Global Public Health Congress October 18-19, 2018 Paris, France

Biography:

Seong Wu Yang is MD, currently training internal medicine residency in Bundang Jesaeng Hospital, South Korea. He pursued his graduation from Yonsei University, College of Medicine. He completed his Bachelor's degree of Business Administration from Hankuk University of Foreign Studies.

 

Abstract:

One person is diagnosed with dementia in Korea every 12 minutes. According to the Ministry of Health and Welfare, the number of patients with dementia in 2017 was estimated to be about 700,000 and is expected to increase rapidly to 1 million by 2024. According to the OECD report, Alzheimer’s disease (AD) is the most common cause of dementia, accounting for approximately 60–80% of cases of dementia. AD is more common in aging populations. There has been a growing interest in AD and its modifiable risk factors, such as cardiovascular disease (CVD), hypertension, Type 2 diabetes mellitus (DM), depression, obesity, smoking, low physical activity, and drinking. Reducing these modifiable risk factors can prevent AD. Recently, an association between sleep-disordered breathing (SDB) and AD has been suggested. According to a previous study, the prevalence of SDB is estimated to be 27% and 16% in middle-aged Korean men and women, respectively. Recent studies have shown a direct association between SDB and cognitive impairment. However, the association between SDB and AD remains controversial, and only few longitudinal studies have been performed in an Asian population. Therefore, the present study was conducted to investigate whether SDB is associated with AD onset, using representative nationwide cohort data with a 14-year follow-up. The present study used the health check-up cohort data from the National Health Insurance Service (NHIS) claims between 2002 and 2015. The study population comprised about 10% of the 5.15 million subjects aged 40–79 years who participated in the national medical check-up between 2002 and 2003. The NHIS cohort data includes all claims data; general health examination results, which are updated every 2 years; and health examination results specified for life-turning points, such as reaching the age of 40 or 66 years between 2002 and 2015. Subjects who were diagnosed with AD (N=1,489) or died (N=5,489) between 2002 and 2005 were excluded from the cohort sample. The study population comprised individuals who were diagnosed with SDB and those without SDB who were matched by using propensity score. The matched cohort was followed up until the onset of AD, death, or end of 2015. The study groups comprised the SDB group (N=727) and the control group (N=3,635). The SDB group comprised patients who were diagnosed with SDB between 2002 and 2005. On the other hand, subjects without SDB were randomly selected to form the control group. Subjects without SDB were matched to subjects with SDB at a ratio of 5:1 by sex, age, index date (the date of first diagnosis), CVD, hypertension, type 2 DM, depression, body mass index (BMI), smoking status, physical activity, and drinking by using propensity scoring and the stepwise algorithm. The matched cohort was followed up until onset of AD, death, or end of 2015. The cohort data included information on demographic characteristics, medical utilization, medical check-up, and health behavior. After PSM, the chi-square test was used to assess differences in the proportions between the SDB and control groups. To estimate the influence of SDB on AD onset, Kaplan–Meier survival curves and multivariate Cox proportional hazard models were used. Kaplan–Meier curves of the incidence of AD based on the presence of SDB showed differences. The log-rank test showed that the SDB group had a higher risk of AD than the non-SDB group (log-rank test p < 0.0422). After adjusting for the possible confounding variables, patients with SDB were almost 1.58 times more likely to develop AD than those without SDB. The present study showed that SDB was associated with an onset of AD. The findings of this study highlight the importance of the interventions to raise awareness of SDB and the need for the government's support to reduce the barrier in accessing appropriate SDB treatment.

 

Biography:

Navdeep Kaur has completed her Graduation in Dental Sciences from Manipal College Of Dental Science, Karnataka and Masters in Public Health from Punjab University, Chandigarh.  She is currently working as Research Assistant in an ICMR funded project related to introduction of e-IMCI in community settings at Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. She has worked in state funded tobacco control project and also has experience in field work and report writing related to Public Health.

 

Abstract:

The rapid expansion of mobile technology infrastructure presents an unprecedented opportunity to increase access to health care in Low and Middle Income Countries (LMICs). m-Health (Mobile Health) interventions has an opportunity to provide point-of-care decision support to community-based health workers for effective case management. The present study aims at reporting initial investigations into the task of introducing m-health application to improve child health care facilities. It was a sequential, explanatory mixed study which used structured perception checklists and focused group discussions to record the perception of the frontline workers i.e. ANM (Auxiliary Nurse Midwives) (n=40) about using m-health in health care delivery in community settings. It was found that 80% of ANMs were using mobile technology in their work setting and almost all of them were positive about introduction of IT in health care on regular basis. Major concerns of the ANMs were inability to use smart phones, network issues, lack of internet connectivity etc. More than half (65%) of the ANMs expressed ability to use mobile apps on provision of proper trainings. 1/3^rd of the ANMs listed knowledge and skill up gradation as the main use of m-health followed by recording and reporting information as the second most important use. Emergency alarm and GPS tracking were marked as the most and the least desired features, respectively in any m- health application. Overall the ANMs were enthusiastic to use mobile applications in health care delivery.

 

Biography:

Abstract:

29 years-old female presents to Hillside Clinic, a charity run primary healthcare establishment in southern Belize. Her presenting complaints are two-fold, firstly, vaginal itching and discharge and secondly, to have the Implanon NXT contraceptive implant inserted. The vaginal itching and discharge, following history and examination was attributed to vaginal candidiasis and a subsequent treatment plan for this was offered. After thorough counseling, an Implanon NXT was inserted into the patient’s left upper limb. During insertion, evidence of Deliberate Self-Harm (DSH) marks was identified. Initially these marks were put down to a fall in the bathroom by the patient, however on further questioning in a private environment, the patient opened up about things at being ok at home and that she was being both physically and emotionally abused by her husband. She gave numerous examples of alleged recent physical abuse and demonstrated some healing bruises on her body. She also gave examples of where her phone had been taken and broken due to her husband’s jealousy. The patient had 3 children at home, all of whom she vehemently denied any physical or emotional abuse and maintained the alleged abuse only occurred towards her. She agreed this needed to be addressed and after some gentle encouragement, asked for our help in taking this further. Here lies the difficulty, in many developed countries (certainly the USA and UK), in a situation where an alleged victim of domestic violence consents to proceed in having this addressed, the clinician attending would then be able to refer the case to social services, where it would be picked up. In Belize, as with many developing countries, the onus is on the victim entirely. The limit of the clinical involvement is to complete a Ministry of Health Domestic Violence Registration Form, which is not followed-up, but used for data collection purposes. This poses a significant problem in terms of accessing services as it requires a domestic violence victim, who has taken the step to open up to a clinician and ask for help, to go to the police as a separate presentation numerous studies have demonstrated that reporting of domestic violence to the police is low (an estimated less than 50% of cases), due to numerous psychological and perceived social barriers. This case further identifies the need for development in the social aspect of public health in terms and improved accessibility to those systems for patients. It is worth noting that this system does not apply to suspected child abuse, where a clinician is able to report.

 

Biography:

Lucy Kaluvu has completed her Bachelor’s degree in Dental Surgery from the University of Nairobi and is currently pursuing her Master’s in Public Health at the Royal Tropical Institute (KIT) in Amsterdam, The Netherlands. She has a keen interest in clinical research, epidemiology and community health. She has participated in various health conferences and has published case reports with the International Dental Journal and The Institute of Knowledge Management (TIKM).

 

Abstract:

Tobacco products contain a highly addictive psychoactive component known as nicotine. It can either be smoked, sucked, snuffed or chewed. Tobacco use is among the leading predisposing factors in a number of chronic illness and especially oral cancer. Oral changes range from soft tissue abnormalities to aggressive oral cancer. This includes melanosis, periodontal disease, nicotine stomatitis, black hairy tongue and dental caries. This is a case report of a 55 year old, immunocompromised patient and the non-cancerous oral manifestations associated with long term tobacco use. A 55 year old patient presented in the clinic as a referral from the comprehensive care unit, which specializes in physical, emotional and mental care of patients with HIV, in Kilifi District Hospital. She has reported difficulty in eating and generalized pain on the gums and teeth. Extraoral examination revealed a frail looking and undernourished elderly lady. Her hair was thin and scanty. There was nicotine and tar staining on her fingernails. Intraoral examination showed extensive pigmentation of the buccal mucosa, soft and hard palate and the tongue. The dorsum of the tongue had a black, hairy carpet-like lesion that was painless. There were multiple dental caries, especially on the molar teeth. Generalized moderate periodontal disease associated with inflammation of the gingiva and abrasion was also noted. Tobacco cessation is paramount in the management of tobacco-related oral abnormalities. In majority of cases, some of the manifestations are pre-cancerous. Even with cessation, it can take years to reverse effects of tobacco use, especially where gingival recession and periodontal disease is concerned. Therefore advocacy on tobacco ban and strict regulations in tobacco consumption is a key in the significant reduction of tobacco-related oral conditions.