1. Collaboration

Back on the last 20 years all of education companies have decided to push all of efforts on line to spread their contents and get some scale.

That was important to increase margins and decrease costs.

On Healthcare we saw traditional education companies trying to push the same contents to hospitals and clinics thinking these could help them on their challenges.

When we got this picture some years ago we understood those healthcare companies had a deeply arsenal of content inside their walls but they didn’t know how to share it.

2. No Classrooms

A traditional environment of an education company has a professor, a classroom and students.

When we started to transform it on HealthCare we understood the whole spot was a classroom, the professors were inside the own companies and the students could learn and teach on the same time.

3. There is more inside an experience of a benchmark than inside a book about management. If you ride for an hour inside a hospital you can learn more about costs, income, velocity, quality, experience, than reading some article about the same issue. That is the third point of our strategy on this.

Background: The introduction of Highly Active Antiretroviral Therapy (HAART) transformed the treatment of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), improving the quality and greatly prolonging the lives of many infected people. Adherence to these medications have been a major challenge among these patients. There are relatively few rigorous evaluations of interventions to promote adherence to these medications, even fewer have explicitly utilized behaviour change theories. The Health Belief Model (HBM) is a tool that scientists use to try and predict health behaviours.  

Objectives: The broad Objective of this study is to investigate the influence of health beliefs on medication adherence among hiv/aids patients in South Eastern, Nigeria using the Health Belief Model as a theoretical construct.

Background. As cancer is a threatening experience full of uncertainty to patients themselves, it creates a huge gap of knowledge which results in needs of information. However, even though information needs are known to have one of the highest unmet needs among patient needs, identifying whether needed information is met or unmet did not have much attention in contrast to assessing information needs.

Method. Cancer patients were recruited from outpatient cancer treatment and consultation centers, cancer education center, and inpatient clinic. In order to measure information needs and needs-weighted unmet information needs of patients, a survey tool called Toronto Information Needs Questionnaire (TINQ) was used. Demographic, disease, psychological and cognitive, interpersonal, and environmental factors were analysed using hierarchical multiple regression analysis.

Result. While treatment and physical domain scored high in needs, psychosocial and disease had high scores in unmet needs. Multiple regression analysis was conducted based on independent variables suggested by Wilson’s model. Among patient’s general characteristics, education level and treatment status were identified as significant variables. When these socio-demographic and disease factors were controlled, presence of companion in hospital, which is included in the interpersonal characteristic, was found to be an influencing factor.

                Conclusion. Through this study, differences in unmet needs of information according to patient characteristics and influencing variables were identified. Verifying whether needs are met or unmet and how it is related with patient factors will be able to help tailor and customize information provision and improve qualities of supportive and patient centered care for patients.

Recent studies suggest ethnic inequalities in air pollution and health. Very few studies have investigated the role of air pollution on ethnic differences in child health. We used data from the 2016 Nepal Demographic and Health Survey for children aged 0-59 months (n = 2373) to examine whether the association between being exposed to household air pollution from burning solid fuels and child stunting varied by ethnicity and socioeconomic status (SES), employing the ordinary least squares (OLS) and instrumental variable (IV) models. We found strong evidence that exposure to solid fuel smoke increases the probability of being stunted, as well as reduces the height-for-age (HAZ) measure. The difference in means between the HAZ score of children exposed to solid fuels and those not exposed to it was 0.61. The OLS model estimated that up to 42.6% (β = 0.26, p = 0.010) of this difference is due to exposure to solid fuel, after controlling for potential risk factors, while the IV model estimated about 67.2% (β = 0.41, p = 0.003) of the difference. The stratified IV models showed lower HAZ score and stunting among indigenous people compared to the upper caste people. Further stratified analyses indicated that the impact of solid fuel smoke is stronger among indigenous people with low SES, but did not explain SES differences in the impact of solid fuels among the upper caste people. Children from indigenous communities are likely to be more susceptible to the health effects of solid fuel smoke.

 Our literature review study reflects the light on some chemical substances which are widely used in many & different aspects of our children daily practices & try to get the answers for the following important questions. Do these chemicals that our children are widely exposed to since even their prenatal period & throughout their lives have real high risks & dangers on their health? Is the use of these chemicals essential for our kids or we can avoid and replace them with other non-risky substances & hazardous chemical free products ...!! Recently, a lot of systematic review studies have been done to investigate the possible relations between the most common chemical substances that we use daily and possible risks & health problems that may affect our children. Among the chemicals that have been studied intensively in the last few years are Phthalate, Bisphenol A and Parabens which are known endocrine disruptors due to their anti-androgenic and/ or estrogenic effects! The purpose & Objectives of our study are to provide an overview of some widely and commonly used chemicals that are introduced to many of the products essentially used by our children daily, and the possible relations between their use and some of the common health problems & disorders that affect children in order to raise the awareness among parents & health care providers regarding their potential health impacts on children and to provide a proper guidance that help to minimize the avoidable exposure to these risky chemicals and replace them with hazardous chemicals free products till we get enough studies that prove or disprove their risks & effects. Methods & Results our study tries to search through, emphasis on & spot the light on the use of three chemical substances (Paraben, Phthalates & Bisphenol A) that are commonly & widely used in most of our children life aspects, searches for their possible risks & hazards on our kids' health, tries to get relations & connections between these substances & common pediatric health problems & disorders. In our study we reviewed the data collected from many evidences based systematic reviews and Cohort studies have dealt with these hazardous substances & stated the high incidence of their risks & their bad impacts on our kids' health & prove the relation of these chemicals to certain respiratory problems specially wheezing in childhood, ADHD, some atopic conditions and endocrine disruptions among children. Recommendations Our study concluded & suggested that it is better to eliminate exposure to these chemicals as evidences are rising against their safety. It's very important to increase the awareness among parents & health care providers regarding the possible risks of these chemicals and provide them the most proven practical tips for their avoidance. Further epidemiological studies should be conducted in the future to enhance our knowledge in this area.

Background: The Korean Government decided to develop medical tourism industry in 2009. The ultimate goal of pursuing globalization of healthcare was the development of healthcare industry promising more job opportunities. Since then, Korean government invested a lot of money to develop medical tourism industry.

Objective: This presentation deal with the following issues::
1) Current trend of medical tourism in South Korea
2) Policy issues
3) Strategy of government to develop medical tourism industry

Methods: This study uses the government data on foreign patients. The Korean hospitals/clinics are required to report the treatment cases of foreign patients to the government organization(KHIDI) by law.

Discussion: The number of medical tourists increased from 60,201 in 2009 to 364,189 in 2016(KHIDI, 2017). The average annual growth rate from 2009 to 2016 was nearly 30%. The hospital earnings from foreign patients was just $50 million in 2009, but rose to $800 million in 2016, nearly 16 times over a 7-year period.

The strategy of Korean government is to create the value for the medical tourists in the following areas:
1) transparency(e.g., price list, doctor list, tax refund)
2) accountability(e.g., mandatory liability insurance, medical tourist insurance, development of risk and complaint management protocol)
3) professionalism(e.g., national certificate of medical tourism coordinator, development of training programs)
4) safety(e.g., hospital/clinic accreditation)
5) patient advocacy(e.g., setting the upper limit of agency commission)
6) convenience(e.g., medical visa, MT help desk)

Over the past twenty-five years most businesses have been revolutionized by the easy availability of cloud and mobile-based computing systems. Hospitals and health systems were late comers to the enterprise technology game. However, the hospital sector is likely to move towards the trend of using the cloud seen in other businesses. Beyond this a newr generation of technologies include AI (artificial intelligence), VR (virtual reality) and AR (augmented reality), all built on top of cloud computing. Also built on the cloud is the Internet of Things--physical sensors distributed everywhere, such as in smart speakers (Alexa, Google Home), clothing, video cameras, thermostats, medical devices, and more. These enable new types of remote monitoring and management, which are themselves making use of the new capabilities of cloud computing, real-time analysis and AI. The companies with the most advanced technology in AI, voice recognition, sensors and cloud computing are the same ones which have benefitted from the cloud revolution. Concurrently there is huge speculation about what Amazon, Apple and Alphabet/Google will do in health care. There are several obvious scenarios in which new market entrants can change health care but the one in which they take a major role we call “Tech inverting the stack”

Starting with technology, the sensors, trackers, AI systems and processes are soon going to be in place monitoring, measuring and suggesting next steps to both providers and patients. In general, this will move health care from being an event driven system to becoming a consistent process. Theoretically “normal’ patient behavior and activity will not need any response, whereas exceptions and problems will require intervention from a combination of human and machine services. Finally, care delivery – the clinical interventions that make up health care are we know it today – will become an added extra to the top of the health care stack.

In this scenario, the tech platform is the underlying system, with services and professionals on top. There’s no real reason to think it can’t be done, and there’s no reason to suppose that if it is done it won’t radically reduce doctor visits and hospital admissions, and improve patient care. And of course it will have huge implications for the future sociology of health care

Activation of cannabinoid receptor type 2 has been shown to have anti-fibrosis action in some organs such as in liver, skin and heart. However, whether activating cannabinoid receptor type 2 could inhibit pulmonary fibrosis still obscure. The key markers in the pathogenesis of lung fibrosis are, pulmonary fibroblasts and TGF-β1. The aim of the current work was to investigate the stimulating role of cannabinoid receptor 2 agonist AM1241 in in vivo model of pulmonary fibrosis. Lung fibrosis was induced in rat model using bleomycin (0.05 IU) instilled intratracheally once in rats, then rats were treated either with vehicle 0.1 ml of 1:2 DEMSO: PBS or AM1241 (3mg/kg DMSO then diluted  in PBS by ratio 1:2) once daily for 14 days.  The use of AM1241 markedly decreased the pulmonary fibrosis by reducing the level of the profibrotic cytokines TGF-β1 as well as reducing the levels of collagen I and α-SMA. The oxidative stress marker thiobarbituric acid reactive substance showed marked decrease. The histopathological examination of lung revealed that the use of AM1241 could suppress collage deposition and inflammatory reaction as well as decreased fibrosis scoring. Our results indicated that activating cannabinoid receptor type 2 could be a novel significant strategy for curing pulmonary fibrosis.

Female circumcision also called genital cutting or mutilation is an ancient Egyptian practice. It is an invasive procedure of non-medical purposes (1). Nowadays, it has been documented in many other countries all over the world. It threatens about three millions girls every year (2). We report a case of a married couple coming to the clinic with a complaint of infertility. On physical examination of the vulva, there was adhesion of labia minora forming a fibrous septum against proper sexual vaginal intercourse. Past history indicated female circumcision done before marriage. Other parameters of investigations were within the normal values. Cutting of the septum and suturing the raw surfaces of the edge on either side were done under anaesthesia and sterilization precautions. Pregnancy occurred within three months of the procedure. Our case was of the most common performed type of circumcision with excision of the clitoris and the two labia minora that represent the most sensitive organs (3). At circumcision, these organs are hold by forceps; and rose away from the body; then they are cut together (1). Since the operator is non-medical, he/she does not perform suturing the raw edges; and instead keep the victim with approximated thighs to prevent bleeding. Long staying in such approximation results in adhesions between the raw edges on both sides and then formation of the fibrous barrier in-front of the urethral and vaginal openings of the vestibule. It is concluded that female circumcision could result in infertility through adhesions of edges of the wound.

Our literature review study reflects the light on some chemical substances which are widely used in many & different aspects of our children daily practices & try to get the answers for the following important questions. Do these chemicals that our children are widely exposed to since even their prenatal period & throughout their lives have real high risks & dangers on their health? Is the use of these chemicals essential for our kids or we can avoid and replace them with other non-risky substances & hazardous chemical free products ...!! Recently, a lot of systematic review studies have been done to investigate the possible relations between the most common chemical substances that we use daily and possible risks & health problems that may affect our children. Among the chemicals that have been studied intensively in the last few years are Phthalate, Bisphenol A and Parabens which are known endocrine disruptors due to their anti-androgenic and/ or estrogenic effects! The purpose & Objectives of our study are to provide an overview of some widely and commonly used chemicals that are introduced to many of the products essentially used by our children daily, and the possible relations between their use and some of the common health problems & disorders that affect children in order to raise the awareness among parents & health care providers regarding their potential health impacts on children and to provide a proper guidance that help to minimize the avoidable exposure to these risky chemicals and replace them with hazardous chemicals free products till we get enough studies that prove or disprove their risks & effects. Methods & Results our study tries to search through, emphasis on & spot the light on the use of three chemical substances (Paraben, Phthalates & Bisphenol A) that are commonly & widely used in most of our children life aspects, searches for their possible risks & hazards on our kids' health, tries to get relations & connections between these substances & common pediatric health problems & disorders. In our study we reviewed the data collected from many evidences based systematic reviews and Cohort studies have dealt with these hazardous substances & stated the high incidence of their risks & their bad impacts on our kids' health & prove the relation of these chemicals to certain respiratory problems specially wheezing in childhood, ADHD, some atopic conditions and endocrine disruptions among children. Recommendations Our study concluded & suggested that it is better to eliminate exposure to these chemicals as evidences are rising against their safety. It's very important to increase the awareness among parents & health care providers regarding the possible risks of these chemicals and provide them the most proven practical tips for their avoidance. Further epidemiological studies should be conducted in the future to enhance our knowledge in this area.