Nicholas Comninellis’ Presentations

Nicholas Comninellis, President and Professor at the Institute for International Medicine, offers presentations for healthcare professionals, healthcare profession students, and undergraduates. Please Contact INMED to explore potential opportunities.

 

Dr. Comninellis’ most popular presentations include:

 

Videoed Presentations

M3 Conference presentation of From Disaster to Durability

 

From Disaster to Durability

 

Objectives:

 

  • Describe the limitations of the rescue paradigm
  • Explain the Human Development Index
  • Cite examples of community durability

 

Abstract: Disasters, epidemics, and disease crises continue to mar this century. The heartening response from many is to devote time, talent, and treasures to rescue those in crisis. But such efforts have limitations. We must move beyond a rescue emphasis and pursue development of more resilient communities. Such Interventions include economic development, improved basic education, and highly efficient health initiatives. Throughout, we must equip local leaders with vision and skills to continue building strength from within their own communities.

 

TEDx Presentation of International Refugee Care

 

International Refugee Care – Displaced But Not Forgotten

 

Objectives:

 

  • Describe the scope of the worldwide refugee crisis
  • Explain the four recognized phases of refugee care
  • Recount the necessary factors in design of refugee settlements

 

Abstract: Refugee care is a pressing global issue. Today’s world has more refugees seeking asylum than at any time since WWII. 86% of refugees are hosted in developing countries, severely straining existing social infrastructures. International refugee care includes four recognized phases: Pre-Emergency/Mitigation Phase, Emergency Phase, Post-Emergency/Maintenance Phase, and Repatriation Phase. Throughout these phases, refugee leaders must attend to concern over security, location of settlements, mental stress, dependency, and host-refugee relations.

 

TEDx presentation of Controversies in Short-Term Medical Missions

 

Controversies In Short-Term Healthcare Missions

 

Objectives:

 

  • Cite examples of questions of ethics and effectiveness surrounding of such missions
  • Describe the importance of partnerships with national leaders
  • Explain the the virtues of continuity & long-term commitment

 

Abstract: Beyond the popularity of short-term healthcare missions, serious questions are being asked regarding their ethics and effectiveness. Related concerns include lack of continuity, cultural relevance, and competition with existing healthcare services. A key element in assuring ethics and effectiveness is national partnerships: cooperation with host professionals, institutions, and community leaders who guide the healthcare missions in provision of materials, educational instruction, or patient care.

 

M3 Conference presentation of Serving the Forgotten

 

Serving The Forgotten

 

Objectives:

 

  • List objective standards for measuring human well-being
  • Identify groups of people at highest risk for poor health
  • Describe the interdependence of health care, education, and economic growth

 

Abstract: Personal happiness is an insufficient life goal. Betterment of human well-being is more laudable. Worldwide gains have been made towards this end, but multitudes still suffer from preventable disease and absent healthcare. These forgotten people often include immigrants, refugees, minorities, elderly, disabled, non-English speakers, urban and rural poor, and victims of disaster and war. In their defense, health leaders must advocate for comprehensive solutions that include basic education, income generation, and fundamental healthcare services. Health leaders so engaged often also discover deep, personal satisfaction.

 

INMED Humanitarian Health Conference presentation of

Launching Your International Healthcare Career

 

Launching Your International Healthcare Career

 

Objectives:

 

  • Describe principles of wise decision making
  • Enumerate the major professional decisions ahead
  • Enumerate the major personal decisions ahead

 

Abstract: This unique tract is often marked by unusual diseases, minimal resources, and challenging cultural context. Begin by applying the principles of wise decision-making: prayer, analysis of pros and cons, soliciting advice, and ample patience. Professional decisions include selection of a specialty, a community to serve, a sending organization, and language learning needs. Personal decisions include money management, personal health, and family relationships, and legal compliance. Throughout, determination and faith are essential to a virtuous international healthcare career.

 

INMED Humanitarian Health Conference presentation of Emergency Pandemic Control

 

Emergency Pandemic Control

 

Objectives:

 

  • Identify potential emerging epidemic threats
  • Describe epidemic monitoring and investigation methods
  • Cite epidemic control principles

 

Abstract: Increasing international trade and travel increase the likelihood of rapid contagious disease transmission. Examples include the 1918 Spanish influenza pandemic, 2004 SARS epidemic, and today’s continuing COVID-19 cases. Epidemic investigation is based upon finding objective answers to critical questions: the infectious agent, mode of transmission, incubation period, and effective modalities for prevention, diagnosis, and treatment. Epidemic control often requires special attention to disease-associated racism, resistance to local and international cooperation, and extreme stress placed upon low-resource health systems.

 

INMED Humanitarian Health Conference presentation of Universal Donors

 

Universal Donors

 

Objectives:

 

  • List groups of people at greatest risk for poor health
  • Cite the multiple rationales for declining service towards forgotten people
  • Describe a personal action plan to donate your time and talent

 

Abstract: What is your blood type? Type O Negative is the “universal donor” – the rarest and the most useful of all blood types. Healthcare professionals possess skills to protect and restore health. But like people contemplating blood donation, they often hold back from service to those who are most marginalized. Concerns include fear over personal safety, finances, children’s education, and family life, unfamiliar disease, cultural barriers, and inadequate medical resources. These can be mitigated and more healthcare professionals themselves to become “universal donors” on behalf of the world’s most poor.

 

Video excerpt from the presentation The Power of Applied Learning

 

Power of Applied Learning

 

Objectives:

 

  • Cite examples of learners difficulty applying knowledge in real time
  • Describe education modalities to aid application of learning

 

Abstract: INMED President describes his early failure to apply what he learned in tropical medicine school to actual patient care in southern Africa. This failure to launch from didactic learning to actual performance is pervasive throughout education. A key element to successful transition is often practical, real-life experience accompanied by supervision of a dedicated mentor. The Institute for International Medicine makes full use of this model, combining didactic instruction with on-the-field service-learning experiences guided INMED facility in twenty-five developing nations.

 

M3 Conference presentation of The Power of Exemplary Role Models

 

Excerpt from the video presentation The Power of Exemplary Role Models

Power of Exemplary Role Models

 

Objectives:

 

  • Identify influential role models in one’s personal life
  • Describe attributes of virtuous role models
  • Site obstacles against that hinder being an exemplary role model

 

Abstract: Personal role models can profoundly impact our values and aspirations, resulting in exceptional lives or devastating lifestyles. This presentation explores the power of role models, citing examples from early Christianity and the genesis of the Institute for International Medicine. Deliberate selection and rejection of persons to emulate is a vital life skill. This presentation includes with a challenge for personal integrity, action on behalf of the world¹s most forgotten people, and intentionally making oneself available to influence others. Case studies and small group interaction are used throughout.

 

INMED Virtual Humanitarian Health Conference presentation of High-Risk, Low-Resource Maternal Care

 

Low-Resource High-Risk Maternal Care

 

Objectives:

 

  • Identify major causes of worldwide maternal morbidity and mortality
  • Describe effective family planning and contraception
  • Explain management of common delivery complications

 

Abstract: Surviving motherhood is a genuine concern. Maternal and newborn deaths are the 6th and 7th leading causes of life years lost in the world’s poorest nations. Sepsis, post-partum hemorrhage (PPH), eclampsia-preeclampsia, and failure to progress are the leading causes of maternal morbidity and mortality. Major interventions are to reduce family size and to provide quality obstetric care at delivery. Management of PPH requires immediate recognition and treatment, particularly for atony. Basic newborn resuscitation should be universally available.

 

INMED Virtual Humanitarian Health Conference presentation of

Fighting the Diseases of Poverty

 

Fighting The Diseases Of Poverty

 

Objectives:

 

  • Explain how economic development is related to health status
  • Describe how military conflict impacts civilian health
  • Enumerate high-priority effective disease interventions

 

Abstract: Poverty and health are closely associated. The nations of poverty host lowest life expectancy, greatest child mortality, and highest preventable deaths. Three interventions are especially effective. First, promotion of broad-based economic development which usually enhances health infrastructure, Second, mitigation of military conflict, which especially afflicts those most vulnerable. Third, deployment of specific interventions that have proven effective against the leading diseases of poverty.

Career Development

From Inspiration To Mobilization

 

Objectives:

 

  • List groups of people at greatest risk for poor health
  • Cite the multiple rationales for declining service towards forgotten people
  • Describe a personal action plan to donate your time and talent

 

Abstract: It is human nature to defend. Whom will you defend? It natural to step up to a challenge. What challenge will you choose? We witness marvelous progress in healthcare: precision surgery, miracle cancer drugs, faultless vision correction. Yet multitudes are barred from these innovations because of poverty, culture, and distance. Healthcare professionals often desire to serve the poor. But how do we move from such feelings to deliberate steps of action? This presentation takes makes use of popular movie clips demonstrating individuals who advance from inspiration to mobilization.

Health Of You The Traveler

 

Objectives:

 

  • Identify the main hazards for those traveling to low-resource nations
  • Describe actions to protect oneself from illness and injury
  • Explain how to seek appropriate medical assistance in an unfamiliar setting

 

Abstract: Contrary to most perceptions, the leading causes of death among Americans who travel abroad are injuries and exacerbation of preexisting diseases. Advanced preparation includes attention to injury prevention, adequate control of chronic diseases, and measures to prevent infections. The latter include vaccinations, emergency medications, and measures to prevent insect-borne diseases like malaria and dengue. Travel insurance and identification of reputable local medical care providers should be arranged prior to departure. Travelers are also wise to also consider in advance their mental health needs.

Community Health

Appropriate Technology For Global Health

 

Objectives:

 

  • Identify the controversies connected with use of technology
  • Describe guiding principles for application of technologies
  • Cite examples of select technology most appropriate for given settings

 

Abstract: Healthcare is chronically in crisis, especially in low-resource settings. One important principle for successful health systems is appropriate use of technology. It must be reliable, sustainable, and acceptable. Some appropriate uses often include rapid diagnostic tests, mobile health information systems, ultrasound imaging, and adherence to Essential Drugs Lists. Collaboration among healthcare participants is essential, increasing the likelihood that technology will be appropriately applied. This presentation includes interactive case studies and role-play.

Chronic Disease Amid Chronic Poverty

 

Learning Objectives:

 

  • Describe the burden of the chronic diseases in developing countries
  • Innumerate the challenges of managing these illnesses in low-resource settings
  • List effective strategies to combat the most pervasive chronic diseases

 

Abstract: Infectious diseases have been the leading cause of morbidity and mortality throughout history. Today, however, the burden of infectious diseases is diminishing while the mobility from chronic, non-infectious diseases is growing dramatically. Low-resource nations are particularly ill-equipped to manage diabetes, hypertension, chronic lung, and chronic heart diseases. This session illuminates the power of lifestyle improvements, continuity of primary care, provision of life-saving medications, and public health policy.

Health Is Wealth

 

Objectives:

 

  • Explain the tensions between healthcare cost, quality and access
  • Describe the benefits of value-based care
  • Explain how to implement value-based care payment into a medical practice

 

Abstract: Health is in crisis throughout the world. Cost is high and growing. Access is limited, especially for those separated by distance or financial means. Quality of care is also variable and difficult to assure. Systems of healthcare should result in healthier lives, not simply more services. A useful strategy is to pay for healthcare based on value of care, rather than on volume of care alone – so called Value Based Reimbursement. This is based upon compliance with practice guidelines. Primary care is research-proven to improve quality and length of life, and to reduce overall costs. Health is Wealth, and we do well to incentivize this fact.

Health Leadership for Low-Resource Communities

 

Objectives:

 

  • Cite examples of ineffective and inefficient healthcare
  • Explain the four levels of health interventions
  • Describe the health planning cycle

 

Abstract: Health is in crisis for lack of wise leadership, yet such skills are rarely taught. The challenges are greatest in low resource communities. Health leaders must design and implement health systems that are both effective and efficient. Four levels of Interventions are commonly considered: population-oriented, disease oriented, primary care, and hospital care. To design a health system, first assess needs and resources. Second, plan appropriate interventions. Third, assure these are carried out. This three-step process is ideally cyclical and continuous.

Health Through The Eyes Of Culture

 

Objectives:

 

  • Cite health interventions that are ineffective due to cultural irrelevancy
  • Explain four principles of cultural competence
  • Describe a process of observing, understanding, and adjusting to local cultures

 

Abstract: Culture, health, and healthcare are all closely connected. Better cross-cultural skill holds promise for reducing health disparities and improving health outcomes. Culturally competent healthcare is attained through increasing awareness of differences and biases, developing expressions of respect, increasing knowledge of cultures, and applying the skills of observing, understanding, and adjusting. This presentation includes case studies and interactive use of role-playing to enhance the learning experience.

Post-Covid Global Health

 

Objectives:

 

  • Express a broad definition of health
  • Explain Covid-19’s impact on worldwide economy, education, and health status
  • Describe a strategy for post-Covid global health based upon the Human Development Index

 

Abstract: The Covid-19 Pandemic collapsed economies, overwhelmed healthcare systems, and killed millions of people. In the wake of the Pandemic, what is the way forward towards global health? Health leaders must identify the leading risk factors for life years lost, including malnutrition and unsafe drinking water, and undertake initiatives to reduce these. Basic education and economic growth must be assured, as these also heavily impact health. Examples are cited from the nation of Angola where such community health and development interventions are in progress.

Patient Care

Abdominal Pain Emergency Management

 

Objectives:

 

  • Describe the leading causes of acute abdominal pain.
  • List the clinical signs associated with leading causes of acute abdominal pain.
  • Describe the special assessment of acute abdominal pain in children and females.

Abstract: Acute abdominal pain represents 15 percent of visits to emergency departments. 35 percent of primary care physicians report uncertainty with management. Correct diagnosis is paramount to correct management of acute abdominal pain. Evaluation begins with careful history with special attention to precipitating factors. Patient age and sex also highly influence the differential diagnosis. Physical exam with pain localization is associated with likely diagnoses, often confirmed through evidence gathered from selective laboratory and imaging.

Chest Pain Emergency Management

 

Objectives:

 

  • Describe the leading causes of acute chest pain.
  • List a differential diagnosis, including associated signs, for acute chest pain.
  • Describe emergency management of acute myocardial infarction.

Abstract: Acute chest pain is the most common serious condition prompting patients to seek emergency care. Primary care physicians are often those to first manage such patients. Correct diagnosis is paramount to appropriate treatment of acute chest pain. Evaluation begins with careful history with special attention to coronary artery disease risk factors. Patient age also highly influences the differential diagnosis. Causes of acute chest pain can often be divided into five categories: psychological, chest wall, gastrointestinal, pulmonary, and cardiovascular causes. EKG interpretation skill is essential, as is precise medical management of acute coronary syndrome.

Clinical Prevention

 

Objectives:

 

  • Describe the role of primary care providers in clinical prevention
  • List the leading leading risk factors for early death worldwide
  • Name and explain the four categories of clinical prevention

 

Abstract: Primary healthcare providers enjoy influential opportunities to prevent disease and promote health. Risk factor identification and reduction are paramount. Clinical prevention has four categories: counseling, disease screening, immunization, and chemoprophylaxis. Counseling should be on topics that both impact health and on which counseling has proven effective. Criteria for effective screening are strict, and few diseases qualify. Hypertension is an excellent qualifying example. Immunization includes vaccines throughout life. Chemoprophylaxis is medication to prevent disease, such as aspirin to prevent coronary artery disease.

Helping Babies Breathe Newborn Resuscitation

 

Objectives:

 

  • Identify health risks for newborns immediately following delivery
  • Explain the importance of ventilation within one minute
  • Demonstrate effective newborn ventilatory support

 

Abstract: Some one million newborns die each year from inability to breathe at birth. This presentation introduces Helping Babies Breathe (HBB), an evidence-based educational program to prepare learners to teach basic neonatal resuscitation techniques in low-resource locations to benefit midwives, mid-level providers, and traditional birth attendants. Presentation highlights include the concept of the Golden Minute, basic bag and mask ventilation techniques, and continued newborn care during the first hours of life.

HIV Medicine for Low-Resource Communities

 

Objectives:

 

  • Describe the current epidemiology of HIV disease
  • Explain the leading prevention strategies against HIV transmission
  • State the principles of HIV anti-retroviral treatment
  • List the leading opportunistic infections, and their management

 

Abstract: HIV remains a leading cause of life years lost in the world’s poorest nations. Effective means are available to both prevent and treat HIV/AIDS. However, bias and lack of leadership often obstruct these life-saving interventions. Healthcare leaders must redouble efforts to overcome these barriers. The ABCs of HIV prevention continue to be effective messaging. HIV screening is widely accessible, and prevention of mother-to-child transmission is particularly effective. Treatment of HIV and AIDS is facilitated by today’s simpler protocols. Test-and-treat holds promise to eradicate HIV infection.

Hypertension & Syndrome Management

 

Objectives:

 

  • Describe the rise and threat of non-communicable, chronic diseases
  • Explain hypertension management principles
  • Describe the design and use of syndrome management protocols

 

The world is seeing a dramatic rise in non-communicable, chronic diseases. Among these, hypertension is the seventh leading risk factor for life years lost in low-income nations. Use of syndrome management protocols for common disorders, like hypertension, carries many benefits, including faster care, simplified drugs and supplies, and faster training of new personnel. Protocols must be tailored for location and cultures, have buy-in from the healthcare team. This presentation makes use of role play and case studies.

Malaria: A Disease of Poverty

 

Objectives:

 

  • Describe the magnitude of the malaria challenge
  • Explain care for suspected cases of malaria
  • Detail principles for malaria prevention

 

Abstract: Malaria has killed more people than all plagues and all wars in the entire history of the world combined. It is most lethal toward African children and pregnant women. Other diseases cause similar symptoms, so diagnosis should be confirmed by laboratory. Malaria treatment should account for malaria species, medication availability, local medication resistance, and the clinical status of the patient, including pregnancy and oral tolerance. Treatment requires monitoring for complications. Vector control is the chief preventive intervention, and malaria vaccine development continues.

Malnutrition and Diarrhea Diseases

 

Objectives:

 

  • Describe the two diarrhea syndromes and their management
  • Explain principles of water purification and sanitation
  • Recount the spectrum of common nutritional disorders
  • Explain principles of the re-nutrition

 

Abstract: Undernutrition and unsafe drinking water are among the three leading risk factors for life years lost in low-income nations. Diarrhea management is aided by division into two syndromes: gastroenteritis and dysentery. Maintenance of hydration is critical to treatment. Multiple technologies are useful for assuring safe drinking water and sanitation. Protein and calorie malnutrition can present with a spectrum of signs. Treatment must consider locally available foods and cultural practices. Micronutrient deficiencies, such as iodine and vitamin A, must also be considered.

Obstetrical Skills for Emergencies

 

Objectives:

 

  • List the two most powerful interventions to improve reproductive health
  • List the leading peripartum causes of maternal death
  • Describe appropriately recognition and management of post-partum hemorrhage, shoulder dystocia, and breech presentation

 

Abstract: 98 percent of maternal deaths worldwide occur in low-resource communities and are almost entirely preventable. Leading causes of peripartum death include sepsis, hemorrhage, preeclampsia/eclampsia, and failure to progress. System-wide improvements in contraception, prenatal care, and obstetrics care at delivery hold promise to improve pregnancy outcomes. Common delivery complications must be immediately recognized and managed, including postpartum hemorrhage, shoulder dystocia, and breech presentation.

Tropical Fever Evaluation

 

Objectives:

 

  • Explain the unique challenges to evaluating tropical fever
  • Describe the importance of considering local geography and epidemiology
  • Enumerate symptoms and signs that suggest particular diagnoses

 

Abstract: Evaluation of fever in a tropical setting is a daunting clinical challenge due to unfamiliar causes, limited diagnostics, and cultural divides. Begin with knowledge of local epidemiology to assess probabilities. Next, glean clues from the history, such as freshwater exposure (schistosomiasis) and physical exam such as conjunctival injection (leptospirosis). The proliferation of rapid point-of-care diagnostic tests holds promise. Most importantly, malaria test and neutrophil count can suggest probable causes of tropical fever. This presentation includes case studies and interactive role-play.

Tropical Medicine Case Studies – Nonsurgical

 

Objectives:

 

  • Define the meaning of the term “diagnosis”
  • Describe the importance of considering local geography and epidemiology
  • List a differential diagnosis for tropical fever, acute respiratory distress, and acute diarrheal illness

 

Abstract: Effective management of disease in low-resource settings is particularly challenging. Begin by first understanding the epidemiology of the community. Armed with a general understanding of probabilities, apply astute attention to history and physical findings, with little expectation for laboratory or imaging data. Treatment options must also be modified to conform to local and often limited resources. Finally, be keen to use each patient care opportunity to both hone skills and to transmit those skills to others. This presentation includes use of interactive case studies.

Tropical Medicine Case Studies – Surgical

 

Objectives:

 

  • Describe the importance of considering local geography and epidemiology
  • List a differential diagnosis and management for tropical acute abdominal pain
  • List a differential diagnosis and management for chronic, draining wounds
  • List a differential diagnosis and management for acute cellulitis syndrome

 

Abstract: Effective management of disease in low-resource settings is particularly challenging. Begin by first understanding the epidemiology of the community. Armed with a general understanding of probabilities, apply astute attention to history and physical findings, with little expectation for laboratory or imaging data. Treatment options must also be modified to conform to local and often limited resources. Finally, be keen to use each patient care opportunity to both hone skills and to transmit those skills to others. This presentation includes use of interactive case studies.

Tuberculosis & Leprosy: Diseases of Poverty

 

Objectives:

 

  • State today’s extent of TB and leprosy worldwide
  • Describe salient symptoms and signs of TB & leprosy
  • Explain treatment principles for TB and leprosy
  • Describe DOTS for preventing treatment failures
  • List strategies for TB & leprosy prevention

 

Abstract: One-third of the world’s citizens are infected with TB and 5-10% will develop clinical disease. 95% of live in the poorest nations where TB is activated by HIV and malnutrition. Most TB is pulmonary and diagnosed by identification of acid-fast bacilli. Most countries have well-designed TB management protocols. Leprosy continues to be a concern, with some 200,000 new cases each year. Leprosy presents with a spectrum between tuberculoid leprosy (paucibacillary) and lepromatous leprosy (multibacillary). Leprosy medications are effective, and treatment requires a multidisciplinary approach.

Please contact INMED to explore any of these presentation options.

View Dr. Comninellis’ biography.