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Abstracts

Accepted abstracts will be published in the AIC program and made available on here.

Poster presenters will be able to share the results of their research with students and professionals at the conference. The poster presentation will be held on Saturday, February 6th, 2015.  Please fill out the abstract submission form at (http://goo.gl/forms/xnuPRKV8U4) by January 15th, 2016. Abstracts will be reviewed by the HSSA Academic Committee, and if there is a large amount of submissions, selection will be based on originality, relevance to the AIC theme, and merit. All applicants will be notified by January 22nd, 2016 regarding the status of their application. 

 

Knowing Hepatitis C: Breaking the silence of a viral epidemic

Author: Mary Obstfeld

Hepatitis C (HCV) is a prevalent chronic disease that affects people and burdens healthcare systems around the world. It often goes undetected for decades until patients present with advance liver disease. New guidelines recommend a change in screening to better identify those with the virus before liver damage occurs. Treatment options with better cure rates are now available that give hope in the battle to decrease the incidence of advanced liver disease and death due to HCV. Nurse practitioners (NPs) have established roles around the world as leaders in surveillance and management of chronic illnesses. NPs providers who have a good background knowledge of HCV are better equipped to play an integral role in identifying those who should be tested and treated, leading to the future eradication of HCV.

 

Diabetes Education: How does the type of healthcare provider affect clinical outcomes?

Author: Michael Taylor

INTRODUCTION: As a chronic disease, diabetes mellitus is frequently diagnosed around the globe. ~9.3% of Canadians (3.4 million) and ~9% of adults worldwide (347 million) are currently living with diabetes; this prevalence is expected to grow considerably over the next two decades. While the disease can be managed effectively through dedicated treatment regimens, diabetes in any form presents both a physiological encumbrance within the human body, as well as a large economic burden on healthcare systems worldwide. BACKGROUND: Managing diabetes involves the frequent use of diverse healthcare providers; physicians, nurses, dieticians, and psychologists are just a few examples. Moreover, healthcare professionals provide varying degrees of education to patients with diabetes regarding current treatments, prognosis, and future clinical outcomes. PURPOSE: The goal of the current study is to decipher the determinant differences among healthcare providers that are associated with relative successes in patient and treatment outcomes. In particular, this project will determine the education factors that are correlated with an attenuation of HbA1c and FPG toward clinically determined goals for Albertan patients who received a type 1 or type 2 diabetes diagnosis within the past five years. METHODS: Using linkages between data provided by the National Physician Survey, the annual Canadian Community Health Survey (proxy for healthcare utilization), and Alberta Health Services’ Data Integration Measurement and Reporting unit (to determine diagnoses and patient outcomes), stepwise regressions (backward and forward) will establish the relevant and significant education correlates. POTENTIAL PRIMARY CORRELATES: Patient demographics, disease duration, comorbid chronic diseases, education content and context.

 

Better Transitions from Healthcare Students to Working Health Care Providers of Tomorrow

Authors: Lauren Lee

Background. Nursing and health care students in general experience longer studying hours and consequently suffer from less leisure time and higher stress. Students will transition into working health care providers who will face emotional, stressful work and will be at risk of burnout. Despite the relevance, stress management and self-care are rarely incorporated into the curriculum. Methodology. We conducted a literature overview and sought examples of innovative changes in the nursing curricula that helped students to handle stress better. We also brainstormed alternative ways stress management could be integrated into the curriculum. Findings. The literature overview suggested schools to work on students’ physical well-being, health promotion, effective coping mechanism, and social support network to better manage stress. Lifestyle that includes proper sleep, exercise, and eating habits are linked to better stress management by students. One study allotted time out of students’ clinical practice for health promotion. This yielded significant improvements in leading a healthier lifestyle, including better coping with stress. Another study observed that teaching students about appropriate coping mechanisms helped students to feel more capable of handling stress. Social support network was found to contribute to reduced anxiety and increased capability to manage stress. Conclusion. The literature identifies gaps in the nursing curriculum in preparing their students to manage stress and suggests innovative changes needed in the curriculum to promote stress management. With the rewarding but highly stressful professions in health care, schools need to do more to ensure their students are prepared to meet the challenges of the profession.

 

 

Reasons for the Underuse of Adjuvant Chemotherapy in Elderly Patients with Stage III Colon Cancer

Author: Emma Lee, Jenny Ko, Hagen Kennecke, Howard Lim, Daniel Renouf, Sharlene Gill, Ryan Woods, Caroline Speers, Winson Cheung

Objectives: Our aims were to characterize adjuvant chemotherapy (AC) use among elderly patients (EPs) with stage III colon cancer (CC) and to identify potential reasons for under-treatment. Methods: Descriptive statistics were used to summarize treatment patterns in young patients (YPs) aged <70 vs. EPs ≥70 years. Multivariate Cox regression models were constructed to evaluate the associations between AC and cancer-specific (CSS), disease-free (DFS), and overall survival (OS) and to determine whether these were modified by age. Results: We identified 810 patients: 51% men, 52% YPs, and 74% received AC. Compared to YPs, EPs were less likely to receive AC (57% vs. 91%, p<0.01). Frequent reasons for non-treatment included age, comorbidities and perceived minimal benefit from AC. Among AC-treated individuals, EPs were less likely to receive FOLFOX (32% vs. 74%, p<0.01) because of advanced age, comorbidities, and patient preference. Once AC was given, EPs had similar rates of treatment discontinuations (34% vs. 26%, p>0.05) and dose reductions (63% vs. 61%, p>0.05) as YPs. Reasons for treatment interruptions included side effects, progressive disease, and patient choice. Receipt of either FOLFOX or capecitabine was correlated with improved CSS, DFS and OS when compared to surgery alone; this effect was not modified by age. Conclusions: EPs with stage III CC frequently received either no AC or capecitabine monotherapy due to advanced age and comorbidities. The effect of AC on survival was similar across age groups, with comparable side effects and rates of treatment modifications. AC should not be withheld because of advanced age alone.

 

 

 

Feasibility and Acceptability of Integrated Cardiac Rehabilitation in Patients Referred for Autologous Bone Marrow Transplantation: An Interprofessional Approach

Authors: Derek Rothe MN-NP Student, Nan Cox-Kennett MN-NP, Dr. Gabor Gyenes, Dr. Ian Paterson, Dr. Irwindeep Sandhu, Dr. Chris Venner, and Dr. Edith Pituskin

Background: High-Dose Chemotherapy (HDCT) and bone marrow/hematopoietic cell transplantation (BMT) is established therapy for many malignancies. While advances in transplant practice have led to improved cancer-specific outcomes, HDCT negatively impacts healthy organ function via direct effects (i.e., high-dose cytotoxic injury to organ systems) and indirect effects (i.e., functional disability).The resulting cardio-metabolic sequelae such as dyslipidemia, hypertension, diabetes, and weight gain (with lean body mass loss) contribute to the significantly increased rates of cardiovascular (CV) mortality and heart failure (HF) observed in HDCT survivors.Cardiac rehabilitation/secondary prevention (CR/SP) programs are a level one recommendation in multiple CV diseases, significantly reducing secondary CV risk and events. Currently the feasibility of integrating standard multidisciplinary CR/SP programs in outpatients (PTS) referred to HDCT is unknown. Aim: To prospectively evaluate feasibility and acceptability of routing referral to a multidisciplinary CR/SP program in unselected lymphoma PTS referred for autologous HDCT/BMT. Methods: Lymphoma PTS referred for HDCT/BMT were serially screened and referred to the Northern Alberta Cardiac Rehabilitation Program (NACRP) at the Jim Pattison Centre for Heart Health in Edmonton, AB. The NACRP includes the expertise of a interdisciplinary team including cardiology, exercise physiology, nursing, occupational therapy, physiotherapy, social work, dietary, and psychosocial services. Baseline exercise testing was performed prior to HDCT/BMT. Upon recovery (6 weeks post BMT) testing was repeated, and PTS were invited to participate in the 8-week NACRP for guided exercise rehabilitation and CV risk reduction education. Results: 23 PTS were referred for HDCT/BMT from January 1, 2015 to August 2015. All were referred to the CR/SP program. A total of 15 patients completed the NACRP post transplant. Functional testing demonstrated an increase in patient function indicators and high levels of satisfaction of CR/SP program components were reported. Conclusion: Seamless integration of CR/SP within standard HDCT/BMT care is feasible and acceptable. We expect short term measurable impacts including reduced symptom burden and improved quality of life. Longer term impacts will evaluate CV morbidity and mortality. This work will inform patient-centered care and improve survivorship care across the cancer continuum.

 

 

An exploration of the roles and perceptions of rural Zambian community health volunteers and gender-based violence using focused ethnography

Authors: Paisly Symenuk, Dr. Sylvia Barton

Gender-based violence (GBV) is a global public health concern and should be prioritized at international, national, and community levels as the numerous negative health effects and human rights violations on women, children, and families resulting from gender-based violence are unacceptable. Gender-based violence (GBV) includes any act that results in, or is likely to result in, physical, sexual, or psychological harm which includes coercion, threats, and deprivation. In Zambia, it is reported that 43% of women aged 15-49 have experienced physical violence at least once since age 15. The purpose is to explore the roles and perceptions of rural Zambian community health volunteers referred to as Safe Motherhood Action Group (SMAG) workers in regards to gender-based violence using a focused ethnography design and principles of appreciative inquiry. We aim for 6-12 SMAG workers to participate in semi-structured interviews, one hour in length completed at the rural health centers. Data will be analysed by team thematic analysis of the interview transcripts. The knowledge and expertise elicited from these workers can be used to identify strengths and gaps, in order to support the work of SMAG workers by not- for- profit, community and government organizations. The research findings might also help contribute to the development and refinement a of contextually sensitive and culturally safe understanding of how to respond to gender-based violence in these rural Zambian communities. Ultimately, this research may contribute to the development of community-based interventions.

 

Do gestures serve an interpersonal function?

Authors: Yiwei Chen & Elena Nicoladis

People sometimes gesture, move their hands in meaningful ways, while speaking (McNeill, 2000). Why? One possible reason is to make their meaning clear to the listener. If so, then people who are less sensitive to the conversational needs of others might gesture less than those who are more sensitive. To test this possibility, we measured the degree of autism in adult males. Deficits in social abilities are the core of Autism Spectrum Disorder, which affects males more than females (Lord, Rutter, Le Couteur, 1994). We hypothesize that males who score high on the Autism Spectrum Quotient gesture less frequently. To test our hypothesis, we asked participants to complete the Autism Spectrum Quotient (AQ) questionnaire (Baron-Cohen, Wheelwright, Skinner, Martin, & Clubley, 2001). To elicit gestures, participants talked about a cartoon they watched and responded to questions about scientific (e.g. How does lightning work?) and social concepts (e.g. How do you make a friend?). To account for individual differences in how much they talked, we calculated the participants’ gesture rate as the number of gestures divided by the number of words spoken. The initial results demonstrate a weak correlation between AQ scores and gesture rate for both cartoon and explanation tasks. In other words, the frequency of gesturing is not related to the participants’ degree of autism. These results do not support the argument that gestures serve an important role in interpersonal communication. We argue that gestures may be more related to an individual’s construction of the message he/she wishes to convey.

 

 

PREOPERATIVE ASSESSMENT AND EDUCATION A PATIENT SAFETY INITIATIVE

Authors: Nurin Dhanji and Rozina Rajan

Purpose: A quantitative study was conducted to investigate surgery cancellations due to improper preoperative assessment by health care professionals, mainly nurses. Also to increase awareness in nurses to minimize morbidity and mortality of patients through accurate assessment and education. Methodology: All surgical care units of the University teaching hospital in Karachi, Pakistan were contacted and 28 patients were followed in their pre-operative assessment and education. Based on the assessment, a surgical checklist was developed and education sessions were conducted for the nurses. Results: Paired t-tests were conducted through the SPSS statistical program to identify the difference in the number of surgery cancellations pre and post implementation of this developed preoperative assessment and education checklist for each of the six variables including; anesthesia clearance (p=0.26), lab results (p<0.001), vital signs (p=0.16), procedure teaching (p<0.001), NPO teaching (p=0.043), and pain management teaching (p=0.043). 100 % of the patients (n=28) scheduled for surgery during a week pre and post implementation were included in the study. Conclusion: The implementation of the developed preoperative checklist for nurses decreased the cancellations of planned surgeries and reduced financial burden on patients and health care facility. This is clinically significant although some tested variables were not necessarily statistically significant. Nurses and other health care providers in other countries, could therefore benefit from integrating this pre-operative assessment checklist to provide necessary education to patients. This could therefore reduce the number of patients with cancelled surgeries due to improper pre-operative assessments.

 

 

World Health Organization Model United Nations (WHOMUN)

Author: Feng, Sharon

Background/Purpose Fostering citizenship and making the abstract and vague “global” relevant for learners is difficult; it entails not only teaching about problems, but also engendering empathy to encourage bridging of knowledge and action. Simulations are powerful education techniques that can replicate real world experiences with guided and fully interactive scenarios to help students autonomously arrive at realistic solutions in the local, national and global community. Model World Health Organization (WHO) simulations in the first year medical curriculum of University of Alberta aim to teach about international negotiations, geopolitical health issues, and social determinants of health by developing personal and technical skills, including written and oral communications, research, caucusing, negotiating, and consensus building. Methods University of Alberta year one medical students completed pre- and post- surveys for four simulations since 2012. The delivery and outcome of WHO simulation in medical education was assessed by aims and purposes of the simulation activity; type of knowledge, attitudes, or behaviours addressed; professional discipline of participants; experience of participants; and style of simulation. Results/Observations From 2012 to 2015, simulation surveys (pre n=268, post n=300) have demonstrated a decline in average ratings by participants for achieved aims and purposes of the simulation activity; type of knowledge gained, attitudes, or behaviours addressed; professional discipline of participants and experience of participants. Conclusion The educational effectiveness of WHO simulations to encourage global healthcare citizenship depends on informed facilitators’ ability to successfully engage learners. Flipped classroom world health simulation complements traditional lectures, however improved delivery can enhance student learning.

 

 

 

Improving Sustainability and Community Engagement of Bednet Sales in Rural Tanzania

Authors: Nicola Gale and Caroline O’Keefe-Markman

An analysis of the successes and challenges associated with a bednet distribution project conducted in rural communities in Tanzania. Improvements to a traditional first-come-first-served distribution process allowed us to promote sustainable bednet access and increase community engagement. This was achieved by connecting a local pharmacy owner and a community-based organization (CBO) invested in malaria education to a bednet supply chain. By assisting with initial start-up costs and logistics, a rotating fund was established by both groups whereby bednets are purchased and sold at wholesale cost. Community access was further improved through targeted distribution to vulnerable and geographically isolated populations. The Students’ International Health Association (SIHA) is a multi-disciplinary student organization focused on promoting the ideals of universal access to health. This is achieved through the creation of sustainable, community-based programming that reflects the multi-sectoral nature of health. Through developing relationships with individuals and organizations committed to social change, engaging in co-learning with health education, and promoting local capacity, SIHA supports grassroots change and the sustainable reduction of the social and economic hardships presented by major health threats in low-resource settings.

 

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