Day 1 :
Keynote Forum
Veena Dhawan
Postgraduate Institute of Medical Education and Research, India
Keynote: Novel Strategies to encounter inflammation and ER stress in coronary artery disease
Time : 10:00-10:50
Biography:
Abstract:
Keynote Forum
Khatijah Lim Abdullah
Khatijah Lim Abdullah,
Keynote: Clinical decision-making styles and critical thinking skills among general care nurses in Malaysia
Time : 10:20-11:00
Biography:
Khatijah Lim Abdullah has completed her Doctorate from the University of Southampton UK. She is currently a Professor in Nursing in University of Malaya, Malaysia and Vice President for Qualitative Research Association Malaysia. She has published more than 50 papers in reputed journals and is presently the Chief Editor for Malaysian Journal of Qualitative Research.
Abstract:
The aim of this study is to assess the relationships between critical thinking skills and types of clinical decision-making among general care nurses in Malaysia. This quantitative descriptive correlational study was conducted in nine public hospitals from Peninsular Malaysia. Five hundred and forty nine nurses recruited via multistage cluster sampling, completed the demographic data questionnaire, Health science reasoning test (HSRT) and 24-item Nursing Decision-making instrument (24-NDM). The results of the study show that nurses’ average HSRT score was 13.8±3.4 which meant the majority of them failed to manifest critical thinking skills. In addition, the results show that 65.2% of the nurses studied were more inclined in making quasi-rational decisions, with 24.6% inclined towards analytical-systematic decisions, whereas only 10.2% displayed intuitive-interpretive decisions (=268, df=2, p<0.001). With multinomial logistic regression, only education qualification is significantly associated with the nurses’ critical thinking score, whereas years of working experience and education qualification significantly predicted types of clinical decision nurses made (p<0.001). Finally, there is significant positive relationship between critical thinking skills and clinical decision-making, which accentuates the positive results yielded from previous studies. This finding provides further evidence that critical thinking and clinical decision-making are both interrelated. Since clinical decision-making cannot be easily taught in nursing curricula, cultivating critical thinking among nursing students perhaps is the right remedy for producing future nurses who can make effective clinical decisions
Keynote Forum
Normunds Sikora
Children’s University Hospital, Latvia
Keynote: The proper delivery pressure for cardioplegic solution in neonatal cardiac surgery – an investigation of biomechanical and structural properties in neonatal and adult coronary arteries
Biography:
Normunds Sikora has completed his Residency in Cardiac Surgery in 2008. Afterwards, he finished his PhD in Riga Stradins University. He has done efforts to improve the quality of cardiopulmonary bypass in cardiac surgery in Latvia working as Cardiac Surgeon and Specialist in cardiopulmonary bypass in Clinic for Pediatric Cardiology and Cardiac Surgery, Children’s University Hospital, Riga, Latvia. He is also an Assistant Professor in Riga Stradins University, Department of Surgery. He has established Latvian Society of Cardiopulmonary Bypass being its President currently. He is a National Delegate in European Board of Cardiovascular Perfusion. He has established National Education Program in Cardiovascular Perfusion being its Director currently. He has over 10 papers in different local and international medical journals.
Abstract:
Introduction: One of important issues in pediatric cardiac surgery is myocardial protection. When cardioplegic solution is injected into coronary arteries with a pump to ensure myocardial protection, it is necessary to determine the correct delivery pressure to avoid damage of the heart.
Methods: We investigated 12 coronary artery specimens without cardiac pathology retrieved from autopsies of neonates 9.3±9.7 days old and weight 3.99±0.7 kg and compared them to seven adult specimens with no detected atherosclerosis. Specimens were pressurized from 0 to 200 mmHg with the step of 20 mmHg, while maintaining the length of the sample in situ. Structural damages were investigated afterwards with light microscopy and immunohistochemistry.
Results: There was a rapid increase of strain until the inner pressure reached 80-100 mmHg, whilst the increase of stress in the wall of neonatal coronary arteries was less rapid. When the internal pressure exceeds 100 mmHg, the strain of the arterial wall increases much slower, but the wall stress and modulus of elasticity begin to increase rapidly - the structural elements of the arterial wall have been straightened and possible damage may appear. Results were compared with biomechanical properties of arterial wall of adults and differences had been found. Morphologic examination of tensile properties revealed prominent affection of the vascular wall of neonates with accentuated redistribution (loosening) of medial myocytes and adventitial vasa vasorum after being pressurized with the inner pressure of over than 100 mmHg.
Conclusions: Our experimental results show that the delivery pressure of the cardioplegic solution in neonatal coronary arteries should not exceed 100 mmHg. A raised inner pressure may increase the risk of structural damage of the vascular wall leading to the injury of myocardium.