Patterns and determinants of mammography screening in Lebanese women

Ibrahim Bou-Orm - ORCID: 0000-0003-3563-4014 https://orcid.org/0000-0003-3563-4014The associations of ever using and/or repeating a mammography test with psychosocial and socio-demographic factors were surveyed in 2014 among Lebanese women ≥ 40. A sample of 2400 women was selected across Lebanon. Variables with significant bivariate associations with various types of behaviors were entered in multivariate analysis. Of the total, 105 women (4·4%) had never heard of mammography as a tool for early breast cancer detection. Among the remaining 2295, 45% had ever used it, of whom 10% had obtained it for the first time within the 12 months preceding the survey. Repeaters were 67% of 926 women who had the time opportunity to do so (median lifetime frequency: 2). Older age, higher socio-economic status (SES) and living within the Greater Beirut (GB) area were significantly associated with ever-use. Within GB, psychosocial factors such as perceived susceptibility and benefits were most strongly associated with ever-use. Outside GB, socio-economic advantage seemed to mostly affect ever-use. Only 4% reported opposition from husbands to their mammography, and husband's support was significant for adherence to mammography guidelines mostly outside GB. Higher education emerged also as a significant socio-demographic determinant for ever-repeating in all regions. Perceived comfort of the previous test strongly affected the likelihood of repeating it. Providing mammography free-of-charge may alleviate some obstacles among women with socio-economic disadvantage. Stressing that good results one year do not make the cancer less likely or repeating the test less important, as well as improving the comfort of mammography testing could ensure test repeating.https://doi.org/10.1016/j.pmedr.2016.12.0155pubpu

Did the post war repatriation of Lebanese physicians drive recent Lebanese medical graduates to emigrate? An observational study

<p>Abstract</p> <p>Background</p> <p>A significant number of Lebanese medical graduates have emigrated from Lebanon. The objective of this study was to evaluate the hypothesis that the repatriation of Lebanese physicians educated abroad has contributed to the international emigration of recent Lebanese medical graduates.</p> <p>Methods</p> <p>We analyzed the demographic and educational characteristics and the year of registration of physicians registered with the two physician associations in Lebanon as of 2007. We then analyzed the number of new and total registrants and the physician density for the years 1977–2006. Finally we calculated the percentage of Lebanese graduates of the years 1977–2006 registered as of 2007.</p> <p>Results</p> <p>As of 2007, 10,918 physicians were registered in Lebanon. Most were male (80.4%) and graduated from either Lebanese (36.4%) or Eastern European (30.6%) medical schools. The top three regions of specialty training were Western Europe (31.8%), Eastern Europe (28.4%) and Lebanon (25.7%). About half the physicians registered with the Lebanese Order of Physicians as of 2007 joined during the 1990s decade; only 26.2% of these graduated from Lebanese medical schools during that decade. The number of new registrants increased dramatically in the early 1990s and started decreasing in the early 2000s. About 60% of Lebanese medical graduates of the years 1977–2006 were registered in Lebanon as of 2007. Categorizing Lebanese medical graduates by their year of graduation, the percentage registered in Lebanon as of 2007 showed a "dip" for those who graduated in the early 1990s.</p> <p>Conclusion</p> <p>The high number of physicians educated abroad returning to Lebanon after the end of the civil war may have driven recent Lebanese medical graduates to emigrate.</p

Circle grid fractal plate as a turbulent generator for premixed flame: an overview

This review paper focuses to ascertain a new approach in turbulence generation on the structure of premixed flames and external combustion using a fractal grid pattern. This review paper discusses the relationship between fractal pattern and turbulence flow. Many researchers have explored the fractal pattern as a new concept of turbulence generators, but researchers rarely study fractal turbulence generators on the structure premixed flame. The turbulent flow field characteristics have been studied tand investigated in a premixed combustion application. In terms of turbulence intensity, most researchers used fractal grid that can be tailored so that they can design the characteristic needed in premixed flame. This approach makes it extremely difficult to determine the exact turbulent burning velocity on the velocity fluctuation of the flow. The decision to carry out additional research on the effect circle grid fractal plate as a turbulent generator for premixed flame should depends on the blockage ratio and fractal pattern of the grid. 1

Disclosure of Diagnosis and Prognosis to Cancer Patients in Traditional Societies: A Qualitative Assessment from Lebanon

Background: The issue of when, how, and whether to disclose full information about cancer diagnosis and prognosis to patients is still debated in some parts of the world, including Lebanon. Despite formal academic emphasis on a larger autonomy for Lebanese patients in deciding the course of their disease, there has been no apparent impact on either clinical practices nor public expectations.  The topic of full disclosure is rarely if ever discussed in open fora, or in mass media channels in Lebanon. Subjects and Method: Seven key stakeholders were identified and interviewed regarding obstacles to spelling out clear guidelines within our national context. The interviews were transcribed and subsequently analyzed for recurrent patterns and concepts.Results: Senior oncologists interviewed generally favored gradual disclosure and most perceived a changing trend among both patients and physicians towards more disclosure. They also agreed on a need for the formal training of residents and fellows to better communicate bad news to patients. All the interviewed physicians attested to the benefits of candid disclosure in terms of patient psychology and overall wellbeing. They also mentioned that psychological services, which may facilitate the disclosure process, are greatly under-utilized in oncology. Lawyers highlighted the vagueness of the current Lebanese legislation regarding the obligation of truthful disclosure in comparison to laws in developed countries and the implications on patient autonomy. Conclusion: The study identified the need for improvements at various levels, including interventions to modify the expectations of the Lebanese public regarding cancer disclosure and to clarify existing legislative texts.Keywords: Ethics; Legislation; Middle-East; DisclosureCorrespondence: James Feghali. Faculty of Medicine, American University of Beirut (AUB), Lebanon, 1101 North Calvert Street, 610, Baltimore, Maryland, 21202. E-mail: [email protected]. Telephone: +1-(267)-595-9995.Journal of Epidemiology and Public Health (2019), 4(2): 109-116https://doi.org/10.26911/jepublichealth.2019.04.02.0

Potential health and economic impacts of dexamethasone treatment for patients with COVID-19

Acknowledgements We thank all members of the COVID-19 International Modelling Consortium and their collaborative partners. This work was supported by the COVID-19 Research Response Fund, managed by the Medical Sciences Division, University of Oxford. L.J.W. is supported by the Li Ka Shing Foundation. R.A. acknowledges funding from the Bill and Melinda Gates Foundation (OPP1193472).Peer reviewedPublisher PD

Modelling the COVID-19 pandemic in context : An international participatory approach

Funding RA is funded by the Bill and Melinda Gates Foundation (OPP1193472). LW is funded by the Li Ka Shing Foundation. CF is funded by grant #2017/26770-8, São Paulo Research Foundation (FAPESP). The CoMo Consortium has support from the Oxford University COVID-19 Research Response Fund (ref: 0009280). Scientific writing assistance and editorial support was provided by Adam Bodley, according to Good Publication Practice guidelines.Peer reviewedPublisher PD

From the biomedical model to the Islamic alternative: a brief overview of medical practices in the contemporary Arab world

Following its climax in the 8th century under the Abbasids of Baghdad, the Arab world entered a prolonged period of division and decadence. "Western" medicine was introduced in the 19th century with the support of the general population. The historical participation of Arabs in the elaboration of that "Western" biomedical model and its apparently consensual re-introduction into the Arab world diffused any sense of cognitive alienation vis-à-vis practices promoted initially by non-Arab doctors. In the late 1960s, Islamist thinkers started proposing "Islamic medicine" as an alternative to the encroachment of the "Western" biomedical model within Arab and Muslim nations. In Islamic medicine, disease is attributed to lack of attention to the spiritual dimension of human beings, yet intermediate causal pathways are not provided. Alongside "orthodox" concepts, Islamic medicine promotes some herbal remedies, in addition to faith-healing through prayer and the recitation of holy verses. While most of those practices may be beneficial, they may cause some harm to patients if they entail delaying or denying timely recourse to "orthodox" medical care. There are currently no Islamic medicine training programs in any Arab country, and Islamic medicine has not emerged as a comprehensive health alternative comparable to other non-Western health models.Alternative medicine Coran Islamic medicine

Cancer truth disclosure by Lebanese doctors

Truthful disclosure of cancer diagnosis is still uncommon in some cultures. In Lebanon, legislation is permissive of non-disclosure. Physicians choose the recourse most agreeable to them. This study's goal was to determine the proportion of Lebanese physicians who choose truthful diagnosis disclosure to cancer patients and to identify factors affecting their choice. A survey of a random sample of Lebanese physicians was conducted to determine the proportion of those who prefer truthful diagnosis disclosure to cancer patients and to identify factors affecting that choice. The survey involved 268 participants representing 10% of all physicians practicing in specialties with potential contact with cancer cases in the Greater Beirut area. It was completed by 212 (79%), of whom 47% would usually tell the patient about cancer. Disclosure preference was not associated with gender, location of medical training, rate of patient contact or teaching activities. It was associated with longer clinical practice and with specialties outside primary care. Most participants were open to changing their policies and considered the patient's desire to know, compliance with treatment and the patient's profession as a physician as most influencing in their choice of disclosure. Exploring the Lebanese public predicament regarding disclosure seems necessary.patient-doctor communication Lebanon cancer disclosure