4^th Annual Congress and Medicare Expo on Trauma & Critical Care February 22-23, 2018 Hotel Holiday Inn Paris – Paris, France

Biography:

Julin F Tang is an Anesthesiologist/Intensivist in San Francisco, California and affiliated with UCSF Medical Center and San Francisco VA Medical Center. He is boarded in Anesthesia and Critical Care Medicine. He has received his Medical degree from China Medical College, Taichung, Taiwan in 1978. His clinical research interests involved in the understanding of hemodynamics and pulmonary physiology in both anesthetized and intensive care unit patients.

Abstract:

Ultrasonography in Acute Care Medicine:

The use of portable ultrasonic echocardiography has become a powerful tool in the trauma, critical care and perioperative setting in the hands of non-cardiologist that can provide non-invasive, real-time information that will transform the practice of medicine in time-critical situations. I will present a case series of application of ultrasonography in acute care medicine with findings that affected perioperative management. This is a presentation from a single institution. A well-designed prospective study is needed to validate our findings and improve patient’s outcome.

Biography:

Ossama H Salman is presently working as an Assistant Professor in the Department of Anesthesia, ICU and Pain Management in South Valley University, Egypt. During his Fellowship at the Department of Anesthesia and ICU, Nagoya University, Japan, he has completed his PhD degree on the contribution of neuropeptide Y to edema occurrence, in neurogenic and hydrostatic pulmonary edema (rat models). He has also investigated role of nitric oxide in the rat brain. He is the Head of the Pain Management Unit. He also works as Visiting Pain Consultant at Ministry of Electricity Central Hospital in Cairo.

Abstract:

Background: Intravenous regional anesthesia (IVRA) is an effective procedure for various short trauma surgical interventions on the upper limbs. It provides favorable patient recovery profile with shorter postoperative recovery time and less hemodynamic derangement.
Aim: To investigated the quality of analgesia and hemodynamics when dexmedetomidine or nitroglycerine (NTG) added to lidocaine for Intravenous Regional Anesthesia (IVRA) for traumatic hand and forearm surgery.
Method: Sixty ASA I and II patients undergoing hand and forearm surgery after trauma under, were divided into three groups (20 patients each). Group Dexmedetomidine received IVRA 40 ml lidocaine 0.5% plus 1μg/kg dexmedetomidine. Group Nitroglycerine received IVRA 40 ml lidocaine 0.5% plus 200 μg NTG. Group Control received IVRA 40 ml lidocaine 0.5%. Onset and recovery of sensory and motor block, quality of analgesia, time to tourniquet pain, time to first postoperative analgesic request, the total intraoperative and postoperative analgesic consumption and adverse effects were recorded.

Results: Sensory and motor block onset times were significantly shorter in group Nitroglycerine compared to group Dexmedetomidine and group Control. Sensory and motor block recovery times were significantly prolonged in group Dexmedetomidine and group Nitroglycerine compared to group Control. Sensory and motor block recovery times were significantly prolonged in group Dexmedetomidine compared to group Nitroglycerine (P<0.05). Time to tourniquet pain was higher in group Control compared to both Dexmedetomidine and Nitroglycerine groups. Postoperative VAS and analgesic consumption intra and postoperative were statistically lower in group Dexmedetomidine and group Nitroglycerine compared to group Control (P<0.05). These variables were significantly lower in group Dexmedetomidine in comparison to group Nitroglycerine (P<0.05).
Conclusion: NTG 200 μg added to lidocaine for IVRA shorten sensory and motor block onset times. Dexmedetomidine 1 μg/kg improves the quality of anesthesia and improves intra-operative tourniquet pain and postoperative pain with less intra-operative and postoperative analgesic consumption or hemodynamic instability.

Biography:

Mahdi Asadi is currently working in the Department of Emergency Medicine in Azad Medical University, Qom, Iran. He has received his Medical degree from Tehran University of Medical Sciences. Later, he has worked in Emergency Medicine Resident at Shahid Beheshti University of Medical Sciences from 2011-2014. He is the Representative of Jahrom University of Medical Sciences in association of emergency medicine in Tehran. He was also a Member of Research Council at Jahrom University of Medical Sciences.

Abstract:

Aim: This small pilot study aims to evaluate the role of seating position arrangement in Injury Severity Score (ISS) in traffic coach accidents.
Method: A total of 106 cases representing of 2 traffic coach accidents with similar specification from April 2017 to September 2017 enrolled in this matched case-control study. All included patients were treated at the Emergency Department of the Trauma Center. The injury severity of passengers was determined by ISS calculation. We categorized ISS to 2 group of severe (ISS≥25) and non-severe (ISS≤24) and seating position to front and rear group. Data was analyzed by SPSS.
Result: The case and control group consisted of 16 persons with ISS≥25 and 90 persons with ISS<25, respectively. About 11 persons of the cases seated at front of coach and 5 persons at rear position. In control group, 43 and 47 persons seated at front and rear position, respectively. The risk of severe injury was two times more likely in passengers seating in front of coach (OR=2.405, CI=0.773 to 7.482). Patient’s distribution according to ISS was minor (45.3%), moderate (21.7%), serious (17.9%), severe (8.5%) and critical (6.6%).
Conclusion: As the passengers seated in front of the coach had more likely to sustain severe traumatic injury, so injury severity could be declined by simple intervention such as arrange susceptible passengers in rear seating positions.

Biography:

Hend Mohamed El-Azzazy has completed her PhD from College of Nursing, Alexandria University (1995) and Postdoctoral studies from Tanta University, College of Nursing. She has published more than 15 papers in reputed journals, supervised 7 master’s and doctorate thesis and has been working as Acting Dean of College of Nursing, Sultanate of Oman, Vice Dean of Postgraduates and Research Affairs and the Head of Quality Assurance and Medical Surgical Department and Member of Faculty Council of College of Nursing, Egypt.

Abstract:

Pressure ulcers (PU) are a common problem across all health care settings and the incidence is one of the quality signs of health centers. Critically ill patients are at a high risk for pressure ulcer than are patients in general care areas. The protocol of nursing care provides the intensive care unit (ICU) staff with a decision-making structure that allows immediate response to patients identified as at high risk for pressure ulcers. The study aimed to evaluate the effect of protocol of nursing care for early detection and prevention of pressure ulcer in ICU. The study was carried out in Anesthesia Care Unit at Tanta Emergency Hospital. A convenient sample of 40 adult critically ill patients meeting the inclusion criteria were selected and divided into two equal groups. The control group consisted of 20 critically ill patients undergoing routine care of the unit. Another 20 critically ill patients in the study group were undergoing the protocol of nursing care for pressure ulcer prediction and prevention applied by the researchers. Three tools were used for data collection. Tool-1: Patient assessment tool. It consists of three parts: (1) includes bio-socio-demographic data, (2) includes patient’s medical and nutritional history and (3) includes assessment of critically ill patients related to level of consciousness, level of mobility and skin assessment. Tool-2: Braden Scale risk assessment tool that identifies patients at risk for pressure ulcer development. Tool-3: Ulcer development evaluation. The main result of this study showed that 30% of the control group undergoing routine care of ICU developed pressure ulcer stage-1 at the 7^th day of admission and 60% of them developed stage-2 pressure ulcer at the 15^th day of admission. On the other hand, it was observed that only 10% of study group developed pressure ulcer grade 1 at 15^th day of admission and none of them developed stage-2 pressure ulcer at any time of the study period. It is recommended that periodic clinical assessment of critically ill patients at risk for ulcer development should become a routine for Intensive Care Unit by using Braden scale. Also, the protocol of nursing care for early detection and prevention of pressure ulcer should be generalized at ICUs and other acute care setting.

Biography:

Min Tan is a graduate student of nursing school, West China hospital in Sichuan University. Her research direction is geriatric nursing and has enough expertise in evaluation and passion in improving the health and quality of life among elderly patients. She focused on the relationship between health situation and medication adherence of the diabetic older patients and did her best to find a better method which elderly patients can accept and be easy to implement so as to solve those problems disturbing chronic patients and manage disease process and condition efficiently.

Abstract:

Background: Medication non-adherence and risk factors related to diabetic patients have been investigated widely in prior studies all over the world. However, those studies mainly focused on adults and conducted in developed countries and high-income cities. It is necessary to find information about the prevalence and correlates of medication non-adherence among older patients with diabetes mellitus in western China in order to achieve optimal glycemic control and prevent diabetes-related complications.

Method and materials: A cross-sectional descriptive study was conducted in 1559 older diabetic adults. Our study used a multistage sampling method and conducted in 21 community health centers in 7 cities of western China located in Sichuan Province, Chongqing Municipality, Xinjiang Uygur Autonomous Region, Guizhou Province, Gansu Province, Shanxi Province and Qinghai Province. The variables investigated in the study were demographic, clinical characteristics and medication adherence. Descriptive and Binary logistic regression analysis were performed to determine factors that related to medication non-adherence. 

Results: The results illustrated that 75.5% of participants were medication adherents and that 24.5% of patients were non-adherents. About 23% of elderly patients suffered from at least four chronic diseases and 11% of patients took more than four prescribed medications for treatment. Multivariate logistic regression demonstrated that number of comorbidity (OR=2.194, 95%CI=1.003, 4.803), number of oral medications (OR=2.088, 95%CI=1.198, 3.638), household income (OR=0.452, 95%CI =0.312, 0.656) and marital status (OR=0.684, 95%CI =0.505, 0.927) were associated with medication non-adherence.

Conclusion: Medication non-adherence among elderly patients with diabetes mellitus is a common and vital concern in western China. More attention to geriatric patients with high risk for medication non-adherence is necessary. And strategies should be designed to improve medication adherence especially in those who suffered from comorbidities, taken poly-pharmacy for treatment, had lower household income and married patients.

Biography:

Xie Caixia has completed her Master’s degree from the Third Military Medicine College of China and started her PhD in 2016 in West China School of Medicine, Sichuan University. She is a Head-Nurse of Sichuan Provincial People’s Hospital, who had 6 years’ experience in nursing management and 7 years’ experience in clinical nursing. She has published more than 20 papers in reputed journals.

Abstract:

Background: The emotional intelligence of nurses is closely related to occupational burnout, and mindfulness can improve emotional intelligence. Theory and preliminary evidence suggest that emotional intelligence may mediate the relationship between ICU nurses’ mindfulness and occupational burnout, but further study is needed to validate this finding.

Objectives: The aim of this study was to test the mediating role of emotional intelligence between ICU nurses’ mindfulness and occupational burnout.

Design: A cross sectional study.

Settings: 29 ICUs in seven tertiary hospitals in domain city of Chengdu, China.

Participants: A sample of 883 ICU nurses.

Methods: Data on occupational burnout, mindfulness and emotional intelligence were collected by trained research assistants using the Meshach burnout inventory, mindful attention awareness scale and emotional intelligence scale, respectively. Socio-demographic data were collected by self-report. Pearson’s correlation coefficient was used to analyze correlations between variables. Mediation analysis was performed with structural equation modeling and indirect effects were evaluated with bootstrapping.

Results: The correlations between mindfulness, emotional intelligence, emotional exhaustion, depersonalization and personal achievement were significant. In mediation models, emotional intelligence plays part mediating role in the relationship between mindfulness and emotional exhaustion, mindfulness and depersonalization. That is, the mindfulness factor cannot only influence emotional exhaustion or DE personification through emotional intelligence, but also directly influence emotional exhaustion or DE personification. Emotional intelligence plays a total mediating role in the relationship between mindfulness and personal achievement, that is, mindfulness does not have a direct impact on personal accomplishment, but indirectly affects personal accomplishment through emotional intelligence.

Conclusion: Mindfulness and emotional intelligence appears to be an important factor influencing occupational burnout of ICU nurses. Interventions addressing mindfulness and emotional intelligence should be considered as a way to improve occupational burnout in this population.

Biography:

Neringa Bagdonaite is currently pursuing his PhD in Mykolas Romeris University, Institute of Psychology. He has completed his graduation in Mykolas Romeris University and did research in the field of psychology. His research interests are psychology, psychological trauma, etc.

Abstract:

Aims: The current study aimed to systematically analyze various research done in the area of female posttraumatic stress disorder (PTSD) and alcohol abuse and to critically review these results on the basis of theoretical models as well as answering following questions: (1) What is the reciprocal relationship between trauma/PTSD and alcohol abuse among females; (2) What are the moderating factors/variables of this relationship?

Methods: The computer bibliographic databases EBSCO, Scopus, Springer, Web of Science, Medline, Science Direct were used to search for scientific publications. Systematic analyses sample consisted of peer reviewed, English written papers addressing mixed gender and female PTSD and alcohol abuse issues from 2012-2017 May.

Results: Total of 1011 articles was found in scientific databases related to search keywords of which 29 met the selection criteria and were analyzed. The results of longitudinal research indicate that various traumas especially sexual abuse trauma exposure in childhood is linked with increased risk of problematic alcohol use and re-victimization in adulthood, re-victimization in adolescence, rather than victimization in childhood has a greater impact on the onset and progression of problematic alcohol use in adulthood. Cross-sectional and epidemiological studies also support significant relationships between female PTSD and alcohol abuse. Regards to negative impact of alcohol use on PTSD symptoms results are yet controversial. Some studies suggest that alcohol does not exacerbate symptoms of PTSD over time, while others argue that alcohol abuse worsens PTSD symptoms and is linked to chronicity of both disorders. Motivational and emotional factors have an important impact on alcohol abuse in women with PTSD, when increase in both negative and positive feelings and various motives, specifically coping motives is linked to alcohol use in response to PTSD symptoms. Regards to theoretical models, results of longitudinal studies tend to systematically demonstrate mutual maintenance model perspective, however studies of cross-sectional design reveals self-medication aspects of alcohol use behavior and emphasizes proximal relationship between PTSD symptoms and alcohol abuse.

Conclusions: In general, the results are in line with previous systematic analyses. Findings have important clinical implications, as treatment of comorbid conditions is more complex and time-consuming than those with a single disorder. Therefore, it is important for clinicians working with both disorders to pay enough attention to identification and integration of traumatic events. Likewise teaching effective emotional regulation strategies for coping with distress as well as strategies for experiencing and increasing positive affect, such as mindfulness or engaging in positive visual imagery, would help to reduce problematic alcohol use and the probability of re-victimization in the future.

Biography:

Sandeep Inchanalkar is presently a leading Neurosurgeon in Maharashtra, India. His widely acclaimed mission is to bring healthcare of international standards within the reach of individual. He is an MBBS, MS, DNB and MCh (Neurosurgery) at Bombay Hospital and has done Fellowship in Minimal Invasive Brain and Spine Surgery. He is a Member of Neurological Society of India and presented paper in several national conferences. He was Organizing Secretary and Joint Secretary of Neurological Surgeon’s Conference 2015 and 2016.

Abstract:

Approximately, one million patients present to hospital each year having suffered a head injury. The majority of these patients have minor (GCS 13-15) or moderate injuries (GCS 9-12) and approximately half or less than 16 years. Old males are 2-3 times more likely to have a head injury than females. Head injury is associated with tremendous mortality and morbidity. The head injuries are classified according to the nature of insult (penetrating or blunt) concomitant injuries (isolated or multiple traumas) and the timing (primary or secondary). The Glasgow coma scale (GCS) remains the most commonly used method of assessing the severity of the head injury. Pathophysiologically, it can be cerebral contusions, diffuse axonal injury, subarachnoid hemorrhage, fracture and epidural and subdural hematomas. The five key principles that should guide the management of the head injury patients in ICU are norm tension, normoxia, normocapnia, normothermia and normoglycemia, management involves medical and surgical treatment. Medical management includes positioning, sedation ventilation, ABG management, mannitol (ICP reduction agents), sugar control, temperature regulation and good nursing care. Surgical management includes CSF drainage, craniotomy, lobectomy decompression, etc. Head injury is not a static event that occurs at time zero and recovers to normal at defined later time point. It is a dynamic process that changes over days, weeks and months after the event and outcome cannot be assessed at least 6 months after the head injury. Management of head injury needs a disciplined and team approach for better outcome.

Biography:

Gibril Ceesay is a student and Nurse at the Serrekunda Health Center, Banjul, Gambia. He started his professional nursing career after graduating from The Gambia University at the end of 2016.

Abstract:

Traumatic​ ​brain​ ​injury​ ​(TBI)​ ​is​ ​a​ ​head​ ​injury​ ​that​ ​may​ ​have​ ​many​ ​different​ ​causes,​ ​including​ ​a blow​ ​or​ ​jolt​ ​to​ ​the​ ​head,​ ​penetration​ ​of​ ​the​ ​skull​ ​by​ ​a​ ​bullet​ ​or​ ​other​ ​foreign​ ​object,​ ​fast acceleration​ ​or​ ​deceleration​ ​of​ ​the​ ​head,​ ​or​ ​exposure​ ​to​ ​a​ ​blast​ ​resulting​ ​in​ ​a​ ​disrupted functioning​ ​of​ ​the​ ​brain.​ ​Primary​ ​brain​ ​injury​ ​occurs​ ​at​ ​the​ ​time​ ​of​ ​injury​ ​and​ ​results​ ​from​ ​the physical​ ​stress​ ​(force)​ ​within​ ​the​ ​tissue​ ​caused​ ​by​ ​open​ ​or​ ​closed​ ​trauma​ ​and​ ​requires​ ​emergency treatment​ ​to​ ​prevent​ ​secondary​ ​injuries.​ ​Secondary​ ​injury​ ​to​ ​brain​ ​injury​ ​includes​ ​any​ ​processes that​ ​occur​ ​after​ ​the​ ​initial​ ​injury​ ​and​ ​worsen​ ​or​ ​negatively​ ​influence​ ​patient​ ​outcomes.​ ​The damage​ ​occurs​ ​primarily​ ​because​ ​the​ ​delivery​ ​of​ ​oxygen​ ​and​ ​glucose​ ​to​ ​the​ ​brain​ ​is​ ​interrupted due​ ​to​ ​hypotension,​ ​hypoxia,​ ​ischemia and​ ​cerebral​ ​edema. ​According​ ​to​ ​research,​ ​there​ ​are​ ​millions​ ​of​ ​people​ ​living​ ​with​ ​a​ ​disability​ ​as​ ​a​ ​result​ ​of a​ ​TBI​ ​around​ ​the​ ​world.​ ​Regardless​ ​of​ ​the​ ​severity​ ​of​ ​brain​ ​damage,​ ​injuries​ ​have​ ​both​ ​short​ ​and long-term​ ​effects​ ​on​ ​health,​ ​ranging​ ​from​ ​symptoms​ ​that​ ​have​ ​a​ ​minimal​ ​interference​ ​on lifestyle,​ ​through​ ​to​ ​emotional,​ ​physical​ ​and​ ​psychosocial​ ​changes​ ​that​ ​may​ ​affect​ ​daily activities.​ In addition​ ​to​ ​the​ ​burden​ ​to​ ​the​ ​individual,​ ​brain​ ​injuries​ ​also​ ​have​ ​an​ ​annual economic​ ​burden​ ​on​ ​society,​ ​due​ ​to​ ​both​ ​direct​ ​and​ ​indirect​ ​costs,​ ​such​ ​as​ ​loss​ ​of​ ​productivity. The​ ​age​ ​of​ ​the​ ​individual​ ​is​ ​a​ ​factor​ ​in​ ​brain​ ​injury;​ ​for​ ​example,​ ​more​ ​than​ ​one-third​ ​of​ ​brain injuries​ ​are​ ​due​ ​to​ ​people​ ​falling,​ ​which​ ​is​ ​the​ ​leading​ ​cause​ ​of​ ​TBI​ ​among​ ​the​ ​elderly, whereas transportation-related​ ​brain​ ​injuries​ ​are​ ​the​ ​leading​ ​cause​ ​for​ ​individuals​ ​aged​ ​15​ ​to​ ​30. Studies​ ​have​ ​shown​ ​that​ ​the​ ​decreased​ ​in​ ​mortality​ ​rate​ ​and​ ​improved​ ​outcome​ ​for patients​ ​with​ ​severe​ ​traumatic​ ​brain​ ​injury​ ​can​ ​be​ ​attributed​ ​to​ ​the​ ​approach​ ​of​ ​“squeezing oxygenated​ ​blood​ ​through​ ​a​ ​swollen​ ​brain”.​ According​ ​to​ ​research​ ​adequate​ ​cerebral​ ​perfusion by​ ​monitoring​ ​of​ ​intracranial​ ​pressure​ ​and​ ​treatment​ ​of​ ​cerebral​ ​hypo-perfusion​ ​decrease secondary​ ​injury.​ ​Before​ ​the​ ​individual​ ​with​ ​brain​ ​injury​ ​reaches​ ​a​ ​hospital,​ ​a​ ​structured​ ​trauma system​ ​that​ ​allows​ ​rapid​ ​resuscitation​ ​and​ ​transport​ ​directly​ ​to​ ​an​ ​experienced​ ​trauma​ ​center significantly​ ​lowers​ ​mortality​ ​and​ ​morbidity.​ ​Additionally,​ ​in​ ​order​ ​to​ ​achieve​ ​further improvements​ ​in​ ​outcome​ ​for​ ​patients​ ​with​ ​traumatic​ ​brain​ ​injuries,​ ​sufficient​ ​training​ ​and education​ ​of​ ​medical​ ​personnel​ ​and​ ​the​ ​institution​ ​of​ ​trauma​ ​hospital​ ​systems​ ​should​ ​be implemented.

Biography:

Mohammed N Albaraesi is a Chief Consultant Surgeon in Benghazi Medical Center, Libya (2010-2017). He has also worked as Professor of Surgery in University of Benghazi, Department of Surgery, Faculty of Medicine (2008-2017) and teaching staff, collaborator with the Libyan International Medical University. His research interests lie in the area of laparoscopic, trauma and emergency surgery. He has published more than 20 various research papers in several international journals.

Abstract:

Background: Abdominal trauma considered one of the most common traumas seen in emergency department worldwide. Currently, in our city the majorities of abdominal injuries are related to shrapnel of the missiles.

Objective: To study and evaluate the clinical manifestation, diagnostic approaches and management of different organ injuries as well as the associated morbidity and mortality caused by shrapnel of the missiles and to improve our approach and management in this type of injury.

Materials & Method: A retrospective study of the medical records of 100 patients presenting to the emergency department with history of abdominal trauma in Benghazi Medical Center from 01-01-2016 to 31-12-2016. The clinical manifestations, diagnostic modalities, management, complications and death rate were evaluated.

Results: Patients in 5-40 years were more prone to this type of trauma. Males were predominantly involved. Abdominal pain was the most common presentation and abdominal tenderness was the most common sign. Mean duration of hospital stay for operated cases were 20 days and for non-operated cases were 7 days. Abdominal ultrasound was 81% sensitive and 100% specific in diagnosing solid organ injury. Operative management was done in 85% of cases. Mortality was 7%.

Conclusion: Penetrating abdominal injuries which results from shrapnel of the missiles are common injury in Benghazi. Repeated clinical examinations and use of appropriate diagnostic modalities holds the key in management. Hollow viscous injuries were the most common injury which mandates urgent operative management. Non-operative management and close observation for solid organ injuries in a hemodynamically stable patient is a better option.

Biography:

Tae Chang Jang currently works at the Department of Emergency medicine, Catholic University of Daegu. Tae does research in Emergency Toxicology, Pre-hospital Care and Emergency Medicine. His Research interest are Critical care, trauma, Emergency medicine.

Abstract:

Purpose: Various kinds of educational programs have been tried to achieve skill, willingness and self-confidence in performing cardiopulmonary resuscitation (CPR). Paramedic students usually participate in clinical practice in emergency department as one of their educational courses. We investigated the effects of hospital based clinical practice and participation in real cardiac arrest situation on EMT student.

Methods: From December 2016 to August 2017, 81 paramedic students from ten different University received hospital based clinical practice for three or four weeks in regional emergency medical center and were enrolled in our study. They were asked, using a questionnaire, about their confidence and willingness to perform CPR before and after clinical practice. We also objectively measured two minutes-CPR performance by Laerdal skill reporter before and after clinical practice. In clinical practice, they participated in real CPR situation and took several theoretical examinations but additional CPR practical training was not included.

Results: This study included 48.1% male volunteers, 70.4% with BLS provider certification. Average participation in real CPR situation was 8.35 times. Scores in confidence of CPR were significantly increased (3.80 vs. 4.36, p<0.001). Scores in willingness of CPR were high in both group (4.46 vs. 4.48, p=0.787). Average chest compression depth were significantly increased (51.3 mm vs. 55.5 mm, p<0.001). Average compression rate showed no difference (111 vs. 111, p=0.694). Correct hand positioning and chest recoil also showed no difference in both groups.

Conclusion: Hospital based clinical practice of paramedic students could provide extra confidence to perform CPR and could make chest compression depth adequately.

Biography:

Faiza A Abou El-Soud has completed her RN, BSN from Cairo University and MSN, PhD from College of Nursing, Menuofiya University, Egypt. She was acting as an Assistant Professor of College of Nursing, Menuofiya University since 7 years.

Abstract:

Background: With the intention of maximizing academic success and minimizing academic failure among nursing students, it is a crucial to carry out several researches for better understands the success and failure-related factors for improving academic performance and quality of the nursing graduates that have a direct reflection on the country’s monetary development, social progress, and better living for the individual.

Purpose: The purpose was to investigate associations among the dependent variable (academic performance or GPA) and the independent variables (success and failure factors as well as demographic characteristics of thenursing students).

Methodology: A correlational descriptive-design was conducted with a convenience sample of 150 female senior nursing students, college of nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA. A self-reporting questionnaire has three main categories, which included demographic characteristics of the nursing students; success factors and failure factors were examined to correlate with their academic performance. The data were analyzed using Pearson correlation to estimate the degree of association between students’ performance and success and failure factors as well as their selected demographic characteristics and regression analysis to determine the model summary, ANOVA and coefficient.

Results: It revealed that a positive association between nursing students’ academic performance and the demographic characteristics as age, level of English language skills and language barriers at the P value (0.05) level. In addition, there were degrees of associations between nursing students’ academic performance and certain success factors such as learner factor at 40% and (r=0.408; p=0.000) and lecturer factor at 18% and (r=0.187; p=0.058). Meanwhile, there were degrees of associations between students’ academic performance and failure factors such as learner factor at 39% and (r=0.39; p=0.000), lecturer factor at 21% and (r=0.219; p=0.000); environment factor at 37% and (r=0.372; p=0.000).

Conclusion & Recommendation: Based on the results, great evidence was shown a positive association between the success and failure-related factors and academic performance of the nursing students. Further study on the academic and non-academic interventions are recommended to build nursing students’ abilities and competency skills which can assist help them to overcome failure factors that might influence their academic achievement.

Biography:

Nagwa Abdel Fadeel A Afefy has completed her PhD from College of Nursing, Cairo University (2008) and Postdoctoral studies from Cairo University, College of Nursing. She has published more than 13 papers in reputed journals, supervised 10 master’s theses and working at quality assurance unit, community service committee, students’ activities committee, student’s affairs committee, maternal and new born health nursing department committee and is also a Member of Faculty Council of College of nursing, Egypt.

Abstract:

Background: Weight gains during pregnancy have an important health implication on pregnancy outcomes.

Aim: The aim of the current study was to assess the impact of gestational weight gain educational session on pregnant women’s knowledge and perception.

Methods: A quasi experimental design was used to conduct the study. A convenient sample of 100 Saudi pregnant women who attended Obstetrics and Gynecology Outpatient Clinic at King Fahad Hospital in King Abdulaziz Medical City, Ministry of National Guard Health Affairs/Riyadh (KAMC-MNGHA) were recruited. Data was collected by using self-administered close ended questionnaire which consisted of four parts: (1) Socio-demographic characteristics, (2) obstetrical history, (3) knowledge assessment (pre-post assessment) and (4) perception assessment (pre-post assessment). The educational session lasted for 20-25 minutes.

Result: There was a significant improvement in the total knowledge score before and after educational session about pregnancy weight gain including (pregnancy weight gain, risk of over weight gain during pregnancy and risk of less weight gain during pregnancy) (P=0.000 for each), as 72% of the subjects had poor knowledge pretest compared to 91% had good knowledge post-test. Also, there was significant differences in total perception score before and after the session (p=0.000). About two third (64%) had fair perception pretest compared to 69% had good perception post-test. However, there were no significant differences in the knowledge mean score of the pregnant women across their socio-demographic variables and selected obstetrical variables.

Conclusion: Pregnant women have poor knowledge about proper weight gain and its impact on pregnancy outcome. Bridging this knowledge gap is an important step towards improving perinatal outcomes, especially those who enter pregnancy overweight or underweight. The educational session has an impact on improving pregnant women’s knowledge and perception about proper weight gain during pregnancy.

Biography:

Park Ho-Ran has her expertise in evaluation and passion in improving the pediatric health and wellbeing. Her research and education evaluation model based on responsive constructivists creates new pathways for improving healthcare. She has built this model after years of experience in research, evaluation, teaching and administration both in hospital and education institutions.

Abstract:

Purpose: To prevent early childhood accident is primarily necessary, but care should be taken to cope with growing number of childhood trauma accident in recent years. The purpose of this study was to identify parental coping in early childhood injury and to provide basic data for parent’s educational program and desirable directions.

Method: A Q-methodology that provides a method of analyzing the subjectivity of each item was used. 34 selected Q-statements were derived from a literature review and interviews. 47 parents were classified into a shape of normal distribution using 9-point scale. Collected data was analyzed by the pc-QUANL program.

Result: Five types of parental coping in early childhood injury were identified. The first type is the type to problem solving focused on situational coping: Hear the expert opinion carefully and treat to prevent further complications in the future, solve problem step by step carefully. The second type is the safety seeker focused on accident prevention: Consider what the root cause of accident is and to check behavior of child or surrounding environment as to prevent child injury. The third type is the anxious expression focused on emotion: Can’t accept injury situation and showed anxious psychological feelings. The forth type is the problem solving focused on leading judgment: Performs injury solving situation predominantly. The fifth type is the type to safety seeker focused on causal perception: Identify cause of injury situation as a way to prevent recurrence of child’s trauma and try to minimize secondary adverse effects of accident on the future growth of the child.

Conclusion: The results of this study provide improved outlines that different approaches to educational programs can be used for parent in early childhood injury. This study is meaningful to investigate coping type and viewpoint of parents.

Biography:

Amit Frenkel is a Medical Doctor with training in Critical Care and Internal Medicine. He is the Medical Director of the Critical Care outreach team at the Soroka University Medical Centre, a tertiary 1100 bed teaching hospital with more than 65,000 hospitalizations and about 200,000 emergency department visits annually. His current research includes the attention to the correlation between different diseases to their laboratory results.

Abstract:

Statement of the Problem: Glucocorticosteroids (GCS) are known to cause the hematologic effect of leukocytosis and neutrophilia. Leukocytosis is a key parameter in establishing the diagnosis of sepsis and in the estimation of its severity. In this study, we quantified the effect of chronic or acute GCS treatment on the level of leukocytosis in patients with acute infectious process in a critical care unit.

Methodology & Theoretical Orientation: We conducted a retrospective cohort study of patients with an acute infection hospitalized in tertiary medical center between the years 2003-2014. Patients were classified into three categories: Chronic GCS treatment, acute GCS treatment, no GCS treatment. The primary outcome was the maximal WBC count within the first 24 hours from admission.

Findings: We identified 5468 patients with acute infection: 333 of them with chronic GCS treatment, 213 with acute GCS treatment and 4922 with no GCS treatment. The overall maximal leukocytes count was higher in GCS therapy groups: 15.4±8.3×10⁹/L for the acute GCS treatment, 14.9±7.4 ×10⁹/L for chronic GCS treatment and 12.9±6.4×10⁹/L for the no GCS group (P<0.001).

Conclusion & Significance: In patients with acute infections chronically treated with GCS, an increase in the WBC is at average of 5×10⁹/L. These data must be taken into consideration while using the level of leukocytosis as a parameter in the diagnosis of the infectious process in critical care patients.

Biography:

Min-Feng Tseng is a board-certified Nephrologist at Tri-Service General Hospital, National Defense Medical Centre. He has his expertise in improving the individual outcome and health. In addition to his clinical duties, he maintains an active clinical research program, which focuses on studying acute kidney injury, critical care nephrology and hypertension in chronic kidney disease.

Abstract:

Statement of the Problem: There is limited information on the outcome of acute kidney injury (AKI) in patients with traumatic intracranial hemorrhage (tICH). The aim of this study is to estimate the outcome using different renal replacement therapy on the survival rate and rate of long term renal-replacement therapy in adult tICH patient.

Methodology & Theoretical Orientation: We retrospectively identified a total of 310 tICH patients with AKI who required glycerol or mannitol therapy admitted to the intensive care unit during a 10 year period ending DEC 2010 from the National Health Insurance Research Database. Demographic data, severity of tICH, medication, level of care, type of head surgery were collected. All patients subjects were older than >18 years. We also excluded patients diagnosed with tICH before the cohort entry date, hemodialysis before tICH, chronic kidney disease/cancer/coagulation defects/purpura and other hemorrhagic conditions, mortality/mechanical ventilation/ischemic heart disease before tracking. The primary outcome was overall survival at day 30. The secondary outcome was the rate of long term HD therapy.

Findings: A total of 310 patients were enrolled. The Kaplan-Meier estimates of mortality at day 30 did not differ significantly between the continuous vino-venous hemofiltration (CVVH) and intermittent hemodialysis (HD) strategies (Adjusted hazard ratio: 0.782, 95% CI, 0.239 to 2.558; P=0.685). The rate of long term HD was higher in the HD-strategy group than in the CVVH-strategy group (Log-rank P=0.021) especially in injury severity score 16 group.

Conclusion & Significance: tICH patient with AKI receiving CVVH may have effect on renal blood flow protection or cytokine removal which lowers the rate of long term HD.

Biography:

Eunsuk Choi has completed her PhD from Seoul National University School of Nursing. She is known for occupational health research targeting prevention and management of work-related diseases. She has published more than 50 papers in reputed journals.

Abstract:

Aim: The purpose of this study was to analyze literature related to post-traumatic growth among police officers.

Methods: Comprehensive literature searches using Ovid-Embase, Ovid-Medline, Cochrane, PubMed and RISS were conducted. The research terms included police officers, police, trauma, posttraumatic growth, and growth.

Results: A total of 9 studies were identified. In the Korean researches, PTG was positively correlated with self-esteem, problem focused coping, emotion focused coping, social support, self-disclosure and deliberate rumination. In the foreign researches, PTG was correlated with thriving, resilience, events involving threat, personal relationship stress, trauma severity, life stress and gratitude. Demographic variables such as female, white were also associated with PTG.

Conclusion: To improve post-traumatic growth of police officers, strategies to increase stress coping, social support, are needed. Strategies to decrease stress, trauma and PTSD symptoms should be developed.

Biography:

Abstract:

Background & Aim: Endotracheal intubation is known to be prolonged by wearing Chemical Personal Protective Equipment (C-PPE). Aim of this stiudy is to evaluate the efficiency of airway control by using 2^nd generation supraglottic airway devices (SAD) as compared with endotracheal intubation wearing C-PPE.

Methods: This trial involved 117 medical practitioners from five groups: medics, paramedics, general practitioners, residents and anesthesiologists in the reserve army. Four devices were examined: Endotracheal tube with direct laryngoscopy; 1^st generation laryngeal mask airway Unique (Figure-1) and two of the 2^nd generation SAD; the laryngeal tube suction disposable (Figure-2) and laryngeal mask airway supreme (Figure-3). Each subject practiced each of the four study devices on a simulator for six times: Three times while wearing C-PPE and three times wearing standard uniform. Primary measures were success or failure to achieve airway control, number of attempts to achieve airway control and time to insertion. Secondary endpoint was a subjective assessment.

Result: More attempts were required to airway control with ETT compared with any other devices, with and without C-PPE (p<0.001). Airway control with ETI was 88% longer than the time required other devices. No statistically difference was noted when comparing the different SAD’s. For all devices, the mean times to achieve an airway were longer when operators were equipped with C-PPE as compared with standard uniform (Table-1). Subjectively, difficulty levels were significantly higher for ETI than for all other devices (p<0.0001).

Conclusion: Using second generation SADs significantly shortens the time for airway control while wearing C-PPE compared with ETI.