Abstract

Background: Cardiovascular diseases(CVDs) are a rising global burden. Preventative strategies such as Cardiac Rehabilitation(CR) have shown marked reduction of disease burden. Despite this, CR is underutilized worldwide. This study aims to identify the barriers to CR among patients diagnosed with CVD. Methods: A scoping review of the literature was conducted following PRISMA-ScR guidelines for database search and screening. Three major databases including CINAHL, PubMed, and Scopus databases were used to obtain studies published between 2010 to2021. Keywords such as “Cardiac rehab*”, “Barrier*”, “Cardiovascular”, “Disease” And “diagnos*”Were utilized in order to obtain subject specific studies relevant to the research question. Results: From the initial 1348 studies only 13 were included in the final analysis, consisting of both qualitative and quantitative designs. Thematic analysis included“healthcare system-related factors”, “Socioeconomic factors”, and “individual characteristics”. Healthcare system-related factors were mostly related to poor availability of CR programs, lack of proper referral strategies, inadequate knowledge of CR provider and inter-provider communication issues, and lack of alternative methods of CR delivery.Socioeconomic barriers were lack of education, longer distance to CR facilities, high cost of care, unemployment, and poor income status. Identified individual characteristics were female gender, older age, and comorbidities. Conclusion: Lack of resources, poor access, educational attainment and high cost of care were some of the barriers to CR, particularly in LMICs. Health policymakers and healthcare providers should implement strategies incorporating issues identified in this scoping review. Systematic reviews may be required to confirm these findings. 

Biography

Dr Hanna is an Associate Professor of Public Health with medical background (MBBS). His public health journey started with a PhD project in 2003 (Monash University) around the topic of lifestyle determinants of musculoskeletal disease where over 25 journal articles were published in reputable journals as a result. Following the PhD journey, Dr Hanna went on to continue his work on lifestyle and behavioural factors and their effect on other chronic non-communicable disease such as obesity, diabetes, mental health and cardiovascular disease. He has a NHMRC fellowship in public health (Monash and Baker Heart and Diabetes Institute, 2007-2011) and has worked in various communities including 3 years in the Gulf region (Qatar) where he investigated cultural and social determinants of health and disease. As a result of his commitment to public health research, Dr Hanna published over 100 journal articles and reports and over 80 national and international conference presentations on related projects.

Abstract

Ethiopia is a country with the second highest population in Africa. At present the estimated total population of the country is more than120 Million. It is expected that the total population of Ethiopia will be around 200 million by the end of 2050 with the majority being young both in Ethiopia and the rest of Africa. It is necessary and mandatory to establish new and modern health sectors to create the health security of hope to the growing population. It is important starting now to install new modern innovative technology-based health and health related areas including agricultural sector for the better life and balanced Nutrition in each country. Environmental health and climate change must be also put as a main factor of health, economic and social challenges of 21 century in the modern era. The role of Flora and Fauna and their natural influence and contribution to health and disease in this dynamic world will not undermine. Hence, including international medical centers establishing innovative Global One Health University of Science and Technology will be one of the main key tools to overcome the problem of the demographic explosion, the health hazard consequences including climate disaster by producing high skilled innovative man power. In the last few years ago, the communicable diseases like HIV/AIDS, Tbc, Malaria, and others include STD were the most researched topics in Ethiopia and in many African countries. We find very few studies on non-communicable disease in the literature of African studies like Diabetes and minor mother-child health care. But, currently, based on some different studies it shows that not only communicable diseases were a big enemy or challenge of Africa; but it is clear now both communicable and non-communicable diseases have been affecting the total population of Africa. In relation to this the world is facing with animal born disease which is called zoonosis. This kind of disease like zoonosis, food born disease, vector born disease, chemical & biological disasters, climate and environmental catastrophes currently seek a special attention and study as well as research by global universities all over the world for the bilateral benefit of each international country to control the pandemic like COVID-19. The Ethiopian health system has hospitals, health centers, health stations/posts, private clinics, and very limited biomedical laboratories in the big cities. In additions to this there are pharmacies and drug stores in limited places. Of course, all are playing a big role all over the country for disease prevention and for therapy of the patients. But when we compare the total population of the country and the development of health system, it is not sufficient to give an optimal health supply all over the country. Most of the available health care centers are not easily accessible and all are not organized in a modern way. The distribution of the medical care centers is not identical or fair distribution in rural and urban dwellers of Ethiopia. The medical products, medical devices and the medicaments are not available adequately all over the country. Both the quality and quantity are not well adequate for treatment and distribution of the whole health sectors. Hence, the traditional medicine plays a big role parallel to modern medicaments. The consumption of the traditional medical plants by the total population of the country is estimated to be high. But due to unregistered data it is not possible to explain with statistical quantitative figures. It is recommended to the health minister of Ethiopia to organize and document the traditional medicine and the medical plant in Ethiopia equally as is done for the modern usable medicaments. It is absolutely recommended to bring it the curriculum of medical Education in Ethiopia and creating independent departments within the medical schools. This can be taken as an example from the China Traditional Medicine system. The Ethiopian population lives in both rural and urban areas. The largest numbers of Ethiopian dwellers are living in the rural areas. The infrastructure of some regions is not well constructed to reach the medical centers. In this case the accessibility of good health supplies like good medical personals and referral hospitals as well as pharmacies with good medicaments are very few or limited. The accessibilities to modern Medical Diagnostic laboratories and laboratory diagnostic devices are very poor. In the meantime, there are different universities with modern Medical Colleges or Medical Faculties with modern referral hospitals and medical personals. This indicates that the coming of better health care and improvement of health system in the country. However, most referral hospitals are available in the big cities (urban areas). Some Medical Laboratories are available mostly in the capital city Addis Abeba, regional cities and in a limited number in few Zonal cities or surrounding of them. Some drug stores are accessible in different cities and towns. However, the quantities and qualities of medicaments in drug stores are not in an optimum condition. Finally, the availability of hospitals, referral hospitals, pharmacies, drug stores and other health related community services are not enough to serve the total population of the country. There is a very high deficiency of health sectors and medical persons in general. This will be the big challenge of the country if there is no immediate action against the above stated key problems to provide full health to the growing population and climate change. This kind of problem like uncontrolled population growth and climate change is not only a specific national problem but also an international problem in this dynamic world which needs bilateral cooperation and collaboration in different knowledge-based sectors of science and technology/biotechnology. Therefore, establishing modern innovative technology and biotechnology based Kess Waka Meskelo International Medical Center at Tedda – Gonder Ethiopia combined with International Clinics, International Medical/Biomedical Laboratories, and International Clinical Pharmacies in the small towns near by the most rural dwellers of the country is one of a crucial solution to avoid or minimize the deficiency of health sectors in the community. This medical center will give a national and international community service. In this case, strong bilateral collaboration, and cooperation with German-Ethiopia for Establishing like Kess Waka Meskelo International Medical Center (KW- MIMC) in Tedda-Gonder playing a big role economically and socially regarding to Global Public Healthcare, Innovative Medical and Biomedical Education, Global Disease Prevention, Global Disease Control, Global Medicament as well as Vaccine Research and Development including Drug as well as Food Safety and Security nationally and globally. The other important benefit of the strong bilateral cooperation and collaboration with German-Ethiopia through the proposed medical center will be to doing research, education, training, and health consultation for medical as well as paramedical personals frontal or via technology-based systems like zoom or teams. The human & veterinary medicine, biomedicine, infection medicine, tropical medicine, virology, molecular medicine, biology, molecular biology, biochemistry, public health, telemedicine, biotechnology, technology, bio engineering, tissue engineering, artificial intelligence, mother-child care and other relevant academic field students can get good advanced practical modern and high-tech oriented academic skills. The center can learn more from German technology and how to apply innovative science and technology in Ethiopia in a modern way. In another side the German population growing rate is the vice versa of Ethiopia. German needs younger qualified manpower to secure the deficiency of skilled manpower. Then the qualified young skilled man power from international medical center in Ethiopia can give a service back for German. In this case vigorous collaboration and cooperation of German – Ethiopia is a crucial master key problem solving and mutual profitable golden bilateral project for Establishing Kess Waka Meskelo International Medical Center (KW- MIMC) and then for the foundation of Global /international One Health Universal University of Science and Technology in Tedda-Gonder Ethiopia. This kind of inter connected international/global mutual benefitable network must be exist and continue to prevent the global problem of both countries on time and properly.

Biography

Immunologist,Certified, Drug Safety Officer,Pharmacovigilance and Clinical Trials Specialist.Currently working at Seramun Diagnostica Biotechnology Company in the Dept.of Research and Development as a Research & Development Scientist in the field of Immunoassay.Completed PhD from Charite’-University of Medicine Berlin, Center for Internal Medicine and Dermatology, Internal Medicine Dept. of Rheumatology and Clinical Immunology; German Rheumatology Research Center Berlin; Institute for Immunology, Center for Infection Medicine of Freie University Berlin. Ambassador of Brain City Berlin for Science and Technology. Diaspora Expert for Developing Countries in relation to health, education, research and consultation. Co-advisor and lecturer for Master and PhD students & lecturer of undergraduate students in different Ethiopian Universities. Ambassador of Tedda Health Science College in Gonder/ Ethiopia. Board Member of Ethiopian Institute of Textile and Fashion Technology EiTEX & Biorefinery Research Center (BRRC of EiTEX) in Bahir Dar University-Ethiopia, Board Member & Co-Founder and General Secretary of International Verein für Gesundheitsförderung in Äthiopien (IVGFÄ) at Germany. Vice-President of Bridge Ethiopia Network for Science and Technology (BE-NeST) in Germany. Auditor of German Society for Lupus Research Society/ Deutsche Gesellschaft für Lupus Forschung (DGLF) e,V.in Berlin-Germany.

Abstract

The COVID19 pandemic was characterized by the introduction of a novel pathogen of great virulence to the human condition. It was in discriminant in transmission and infection, with many to succumb to severe illness and death. This would include those with social inequalities known as social determinants of health given their impact on disease outcomes. These social determinants of health include poverty, geography and minority status among others and are associated with limited accessibility of the health care system and poor health literacy. This ineffective healthcare utilization is also manifest in a lack of compliance with public health policy. In my discussion, I will review these elements and in particular those unique to children in the United States with special attention to school disruption and respiratory system conditions exacerbations. A discussion of the failure to account for a lack of school sponsored meals, and special needs services which lead to declines for children with social determinants risks will be presented. As well, a discussion of those conditions such as poor housing, overcrowding, and inactivity as contributing to respiratory system condition exacerbations will follow. 

Biography

Linda is a General Pediatrician with a long history of working with the underserved in rural and urban settings. As well, she has worked in the non-profit and academic sectors as a public health educator. In this regard, her creative use of social media for civic engagement has been an addition to the public health discourse in the promotion of child health and well-being. In research, she has been a contributor to basic science and clinical investigation. Study subject has included the immunology of HIV, and the clinical effects of hypertension, diabetes, and lead toxicity in children. Her work with obesity includes community events such as health fairs and healthy cooking seminars in rural Alabama. In addition, patients in rural Georgia were invited to Zumba in the Park, courtesy of grant funding and non-profit support. This is to supplement the daily efforts to encourage the adoption of healthy lifestyle choices in the face of food deserts, inactivity, and poverty which exacerbate obesity for rural and BIPOC populations. Education: University of Virginia, B.A Chemistry, B.A French University of Chicago-Pritzker School of Medicine, M.D Emory University School of Public Health, MPH. Informatics

Abstract

Zoonotic spillover, or the transmission of a pathogen from a vertebrate animal to a human, presents a global public health burden and is a poorly understood phenomenon. A spillover event requires several factors to align, including the ecological, epidemiological, and behavioral determinants of pathogen exposure, and human factors that affect susceptibility to infection. These happenings occur around the world constantly and have the potential to lead to the next worldwide pandemic. Factors like climate change and economic development are also rapidly increasing human and animal interaction. New surveillance technologies and risk analytics need to be developed to keep up with an increasingly interconnected world between humans and animals. 

            HSR.health is developing a new public health model and decision support solution that leverages advanced data science techniques to respond faster and more accurately to zoonotic spillover events in the 21st century. Our solution utilizes geospatial analysis and machine learning to combine multiple diverse datasets including but not limited to earth observation data, genomic surveillance data, mobility data, social determinants of health data (i.e., population demographics), environmental data, climate change data, and health outcomes data for the purpose of holistically understanding the pathways and drivers behind zoonotic spillover. The model’s analytics identifies geographical areas at risk. By combining these analytics with patient level data on disease incidence and symptomatology, public health decision makers can respond with surgical precision when and where a zoonotic spillover event may occur.

Biography

Over a 20-year career in cybersecurity and information technology, Ajay has seen companies create true competitive advantage from successful management of security and technology initiatives. At the same time, healthcare is burdened with outdated technology infrastructure and inefficiencies - which are often measured in human lives. Ajay decided to take his understanding of technology and implementation to disrupt and innovate healthcare. In launching HSR.health, Ajay leverages the best of tech to transform American healthcare into a system that innovates healthcare delivery achieving improved quality, lower costs, and health equity. Under Ajay's leadership, HSR.health pivoted to support COVID response in the US and globally. And through its lessons learned has developed insights into how health risks impact broader markets. The company is developing a digital Pandemic Early Warning and Response Platform to identify and mitigate impact of future pandemics. In addition to his work at HSR.health, Ajay Chairs the Health Domain Working Group for the Open Geospatial Consortium, the global standards setting body for all things Geo; serves as the Vice-Chair of the Board of Directors of Holy Cross Health, a multi-hospital social safety net health system in Montgomery County, MD; Chairs the Revenue Committee of the Board of Governors for his alma mater, the fearless University of Maryland, College Park; and serves on the Board of Visitors for Wake Forest University, a Top 30 private research university in the US. If he isn't using the HSR.health geospatial platform to map disease rates against social factors to identify solutions to population health challenges, such as the opioid epidemic or maternal mortality, you can find him at sporting events (#LetsGoNats, #ALLCAPS) or behind the mic bursting eardrums while belting out his favorite pop music tunes from U2, Sting, George Michael, or Imagine Dragons.

Abstract

The use of electronic cigarettes among adolescents has remained a major public health concern. Reports have shown that the adolescent brain is still growing and can be affected by nicotine and cancer-causing chemicals contained in e-cigarettes. The rising trend of e-cigarette use by adolescents has reportedly reached epidemic proportions and there is a knowledge gap in the factors associated with this behavior and the provision of appropriate interventions for the at-risk population.  This quantitative, cross-sectional design study investigated the association between sociodemographic factors and Texas adolescents’ use of e-cigarettes, by conducting secondary data analysis of the Texas Department of State Health Services Youth Tobacco Survey.  The theory of planned behavior guided this study, and Pearson’s Chi-Square and Logistic Regression analyses were conducted. The sociodemographic factors examined for potential association with e-cigarette use among Texas adolescents included age, gender, and race/ ethnicity, while the covariates include socioeconomic status and area of residence. The results showed that age (p < .001) was significantly associated with adolescent e-cigarette use. Increasing age is associated with greater odds of e-cigarette use. The findings from this study may offer potential positive social change by providing a better understanding of how sociodemographic factors influence adolescent e-cigarette use. The results from this study might also guide public health practitioners in developing audience-targeted health promotion programs for mitigating adolescent e-cigarette use.

Biography

Christie Okonkwo has completed hersecond PhD in Public Health from Walden University, USA. She had a previous PhD in Pharmaceutical Chemistry from the University of Lagos, Nigeria, and worked as a Research Scientist at the Nigerian Institute of Medical Research, Lagos, then undertook postdoctoral studies at the Department of Medical Microbiology, New York University, USA. Transitioning into healthcare, she has been practicing as a Registered Nurse; but is passionate about public health issues related to substance use - the focus of her dissertation. She is the Founder of The ReachOut Foundation for Children and Youth Inc, a Non-Profit Organization.

Abstract

Biography

Prof. Swapna Chaudhuri is an alumnus of University of Calcutta. Presently she is an Emeritus Medical Scientist at Chittaranjan National Cancer Institute,Calcutta, India.She had joined School of Tropical Medicine in 2008 as Professor. Her research area is the fields of Cancer Immunology and Immunotherapy, Respiratory and Infectious Immunology and Immunotherapy, Cryptoccocal Immunology and Immunotherapy and Haematopoitic Stem cell Immunology and Immunotherapy.Taught at both postgraduate and undergraduate levels. Published seventy five papers in high impact factor journals and also reviews, monograms, book chapters, commentaries. Has won many Academic laurels and Fellowships, affiliated to twelve Academic Societies, Editorial Committee member of many National and International journals, Reviewer of fifty six high impact factor journals, Principal Investigator of twenty one projects, Supervised 21 PhD, MD and DM students. ORG

Abstract

Introduction The coronavirus (Covid-19) is a respiratory disease that spreads globally. The severity and risk of mortality of the disease is important to everyone and more specifically to the elderly, patients with co-morbidities as well as immunosuppressed patients. Spreading of the pandemic created barriers and difficulties for diagnosis, treatment and follow-up chronic diseases. Providing regular and routine comprehensive patient care to those living with a chronic condition was discontinued during the acute phase of the pandemic, but also afterwards for a number of reasons related to lockdowns (closure of health care facilities), lack of public transportation, but also the process of fragmentation and reductions in health services. [1] Methods In this presentation, data and analysis from both the British and international evidences will be used to highlight the impact of Covid 19 on (i) patients with chronic problems, and to those at risk; (ii) health care systems, as well as (iii) the management methods for these complex patients, combined with data and assessments from the Office for British National Statistics (ONS). [2] Discussion COVID-19 can infect people of different ages, especially by affecting the older age group. In addition, people with co-morbidities and immunosuppressive present themselves more susceptible to serious C19 disease and a greater risk for higher death rate. The World Health Organization (WHO) has recommended that patients with concomitant diseases and weak immunity should be better protected and without discrimination from infection. Regardless of the prognosis of the disease, patients who presented with various comorbidities have shown a high risk for severity and disease complications. The presentation will discuss the risk and the preventive factors including the protective effect of vaccination against C19; patient experiences and struggles, and the importance/ challenges of offering a more integrated and holistic healthcare system as well as some of the lessons learned so far. Conclusions Any disruption and fragmentation of health care services has been seen to have longer-term negative effects to those most vulnerable including those with chronic conditions in terms of health management outcomes that are likely to pass the duration of the COVID-19 pandemic. However, questions about why patients with chronic diseases are more vulnerable to SARSCoV-2 and what interventions should be undertaken to reduce the risks remain open. Priorities will be given to research for a better understanding of appropriate interventions and in time, coordination of health and social care as well as raising the awareness of patients with pre-existing problems for a better disease management. We should continue to improve the vaccination rates (including booster doses uptakes) against C19 for those most vulnerable and continue to protect those groups during the winter periods when they are also faced with seasonal viruses.

Biography

I am a medical doctor with broad experience in public health medicine. I have masters in epidemiology and public health and a track record of: leading and managing large public health projects; conducting health needs assessments; evidence reviews and critical appraisals. My experience expands to leading and coordinating various healthcare programmes, supporting commissioning initiatives and developing & implementing local policies and strategies. Since 2016, I’m leading the programme of health and social care integration as part of Public Health division at London Borough of Southwark Council. During this period, I have contributed to the progress of healthcare integration process and working closely with a range of key partners at a local and South East London level. During the Covid-19 pandemic: I have contributed to the public health response to Covid-19 with a particular focus and leading the work on older adults, vaccination uptake, elements of health protection in supporting local care facilities for the elderly, and for a period of time also providing strategic leadership to the C19 contact tracing program locally. I have been invited and contributed as a lector in several conferences and workshops organized at an international level (2020-‘22) with a focus on Covid-19 pandemic and the impact to healthcare services, lessons learned and the UK experience/response. Over the years, I have been privileged to have collaborated with some of the leading research and healthcare organisations both in UK; and elsewhere, including World Bank, UNDP, UNICEF, USAID, DFID, and Ministry of Health of Albania.

Abstract

Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, is a blanket term for a variety of pathologies that can arise in the oral cavity and consist of a group of diseases, which should be diagnosed in the early stage.  Early recognition and prompt management are key to optimal outcomes. However, there remains a significant knowledge gap in this area among medical practitioners. A recent systematic review revealed that less than half of medical practitioners were aware of common risk factors of premalignant oral lesions or oral carcinoma; further, a low level of awareness was noted among most medical practitioners of common premalignant oral cavity lesions. Thus, there remains a significant need to understand and recognize the presentation, pathophysiology, and management of these conditions.

Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes. The most described etiologies of premalignant oral lesions are cigarette smoking, tobacco, and alcohol exposure. Betel nut chewing has also been associated with the development of oral leukoplakia. Human papillomavirus (HPV) has also emerged as a risk factor.

Oral premalignant lesions occur in roughly between 1.5% and 4.5% of the world's population and disproportionately affect men compared to women. The highest rates were found in Asian, South American, and Caribbean populations, as geographical variance exists due to differing rates of tobacco and alcohol consumption. Oral premalignant lesions account for 17% to 35% of all new cases of oral cavity cancer and undergo malignant transformation between 0.7% and 2.9% annually.

This review will describe the etiology, pathophysiology, pertinent history, and exam findings, as well as management options for these oral cavity malignant precursors.

Biography

Dr. Subodh Nanavati is a graduate of the Govt. Dental college and Hospital, Mumbai and has completed his training in Oral and Maxillofacial Surgery from the same institute. Dr. Subodh Nanavati has been working as an Oral and Maxillofacial for the last 40 years in various capacities including the Consultant, Visiting Professor, Research Director, and Chairman of Central Board of Accreditation of Healthcare Institutes (CBAHI), Shaqra Hospital, Saudi Arabia. Currently he is Director of the Happy Sapiens Dental, Houston, Texas.

Abstract

I was involved in the Covid19 response for Birmingham City Council. Birmingham is the second largest city in the United Kingdom and has significant levels of deprivation. It quickly became apparent that areas of high density and deprivation were facing higher levels of infection and mortality. Given that Covid19 is a respiratory disease public health felt it was important to continue to give stop smoking services to residents even though GP surgeries could no longer undertake this role. We therefore looked to commission an alternative support service using assistive technology. We decided in conjunction with one of our providers that we would introduce an app based service that would allow residents to get advice and support whenever they needed it. We also ensured that they could receive nicotine replacement thereby via a voucher system that could be ‘ordered’ via the app and collected at their nearest pharmacy. There was also a peer support/community support element that was developed.

Outcomes
We found that the Quit with Bella app was used by all groups and ethnicities. The app was found to be beneficial by users and led to people being able to quit over the course of the pandemic. The community of users was found to be supportive to others wanting to quit.

We have continued to offer quit services through the app as many users have reported how beneficial it is to them, especially where they find it difficult to access physical services.

Biography

Dr Marion Gibbon - Assistant Director of Public Health for Birmingham City Council Children and Families. She acts as a bridge between the Children and Families and Public Health Directorates. She has led the development and implementation of health improvement and prevention programmes over many years. She has worked internationally in Kenya, Sri Lanka and Nepal. Her doctoral work took place in Nepal and involved working with communities and particularly women to improve their health. She has undertaken organisational development and been involved in leading change at local, national and international levels. She is very creative and helps others to think outside the box. She has wide-ranging expertise across the public health field.