Chair

Lauren Boardman

College of Coastal Georgia, USA

Co-Chair

Wanju Park

Kyungpook National University, South korea

Session Introduction

Thomas J Franz

Cetero research, USA

Title: Assessing the bioavailability and bioequivalence of topical dermatologic drug products with multiple surrogate tests

Time : 29:00-29:55

Biography:

Thomas J Franz received an MS in Biochemistry and an MD from the University of Oregon Medical School and completed a residency in Dermatology at the University of Washington School of Medicine. He has worked in the fields of cutaneous pharmacology and toxicology for over 40 years, both within academia and the pharmaceutical industry, as well as at the Food and Drug Administration. His special focus is in percutaneous absorption as it relates to issues of BA/BE and he is the developer of the Franz Cell. He has published more than 70 papers in peer reviewed journals and books.

Abstract:

Progress in the development of surrogate methods to evaluate the bioavailability and bioequivalence of drugs applied to the skin has resulted in the generation of a sufficient body of data to justify their use as alternatives to clinical trials for the approval of generic topical drug products. They can also be used during the formulation development phase of both new and generic topicals to assess the relative bioavailability of various test formulations. A number of these (excised skin permeation assay, stratum corneum tape-stripping, microdialysis, transepidermal water loss) have been shown to successfully duplicate the results of clinical trials and demonstrate the bioequivalence of generic products approved by the FDA with an AB rating. Though each of these surrogate tests may not have been sufficiently validated to the satisfaction of regulatory authorities, and each can be criticized as potentially having significant shortcomings, they do not all have the same potential limitation and the results of one can effectively complement the results of another. Selected pairings of these surrogate methods, depending on the therapeutic product class in question, in conjunction with a membrane rate of release assay and irritation/sensitization testing, can offer a scientifically justified, efficient pathway to the approval of generic topical drug products.

Kenneth J. Ruggiero

Medical University of South Carolina, USA

Title: Trauma Resilience and Recovery Program: A Stepped Care Model to Facilitate Recovery after Traumatic Injury

Time : 11:05-11:30

Biography:

Kenneth J Ruggiero has completed his PhD at West Virginia University and has served on the Faculty at the Medical University of South Carolina since 2003. He is a Professor of Nursing and Psychiatry and Co-Director of the Technology Applications Center for Healthful Lifestyles. He has led as Principal Investigator for 4 grants funded by the National Institutes of Health and 7 other grants funded by the Department of Homeland Security and Veterans Administration. He has more than 140 scholarly publications. He serves as an Editorial Board Member for the Journal of Traumatic Stress, Journal of Interpersonal Violence and Journal of Anxiety Disorders.

Abstract:

Traumatic injuries affect people of all ages, genders and races. Trauma care and trauma systems continue to improve, but most of this progress has occurred in pre-hospital and acute care settings. Mental health needs (e.g., posttraumatic stress, depression), which affect more than 20% of patients who experience traumatic injury, continue to be poorly identified and treated after discharge. We recently launched the Trauma Resilience and Recovery Program (TRRP) to address this need at our Level 1 Trauma Center at the Medical University of South Carolina. TRRP is a new 4-step service that we believe has tremendous potential to serve as a cost-efficient, scalable, and sustainable model of care. It represents collaboration between leaders in Psychiatry, Trauma Surgery, Pediatrics, Nursing, and Tele-health. Our four-step process includes: In-hospital education; 30-day mental health telephone screening; comprehensive mental health assessment and delivery of best-practice treatment for PTSD or depression. Tele-health technology is offered at steps 3 and 4 to address barriers to accessing face-to-face services. This presentation will outline the structure of our service, data describing successes and challenges in our first year of operation and results of three pilot studies that we completed with adults and adolescents after traumatic injury. The pilot studies addressed the prevalence and risk factors associated with mental health recovery as well as a novel text messaging program to assist in self-monitoring emotional recovery. In our first 3 months since launching the program, we have served approximately 150 patients through the program.

Sumaiya Mohamed

Centre for the study of violence and reconciliation(CSVR), South Africa

Title: The impact of war and the on-going challenge to survive as a refugee in South Africa on mental health and resilience

Time : 11:55-12:20

Biography:

Sumaiya Mohamed has completed her Masters degree in Community Based Counseling Psychology from the University of the Witwatersrand, South Africa. She currently works as a Psychosocial Trauma Professional at the Centre for the Study of Violence and Reconciliation (CSVR), in the trauma clinic, providing psychotherapeutic services to torture survivors (individuals, groups and families).

Abstract:

The Centre for the Study of Violence and Reconciliation is a non-governmental organization that provides psychological services to torture survivors, with the aim of promoting psychosocial rehabilitation and mental wellbeing. A large group of individuals that we work with in the trauma clinic are refugees and asylum seekers coming from war torn countries in Africa, who are either direct or indirect torture survivors. Clients that come to the trauma clinic present with a wide spectrum of mental health disorders and current stressors. Common mental disorders that clients present with at the trauma clinic include: Post Traumatic Stress Disorder; Anxiety Disorders; Depressive disorders; Somatic disorders; and Psychosis. Coupled with this, clients face a number of current stressors in South Africa that impact on their mental wellbeing further. These current stressors include: Bereavement and loss; social isolation; adapting to a new environment; family breakdown; getting medical, legal and social needs met; and safety concerns. Taking into account the mental disorders presented in clients and their experience of current stressors that further impact on their mental wellbeing, we see a myriad of complexities that we work with in therapy with these clients. Reactions to these experiences are usually the result of a complicated interplay between past traumas (psychological impacts stemming from the torture experience in the country of origin), current stressors, and risk and protective factors. Using information gathered on the CSVR’s centralized M&E system as well as through clinical reflections on therapy with torture survivors, this paper explores the complexity of providing psychosocial services to survivors of torture in contexts of continuous traumatic stress and daily stressors. The implications for therapy in such situations are explored.

Session Introduction

Alhad Anant Pawar

INHS Asvini, India

Title: Mindfulness: An effective way to enhance Resilience

Time : 13:20-14:50

Biography:

Alhad Anant Pawar is recognized as a Psychiatrist with a strong history and solid reputation for innovative military leadership, community based interventions, integrity based outcomes and an unprecedented ability to ensure optimal state of mind of the clientele. He has vast professional and personal experiences in his duties as a Military Leader, Keynote Speaker, Physician, Academician, Researcher, Author, Guide and Mindfulness Instructor. He is a strategic visionary who has combined 27+ years of experience in mental health with a comprehensive understanding of the issues in today’s life environments. He has completed his MBBS and MD from Armed Forces Medical College, India and currently commanding the largest hospital of Indian Navy.

Abstract:

Resilience is an individual's ability to adapt to stress and adversity and also to bounce back from a negative experience. A number of approaches to resilience-building have been developed, gathering attention mainly on the theory and practice of behavioral therapy. Development and enhancement of resilience among military personnel is highly essential as they experience higher degree of stressful situations and adversities. An emerging field in the study of resilience is application of mindfulness meditation towards enhancing resilience. Mindfulness is a process through which one pays attention to experiences in the present moment in an intentional and nonjudgmental manner. There has been a significant increase of interest in research, application and understanding psychological effects of mindfulness-based interventions in recent years. Numerous studies have examined and demonstrated the benefits of these interventions on various domains of human functioning, ranging from cognition, attention, psycho-somatic and physical symptoms, improved well-being and greater psychological resilience. Research has also demonstrated various psychological and neurobiological mechanisms through which mindfulness may lead to improved psychological functioning and enhanced resilience which in turn ensure ready and resilient workforce. This workshop conducted by Dr AA Pawar and Dr JK Panda aims to integrate findings from studies from various disciplines that highlight a variety of ways through which mindfulness enhances resilience. The workshop will also include an experiential exercise, during which the audience will be invited to engage in a brief, guided mindfulness practice to gain practical understanding of mindfulness.

Jayant Kumar Panda

INHS Asvini, India

Title: Building Resilience in Nursing Students: Implementing Techniques to Foster Succes

Time : 13:20-14:50

Biography:

Dr JK Panda is a medical graduate from SCB Medical College, Cuttack, Odisha and has done post-graduation in Public Health (MPH) from Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. His research interests include Mindfulness, Resilience, Positive Psychology, Quality of Life and overall Mental Health. He is trained in Vipassana and practicing mindfulness regularly. He has conducted mindfulness training programs for personnel from various trades, echelons and spheres of life. He has conducted various studies on mindfulness, resilience, stress, depression; and actively involved in a range of mental health initiatives towards bulletproofing of minds of military personnel. He aspires to help improve the quality and accessibility of mental health services through teaching, research, community outreach and advocacy.

Abstract:

Resilience is an individual's ability to adapt to stress and adversity and also to bounce back from a negative experience. A number of approaches to resilience-building have been developed, gathering attention mainly on the theory and practice of behavioral therapy. Development and enhancement of resilience among military personnel is highly essential as they experience higher degree of stressful situations and adversities. An emerging field in the study of resilience is application of mindfulness meditation towards enhancing resilience. Mindfulness is a process through which one pays attention to experiences in the present moment in an intentional and nonjudgmental manner. There has been a significant increase of interest in research, application and understanding psychological effects of mindfulness-based interventions in recent years. Numerous studies have examined and demonstrated the benefits of these interventions on various domains of human functioning, ranging from cognition, attention, psycho-somatic and physical symptoms, improved well-being and greater psychological resilience. Research has also demonstrated various psychological and neurobiological mechanisms through which mindfulness may lead to improved psychological functioning and enhanced resilience which in turn ensure ready and resilient workforce. This workshop conducted by Dr AA Pawar and Dr JK Panda aims to integrate findings from studies from various disciplines that highlight a variety of ways through which mindfulness enhances resilience. The workshop will also include an experiential exercise, during which the audience will be invited to engage in a brief, guided mindfulness practice to gain practical understanding of mindfulness.

Session Introduction

Chelsea Robertson

King’s College London, UK

Title: Attitude Towards Trauma Exposure and Psychological Support in the Fire Service

Time : 14:50-15:15

Biography:

Chelsea Robertson is currently pursuing MSc at King’s College London, having gained her undergraduate degree from University of Dundee, Scotland. She has spent time abroad studying Disaster Psychology in New York and trained in Psychological First Aid with the American Red Cross. Recently she is working under the supervision of Professor Neil Greenberg who is the President of the UK Psychological Trauma Society to investigate Trauma Risk Management (TRiM) as a means of early PTSD prevention in fire fighters. She was trained to become a TRiM Practitioner and will graduate this September with an MSc in Organizational Psychiatry and Psychology.

Abstract:

Trauma Risk Management (TRiM) is an in-house peer support program for traumatic stress that originated in the armed forces. TRiM was designed for use in the emergency services but can be used in any workforce at high risk to stressors which could have a detrimental effect on employee mental health. The intervention trains employees to recognize early distress signs in peers by conducting basic risk assessments. Previous research acknowledges TRiM as an accepted supplementary method of staff support, however does not address the stigmatic attitude of employees when help-seeking. This paper investigates the use of TRiM in the fire service, using qualitative methodology to explore the reasoning behind the positive attitude and adaption towards the intervention. Specifically, I will juxtapose Critical Incident Debriefing (CID) and TRiM as methods of mental health support, focusing on the difference in negative connotations of CID and positive attitude towards TRiM. By examining methods of support for mental health that are accepted in the workplace, we are promoting positive help-seeking. I argue that by understanding the reasoning behind whether an intervention is accepted and used we can take the positive aspects and more widely implement the desired and effective mental health support.

Azadeh Shahrad

Swedish University of Agricultural Sciences, Sweden

Title: Sustainable health for successful integration into the Swedish society through nature-based rehabilitation in Alnarp Rehabilitation garden

Time : 15:15-15:40

Biography:

Azadeh Shahrad has obtained her Master degree in Landscape Planning in 2013. Presently, she is working as a Research Assistant at Department of Work Science, Business Economics and Environmental Psychology.

Abstract:

The global refugee crisis calls for attention to comprehend the psychological consequences of forced migration and displacement. Immigrants’ mental health has been at risk because of the exposure to trauma and violence before migration. Moreover, postmigration experiences e.g. having been exposed to mortal danger during flight, stress of adaption, discrimination etc. The aim of this study is to investigate if a ten weeks nature-based rehabilitation program can contribute to improved health and well-being among newly arrived refugees in Sweden during participation in a two-year integration program, managed by the Swedish Public Employment Service. The rehabilitation is performed at Alnarp Rehabilitation Garden and was scheduled for three days a week, each day lasting for four hours. The rehabilitation program is carried out in group of five to ten individuals and was managed by an occupational therapist, a physiotherapist and two horticulturists. The aim of the program is to enhance a salutogenic curative process for better wellness through sensory impressions, activities and rest. The evaluation is conducted as participant observation study, along with in-depth interviews at the end of the program, and with a register follow-up after one year. The work is conducted in a joint effort with the Swedish Public Employment Service and the healthcare authorities in Scania County in order to find means for sustainable integration of refugees into Swedish society. The study will run until March 2016 and is approved by regional ethic committee.

Mona Radwan

Zagazig University, Egypt

Title: Depression and substance abuse among refugees and immigrants of USA

Time : 15:40-16:05

Biography:

Mona Radwan has completed her PhD from Zagazig University and Postdoctoral studies from Lund University, School of Medicine and School of Social Sciences respectively. She is one of the Member steering committees of Women in Great Sciences at Lund University (WINGS). She has published in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

Mental health problems involving major depression disorder, post-traumatic stress disorder and general anxiety disorder are familiar among lately arrived immigrants and refugees. Although many immigrants and refugees are resilient, traumatic experiences and resettlement stressors have an immense effect on their mental well-being. The study objective was to estimate the rate of major depression among refugees versus immigrants to United States of America and their relation to substance abuse. In 2004- 2005 our study was carried out as part of large survey directed to refugees who arrived after 1991 and immigrants who arrived before 1991 from Iraq to USA. Out of 5,490 participants, 350 were randomly selected of Iraqi born one, who lives in the greater Detroit of Michigan, USA. The study groups were classified into refugees and immigrants, furthermore divided into those with major depression and not. Participants were interviewed to answer standard questionnaire which include 103 questions. An informed consent had been taken from all participants in the study. Out of all the participants, 43.9% of the refugees have major depression which is significantly higher than immigrants; 11%, while the substance abuse was 49.7% among the immigrants significantly more than refugees; 41.5%. Moreover, years in USA, ethnicity, gender and smoking status are the predictors for the substance abuse among the study group; while gender, ethnicity, education and employment status are the predictors for the major depression among refugees. In conclusion there are multiple contributing factors to major depression and substance abuse among refugees than among immigrants.

Break: Networking & Refreshment Break 16:05-16:25 @ Foyer

Zhaleh Ahani

Razi University of Kermanshah, Iran

Title: The effectiveness of cognitive-behavioural intervention on dysfunctional attitudes mate selection in female students

Time : 16:25-16:50

Biography:

Zhaleh Ahani has received her BA degree in Guidance and Counseling from Razi University of Kermanshah in Iran. She has completed MA in Family Counseling and has 7 papers published to her credit.

Abstract:

Irrational Attitudes and beliefs are one of the factors that prevented the marriage. Their rational attitudes and imaginations of person can play a significant role in creating a dysfunctional emotional relationship. Irrational attitudes are effective on mental health. Attitudes determine behavior. We can change behavior by changing attitudes. This study aimed to investigate the effectiveness of cognitive-behavioral intervention on dysfunctional attitudes mate selection in female students. The study type was semi- experimental using pre-test and post-test with control group. The research instrument was attitude toward mate selection questionnaire. Data were analyzed using multivariate analysis of covariance. The results showed a significant difference between the two groups dysfunctional attitudes mate selection (Ease of effort, Love is enough, Idealization, Opposites Complement). According to the findings, cognitivebehavioral intervention in changing dysfunctional attitudes mate selection can be an effective step in meeting the youth to the mate selection

Session Introduction

Ata ur Rehman

Dow University of Health Sciences, Pakistan

Title: Patterns of anxiety among patients with Stoma and its determinants: A single center experience

Time : 16:50-17:15

Biography:

Ata ur Rehman has completed his MBBS from Jinnah Medical Dental College in 2008. He has completed his training in General Surgery for Post graduation program. He is currently working as a Registrar in the Department of Surgery at Dr. Ziauddin University Hospital KDLB campus.

Abstract:

Stoma surgeries have become a common procedure for patients suffering from various abdominal pathologies, which lead to increase in life expectancy of patients with severe abdominal diseases. There are several psychological conditions which stoma patients have to deal with including anxiety, depression, fear and social isolation. This study aimed to examine the burden of anxiety among stoma patients and the determinants leading towards anxiety among stoma patients in Pakistan. A cross-sectional study was conducted on 97 in-patients at surgical unit of Civil Hospital Karachi. Patients included those who had undergone abdominal surgery for various abdominal pathologies and had been given a stoma from January 2013 to March 2014 were included in this study. Data was collected through a modified anxiety questionnaire which included questions on stoma management, care, anxiety and fears related to stoma. The overall prevalence of anxiety regarding stoma among patients was 56.7% (n=55). Patients younger than 30 years of age were found to be more anxious 58.2% (n=32). Females were more likely to be anxious as compared to males; (OR=1.62, 95% CI=0.68-3.85, p-value=0.274). Patients were twice more likely to be anxious if they had a double barrel stoma as compared to loop stoma; (OR=2.47, 95% CI=0.61-9.93, p-value=0.203). This study suggests that a considerable proportion of patients with stoma suffer from anxiety but this study did not find any significant determinant of anxiety among stoma patients, perhaps due to smaller sample size. We need further evidence on anxiety among disease specific stoma patients with longitudinal studies having larger samples.

Sara Khan

The Indus Hospital, Pakistan

Title: Levels of Depression and Anxiety Post-Mastectomy in Breast Cancer Patients at a Public Sector Hospital in Karachi, Pakistan

Time : 17:15-17:40

Biography:

Sara Khan is a Consultant Clinical Psychologist and runs her own clinic for mental health. Currently she is associated with The Indus Hospital, a charitable hospital in Karachi and is serving as Head of the Counseling Department nationwide for Global Fund’s TB Program, Pakistan. She is also a Member of Editorial Boards online and in local journals.

Abstract:

There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns associated with it, but what happens after the procedure is of great significance too.This cross sectional study focuses on the several psychological connotations attached to mastectomy and how the patients cope with it.The sample size consisted of 88 in patients at the different surgical units of the Civil hospital, Karachi from January 2012-December 2014; who had under gone mastectomy. The questionnaire was administered before they were discharged i.e., within 3 days of the surgical procedure. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then it was preceded by asking them questions from a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, a mixture of psychological and physiological symptoms attached to it. There were a total of 88 patients out of which 36 (41%) were aged [51 to 60] years, 24 (27.2%) of the patients lies under age category of [41 to 50] years, age category of [61 and above] were 17 in number (19.3%) whereas the least number of patients i.e., 11 (12.5%) comprised of [30-40] years of age, which happens to be the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories i.e., severe level of depression and anxiety was most prevalent whereas moderate level of such symptoms was followed by it, relatively fewer patients felt mild or no depression symptoms. It was concluded that going through mastectomy leads to moderate to severe level of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of them.