A Conceptual Definition of Vocational Rehabilitation Based on the ICF: Building a Shared Global Model

Background The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework and classification system by the World Health Organization (WHO) to understand functioning. The objective of this discussion paper is to offer a conceptual definition for vocational rehabilitation (VR) based on the ICF. Method We presented the ICF as a model for application in VR and the rationale for the integration of the ICF. We also briefly reviewed other work disability models. Results Five essential elements of foci were found towards a conceptual definition of VR: an engagement or re-engagement to work, along a work continuum, involved health conditions or events leading to work disability, patient-centered and evidence-based, and is multi-professional or multidisciplinary. Conclusions VR refers to a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. We propose that the ICF and VR interface be explored further using empirical and qualitative works and encouraging stakeholders' participatio

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

Synthesis of phosphorylated calix[4]arene derivatives for the design of solid phases immobilizing uranyl cations.

International audienceWith the aim of developing supports for uranyl cations immobilization, new 1,3-alternate calix[4]arenes bearing both phosphonic acid functions as chelating sites and N-succinimide-4-oxabutyrate as the anchoring arm were synthesized in good yields. The coupling of such calixarenes to a gel was performed and a successful immobilization of uranyl cations was obtained

International Clinical Guidelines at the American University of Beirut, Physical Therapy Department: Strategy of Implementation and Evaluation

Purpose. The purpose of the study is (1) to describe the selection process of an international clinical guideline (CGL) for patients with low back pain (LBP) for adoption and implementation at the Physical Therapy Department at the American University of Beirut Medical Center (AUBMC), and (2) to evaluate the physiotherapists’ compliance. Method. International guidelines were identified through a literature search and compared according to the AGREE instrument for selection. Quality indicators were selected. Physiotherapists were educated about guidelines’ benefits and the content of the adopted guidelines during interactive sessions; patients’ files were optimized and audited in order to evaluate compliance. Results. Out of six guidelines for LBP, we selected that of the Royal Dutch Association of Physiotherapy. Full adherence of physiotherapists to the educational sessions was noted. A total of 72 patient files were available. However, only 23 out of 72 files (32%) were complete to test the therapists’ adherence to the new assessment forms using 13 quality indicators. A high level of compliance with a mean score of 90% was recorded for the diagnostic process indicators, and a low level for the mean score of therapeutic process indicators (42%) except the indicator for the advice to stay active (100%). The mean score for the outcome of care was very low (13%). Conclusions. Dutch guidelines for low back pain were selected for adoption and implementation. A relatively high level of adherence to guidelines recommendations was noticed in the diagnostic process and a low level in the therapeutic process

Validation of a new method for monitoring trace elements in Mediterranean cereal soils

International audienceIn the Mediterranean region, agricultural soils are seriously polluted with toxic trace elements (TEs) which could enter the food chain via the soil-plant trophic chain. For food safety reasons, the monitoring of TE concentrations in these agricultural soils is thus imperative. The most powerful monitoring method for TE measurements is based on perchloric acid (HClO4) and hydrofluoric acid (HF) digestion, commonly used as reference total digestion (RTD) method, with consequent use of inductively coupled plasma optical emission spectrometry (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS). Unfortunately, HF and HClO4 manipulations are highly dangerous and ICP-OES and ICP-MS apparatus are very expensive, thus they are unaffordable, notably in developing countries. In this paper, an alternative, microwave sulphuric digestion (MSD) method, combined with atomic absorption spectroscopy (AAS) is proposed. First, the suggested method was validated on a soil certified reference material, for the determination of 7 TEs (As, Cd, Co, Cr, Cu, Ni and Pb). Second, the MSD method was applied on agricultural soil samples situated in the Bekaa valley, East Lebanon and results were compared to those of RTD method. The MSD method, coupled to AAS, offers a promising and feasible alternative to HF, as well as, aqua regia based methods

Intestinal presentation of non-Hodgkin lymphoma: Case report

Background: MEITL (monomorphic epitheliotropic intestinal T-cell lymphoma) is a rare primary intestinal T-cell lymphoma associated with high mortality rate. Being intestinal this implies difficult diagnostic workup and management. Case: We present a case of 59-year-old male presented with abdominal pain and found to have 15 × 11 cm mass in the right iliac fossa. Decision for surgical excision was retained and the Pathological examination determined monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) with CD30 positive immune-histochemical profile. Conclusion: MEITL is a rare entity which retains challenging diagnosis and management as well as variable immune-histochemical profile. In the absence of clear guidelines for the management of intestinal manifestation of lymphoma, surgical approach may have its indications.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Lebanese Population Exposure to Trace Elements via White Bread Consumption

International audienceThe objective of this study was to assess Lebanese population exposure to trace elements (TEs) via white pita consumption. A survey of white pita consumption was achieved among one thousand Lebanese individuals, grouped into adults (above 15 years old, men, and women) and young people (6–9 and 10–14 years old). The most consumed pita brands, labeled B1, B2, and B3, were selected. Levels of TEs (i.e., As, Cd, Co, Cr, Hg, Ni, and Pb) in B1, B2, B3 pitas were measured. The highest contents of TEs in pitas were: Ni (1292 µg/kg) and Co (91 µg/kg) in B1; As (400 µg/kg) and Cd (< 15 µg/kg) in B2; Cr (363 µg/kg), Pb (260 µg/kg), and Hg (0.89 µg/kg) in B3. The pita brand B3 was the source of the highest TEs exposure, except for Ni for which it was B1. Daily exposures to TEs due to the fact of pita consumption were compared to safety levels. There were no safety concerns for Hg, Cd, Cr or Co (except the 95th percentile of 6–9 years old). An excess of the Ni tolerable daily intake was observed for the most exposed populations. The very low margins of exposure for As and Pb suggest a worrying risk for the Lebanese population

Why are you draining your brain? Factors underlying decisions of graduating Lebanese medical students to migrate

In the context of a worldwide physician brain drain phenomenon, Lebanon has the highest emigration factor in the Middle East and North Africa. In this manuscript we aim to identify and develop a conceptual framework for the factors underlying the decisions of graduating Lebanese medical students to train abroad. We conducted two focus groups and seven semi-structured individual interviews with 23 students. In the deductive analysis (based on the push-pull theory), students reported push factors in Lebanon and pull factors abroad related to five dimensions. They focused predominantly on how training abroad provides them with a competitive advantage in an oversaturated Lebanese job market. An inductive analysis revealed the following emerging concepts: repel factors abroad and retain factors locally; societal expectations that students should train abroad; marketing of abroad training; and an established culture of migration. The marketing of abroad training and the culture of migration are prevalent in the academic institutions.Lebanon Middle east Brain drain Migration Physicians Medical students

Lebanese pita extracts with presence of trace elements: hazard assessment

International audienceAmong Trace Elements (TE) that can be present in food, some are known to be toxic and must be monitored. Regarding food safety, it is relevant to study the case of the pita, since it represents a large part of the daily diet of the Lebanese population. In a previous study, the Lebanese Agricultural Research Institute (LARI) analyzed the presence of several TE (arsenic, cadmium, cobalt, chromium, mercury, nickel and lead) in white Lebanese pita. Although the toxicity of each TE is known individually, it is important to test the toxicity of the mixture of TE, present in the bread, in order to check the presence of "cocktail" effects between TE, especially synergism