Day 2 :
Manchester Metropolitan University, United Kingdom
Keynote: An Exploration of Healthcare-Related Locus of Control in COPD Patients Attending Group-Based Pulmonary Rehabilitation
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Mr David Edwards is a Senior Lecturer in Physiotherapy at Manchester Metropolitan University. He completed this project as part of the award of a Masters in Clinical Research (MClin Res) from The University of Manchester in 2014, which he was awarded a Distinction for. The article was published in Physiotherapy Practice and Research in January 2017. His background consists of work with COPD patients in Central Manchester as a specialist physiotherapist, with a specific focus on Pulmonary Rehabilitation. He also has a significant background in critical care physiotherapy with both adults and children.
Aims: Pulmonary rehabilitation is of proven benefit in improving function and health-related quality of life in patients with COPD; however long-term maintenance is poor. Though reasons for this are not fully understood, psychological concepts such as Health Locus of Control (HLOC) may be of interest. This exploratory study aimed to investigate whether HLOC can be altered through pulmonary rehabilitation.
Methods: A non-randomised controlled Before/After design was used. Eligible participants with a diagnosis of COPD and attending their first pulmonary rehabilitation programme were invited to participate. The intervention consisted of standard pulmonary rehabilitation care - a six-week course comprising twice-weekly group-based exercise and education sessions. Participants completed the Multidimensional Health Locus of Control Form-C (MHLC-C) and standard assessments pre (baseline) and post the six-week programme.
Results: 96 patients were invited to participate, 46 consented and 20 completed both pre-and-post study outcomes. Significant improvement between pre-and-post tests were found for two MHLC-C dimensions (Internal: mean increase 5.4, p=0.012 and Doctors: mean increase 2.1, p=0.016).
Conclusions: Though limited by methodological issues, the results tentatively suggest that HLOC can be significantly altered through group-based pulmonary rehabilitation, potentially through enhanced self-management and education strategies empowering patients. Further investigation of these findings and the relationship with long-term maintenance is warranted.
National University, Costa Rica
Keynote: Meta-analysis on the physiological benefits and quality of life of muscle training in patients with chronic obstructive pulmonary disease
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Jimenez C Enmanuel within his academic training, he is a RRT-Respiratory Therapist graduated from Santa Paula University, and holds a master's degree in integral health and human movement / emphasis in graduate health at the National University of Costa Rica, in addition to completing the course of Cardiopulmonary Rehabilitation phase II in The National University of Costa Rica, and performed the certification of pediatric and neonatal critical air transport of the Asturian association of pediatric intensive care.
He works in the Costa Rican social insurance fund from 2000 to the present, in 2005 until 2008 he worked in clinical research at the ICIC, during this same period also work in home care program for patients with COPD from 2013 to 2016 was coordinator of the cardiopulmonary rehabilitation center at the Adolfo Carit Eva Women's Hospital and from 2015 to date The director of the Santa Paula cardiopulmonary rehabilitation center at Santa Paula Clinic.
Justification: the existence of important peripheral muscular dysfunction contribute at very substantial manner to reduce the tolerance to exercise in a patient with chronic obstructive pulmonary disease.
Methods: this was an exhaustive research on benefits of exercise training for a group of patients, thirteen studies were found (n=351), from these four were excluded studies. The analysis was done using the SPSS v 15.0, and Excel 2007, p< .05 was considered the significance value.
Results: the moderating variables that were meta-analysis were present in more than two experimental investigations. In total eight variables were found from which six variables showed significant effects (oxygen consumption, volume minute, heart rate, breathing rate, fatigue, dyspnea, emotional condition, six walking test).
Two control groups were compared, heart rate and breathing rate had a significant effect in the group that did exercise.
Another analysis assessed the type of training: muscle streng, aerobic resistance, or combination of both, including body part involved, no significant difference was found.
In both comparisons the training type and the body part involved gives a significant effect.
Conclusion: the types of training should be combined for upper and low limbs.
Biophilia Institute, Japan
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Taki Takizawa is neither a doctor nor an engineer but served as the Fujisawa city councilor after graduating Keio University, and has been striving to socialize the Rehabilitation Method, which he recognized and organized. He got the 24 patent in Japan, the United States, and Australia. In order to sustain a super-aged society as one of the baby boomers, he organized the study group and promoted the research. At last, the Biophilia Academy was authorized the non-profit registered academic organization officially.
He has gained the 18 research grants from the Japanese government and else for doing those since 1995. The Japanese Biophilia Rehabilitation Journal No.2017 volume 1 was published as a memorial edition this time for his 26 pieces of papers that summarized their history. He finished the course of the master's degree for the kind of social technology at the University of the Air at the age of 60.
The society that an age pyramid reverses is unprecedented for the human beings in the modern world. Aging progresses quickly with baby boomers' aging, and it is expected that the severe society "one young man supports one elderly” visits soon as well as the disabled elderly increase in Japan. And these are global subjects that the World Health Organization makes targets to solve. All Japanese are covering the whole nation medical insurance. And all cerebrovascular disease and bone fracture patients have received rehabilitation medical treatment as much as they need but the increase of requiring-care elderly is remarkable.
In such a situation, the human change in connection with the rehabilitation medicine in Japan doubled to 1787 from 810 medical specialists in about ten years by 2012, and the physiotherapist increased 470% to over 100,000 people from 20,000 people and up. Reduction of those who need requiring care was expected by those increase. However, they doubled 5,540,000 people in 2012 from 2,180,000 in 2000. And five academic societies and the Japanese Ministry of Health, Labour and Welfare published the Stroke treatment guidelines in 2004. They examined the effect on comparing the results of the typical technique of neuromuscular facilitation technique (FT) and the traditional technique (TT) (muscular power reinforcement, the range of motion (ROM) ex. and Motion Training). They reported very few effective results deriving from FT than TT in it. These aspects have suggested that the restructuring of the rehabilitation medicine is required. We have proposed the effective intervention method, which was patented by US and AU patent office. The patients who treated by the method exceeds 30% has re-acquired walking from bedridden. In a lecture, the author introduces the Takizawa method based on the motivative exercise, devices to use and the result of our research from 1989.
Department of Health & Family Welfare, India
Rakesh K Gupta is the Deputy Director, Non-Communicable Diseases, Department of Health & Family Welfare, Punjab. He has expertise in managing National Non-Communicable diseases Programs especially Blindness Control/Tobacco Control Programs and has professional experience of 33 years in service. He has represented MOHFW in WHO ENDS Consultation in Panama 2016 and WHO consultation on Plain packaging in Geneva 2017.
Background and challenges to implementation: Electronic Nicotine Delivery System (ENDS) popularly known as e-cigarettes are highly addicting and potentially lethal products. It is mostly being used by children and youth because these are glamorised by the tobacco industry. Though not generally available in stores, they are widely promoted and sold through E commerce sites with discount offers. Sales are increasing sharply all over the world. Punjab was the first state in India to declare Electronic Nicotine Delivery System (ENDS) as unapproved under Drugs and Cosmetics Act in 2013. Intervention or response: A circular was issued by Government of Punjab regarding declaration of manufacture and sale of ENDS as illegal. To counter the sale on the Ecommerce site, Punjab Government had issued a Demi-Official letter to Cyber Crime cell regarding the sale of E-cigarettes in 2016. Awareness notices were sent to various E commerce sites regarding the sale of E cigarette. District level Task Force effectively implements the ban through conducting raids at suspected point of sale, which is being monitored monthly by Deputy Commissioners of all Districts. Results and lessons learnt: Cyber Crime Cell identified the 26 E commerce sites that were selling the E cigarettes. Letter was sent to these sites regarding the Blocking/banning the sale of e cigarettes. After that No E commerce sites are selling e cigarettes in Punjab Conclusions and key recommendations: The declaration by the Government of Punjab opens the way for other states to follow suit, and prevent ENDS becoming an additional marketing strategy for tobacco companies.