Polypectomy Techniques, Endoscopist Characteristics, and Serious Gastrointestinal Adverse Events

Background: A use of polypectomy techniques by endoscopist specialty (primary care, surgery, and gastroenterology) and experience (volume), and associations with serious gastrointestinal adverse events, were examined. Methods: A retrospective follow-up study with ambulatory surgery and hospital discharge datasets from Florida, 1999-2001, was used. Thirty-day hospitalizations due to colonic perforations and gastrointestinal bleeding were investigated for 323,585 patients. Results: Primary care endoscopists and surgeons used hot biopsy forceps/ablation, while gastroenterologists provided snare polypectomy or complex colonoscopy. Low-volume endoscopists were more likely to use simpler rather than complex procedures. For hot forceps/ablation and snare polypectomy, low- and medium-volume endoscopists reported higher odds of adverse events. For complex colonoscopy, higher odds of adverse events were reported for primary care endoscopists (1.74 [95%CI, 1.18 to 2.56]) relative to gastroenterologists Conclusions: Endoscopists regardless of specialty and experience can safely use cold biopsy forceps. For hot biopsy and snare polypectomy, low volume, but not specialty, contributed to increased odds of adverse events. For complex colonoscopy, primary care specialty, but not low volume, added to the odds of adverse events. Comparable outcomes were reported for surgeons and gastroenterologists. Cross-training and continuing medical education of primary care endoscopists in high-volume endoscopy settings are recommended for complex colonoscopy procedures

Stress, coping and well-being in Lebanese entering college students

Session presented on: Tuesday, July 23, 2013: Purpose: A theoretical framework for adolescent coping has been developed but not tested in contexts of high uncertainty. This study aimed to test the applicability of the Seiffge-Krenke model to Lebanese entering college students. Methods: A descriptive correlational cross-sectional design was used to explore the relationships of stress, uncertainty, resilience, religiosity, socioeconomic status, social support to coping and well-being in Lebanese newly admitted college students. A sample of 293 college students enrolled in a private university completed a self-reported survey. Results: Results indicated that future, school, self, and parents were the most stressful situations experienced. Increased stress was correlated with low social support, low resilience and withdrawal coping. Stress related to self, resilience, uncertainty, social support, withdrawal coping and gender accounted for 54% of the variance in well-being. Conclusion: Results provide a better understanding of predictors of well-being in Lebanese youth and are valuable in developing culturally sensitive interventions

Morphometric analysis of prenatally exposed children to anticonvulsant drugs

OBJECTIVE: To evaluate the morphometric effect of prenatal exposure to phenytoin, phenobarbital and carbamazepine on the shape of the maxilla the posterior and overall cranial base. MATERIAL AND METHODS: Sample selection: This study is a retrospective analyses of lateral cephalograms of 67 (Phenobarbital =21, Phenytoin=21, Carbamazepine=25) children age 6 to 16 who had been exposed prenatally to one of these drugs and compared to a control group of 44 unexposed children of the same age. Cephalometric films were digitized and anatomical landmarks identified by a single investigator. Landmarks were chosen to outline the maxilla, the posterior and overall cranial base. Morphometric analysis including Procrustes superimposition was used to compare the exposed children to the control group. Principal components analysis (PCA) and MANOVA tests were performed to determine the differences between the two groups. RESULTS: The superimposed average showed a significant difference between the two groups. In the exposed group, the anterior cranial base was vertically shorter. Glabella was more inferior and anterior relative to nasion, and the nasal tip was more superior and posterior. Orbitale was more inferior and posterior, suggesting a more posterior articulation with maxilla. The posterior cranial base was vertically taller and sagittally shorter. Also in the exposed group, the maxilla was vertically shorter. CONCLUSION: These results demonstrate a shorter, retrusive maxilla that articulates more posteriorly with a shorter anterior cranial base, confirming the midface hypoplasia of traditional anticonvulsant facies

The lived experience of Lebanese oncology patients receiving palliative care

The purpose of this study was to uncover the lived experience of Lebanese oncology patients receiving palliative care. The study design was based on the Utrecht School of phenomenology based on the Dutch school of phenomenology. This study followed purposeful sampling in which ten participants six women and four men with a mean age of 54.4 years were selected. The proposed research was approved by the Institutional Review Boards at the American University of Beirut and Duquesne University. In-depth semi-structured interviews along with observation-field notes were used as the source for data collection. Data were analyzed using the hermeneutic phenomenological approach based on the Utrecht School of Phenomenology. The participants highlighted their distress from being dependent; their dislike for pity; their worry for the family and the worry about the family\u27s worry; their reliance on God and divinity; their dislike of the hospital stay; their need to be productive; their fear of pain; and the impact of communication on them. Specific nursing action to help decreasing patients fear include exploring patients\u27 ideas, beliefs and experiences regarding pain and analgesics treatment, and encouraging patients\u27 participation through proper communication. Nursing education need to emphasize palliative care in the curricula. At the policy level, policy makers need to take into account patients\u27 needs while deciding on national health policy. Further research is suggested to explore the new emerging themes and to study the lived experience of caregivers of cancer patients

Terrain analysis for parcels evaluation based on UAV data-sets

The use of Unmanned Aerial Vehicles (UAVs) in geosciences is now widespread and operational for several applications – 3D modeling, quarry monitoring, archeology, forestry and terrain analysis. Land surveyors for the economy of time and money are using UAVs in their big projects. Real estate market in Lebanon is very specific and unstable, parcels prices vary from place to another without any criteria. The objective of this study is to evaluate parcels based on terrain weighted analysis of elevations, slope, and curvatures generated from UAV datasets. As a result of the geospatial analysis, a land evaluation derivative map of the study area generated to be a base for parcel classification. Parcels classified according to the map of standards resulting from our research gives the opportunities to real estate companies and cadastral experts to evaluate and put the suitable land pricing for a powerful and stable market. The final output resulted from terrain analysis is a cadastral map showing the real estate rate of parcels.

Multiscale Landforms Classification Based on UAV Datasets

The advance uses of Unmanned Aerial Vehicles (UAV) in geosciences by producing very high spatial resolution Digital Surface Models (DSMs), the various UAV flight altitudes led to different scales DSM. In this paper, we analyzed terrain forms using Topographic Position Index (TPI), landforms extracted by Iwahashi and Pike method and morphometric features of three different spatial resolutions DSM processed from different UAV flights height datasets of the same study area.Topographic Position Index (TPI) is an algorithm for measuring topographic slope positions and to automate landform classi?cations, Iwahashi and Pike had developed an unsupervised method for classification of Landforms and we have used the techniques developed by Peuker and Douglas, a method classifying terrain surfaces into 7 classes.Landforms extracted from the three indices listed above at the three flight heights of 120, 240 and 360 meters and compared with each other to understand the generalization of different scale and to highlight which landforms are more affected by the scale changes