Day 2 :
Keynote Forum
Heather MacDonald
University of New Brunswick, USA
Keynote: FAIR Play: Respite for Parents Caring for Children Requiring Complex Home Care
Time : 9:30-10:00
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 carer givers.rnrnIn this ethnographic study there were: rnrn47 Participantsrn19 Mothersrn4 Fathersrn7 Grandparentsrn13 Nursesrn4 Social WorkersrnrnrnData Collection consisted of in-depth interviews; participant observation; and document review. There were five emergent themes: Parents Caring; Caring and the Impact on Parental Identity; The Nature of Respite; and Fair Play. In this paper the key categories within the theme Fair Play will be discussed. These categories include:rnrnrn care obligationsrn feelings of entitlementrn respite information needsrn ongoing support needsrn negotiating the system and equityrn
Keynote Forum
Josef Holzki
University Children´s Hospital, Belgium
Keynote: Do new publications on the anatomy of the larynx of neonates and infant help to prevent intubation injury?
Time : 9.00 to 9.30
Biography:
Dr Josef Holzki is a teaching professor at the University Children´s Hospital Liège, Belgium, after retiring from being Director/Chairman of the department of Pediatric Anesthesia and Surgical Intensive Care Unit (SICU) in Children´s Hospital Cologne, Germany for 23 years. He also served as a President of the FEAPA (Federation of European associations of Pediatric Anesthesia), Lecturer in international meetings of Pediatric Anesthesia and –intensive care and airway endoscopy, honorary member of the Association of Pediatric anesthesia of Great Britain and Ireland (APA).
Abstract:
To give a convincing overview of the pediatric larynx we have to rely on anatomical findings depicting the funnel (conical) shape of the unyielding cartilaginous structures (1) with the apex at the outlet of the larynx (2). However, the distensible part of the larynx, consisting of glottis and anterior wall superior of the arch of the cricoid cartilage, are not convincingly described yet because radiological methods (MRI and CT-scans) cannot demonstrate the distention of this part which occurs during every intubation. These two aspects of the larynx can lead to controversial discussions which affect the work of nurses how to deal with tracheal tube care.rnAirway endoscopy with small endoscopic lenses (type Hopkins) can visualize glottis, sub-glottis space and the narrow outlet of the cricoid ring during spontaneous breathing under anesthesia, confirming rigid anatomical and distensible structures of the larynx. Simultaneous documentation of airway injury leads to desirable early treatment. rnNewer studies, relying on MRI and CT-scans without accompanying endoscopy (3) might lead to inadequate interpretation of their findings in relation to intubation trauma.rnrnVideo-laryngoscopy as a first step to establish endoscopic technology to visualize the intubation procedure can help to prevent airway injury.rn
Keynote Forum
Luis Beato-Fernández
General Hospital of Ciudad Real, Spain
Keynote: Relationship of Comorbid Depression with Personality Dimensions and Perceived Parental Rearing in Eating Disorders
Time : 09:30 to 10:00
Biography:
Luis Beato-Fernández (MD. PhD.) has completed his MD from University of Seville (Spain) and postdoctoral studies PhD from University of Cordoba School of Medicine. He is the director of Eating Disorders Unit at the General Hospital of Ciudad Real and he is professor at the School of Medicine University of Castilla La Mancha. He has published more than 25 papers mainly related to Eating Disorders in adolescents.
Abstract:
Up to 40% of patients who suffer from an Eating Disorders have comorbid symptoms of low mood. Personality dimensions and family relationships could be related to depressive mood and constitute a risk factor for depression in EDs. The aims were to see which temperament and character dimensions were associated with depression, controlling the influence of parental rearing styles, mainly with its outcome at two-year follow up in eating disorders (EDs). We also studied the relationship of these variables with self-esteem and anxiety. Methods: Participants (N=94) had 28 Anorexia nervosa (AN), 38 Bulimia nervosa (BN) and 28 Eating disorders not otherwise specified (EDNOS). The Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self Esteem Questionnaire (RSE), Eating Disorder Inventory (EDI-2), Temperament and Character Inventory (TCI) and the EMBU (Swedish acronym for ‘My memories of upbringing’) were administered. Results: Depression at the beginning (t0) was severe in 22% of the cases. Harm Avoidance and Novelty Seeking had an effect on depressed mood at t0, mediated by Ineffectiveness. Responsibility (SD1) was associated with scores on the BDI at two years follow up (ß=-0.37, 95% CI -2.6, -0.6, p<0.01). However we didn't find any relationship between the EMBU and BDI scores one and two years later. Conclusion: Low mood in EDs could be more related to personality dimensions than factors related to "upbringing" and enhancing self-efficacy and self-directness is crucial for a good clinical outcome.
Keynote Forum
Arup Roy-Burman
University of California San Francisco, USA
Keynote: Frontline Engagement through Social Gamification: Reducing Healthcare-Associated Conditions—and Having Fun!
Time : 10:00-10:30
Biography:
Dr. Roy-Burman is an Associate Professor of Pediatrics at UCSF, where he serves as Medical Director of the Pediatric ICU and Director of Transport & Access. He completed his MD at UCSF, Residency in Pediatrics at Stanford University, and Fellowship in Pediatric Critical Care at UCSF and Children’s Hospital Oakland. Dr. Roy-Burman also serves as the Medical Director of NGO Global Healing\'s Roatan (Honduras) program, as well as lead for the multi-UC campus Transdisciplinary Immersion in Global Health Research and Education (TIGRE). An innovator with technology, he is pioneering efforts to engage frontline staff through social gamification to improve quality.
Abstract:
Hospitals are dangerous. The US healthcare industry wastes over $200 billion dollars annually in failed attempts to optimize care. Medical errors cause over 440,000 deaths.rnWhy? Best Practice Standards are NOT standard practice. Current technological solutions focus on the centuries-old dyad of doctor and patient, neglecting a key gap: Our frontline staff-- nurses, therapists, pharmacists-- who actually deliver care. The frontlines are lost in a system of accelerating complexity and encumbered by traditional professional silos-- with technology more a barrier than an enabler.rnrnAt UCSF, we are developing a mobile workforce solution to engage frontline staff in generating, learning, and adhering to best practices. Smart incentives, gamified learning and just-in-time tutorials — selected and created by the frontlines to meet their unit’s needs— work together to decrease hospital-acquired conditions and increase patient satisfaction. We deployed our prototype in pediatric BMT, Heme-Onc, and ICU, aiming to reduce central line-associated bloodstream infections (CLABSI)-- a costly, dangerous problem at all hospitals, though one addressable by adherence to best practices -- if only staff could be incentivized to rigorously master the standards of care.rnrnMotivated by fun, software-based contests with real-world recognition and prizes, nurses engaged. The result: CLABSI was cut by 48%, with an estimated savings of 3 lives, over 300 hospital days, and $1M USD. With continued development and broad adoption, this platform will not only enhance internal outcomes, but can also drive inter-institutional sharing of practice standards and previously siloed internal improvements, elevating healthcare quality worldwide.rn