Alternative Urbanism in the Historic City Centre: A Transnational Perspective on Theory and Practice

Historic city centres are characterised by the tension between the local, represented by authentic spaces of everyday life, and the global, responding to the needs of tourism industry and capital flows. Under the neoliberal paradigm, state-led urban regeneration projects often benefit developers and private investors with little regard to the socio-economic dynamics of existing communities. Recently, this approach has been challenged by alternative practices of placemaking that represent a transition from top-down imposition of urban change to the co-production of space. Such practices are characterised by a more temporary, flexible and tactical approach to the design of space. They represent a collective desire that involves several actors, from local residents and business owners, to civil society organisations and design professionals in the role no longer of the exclusive author but as facilitators and mediators of change. Observing the development of such practice in the western world, and the corresponding theorisation attempts developed mostly by western scholars, this paper looks further to its applications in the global South, with evidence drawn from empirical research in London, UK and Cairo, Egypt. The paper suggests that alternative urbanism may be indicative of a longer-term transition towards a more equitable urban planning practice

On the Use of Key Assignment Schemes in Authentication Protocols

Key Assignment Schemes (KASs) have been extensively studied in the context of cryptographically-enforced access control, where derived keys are used to decrypt protected resources. In this paper, we explore the use of KASs in entity authentication protocols, where we use derived keys to encrypt challenges. This novel use of KASs permits the efficient authentication of an entity in accordance with an authentication policy by associating entities with security labels representing specific services. Cryptographic keys are associated with each security label and demonstrating knowledge of an appropriate key is used as the basis for authentication. Thus, by controlling the distribution of such keys, restrictions may be efficiently placed upon the circumstances under which an entity may be authenticated and the services to which they may gain access. In this work, we explore how both standardized protocols and novel constructions may be developed to authenticate entities as members of a group associated to a particular security label, whilst protecting the long-term secrets in the system. We also see that such constructions may allow for authentication whilst preserving anonymity, and that by including a trusted third party we can achieve the authentication of individual identities and authentication based on timestamps without the need for synchronized clocks

Children and their parent's perceptions of overweight and obesity in Kuwait children

Background: The prevalence of overweight and obesity among children are a major public health concern internationally. Recognition of overweight and obesity status is an important step to prevent unhealthy weight. This study was designed to assess the prevalence and to explore the perceptions of children and their parents towards overweight and obesity in children. Methods: A cross-sectional study approach was utilized surveying 635 children aged 11 to 14 years (males and females) in 12 randomly selected public schools in Kuwait. Trained nurses performed measurements of children's height and weight to determine their Body Mass Index.Valid questionnaire were used to assess children and their parent perception of child's weight. Results: One quarter of the surveyed children 25.5% (N = 162) were overweight. Over one third of the participants 36.5% (N = 232) were classified as obese. The nurses' measurements did not coincide with the children's perceptions but were better aligned with parents' perceptions of overweight and obesity. Conclusion: The results indicated that there is high prevalence of overweight and obesity among Kuwaiti children. Furthermore, both the children and their parents underestimate the child weight status. Health education programs are highly recommended

Validated instruments used to measure attitudes of healthcare students and professionals towards patients with physical disability: a systematic review

<p>Abstract</p> <p>Background</p> <p>Instruments to detect changes in attitudes towards people with disabilities are important for evaluation of training programs and for research. While we were interested in instruments specific for medical students, we aimed to systematically review the medical literature for validated survey instruments used to measure attitudes of healthcare students and professionals towards patients with physical disability.</p> <p>Methods</p> <p>We electronically searched Medline, EMBASE, PsycINFO, Health and Psychosocial Instruments. We included papers reporting on the development and/or validation of survey instruments to measure attitudes of healthcare students and professionals towards patients with physical disability. We excluded papers in which the attitudes were not measured in a provider-patient context. Two reviewers carried out titles and abstracts screening, full texts screening, and data abstraction in a duplicate and independent manner using standardized and pilot tested forms.</p> <p>Results</p> <p>We identified seven validated survey instruments used for healthcare students and professionals. These instruments were originally developed for the following target populations: general population (n = 4); dental students (n = 1); nursing students (n = 1); and rehabilitation professionals (n = 1). The types of validity reported for these instruments were content validity (n = 3), criterion-related validity (n = 1), construct validity (n = 2), face validity (n = 1), discriminant validity (n = 1), and responsiveness (n = 1). The most widely validated and used tool (ATDP) was developed in the late 1960s while the most recent instrument was developed in the early 1990s.</p> <p>Conclusion</p> <p>Of the seven identified validated instruments, less than half were specifically designed for healthcare students and professionals and none for medical students. There is a need to develop and validate a contemporary instrument specifically for medical students.</p

Survey instruments used in clinical and epidemiological research on waterpipe tobacco smoking: a systematic review

<p>Abstract</p> <p>Background</p> <p>The primary objective was to systematically review the medical literature for instruments validated for use in epidemiological and clinical research on waterpipe smoking.</p> <p>Methods</p> <p>We searched the following databases: MEDLINE, EMBASE, and ISI the Web of Science. We selected studies using a two-stage duplicate and independent screening process. We included papers reporting on the development and/or validation of survey instruments to measure waterpipe tobacco consumption or related concepts. Two reviewers used a standardized and pilot tested data abstraction form to collect data from each eligible study using a duplicate and independent screening process. We also determined the percentage of observational studies assessing the health effects of waterpipe tobacco smoking and the percentage of studies of prevalence of waterpipe tobacco smoking that have used validated survey instruments.</p> <p>Results</p> <p>We identified a total of five survey instruments. One instrument was designed to measure knowledge, attitudes, and waterpipe use among pregnant women and was shown to have internal consistency and content validity. Three instruments were designed to measure waterpipe tobacco consumption, two of which were reported to have face validity. The fifth instrument was designed to measure waterpipe dependence and was rigorously developed and validated. One of the studies of prevalence and none of the studies of health effects of waterpipe smoking used validated instruments.</p> <p>Conclusions</p> <p>A number of instruments for measuring the use of and dependence on waterpipe smoking exist. Future research should study content validity and cross cultural adaptation of these instruments.</p

Post-graduation migration intentions of students of Lebanese medical schools: a survey study

<p>Abstract</p> <p>Background</p> <p>The international migration of physicians is a global public health problem. Lebanon is a source country with the highest emigration factor in the Middle East and North Africa and the 7th highest in the World. Given that residency training abroad is a critical step in the migration of physicians, the objective of this study was to survey students of Lebanese medical schools about their intentions to train abroad and their post training plans.</p> <p>Methods</p> <p>Our target population consisted of all students of Lebanese medical schools in the pre-final and final years of medical school. We developed the survey questionnaire based on the results of a qualitative study assessing the intentions and motives for students of Lebanese medical schools to train abroad. The questionnaire inquired about student's demographic and educational characteristics, intention to train abroad, the chosen country of abroad training, and post-training intention of returning to Lebanon.</p> <p>Results</p> <p>Of 576 eligible students, 425 participated (73.8% response rate). 406 (95.5%) respondents intended to travel abroad either for specialty training (330 (77.6%)) or subspecialty training (76 (17.9%)). Intention to train abroad was associated with being single compared with being married. The top 4 destination countries were the US (301(74.1%)), France (49 (12.1%)), the United Kingdom (31 (7.6%)) and Canada (17 (4.2%)). One hundred and two (25.1%) respondents intended to return to Lebanon directly after finishing training abroad; 259 (63.8%) intended to return to Lebanon after working abroad temporarily for a varying number or years; 43 (10.6%) intended to never return to Lebanon. The intention to stay indefinitely abroad was associated male sex and having a 2^ndcitizenship. It was inversely associated with being a student of one of the French affiliated medical schools and a plan to train in a surgical specialty.</p> <p>Conclusion</p> <p>An alarming percentage of students of Lebanese medical schools intend to migrate for post graduate training, mainly to the US. A minority intends to return directly to Lebanon after finishing training abroad.</p

Graduates of Lebanese medical schools in the United States: an observational study of international migration of physicians

BACKGROUND: As healthcare systems around the world are facing increasing physician shortages, more physicians are migrating from low to high income countries. As an illustrative case of international migration of physicians, we evaluated the current number and historical trends of Lebanese medical graduates (LMG) in the US, and compared their characteristics to those of US medical graduates (USMG) and other international medical graduates (IMG). METHODS: We evaluated the number of LMG using the 2004 the American Medical Association Physicians' Professional Data (AMA-PPD) and then compared it to the number of graduates of other countries. We evaluated the historical trends using the 1978–2004 historical files of the AMA-PPD. We analyzed the characteristics of all LMG and compared them to a random sample of 1000 USMG and a random sample of 1000 IMG using the 2004 AMA-PPD. RESULTS: In 2004, there were 2,796 LMG in the US, constituting 1.3% of all IMG. Compared to other foreign countries contributing to the US physician workforce, Lebanon ranked 2nd after adjusting for country population size (about 4 million) and 21st overall. About 40% of those who graduated from Lebanese medical schools in the last 25 years are currently active physicians in the US. Since 1978, the number of LMG in the US showed a consistent upward trend at a rate of approximately 71 additional graduates per year. Compared with USMG and IMG, LMG were more likely to work in medical research (OR = 2.31; 95% Confidence Interval (CI) = 1.21; 4.43 and OR = 2.63; 95% CI = 1.34; 5.01, respectively) and to be board certified (OR = 1.43; 95% CI = 1.14; 1.78 and OR = 2.04; 95% CI = 1.65;2.53, respectively) and less likely to be in family practice (OR = 0.14; 95% CI = 0.10; 0.19 and OR = 0.18; 95% CI = 0.12; 0.26, respectively). CONCLUSION: Given the magnitude and historical trends of migration of LMG to the US, further exploration of its causes and impact is warranted. High income countries should consider the consequences of their human resources policies on both low income countries' and their own healthcare systems

Parenteral anticoagulation may prolong the survival of patients with limited small cell lung cancer: a Cochrane systematic review

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Meta-analysis of antibiotics versus appendicectomy for non-perforated acute appendicitis

Background: For more than a century, appendicectomy has been the treatment of choice for appendicitis. Recent trials have challenged this view. This study assessed the benefits and harms of antibiotic therapy compared with appendicectomy in patients with non-perforated appendicitis. Methods: A comprehensive search was conducted for randomized trials comparing antibiotic therapy with appendicectomy in patients with non-perforated appendicitis. Key outcomes were analysed using random-effects meta-analysis, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Five studies including 1116 patients reported major complications in 25 (4.9 per cent) of 510 patients in the antibiotic and 41 (8.4 per cent) of 489 in the appendicectomy group: risk difference -2.6 (95 per cent c.i. -6.3 to 1.1) per cent (low-quality evidence). Minor complications occurred in 11 (2.2 per cent) of 510 and 61 (12.5 per cent) of 489 patients respectively: risk difference -7.2 (-18.1 to 3.8) per cent (very low-quality evidence). Of 550 patients in the antibiotic group, 47 underwent appendicectomy within 1 month: pooled estimate 8.2 (95 per cent c.i. 5.2 to 11.8) per cent (high-quality evidence). Within 1 year, appendicitis recurred in 114 of 510 patients in the antibiotic group: pooled estimate 22.6 (15.6 to 30.4) per cent (high-quality evidence). For every 100 patients with non-perforated appendicitis, initial antibiotic therapy compared with prompt appendicectomy may result in 92 fewer patients receiving surgery within the first month, and 23 more experiencing recurrent appendicitis within the first year. Conclusion: The choice of medical versus surgical management in patients with clearly uncomplicated appendicitis is value-and preference-dependent, suggesting a change in practice towards shared decision-making is necessary.Peer reviewe