Decision Making Process and Contralateral Prophylactic Mastectomy

The increased rate of contralateral prophylactic mastectomy (CPM) among women with early stage unilateral breast cancer has raised concerns particularly with the lack of evidence for a survival benefit related to the CPM procedure and with the low risk of developing contralateral breast cancer among women with early stage sporadic breast cancer. The purpose of this quantitative cross-sectional study, using normative decision theory as the framework, was to assess the influence of the partner, physician, and media on the decision of women with unilateral breast cancer who decided to undergo CPM. Women with stage 0 to III early stage unilateral breast cancer ages 20-60 years old who underwent CPM at MD Anderson Cancer Center in the U.S. between January of 2010 and December of 2017 were surveyed on factors influencing their decision to undergo CPM. Logistic regression (binomial distribution with logit link) was used to analyze the data. The results revealed that partners, physicians, and media all had significant influence (p \u3c 0.05) on the decision-making process of women with unilateral breast cancer to undergo CPM. The findings of this study may inform policy by highlighting the need for decision aids, programs, or tools that help women with unilateral breast cancer make informed decisions that are evidence-based regarding the efficacy of CPM

Inquiry Based Teaching in Literature Classrooms

AbstractNowadays, education is no longer to provide information to students, but rather to prepare learners to become active 21st Century critical thinkers (UNESCO, 1998). The need to communicate is instinctive (Stegmaier, 2011) and from this instinctive need, language developed (Pinker, 1996). Language supports and enhances our thinking and understanding for it permeates the world in which we live. It also plays a vital role in the construction of meaning. Language empowers learners and provides them with an intellectual framework to support their conceptual development and critical thinking. To acquire language, learning through inquiry has emerged as a means that allows for smoother and more effective communication. Teaching language through inquiry is becoming more prevalent. More specifically, teaching English as a second language, language or literature, using inquiry based method facilitates the learners⿿ ability of acquiring the new language. To carry out this ongoing research, data have been collected from language and literature tests that learners sat for after having followed strategies that incorporate inquiry-based techniques. The tests have been designed by the teachers and were carried out during the scholastic year to assess the learners⿿ acquisition of material. The participants are the learners of Grades 10- levels 1 and 5 in the school where the researchers teach. The researchers hypothesized that the participants⿿ performances and their critical thinking skills will improve. The results proved the hypothesis. The researchers recommend that the method be incorporated in literature classrooms

Support for UNRWA's survival

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland

Prioritising women’s and girls’ health in disaster settings: Lessons from the COVID-19 pandemic and the overlapping crises affecting Beirut, Lebanon

The COVID-19 pandemic has placed strain on healthcare systems across the world; however, countries experiencing overlapping crises such as economic or political unrest face immense pressure in ensuring routine healthcare services can continue to operate. Despite being less likely suffer severe disease or die from COVID-19, data suggest women have experienced poorer mental health, higher rates of unemployment, and more social isolation during the pandemic. In general, we know women and girls experience multiple forms of disadvantage in disaster contexts including being more likely to become homeless, work as an unpaid carer, and to experience poverty. Research from previous disaster contexts has demonstrated that women’s healthcare services tend to be deprioritised in the emergency response, and reports suggest this has been the case during the COVID-19 pandemic. This paper highlights key priorities for safeguarding women’s and girls’ health in disaster contexts, especially during the COVID-19 pandemic, by drawing on learning from the multiple crises facing Beirut, including responding to the pandemic, economic collapse, and the Beirut Port Explosion in 2020

Annexes to IDRC Final Report

This report is an agglomeration of other reports from conferences, curriculum development, presentations, public health, and higher education faculties in the Arab region. It includes several reports on the use of tobacco and water pipes, a bibliography of outputs regarding agriculture, environment and health research, and a policy institute conference agenda on the topic of war and humanitarianism

Shaping research for health in the Arab world : a systems and network approach to advance knowledge, inform policy, and promote public health

This initiative at the Faculty of Health Sciences (FHS) aimed to strengthen systems and institutions for research and education in public health and facilitate opportunities for interdisciplinary collaboration on critical health issues across institutional and geographical boundaries in the MENA region. To this end, FHS developed and promoted a model for public health schools based on three collaborating academic Centers to enhance synergies between research, capacity development of junior researchers, knowledge translation and professional practice

Influencers of the Decision to Undergo Contralateral Prophylactic Mastectomy among Women with Unilateral Breast Cancer

(1) Background: The relatively high rate of contralateral prophylactic mastectomy (CPM) among women with early stage unilateral breast cancer (BC) has raised concerns. We sought to assess the influence of partners, physicians, and the media on the decision of women with unilateral BC to undergo CPM and identify clinicopathological variables associated with the decision to undergo CPM. (2) Patients and Methods: Women with stage 0 to III unilateral BC who underwent CPM between January 2010 and December 2017. Patients were surveyed regarding factors influencing their self-determined decision to undergo CPM. Partner, physician, and media influence factors were modeled by logistic regressions with adjustments for a family history of breast cancer and pathological stage. (3) Results: 397 (29.6%) patients completed the survey and were included in the study. Partners, physicians, and the media significantly influenced patients’ decision to undergo CPM. The logistic regression models showed that, compared to self-determination alone, overall influence on the CPM decision was significantly higher for physicians (p = 0.0006) and significantly lower for partners and the media (p < 0.0001 for both). Fifty-nine percent of patients’ decisions were influenced by physicians, 28% were influenced by partners, and only 17% were influenced by the media. The model also showed that patients with a family history of BC had significantly higher odds of being influenced by a partner than did those without a family history of BC (p = 0.015). (4) Conclusions: Compared to self-determination, physicians had a greater influence and partners and the media had a lower influence on the decision of women with unilateral BC to undergo CPM. Strong family history was significantly associated with a patient’s decision to undergo CPM