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1.
Aesthetic Plast Surg ; 2024 Sep 12.
Article in English | MEDLINE | ID: mdl-39266683

ABSTRACT

BACKGROUND: The United States Food and Drug Administration (FDA) recommends silicone breast implant rupture surveillance using MRI or ultrasound beginning at 5-6 years post-insertion and every 2-3 years thereafter. No surveillance guidelines exist in Canada or the UK. This study aims to identify surveillance practices and perceived barriers to surveillance among plastic surgeons in Canada and the UK and compare surgeon practices between public and private sectors. METHODS: All active members of the Canadian Society of Plastic Surgeons (CSPS) and British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) with an interest in breast surgery were surveyed. Surgeon demographics, screening practices and perceived barriers to screening were analyzed. Fisher's exact test was used to detect significant associations. RESULTS: The survey response rate was 16%. Most surgeons (68%, n=58/85) were familiar with FDA guidelines; however, only 2.4% (n=2/85) followed them. Surgeons in private practice screened significantly more than surgeons in the public sector [45% (n=13/29) vs 13% (n=7/56), p<0.002]. Among surgeons, ultrasound and high-definition ultrasound were the most common screening modalities and a perceived lack of clinical necessity followed by a perceived lack of satisfactory evidence qualifying these guidelines was the most reported barrier to screening. CONCLUSION: Despite awareness of FDA guidelines, compliance among surgeons surveyed remains low, reportedly due to a perceived lack of necessity or evidence base. Most public sector surgeons opt not to screen and do not recommend surveillance, even without barriers. While governing bodies should consider current practices to shape guidelines, increasing surgeons' awareness on their evidentiary foundation and potential consequences of silent ruptures is imperative. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

2.
Biosocieties ; : 1-26, 2023 May 22.
Article in English | MEDLINE | ID: mdl-37359140

ABSTRACT

Drawing upon 152 in-depth qualitative interviews with residents in Austria carried out in the first year of the pandemic, this article discusses how people's experiences with COVID-19 policies reflect and reshape state-citizen relations. Coinciding with a significant government crisis, the first year of COVID-19 in Austria saw pandemic measures justified with reference to a biological, often medical understanding of health that framed disease prevention in terms of transmission reduction, often with reference to metrics such as hospitalisation rates, etc. Instead of using this biomedical frame, our interviewees, however, drew attention to biopsychosocial dimensions of the crisis and problematised the entanglements between economy and health. We call this the emergence of a biosocial notion of citizenship that is attentive to psychological, social and economic dimensions of health. Insights into the biosocial nature of pandemic citizenship open a window of opportunity for addressing long-standing social injustices.

3.
SSM Qual Res Health ; 2: 100158, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36092769

ABSTRACT

The sudden and dramatic advent of the COVID-19 pandemic led to urgent demands for timely, relevant, yet rigorous research. This paper discusses the origin, design, and execution of the SolPan research commons, a large-scale, international, comparative, qualitative research project that sought to respond to the need for knowledge among researchers and policymakers in times of crisis. The form of organization as a research commons is characterized by an underlying solidaristic attitude of its members and its intrinsic organizational features in which research data and knowledge in the study is shared and jointly owned. As such, the project is peer-governed, rooted in (idealist) social values of academia, and aims at providing tools and benefits for its members. In this paper, we discuss challenges and solutions for qualitative studies that seek to operate as research commons.

4.
Ann Biol Clin (Paris) ; 79(6): 579-586, 2021 Dec 01.
Article in English | MEDLINE | ID: mdl-34859791

ABSTRACT

Automated immunoassays have been introduced to complement real time PCR (RT-PCR) in the battle against SARS-CoV-2. This study compares four serological automated immunoassays by different manufacturers (Abbott, Euroimmun, Roche and Snibe) that are available in Lebanon with regards to specificities, sensitivities, inter-agreement and positive/negative distinction abilities. One hundred and fifty-seven samples (73 with a positive RT-PCR and 84 controls) were analyzed. The 73 study samples were divided into 3 time categories: ≤ 7 days, 8-13 days and ≥ 14 days based on time since first positive RT-PCR or first symptoms. The category "total days" was studied as the average of all the three time categories. All assays had 100% specificity and their sensitivities in the "total days" category ranged from 75.3% to 20.6% (Snibe IgM). The sensitivity was low for all at ≤ 7 days and increased gradually in the other time categories. The IgG assays by different manufacturers showed high inter-agreement. The assays also showed good positive/negative discriminative abilities after 14 days. The four studied automated immunoassays (except for Snibe IgM) show an adequate diagnostic performance when used 14 days after first positive PCR or first symptom onset.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Humans , Immunoassay , Immunoglobulin G , Lebanon , Sensitivity and Specificity
5.
East Mediterr Health J ; 26(6): 736-743, 2020 Jun 24.
Article in English | MEDLINE | ID: mdl-32621510

ABSTRACT

BACKGROUND: Lebanon has a decentralized/fragmented transfusion system. The current blood supply does not meet the World Health Organization target of achieving 100% voluntary non-remunerated blood donation (VNRD). There are currently 3 types of donors/donations in Lebanon: replacement/family donations (70-75%), VNRD (20-25%), and compensated donations (5-10%). Remunerated donations are illegal. AIMS: This report summarizes the content of presentations given during the first World Blood Donor Day seminar in Lebanon in June 2017. The aim is to describe the current Lebanese blood supply system and the major road blocks and to suggest practical recommendations that may assist in achieving 100% VNRD. METHODS: The content of presentations given during the first World Blood Donor Day seminar in Lebanon in June 2017 were summarized. RESULTS: The seminar was attended by all major stakeholders involved in transfusion medicine (Lebanese National Committee of Blood Transfusion, Hospital Blood Banks directors, Lebanese Army Blood Bank, Lebanese Red Cross and Donner Sang Compter). CONCLUSIONS: The Ministry of Public Health should focus on performing regular audits regarding the implementation of national guidelines. There is a need for a national blood supply committee, unifying all stakeholders in the transfusion and donation fields. Transfusion medicine should be declared by law as a public health issue and considered a priority for patient safety.


Subject(s)
Blood Banks , Blood Donors/supply & distribution , Blood Safety , Blood Transfusion , Congresses as Topic , Humans , Lebanon
6.
Ann Biol Clin (Paris) ; 77(6): 701-711, 2019 12 01.
Article in French | MEDLINE | ID: mdl-31859650
8.
Policy Sci ; 52(2): 299-314, 2019.
Article in English | MEDLINE | ID: mdl-31148877

ABSTRACT

Current political developments in established liberal democracies in both Europe and North America have fundamentally called into question the normative relations between truth, knowledge and politics. Whether labeled "posttruth" or truthiness, commentators lament the willful spread and deployment of nonknowledge and ignorance as important political forces. In this paper, we discuss ignorance in its strategic dimension by weaving together insights from the sociology of ignorance with a policy-scientific approach. By means of three empirical vignettes, we demonstrate that ignorance is more than the flipside of knowledge or merely its lack: it is a constitutive feature of the policy process and is thus not uniquely symptomatic of the current era. We conclude by arguing for what we call a symmetrical approach in which ignorance receives the same quality of attention that knowledge has historically received in the policy sciences. To make fully visible the different forms of ignorance that shape policy processes, policy scholars must hone their "agnoto-epistemological sensibilities" to cope with the current challenges and advance a policy science for democracy.

9.
Can J Ophthalmol ; 52(5): 499-502, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28985811

ABSTRACT

OBJECTIVE: To determine the acuity of ophthalmology referral for orbital fractures. METHODS: This is a retrospective chart review of 73 cases of orbital fractures over a 1-year period at a level I trauma centre. All consultations including those for orbital fractures were included in the study. The age and sex of the patient, date and time of initial emergency room (ER) arrival, date and time of input of the ophthalmology consultation, date and time the patient actually saw ophthalmology, reasons for consultation, location of examination, mechanism, and ocular findings at initial and follow-up examination, and any orbital surgery performed were recorded. RESULTS: Of the 73 patients referred, 10 had an ocular abnormality on examination. Of the 65 routine referrals for orbital fracture received, 5 had an ocular abnormality on examination, whereas 5 of the 8 patients referred for an ocular abnormality in addition to the orbital fracture had an ocular abnormality, for an overall rate of 13.7%. Of the routine referrals, none had severe ocular injuries, such as globe rupture or retrobulbar hemorrhage, requiring immediate ocular intervention. CONCLUSIONS: Orbital fractures may be associated with severe ocular abnormalities, although routine cases of orbital fractures in the absence of suspicion of serious ocular injury may be less likely to have abnormalities requiring emergent evaluation by an ophthalmologist. A prospective study evaluating orbital fractures would help clarify this.


Subject(s)
Eye Injuries/etiology , Orbital Fractures/complications , Adolescent , Adult , Aged , Aged, 80 and over , Eye Injuries/diagnosis , Female , Humans , Male , Middle Aged , Orbital Fractures/diagnosis , Orbital Fractures/surgery , Patient Acuity , Physical Examination , Referral and Consultation , Retrospective Studies , Trauma Centers/classification , Young Adult
10.
Int J Infect Dis ; 46: 64-70, 2016 May.
Article in English | MEDLINE | ID: mdl-26996458

ABSTRACT

Antimicrobial resistance is closely linked to antimicrobial use and is a growing concern worldwide. Antimicrobial resistance increases healthcare costs substantially in many countries, including Lebanon. National data from Lebanon have, in the most part, been limited to a few academic hospitals. The Lebanese Society of Infectious Diseases conducted a retrospective study to better describe the antimicrobial susceptibility patterns of bacterial isolates in Lebanon. Data were based on records retrieved from the bacteriology laboratories of 16 different Lebanese hospitals between January 2011 and December 2013. The susceptibility results of a total 20684 Gram-positive and 55594 Gram-negative bacteria were analyzed. The prevalence rate of methicillin-resistant Staphylococcus aureus was 27.6% and of vancomycin-resistant Enterococcus spp was 1%. Streptococcus pneumoniae had susceptibilities of 46% to oxacillin, 63% to erythromycin, and 98% to levofloxacin. Streptococcus pyogenes had susceptibilities of 94% to erythromycin and 95% to clindamycin. The mean ampicillin susceptibility of Haemophilus influenzae, Salmonella spp, and Shigella spp isolates was 79%, 81.3%, and 62.2%, respectively. The extended-spectrum beta-lactamase production rate for Escherichia coli was 32.3% and for Klebsiella spp was 29.2%. Acinetobacter spp showed high resistance to most antimicrobials, with low resistance to colistin (17.1%). Pseudomonas spp susceptibilities to piperacillin-tazobactam and imipenem were lower than 80% (79.7% and 72.8%, respectively). This study provides population-specific data that are valuable in guiding antimicrobial use in Lebanon and neighbouring countries and will help in the establishment of a surveillance system for antimicrobial resistance following the implementation of a nationwide standardization of laboratory methods and data entry.


Subject(s)
Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Bacterial Infections/microbiology , Drug Resistance, Bacterial , Bacteria/classification , Bacteria/isolation & purification , Bacterial Infections/drug therapy , Bacterial Infections/epidemiology , Hospitals/statistics & numerical data , Humans , Lebanon/epidemiology , Microbial Sensitivity Tests , Retrospective Studies
11.
J Vis ; 15(9): 6, 2015.
Article in English | MEDLINE | ID: mdl-26200887

ABSTRACT

We have measured the relative perceptual scales for chromatic and luminance blur in dense textures comprised of color and luminance Gabors, using a modification of the method of paired comparisons. We find that the rate at which perceived blur grows with physical blur, when normalized to 1.0 for luminance, is 0.2 for red-green and 0.06 for blue-yellow blur. It is argued that the relatively severely compressed perceptual scales for red-green and blue-yellow blur are a contributary factor to the observation that when the color but not luminance layer of an image of a natural scene is blurred, there is little or no impression of blur (Wandell, 1995).


Subject(s)
Color Perception/physiology , Contrast Sensitivity/physiology , Light , Pattern Recognition, Visual/physiology , Vision, Ocular/physiology , Humans , Visual Analog Scale
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