5th International Conference on Pediatric Nursing and Healthcare July 11-12, 2016 Cologne, Germany

Chair

Heather L MacDonald

University of New Brunswick, Canada

Co-Chair

Hee Yun Lee

University of Minnesota, USA

Session Introduction

Arthur Engler

University of Connecticut

Title: Effectiveness of a perinatal and pediatric End-of-Life Nursing Education Consortium (ELNEC) curricula integration

Biography:

Dr. Engler completed his PhD in nursing in 1999 at the Catholic University of America in Washington DC. He has been on the faculty of the University Of Connecticut School Of Nursing in the U.S. since that time. He is the coordinator of the undergraduate pediatric nursing program and the author of numerous papers on pediatric and neonatal nursing.

Abstract:

Background: Educational practices and national guidelines for best practices of providing palliative care to children and their families have been developed and are gaining support; however, the dissemination of those practices lags behind expectations. Incorporating education for pediatric palliative care into nursing pre-licensure programs will provide guidelines for best practices with opportunities to enact them prior to graduation. Objective: To evaluate the effect of an integrated curriculum for palliative care on nursing students' knowledge. Design: Matched pretest–posttest. Setting: One private and one public university in the northeastern United States. Participants: Two groups of baccalaureate nursing students, one exposed to an integrated curriculum for palliative care and one without the same exposure. Methods: Pre-testing of the students with a 50-item multiple choice instrument prior to curriculum integration and post-testing with the same instrument at the end of the term. Results: This analysis demonstrated changes in knowledge scores among the experimental (n = 40) and control (n = 19) groups that were statistically significant by time (Wilks' Lambda = .90, F(1, 57) = 6.70, p = .012) and study group (Wilks' Lambda = .83, F(1, 57) = 11.79, p = .001). Conclusions: An integrated curriculum for pediatric and perinatal palliative and end-of-life care can demonstrate an increased knowledge in a small convenience sample of pre-licensure baccalaureate nursing students when compared to a control group not exposed to the same curriculum. Future research can examine the effect on graduates' satisfaction with program preparation for this specialty area; the role of the use of the curriculum with practice-partners to strengthen transfer of knowledge to the clinical environment; and the use of this curriculum inter professionally.

Laurence Baldwin

Coventry University, UK

Title: Does the rise of metrics in UK healthcare threaten or offer opportunities for nursing identity in child and adolescent mental health?

Biography:

Laurence Baldwin is a Senior Lecturer in Mental Health Nursing at Coventry University, and leads the Children and Young People’s Neurodevelopmental Team at Derbyshire Healthcare Trust. He completed his PhD at the University of Nottingham, and was previously a Consultant Nurse for Child and Adolescent Mental Health Services in Derbyshire, England. He has published several papers and chapters and been involved in multi disciplinary and community-based participatory research projects. His work for the Royal College of Nursing included representing nursing on the CAMHS Ministerial Taskforce which published the influential ‘Future In Mind’ report in March 2015.

Abstract:

Child and adolescent mental health services (CAMHS) within the UK National Health Service have often been seen as a ‘Cinderella service’ but due to increasing pressure and attention have received much more policy development in the past ten years. Important amongst this is the development of Children and Young People’s Improved Access to Psychological Therapies (CYP-IAPT) which emphasizes evidence-based approaches, and the use of routine outcome measures. Whilst it is giving nurses increased access to training in cognitive behavioural therapies, systemic therapies and parenting therapies, it does not put much emphasis on the things which young people identify as important for young people in terms of engagement, or skills which have traditionally been seen as nursing strengths. This approach, and emphasis on generic skills, has implications for the identity of CAMHS nurses, who make up 40% of the CAMHS workforce (the largest single professional group). Whilst other professional groups have been careful to protect their professional identity, nursing within this speciality has not been so quick to assert its unique identity and contribution to care, so psychologists and psychiatrists have provided the main leadership within this speciality. Mental health and paediatric nursing priviledges the relational aspects of care which are important to children and young people, and should be in a better position to qualitatively enunciate the contribution that nurses make to CAMHS. This session will explore options for CAMHS nurses to better explain and value their contribution to care.

Valliammal Shanmugam

National Institute of Mental Health and Neuroscience, India

Title: Effect Of Massage Therapy to Improve Lung Function And reduce Anxiety Among Asthmatic Children

Biography:

Dr.Valliammal Shanmugam has completed her Ph.D at the age of 35 years. Currently working in College of nursing , NIMHANS- an Institiute of National Importance. She is holding the position of Head of the Nursing Research department & Subject Teacher in Pediatric Nursing for nursing students. She has published more than 30 papers in reputed journals and she serves has an editorial board member & peer reviewer of reputed nursing journals. She has organised more than 40 national & international conferences, workshops, seminars, symposium. She is a recognized PhD Nursing examiner in reputed universities in the country.

Abstract:

Worldwide childhood asthma appears to be increasing in prevalence despite considerable improvement in management and pharmacopeia. Asthma prevalence in children is expected to be twice in 2020. The aim of the study is to assess the effectiveness of massage therapy on lung function and anxiety among asthmatic children, carried out in two different tertiary care hospitals with 238 consecutive asthmatic children who are attending the outpatient department. Institutional ethical committee approval was obtained. Children between the age group of 8 – 12 years are diagnosed as asthma within 2 years was included in the study. By using Purposive Sampling technique, 238 samples were selected and are divided as 120 in study group and 118 in control group. An informed consent was obtained from the parents. Detailed history and the findings were recorded in a predesigned patient proforma. Initially, study group and control group children were assessed for Peak Expiratory Flow Rate, Forced Expiratory volume in one second, Forced Vital Capacity, Forced Expiratory Ratio by Microplus Spirometer. Heart Rate and Respiratory Rate was assessed manually and anxiety level was assessed by using Modified Spence Children Anxiety Scale. The study group children received intervention (Massage) for 20 minutes which includes hot pack application, Deep breathing exercises, Kneading, Thumb stroke, Effleurage, Friction, Raking which performed 20 30 minutes during bed time daily for a month. The mothers of asthmatic children were asked to observe the technique of massage therapy. Education film of massage therapy (CD), booklet for massage therapy and massage practice dairy which was developed by researcher was given. Mothers were instructed to do massage to their children for 20 minutes just before the bedtime for a month and they have reinforced to attend the hospital alternate week to share their views and perform massage in front of the investigator. On 15th day and 30th day lung function and anxiety was assessed by using the same tool. The findings showed a highly statistically significant difference between pretest and posttest lung function scores PEFR (F=380.69) FEV1 (F=578.86) FVC (F=653.12) FER (F=558.43) HR (F=78.61) and RR (679.20) at p=0.001 and negative correlation between anxiety and lung function scores among asthmatic children in study group. To conclude, massage therapy combined with standard treatment is more effective in children with asthma.

Tugce Torun

Hacettepe University, Turkey

Title: Examining Burnout and Job Satisfaction of Nurses Working in Pediatric Units

Biography:

TuÄŸçe TORUN is a Research Assistant in Pediatric Nursing Department at Hacettepe University, Ankara, Turkey. She worked in Kreiskrankenhaus Lörrach State Hospital-Germany between 2011- 2012. TORUN completed her Master Thesis : Examining Burnout and Job Satisfaction of Nurses Working in Pediatric Units. She continues the PhD. Program at the Hacettepe University.

Abstract:

This study was conducted to determine the levels of burnout and job satisfaction of pediatric nurses and the relationship between them. The study sample comprised of 235 nurses who were working at least 6 months in Children’s Hospital of Hacettepe University, and Sami Ulus Maternity and Children Hospital. The data were collected by sociodemographic data form, Maslach Burnout Inventory, and Minnesota Satisfaction Questionnaire. Independent-samples t test, One-Way Analysis of Variance and the Pearson Correlation test was used. Most of the nurses were female, married, bachelor and with no children. The mean scores in the burnout inventory are 20.0±6.89 for the subscale emotional burnout, 19.7±4.43 for the subscale personal accomplishment, and 5.7±3.38 for the subscale depersonalization and the mean scores of the general satisfaction for the job satisfaction questionnaire is 2.6±0.62. There was a significant relationship between each subscales of burnout and job satisfaction (p<0.05). The levels of depersonalization in the nurses who were not married and had no children were significantly high, the scores of extrinsic satisfaction of the women were significantly lower (p<0.05). The levels of burnout and job satisfaction did not change according to the education level of the nurses (p<0.05), but it was changed significantly according to their duties in the hospital, the ability of using their autonomy and the facts of using regular leaves per week (p<0.05. It is important to investigate the levels of burnout and job satisfaction of the nurses and the factors which affect them regularly and the working conditions should be improved.

Andrea Cevasco-Trotter

University of Alabama, USA

Title: Developmental music therapy programming for extremely low and low birth weight premature infants

Biography:

Andrea Cevasco-Trotter is the Director of Music Therapy and an Associate Professor at The University of Alabama. She researches the effects of developmental music therapy interventions on premature infants’ physiological and behavioral parameters. Dr. Cevasco’s work has been published in the Journal of Music Therapy, Music Therapy Perspectives, and Pediatric Nursing; recently, she has published several textbook chapters. She serves as a member of the Editorial Committee for the Journal of Music Therapy and Music Therapy Perspectives as well as on the Board of Directors for the Certification Board for Music Therapists.

Abstract:

Premature infants in the Neonatal Intensive Care Unit (NICU) are exposed to loud noises, bright lights, and medical procedures that inhibit necessary sleep for neurological growth and development. Since the 1990s, researchers found that music assists in pacifying infants. The purpose of this presentation is two-fold: 1) to describe evidence-based music therapy protocols that are designed to meet the developmental needs of premature infants in the NICU and provide positive outcomes, and 2) to describe the outcomes of a research study involving a developmental music therapy program, based on existing protocols, to enhance and expand music therapy services for infants in the NICU. This study was especially novel in that infants as young as 25 weeks post corrected age (PCA) received live music, recorded music was utilized once infants were 30 weeks and older, and music and multimodal stimulation (MMS) was implemented for infants once they were 32 weeks and older. Infants in the experimental group went home earlier 3.6 days sooner than infants in the control group; experimental infants weighing less than 1500 gram went home 13 days earlier than those in the control group. Analysis of oxygen saturation levels and heart rate prior to, during, and post music therapy indicate positive trends. Special emphasis will be placed on how music therapist can meet the needs of very low and extremely low birth weight infants.

Elaine Uppal

The University of Manchester, UK

Title: The Human Rights of Children with reference to Child Protection

Biography:

Elaine Uppal is a Senior Lecturer in Midwifery at the University of Manchester, UK. She is currently writing up her PhD thesis: ‘Interprofessional Learning in a Community of Child Protection Practice’. She has an interest in Child Protection and has co-authored a book: Powell, J. & Uppal, E. (2012) Safeguarding babies and Young Children for Early Years Professionals. Open University Press, Buckingham, UK.

Abstract:

It is imperative to place the needs and rights of children as the central concern. This paper will set the context of safeguarding practice in terms of the universal and targeted services available to improve the well-being of children and recognise and respond to indicators of abuse. This will be set within the legislative and policy framework to achieve a sense, not only of child protection services and processes but also the supportive services and measures that can be put in place for families to prevent abuse. Rights can be defined and adhered to differently depending upon context, location, interpretation and availability. Banks (2006: 104) emphasises the broad nature of the term, referring to a range of claims, liberties, powers and relationships. Meagher and Parton (2004: 24) suggest that justice and rights are compatible and even indispensable to each other. Justice and respect are noted as key components of social care practice (Orme, 2002; Banks, 2006). However justice in terms of an individual’s rights to care for example, is often necessarily balanced against the availability of resources and number of people in need in a form of distributive justice, meaning that needs are determined by service availability that may be incompatible with principles of social care (Orme, 2002; Fairbairn and Fairbairn, 1988). Balancing the needs of various individuals within a scenario is also a dilemma for practitioners, particularly within a safeguarding context where addressing parents or carers’ needs could impact positively on the care of children; however this must not be to the point of being detrimental to the child’s well-being.

Dina Kamal

Astoon Hospital, KSA.

Title: Detection of viral acute lower respiratory tract infection in hospitalized infants using real-time PCR

Biography:

Dina Kamal is an Assistant Professor of Pediatric Pulmonology, Cairo University working as a Pediatric consultant, Astoon Hospital, al khobar, KSA. She was graduated in 1998 from Department of Medicine, Cairo University. She continued her post graduate studies got my master degree from Cairo University at 2003 and joined the academic work as assistant lecturer, later as a lecturer in pediatrics at Cairo University. She continued her academic work at Cairo University and got M.D. Degree of Pediatric Pulmonology in October 2007. In 2012 she was promoted as an assistant professor in the department of pediatric pulmonology, Cairo University and up to now. She is interested in studying and teaching pulmonary function in infants and did a lot of studies in the field of pulmonary function in infants by using infant plethysmography and published a lot of research papers in the past few years.

Abstract:

Introduction Acute lower respiratory tract infection in children causes significant morbidity in the developing countries. Documentation of virus infection using PCR and clinical characteristics of patients affected with viral pneumonia are reviewed in this study. Methods 51 children less than three years admitted to the Pediatric Hospital, Cairo University with viral pneumonia were included. All patients had undergone nasopharyngeal aspirate for PCR viral detection. Results A total of 51 cases were enrolled in the study, of which 7 cases were negative while 44 children were positive for viruses. The most common respiratory virus was Rhinovirus in 32 patients (72.2%), then parainfluenza virus (PIV) in 12 (27.3%), of which subtypes PIV1 were 2 (4.5%), PIV3 were 5 (11.4%) and PIV4 were 5 (11.4%) cases. The third common viruses were respiratory syncytial virus (RSV) in 9 (20.5%) cases of which 3 (6.8%) were RSVA and 6 (13.6%) were RSVB and adenovirus in 9 cases (20.5%). Boca virus was found in 8 (18.2%) patients, corona virus 2 (4.5%) patients, H1N1 2 (4.5%) patients, enterovirus 2 patients (4.5%) and human metapneumovirus in one case (2.3%). Influenza B and PIV2 were not detected. Coinfection was found in 28 (63.7%). Mortality occurred in 12 (23.5%). There was no significant relation between virus type or coinfection with disease severity. Conclusions RV was the most commonly detected virus in children under 3 years admitted with acute lower respiratory tract infections. Coinfection was present in the majority of our patients; however it was not related significantly to parameters of disease severity.

Niang Hui Feng

National Yang-Ming University, Taiwan

Title: Evaluation of the Impact of Multi-Module Pediatric Palliative Care Training in Pediatric Clinicians

Biography:

National Yang-Ming University, Taiwan

Abstract:

A lack of knowledge of pediatric palliative care and the resulting lack of confidence in oneself may create hesitation in caring for dying children and their families. Few training programs focus specifically on pediatric palliative care and no multi-module training program in pediatric palliative care is available in Taiwan. Objectives: To examine the impact of multi-module pediatric palliative care training on pediatric clinicians. Methods: A quasi-experimental study provided educational training in pediatric palliative care to pediatric clinicians and used a pre-test and a post-test to assess outcomes. A multi-module pediatric palliative care training program was presented at a four-day training conference for clinicians in Taiwan, and all pediatricians and all pediatric nurses who completed the entire four-day training program were invited to participate. A questionnaire was used to assess different research goals. Results: Thirty-nine pediatric nurses and eleven doctors participated in this study for a response rate of 83.3%. Results showed a significant main effect (p =0.002) of training on confidence levels among pediatric clinicians in a variety of areas, including emotional support for clinicians, implementation of palliative care, ethical and legal issues, and emotional support for dying children and their families. Conclusion: Our research suggests that education program can effectively boost pediatric clinicians’ confidences regarding providing palliative care for children and their families. Further investigations are needed to evaluate the long-term effectiveness of an interdisciplinary and multifaceted training approach to pediatric palliative care training.

Chair

Josef Holzki

University Childrens Hospital, Belgium

Co-Chair

Arthur Engler

University of Connecticut, USA

Session Introduction

Heather L MacDonald

University of New Brunswick, USA

Title: FAIR Play: Respite for Parents Caring for Children Requiring Complex Home Care

Biography:

Dr. MacDonald completed a Master’s degree in Nursing at the University of Toronto, Canada and a PhD at the University of Manchester in the UK. Currently she is a Professor in the Faculty of Nursing at the University of New Brunswick (Canada). Dr. MacDonald’s doctoral work examined respite for parents who were caring for children who required complex care. This paper comes from that work. Dr. MacDonald has three children of her own.

Abstract:

Advances in nursing and medical care augmented by developments in pharmaceutical and health technologies have led to an increasing number of children who require complex care at home. Parents are their caregivers. In an attempt to learn more about this caregiving role and how the parents accessed respite an ethnographic study consisting of 47 participants: 19 mothers; 4 fathers; 7 grandparents, 13 nurses; and 4 social workers was undertaken. One of the key categories that emerged from the data was Fair Play. Data collection included in-depth interviews, participant observation, and a document review. All of the participants were interviewed using a question guide that resulted in a conversational approach. Participant observation occurred in the homes of the children as well as in respite facilities. Documents such as respite policies and the carers Act were reviewed in detail. Four themes emerged from the data: Parents Caring; Caring and the Impact on Parental Identity; The Nature of Respite; and Fair Play. Fair Play will be discussed here. According to the Oxford Dictionary Fair play means “reasonable treatment or behavior.” To the parents in this study Fair play was “a sense of give and take.” Fair play is a desired outcome in the struggle to provide respite care in an environment in which the rules are not only unspoken, but vary between the players; and where breaking the rules may provide more gains than being cooperative. The key categories within Fair play are: • Care Obligations • Feelings of Entitlement • Respite Information Needs • Ongoing Support Needs • Negotiating the System • Equity

Kendra Russell

Middle Georgia State University, USA

Title: Improving Health Care of Premature Infants with Non-invasive Nursing Interventions

Biography:

Dr. Kendra Russell serves as Associate Professor and Director of the Macon Graduate Center at Georgia College. She completed her BSN and MSN in Nursing Administration at Georgia College and Doctorate in Nursing at Georgia State University, Atlanta, Ga. Dr. Russell’s clinical background is in neonatal intensive care and pediatrics. Dr. Russell’s research focus is in maternal/infant outcomes and she has published and presented her research at local, state, national, and international conferences. She has eight years of administrative experience serving as a RN-BSN program coordinator, department chair – undergraduate nursing, and assistant director of nursing.

Abstract:

Bedside nurses are expected to translate the best research into practice to provide the highest quality and level of care. Premature births are a global issue with the highest rates occurring in countries with limited resources and high poverty. Although there have been slight improvements in these rates, medical care has focused on improving survivability. A number of these infants face deficits in vision, hearing, cognition, and musculoskeletal development. These deficits, especially in low birth weight (<2500 grams) and very low birth weight (<1500) infants, may have long term effects.exhibited in disorders such attention deficit disorder, learning disabilities. Neuroprotective care is a developing science and is an essential component of providing care that promotes, stability and regulation, brain development, and attachment. Research has shown promise in these areas and the results of two studies will be explored as well as future indications for non-invasive hemodynamic monitoring with premature infants. Practice aimed at providing support for optimal short and long-term outcomes will conversely decrease the morbidities continuing to occur within this vulnetable population.

Ashlea D. Cardin

Missouri State University, USA

Title: Use of the Neonatal Integrative Developmental Care Model to Transform Caregving Culture in the Neonatal Intensive Care Unit

Biography:

Dr. Ashlea Cardin has been a pediatric and neonatal occupational therapist at Mercy Kids Hospital, Springfield, MO, USA, for over 16 years. She is Board Certified in Pediatrics by the American Occupational Therapy Association, is certified to administer the Neonatal Oral Motor Assessment Scale, is designated as a Neonatal Developmental Care Specialist by the National Association of Neonatal Nurses, and serves as a consultant for Philips Healthcare’s Global Wee Care Program. Dr. Cardin is also an Assistant Professor of Occupational Therapy at Missouri State University, teaching pediatrics, research, and theory courses.

Abstract:

American author Leo Buscaglia once stated that “Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.” This quote rings especially true for skilled healthcare professionals working in the Neonatal Intensive Care Unit (NICU) setting. In preparation for the departure from an older, traditional open-bay NICU to a newly-designed unit comprised of single-family rooms, Mercy Kids Hospital (Springfield, Missouri, USA), NICU co-workers sought transformation: of caregiving attitudes, care practice, and outcomes for hospitalized infants and their families. Beyond identifying what equipment should be transferred to the new unit, team members in the NICU at Mercy-Springfield began examining what aspects of care should be transferred as well – or possibly left behind. NICU staff verbalized a desire to change not only the physical environment, but also their culture of caregiving by embarking on a journey toward improved neuroprotective family-centered developmentally supportive care. Utilizing the Neonatal Integrative Developmental Care Model (Altimier & Phillips, 2013) as a framework, Mercy-Springfield identified specific goals and aim statements within each of the model's seven core measures. The purpose of this presentation is to explicate how Mercy-Springfield used this model to (1) critically and honestly reflect on current care practice, and the (2) transform the NICU environment, increase family partnership in caregiving, improve positioning and handling practice, safeguard infant sleep, minimize infant stress and pain, protect skin integrity, and optimize nutrition.

Salah Thabit Al Awaidy

Ministry of Health, Oman

Title: Cost Effectiveness of a pentavalent rotavirus vaccine in Oman

Biography:

Dr Salah T. Al Awaidy is a Communicable Diseases Adviser in Health Affairs, Ministry of Health, Muscat, Oman. He is a medical doctor and holds a Master’s in Epidemiology. He is currently the adviser on Communicable Disease Surveillance, Elimination and Eradication of Communicable Diseases of Public Health Importance, EPI, vaccine supply chain system and IHR at the Ministry of Health, Oman. He was the Director of Communicable Disease Surveillance and Control at MoH, HQ, Oman between 1997-2011, IHR national focal point 2002-2013 and was a member in several of the professional committees namely: Strategic Advisory Group on Immunization (SAGE), WHO Geneva (2005-2007); Strategic Advisor Group on Vaccine and Store Management Training Courses (2005-2008), WHO Geneva; Strategic TB Advisory Board (STAG) 2007-2011 2014- till date.

Abstract:

Background: Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in Oman Methods: A Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives. Results: A universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective. Conclusions: Universal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal perspective.

Zehra AYDIN

Hitit University, Health School, Turkey

Title: Diagnostic levels of Mothers having Children between the age of 0-6 years about Taking Precautions against Home Accidents and the Effects of Training on Home Accidents

Biography:

Mrs. Zehra AYDIN was born in Iğdır, Turkey in 1986. She is a PhD student in Istanbul University Institute of Health Science. She has been working in Hitit University Health School since 2013.

Abstract:

This study was designed and carried out to determine the attitude of mothers with 0-6 years old children towards safety measures taken against home accidents and the effects of home accidents training on mothers’ knowledge level. The study has been carried out in the city of Çorum in Turkey between the dates of 20.11.14-03.03.15. 200 mothers who had kindergarten children in the age group of 0-6 and who agreed to take part in the study were included and constituted the study sample. The data of the study was collected by using Questionnaire Survey Data and applying the Scale for Identification of the Safety Measures Taken by Mothers to Prevent Home Accidents of Children in the 0-6 age group. It was determined that there is a statistically significant difference between the income level of mothers, family type, accident status of children and the obtained point average from the scale (p<0.01). While the scale point average before training (BT) was 70.95±13.41 the point average after training (AT) has been identified as 151.72±61.67. It was determined that the difference of point averages between BT and AT is statistically significant (p<0.001). The training for the prevention of home accidents provided to mothers has led to an increase in knowledge on this topic and it has been determined that mothers whose children had an accident before have gained experience as a result of those accidents. Therefore it is highly recommended to increase the awareness of mothers on the prevention of home accidents.

Guillermo Godoy

University of Alabama and DCH, USA

Title: Introduction to Pediatrics Bioethics

Biography:

Guillermo Godoy graduated from San Carlos University in Guatemala, the only Medical School at that time in Guatemala. He did a residency in Pediatrics at Roosevelt Hospital and again when he came to United States of America, he repeated a Pediatrics residency at The University of Arkansas Medical Sciences/Arkansas Children's Hospital from 1980 to 1982. Then he did his Perinatal Medicine-Neonatology fellowship at The University of Alabama in Birmingham from 1982 to 1985 and stayed on the Neonatology staff for one year. He is in Tuscaloosa, Alabama at the DCH Health System NICU's since 1986. He is an Associate Professor of Pediatrics and Obstetrics at The University of Alabama, Tuscaloosa. He was Chairman of the Pediatrics Department and the Chief of Medical Staff. He helped to establish the Ethics Committee at the DCH Health System Hospitals in 1987. He published many manuscripts, especially in the areas of neonatal infections and cardiopulmonary pathophysiology. He have been invited to lecture about these topics in several institutions. He is actively involved in the development of CPOE/EMR and electronic progress notes at his institution.

Abstract:

Before we tackle the specific clinical problems and situations in the neonatal population, I will highlight the principles and most common thoughts to deal with them in an appropriate, systematic and standardized manner. The Ethical problems in the Neonatal Intensive Care setting have increased as the therapies and procedures have become more invasive, more technical and more expensive. The ethical dilemmas vary depending on the population studied. We will discuss these factors that individualize how we make decisions in the NICU.

Nasim Al-Sebai

Emirates college of Technology, UAE

Title: Nutritional Pharmacology of Taurine in Pediatric Nursing and Healthcare

Biography:

Nasim Alsebai MD, pediatric surgeon, anatomist, researcher and lecturer,I have graduated from Faculty of Medicine - Aleppo University at the age of 22,I have done the Pediatric Surgery Residency Training in Syria from Aleppo University Hospital - Faculty of Medicine where I got the master degree in Surgery - Pediatric Surgery, and this followed by Master of Science degree in Human Anatomy from the Anatomy Department - Aleppo University. I am currently working as an Anatomy lecturer in the College of Medical & Health Sciences in Emirates College of Technology, Abu Dhabi. I have worked in UAE over the last years in both clinical and faculty positions. I am actively involved in clinical research and academic publications.

Abstract:

There is no dietary requirement for taurine, since the body can make it out of vitamin B6 and the amino acids methionine and cysteine. Taurine found in high concentration levels in various tissues of humans, Including in the nervous system and muscles, taurine is one of the most abundant amino acid derivatives in the body. It is thought to help regulate heartbeat, maintain cell membranes, and affect the release of neurotransmitters (chemicals that carry signals between nerve cells) in the brain. Deficiencies occasionally occur in vegetarians, whose diets may not provide the building blocks for making taurine, one of the building blocks of proteins. Taurine conjugates with bile acids to form bile salts that are needed for fatty acid absorption. Although glycine can also conjugate with bile acids, taurine conjugates predominate in human milk fed preterm infants during early infancy. Taurine insufficiency is associated with impaired bile acid secretion, reduced absorption or fat and fat-soluble vitamins (particularly vitamin D), abnormal hepatic function, and hepatic cholestasis associated with prolonged administration of parenteral nutrition in preterm infants. Evidence exists that taurine has important roles in intestinal fat absorption, hepatic function, and auditory and visual development in preterm or low birth weight infants. Observational data suggest that relative taurine deficiency during the neonatal period is associated with adverse long-term neurodevelopmental outcomes in preterm infants. Taurine is also reported to improve maturation of ABER in pre-term infants and has a role in osmoregulation of CNS and may act as neuroinhibitor. Taurine is the most abundant free amino acid in breast milk in the human. Indeed, It is reported that the cows' milk samples were relatively low in taurine compared to the breast milk samples of human. Also it suggested that taurine plays an important role in learning, Therefore, we suggest that taurine supplementation for preterm or low birth weight infants on growth and development should be taken in considerations

Priscila Costa

Federal University of Sao Paulo, Brazil

Title: What are some of the nursing challenges? Before PICC insertion: Can PICC-related complications be predicted?

Biography:

Pricilla

Abstract:

Advances in neonatal intensive care have improved the survival rates of severely ill preterm newborns. This population usually requires a safe vascular access in order to infuse parenteral nutrition, intravenous fluids, and medications such as antibiotics. Nurses are constantly challenged to improve methods of safe and consistent vascular access for this vulnerable population. The frequent use of percutaneously inserted central catheters (PICC) requires evidence to inform best practices for nurses. What are some of the nursing challenges? Before PICC insertion: Can PICC-related complications be predicted? Some studies1,2,3 identified predictors of unplanned removal of PICC lines in infants. The early recognition of these predictors provides evidence for nurses to implement preventative measures in order to decrease catheter-related complications, medical costs, mortality and suffering of the infant and his family. A risk score with an accuracy of 0.76 was developed combing some predictors of unplanned removal. The risk score was made up of the following risk factors: transient metabolic disorders, previous insertion of catheter, use of a polyurethane double-lumen catheter, infusion of multiple intravenous solutions through a single-lumen catheter, and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points)3. During PICC insertion: what are the strategies for pain management? PICC insertion results in a pain response of moderate to severe intensity4. However, measures for the relief of pain caused by the procedure are uncommon in neonatal care. A study showed that analgesic or sedative strategies occurred in only 34.6% of catheter placements. Non-pharmacological strategies such as oral sucrose or non-nutritive sucking were adopted in only 2.4% of the procedures5. After PICC insertion: should nurses verify tip position? It is known that the best location for the tip of a PICC is the lower third of the superior vena cava (SVC), close to the SVC-RA junction. However catheter tip can be located at noncentral positions, such as axillary, subclavian, brachiocephalic, or iliac veins. Considering that identifying catheter´s tip, and a frequent monitoring of noncentral PICCs are necessary to detect and prevent catheter-related complications such as extravasation and thrombosis, it is crucial enable nurses to verify tip position at radiography. Nurses can use the thoracic vertebral bodies (T) and the carina as anatomical landmarks to determine the location of the catheter tip on radiographs. The catheter tip is considered to be located at the subclavian vein if it was located at the T1 level, brachiocephalic vein at the T2 level, superior vena cava at the T3-T5 level, superior vena cava-right atrium junction at the T6 level, or at two vertebral bodies under the carina and at the right atrium if it was located at the T7 to T8 level. It can be considered to be at the inferior vena cava if it is located at the T9 to T10 level and at the iliac vein if it is below the T9 to T10 level. Another aspect of interest is the prevalence of noncentral PICCs. A study showed that 12.6% of the catheters were placed in noncentral veins, such as subclavian vein (10.1%), iliac vein (1.7%), and the axillary vein (0.9%) PICCs6. Conclusion The use of standardized evidence based care practice checklists, bundled care practices, and a dedicated PICC team should be encouraged to improve nursing quality of care worldwide.

Chair

Heather L MacDonald

University of New Brunswick, Canada

Co-Chair

Hee Yun Lee

University of Minnesota, USA

Session Introduction

Niang-Huei Peng

National Yang-Ming University, Taiwan

Title: Evaluation of the Impact of Multi-Module Pediatric Palliative Care Training in Pediatric Clinicians

Biography:

Dr. Niang-Huei Peng is an Assistant Professor at National Yang-Ming University, Taipei City, in Taiwan. Her professional major is pediatric nursing care, and minor major is neonatal nursing care. Her major research areas are as follows: 1.Improvement the Neonatal/ Pediatric palliative care in Taiwan 2.Exploration the Stress Responses of Preterm Infant in NICU 3.To Explore the Energy Expenditure in Preterm Infants during Periods of Environmental Stress in Neonatal Intensive Care Unit. 4.An Innovation of apparent of automatic audio and vibrotactile stimuli for interrupting apenic episodes in preterm infants She has published different research papers regarding above research topics and has been serving as an editorial board member of the Palliative Medicine & Nursing: Open Access.

Abstract:

Background: A lack of knowledge of pediatric palliative care and the resulting lack of confidence in oneself may create hesitation in caring for dying children and their families. Few training programs focus specifically on pediatric palliative care and no multi-module training program in pediatric palliative care is available in Taiwan. Objectives: To examine the impact of multi-module pediatric palliative care training on pediatric clinicians. Methods: A quasi-experimental study provided educational training in pediatric palliative care to pediatric clinicians and used a pre-test and a post-test to assess outcomes. A multi-module pediatric palliative care training program was presented at a four-day training conference for clinicians in Taiwan, and all pediatricians and all pediatric nurses who completed the entire four-day training program were invited to participate. A questionnaire was used to assess different research goals. Results: Thirty-nine pediatric nurses and eleven doctors participated in this study for a response rate of 83.3%. Results showed a significant main effect (p =0.002) of training on confidence levels among pediatric clinicians in a variety of areas, including emotional support for clinicians, implementation of palliative care, ethical and legal issues, and emotional support for dying children and their families. Conclusion: Our research suggests that education program can effectively boost pediatric clinicians’ confidences regarding providing palliative care for children and their families. Further investigations are needed to evaluate the long-term effectiveness of an interdisciplinary and multifaceted training approach to pediatric palliative care training.

Marie Wilhsson

Halmstad University, Sweden

Title: Handling demands on success ‐ a conceptual model of adolescents’ coping with everyday life from a gender perspective

Biography:

Marie Wilhsson, Halmstad University, School of Social and Health Sciences.

Abstract:

Stress among adolescents in Western societies is becoming an issue of increasing concern and the global trend of adolescents health shows a gradual deterioration that is independent of national differences and increases with age (Currier et al, 2012). Research shows that many adolescents report high levels of stress, associated with a change in expectations about performance and an increased focus on school results (Schraman et al, 2011; Moknes et al, 2014). Purpose/methods The aim of this study was to explore the main concern of adolescents to get a deeper knowledge on how they cope with demands in everyday life. Grounded theory was used as a method to generate a model. Results The core category “striving to be successful and to succeed” explains participants main concern in their everyday lives as a continuous process aiming for success in the present and to succeed throughout their lives. The category is what the participants describe as a race against time and can be divided into the two conceptual categories “struggling with time” and “separating life into different worlds”, pronouncing how they struggle and cope with their main concern in order to obtain wellbeing. Our results show a difference between how girls and boys cope with their demands. Conclusions We show that girls and boys used different strategies to cope with stress in their everyday life. The results are based on adolescent’s experiences and are therefore an important contribution for initiating interventions aimed at promoting adolescents mental health from a gender perspective.

Chair

Josef Holzki

University Childrens Hospital, Belgium

Co-Chair

Arthur Engler

University of Connecticut, USA

Session Introduction

Kendra Russel

Georgia College & State University, USA

Title: Improving Health Care of Premature Infants with Non-invasive Nursing Interventions

Biography:

Dr. Kendra Russell serves as Associate Professor and Director of the Macon Graduate Center at Georgia College. She completed her BSN and MSN in Nursing Administration at Georgia College and Doctorate in Nursing at Georgia State University, Atlanta, Ga. Dr. Russell’s clinical background is in neonatal intensive care and pediatrics. Dr. Russell’s research focus is in maternal/infant outcomes and she has published and presented her research at local, state, national, and international conferences. She has eight years of administrative experience serving as a RN-BSN program coordinator, department chair – undergraduate nursing, and assistant director of nursing.

Abstract:

Bedside nurses are expected to translate the best research into practice to provide the highest quality and level of care. Premature births are a global issue with the highest rates occurring in countries with limited resources and high poverty. Although there have been slight improvements in these rates, medical care has focused on improving survivability. A number of these infants face deficits in vision, hearing, cognition, and musculoskeletal development. These deficits, especially in low birth weight (<2500 grams) and very low birth weight (<1500) infants, may have long term effects.exhibited in disorders such attention deficit disorder, learning disabilities. Neuroprotective care is a developing science and is an essential component of providing care that promotes, stability and regulation, brain development, and attachment. Research has shown promise in these areas and the results of two studies will be explored as well as future indications for non-invasive hemodynamic monitoring with premature infants. Practice aimed at providing support for optimal short and long-term outcomes will conversely decrease the morbidities continuing to occur within this vulnetable population.

Arthur J. Engler

University of Connecticut, USA

Title: Effectiveness of a perinatal and pediatric End-of-Life Nursing Education Consortium (ELNEC) curricula integration

Biography:

Dr. Engler completed his PhD in nursing in 1999 at the Catholic University of America in Washington DC. He has been on the faculty of the University of Connecticut School of Nursing in the U.S. since that time. He is the coordinator of the undergraduate pediatric nursing program and the author of numerous papers on pediatric and neonatal nursing.

Abstract:

Background: Educational practices and national guidelines for best practices of providing palliative care to children and their families have been developed and are gaining support; however, the dissemination of those practices lags behind expectations. Incorporating education for pediatric palliative care into nursing pre-licensure programs will provide guidelines for best practices with opportunities to enact them prior to graduation. Objective: To evaluate the effect of an integrated curriculum for palliative care on nursing students' knowledge. Design: Matched pretest–posttest. Setting: One private and one public university in the northeastern United States. Participants: Two groups of baccalaureate nursing students, one exposed to an integrated curriculum for palliative care and one without the same exposure. Methods: Pre-testing of the students with a 50-item multiple choice instrument prior to curriculum integration and post-testing with the same instrument at the end of the term. Results: This analysis demonstrated changes in knowledge scores among the experimental (n = 40) and control (n = 19) groups that were statistically significant by time (Wilks' Lambda = .90, F(1, 57) = 6.70, p = .012) and study group (Wilks' Lambda = .83, F(1, 57) = 11.79, p = .001). Conclusions: An integrated curriculum for pediatric and perinatal palliative and end-of-life care can demonstrate an increased knowledge in a small convenience sample of pre-licensure baccalaureate nursing students when compared to a control group not exposed to the same curriculum. Future research can examine the effect on graduates' satisfaction with program preparation for this specialty area; the role of the use of the curriculum with practice-partners to strengthen transfer of knowledge to the clinical environment; and the use of this curriculum inter-professionally.

Sunil Jatana

Melaka Manipal Medical College, Malaysia

Title: Controlled Oxygen Therapy To Neonates By Oxygenhood In The Absence Of Oxygen Analyser

Biography:

He has done MBBS and Post-graduation (MD) in Paediatrics, from Armed Forces Medical College, Poona University, India. He has served in various teaching and other hospitals of Armed Forces, India for 36 years followed by Professor Paediatrics in D. Y. Patil Medical College, Pune, India and currently working as Professor Paediatrics in Melaka Manipal Medical College, Malaysia. He is a recognized Undergraduate & Postgraduate Teacher and examiner MBBS, DCH & MD of various universities in India. He was the executive editor of Medical Journal Armed Forces India in the past & and is a referee for 2 Medical Journals in India. He has published 15 papers and presented many papers and chaired scientific sessions in National conferences. He is a member of Indian Academy of Paediatrics and has been a Member of Executive Board, Indian Academy of Paediatrics in 2011. undergraduate pediatric nursing program and the author of numerous papers on pediatric and neonatal nursing.

Abstract:

Background: A study was conducted to evaluate and to evolve a system of standardizing the oxygen concentration inside the oxygen hood and to develop guidelines for controlled FiO2 administration by changing size of the hood, lid position on the hood and the oxygen flow rate, without an oxygen analyzer. The effect of low flow rates on carbon dioxide (CO2) retention inside the head box was also studied. Design settings & method: A dummy patient and thirty neonates, requiring oxygen to be delivered through head box, constituted the material for the study group. Oxygen content in the head box was measured using a standard oxygen analyzer while the size of head box; flow rate and lid position were changed independently and in combination. The head boxes were tested on a dummy patient. These results were analyzed, a general guideline derived, and were applied to thirty neonates requiring oxygen therapy using head box. Multiple readings were taken. Data thus collected was tabulated, statistically analyzed, and appropriate conclusions drawn. Results: Volume of headbox had an inverse relation with the oxygen concentration inside the headbox. A smaller sized headbox achieved better & more predictable oxygen concentration at all flow rates. Maximum difference in oxygen concentration by varying the lid position was observed in the large headbox. Keeping the variables constant, oxygen concentration was lower in babies as compared to dummy, which is statistically significant. No significant CO2 retention was found at flow rate of 4 L/pm in a small & 3 L/pm in a medium & large head box respectively. Conclusion: It is possible to predict the oxygen concentration inside the head box depending upon various variables without the use of oxygen analyzer. Larger the size of the head box and higher the lid position, lesser the oxygen concentration achieved at a given oxygen flow rate. Oxygen concentration achieved in babies is lesser than the concentration achieved in a dummy. Flow rates of less than 4L/pm in small & 3 L/pm in medium & large sized head boxes are associated with CO2 retention.

Dina Kamal Mostafa

Astoon Hospital, Saudi Arabia

Title: Detection of viral acute lower respiratory tract infection in hospitalized infants using real-time PCR

Biography:

Dina Kamal is an Assistant Professor of Pediatric Pulmonology, Cairo University working as a Pediatric consultant, Astoon Hospital, al khobar, KSA. She was graduated in 1998 from Department of Medicine, Cairo University. She continued her post graduate studies got my master degree from Cairo University at 2003 and joined the academic work as assistant lecturer, later as a lecturer in pediatrics at Cairo University. She continued her academic work at Cairo University and got M.D. Degree of Pediatric Pulmonology in October 2007. In 2012 she was promoted as an assistant professor in the department of pediatric pulmonology, Cairo University and up to now. She is interested in studying and teaching pulmonary function in infants and did a lot of studies in the field of pulmonary function in infants by using infant plethysmography and published a lot of research papers in the past few years.

Abstract:

Introduction Acute lower respiratory tract infection in children causes significant morbidity in the developing countries. Documentation of virus infection using PCR and clinical characteristics of patients affected with viral pneumonia are reviewed in this study. Methods 51 children less than three years admitted to the Pediatric Hospital, Cairo University with viral pneumonia were included. All patients had undergone nasopharyngeal aspirate for PCR viral detection. Results A total of 51 cases were enrolled in the study, of which 7 cases were negative while 44 children were positive for viruses. The most common respiratory virus was Rhinovirus in 32 patients (72.2%), then parainfluenza virus (PIV) in 12 (27.3%), of which subtypes PIV1 were 2 (4.5%), PIV3 were 5 (11.4%) and PIV4 were 5 (11.4%) cases. The third common viruses were respiratory syncytial virus (RSV) in 9 (20.5%) cases of which 3 (6.8%) were RSVA and 6 (13.6%) were RSVB and adenovirus in 9 cases (20.5%). Boca virus was found in 8 (18.2%) patients, corona virus 2 (4.5%) patients, H1N1 2 (4.5%) patients, enterovirus 2 patients (4.5%) and human metapneumovirus in one case (2.3%). Influenza B and PIV2 were not detected. Coinfection was found in 28 (63.7%). Mortality occurred in 12 (23.5%). There was no significant relation between virus type or coinfection with disease severity. Conclusions RV was the most commonly detected virus in children under 3 years admitted with acute lower respiratory tract infections. Coinfection was present in the majority of our patients; however it was not related significantly to parameters of disease severity.

Ashela D Cardin

Missouri State University, USA

Title: Use of the Neonatal Integrative Developmental Care Model to Transform Caregving Culture in the Neonatal Intensive Care Unit

Biography:

Dr. Ashlea Cardin has been a pediatric and neonatal occupational therapist at Mercy Kids Hospital, Springfield, MO, USA, for over 16 years. She is Board Certified in Pediatrics by the American Occupational Therapy Association, is certified to administer the Neonatal Oral Motor Assessment Scale, is designated as a Neonatal Developmental Care Specialist by the National Association of Neonatal Nurses, and serves as a consultant for Philips Healthcare’s Global Wee Care Program. Dr. Cardin is also an Assistant Professor of Occupational Therapy at Missouri State University, teaching pediatrics, research, and theory courses.

Abstract:

American author Leo Buscaglia once stated that “Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.” This quote rings especially true for skilled healthcare professionals working in the Neonatal Intensive Care Unit (NICU) setting. In preparation for the departure from an older, traditional open-bay NICU to a newly-designed unit comprised of single-family rooms, Mercy Kids Hospital (Springfield, Missouri, USA), NICU co-workers sought transformation: of caregiving attitudes, care practice, and outcomes for hospitalized infants and their families. Beyond identifying what equipment should be transferred to the new unit, team members in the NICU at Mercy-Springfield began examining what aspects of care should be transferred as well – or possibly left behind. NICU staff verbalized a desire to change not only the physical environment, but also their culture of caregiving by embarking on a journey toward improved neuroprotective family-centered developmentally supportive care. Utilizing the Neonatal Integrative Developmental Care Model (Altimier & Phillips, 2013) as a framework, Mercy-Springfield identified specific goals and aim statements within each of the model's seven core measures. The purpose of this presentation is to explicate how Mercy-Springfield used this model to (1) critically and honestly reflect on current care practice, and the (2) transform the NICU environment, increase family partnership in caregiving, improve positioning and handling practice, safeguard infant sleep, minimize infant stress and pain, protect skin integrity, and optimize nutrition.

Francis J DiMario

The University of Connecticut, USA

Title: Paroxysmal non-epileptic events in childhood

Biography:

Dr DiMario completed his M.D. at Tufts University and his M.A. in Adult Education from the University of Connecticut. His academic focus is in clinical teaching and conducting research in children with non-epileptic paroxysmal disorders and neurocutaneous diseases. He has authored over 100 peer-reviewed publications and the textbook, Non-Epileptic Childhood Paroxysmal Disorders, Oxford University Press. He has received multiple outstanding teacher awards, has served on the editorial boards of Pediatrics and J Child Neurology, the medical advisory boards for the National Tuberous Sclerosis Alliance, Epilepsy Foundation of America, and is a reviewer for numerous pediatric and neurological journals. He is an active member of the; CNS, AAP, AAN, ANA and SPR.

Abstract:

This is a review of some of the spells of childhood, which are often erroneously thought to be seizures. The initial segment of the presentation will provide the listener with a format and clinical approach toward best categorizing an entity being described by any forlorn parent. Specific case descriptions and video examples are provided for clarity and diagnostic assessment. This will be followed by a thoughtful discussion of the examples provided. The goal is to help clinicians better distinguish between non-epileptic and epileptic events by reviewing commonalities and differences between the two. These events are common in any pediatric practice and well worth knowing. This presentation can be augmented by use of the author’s accompanying textbook and related publications.

Chair

Sunil K Jatana

Melaka Manipal Medical College, Malaysia

Co-Chair

Laurence Baldwin

Coventry University, UK

Session Introduction

Carol Chamley

Coventry University, UK

Title: Leading -edge Realism Across Pedagogical Boundaries: Transforming Learning through Augmented Reality for Professional Practice in Contemporary Paediatric Orthopaedic and Trauma Care

Biography:

Currently working as Senior Lecturer /Nurse Researcher at Coventry University and a clinical background inatri paedic trauma orthopaedics, neurology and infectious diseases including caring for children with HIV and AIDS, having trained as a paediatric nurse at Great Ormond Street London. Currently being engaged in several post -doctoral research projects including Compassionate Practice Education, Disruptive Media, CAMHs, Values Exchange and Recruiting to Values having successfully worked on a collaborative service improvement project between Coventry University and University Hospitals Coventry and Warwickshire Children’s Emergency Department.

Abstract:

Paediatric orthopaedics is a highly specialized and distinctive field of paediatric practice. This contemporary module aimed to evaluate critically, evidence-based care and management associated with paediatric orthopaedic and traumatic conditions, including rehabilitation and future –focused transitional care. Developed collaboratively with senior clinicians, nurses, academics and learning technologists this innovative module sought to deliver high quality professional evidence-based education. The pedagogical strategy proposed to blend traditional teaching approaches with up-to-date and leading edge technology which actively and rapidly engaged students, whereby learning is enhanced in real-time, promptly immersing students with deeper involvement in situated learning experiences. Therefore first generation users have been introduced to ‘Augmented Reality’ during the delivery of this post registration Paediatric Orthopaedic and Trauma Module. Augmented Reality was co-constructed collaboratively as a pedagogical strategy which reflects a direct or indirect view of a physical real-world environment mediated through the use of mobile technology. Visual elements were augmented by computer, generating sensory inputs aiming to enrich learning through real-world visualization and understanding of related paediatric trauma and orthopaedic conditions such as musculo-skeletal anatomy, blood flow, fractures and images. By ‘tapping’ hot spots’ on manikin images these could be manipulated to zoom in or rotate, coupled with associated video clips, MCQ and text, all of which strengthen and deepen learning for clinical practice. In essence Augmented Reality provided rich details normally hidden in one dimensional images or text and by crafting existing images and blending new information thus reflecting ‘leading edge realism techniques’. Furthermore in-virtuo learning prepares students/practitioners for professional life whereby they can be exposed to quite complex learning and skills safely.

Laurence Baldwin

Coventry University, UK

Title: Does the rise of metrics in UK healthcare threaten or offer opportunities for nursing identity in child and adolescent mental health?

Biography:

Laurence Baldwin is a Senior Lecturer in Mental Health Nursing at Coventry University, and leads the Children and Young People’s Neurodevelopmental Team at Derbyshire Healthcare Trust. He completed his PhD at the University of Nottingham, and was previously a Consultant Nurse for Child and Adolescent Mental Health Services in Derbyshire, England. He has published several papers and chapters and been involved in multi disciplinary and community-based participatory research projects. His work for the Royal College of Nursing included representing nursing on the CAMHS Ministerial Taskforce which published the influential ‘Future In Mind’ report in March 2015.

Abstract:

Child and adolescent mental health services (CAMHS) within the UK National Health Service have often been seen as a ‘Cinderella service’ but due to increasing pressure and attention have received much more policy development in the past ten years. Important amongst this is the development of Children and Young People’s Improved Access to Psychological Therapies (CYP-IAPT) which emphasizes evidence-based approaches, and the use of routine outcome measures. Whilst it is giving nurses increased access to training in cognitive behavioural therapies, systemic therapies and parenting therapies, it does not put much emphasis on the things which young people identify as important for young people in terms of engagement, or skills which have traditionally been seen as nursing strengths. This approach, and emphasis on generic skills, has implications for the identity of CAMHS nurses, who make up 40% of the CAMHS workforce (the largest single professional group). Whilst other professional groups have been careful to protect their professional identity, nursing within this speciality has not been so quick to assert its unique identity and contribution to care, so psychologists and psychiatrists have provided the main leadership within this speciality. Mental health and paediatric nursing priviledges the relational aspects of care which are important to children and young people, and should be in a better position to qualitatively enunciate the contribution that nurses make to CAMHS. This session will explore options for CAMHS nurses to better explain and value their contribution to care.

Valliammal Shanmugam

National Institute of Mental Health and Neurosciences, India

Title: Effect Of Massage Therapy to Improve Lung Function And reduce Anxiety Among Asthmatic Children

Biography:

Dr.Valliammal Shanmugam has completed her Ph.D at the age of 35 years. Currently working in College of nursing , NIMHANS- an Institiute of National Importance. She is holding the position of Head of the Nursing Research department & Subject Teacher in Pediatric Nursing for nursing students. She has published more than 30 papers in reputed journals and she serves has an editorial board member & peer reviewer of reputed nursing journals. She has organised more than 40 national & international conferences, workshops, seminars, symposium. She is a recognised Ph.D Nursing examiner in reputed universities in the country.

Abstract:

Worldwide childhood asthma appears to be increasing in prevalence despite considerable improvement in management and pharmacopeia. Asthma prevalence in children is expected to be twice in 2020. The aim of the study is to assess the effectiveness of massage therapy on lung function and anxiety among asthmatic children, carried out in two different tertiary care hospitals with 238 consecutive asthmatic children who are attending the outpatient department. Institutional ethical committee approval was obtained. Children between the age group of 8 – 12 years are diagnosed as asthma within 2 years was included in the study. By using Purposive Sampling technique, 238 samples were selected and are divided as 120 in study group and 118 in control group. An informed consent was obtained from the parents. Detailed history and the findings were recorded in a predesigned patient proforma. Initially, study group and control group children were assessed for Peak Expiratory Flow Rate, Forced Expiratory volume in one second, Forced Vital Capacity, Forced Expiratory Ratio by Microplus Spirometer. Heart Rate and Respiratory Rate was assessed manually and anxiety level was assessed by using Modified Spence Children Anxiety Scale. The study group children received intervention (Massage) for 20 minutes which includes hot pack application, Deep breathing exercises, Kneading, Thumb stroke, Effleurage, Friction, Raking which performed 20 30 minutes during bed time daily for a month. The mothers of asthmatic children were asked to observe the technique of massage therapy. Education film of massage therapy (CD), booklet for massage therapy and massage practice dairy which was developed by researcher was given. Mothers were instructed to do massage to their children for 20 minutes just before the bedtime for a month and they have reinforced to attend the hospital alternate week to share their views and perform massage in front of the investigator. On 15th day and 30th day lung function and anxiety was assessed by using the same tool. The findings showed a highly statistically significant difference between pretest and posttest lung function scores PEFR (F=380.69) FEV1 (F=578.86) FVC (F=653.12) FER (F=558.43) HR (F=78.61) and RR (679.20) at p=0.001 and negative correlation between anxiety and lung function scores among asthmatic children in study group. To conclude, massage therapy combined with standard treatment is more effective in children with asthma.

Salah Thabit Al Awaidy

Ministry of Health, Oman

Title: Cost Effectiveness of a pentavalent rotavirus vaccine in Oman

Biography:

Dr Salah T. Al Awaidy is a Communicable Diseases Adviser in Health Affairs, Ministry of Health, Muscat, Oman. He is a medical doctor and holds a Master’s in Epidemiology. He is currently the adviser on Communicable Disease Surveillance, Elimination and Eradication of Communicable Diseases of Public Health Importance, EPI, vaccine supply chain system and IHR at the Ministry of Health, Oman. He was the Director of Communicable Disease Surveillance and Control at MoH, HQ, Oman between 1997-2011, IHR national focal point 2002-2013 and was a member in several of the professional committees namely: Strategic Advisory Group on Immunization (SAGE), WHO Geneva (2005-2007); Strategic Advisor Group on Vaccine and Store Management Training Courses (2005-2008), WHO Geneva; Strategic TB Advisory Board (STAG) 2007-2011 2014- till date.

Abstract:

Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in Oman Methods: A Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives. Results: A universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective. Conclusions: Universal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal perspective.

Khalid Elawad

Clinical Affairs Department, Qatar

Title: The impact of a robust infection control protocol in high risk primary healthcare settings in the prevention of healthcare MERS - CoV outbreaks in Qatar, 2012 - 2015

Biography:

Dr Khalid Elawad has completed his MBBS at the age of 28 years from liviv medical institute in Ukraine and postgradute diploma in public health studies from Algazira University School of Medicine. After that he did his M.Sc. in applied public health (09/2009-11/ 2011) University of Wales Institute Cardiff, United Kingdom. From 2011 he is registered as fellow of the Royal Society for Public Health (RSPH) in United Kingdom. Now He is Public health consultant working as Acting manager of communicable disease control and infection prevention and control PHCC in the primary health care corporation Doha, Qatar. He has published more than 4 books in health promotion and communicable diseases prevention.

Abstract:

The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is an emerging infection that causes severe illness in patients, particularly those with comorbidities; and has a high mortality rate. Healthcare associated outbreaks have been reported across the Gulf region and the Republic of Korea. While there have been cases of MERS-CoV in Qatar, no healthcare associated outbreaks have been reported. The aim of this paper is to give a description of the infection prevention and control protocol implemented by the Primary Health Care Corporation to manage suspected or probable cases of MERS-CoV in the primary health care setting. This paper focuses on Alshahania Health Centre which is considered to be a high risk area due to its proximity to the camel shelter and race track. In order to gain an understanding of how patients visiting the health center are managed. Data was collected through a visit to the Alshahania Health Centre which included discussions with staff and documentation review. Our findings show that the infection control protocol implemented at Alshahania Health Centre is very robust and ensures that staff has clearly defined responsibilities in the management of a suspected case of MERS-CoV. A dedicated Isolation Team ensures a timely risk assessment is carried out which then triggers actions that reduce the risk of exposure to both patients and staff. The experience at Alshahania Health Centre also demonstrates that good communication and leadership are important factors in order to successfully embed infection control in clinical practice and prevent healthcare associated outbreaks of MERS-CoV.

Santosh Mahindrakar

All India Institute of Medical Sciences, India

Title: Pediatric falls and trauma scores: are they associated?

Biography:

Mr. Santosh (Registered Nurse), 31 years of age is a PhD student at Department of Trauma Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi. He has completed his Master in Community Health Nursing (2010) and Masters in Public Health (2014). He has qualified for National Eligibility Test (NET) in Preventive and Social Medicine in year 2010 and DAAD Fellow in November – December 2014. He served as a research assistant in Towards Improving Trauma Care Outcome (TITCO) in India. He served as a faculty in different nursing institute in varying capacity as clinical instructor to assistant professor.

Abstract:

Unintentional injuries are the major cause of death among pediatric age group. Fall is a major contributor in unintentional injuries, a minor fall may cause a major head injury among the children. Hence this study is aimed to study the association of vital signs and trauma scores to their outcome following fall. Methodology: Data was retrieved from a prospectively maintained trauma registry at a level 1 trauma centre, New Delhi for a period of 1st October 2013 to 15th September 2015. It included all admitted multiple injury patients from emergency department and also who died between arrivals to admission. Patients with single long bone injuries and brought dead were excluded. The data were further analyzed using SPSS 23. Results: There were 4692 samples, among them 7.5% (353) were from pediatric age below 13 years and all of them were unintentional injuries. Majority (65.2%) had history of fall, followed by (27.5%) road traffic accidents. Among the fall, 67.8% were male, with mean age of 4.4±3 years and 47.8% of them were between age group of 0-3. On presentation 30% of them had GCS ≤ 8, 34.3% were intubated on arrival. In this cohort, mean values of oxygen saturation (93.9±17), respiratory rate (19.5±18 per minute), heart rate (107±29 beats/minute), and systolic blood pressure (105.8±22 mm of Hg). Among these only systolic blood pressure was statistically associated with outcome (P=.025). Mean ISS, NISS and RTS were 11.12±6.22, 16.92±8.8 and 6.7547±1.518 respectively. Among these RTS was statistically associated with outcome. Total mortality was 14.8% and was highest (25.9%) among infants followed by (19.3%) toddlers and least (6.9%) were school going age (6-12 years). Conclusion: Systolic blood pressure on arrival and RTS were statistically associated with the outcome in the group of pediatric patients arriving with fall.  

Alok Kumar

Mayo University Hospital, Ireland

Title: REDUCING WAITING TIME FOR CHILDREN IN ACCIDENT AND EMERGENCY, THE LEAN WAY

Biography:

Dr Alok completed his training in Paediatrics from RCPI, Ireland. He is currently working as a General Paediatric Consultant at Mayo University Hospital, Ireland. “Reducing waiting time in accident emergency- The Lean Way” was done while Dr Alok Kumar was undergoing his training in General Paediatrics at Mayo University Hospital, Castlebar (2009-2010). He has enrolled for Specialist Diploma in Quality Management- lean healthcare system as part of my on-going training in Paediatrics and he could see there was unnecessary delay for children in Emergency Department- overcrowding, delay in getting orthopaedic, surgical teams, waiting for laboratory tests etc. He applied the Lean methodology to eliminate waste and thus improve patient flow. Dr Alok have presented this topic as Poster presentation at EBHC (Taormina- 2013), International Quality and Safety meeting – BMJ, Paris and received a good response, and other different interesting facets were discussed for reducing waiting time in Accident and Emergency.

Abstract:

BACKGROUND: Unplanned nature of patient attendance in A&E leads to unnecessary waiting time for children. This process has a clinical and operational part to it. While doing my course, I realized lean strategies could be utilized to reduce waiting time in A&E. AIMS: This project is to identify and reduce the number of non-value added steps along the patients' journey (Children of 0-14 years of age) attending emergency department at Mayo General Hospital. This is aimed to reduce the waiting time, reduce the overall time, and thus, improve the patient experience and render better patient care attending emergency department at Mayo General Hospital. METHODS: I have formed a team, which was duly approved by hospital management. The team has hardworking, experienced, dedicated and committed hospital staff. The team consisted of: - Paediatric Consultant, Registrar, senior house officer (NCHDS) - PROJECT MANAGER: Myself - Clinical Nurse Manager III- Paediatrics, A&E. - Assistant Staff Officer. - Staff nurses-Paediatric, A&E. - Other members will be co-opted as necessary - And last but the most important- the patient; children The team has been established and is already undertaking a number of activities and weekly meetings. The main steps included: - Establish clearly existing waiting times for paediatric patient. - Establish clearly the existing patient journey - Identify stakeholders to involve in the process mapping session. - Identify issues/ solutions/bottlenecks/ decision points. - Identify where value added and non-value added activity exists. - Explore options to improve the position. This should ideally include: 1. Implementation of improvement plans 2. Re-evaluation of the effectiveness of improvement plans. - And last but the most important- the patient, children. To further my lean project I formulated a document to record time taken for children in accident and emergency in the various stages of their waiting period-current visual map. This format mapped the time taken for paediatric patients at various stages that a patient generally has to undergo i.e. in medical terms, history & examination, differential diagnosis, investigation, interpret results, definitive diagnosis, determine care plan, implement and follow up review. RESULTS: Future VSM was formulated taking care of the variations /delays seen. Discussions were made with paediatric consultants, senior staff nurses, senior house officers, registrars and their observations and opinions were taken into account. We have a system already in place. To introduce improvement into it, the following current recommendations were suggested, based on current value stream map analysis. VARIABLES SUGGESTIONS: 1. >3 children waiting to be seen in A&E in Monday mornings, Friday afternoon, Bronchiolites, Gastroenterites season. The Paediatric registrar is called to assist. Team on call to use the 5S principals to organize the work and instilling the discipline. Visual display: On call team takes a look at the board- (e.g. 5 children waiting): and gets into action. 2. Interdepartmental transfer e.g. transfers between surgeons and orthopaedics Better communication and better team play will lessen waiting period. 3. Children may be kept waiting for bed once admitted- thus increasing the total waiting time. Liasion of A&E with Paediatric Ward for quicker transfer to ward. 4. One ED cubicle-causes delay if more than three children need to be seen. There should be provision for second cubicle which if not in use can be used by the Emergency department. 5. Lab, X-ray department should be contacted at appropriate time to avoid unnecessary delay, thus leading to better time management. The main idea is to holistically assess, diagnose, treat, discharge/ refer, and evaluate child care in a safe and co-ordinate way in line with the best practice, incorporating health promotion, education, and risk reduction, in the run. Thus, application of these measures: (a) Registrar led On-call Team (b) Visual display of number of waiting children, (c) Discussion and application of Lean Tools with the NCHD Team (d) Better communication with surgical and orthopaedic teams (e) Constant Consultant supervision (f) Making the new team aware of the issue of reducing waiting time in A&E during the induction meeting itself, LIMITS: Old staff resisting change, some NCHDs non -compliant. CONCLUSIONS: Reducing waiting for children in ED. Lean thinking is about team involvement. Lean thinking is about team involvement. It focuses on the process, not on individuals. This is because teams are superior to individuals at identifying and implementing improvement opportunities. I have had meetings with the medical, the surgical and the obstetric team and have persuaded them to have projects on similar lines, to discuss and be familiarized with Lean Tools (5S, Value Stream Map, Kanbans, Kaizen events, Visual Display), and formulate a Current Value Stream map. Formulating Current Value Stream Map for each individual Team will help them to 'go and see' and give them their 'waste goggles'. This will help the above team doctors to redesign care accordingly and reduce waiting time in accident & emergency for the adult patients as well, thus delivering best possible care. Our aim is to deliver the best for patients, for staff, for our community and for the taxpayer.

Chair

Heather MacDonald

University of New Brunswick, USA

Co-Chair

Kendra Russell

Georgia College & State University, USA

Session Introduction

Gamila S.M. El-Saeed

National Research Centre, Egypt

Title: Relationship between Hepcidin, L-Carnitine, Anemia and Inflammation in Children of Hemodialysis

Biography:

Dr. Gamila S.M.El-Saeed has completed her M.D from Medical University in Basic Science and Biochemistry from Cairo College, Egypt She has published more than 30 papers in international journals. She is a professor of Medical Biochemistry in National Research Centre, Egypt.

Abstract:

Background: The majority of studies on anemia, inflammation, and disturbances of iron metabolism have focused on patients in end-stage renal failure; this study aim was to investigate the relation ship between Carnitine and Hepcidin levels among the children of hemodialysis end stage renal disease (ESRD) and iron metabolism in them. Method: Thirty children with ESRD undergoing HD, and thirty healthy, age- and sex-matched children were included. Serum levels of iron, ferritin and total binding capacity (TIBC), hemoglobin, albumin (ALB) .Total L- Carnitine(LC), high-sensitivity C-reactive protein( hs CRP), hepcidin, were measured. Result: Abnormal serum inflammatory changes iron status and LC , were exhibited in HD children compared with healthy controls, Pearson’s correlation revealed a significant inverse correlation between hepcidin levels and ferritin, and positively with hsCRP and iron where serum albumin positively with hsCRP and ferritin , also a postive correlation found between LC and iron, ferritin.A multivariate regression analysis demonstrated a positive correlation between inflammatory risk marker hs CRP >3 mg/l) and hepcidin levels. Also a positive correlation was found between LC and iron levels. Conclusion: In children under hemodialysis, oral L-carnitine can increase serum albumin level and prevent CRP rising, beneficial effects of L-carnitine on anemia and, its supplementation is recommended for these patients. Malnutrition-inflammation complex is an incremental predictor in hemodialysis patients. Further studies are needed to assess whether modulating inflammatory or Nutritional processes can improve anemia management. Key words: Hepcidin ,L-Carnitine, Anemia, Inflammation ,Children, Hemodialysis.

Shewikar Farrag

Umm Al-Qura University, KSA

Title: Quality of life and self esteem of Egyptian children with type I Diabetes

Biography:

The present study had the purpose for the evaluation of the health related quality of life (HRQoL) and self esteem (SE) of children &adolescents with diabetes mellitus type 1, analyzing the relation between these constructs in this population and comparing these results with those of non diabetic ones, and finding if there is association between metabolic control (Hb A1c) and these psychosocial correlates (HRQoL & SE). Materials &Methods: Generic Core Scales (GCS) were designed to measure the core health dimensions in both healthy and patient populations. PedsQL 3.0 diabetic module (DM) was developed to measure diabetes-specific HRQoL, for youths with T1DM. Hare Area-Specific Self-Esteem Scale, measures adolescents’ feelings about their worth and importance among peers, as students, and as family members. Results: The mean total HRQoL scale scores (child self report and parent-proxy reports) were 75.42, 72.37 for diabetics and 94.80, 96.83 for healthy ones, with significant difference (<0.001). Also, diabetics showed lower self esteem (2.31) than healthy ones (2.05) as higher scores indicate lower self esteem. Conclusion: Children with diabetes had lower quality of life than healthy ones in the physical, emotional and social domains. The SE and QoL concepts were correlated, i.e. the better the quality of life of diabetic children the higher the self-esteem.

Abstract:

Dr Shewikar Farrag is an Egyptian Doctor of Pediatric nursing who has completed her Ph.D from Sheffield University, UK in 2005and she is currently working as an Associate Prof at the Faculty of Nursing, Umm Al-Qura University, KSA. Dr Farrag was an international visiting scholar at the university of Wisconsin-Madison, USA in 2004 & an International Fellow at the Africa Regional Sexuality Resource Centre, Nigeria, 2007. A peer reviewer for Journal of Nursing Scholarship since 2006. Peer Reviewer for The Arab World Version of Kozier and Erb's Fundamentals of Nursing Text Book 2011. Editorial board member / Associate Editor at the Medical Journal of Umm Al-Qura University, KSA 2013.

Chair

Francis J DiMario

The University of Connecticut, USA

Co-Chair

Anita D Berry

Advocate Children�s Hospital Downers Grove, USA

Session Introduction

Santosh Mahindrakar

AIIMS, India

Title: Pediatric falls and trauma scores: are they associated?

Biography:

Mr. Santosh (Registered Nurse), 31 years of age is a PhD student at Department of Trauma Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi. He has completed his Master in Community Health Nursing (2010) and Masters in Public Health (2014). He has qualified for National Eligibility Test (NET) in Preventive and Social Medicine in year 2010 and DAAD Fellow in November – December 2014. He served as a research assistant in Towards Improving Trauma Care Outcome (TITCO) in India project. He served as a faculty in different nursing institute in varying capacity as clinical instructor to assistant professor.

Abstract:

Introduction: Unintentional injuries are the major cause of death among pediatric age group. Fall is a major contributor in unintentional injuries, a minor fall may cause a major head injury among the children. Hence this study is aimed to study the association of vital signs and trauma scores to their outcome following fall. Methodology: Data was retrieved from a prospectively maintained trauma registry at a level 1 trauma centre, New Delhi for a period of 1st October 2013 to 15th September 2015. It included all admitted multiple injury patients from emergency department and also who died between arrivals to admission. Patients with single long bone injuries and brought dead were excluded. The data were further analyzed using SPSS 23. Results: There were 4692 samples, among them 7.5% (353) were from pediatric age below 13 years and all of them were unintentional injuries. Majority (65.2%) had history of fall, followed by (27.5%) road traffic accidents. Among the fall, 67.8% were male, with mean age of 4.4±3 years and 47.8% of them were between age group of 0-3. On presentation 30% of them had GCS ≤ 8, 34.3% were intubated on arrival. In this cohort, mean values of oxygen saturation (93.9±17), respiratory rate (19.5±18 per minute), heart rate (107±29 beats/minute), and systolic blood pressure (105.8±22 mm of Hg). Among these only systolic blood pressure was statistically associated with outcome (P=.025). Mean ISS, NISS and RTS were 11.12±6.22, 16.92±8.8 and 6.7547±1.518 respectively. Among these RTS was statistically associated with outcome. Total mortality was 14.8% and was highest (25.9%) among infants followed by (19.3%) toddlers and least (6.9%) were school going age (6-12 years). Conclusion: Systolic blood pressure on arrival and RTS were statistically associated with the outcome in the group of pediatric patients arriving with fall.

Zeddy Komen

Kenyatta National Hospital, Kenya

Title: To describe the common medical presenting problems of children attending a paediatric emergency department (ED) within 2 years at the Kenya ta National Hospital

Biography:

Registered Nurse

Abstract:

Objective: To describe the common medical presenting problems of children attending a paediatric emergency department (ED) within 2 years at the Kenya ta National Hospital Design A retrospective review of electronic patient records. Setting : Kenyatta National Hospital Kenya Patients A cohort of children and young people aged 0–12 years who attended the ED between February 2013 and 6 February 2015 (n=39 394) Main outcome measures and results Information on presenting problem, demographic data and source of referral were collected. Presenting problems were ranked and with existing data using the difference between proportions analysis and the significance test for a difference in two proportions. A total of 12000 children (47% boys) were seen with compared with 10 369 attendances from the 1997 cohort, an increase of 42%. Most (85%) ED attendances can be accounted for by the 10 most common presenting problems, including breathing difficulty (2494, 20.1%), febrile illness (1752, 14.1%), diarrhoea with or without vomiting (1731, 14.0%), rash (1066, 8.6%) and cough (835, 6.7%). Similar proportions are described to a decade earlier; however, there were fewer patients attending with breathing difficulty (−10.9%, p<0.001). Conclusions Over a Two-year period, there has been a rise in the number of people attending the ED with medical conditions. The 10 most common presenting problems account for 85% of medical attendees. These results suggest the increasing utilisation of ED services for children with common medical presenting problems and should inform further research exploring the pathways for attendance and the thresholds in seeking medical advice in order to inform the management of Kenya ta National Hospital, government and ministry of health, of Pediatric emergency and urgent care services and for purposes of planning.

Chair

Sunil K Jatana

Melaka Manipal Medical College, Malaysia

Co-Chair

Laurence Baldwin

Coventry University, UK

Session Introduction

Mahnaz Shoghi

Iran University of Medical Sciences, Tehran, Iran

Title: Standing together: everyday life of mothers with a leukemic child

Biography:

Mahnaz Shoghi is an Assistant Professor IRAN University of medical sciences, Tehran City, in IRAN. Her MSN is pediatric nursing care. Her professional major is pediatric nursing care, and minor major is neonatal nursing care. Her field research works are 1- nursing care in children with chronic illnesses and their family , 2- family center care in children 3- health promotion in children.

Abstract:

Aims and objectives. To gain insight into everyday living mothers of children with leukemia. The main objective of this study was trying to know the life stories of a mother dealing with leukemic child and see in its true colors. Background. When a child is being clinically diagnosed with leukemia, parents face with a real terrible shock that usually results in a huge change in their normal life. Both parents especially mothers should tackle a new life by supporting and backing their leukemic child through some activities such as home-based treatment. Method: one-time individual in-depth interview was the procedure that the researchers went through while considering grounded theory as the basis of their study. Sixteen mothers took part in this study and the interviews were carried out in two oncology ward in Tehran University Hospitals. Findings: Standing together with a leukemic child is one of the things that occur in a mother’s everyday life when she knows about her child’s severe illness. This mother gets so close to her child and she makes one with her/him. In this way, on the one hand, the mother’s quality of life suffers and in the long run it causes weariness. On the other hand, it ruins other roles of mother. It seems that those mothers who make one with their leukemic child go through all the processes of a chronic disease while being there for their child in spite of the fact that they are not a real patient.

Chair

Sunil K Jatana

Melaka Manipal Medical College, Malaysia

Co-Chair

Laurence Baldwin

Coventry University, UK

Session Introduction

Veronica Svärd

University of Gothenburg, Sweden

Title: The influence of organizational and professional factors on child maltreatment reports within children’s hospitals

Biography:

Veronica Svärd has completed her PhD in May 2016 from the University of Gothenburg. She is a hospital social worker, researcher and lecturer who works at Karolinska University Hospital and the Department of Social Work at the University of Gothenburg.

Abstract:

All health care professionals in Sweden are required to report children whom they suspect are subject to maltreatment to Social Services, but they have been shown to report less frequently than other professionals. Based on a quantitative study within the four largest children’s hospitals in Sweden the organizational and professional conditions and the professionals’ assessment and reporting experiences are explored. The findings show differences between the hospitals and the professions, and great differences between professional groups’ assessment and reporting experiences. Nurses and nurse assistants showed a lower level of awareness and knowledge of risk to children, the legal framework and the available organizational support than physicians and hospital social workers. The reporting experiences were also reflective of these conditions: while half the respondents had never made a report, there were at the same time clear differences between the professions as nine out of ten nurse assistants and more than two thirds of the nurses had never made a report. Some organizational and professional factors were found to have a significant impact on the respondents reporting experiences. Longer working experience and access to guidelines and routines were related to being a high reporter, but also related to experiences of deciding not to report. The study argues that all professional groups need to have equal access to education, with the opportunity to become more involved in the assessment and reporting process and to strengthen multidisciplinary structures. This would reduce the insecurity in assessment and the strategies of avoidance among some professionals.

Chair

Kendra Russell

Middle Georgia State University, USA

Co-Chair

Victoria Munoz Martinez

Ciudad Real University Hospital, Spain

Session Introduction

Victoria Munoz Martinez

Ciudad Real University Hospital, Spain

Title: Influence of Parental Rearing Styles on Attitude Towards Change in Eating Disorders

Biography:

Victoria Muñoz Martinez ( MD) has completed his MD from University of Castilla La Mancha (Albacete, Spain) and nowdays is working at her PhD with Dr. Luis Beato. She is working as a Infant and Adolescent Psychiatry at the General Hopsital of Ciudad Real. She also collaborates with the School of Medicine at the University of Castilla La Mancha.

Abstract:

Introdiuction: It is known that patients with an Eating Disorder (ED) present difficulties to collaborate with the treatment, both at the beginning and in the end. This is an important aspect because it influence at the outcome. Different studies also demonstrated the relationship between parental bonding and eating disorders. This study presents the relationship “perceived rearing styles” and ‘‘attitude towards change’’ among eating disorder patients considering the diagnosis criteria of DSM-IV-TR (American Psychiatric Association -APA-, 1994). Methods: One hundred and sixty-six eating disorder patients were divided into three groups according the DSM-IV-TR criteria: 66 (39.8%) patients met criteria for bulimia nervosa, 49 (29.5%) patients met criteria for anorexia nervosa and 51 (30.7%) patients met criteria for an eating disorder not otherwise specified. All of them were evaluated for family relationship (APGAR familiar), their attitudes towards change (ACTA) and their memories of parental upbringing EMBU after one year of treatment. Results: A multiple regression analysis was performed. The find of the research showed that patients with ED and high Scores in ‘’overprotection’’ perceived during childhood showed higher levels in ‘‘pre-contemplation’’ and lower scores in ‘‘action’’ and ‘’maintenance’’. Regarding , ‘‘rejection’’ during upbringing was directly correlated with higher scores in ‘‘pre-contemplation’’ at one year follow-up regardless of family dysfunction. At least, ‘‘warm’’ perceived was related to higher scores in ‘‘action’’. Conclusions: Highlight the novel part of this study who shown the relationship between parental rearing styles and motivation to change. The results suggest how parental bonding is associated with motivation to change in eating disorders and also influences at the outcome of these patients.

Selen OZAKAR AKCA

Hitit University Health School, TURKEY

Title: Effects of Anemia on Physical, Mental and Neuromotor Development of Pre-School Children (5-6 Years Old)

Biography:

Assist. Prof. Dr. Selen OZAKAR AKCA was born in Samsun, Turkey in 1980. She received her PhD degree from Istanbul University Institute of Health Science with the thesis entitled “Risk-Taking Behaviours of Adolescents and The Effect of Nursing Practice on Substance Abuse in Accordance With Model of Change in Adolescents” in 2013. She has been working in Hitit University Health School since 2008. She is married and has a son.

Abstract:

Anemia is defined as a reduction of red cell mass in hematocrit or milliliter in blood hemoglobin concentration and thus results in a reduction of oxygen carrying capacity and the amount of oxygen that reach the tissues. Anemia is a disease affecting many hematological and non-hematologic systems. Therefore it leads to biochemical changes in cellular functions and has effects on growth, psychomotor and mental development, behavior, immune-gastrointestinal system, physical capacity and thermoregulation. According to the data of the World Health Organization (WHO) anemia is a prevalent health problem that leads to increased morbidity and mortality of especially pre-school children. Anemia is recognized as a major health problem due to the negative effects on the mental and physical development during childhood. With this study it was aimed to determine the anemia status of children visiting the kindergarten affiliated to Çorum Directorate of Education with non-invasive method and to investigate the effects of anemia on physical, mental and neuromotor development of children. While the status of anemia has been evaluated by using a non-invasive measurement device the data of the study has been collected by filling out Questionnaires, Evaluation forms of children’s physical development and Denver Developmental Screening Test II. According to the results obtained from the study it is seen that anemia and malnutrition could have a negative impact on children’s neuromotor development.

Hala Mohamed Shalaby

Riyadh Care Hospital, Saudi Arabia

Title: Breast Feeding

Biography:

Dr Hala Mohamed Shalaby is a Pediatric & Neonatology Specialist in Riyadh Care Hospital, Saudi Arabia since 2001. She did her M.B.B.CH in 1989 and Post graduate Diploma (DCH) in General Pediatric, MRCPCH of Pediatric & Child Health in 2015. She worked as Intern (House officer) at Zagizag University, Egypt (1990-1991), General Practitioner (1991-1992) Egypt, Pediatric Resident (1992-1994), Egypt. Dr Shalaby then shifted to Saudi Arabia and worked as a Pediatric and Neonatology Resident at Thadiq General Hospital and Al Yamamah Hospital respectively. Dr Shalaby is specialist in Indotracheal Intubation, Central Line Insertions (UAC & UVC), Chest Tube Insertion, Blood Exchange, Lubar Puncture.

Abstract:

The Composition of Breast Milk Mature human milk contains (FAT (high contents of palmitic &oleic acids 5%-3% PROTEIN (the principal proteins are casein 0.8-0.9%.CARBOHYDRATE calculated as 7.2%-6.9%.lactose,Mineral constitutes expressed as ash 0.2% & Its Energy content is 60- 75 kcal /100 ml. Is the natural first food for babies? It provides all the energy & nutrient that the infant needs for the first months of life,& it continues to provide up to half or more of a child” nutritional needs during the second half of the first year. What are the advantages of: FOR THE BABY? Breast milk contains the ideal nutrition for the infants in an easily digested form Vitamins.Protein.Fat& antibodies. It protects the infant against infectious & chronic. 1. Diseases as it contains antibodies .It promote sensory & cognitive development. 2. It reduces infant mortality due to common. 3. Childhood illness such as diarrhea or pneumonia 4. Finally, it is a secure way of feeding& safe for the environment. FOR THE MOTHER: 1. It helps the uterus to return to its pre-pregnancy size by stimulating oxytocin hormone release 2. It helps the loss of weight by burning extra calories. Also, it lowers the risk of breast & ovarian cancer. 3. It increases the bond between the mother & the baby by skin –to-skin touch contact. AAP RECOMMENDATIONS EXCLUSIVE BREAST FEEDING for 6 months TO enable mothers to establish &sustain exclusive breast feeding for 6 months WHO &UNICEF recommend to: 1. Initiation of breastfeeding within the first hour of life. 2. Exclusive breastfeeding that the infant only receives breast milk without any additional food or drink. 3. Breastfeeding on demand-that is as often as the child wants, day & night. 4. NO use of bottles, teats or pacifiers. What are the ABCs of Breastfeeding? A=Awareness Watch for the baby’s signs of hunger. This is called “on demand feeding, IN the first few weeks, may be times every 24 hours nursing 8-12. B= Be patient. Breastfeed as long as the baby wants to nurse each time. Infants typically breastfeed for 10-20 minutes on each breast. C = Comfort. This is key Relax while breastfeeding & the milk is more likely to “let down & flow”. MESSAGE TO TAKE HOME: EXCLUSIVE BREASTFEEDING FOR THE FIRST 6 MONTHS IS RECOMMENDED BY WHO

Chair

Kendra Russell

Middle Georgia State University, USA

Co-Chair

Victoria Munoz Martinez

Ciudad Real University Hospital, Spain

Session Introduction

Gamila S.M. El-Saeed

National Research Centre, Egypt

Title: Relationship between Hepcidin, L-Carnitine, Anemia and Inflammation in Children of Hemodialysis

Biography:

Dr. Gamila S.M.El-Saeed has completed her M.D from Medical University in Basic Science and Biochemistry from Cairo College, Egypt She has published more than 30 papers in international journals. She is a professor of Medical Biochemistry in National Research Centre, Egypt.

Abstract:

Background: The majority of studies on anemia, inflammation, and disturbances of iron metabolism have focused on patients in end-stage renal failure; this study aim was to investigate the relation ship between Carnitine and Hepcidin levels among the children of hemodialysis end stage renal disease (ESRD) and iron metabolism in them. Method: Thirty children with ESRD undergoing HD, and thirty healthy, age- and sex-matched children were included. Serum levels of iron, ferritin and total binding capacity (TIBC), hemoglobin, albumin (ALB) .Total L- Carnitine(LC), high-sensitivity C-reactive protein( hs CRP), hepcidin, were measured. Result: Abnormal serum inflammatory changes iron status and LC , were exhibited in HD children compared with healthy controls, Pearson’s correlation revealed a significant inverse correlation between hepcidin levels and ferritin, and positively with hsCRP and iron where serum albumin positively with hsCRP and ferritin , also a postive correlation found between LC and iron, ferritin.A multivariate regression analysis demonstrated a positive correlation between inflammatory risk marker hs CRP >3 mg/l) and hepcidin levels. Also a positive correlation was found between LC and iron levels. Conclusion: In children under hemodialysis, oral L-carnitine can increase serum albumin level and prevent CRP rising, beneficial effects of L-carnitine on anemia and, its supplementation is recommended for these patients. Malnutrition-inflammation complex is an incremental predictor in hemodialysis patients. Further studies are needed to assess whether modulating inflammatory or Nutritional processes can improve anemia management. Key words: Hepcidin ,L-Carnitine, Anemia, Inflammation ,Children, Hemodialysis.

Shewikar Farrag

Umm Al-Qura University, KSA

Title: Quality of life and self esteem of Egyptian children with type I Diabetes

Biography:

Dr Shewikar Farrag is an Egyptian Doctor of Pediatric nursing who has completed her Ph.D from Sheffield University, UK in 2005and she is currently working as an Associate Prof at the Faculty of Nursing, Umm Al-Qura University, KSA. Dr Farrag was an international visiting scholar at the university of Wisconsin-Madison, USA in 2004 & an International Fellow at the Africa Regional Sexuality Resource Centre, Nigeria, 2007. A peer reviewer for Journal of Nursing Scholarship since 2006. Peer Reviewer for The Arab World Version of Kozier and Erb's Fundamentals of Nursing Text Book 2011. Editorial board member / Associate Editor at the Medical Journal of Umm Al-Qura University, KSA 2013.

 

Abstract:

The present study had the purpose for the evaluation of the health related quality of life (HRQoL) and self esteem (SE) of children &adolescents with diabetes mellitus type 1, analyzing the relation between these constructs in this population and comparing these results with those of non diabetic ones, and finding if there is association between metabolic control (Hb A1c) and these psychosocial correlates (HRQoL & SE). Materials &Methods: Generic Core Scales (GCS) were designed to measure the core health dimensions in both healthy and patient populations. PedsQL 3.0 diabetic module (DM) was developed to measure diabetes-specific HRQoL, for youths with T1DM. Hare Area-Specific Self-Esteem Scale, measures adolescents’ feelings about their worth and importance among peers, as students, and as family members. Results: The mean total HRQoL scale scores (child self report and parent-proxy reports) were 75.42, 72.37 for diabetics and 94.80, 96.83 for healthy ones, with significant difference (<0.001). Also, diabetics showed lower self esteem (2.31) than healthy ones (2.05) as higher scores indicate lower self esteem. Conclusion: Children with diabetes had lower quality of life than healthy ones in the physical, emotional and social domains. The SE and QoL concepts were correlated, i.e. the better the quality of life of diabetic children the higher the self-esteem.

Session Introduction

Selen Ozakar Akca

Hitit University Health School, Turkey

Title: Risky Behaviour Patterns of the Youth: Sexuality, Substance Abuse and Driving Entertaining/motor Vehicles

Biography:

Selen Ozakar Akca has received her PhD degree from Istanbul University Institute of Health Science with the thesis entitled “Risk-Taking Behaviours of Adolescents and The Effect of Nursing Practice on Substance Abuse in Accordance With Model of Change in Adolescents” in 2013. She has been working in Hitit University Health School since 2008.

Abstract:

Early diagnosis and prevention of risky behaviors of the youth, counseling and guidance services are among the important roles of professionals working with young people. In this study it was aimed to determine the sexual behavior, substance abuse and driving entertaining/motor vehicles attitudes of 16-18 years old young people, who constitute the most risky age range in the adolescence period. All young people in the 16-18 age group of vocational school (N=980) created the universe of the study, no sample selection was made and volunteers consisted the sample of the study (n=790). The questionnaire (QF) including young persons’ socio-demographic characteristics, sexual behaviours, substance abuse and driving entertaining/motor vehicles attitudes determining questions has been applied. Research data was evaluated with appropriate statistical methods. Average age value of young participants in the study was 17.36±0.2 years and all of them were male. It was determined that 73.4% of the youth had sexual intercourse and 61.1% did not receive education about healthy sexual life. It was seen that 43.5% of those think cigarettes are not harmful for health, 39.2% alcohol and 37.1% drugs/volatile substances. Furthermore it was determined that 14.1% of the youth participating in the study tried alcohol, 13.7% drugs/volatile subtances, 62% drive motor vehicles, 28.6% disregard traffic rules and 42.8% do not wear safety belts. It is remarkable that the sexual behaviour, driving entertaining/motor vehicles and subtance (cigarette, alcohol, drugs/volatile substances) use rate of the majority of young people in high schools is really high. In this regard the importance of ensuring cooperation with school administrators in order to identify risky behaviours of the young, plan appropriate interventions and taking necessary measures is obvious.

Marie Wilhsson

Halmstad University, Sweden

Title: Handling Demands on Success Among Girls and Boys in Primary School-A Conceptual Model

Biography:

Marie Wilhsson is a PhD student since 2012 at School of Health and Welfare. His clinical background is in pediatric care, school nursing and psychiatric youth care.

Abstract:

Background: Stress among adolescents in Western societies is becoming an issue of increasing concern and the global trend of adolescents’ health shows a gradual deterioration that is independent of national differences and increases with age. Research shows that many adolescents report high levels of stress, associated with a change in expectations about performance and an increased focus on school results. Purpose/methods: The aim of this study was to explore the main concern of adolescents to get a deeper knowledge on how they cope with demands in everyday life. Grounded theory was used as a method to generate a model. Results: The core category “striving to be successful and to succeed” explains participants’ main concern in their everyday lives as a continuous process aiming for success in the present and to succeed throughout their lives. The category is what the participants describe as a race against time and can be divided into the two conceptual categories “struggling with time” and “separating life into different worlds”, pronouncing how they struggle and cope with their main concern in order to obtain wellbeing. Our results show a difference between how girls and boys cope with their demands. Conclusions: We show that girls and boys used different strategies to cope with stress in their everyday life. The results are based on adolescent’s experiences and are therefore an important contribution for initiating interventions aimed at promoting adolescents mental health from a gender perspective.

Session Introduction

Clare Elizabeth Gilbert

London School of Hygiene & Tropical Medicine, UK

Title: The role of nurses in the prevention of blindness from retinopathy of prematurity

Biography:

Position: Professor of International Eye Health, London School of Hygiene & Tropical Medicine Qualifications: MB ChB; FRCOph; MD; MSc (Epi) Experience: Over 25 years experience of research in low and middle income countries, focussing on blinding eye diseases of children, including retinopathy of prematurity. First to describe the “third epidemic” of blindness due to ROP in middle income countries. Teaches on Masters in Public Health for Eye Care; currently supervising 5 PhD students Over 220 peer reviewed publications and more than 20 chapters. Clare is Research Advisor in Eye Health for Sightsavers, is a member of the Advisory Board of the Vision Impact Institute, is a Senior Advisor, USAID Child Blindness Program and Scientific Advisor to the Queen Elizabeth Diamond Jubilee Trust. Awards: American Academy of Ophthalmology’s International Prevention of Blindness Award (2011), Lighthouse International’s Pisart Vision Award (2012) and the L’Occitane Foundation’s Sight Award (2014).

Abstract:

The incidence of blindness from retinopathy of prematurity (ROP) is increasing, particularly in middle and low income countries as services for preterm infants expand. The annual incidence of blindness and visual impairment from ROP in 2010 was estimated to be 32,200 with the greatest number being in South Asia. Nurses can play a key role in reducing the risk of blindness from ROP, by counselling mothers at risk of preterm delivery to deliver in well equipped facilities and by reducing exposure of preterm infants to the known risk factors for ROP such as sepsis (hand washing and aseptic techniques); poorly administered and monitored supplemental oxygen (setting alarms correctly; responding to alarms appropriately); reducing stress (pain control, reduce unnecessary handling, swaddling and kangaroo care) and by promoting good nutrition (human breast milk). Nurses can prepare infants for screening for ROP and assist the ophthalmologist during examination, and can counsel parents of infants who need ongoing screening after discharge from the unit of the importance of attending the appointments.