1 st ANNOUNCEMENT

12 in conjunction with
IDI accredited

th
4 International Nutrition Symposium
Evidence Based to Patient Centric Therapy
29-30 July 2017 | REDTOP Hotel, Jakarta JOIN FREE PAPER & POSTER PRESENTATION AWARD
Abstract submission deadline: 16 June 2017
w w w. n u t r i i n d o n e s i a . o r g
Organized by: Contributing Organizations:

INDONESIAN
NUTRITION + +
ASSOCIATION

PROGRAM INVITED SPEAKERS

PRE-SYMPOSIUM WORKSHOPS SYMPOSIUM, 29-30 July 2017 Indonesian Speakers
27 July 2017 Ÿ MAIN TOPICS OF THE PROGRAM Adhrie Sugiarto Irsan Hasan
• Critical Care Nutrition - Iqbal Mustafa and Xavier Leverve Memorial Lecture Ari Fachrial Syam Luciana Sutanto
- Metabolic Changes in Critically Illness - Nutrition and Cancer Delmi Sulastri Niken Puruhita
- Hemodynamic & Electrolyte Changes in - Nutrition and Metabolic Disease Dian Novita Chandra Rudyanto Sedono
Critically Illness - Child & Maternal Nutrition
- Micronutrient Deficiency in ICU Patient Diana Sunardi Saptawati Bardosono
- Adults Critical Care Nutrition
- Pediatric Critical Care Nutrition - Glycemic Index and Pre-diabetic: State of the Art Dita Aditianingsih Stella E. Bela
- Critical Care Nutrition Guidelines - Update on Nutrition and Cardiovascular Risk Endang Sunaryo Toar Lalisang
- Parental Bounding and Family Happiness Hartono
•Basic Parenteral Nutrition Workshop
- Introduction - Sarcopenia in Critically ill patient
- Fluid and Hemodynamic Physiology - Osteoarthritis Nutrition Prevention and Treatment
- Human Intestinal Ischemia Reperfusion International Speakers
- Parenteral Nutrition Formulae
- Catheter Access - Newest Diagnostic Criteria for Malnutrition Ernest Benjamin (USA)
- Parenteral Nutrition Administration - Dietary Habit and Neurological Features Elizabeth Babu (USA)
- Cardio Metabolic Risk in Adolescent Hamid Jan (Malaysia)
- Healthy Breakfast for Healthy Adult Imelda Agdeppa Angeles (Philippines)
28 July 2017 - Sport Nutrition, vo2 Max and Wellness
• Basic Enteral Nutrition Joseph Varon (USA)
- Introduction Khrisnan Siram (USA)
- Physiology of Gastro-intestinal System Ÿ SPECIAL GROUP DISCUSSION Marek Nalos (Australia)
- Enteral Nutrition Selection & Administration - Perioperative Nutrition Ravinder Reddy (India)
- Tube Feeding Selection & Management - Nutritional Research & Methodology Ideas & Reza Norouzy (Iran)
- Enteral Nutrition Monitoring & Evaluation Linking Santiago Herrero (Spain)
•Communication in Patient Consultation Ÿ FREE PAPER & POSTER PRESENTATION
- How to Improve your Communication Skill
with Patients
- Interactive discussion and Attractive Practice

ORGANIZING COMMITTEE:
Advisor: Chair: Scientific: Treasurer:
Ernest Benjamin (USA) Luciana Sutanto Dian Novita Niken Puruhita Mia Puspita Ratih
I Ketut Salam Hartono Rudyanto Sedono
Saptawati Bardosono Secretary: Hamid Jan (Malaysia) Samuel Oetoro Publication and Documentation:
Joseph Varon (USA) Stella E. Bela Imelda Agdeppa (Philippines) Toar Lalisang Diana Sunardi

FREE PAPER PRESENTATION AWARD

The committee invites participant to present their work at the symposium for Free Paper & Poster Presentation Award. Please submit your abstract
before 16 June 2017 to secretariat@nutriindonesia.org. Please read the abstract submission guidelines before submitting the abstract.
Please do register your participation on the symposium before submitting your abstract.
ABSTRACT GUIDELINES
• Please indicate preferences of your abstract: Free Paper OR Poster Presentation
• Abstract must be submitted and presented in English.
• Abstract must contain original material neither publish nor presented elsewhere prior 16 June 2017.
• Abstract must not be more 250 words, single-spaces and in upper and lowercase letters.
• Please structure your abstract using the following heading: Objectives, Methods, Results, Conclusion.
• Table, graphics, and charts, are permitted in abstract.
 REGISTRATION FORM
Please return this form to:
Fax: (+62-21) 570 5798 or Email: registration@nutriindonesia.org or Online registration at www.nutriindonesia.org
PARTICIPANT (Please Complete all fields using BLOCK LETTERS)
Prof. Dr. Mr. Ms. Other:

Full Name :

Student Nurse general practioner specialization:

Company/Institution :

Address :

City : Postal Code :

Phone Number : Fax Number : Country:

(country code / city code / number) (country code / city code / number)

(country code / city code / number)

Email : Mobile Phone :

REGISTRATION FEE
Symposium (29-30 July 2017) ORGANIZATION
NON-MEMBER Pre-Symposium Workshop (27 July 2017)
MEMBER
Early Bird (before 10 May 2017) Rp 875.000 Rp 900.000 Critical Care Nutrition Rp 1.500.000
Basic Parenteral Nutrition Workshop Rp 1.500.000
Normal - On Site Rp 990.000 Rp 1.100.000
(11 May - 30 July 2017) Pre-Symposium Workshops (28 July 2017)
Student Rp 850.000 Basic Enteral Nutrition Workshop Rp 1.500.000
Communication in Patient Consultation Rp 1.500.000
Group Registration
For 10 (ten) persons of group registration will get 1 (one) additional free registration. • Workshop participants are only allowed to attend the workshop they
registered for, otherwise another workshop registration fee will be applied
ENTITLEMENT OF SYMPOSIUM REGISTRATION FEE • Workshop will be presented in Indonesian and no interpreter service will be
provided for overseas participant
Symposium kits and certificate, entrance to all scientific program and
exhibition, opening ceremony, luncheon and morning and afternoon
refreshment during the symposium ACCOMMODATION
Secretariat has secured accommodation for participants.
Join Special Group Discussion limited for 20 pax / group on 30 July 2017 Please call us to get special rate.
1. Nutritional Research and Methodology Ideas and Linking Yes No
2. Perioperative Nutrition Yes No

Credit Card
METHODS OF PAYMENT Visa MasterCard
Cash (payment can be settled at the secretariat prior to the event’s date Card number :
or on site)
Security number : Expiry date :
(month/year)
Transfer (for our references and administrative purpose, please copy us Total Amount :
the bank transfer transaction)
Symposium Secretariat must received in FULL AMOUNT (any handling Card holder name :
fee for remittance will be borne by the participants) Address :
Account Name : PT Pactoconvex Niagatama
Bank Name : BANK CIMB Niaga, Cab. Kuningan Lippo Life Please copy us your credit card (both side) to avoid any difficulties
Bank Address : Plaza Centris Lt.1, Jl. HR Rasuna Said kav B5, I hereby authorized the 12th Symposium of Nutri Indonesia Secretariat to debit the above
Jakarta Selatan mentioned credit account with the total value of the items booked by me on this form .
Account No. (IDR) : 1730100783009 I have read and agreed to the disclaimer of liabilty and agree to abide by decision of
Symposium Secretariat or person entrusted by the Committee, with respect to operation of
Symposium

Card holder Signature : Date :

Note :
1. This registration will be accepted only upon received of payment
2. There will be a 50% charge for written cancellation received before and on 15 May 2016, with no
refund after this date.
3. All refund will be processed after the symposium.

SECRETARIAT
Indonesian Nutrition Association
c/o Pacto Convex Ltd.
Grand Sahid Jaya Hotel, 2nd Floor Arcade S2
Jl. Jend. Sudirman No. 86, Jakarta 10220 - Indonesia
Phone: (62-21) 570 5800 Ext. 504/508; 573 5538 (Direct)
Fax: (62-21) 570 5798 | Mobile: 0812 1318 5724 / 0856 924 00099
E-mail : registration@nutriindonesia.org
Contact Person : Ms. Mutia Wulandari / Ms. Niken Anjani