Registration Form

Transcription

Registration Form
Invited Faculty
Walid Fitaihi,
MD, MPH, FACE
Consultant, Endocrinology and
Diabetes
Founder, Chairman, Board of
Directors & CEO
International Medical Center
Registration
Form
Emad Al-Jahdaly,
MD, FRCPC
Consultant, Occupational and
Environmental Medicine
International Medical Center
Prof. Ward Flemons,
MD, FRCPC, FACP
Professor of Medicine
Faculty of Medicine
University of Calgary
Prof. Richard Johnson,
MD, FACP
Professor of Medicine
Department of Medicine
University of Colorado Denver
Prof. Ezzeldin Ibrahim,
MD, FRCP, FACP, MSc
30 CME Hours Accredited
Senior Consultant, Oncology
Chief Medical Officer
Director, Oncology Center
Executive Director, Research Center
International Medical Center
Health Impact of
Modernization
Niki I. Kontou,
BSc, MSc, PhD
Supervisor, Department of Nutrition
Saint Savvas Cancer Hospital
Tuesday to Thursday, 4th – 6th of March 2014
Intercontinental Hotel, Jeddah, KSA
James Lewis,
BSc, MSc, PhD
Lecturer in Nutrition
School of Exercise and Health
Sciences
Loughborough University
Prof. Eberhard Ritz,
MD, PhD
Professor of Medicine
Department Internal Medicine
Ruperto Carola University
Prof. Graham MacGregor,
MD, MRCP
Professor of Cardiovascular Medicine
Wolfson Institute of Preventive
Medicine
Queen Mary, University of London
Prof. Virend Somers,
MD, D.Phil., FAHA, FACC,
FCCP
Professor of Medicine
Consultant & Clinical Investigator
Mayo Clinic & Mayo Foundation
Prof. Terje Pedersen,
www.healthandmodernization.com
MD
Professor of Cardiology, University of
Oslo
Section Head, Center of Preventive
Medicine, University of Oslo Hospital
Matthew Tracey,
OMD
Consultant, Oriental Medicine &
Acupuncture
Director, Complementary Medicine
Center
International Medical Center
Supported by:
Official Carrier:
MRK-G-3-2014
Tear off
Welcome
Objectives
Dear Colleague,
In this conference we are planning four major tracks, three of which are, focusing on Nutrition, Environment and Life Style, the
three areas that had the most dramatic change over the last few decades.
On behalf of The International Medical Center (IMC), It gives me a great pleasure to invite you to the international conference
titled “Health Impact of Modernization” to be held in Jeddah, Saudi Arabia on March 2014 ,6-4.
Over the last three decades, the people of Saudi Arabia have witnessed major cultural, economic, and social changes that influenced
the incidence and burden of many health problems. Accordingly, the country is in need -more than at any other time- for a public
health infrastructure that works with our medical system to prevent disease and improve health. Any realistic healthcare reform
must emphasize prevention, not just treatment of the sick. Underlying our health care system’s many troubles are the fundamental
problems of cost and accessibility.
Those are some of the many challenges that we face today and what prompted planning for this event. To the best of our knowledge,
no similar gathering was ever organized at a regional level to address those challenges. The conference was structured to address
various health issues assembled into four main tracks: obesity, nutrition, environment, and lifestyle.
I’m confident that we will enjoy the event and we could formulate a set of realistic and achievable recommendations that we would
be committed to peruse. This event could be a landmark to adopt a new paradigm for the future of healthcare in Saudi Arabia.
Walid A. Fitaihi, MD, MPH, FACE
Chairman, Board of Directors & CEO
International Medical Center
Tuesday to Thursday, 4th – 6th of March 2014
It will address the effects of modernization on human and population health at multi levels; at the level of public health policy
makers, at the level of health care providers and at the level of individuals. By doing so we hope that modernization will keep its
positive effects on health and avoid the potential harm.
Changes in life style and health have been correlated and intertwined throughout human history. Each era of time had its own
characteristic disease epidemiology. Starting the end of the 21st century there were new breakthrough discoveries and changes in
the field of technology that significantly affected life style. This modernization in life style and movement from rural to urban living
had a major impact on disease epidemiology, causing a great shift from communicable diseases to chronic non communicable ones.
The population of the Gulf region has experienced a peculiar type of change and modernization. A boom in industry, technology
and entrepreneurship forced modernization and changes in life style faster than any other part in the world. The concern about
the rapidity of similar change has been cited in few populations around the world where disease impact is very well recognized
and is imposing health care challenges at all levels, government, communities and personal. Similar trends are being noticed in
the Gulf population with the rapid rise in chronic, non communicable types of diseases such as cancer, obesity, diabetes mellitus
and coronary artery disease to name a few.
The International Medical Center is planning this conference entitled “Health Impact of Modernization” that will shed the light
on the new disease epidemiology and its behaviour in this part of the world.
International, regional and local world renowned speakers are being invited to share with us their views, experiences and potential
solutions.
We would really appreciate that you can join us and support this unique event. For more information and details, please visit our
website www.healthandmodernization.com.
We hope this meeting will be of an added value to your practice and wish you could all enjoy Jeddah.
Prof. Ezzeldin M. Ibrahim, MD, FRCP, FACP, MSc
President of the Conference
Chief Medical Officer
Director, Oncology Center
Executive Director, Research Center, International Medical Center
Registration Form
Title:
 Dr.  Mr.  Mrs.  Ms.  Other: _________________________ Gender:  Male  Female
Kindly, use BLOCK CAPITAL LETTERS
First Name:
Who Should Attend?
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Healthcare Policy Makers
Academicians
Healthcare Providers
Nutritionists
Clinicians
Occupational Therapists
General Practitioners
Medical Students
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Epidemiologists
Environment Experts
Medical Sub-specialties
Health Insurance Professionals
Family Medicine Physicians
Nursing Staff
Junior Physicians
Residents
Middle Name:
Last/ Family Name:
Saudi Commission for Health Specialties (SCFHS) registration number*:
Registration Type:
Invited Faculty
 Physician (SR 250)
 Resident, other healthcare Specialties (SR 150)
Institution / Hospital: _ _____________________________ ____________________________________________________________
Conference’s Overview
Dear Colleagues,
Health Impact of Modernization
Office Tel.: _________________________
Badr Abdulrauf,
MD, FRCSC
Consultant, Plastic Surgery
Section Head, Plastic Surgery
King Faisal Specialist Hospital &
Research Center, Jeddah
Prof. Sami Bahna,
MD, DrPH
Professor of pediatrics and medicine
Chief, Allergy and Immunology
Section
Louisiana State University Health
Sciences Center
Abdullah Al-Osaimi,
MD, FACP, FACG, AGAF
Division Chief, Hepatology
Medical Director, Liver Transplant
Division of Gastroenterology and
Hepatology
Temple University Hospital
Waleed Bukhari,
MD, FACS
Senior Consultant, Advanced
Laparoscopic, Bariatric & General Surgery
Director, Advanced Laparoscopic &
Bariatric Surgery Center
International Medical Center
Ziad Al-Zoubi,
MD, MSc, Dip.
Consultant, Spine and Orthopedic
Surgery
Jordan Orthopedic & Spinal Centre
Honorary President, Pan Arab Spine
Society
Linda Davis,
BSc, MSc, PhD
Associate Professor
Department of Surgery and Breast
Cancer Research Program
West Virginia University
Ext.: ___________
Office Fax: _________________________ Ext.: ____________
YES, I would like to receive information about future events @ IMC via email or SMS (mobile), My e-mail Address is:
My Mobile Number is:
*CME Policy:
*Participants will be accredited a number of CME hours respective to the activities attended conditional to the submission of a complete feedback form.
*Certificates of attendance will be distributed at the end of the second day of the event.
Registration:
A nominal fee is set for this program to facilitate the attendance to all those interested:
PhysiciansSR 250
Residents & Other healthcare Specialties SR 150
Payment Terms:
Payment is accepted in cash to the address below, through direct debit on your Credit Card, or paid directly through bank transfer to the following
account:
Account #: 05268501650
Bank: Saudi Fransi Bank – Main Branch, Jeddah, Saudi Arabia
Account Name: International Medical Center
IBAN #: SA56 5500 0000 0052 6850 1650
• Registration is not confirmed until a full payment is received.
• Please send the registration with the deposit slip by email to [email protected]
For Registration, Payments & Further Information, please visit the website or contact:
Ms. Luzbelle G. Lita, Registration Coordinator, International Medical Center, Jeddah
Telephone: +966-12-650-9000 Ext: 1214
Email: [email protected]
For Accommodation & hospitality Queries:
Mr. Ahmed Al-Nemri, Delegates Relations
Telephone: +966-54-167-3432
Email: [email protected]