the first year of life, and can yield sustainable results (dosing). This presentation will discuss findings from novel robotic and sensor technologies aimed at preventing learned non-use, promoting movement exploration, and improving cognition and mobility in infants and toddlers with brain insult. The presentation will also focus on the differential effects of reinforcement and error-based movement learning in this population, including neural correlates, and implications for dosing.

Keynote Forum

Adel Harb

King Fahad Specialist Hospital, Saudi Arabia

Keynote: Current Challenges facing Nursing Education in Saudi Arabia

Time : 11:40-12:20

Biography:

Adel Harb graduated from University of Jordan in 1993. He had worked as Cardiac Registered Nurse in Jordan. He completed his master’s degree in education from University of Jordan on 1998 and a master’s degree in Critical Care from Ohio State University on 1999. Worked at Ministry of National Guards for Health Affairs (NGHA-Riyadh) on 2003 as Clinical Resource Nurse in Nursing Education till 2010. Then worked in NGHA (Madinah) as Supervisor for Safety and Quality till 2014. During 2014-2017 worked as Director of Nursing Education at Security Forces Hospital- Riyadh. On Jan 2018 has joined Nursing Education at King Fahad Specialist Hospital as Nursing Educator Manager Obtained PhD in Healthcare Administration on 2010 and worked as visiting Professor Assistant. Supervising all Saudi Nursing Students - Interns and graduates. Publications: one book "Cardiology for Registered Nurses", 15 Abstracts and Papers. 3 Researches. He served as a speaker at several international Symposia and conferences, Saudi Heart Association member as senior Regional Faculty for ACLS. Currently is developing a Case Management Post Graduate Diploma Program.

 

Abstract:

Kingdom of Saudi Arabia is facing many health related challenges. It was on 1954 when Ministry of Health (MOH) has established Nursing as a profession. Since the last 64 years, nursing has faced many obstacles, difficulties and challenges and there was a direct impact on the growth and development in Nursing Education. Unfortunately, these challenges facing Nursing Education in Saudi Arabia are increasingly complex and dynamic. The main purpose of this paper is to highlight and discuss those challenges through Structure – Process- Outcome model. Moreover, this paper will address some potential strategies that could overcome these challenges and move Nursing Education and Nursing Profession forward and meet the Saudi Arabian vision 2030

Keynote Forum

Salil Uppal

Uppal Neuro Hospital, India

Keynote: Prevalence of Migraine in Epilepsy

Time : 12:20-13:00

Biography:

Uppal is a Doctor of Medicine in Neurology. He is the Medical Director of Uppal Neuro Hospital in Amritsar. His area of interests lies in Stroke, Epilepsy, Neuro Critical Care, and Movement Disorders. His research works include Non- motor symptoms in Parkinson's Disease, Transcranial Doppler in Acute Ischemic Stroke, Epilepsy and Migraine.

Abstract:

Headache is commonly associated with seizures as an inter-ictal, preictal, ictal, or postictal phenomenon, it is often neglected because of the dramatic neurological manifestations of the seizure. A prospective study was designed to identify epidemiological association between headache and epilepsy and  to evaluate the types and frequency of seizure-associated headaches in patients with epilepsy on anti-epileptics. AIMS AND OBJECTIVES  To  evaluate the type and frequency of  headache in people with epilepsy and risk factors with special attention to the anatomic localization of the epileptogenic focus, seizure classification (focal versus generalized) while on antiepileptic drugs over a period of 3 months. STUDY DESIGN   Study conducted at  Outdoor Patient Department, of Department of Neurology, DMC&H, Ludhiana. Patients ³17 years  with a diagnosis of epilepsy more than 2 years on single antiepileptic agent  - with new onset headache ,increase in frequency and severity of headache in epilepsy were taken . Headache data  analyzed according to IHS criteria, Epilepsy classified  according to the 2010  (ILAE) Commission report. Results  73 cases (29 female, males 44) on antiepileptic monotherapy  were taken .Mean age was 26years,  median age at epilepsy onset  was 15 years  ,median epilepsy duration  was  8years.Generalized epilepsy seen in  48 (66%),  focal epilepsy  25 (33%) . 23 (30%) reported  headache , inter-IH in 15 (40%)and  peri- IH occurred in 12 ( 50%) of these  5 (18.3 %) had an associated inter-IH,  7  had headache related to the seizures,  Carbamazepine, levetricetam ,valproate, oxcarbamazepine ,lamictal  given in 17,18,29, 6, 2, patients 7,5 ,10,2 1had headache

 

Keynote Forum

Kiminobu Sugaya

University of Central Florida, USA

Keynote: Small molecule based neuroregeneration therapy for Alzheimer's disease

Time : 9 am to 6 pm

Biography:

Kiminobu Sugaya has been a professor of medicine at the Burnett School of Biomedical Science, College of Medicine, University of Central Florida since 2004. He is Director of the Multidisciplinary Neuroscience Alliance, and a Chair of the Central Florida Chapter of the Society for Neuroscience. His primary research focus has been developing regenerative medicines for neurodegenerative diseases, such as Alzheimer's disease and Parkinson's disease using iPS and adult stem cells. Dr. Sugaya earned his B.S., M.S. and Ph.D. from the Science University of Tokyo. He received postdoctoral training under the direction of Dr. Ezio Giacobini, who is responsible for breakthroughs in cholinesterase Alzheimer's disease therapies.

Abstract:

Despite decades of investigations in both laboratory and clinic, the pathophysiological mechanism of Alzheimer’s disease (AD) still remains unknown. Current problem of developing AD research is that many treatments have been found to be very effective in AD animal models but they failed show significant effects in clinical trials. Thus, establishment of an effective treatment in a model, which represent pathophysiology of AD is needed. Previously, we were able to show improved cognitive function of aged, memory-impaired animals through the implantation of human neural stem cells (NSCs), which produced much excitement throughout the research world and the overall medical community; given the implication that this could lead to a cure for all neurodegenerative diseases, including AD. However, when we transplant NSCs to a transgenic animal model produces Amyloid-β (Aβ) plaque formation in the brain by expressing familial AD mutant amyloid precursor protein (APP), mimicking the pathological condition of AD, we did not find any new neuronal development formed from the donor cells. This indicates that transplantation of NSCs by itself may not be a cure for AD. Here we show that the combination drug therapy of Posiphen (reducing APP level) and NBI-18 (increasing endogenous neural stem cell) increased neurogenesis and significantly improved memory in the transgenic AD mouse model. This combination therapy could bring us an effective treatment for AD. I will further discuss the use of iPS cell to confirm this efficacy in vitro 3D human AD brain model.

 

 

  • Maternal and Neonatal Nursing | Neuroimmunology | Nursing Education and Management | Mental Health Nursing | Community Health Nursing | Neuro oncology and Stem Cell Therapies | Nursing Practice

Session Introduction

Jennifer Miller

Mednax, USA

Title: Improved Parental Self-Care During the NICU And Beyond
Speaker
Biography:

Jennifer Miller has 19 years of Neonatal ICU experience in both the capacity of a Registered Nurse and Neonatal Nurse Practitioner.  Jennifer has a passion for the overall well-being of NICU families.  Her strong commitment and motivation ignited her into developing and creating a NICU Parent Advisory Council (Phoenix AZ 2013) to support families who are faced with the physiological and psychological challenges inside and outside of the NICU walls.  Her purpose of connecting current and veteran NICU families together has earned an excellence award in the Neonatal Practitioner Innovator category from MEDNAX Health Solutions Partner.  She is also a personal health coach who enjoys being physically active through travelling around the world while consuming the magnificent outdoor activities of her home state of Colorado.  She is an outstanding advocate who has a vision of making each NICU parent healthier through fitness and adopt an early self-care pattern improving the entire physical and psychological well-being to raise healthier Neonatal ICU baby graduates.

Abstract:

Background: When babies are born and admitted in the NICU for a prolonged period of time, evidence-based research has revealed increased level of anxiety, stress, and post-partum depression affecting NICU parents. These psychological conditions interfere with their ability to bond, breastfeed and care for their child while in the NICU and upon transitioning to home. As they go through their NICU journey, the uncertainty of not knowing whether their baby will live or die can cause their inability to do self-care to meet their own basic needs. They also have high tendencies to feel isolated and alone that can cause major psychological issues common to NICU parents. Assessment: Exercise releases a natural hormone, serotonin, that regulates one’s psychological status or mood. By improving one’s mood, they have the ability to deal with stressful situations better. Self-confidence and self- efficacy are also positively affected giving parents increased belief in caring for themselves and a medically fragile child. Recommendation: Program development based on self-care for these families starting in antepartum and immediately after arriving in the NICU. There would be varying different levels of self-care from basic human needs, medication, yoga, meditation, walking or more intense workouts. This program would also come with a virtual NICU community where there would be nothing but positivity to help one another understand they are not alone and the importance of learning to take care of yourself so you can then take care of you NICU grad and your family. Objectives: The main objective is to decrease the incidence in psychological problems that are related to the NICU. Improved self-care will also improve breast feeding rates, parent bonding and parental emotional states throughout the child’s life span.

Giuseppe Donato

University Magna Graecia of Catanzaro, Italy

Title: Role of innate immunity in glioma growth and progression

Time : 14:30-15:00

Speaker
Biography:

Giuseppe Donato is an associate professor of pathological anatomy at the Magna Graecia University of Catanzaro (Italy). He has developed skills in all areas of human pathology and especially neuropathology, working in Italy and other european countries. In recent years he has focused on aspects of the immune response associated to neoplasia, especially concerning the role of mast cells and macrophage polarization.

 

Abstract:

Although the last WHO classification of brain tumors (2016) has given greater importance to genetic alterations of gliomas, there is an increasing amount of data about the immunological aspects related to this type of neoplasms, that solicit us to focus our attention on the interactions between the immune system and glial tumors. All types of cells of innate immunity may affect the gliomas biology. Macrophage polarization plays a pivotal role in the growth and progression of glial neoplasms where number and type of macrophages varies with the histopathological grade. Moreover, the state of macrophages polarization can be seen as a continuum and possibly reversible through pharmacological interventions. Mast cells are active in various malignant tumors, but their role is not always clear; they may infiltrate mouse and human gliomas in such an extent that depends on glioma grade. “Tumor educated” Mast Cells decrease glioma cell proliferation and migration but promote glioma cell differentiation. Natural Killer cells (NK) can induce the cytolysis of tumor cells and can secrete cytokines. In gliomas, generally, the presence of infiltrating immune cells with immunosuppressive roles such as macrophages and NK, correlates with poorer patient prognosis even if exosomes derived from NK have antitumor effects on glioblastoma cells both in vitro and in vivo. As frequently happens in other cancer patients, glioma patients usually have a strong neutrophilia; the neutrophils-to-lymphocytes count (NLR) higher than 4 has been associated with poor prognosis when measured before treatments. Moreover, there is a correlation between NLR value, the extent of neutrophil infiltration, the glioma grade and the acquired resistance to anti-VEGF therapy. In conclusion, data arising from innate immunity interactions have practical implications and require an urgent inclusion in WHO classification and in histopathological reporting.

 

Venus Medina-Maldonado

Pontifical University of Ecuador, Ecuador

Title: Perceptions of the violence in the workplace among nursing staff - preliminary results
Speaker
Biography:

Dr Venus Medina-Maldonado currently works at the Nursing Faculty, Catholic Pontifical University of Ecuador as lecturer and researcher. She teaches subjects such as historical context and development in nursing, Family Nursing, Evidence based Nursing and Dissertation, her research interest is focused on preventing and responding to gender based Violence.

Abstract:

Several studies have established the prevalence of workplace violence in the health sector being the nursing staff more likely to experience physical violence and bullying than other health worker’s. In spite of this, in Ecuador only a few researches have directly investigated the issues on nurses’ in association to type of violence, perpetrators, well-being affectation and protecting measures available in the health institutions. Methodology & Theoretical Orientation: A qualitative study with phenomenological method was carried out in (01) major hospital in Quito, Ecuador. Participants were selected from a convenience sample and, before starting the discussion, were given information consent forms to sign. Participants were n = 41/210 professional nurses and the considered selection criteria were being professional, over age 18, and being employers at the hospital as minimum 2 years. The technique selected in data collection was Focus Group Discussion (FGD). Data were collected from Jun. 2018 to Jul. 2018. Discussions were recorded and stored in voice files using a digital recorder. The Mayring’s approach was used for the interpretative process. The feminist epistemological framework was utilized to analyze the power imbalances in the work relationship and the context in which it occurs. Findings: Nursing staff in this study expressed during discussion lack of clarity about what constitutes violence in the workplace, lack of understanding about the magnitude of the problem, nurses affected mostly try to ignore the situation because they considered this to be a typical incident in the workplace, they did not report the situation and it has caused underregistration. The aggressors were mostly staff members, supervisor and general public. When nurses narrated their experiences with violence the researchers identified verbal abuse, bulling/mobbing, sexual harassed and physical violence. Conclusion & Significance: The evidence allowed us to admit that the situation is a significance problem in magnitude and severity. Our recommendations will be oriented toward the implementation of a preventative and minimizing aggression program in the Hospital.

Francis Kyerepagr Kobekyaa

University of KwaZulu-Natal, South Africa

Title: Exploration of the perceived barriers to collaborative clinical facilitation among nurse educators, preceptors, clinical nurses/midwives and nursing and midwifery students in Northern Ghana
Speaker
Biography:

Francis Kyerepagr Kobekyaa is a Nurse Educator at the St. Joseph’s Midwifery Training College, Jirapa in the Upper West Region of Ghana. Francis started his nursing career as a Community Health Nurse after graduating from the Jirapa Community Health Nursing Training School in 2004. Thereafter, he worked at Ketuo Health Centre as the Community Nurse in-charge of the facility in the Puffien Sub-District. He also doubled up as the CHOs’ Supervisor responsible for two CHPS Zones in the SubDistrict. During his time, the Sub-District recorded an increased in skilled delivery with improved maternal and child health service performance indicators. In 2007, he gained admission to the Presbyterian University, an affiliate of the University of Ghana where he obtained Bachelor of Science in Nursing and Registered General Nursing Licensing Certificates. In 2014, he obtained a scholarship from the Netherlands Initiative for Higher Education to pursue an Honours Degree in Nursing Education at the University of KwaZulu-Natal, Durban. He graduated in 2016 and continued with a Full Research Masters (Mphil) in Nursing Research at the same university with funding from the Vice Chancellor of the university. He is currently working on two articles for publication.

Abstract:

Background: The hindrances to collaborative clinical facilitation for effective practical learning of nursing students are worrying. Aim: The aim of this study was to explore the perceived barriers to collaborative clinical facilitation among nurse educators, preceptors, clinical nurses/midwives and nursing and midwifery students at two selected nursing and midwifery colleges and a hospital in Northern Ghana. Methods: This study adopted a constructivist paradigm using a qualitative exploratory-descriptive approach. Purposive and systematic sampling methods were used to select participants for the study. Data were gathered through focus groups discussions and individual in-depth interviews and transcribed verbatim. The data were analyzed using Framework Analysis Method. Findings: The study findings showed a sharp increase in student population at the colleges causing overcrowding and congestion at the clinical learning environments. Preceptors and other clinical staff who are trained and mandated to facilitate clinical teaching were insufficient, and therefore not available at all health care facilities or wards every time for students’ guidance and support. Participants further reported role confusion among staff due to lack of working agreements between staff of colleges and health facilities over who had the prime responsibility for clinical teaching of nursing students. This resulted in an adversarial relationship among key players of the collaborative network. Lack of time, heavy workload and busy ward schedules equally impacted negatively on the practice of collaborative clinical facilitation. Conclusions: Based on these findings, nursing and midwifery colleges, in collaboration with healthcare facilities, need to create clinical placement calendars to coordinate students’ clinical schedules in the wards in order to avert the challenge of overcrowding. This would provide students the opportunity to be effectively supervised and guided during clinical practice in the ward. Ethical Clearance Reference Number: HSS/1553/016M.

Zamzaliza Abdul Mulud

UiTM Selangor, Malaysia

Title: Effect of A Multidisciplinary Education Program on Women with Pregnancy Induced Hypertension in Rural Malaysia
Speaker
Biography:

Zamzaliza Abdul Mulud is an academician in Centre for Nursing Studies, UiTM Malaysia. Her specialization is in the nursing field specifically in medical surgical, mental health and gerontological nursing. Her research interest includes the effect of the educational program, resilience among caregivers of individuals with illness, quatitative research, and caregiver burden.

Abstract:

Pregnancy-induced hypertension (PIH) is among the top four most common causes of maternal death in Malaysia. The purpose of this study was to examine the effect of a multidisciplinary education program on knowledge, attitude and perceived behavior control of PIH management among antenatal women diagnosed with PIH in rural Malaysia. A quasi-experimental study with pre and post design was conducted to measure the effect of a multidisciplinary education program on study variables guided by the Theory of Planned Behaviour. Sixty-three antenatal mothers with PIH from 6 Maternal and Child Health Clinic in Lahad Datu, Sabah participated in this study and participants were assigned to intervention (n=32) and control group (n=31). Participants in experimental group attended a multidisciplinary education program (8 hours workshop) regarding PIH management and blood pressure control, nutrition, and exercise. Whereas, the control group, did not receive any. Data were collected using a set of questionnaire which measures sociodemographic characteristics of the participants, blood pressure level, knowledge and attitude of PIH management and perceived behavior control. Data were collected from both intervention and control group pre-test and 14 days post-test. A t-test of mean differences was used to examine the effect of the multidisciplinary education program on knowledge, attitude and perceived behavior control of PIH management. Findings showed that there were significant differences in mean score pre and post-test for knowledge (t = 4.97, p < 0.001) and attitude of PIH management (t = 2.76, p < 0.001). However, there was no significant difference in perceived behavioral control between intervention and control group. Findings of this study indicated that the multidisciplinary education program might be utilized as an effective management program for antenatal mother diagnosed with PIH residing in rural areas.

Day 2 :

Keynote Forum

Adel Harb

King Fahad Specialist Hospital, Saudi Arabia

Keynote: Developing charge nurses as frontline leaders through transformative learning

Time :

Biography:

Adel Harb graduated from University of Jordan in 1993. He had worked as Cardiac Registered Nurse in Jordan. He completed his master’s degree in education from University of Jordan on 1998 and a master’s degree in Critical Care from Ohio State University on 1999. Worked at Ministry of National Guards for Health Affairs (NGHA-Riyadh) on 2003 as Clinical Resource Nurse in Nursing Education till 2010. Then worked in NGHA (Madinah) as Supervisor for Safety and Quality till 2014. During 2014-2017 worked as Director of Nursing Education at Security Forces Hospital- Riyadh. On Jan 2018 has joined Nursing Education at King Fahad Specialist Hospital as Nursing Educator Manager Obtained PhD in Healthcare Administration on 2010 and worked as visiting Professor Assistant. Supervising all Saudi Nursing Students - Interns and graduates. Publications: one book "Cardiology for Registered Nurses", 15 Abstracts and Papers. 3 Researches. He served as a speaker at several international Symposia and conferences, Saudi Heart Association member as senior Regional Faculty for ACLS. Currently is developing a Case Management Post Graduate Diploma Program.

Abstract:

Nurses at all levels must be prepared and developed to lead change to advance health care.  Historically, in most healthcare institutes, nursing leadership development programs have focused on nurses in senior management or executive roles rather than those working in frontline leadership roles. This article will describe a professional development initiative program attended by 169 charge nurses. The program has a comprehensive curriculum and road map for developing frontline leaders and ensuring charge nurses are trained, mentored, and supported in their roles. Program development, evaluation, and lessons learned that can be applied in other organizations are discussed

Keynote Forum

Kita Sallabanda Diaz

University Complutense of Madrid, Spain

Keynote: Combined treatment of Spine tumors

Time : 10:40-11:20

Biography:

Kita Sallabanda Diaz has more than 25 years of experience in the field of Neurosurgery. He currently works in this specialty at the Genesiscare Madrid - Arturo Soria, while he is an external medical consultant at the San Carlos University Clinical Hospital in Madrid. Author of Treaty of Radiosurgery (2012) and Guide of Brain Metastases (2015), has published in numerous scientific media of the Spanish and world scene. He is the current President of the Spanish Society of Radiosurgery and the Neuro-Oncology Committee of the Clinical Hospital of Madrid. In the field of teaching, he is an associate professor at the Complutense University of Madrid. His area of expertise mailnly lies in Cyberknife SRS, Epilepsy, Cognitive functions and brain metastases.

Abstract:

Every year in the U.S., 180,000 new cases are diagnosed and 20,000 of them with medular compression. 5-14% of patients with cancer develop Spine metastases, from them 33% Bone 4% Leptomeningeal 0.1-0.4 Intramedullary. 60% of Spinal Metastases appear in patients with: Breast Cancer Lung Cancer,Prostate Cancer (7.4%). The treatment basicaly is based on: SURGERY, RADIOTHERAPHY COMBINED TREATMENT, RADIOSURGERY. Until 1990 the first treatment was Radiotheraphy, later we come back to surgery, Patchel trial demostrate the superority of surgery (Lancet 2005), Clase I evidence. From these time we take in considerstion NOMS and SINS criteria-The developmant of techonlogy in radiotheraphy make us to chamge the paradigm. Radiosurgery take a very important role in the treatment of sipne tumors. The combine treatment is our first option, surgery and radiosurgery. The principal indication of Spine Radiosurgery as a primary treatment are: residual tumors after surgery, recurrent tumours, multiple lesión, unfarable localization, high risk for open surgery. We present our seria, experience and biblography revisión about the combine treatment in spine pathology.

 

  • Critical Care Nursing | Neurology | Neuromuscular Diseases | Neurodegenerative Diseases | Neurosurgery | Women’s Health Nursing

Session Introduction

Mike Snape

AMO Pharma Ltd, UK

Title: The utility of concordant trend analyses in a Phase 2 study in Congenital and Childhood Onset Myotonic Dystrophy Type 1: a case example

Time : 11:40-12:10

Speaker
Biography:

Dr Mike Snape received his BA with Honors at Oxford University, England and his PhD from London University after study at the Maudsley and Bethlem Hospital. Mike presently holds an adjunct Professorship at CASE Western university. He has 30 years of experience in pharmaceutical research and development and has managed relevant projects from pre-clinical through clinical stages of development. He is named as an inventor on 5 pharmaceutical patents including 3 new chemical entities and has published numerous abstracts in international scientific and medical journals. He previously worked in CNS R&D at AstraZeneca and also has extensive experience of research and development projects in the field of CNS disorders in a small life science company environment having been Principal Scientist at Cerebrus Ltd and Associate Director at Vernalis, and was a founder of Neuropharm. Mike initiated one of the first industry sponsored clinical projects in autism in 1997, lead the first industry sponsored multi-center studies of a core symptom of autism, and some of the first industry sponsored studies in Fragile X Syndrome. More recently Mike was one of the founders of AMO Pharma Ltd. The company is working to identify and advance promising therapies for the treatment of serious and debilitating diseases in patient populations with significant areas of unmet need, including rare, debilitating childhood onset neurogenetic disorders with limited or no treatment options. AMO Pharma submitted the first successful application for Fast Track Status for congenital myotonic dystrophy program to be granted by the FDA.

Abstract:

Statement of the Problem: Proof-of-concept clinical trials in rare diseases such as congenital and childhood onset myotonic dystrophy Type 1 are often hampered by a lack of knowledge concerning optimal outcome measures to detect efficacy. The concordant trends analysis offers a solution in which efficacy is assessed by evaluating the trends on several within-study assessments, provided the assessments are quasi- or wholly-independent. Positive findings using this analytical technique are unlikely to arise due to chance alone. Methodology & Theoretical Orientation: AMO-02/tideglusib is a novel, orally administered GSK-3β enzyme inhibitor. Overactivity of GSK3β has been identified as a key pathophysiological feature of congenital and childhood onset myotonic dystrophy. Accordingly, this Phase 2a clinical trial explored the utility of AMO-02 in 16 adolescents and adult subjects with this form of myotonic dystrophy across a 12-week treatment period. Outcome measures included disease-specific rating scales, functional/performance-based assessments, and biomarkers. Findings: AMO-02 rendered clinical benefit to the majority of subjects after 12 weeks of treatment. The concordant trend analysis revealed a clear dose-response relationship that favored the 1000 mg over 400 mg dose. Four of the 10 efficacy variables (i.e. grip strength, Clinician VAS rating scale, Caregiver Top 3 Concerns rating scale, and OSU CGI-I rating scale) differed in favor of 1000 mg over 400 mg dose and there was no worsening in the remaining six variables. Conclusion & Significance: The concordant trend analysis provides reiterative confidence about the study findings. This is important since this novel therapeutic area lacks gold standard outcome measures and this study was the first clinical trial conducted in this specific population. Accordingly, AMO-02 merits further progression in clinical development in this population of individuals affected by early-onset myotonic dystrophy, and the 1000 mg dose may have the best prospect of establishing a consistent efficacy signal.

 

Rami Maged Mahmoud

Ta' heal Rehabilitation Center, Egypt

Title: Effect Of Transcutaneous Electrical Nerve Stimulation And Conventional Therapy In Post-Stroke Dysphagic Patients: A Randomized Controlled Trial
Speaker
Biography:

Dedicated RPT offering 4 years of experience in physical therapy field. A history of exemplary ratings on performance reviews; bilingual fluency (English and Arabic) and solid credentials that includes Egyptian licensure, B.Sc degree in physical therapy and Master degree with GPA 2.63. Background includes work with neurologic, orthopedic and pediatric patients. Well-versed in a broad range of PT programs, treatments and modalities restoring function and mitigating disability for diseased and injured patients. Excellent interpersonal/communication skills and proficiency in patient assessment, time management and therapy program design/execution. Enthusiastic team player deeply committed to delivering quality care and achieving superior patient outcomes as a member of a multidisciplinary case-management team. 

Abstract:

Post stroke dysphagia (PSD) can decrease the quality of life, increase the risk of medical complications and mortality. So it is a great concern for patients and a tough problem for clinicians. Purpose: The current study was conducted to investigate the effect of adding TENS to the conventional therapy of treating PSD. Methods: Thirty patients complaint from post stroke dysphagia were participated in this study, their ages were ranged from 45 to 85 years. They were randomly divided into two equal groups. Group (A): Received 3 weeks of treatment with Transcutaneous Electrical Nerve Stimulation (TENS), frequency 80 HZ, pulse duration of   300 μsec, intensity according to the patient’s tolerance ranging from 2.5 to 25 mA, duration of treatment 30 min three times/week in addition to the conventional therapy. While Group (B): Received 3 weeks of treatment with conventional therapy and placebo TENS, duration of treatment 30 min three times/ week. Results: Both treatment protocols are effective, minimally invasive option for treatment of patients complaining of post stroke dysphagia, both groups produced subjective improvement and there is a significant increase in both The Functional Oral Intake Scale (FOIS) and The Mann Assessment of Swallowing Ability (MASA) of group A compared with that of group B post treatment. Conclusion: There was significant increase in the MASA of group A compared with that of group B post treatment. Moreover, there was a significant increase in the median values of FOIS of group A post treatment compared with that of group B.

 

Dorothy Ado-Mensah

University of Cape Coast, Ghana

Title: Psychological distress (stress, anxiety, and depression) and quality of life among chronic kidney diseases patients on dialysis at the cape coast teaching hospital
Speaker
Biography:

Abstract:

Psychological distress (stress, anxiety, and depression) and quality of life among chronic kidney diseases patients on dialysis at the cape coast teaching hospital Haemodialysis has proven to be the most effective treatment modality due to its efficiency in sustaining patients for a very long period. Despite this, there is evidence to suggest that factors such as stress, depression and anxiety moderates the quality of life of CKD patients on dialysis. Nephrology clinicians primarily should not only treat the physical symptoms of kidney disease but explore and proactively recognise the emotional and psychosocial realities of patients with this disease. The purpose of the study was to investigate the psychological distress and quality of life among Chronic Kidney Disease patients on dialysis at the Cape Coast Teaching Hospital. The study adopted a descriptive survey design. The purposive sampling technique was used to sample 38 patients. Depression, Anxiety and Stress Scales (DASS 42) was adapted to measure psychological distress and quality of life was measured using the World Health Organisation Quality of Life Instruments (WHOQOL-BREF). Data was analysed using Pearson Product Moment Correlation Coefficient, and Independent t test. The result of the study Majority of patients with CKD experience varying levels of psychological distress. Further the study found a negative correlation between psychological distress (stress r= -.488, anxiety r= -.537 and depression r= -.467, n=40, p=.001) and CKD patients’ quality of life. Finally, no significant differences was observed in the psychological distress of males (M=72.64, SD= 9.61) and females M=68.93, SD= 4.33; t (35.95) = 1.67, p =.104 (2 tailed). It was recommended that renal care practitioners should be educated on the need to refer patient to Clinical Psychologist for proper management of psychological related cases. Also, a robust multidisciplinary team approach for the management of renal cases.

Norfidah Mohamad

UiTM Selangor, Malaysia

Title: The Role of Social Support Environment in Medication Adherence among Individuals with Type 2 Diabetes Mellitus
Speaker
Biography:

Norfidah Mohamad is a senior lecturer in Centre for Nursing Studies, UiTM Selangor, Malaysia. Her specialization is in Critical Care Nursing. Her research work and interest are in the area of Critical Care Nursing which focus in Intensive Care Nursing and Cardiology Nursing.

Abstract:

The National Health Morbidity Survey (NHMS) reported that the prevalence of Malaysian with diabetes mellitus (DM) is 11.6% and 14.6% for individuals age 18 and above and 30 and above respectively. Adherence to medications is an important aspect in patients’ management as many studies reported that non-adherence to medication could lead to hospitalization and higher mortality rates among this population. Thus, this study aimed to determine the prevalence of non-compliance of medication and to examine the association between medication adherences with social support among patients with Type 2 DM in Malaysia (n=173). A cross sectional study was conducted using a self-administered questionnaire which consists of three parts; socio-demographic data, the Morisky Scale to measure medication adherence and the Medical Outcome Study Modified Social Support Survey (MOS MSSS). Results showed that 2.4% of the total number of patients demonstrating a low level of compliance towards the medication. The most common types of social support received by patients was affectionate support which has been proved throughout previous studies to have effect on DM patients’ quality of life. Surprisingly, the lowest type of social support reported by the patients was emotional support. There was a significant positive correlation between medication adherence and social support (rho=0.154, p=0.043). Finding of this study was in agreement with previous studies that social support was the main determinant of compliance to medication. Among all the sources of social support, doctors (physician) were selected by patient as the main source of support followed by spouse, children and nurses. Findings from the present research contribute to the growing evidence on the role of social support environment towards medication adherence among individuals with Type 2 DM. Thus, future research regarding the development of interventions on importance of social support and medication adherence is suggested among this population.