Objectives-To measure the preference regarding disclosure of a serious diagnosis, and its determi... more Objectives-To measure the preference regarding disclosure of a serious diagnosis, and its determinants, of the Lebanese public. Design and setting-Non-random sample survey of 400 persons interviewed in health care facilities in Beirut in 1995. Results-Forty-two per cent of respondents generally preferred truth not to be disclosed directly to patients. Preference for disclosure was associated with younger age, better education and tendency to rapport-building with physicians. There were no meaningful associations between place of residence (urbanlrural), level of religious practice, or religious affiliation, and preference for disclosure. Conclusions-Under one plausible interpretation, this survey suggests that the expectation for concealment will decrease as the advantage of knowledge in better coping with disease is understood by an increasingly better educated public, and that the Lebanese public will increasingly come to expect direct andfull disclosure ofserious diagnoses.
Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different... more Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different interocclusal recording materials (wax and polyether), have been proposed as an easier alternative to extraoral tracing devices or axiographs. There is no consensus as to which combination is the nearest to the recognized standard extraoral tracing devices. This trial measured differences in performance among four combinations of interocclusal recordings in calculating the horizontal condylar inclination (HCl). The mean HCI measurement obtained by axiograph was 50.3 degrees (SD = 10.2) for the right condyle and 52.5 degrees (SD = 9.3) for the left. Of the four tested combinations, the arcon Whip Mix with wax was most likely to reproduce HCI values obtained using the axiograph.
Journal of Epidemiology and Community Health, Aug 1, 2011
(RII¼0.39e0.58). For females, SEI begins at 20e24 years (RII¼0.27) with pronounced inequalities a... more (RII¼0.39e0.58). For females, SEI begins at 20e24 years (RII¼0.27) with pronounced inequalities at 60e79 years and peaking at 65e69 years (RII¼0.30e0.48). All four morphology groups demonstrate inequalities for lung cancer. For cervical cancer, squamous cell carcinoma dominates; in oesophageal cancer, squamous cell carcinoma followed by adenocarcinoma and ultimately other morphologies show inequalities. For head and neck cancers; hypopharynx, piriform sinus and larynx followed by lip, oral cavity and ultimately oropharynx, base of tongue, palate and tonsil show inequalities. We conclude: age, morphology, sex and site provide important information to better understand SEI.
Objectives: This study aimed to assess the psychosocial determinants of intention to seek palliat... more Objectives: This study aimed to assess the psychosocial determinants of intention to seek palliative care for the client themselves, or intention to enroll a family member in palliative care among the public in Lebanon. Methods: A cross-sectional study was initiated in 2020 on a convenience sample of adults permanently living in the Greater Beirut (GB) area; people with no current or previous experience with palliative care either for themselves or for someone dear to them were included. Verbal consent was obtained before data collection, and participants received a questionnaire to be self-completed, statistical analysis was performed using SPSS statistics version 23.0. Results: A total of 875 participants with a mean age of 42 years were interviewed, of whom 24 participants (2.7%) had had a previous experience with PC, either personally or with someone very close to them. The best-fit multivariate predictive model for intention to use PC included older age, positive attitude, and ...
Le Journal médical libanais. The Lebanese medical journal, 1995
The Lebanese Ministry of Health has requested public health experts to assess the most common hea... more The Lebanese Ministry of Health has requested public health experts to assess the most common health problems seen in Primary Health Care (PHC) facilities. This paper presents the results of this assessment conducted in a convenience sample of PHC centers. The assessment aimed at identifying areas of strength and gaps in the current system. Data were drawn from 23 PHC centers in various regions of Lebanon, in addition to an 8-year review of the experience of the Department of Family Medicine at the American University Hospital. In general, 46% of all visits to PHC centers did not include any kind of diagnosis. Most centers provided data on large categories of diseases without breakdown into specific entities. The most commonly identified health problems were hypertension, diabetes and asthma, in addition to eye and ear diseases, cardiologic conditions, and dermatologic problems. Other health problems included ill-defined signs and symptoms associated most likely with mental distress...
Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different... more Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different interocclusal recording materials (wax and polyether), have been proposed as an easier alternative to extraoral tracing devices or axiographs. There is no consensus as to which combination is the nearest to the recognized standard extraoral tracing devices. This trial measured differences in performance among four combinations of interocclusal recordings in calculating the horizontal condylar inclination (HCl). The mean HCI measurement obtained by axiograph was 50.3 degrees (SD = 10.2) for the right condyle and 52.5 degrees (SD = 9.3) for the left. Of the four tested combinations, the arcon Whip Mix with wax was most likely to reproduce HCI values obtained using the axiograph.
Le Journal médical libanais. The Lebanese medical journal, 1997
Two measures of care were estimated from a random sample of 2033 (65%) bills presented to the Min... more Two measures of care were estimated from a random sample of 2033 (65%) bills presented to the Ministry of Public Health (MOPH) by hospitals from all over Lebanon in February 1994. Average length-of-stay was 5 days in surgery, 5.5 days in medicine, and 2.4 days in obstetrics. Average daily costs of hospitalization were 296,971 LL (approximately 170 US$) in surgery, 142,690 LL (approximately 81.5 US$) in medicine, and 225,000 LL (approximately 129 US$) in obstetrics. While neither one of these outcomes was affected by patients' sex, differences were found by age, and hospitals' geographical location and classification. Implications and recommendations for effective evaluation of subsidized care, and better allocation of public funds are discussed.
AIDS education and prevention : official publication of the International Society for AIDS Education, 1991
Selected sociodemographic, psychosocial, and behavioral variables were used to predict maintenanc... more Selected sociodemographic, psychosocial, and behavioral variables were used to predict maintenance or relapse in sexual practices over a 1-year interval in a cohort of homosexual men in Chicago. Univariate analyses and multivariate logistic regression were used to define predictive models for safer practices separately for insertive and receptive and sex. Demographic and psychosocial variables were not associated with subsequent relapse. Neither was HIV serostatus. Using more rigorous multiple logistic regression, only monogamous relationships, less peer support, and less assertiveness in negotiating safer sex appeared to predict relapse to less safe practices. The importance of interpersonal variables and social norms for future interventions among homosexual men is discussed.
This study is the first of its kind in Kuwait. It evaluates various risk factors associated with ... more This study is the first of its kind in Kuwait. It evaluates various risk factors associated with perinatal mortality (PNM) in the Al-Jahra district hospital during the period January 1995-December 1997. Risks associated with PNM were age above 30, parity above 8, history of abortion or perinatal death, lack of antenatal care, presence of chronic maternal disease, hydramnios, antepartum haemorrhage, breech presentation and low Apgar scores. The effect of the appropriate preventative programmes involving highlighting women at risk of perinatal mortality and probable intervention are discussed.
Sexual behavior change to reduce the risk of HIV infection is a dynamic multi-staged process. We ... more Sexual behavior change to reduce the risk of HIV infection is a dynamic multi-staged process. We present an empirical model for change, where we describe a stage of initiation of safer sexual practices, followed by a consolidation stage, and a long-term maintenance stage. The process of change can be interrupted by occasional or repeated lapses. We apply this multi-stage model to sexual behavior in a cohort of gay men from the Chicago area. The prevalence of various stages are reported between 1986 and 1991. Men infected with HIV tended to initiate change to safer sex later than those who were not, but maintained change or relapsed to unsafe practices in the same proportion. Implications regarding factors associated with relapse to unsafe sex, and interventions to prevent relapse, are discussed
... Adel Shehata1, Salim M. Adib2, Aiad A. Al-Anzi1 1Department of Medicine, Al-Jahra Hospital, K... more ... Adel Shehata1, Salim M. Adib2, Aiad A. Al-Anzi1 1Department of Medicine, Al-Jahra Hospital, Kuwait 2Department of Community Medicine, Health Sciences Center, Kuwait University, Kuwait ... 13. Al-Harthi SS. The morbidity and mortality pattern of brucella endocarditis. ...
Reviewing the existing research this article traces the behavioral change among homosexual and bi... more Reviewing the existing research this article traces the behavioral change among homosexual and bisexual men in the US between 1981-91 and discusses behavioral research goals for the future. First detected in 1981 AIDS quickly became associated with the homosexual and bisexual male community. Between 1981 and 1984 the research community made remarkable advances in coming to understand the epidemic. Case-control studies pointed out the high AIDS risk associated with some of the sexual practices of homosexual and bisexual men: multiple sex partners anonymous partners and unprotected anal intercourse. With the aid of behavioral experts the gay community began conducting an array of information and education programs. In 1983 the Center for Disease Control developed "safer sex" guidelines which revolved around the use of condoms. From 1984-88 education efforts led to dramatic behavioral changes which led some to believe that AIDS had been conquered among the homosexual and bisexual population. But the AIDS epidemic brought along with it discrimination against gays. Calls for HIV counseling and testing intensified. As the epidemic moves into its second decade researchers have noticed a relapse into unsafe sexual practices. Researchers have also found that the incidence of HIV has not decreased among special subgroups of the homosexual and bisexual community: younger men who recently became sexually active blacks and Hispanics men of lower socioeconomic status those who life outside large urban centers and those who do not identify with the gay lifestyle. For this decade behavioral research goals include maintaining the existing educational programs and revising them as new developments necessitate and working towards long-term maintenance of behavioral change.
Aggregate data of the National Cancer Registry in Lebanon cannot discriminate cancer incidence in... more Aggregate data of the National Cancer Registry in Lebanon cannot discriminate cancer incidence in small areas. Trained community members surveyed the permanent population of the Baakline municipality using the verbal autopsy approach. We surveyed 1042 households with at least 1 member living permanently in Baakline during 2000-2008. Data covered 4330 persons yielding 34 143 years of observation and 56 new cases of cancer were reported. Median age at diagnosis varied significantly between men (77 years) and women (56 years). The most common types were lung cancer (20%) followed by colorectal (12.5%) and breast (9%). Estimated crude cancer incidence rate was 164 cases/100 000 persons/year, significantly higher in men (194) than women (130), and much lower overall than the national figure (218). The permanent Baakline population is older than that of Lebanon itself, yet the cancer incidence rate is markedly lower than the national figure. This finding pleads for serious efforts to preserve the low environmental contamination and the healthy lifestyles in food and tobacco abstinence that have protected the population so far.
Cancer registration is a core component of national and regional cancer control strategies. In th... more Cancer registration is a core component of national and regional cancer control strategies. In the Middle East, North-Africa and Turkey (MENAT) region, capacity and resources for cancer registration is variable and shaped by multiple contextual challenges. This viewpoint maps out practical recommendations around cancer registration, in an attempt to inform cancer control planning, policy, and implementation. The recommendations laid out in this viewpoint are informed by the discussions held at the Initiative for Cancer Registration in the MENAT (ICRIM) virtual workshop, which convened registry managers, policy makers, and international agencies from 19 countries in the MENAT region. The discussions were distilled in four categories of recommendations, revolving around cancer registration procedures, collaborative governance, putting cancer registration on the map, and capacity building. This viewpoint provides a much-needed mapping of practical recommendations around cancer registra...
Introduction: The increase in the population of 60 years and above has led to an increase in deme... more Introduction: The increase in the population of 60 years and above has led to an increase in dementia. Middle East and North Africa region (MENA) has one of the highest prevalence of dementia. One of the factors revealing promising results in reducing the burden of dementia, yet not researched in MENA and in other parts of the world, is physical activity. Objective: We aimed to assess the association between subjective and objective physical activity, and memory recall of older adults with no dementia in Lebanon. We also investigated the moderating effect of sex and place of residence on this association. Methods: This is a secondary data analysis of a cross-sectional study conducted in 2013 on a community of 502 older adults 65 years of age and above, selected randomly from two areas, Lebanon’s capital, Beirut, and Mount Lebanon. After excluding those who had dementia diagnoses and who did not have data on physical activity, the eligible sample was 459 persons. Physical activity wa...
Objectives-To measure the preference regarding disclosure of a serious diagnosis, and its determi... more Objectives-To measure the preference regarding disclosure of a serious diagnosis, and its determinants, of the Lebanese public. Design and setting-Non-random sample survey of 400 persons interviewed in health care facilities in Beirut in 1995. Results-Forty-two per cent of respondents generally preferred truth not to be disclosed directly to patients. Preference for disclosure was associated with younger age, better education and tendency to rapport-building with physicians. There were no meaningful associations between place of residence (urbanlrural), level of religious practice, or religious affiliation, and preference for disclosure. Conclusions-Under one plausible interpretation, this survey suggests that the expectation for concealment will decrease as the advantage of knowledge in better coping with disease is understood by an increasingly better educated public, and that the Lebanese public will increasingly come to expect direct andfull disclosure ofserious diagnoses.
Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different... more Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different interocclusal recording materials (wax and polyether), have been proposed as an easier alternative to extraoral tracing devices or axiographs. There is no consensus as to which combination is the nearest to the recognized standard extraoral tracing devices. This trial measured differences in performance among four combinations of interocclusal recordings in calculating the horizontal condylar inclination (HCl). The mean HCI measurement obtained by axiograph was 50.3 degrees (SD = 10.2) for the right condyle and 52.5 degrees (SD = 9.3) for the left. Of the four tested combinations, the arcon Whip Mix with wax was most likely to reproduce HCI values obtained using the axiograph.
Journal of Epidemiology and Community Health, Aug 1, 2011
(RII¼0.39e0.58). For females, SEI begins at 20e24 years (RII¼0.27) with pronounced inequalities a... more (RII¼0.39e0.58). For females, SEI begins at 20e24 years (RII¼0.27) with pronounced inequalities at 60e79 years and peaking at 65e69 years (RII¼0.30e0.48). All four morphology groups demonstrate inequalities for lung cancer. For cervical cancer, squamous cell carcinoma dominates; in oesophageal cancer, squamous cell carcinoma followed by adenocarcinoma and ultimately other morphologies show inequalities. For head and neck cancers; hypopharynx, piriform sinus and larynx followed by lip, oral cavity and ultimately oropharynx, base of tongue, palate and tonsil show inequalities. We conclude: age, morphology, sex and site provide important information to better understand SEI.
Objectives: This study aimed to assess the psychosocial determinants of intention to seek palliat... more Objectives: This study aimed to assess the psychosocial determinants of intention to seek palliative care for the client themselves, or intention to enroll a family member in palliative care among the public in Lebanon. Methods: A cross-sectional study was initiated in 2020 on a convenience sample of adults permanently living in the Greater Beirut (GB) area; people with no current or previous experience with palliative care either for themselves or for someone dear to them were included. Verbal consent was obtained before data collection, and participants received a questionnaire to be self-completed, statistical analysis was performed using SPSS statistics version 23.0. Results: A total of 875 participants with a mean age of 42 years were interviewed, of whom 24 participants (2.7%) had had a previous experience with PC, either personally or with someone very close to them. The best-fit multivariate predictive model for intention to use PC included older age, positive attitude, and ...
Le Journal médical libanais. The Lebanese medical journal, 1995
The Lebanese Ministry of Health has requested public health experts to assess the most common hea... more The Lebanese Ministry of Health has requested public health experts to assess the most common health problems seen in Primary Health Care (PHC) facilities. This paper presents the results of this assessment conducted in a convenience sample of PHC centers. The assessment aimed at identifying areas of strength and gaps in the current system. Data were drawn from 23 PHC centers in various regions of Lebanon, in addition to an 8-year review of the experience of the Department of Family Medicine at the American University Hospital. In general, 46% of all visits to PHC centers did not include any kind of diagnosis. Most centers provided data on large categories of diseases without breakdown into specific entities. The most commonly identified health problems were hypertension, diabetes and asthma, in addition to eye and ear diseases, cardiologic conditions, and dermatologic problems. Other health problems included ill-defined signs and symptoms associated most likely with mental distress...
Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different... more Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different interocclusal recording materials (wax and polyether), have been proposed as an easier alternative to extraoral tracing devices or axiographs. There is no consensus as to which combination is the nearest to the recognized standard extraoral tracing devices. This trial measured differences in performance among four combinations of interocclusal recordings in calculating the horizontal condylar inclination (HCl). The mean HCI measurement obtained by axiograph was 50.3 degrees (SD = 10.2) for the right condyle and 52.5 degrees (SD = 9.3) for the left. Of the four tested combinations, the arcon Whip Mix with wax was most likely to reproduce HCI values obtained using the axiograph.
Le Journal médical libanais. The Lebanese medical journal, 1997
Two measures of care were estimated from a random sample of 2033 (65%) bills presented to the Min... more Two measures of care were estimated from a random sample of 2033 (65%) bills presented to the Ministry of Public Health (MOPH) by hospitals from all over Lebanon in February 1994. Average length-of-stay was 5 days in surgery, 5.5 days in medicine, and 2.4 days in obstetrics. Average daily costs of hospitalization were 296,971 LL (approximately 170 US$) in surgery, 142,690 LL (approximately 81.5 US$) in medicine, and 225,000 LL (approximately 129 US$) in obstetrics. While neither one of these outcomes was affected by patients' sex, differences were found by age, and hospitals' geographical location and classification. Implications and recommendations for effective evaluation of subsidized care, and better allocation of public funds are discussed.
AIDS education and prevention : official publication of the International Society for AIDS Education, 1991
Selected sociodemographic, psychosocial, and behavioral variables were used to predict maintenanc... more Selected sociodemographic, psychosocial, and behavioral variables were used to predict maintenance or relapse in sexual practices over a 1-year interval in a cohort of homosexual men in Chicago. Univariate analyses and multivariate logistic regression were used to define predictive models for safer practices separately for insertive and receptive and sex. Demographic and psychosocial variables were not associated with subsequent relapse. Neither was HIV serostatus. Using more rigorous multiple logistic regression, only monogamous relationships, less peer support, and less assertiveness in negotiating safer sex appeared to predict relapse to less safe practices. The importance of interpersonal variables and social norms for future interventions among homosexual men is discussed.
This study is the first of its kind in Kuwait. It evaluates various risk factors associated with ... more This study is the first of its kind in Kuwait. It evaluates various risk factors associated with perinatal mortality (PNM) in the Al-Jahra district hospital during the period January 1995-December 1997. Risks associated with PNM were age above 30, parity above 8, history of abortion or perinatal death, lack of antenatal care, presence of chronic maternal disease, hydramnios, antepartum haemorrhage, breech presentation and low Apgar scores. The effect of the appropriate preventative programmes involving highlighting women at risk of perinatal mortality and probable intervention are discussed.
Sexual behavior change to reduce the risk of HIV infection is a dynamic multi-staged process. We ... more Sexual behavior change to reduce the risk of HIV infection is a dynamic multi-staged process. We present an empirical model for change, where we describe a stage of initiation of safer sexual practices, followed by a consolidation stage, and a long-term maintenance stage. The process of change can be interrupted by occasional or repeated lapses. We apply this multi-stage model to sexual behavior in a cohort of gay men from the Chicago area. The prevalence of various stages are reported between 1986 and 1991. Men infected with HIV tended to initiate change to safer sex later than those who were not, but maintained change or relapsed to unsafe practices in the same proportion. Implications regarding factors associated with relapse to unsafe sex, and interventions to prevent relapse, are discussed
... Adel Shehata1, Salim M. Adib2, Aiad A. Al-Anzi1 1Department of Medicine, Al-Jahra Hospital, K... more ... Adel Shehata1, Salim M. Adib2, Aiad A. Al-Anzi1 1Department of Medicine, Al-Jahra Hospital, Kuwait 2Department of Community Medicine, Health Sciences Center, Kuwait University, Kuwait ... 13. Al-Harthi SS. The morbidity and mortality pattern of brucella endocarditis. ...
Reviewing the existing research this article traces the behavioral change among homosexual and bi... more Reviewing the existing research this article traces the behavioral change among homosexual and bisexual men in the US between 1981-91 and discusses behavioral research goals for the future. First detected in 1981 AIDS quickly became associated with the homosexual and bisexual male community. Between 1981 and 1984 the research community made remarkable advances in coming to understand the epidemic. Case-control studies pointed out the high AIDS risk associated with some of the sexual practices of homosexual and bisexual men: multiple sex partners anonymous partners and unprotected anal intercourse. With the aid of behavioral experts the gay community began conducting an array of information and education programs. In 1983 the Center for Disease Control developed "safer sex" guidelines which revolved around the use of condoms. From 1984-88 education efforts led to dramatic behavioral changes which led some to believe that AIDS had been conquered among the homosexual and bisexual population. But the AIDS epidemic brought along with it discrimination against gays. Calls for HIV counseling and testing intensified. As the epidemic moves into its second decade researchers have noticed a relapse into unsafe sexual practices. Researchers have also found that the incidence of HIV has not decreased among special subgroups of the homosexual and bisexual community: younger men who recently became sexually active blacks and Hispanics men of lower socioeconomic status those who life outside large urban centers and those who do not identify with the gay lifestyle. For this decade behavioral research goals include maintaining the existing educational programs and revising them as new developments necessitate and working towards long-term maintenance of behavioral change.
Aggregate data of the National Cancer Registry in Lebanon cannot discriminate cancer incidence in... more Aggregate data of the National Cancer Registry in Lebanon cannot discriminate cancer incidence in small areas. Trained community members surveyed the permanent population of the Baakline municipality using the verbal autopsy approach. We surveyed 1042 households with at least 1 member living permanently in Baakline during 2000-2008. Data covered 4330 persons yielding 34 143 years of observation and 56 new cases of cancer were reported. Median age at diagnosis varied significantly between men (77 years) and women (56 years). The most common types were lung cancer (20%) followed by colorectal (12.5%) and breast (9%). Estimated crude cancer incidence rate was 164 cases/100 000 persons/year, significantly higher in men (194) than women (130), and much lower overall than the national figure (218). The permanent Baakline population is older than that of Lebanon itself, yet the cancer incidence rate is markedly lower than the national figure. This finding pleads for serious efforts to preserve the low environmental contamination and the healthy lifestyles in food and tobacco abstinence that have protected the population so far.
Cancer registration is a core component of national and regional cancer control strategies. In th... more Cancer registration is a core component of national and regional cancer control strategies. In the Middle East, North-Africa and Turkey (MENAT) region, capacity and resources for cancer registration is variable and shaped by multiple contextual challenges. This viewpoint maps out practical recommendations around cancer registration, in an attempt to inform cancer control planning, policy, and implementation. The recommendations laid out in this viewpoint are informed by the discussions held at the Initiative for Cancer Registration in the MENAT (ICRIM) virtual workshop, which convened registry managers, policy makers, and international agencies from 19 countries in the MENAT region. The discussions were distilled in four categories of recommendations, revolving around cancer registration procedures, collaborative governance, putting cancer registration on the map, and capacity building. This viewpoint provides a much-needed mapping of practical recommendations around cancer registra...
Introduction: The increase in the population of 60 years and above has led to an increase in deme... more Introduction: The increase in the population of 60 years and above has led to an increase in dementia. Middle East and North Africa region (MENA) has one of the highest prevalence of dementia. One of the factors revealing promising results in reducing the burden of dementia, yet not researched in MENA and in other parts of the world, is physical activity. Objective: We aimed to assess the association between subjective and objective physical activity, and memory recall of older adults with no dementia in Lebanon. We also investigated the moderating effect of sex and place of residence on this association. Methods: This is a secondary data analysis of a cross-sectional study conducted in 2013 on a community of 502 older adults 65 years of age and above, selected randomly from two areas, Lebanon’s capital, Beirut, and Mount Lebanon. After excluding those who had dementia diagnoses and who did not have data on physical activity, the eligible sample was 459 persons. Physical activity wa...
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