^{2nd Annual Congress on} Emergency Medicine and Acute Care June 10-11, 2019 Helsinki, Finland

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Integral Pelvic Th erapy (IPT) is a holistic form of pelvic fl oor therapy for women, with the aim of restoring balance in the pelvic area. Th is is done by using soft  external and internal massage techniques in which concepts such as consent, presence and the capacity of slowing down are essential, suitable for every woman who simply wants to know more about her body, sexuality or general wellbeing. But also to treat conditions like a numb feeling in the pelvic area, dyspareunia, sexual trauma, hyper-hypotone pelvic fl oor, stress/urge incontinence, organ prolapse or chronic infl ammations around the area of the vulva and as preparation before, during and birth. Th e IPT- practitioner works only aft er an embodied felt consent in the feminine body, so the client has an autonomous position, where she can receive the touch, instead of undergoing the treatment. For most women, this way of touching makes all the diff erence in feeling violated or not and can be applied in any case in the health care. An IPT-practitioner works with an extremely sensitive touch where full presence is required to notice the slightest change in color, tone and breathing of the client. Case study: One Client 34 years old she got stabile marriage and gives birth 1.5 years ago. She is having severe pain in het vulva area, since she was at age 15. She feels the vulvar skin cracking during intercourse and due to the pain, she not intimate with her partner anymore. Th is is causing relationship issues. She went to the gynecologist, dermatologist, sexologist, pelvic fl oor therapist and at a psychologist. She had ultrasounds and a MRI-scan. She was diagnosed with Vulvary Vestibulitis Syndrome but no therapy helped. At last her psychologist was aimed at acceptance of the pain. At this point she felt devasted and came to me for help. Treatment was applied to give a soft  stretch on the fasciae of the inner labia were tension and small restrictions were felt. Th is gave the client confi rmation about her pain. Slowly, with a lot patience, the restrictions melted away and the area of the vulva became less painful. Due to the memory of painful intercourse and medical examinations, stored emotions came loose. Aft er two treatments, the client could receive an external and internal touch without pain, for the fi rst time aft er 19 years. Th is is not a single case. I have worked with many clients like the above. Th e combination of presence, consent and touch with awareness, seems to have an incredible benefi cial eff ect on the emotional and physical layer in a women’s body. It is time for research, so this form of therapy can be accepted as a full form of complementary care in womans pelvic health. 

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India is a booming economy, though it is challenged by an ever-growing population and a perennially burdened health care system. Government hospitals struggle to provide quality care and health insurances are not yet within the reach of the common man. Emergency departments are in dearth and emergency transfers lack promptness and standardized practices. Th e infrastructure does not support air transfers (helicopter services) to all zones and also unaff ordable by the majority of its citizens. Road ambulances are not quick enough, needless to say unapproachable in some urban and majority of rural areas. Call centres are not yet professional enough to cope up with the medical emergency needs of the country. With all these limitations and aff ordability issues, having to respond promptly to emergencies within the golden hour for this large population with a conservative mindset, there had to be a concept which could fi rst be aff ordable and also accessible to the larger society. An insight into how for the fi rst time in India, the urgent care concept evolved. How an urgent care is made aff ordable to the people. What are the advantages of an urgent care center in your own locality and what are the diffi  culties of running an urgent care center in a large developing nation? Why urgent care centers are quickly becoming the preferred choice over traditional physician appointments and emergency room visits. Peek into the heart of an Indian urgent care center which could be the future of prompt emergency care in this diverse cultural land.

Biography:

Shamim Ahmad Bhat is working as a Consultant Emergency Medicine in Dept. of Emergency Medicine King Saud Medical City Riyadh. He is a board certifi ed from India and currently holding the chair of Academic and research co coordinator in the same department. He is also holding the chair of deputy program director for Saudi diploma in emergency medicine. He is the director of the TRR (KSMC and ALFRED University) training in King Saud Medical City. He is a part of the panel of evaluators and examiners for Saudi board of Emergency Medicine, approved by Saudi commission for health specialties. 

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Background: Dementia is a general term for a number of progressive, organic brain diseases, characterized by memory loss and degeneration of cognitive skills. Most neurodegenerative diseases that lead to dementia are characterized by processes that result in the aberrant polymerization of proteins, and a small proportion of subjects with these diseases develop dementia as a direct result of the presence of mutations or polymorphisms in genes that infl uence these processes. Th e most common cause of dementia, and the best studied, is Alzheimer’s disease. Other important causes include vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Management of dementia is largely focused on helping caregivers to cope with the increase in physical dependence of patients as the disease progresses, or with the emergence of troublesome neuropsychiatric symptoms.  Cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists off er some help in ameliorating the inevitable cognitive decline found in Alzheimer’s disease. Although considered as discrete entities, these diseases are not mutually exclusive and mixed pathologies are common.  Th e etiology of dementia is determined by the underlying causative disease. By age 100, the number spikes to 60 percent. Of those who develop dementia, roughly 60 percent will prove to have Alzheimer’s disease. It’s predicted that the current number of patients with Alzheimer’s disease in the United States is roughly 5 million. In Th e United States, average month costs per patient totaling for nursing home care (approximately $19,900), followed by out-of-pocket spending (approximately $8,200), formal home care (approximately $12,700), and Medicare (approximately $9,700). Due to demographic developments, it is expected that by the year 2050, the number of persons suff ering from a moderately severe or severe dementia among the population over the age of 65 years will total more than two million cases. Worldwide, there are now an estimated 24 million people living with some form of dementia. Without a major medical breakthrough in the fi ght against dementia, this number could jump to as many as 84 million who have age-related memory loss by the year 2040. Method: Qualitative research, methods and methodologies, has received increased attention in health care research, and data collect is still being collected at this present time. In the fi eld of dementia care qualitative research has been used extensively to study the lived experience of family members and more particular family caregivers. In particular burden and coping have been paid attention to. In addition to the domain of the care for persons suff ering from dementia. Our qualitative research is oft en used to study the lived experience of health care our “clients”, their perception of their situation and the meaning they give to the situation they are in. It allows uncovering processes at play in dealing situations in care giving and ward atmosphere have been fruitfully studied using this method. Observation studies, oft en using video-registration, can help to understand care processes in dementia care, in addition to clinical trials. Signifi cance: Th e prevalence of dementia rises steeply with increasing age and although there are a number of forms of dementia, Alzheimer's disease is the most common, and most well-known, of the age-related memory loss diseases. Currently, more than fi ve million Americans suff er from Alzheimer's, and it is the seventh leading cause of death in the U.S. About 13% of Americans over the age of 65 have Alzheimer's and half of those over age 85 will develop Alzheimer's or a closely related dementia.Result: To date, mutations in three genes (amyloid precursor protein, presenilin 1 and presenilin 2) have been described which lead to this early form of Alzheimer’s disease and dementia related illnesses. Th ese mutations all have the same eff ect, which is the increased production of a longer version of bamyloid peptide (42 amino acids compared with 40 amino acids); this aggregates to form a condensed core of amyloid protein that becomes surrounded by degenerating neurites. Th ese relatively large extracellular structures, known as plaques, are a characteristic feature of both sporadic and inherited Alzheimer’s. While current drug therapies only treat the symptoms of Alzheimer's disease, researchers have great hope that in the near future there will be treatments that can stop or slow Alzheimer's. Many clinical studies focus on fi nding better ways to accurately diagnose Alzheimer's disease, particularly in the early stages. Th ese studies will hopefully lead to a trusted method that enables physicians to diagnose persons at risk for the disease even before symptoms appear and begin treatment in time to prevent the development of dementia. Until such time, we found that through the in-home clinical assessment results, proves positive and signifi cant qualitative outcomes for both clients suff ering from dementia and their caregivers. 

Biography:

Shamim Ahmad Bhat is working as a Consultant Emergency Medicine in Dept. of Emergency Medicine King Saud Medical City Riyadh. He is a board certifi ed from India and currently holding the chair of Academic and research co coordinator in the same department. He is also holding the chair of deputy program director for Saudi diploma in emergency medicine. He is the director of the TRR (KSMC and ALFRED University) training in King Saud Medical City. He is a part of the panel of evaluators and examiners for Saudi board of Emergency Medicine, approved by Saudi commission for health specialties.

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Statement of problem: Challenges to recruitment and retention include amongst other, an aging population, increased work load and unattractive salary packages.  Researchers have focused on recruitment, such as an insuffi  cient pool of nursing doctoral graduates and a lack of resources for nursing schools.Th e focus of the analysis was to examine what attracted the nurse educators to teaching, how they were recruited to nursing education. Th e study also aimed to investigate retention of educators. Research Methodology:  An exploratory descriptive design, using a quantitative approach, was used in this study. A structured questionnaire was used. Results: According to the respondents, who are nurse educators, knowing what their responsibilities are and how much authority they have were the retaining factors in their position.  Recommendations: On fi nal analysis several recommendations were proposed: 1. It was recommended that the study should be cascade to other provinces for comprehensive report of nurse educator experiences.  2. Th e researcher also recommended the second translation Factors infl uencing the recruitment and retention of nurse educators in a selected higher education Institute of Nursing in Mpumalanga, South Africa.

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Prioritized care is a term used to defi ne nurses’ inability to carry out holistic care for patients. Literature and the world view suggest that this phenomenon of prioritized care challenges the basic concept of nursing care. It has also been closely linked with issues of patient safety, satisfaction and has been negatively associated with nurse’s job experience. A quantitative study was undertaken among 100 staff  nurses in a tertiary care hospital of South India to identify the activities that nurses gave least and most priority and to also explore the factors responsible for nurse’s decision for prioritization. Findings revealed that individual needs based interventional care like emotional support and teaching, basic care interventions like mouth care, ambulation, etc. were given less priority by nurses. Activities related to therapeutic and diagnostic procedures like administration of medications, were given more priority majority of nurses cited inadequacy of human resource and communication failure as reasons for prioritization. Th e fi ndings suggested a deviation of nursing practice from the original holistic concept of the discipline. Nurse leaders need to acknowledge measure and prevent prioritization to ensure a climate of patient safety and better professional experience for nurses.

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