Day 2 :
Session Introduction
Richard Mupanemunda
University Hospitals Birmingham, UK
Title: Neonatal Intensive Care and Nursing
Time : 10:00-10:30
Biography:
Richard Mupanemunda has completed his Medical studies graduation from University of Southampton. He teaches Pediatrics and Neonatal Medicine at University Hospitals Birmingham NHS Foundation Trust. His interests include the use of inhaled nitric oxide in the treatment of hypoxic respiratory failure in newborns, airway management and the ethics of healthcare provision.
Abstract:
The last 25 years have witnesses continued improvement in the survival of extremely low birth weight infants particularly in the industrialized nations of the world. This has been accompanied by a shift in attitudes to the provision of intensive care to infants regarded as being at the margins of viability. Intensive care is increasingly offered to such infants with significant intra- and inter-country variations in outcomes. Infants of birth weight <500 g encapsulate the moral and ethical dilemmas of perinatal clinicians who struggle to balance the natural parental emotional desire for every effort to be made to save their premature infants with the clinicians’ uncertainty about the infant’s prospects for survival and/or disability. It is difficult for perinatal staff to predict the medical prognosis for extremely preterm infants which means some viable infants might die if not offered aggressive treatment. Detailed outcome data for this group of infants is still limited but reported survival rates vary from 11% to 68% though concerns remain regarding long term morbidity. Common morbidities included bronchopulmonary dysplasia BPD, Retinopathy of Prematurity (ROP), Intraventricular Haemorrhage (IVH), Necrotizing Enterocolitis (NEC) and cerebral palsy. Survival rates increase with increasing birth weight and gestational age, is more likely for small for gestational age than appropriate for gestational age infants, is greater for female infants and singletons. Despite the increased mortality and morbidity, up to a third of survivors have been reported free from handicap at age of two years. Current evidence suggests that a proactive and positive approach to intervention in maternal and newborn care including obstetric interventions, antenatal steroids, tocolysis and caesarian delivery with a neonatologist present at birth, for ‘a trial of life’ including intubation and surfactant administration may increase survival without increasing neurological impairment. Providing perinatal teams with up-to-date outcome data on this group of infants may help further shift attitudes towards a more active and optimistic approach which may encourage higher expectations of a favorable outcome among obstetricians and neonatologists. The Japanese experience clearly supports this view as attested by the amendment of their viability limit from 24 to 22 completed weeks of gestation.
Stephanie Wellington
Nurturing MDs, USA
Title: 5 steps to keep burnout at bay and restore energy and to live and lead for today's physicians
Time : 11:00-12:00
Biography:
Stephanie Wellington has completed her Medical degree at The Ohio State University College of Medicine. She has also completed her Pediatric Residency and Neonatal Fellowship training at New York University School of Medicine. Her love of coaching has expanded and she hosts workshops and private coaching for physicians and medical professionals courageous enough to live into the highest vision for their life and career.
Abstract:
The conversation in the medical community has shifted to include physician’s dissatisfaction, physician burnout and the increasing rates of suicide among doctors in all stages of their careers. While physicians are charged with the task of caring for patients and the teams that support them, who cares for the doctor. Add to that the financial stress of debt from student loans and family responsibilities and it is evident that life as a physician is not as coveted as it once was. With more women entering medical school, we are entering an age where the model of hierarchy and competition are more destructive than constructive. The competitive model breeds comparisons among physicians which contributes to a lack of self-confidence and the ‘not good enough’ syndrome. Women physicians, attempting to find their place in this system, leave behind the natural gifts she has to share with her patients and the medical community. Distress mounts as a woman physician tries to define herself in medicine while balancing other roles in her life. During this talk, participants will: 1. Define Physician Burnout. You may be experiencing it and be unaware. 2. Discover how frustration and dissatisfaction are impacting practice parameters and care teams: acting out and bullying, retreating and doing only what’s necessary, or serving in indifference or maybe even in fear- all keeping you from realizing your full potential so you go home drained, discouraged, and defeated. 3. Explore the concept of Physician Energy. 4. Learn the 5 Step Process to restore your Physician Energy. 5. Learn how to harness the power of Physician Energy to lead and live powerfully
Simone Battibugli
The Children’s Medical Centre, UAE
Title: Diagnostic assessment of cerebral palsy and other neurodevelopmental disorders after NICU: Do not waitand-see
Biography:
Simone Battibugli is a Pediatric Orthopedic Surgeon, currently working as Pediatric Orthopedic Surgeon at The Children’s Medical Centre in Dubai. She has 10 years clinical and research experience as Faculty of Federal University of Sao Paulo. She has completed her Pediatric Orthopedic Fellowship training at Children's Hospital, Chicago, USA and also as a Fellow at Shriners Hospital for Children. Lexington, USA. Her main interest is in evidence based medicine, systematic literature review, management and clinical research on neuromuscular disorders, as cerebral palsy, spina bifida and arthrogryposis multiplex congenital and congenital foot and lower limb deformities and other congenital and acquired musculoskeletal pathologies in children.
Abstract:
Worldwide, Cerebral Palsy (CP) is the most common motor disability in childhood. CP is the result of a non-progressive lesion or injury to developing brain and has multiple causes and clinical manifestations, which leads to a very challenging discussion on diagnosis and screening. CP registers indicate the average age at cerebral palsy diagnosis is 19 months of age, however in most clinical settings the age of CP diagnosis is on average two years or older. It is well-known that delays in diagnosis of cerebral palsy are associated with worse long-term motor function, parental dissatisfaction and higher rates of physical and mental health deterioration. Infants at high risk for neurodevelopmental disorders, including CP, can be identified early, in the first weeks of life, through systematic clinical evaluation combined with specific neuroimaging, neurophysiological tests and when needed genetic testing. The most promising early predictive tool for CP is the General Movement’s Assessment (GMA), which assesses the quality of spontaneous movements of infants in the first 4 months of life. However, as not all children with abnormal findings at neurological examination or on neuroimaging will develop CP, several authors recommend combining GMA with MRI. This combined assessment has been showing high sensitivity and specificity starting from the first months of life (GMA, 98% and 91%; MRI performed at term 86- 100% and 89-97%, respectively). As stated by the World Health Organization, identification of the infant at risk for CP and others neurodevelopmental disorders is a crucial starting point to establish a close relationship between parents and health care providers and to provide early intervention. The broad goal of early intervention is to minimize motor, cognitive, emotional impairments, therefore the remarkable potential of the brain development between preterm age and the age of 1-year post-term offer the best opportunity for early intervention. Hence, ideally early intervention should begin when infants are still in the Neonatal Intensive Care Unit (NICU), mainly by focusing on reduction/minimization of stress factors or soon after NICU discharge. Nevertheless, the main aim of early intervention after hospital discharge is no longer stress reduction but supporting the infant’s development and functional outcomes. Certainly, the best practice will involve comprehensive multidisciplinary programs based on active interventions including physiotherapy, occupational therapy, psychology and neurodevelopmental management. Brain and muscle plasticity in response to target therapies has been demonstrated in children with CP of different age ranges, confirming that neuroplasticity is a lifelong continuous process that enables the brain to change and rewire itself in response to stimulation. However, clinical and experimental findings seem to indicate that, to be maximally effective, early intervention has to be early, intensive, active, individualized and family based. Therefore, the main goal of early motor training is to optimize the development of skilled motor function and avoid musculoskeletal deformities. Poor control of muscles and movement in children with CP can be associated with a wide range of functional challenges. Traditional efforts to manage these motor disabilities have been directed at improving tone and promoting adequate motor patterns. However, contemporary approaches are directed rather to target muscle weakness and poor selective motor control, which is showing very encouraging results. Given that cerebral palsy presents at early in infancy and persists throughout lifetime, effective management must be cost efficient, family friend and based in context of community integration.
Clinical Resource Nurse, UAE
Clinical Resource Nurse, UAE
Title: Use of Gibbs reflective cycle in promoting professional development of health care providers
Biography:
Farha Hijji has completed her double major Master’s degree in Leadership in Health Professions Education from University of Sharjah and Royal College of Surgeons in Ireland. She is working as a Clinical Resource Nurse in Kuwait Hospital-Sharjah and licensed BLS Instructor from American Heart Association.
Abstract:
One of the major models of reflection is Gibbs reflective cycle. It involves six stages headed as description, feelings, evaluation, anlaysis, conclusion and action plan. The process of reflection allows a sense of order to be brought to the descriptions of the experiences and for them to be brought into conscious awareness. Therefore, it should be embedded into professional behaviour for providing high quality care to patients. The workshop will involve exploring the model, understanding the stages involved and practicing reflection using scenarios and actual experiences.