Day 2 :
Keynote Forum
Shavonne Massey
Children Hospital of Philadelphia, USA
Keynote: Considerations in the diagnosis and treatment of neonatal seizures
Time : 10:00-10:30
Biography:
Shavonne Massey is an Attending Physician in the Departments of Neurology and Pediatrics at The Children’s Hospital of Philadelphia and The Perelman School of Medicine at The University of Pennsylvania in Philadelphia, PA. She is a Pediatric Epileptologist with clinical and research interests in the management of brain injured neonates. Within this neonatal population, her specific interests are the use and value of the electroencephalogram in the diagnosis of seizures, development of neurophysiologic biomarkers for brain injury and outcomes, management of seizures, and development of predictive strategies and modeling for acute and chronic outcomes in this population.
Abstract:
Over 800,000 neonates suffer brain injury yearly and seizures are the most common clinical manifestation. Seizures are common during the neonatal period due to age-dependent mechanisms that favor excitability in the immature brain. There are a myriad of potential causes for neonatal seizures, but acute causes, such as hypoxic ischemic encephalopathy, stroke, hemorrhage, and infection, are most common, accounting for up to 80% of cases. The recognition of neonatal seizures is important because seizures are associated with unfavorable acute and chronic outcomes. In the past, seizures were diagnosed clinically, but with growing recognition of the very high subclinical seizure burden that exists in the neonatal population, the electroencephalogram (EEG) is now the gold standard for diagnosing and managing neonates at high risk for seizure occurrence. With the use of EEG, more neonates with seizures are identified bringing considerations in the management of neonatal seizures to the forefront of neonatal care. While there is a growing body of literature on the occurrence and diagnosis of neonatal seizures, many questions remain about the best ways to manage neonatal seizures. Developing best practices for the management of neonatal seizures is of paramount importance given that the mere presence of neonatal seizures can worsen the neurodevelopmental trajectory. This session will review the epidemiology and etiologies of neonatal seizures, as well as the diagnosis of neonatal seizures and the important role of the EEG in accurately diagnosing seizures. The session will also review outcomes data from basic and clinical models of neonatal seizures. The majority of the session will focus on specific considerations in the treatment of neonatal seizures, including when to treat seizures, the mechanisms and data supporting the use of specific antiseizure medications, novel antiseizure medications currently under investigation, and the presence and effect of variability in the treatment of neonatal seizures.
Keynote Forum
Valerie Lynn
Author of The Mommy Plan, USA
Keynote: The Changes in Paid Maternity Leave Policies in the Public and Private Sectors in the United States: Expectations, Reality and Impact. Why It May Not be Enough?
Time : 10:30-11:00
Biography:
Traditional Feminine Healthcare Expert specializing in Postnatal Recovery. Valerie Lynn is one of the leading New Motherhood Recovery Experts in the United State. Valerie, known as The Mommy Planner, has been a major force in introducing and modernizing traditional after birth recovery practices, more specifically the Malay traditions, and treatments to women globally. Valerie has held positions such as Executive Director of the American Malaysian Chamber of Commerce and Principal of VLM Consultancy where she was provided strategic consultancy services for foreign companies entering the Malaysian and APEC markets. She has a Masters’ degree in Economic Development of Southeast Asia from the University of London, School of Oriental and African Studies (SOAS), U.K.
Abstract:
Over the past two years there has been a significant focus on Maternity Leave policies in the United States trail-blazed by billionaire Mark Zuckerberg, Co-Founder of Facebook whose company was one of the first companies to offer extended paid maternity and paternity leave, which now stands at up to four months. This is due to Zuckerberg’s wife, Pricilla Chan, being of Chinese descent who chose to enjoy a more traditional recovery period after giving birth spending time at home. Several companies in the private sector, state, federal and as well as military have followed suit offering for 6 to 52 weeks of paid parental leave. This is also a strategic move in direct relation to stiff competition in the marketplace to attract and keep top talent. The question is, “Is paid maternity leave enough to ensure a productive, contributing employee returns?” In my opinion, it is not. This is only the first step. By providing employees the time and financial support required to welcome, take care of and incorporate a new member into a family is fundamental. However, this investment by the public and private sectors comes with high expectations. Will the ROI, Return on Investment, in paid maternity leave be met? If isn’t, will there be a roll back in maternity leave benefits over the next 5-10 years?
Keynote Forum
Emi John Prince
Institute of Health and Management, Australia
Keynote: Evidence based midwifery
Time : 11:20-11:50
Biography:
Emi John Prince is an Associate Professor, who has completed her PhD in Nursing Science from Vinayaka Missions University, Tamil Nadu. She is nationally and internationally recognized in the areas of Maternity Nursing. She is the Course Coordinator for Postgraduate studies in Nursing at Institute of Health and Management, at NSW. As a Midwife, she works part time at Royal Brisbane Hospital, Brisbane. Her research and scholarly pursuits are in the areas of maternal health and women’s health. She has published her work widely and has written many articles. She is also actively involved in extended professional role as External Examiner (Adjudicator) for PhD thesis for many of the universities.
Abstract:
In midwifery evidence based practice is widely accepted as a fundamental tenant. Evidence based practice is the process of making clinical decisions based upon evidence, clinical experience and patient expectations. It is about using research rather than doing it. Evidence based midwifery believe in the movement away from always doing things in the way in which we were taught and from decisions based on personal opinion. It requires that we look for and appraise research evidence to inform decisions about tests, treatments, patterns of practice, and policy. The evidence drawn on to underpin practice should be in the public domain, open to scrutiny, clinically based, take account of women and their families. The midwife responsibilities is to make use of all available resources to inform her practice including experimental knowledge. She has a duty to weigh up the latest clinical evidence that elicited by her personal observation and to take account of her experience and the woman’s wishes. Evidence-based practice has been deemed important and valuable for nursing and midwifery in many levels. For many years, midwives have shown interest in the idea of evidenceâ€based or effective care. There are a number of good reasons for the interest in evidenceâ€based care
- Sessions: Midwifery Care | Midwifery Nurse practitioner Education | Gynecomastia in Neonatal Babies | Midwifery Skills | Midwives in Maternal care | Midwifery Nursing Practice | Neonatal Research | Womens Health
Chair
Jodie A Dashore
Bio Nexus Health, USA
Session Introduction
Joy Chidinma Oko Uka
University of Salford, UK
Title: Community perceptions of socio-cultural factors that influence maternal mortality and their perspectives on how it could be prevented in Southeast Nigeria
Time : 11:50-12:10
Biography:
Joy Chidinma Oko Uka is a registered Nurse/Midwife (RN, RM, BNSc). She got her Master’s degree in Midwifery (MSc Midwifery) from University of Salford Manchester, United Kingdom, and is currently a PhD student from the same University. She is a young Researcher and Midwifery Lecturer in the Department of Nursing Ebonyi State University Abakaliki, Nigeria. She has published 7 papers in reputed journals.
Abstract:
Maternal mortality is a global health issue with developing countries, such as Nigeria having an unacceptably high occurrence and levels of maternal death especially in the poor and rural communities (UNDP, 2015). Globally, Nigeria and India have been reported as the two countries which are hardest hit by maternal mortality. This research is an investigation of the socio-cultural factors that influence maternal mortality in a South Eastern Nigerian community, and what members of this community perceive to be the best approaches to improve maternal health to help reduce maternal mortality. The databases which were searched for a review of previous empirical research on maternal mortality included Intermid, the UK’s largest online database for midwifery articles, MEDLINE, CINHAL, Science Direct, Web of Science and Google scholar. The databases were explored using the following keywords: Maternal death/mortality, pregnancy, childbirth, culture, belief, death of women, prevention. The study used a qualitative methodology, which included focus group discussions and in-depth one-to-one interviews as the methods of data collection. The sample consisted of 39 participants included were traditional birth attendants, midwives, women, doctors, the village head, religious leader, and the youth leader. Initial findings suggest that, cultural beliefs and religious activities about childbirth as an obligation which every woman must obey, female genital mutilation, spiritual powers (Ogbanje), and also the position of women in the society influence the outcomes of pregnancy and increase the potential for maternal mortality. Thus, an understanding of the impact of cultural dynamics and influences on maternal health is needed for effective public health intervention to improve maternal health in Nigeria. This is because culture plays a vital role in the health of the individual, the family and the community.
Elizabeth Silumba Nee Kasaira
National University of Science and Technology, Zimbabwe
Title: Is mentoring effective for midwifery students in the clinical area? Midwives perceptions at a provincial hospital in Zimbabwe
Time : 12:10-12:30
Biography:
Mrs Elizabeth Silumba nee Kasaira is a Midwifery Educator in Zimbabwe. She holds a Master’s degree in Midwifery Education from the National University of Science and Technology Zimbabwe. She did her BSc Nursing degree majoring in Nursing Education, a Diploma in Midwifery and a Diploma in General Nursing plus a certificate in Maternal and Child Health for Trainers from Tenshi College Japan. She is passionate for midwifery research, education and practice. She teaches midwifery and supervises midwifery research. She is an Active Member of the Zimbabwe Confederation of Midwives Association, as a Vice Chairperson in her province.
Abstract:
Midwifery is a competency based profession in which midwifery students acquire most of their guided learning in the clinical area, hence the need to ensure optimal mentoring which would promote the acquisition of the ideal clinical skills. Failure to support and prepare midwifery students may affect their ability to deliver the required level of midwifery care. This study purposed at exploring the midwives’ perceptions regarding mentoring of midwifery students in the clinical area at Marondera midwifery training institution. A qualitative phenomenological design based on the principles of naturalistic inquiry underpinned this study. The study sample was composed of six recently qualified midwives and ten senior midwives who met the inclusion criteria. Purposive sampling was used to select the sample until saturation was reached. Data were generated using tape-recorded unstructured individual interviews. Colaizzi’s thematic analysis was used to synthesize the findings, and data were presented using the emergent themes. The results generally revealed that mentorship was perceived as an important supportive, teaching and learning strategy. Four themes emerged from the interview data, namely; gross inconsistencies in the mentoring of midwifery students, lack of standardized procedures, poor communication between the school of midwifery and the clinical area and lack of ideal infrastructure which hinder effective mentoring of midwifery students. The results gave rise to the adaptation of Bandura’s social learning theory which was used as an explanatory framework for understanding the study’s findings. Several recommendations were proffered; allocating individual mentors to midwifery students, training programs specifically for mentors, benchmarking to improve training of midwifery students and standardization of mentoring guidelines. Communication between the school of midwifery and the clinical area must improve and there is need for creation of an active national midwifery education board which oversees midwifery teaching and mentoring. The authorities should be committed to the provision of adequate resources to enhance mentorship of midwifery. Further research should focus on identification of where midwives differ and sources of their differences, and then establish solutions to the challenges.
Fusun Terzioglu
Ä°stinye University, Turkey
Title: A new strategy in nursing education: from hybrid simulation to clinical practice
Time : 12:30-12:50
Biography:
Fusun Terzioglu graduated in first place from Hacettepe University in 1989. She won the Ä°hsan Dogramacı Superior Merit Award and Science Incentive Award. She earned her pilot’s license from Republic of Turkey Ministry of Transport. She studied about counseling on assisted reproductive techniques at Liverpool Women’s Hospital Reproductive Medicine Unit in United Kingdom on the British Council Research Scholarship. She studied as a Research Scholar at Kent State University College of Nursing in 2006 for 3 months. She worked as a Research Assistant at Hacettepe University School of Nursing in the Maternity and Women's Health Nursing Division from 1990 to 1997. Her interest includes sexuality and reproductive health and management and leadership. She is member of national and international nurse’s organizations such as INDEN and Sigma Theta Tau. She has been working as a Director of Nursing Services at Hacettepe University Hospitals 2012-2016 and Founding Dean of Faculty of Nursing. She has published more than 70 papers, 15 grant projects, eight books as an editor and author, and more than 100 presentations in the national and international congress. She is also an invited speaker for more than 60 congress and symposium. She is working as a Dean Faculty of Health Science and Director of Nursing of MLPCare.
Abstract:
Background: Various instructional methods and environments are used in nursing education to develop students’ psychomotor and communication skills, reduce their anxiety levels, and enhance their satisfaction.
Objectives: To examine the effect of three different instructional environments on the development of the students' psychomotor and communication skills and their levels of anxiety and satisfaction.
Design: A prospective study design was used.
Methods: The sample of the study consisted of 60 nursing students. Before the implementation of the study, the students' cognitive skills and trait anxiety levels were evaluated. The students were divided into five groups and five nursing activities (Leopold’s maneuvers, teaching breastfeeding, family planning education, teaching vulvar self-examination and teaching breast self-examination) were specified for each group. They implemented these nursing activities under the supervision of a faculty member in the nursing skills laboratory, standardized patient laboratory and clinical practice environment respectively. In each instructional environment, the students' psychomotor and communication skills, state anxiety levels and satisfactions were evaluated.
Results: The median scores for psychomotor skills [nursing skills laboratory=73.1; standardized patient laboratory=81.5; clinical practice environment=88.6] and communication skills [nursing skills laboratory=64.9; standardized patient laboratory=71.6; clinical practice environment=79.0] were found to increase as the students went on practicing in a more complicated environment (p<0.05). Similarly, it was determined that the students' anxiety levels decreased as they were practicing incrementally [nursing skills laboratory=33.0; standardized patient laboratory=32.0; clinical practice environment=31.0]. As the instructional environments were getting more similar to the reality, the students' satisfaction levels were found to become higher.
Conclusions: Students who deliberately practice in the instructional environments until they are competent develop their psychomotor skills while reducing their anxiety levels, and enhancing their communication skills and satisfaction. For that reason, the development of students' competency areas is thought to be effective for the enhancement of patients and healthcare workers’ safety.
Kuldeep Singh
Ultrasound and Color Doppler Clinic, India
Title: Color Doppler in fetal hypoxia: An aid in diagnosing, managing and timely termination
Time : 12:50-13:10
Biography:
Dr. Kuldeep Singh has been practicing ultrasound for over 18 years in South Delhi, INDIA. He is known for his ultrasound skills in Anomaly Scanning, Color Doppler Scanning and High risk pregnancy evaluation. He has more than 150 lectures in various national and international conferences. He has more than 100 articles and chapters to his credit and has authored 16 books on Ultrasound in Obstetrics, Gynecology and Infertility. His books have been translated into Spanish, Chinese and Portugese. The IMAGING SCIENCE AWARD was honored to him at the AICOG 2008. He is presently the President of the Delhi Chapter of IFUMB. He has been appointed as associate director of Ian-Donald Inter University School of Medical ultrasound.
Abstract:
The uteroplacental and fetoplacental circulations can be assessed by color Doppler a non-invasive method for understanding and studying fetal circulations. The uterine artery flow tells us the status of the uteroplacental circuit. The umbilical artery, middle cerebral artery, descending aorta, ductus venosus and umbilical vein study tells us the fetal adaptation to any hypoxic insult. With impaired placentation causing changes in the uterine artery one needs to be carefully surveying the fetal circulation for any adaptive changes. With hypoxic insult the blood flows preferentially to vital organs like the brain, heart and adrenals with compensatory shunting from the non-vital organs the abdominal viscera and lower limbs. The three ratio systolic/diastolic ratio, pulsatility index and resistive index are markers of resistance and thus are reflecting impedance values which are inversely proportional to the amount of blood flow in the respective vessel or organ. So brain sparing causes a high PI and brain edema would finally cause a rise in the Middle cerebral artery PI. This tool finally helps us to fine tune the administration of steroids in a premature fetus and timely termination of pregnancy to reduce the stay of the neonate in the ICU and reduce neonatal morbidity and mortality.
Juliet Ndhlovu
National University of Science and Technology, Zimbabwe
Title: Women’s post abortion self-care and practices: A case of women attending the Mpilo Hospital gynecology clinic in Zimbabwe
Time : 15:20-15:40
Biography:
Juliet Ndhlovu is a Midwifery/Nurse Educator in Zimbabwe. She holds a Master’s degree in Midwifery Education from the National University of Science and Technology (NUST) in Zimbabwe, BSc Nursing degree majoring in MCH and Nursing Education with the Zimbabwe Open University, Diploma in Midwifery and a Diploma in General Nursing, a certificate in Family Planning and Intrauterine device insertion, a certificate in Syndromic Management of Sexual Transmitted Infections. She teaches General Nursing students at Mpilo Central Hospital, the second largest Central Hospital in Zimbabwe. She teaches theory for General Nurse Students and supervises, mentors them in the clinical area and supervises the students in research writing. She is an active member of the Zimbabwe Confederation of Midwives Association and Zimbabwe Nurses Association. She has attended various conferences of the above mentioned associations. She is currently a committee member at a branch of the Zimbabwe Confederation of Midwives Association.
Abstract:
This study is a qualitative enquiry, which used a phenomenological approach, the study sought to assess the self-care knowledge and practices among women who had abortion in their previous pregnancies The central point of the problem statement is that the women lack counseling/education on discharge post abortion on how to care for themselves at home and using some positive practices on self-care. The objectives of the study were to explore women’s knowledge of self-care post abortions, explore women’s self-care practices post abortion and to establish barriers to self-care among women post abortion. The populations under study were women who had a history of abortion whether spontaneous or induced. Sampling was done through convenience/purposive sampling and the sample consisted of 12 women. Data was collected through semi- structured interviews after they had voluntarily consented. The interviews were conducted in private settings and confidentiality was maintained through use of alphabetically corded audio recordings. Data analysis was done using Colaizzi’s strategy for data analysis a method cited in Polit and Beck (2014). The emergent themes were identified through a decision trail, which involved listening to the audio recordings, verbatim transcripts and a vertical summary of the individual transcripts and then identifying themes that ran across all conversations. The themes that emerged from the women were lack of counseling and education on discharge, lack of knowledge on self -care, practices which hinder women to care for self and lack of emotional support. The recommendations made were The midwives need to strengthen the counseling and education skills to women upon discharge so that they are well informed on how to care for themselves at home, More research studies to be done in relation to women’s post abortion self-care knowledge and practices so as to prevent post abortion complications, reduce maternal morbidity and mortality and to ensure meeting the sustainable millennium goal number 5,there is need to for midwives to be cultural and religious sensitive during care of these women not to ridicule, discourage harmful practices and encourage harmful ones in a more sensitive manner, There is need for community involvement and sensitization on post abortion care, so as to build up support of women by significant others at home.
Yayehyirad Yemane
Mizan-Tepi University
Title: Assesement of the proportion and associated factors of episiotomy at public health institutions of Axum town,Tigray region, North Ethiopia, 2016
Time : 15:40-16:00
Biography:
Yayehyirad Yemane has done Bachelor of Science in Midwifery from University of Gondar, Ethiopia in July 12 -2012, then he was working as Head of the Department in Department of Midwifery College of Health Sciences, Mizan-Tepi University for one year. Then he has joined his Masters education in Mekelle University in September 2-2013. He is graduated from Mekelle University with the speciality of Masters of Clinical Midwifery. Currently, he is working as Lecturer at Department of Midwifery College of Health Sciences, Mizan-Tepi University.
Abstract:
Background: Episiotomy means simply a 2nd degree tear to enlarge outlet, for expulsion of the fetus with tolerable damage or injury. Historically, episiotomy has been an element of vaginal delivery, with the rationale of preventing extensive perennial tearing. Incidence varies according to parity, patient population, indication, and health care provider practicing obstetrics. Study findings showed that higher rate of episiotomy in Ethiopia.
Objective: To assess the proportion of episiotomy performance and its associated factors in Axum town public health institutions 2015.
Methods: Facility based cross- sectional study design was employed in three Public health institutions in Axum town, Tigray, Ethiopia 2015. Information was retrieved retrospectively from a total of 338 maternal charts that were selected using systematic random sampling technique. The data were collected using pre-tested and structured data extraction format.Using SPSS version 20 software, descriptive statistics, bivariate and multivariate logistic regression analysis was done and during bivariate logistic regression analysis those variables at p-value <0.2 was transferred to multivariate logistic regression analysis and during multivariate logistic regression analysis variables at P-value <0.05 were considered as statistically significantand AOR with 95% CI was used to control for possible confounders and to interpret the result.The result is summarized using tables, graphs and charts for different variables.
Results: Out of 338 deliveries the proportion of episiotomy was 140(41.44%).The odds of episiotomy practice were 1.8 times greater among primipara when compared with multiparous women[AOR=1.89 (1.08, 3.23)], 8.9 times greater among mothers whose labor were assisted by vacuum as compared to those who delivered by normal vaginal delivery [AOR=8.99(4.25, 19.03)], 4.7 times greater among deliveries whose fetal presentation was face when compared with vertex presentations [AOR=4.76(1.94, 11.67)].
Conclusion: The proportion of episiotomy practice is high parity, face presentation, mode of delivery, birth attendant and 1st minute Apgar score were significantly associated with practice of episiotomy.
Abolfazl Mahmoodi Shahid
Beheshti Medical University, Iran
Title: Investigating the relationship of social support and quality of life with the level of stress in pregnant women using the PATH model
Time : 16:20-16:50
Biography:
Abolfazl Mahmoodi Shahid graduated from Medical School of Shahid Beheshti University Tehran, Iran in 1998. He worked in Zaaim Hospital, Pakdasht city, one of the overpopulated cities in Tehran suburb for two years at Emergency Department (2000-2003). He was an Emergency Doctor, the most famous in Iran. Since then, he has been working in his Skin Care and Beauty Clinic and Emergency Department in Iran Mehr Hospital. It is noteworthy that he is one of the countrywide members of health plan in Iran selected universities. He has published some papers and a book “Lifestyle and its approach”.
Abstract:
Background: Lack of adequate social support, stress, and generally poor quality of life during pregnancy leads to adverse pregnancy outcomes for both the mother and the baby.
Objectives: This study aimed to investigate the relationship of social support and quality of life with level of stress during pregnancy.
Materials and Methods: This was a descriptive-correlative study conducted on 210 pregnant women (meeting study criteria), attending Shahriar Social Services Hospital during 2012. Purposive convenient sampling was used. Study subjects completed questionnaires of obstetrics and demographics, VAUX social support, World Health Organization quality of life, and stress during pregnancy. Data were analyzed with SPSS-19 and Lisrel 8.8, utilizing statistical path analysis.
Results: The final path model fitted well (CF1 = 1, RMSEA = 0.00) and showed that direct quality of life paths with β = Ë— 0.2, and indirect social support with β = Ë— 0.088 had the most effects on reduction of stress during pregnancy.
Conclusion: Social support indirectly and quality of life directly affect stress during pregnancy. Thus, health officials should attempt to establish measures to further enhance social support and quality of life of pregnant women to reduce stress and its consequences during this time.