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Ahmed F, Craig R, Omar A, El-Masri M. Self-Reported Study Analyzing Physicians' Personal Compliance with Health Prevention Guidelines in a Medium-Sized Canadian Community. J Prim Care Community Health 2023; 14:21501319231162480. [PMID: 36974347 PMCID: PMC10052478 DOI: 10.1177/21501319231162480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
There have only been limited studies that have assessed the attitude of Canadian physicians toward their own physical health. The aim of our study was to explore the self-reported health maintenance behavior and the predictors of health practices among physicians in a small-medium sized Canadian community. We used a descriptive mailed in self-report survey to contact all 649 physicians registered with the Essex County Medical Society, with a 36% response rate. Our results showed that 81% of physicians in Windsor-Essex County were satisfied with how well they care for themselves, despite reporting low levels of physical activity and a lower percentage of respondents having family physicians than the general population. Five independent factors were identified with physician self-perceived health satisfaction: Physician age of 45 to 54 (95% CI 0.17-0.92; OR 0.39), graduating from Canadian medical schools (95% CI 0.15 to 0.80; OR 0.35), having more than one co-morbidity (95% CI 0.13-0.72; OR 0.31), physicians who had a regular family doctor (95% CI 1.12-5.52; OR 2.43), and engagement in regular moderate weekly exercise (95% CI 1.05-4.94; OR 2.28). We also contrasted the preventive health screening markers of our study to compliance rates of the general population as well as the national physician study. Our results showed that screening rates among our study physician group differed markedly from the general population. For colorectal and breast cancers, physicians in our study reported screening rates of 77.8% and 37.3% respectively, compared with the general population, who's screening rates are 32.3% and 72.5%. Future studies exploring specific targeted health promotion interventions that could address these factors may be warranted in order to further improve Canadian physician health, and ultimately improve their ability to take care of their patients.
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Affiliation(s)
- Fawad Ahmed
- Western University, London/Windsor, ON, Canada
| | - Ryan Craig
- Western University, London/Windsor, ON, Canada
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2
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Cooper G, El-Masri M, Kyle De M, Tam N, Sbrocca N, Awuku M, Jacobs L. Impact of an urban regional medical campus: perceptions of community stakeholders. Can Med Educ J 2021; 12:e46-e59. [PMID: 33680230 PMCID: PMC7931487 DOI: 10.36834/cmej.69951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Regional medical campuses (RMC) have shown promise in addressing physician shortages. RMCs have been positively evaluated in rural/remote communities, however, it is unclear whether this model will be as beneficial in underserved urban areas. This study evaluated the impact of a RMC on a midsized urban city (Windsor, Ontario). We compare our results with a similar study conducted in a remote community in British Columbia (BC). METHODS A broad array of community stakeholders representing different sectors were consulted using a semi-structured interview format replicated from the BC Northern Medical Program (NMP) study. Thematic analysis based on the resulting rich data was conducted within a grounded theory context. RESULTS Twenty-three participants (52% male) representing healthcare, education, business, community and government/politico sectors were consulted. Their views regarding the Windsor Regional Medical Campus (WRMC) aligned around several themes: improved healthcare, enhanced community reputation, stimulated economic/community development, expanded training opportunities and an engaged community regarding the WRMC. These results were compared to the main findings of the NMP study with both similarities (e.g. increased community pride) and differences (e.g. resource concerns) discussed. CONCLUSION Community stakeholders provided strong support for the WRMC through their perceptions of its positive impact on this urban region. These findings are consistent with similar RMC studies in rural/remote areas. Those interested in developing a RMC might benefit from considering these findings.
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Affiliation(s)
- Gerry Cooper
- Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
| | - Maher El-Masri
- Daphne Cockwell School of Nursing, Ryerson University, Ontario, Canada
| | - Mars Kyle De
- PGY1 Family Medicine Resident, Windsor Campus, Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
| | - Nathan Tam
- PGY1 Family Medicine Resident, Waterloo Regional Campus, Michael G. DeGroote School of Medicine, McMaster University, Ontario, Canada
| | - Nicole Sbrocca
- Cancer Program, Windsor Regional Hospital, Windsor, Ontario, Canada
| | - Mark Awuku
- Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
| | - Lawrence Jacobs
- Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
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3
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Albdour M, El-Masri M, Hong JS. A Descriptive Study of Bullying Victimization Among Arab American Adolescents in Southeast Michigan Middle and High Schools. J Pediatr Nurs 2020; 55:232-238. [PMID: 32966963 DOI: 10.1016/j.pedn.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE This cross-sectional study examined the frequency of different forms of bullying victimization (verbal, physical, and social), predictors of victimization, and whether bullying is reported to an adult. DESIGN AND METHODS The study utilized a community sample of 150 Arab American adolescents, age 12 to 16 years. The Adolescent Peer Relations Instrument-Victimization Scale was used to determine the participant's experiences of victimization in the past year. The adolescents indicated where bullying occurred, why, and whether they reported the incidence to an adult. RESULTS Approximately 30% of the study sample reported that victimization occurred occasionally (once a month or more frequent). Classrooms and hallways were the most common locations where bullying had occurred. Country-of-origin and obesity were the most frequent reasons for victimization. Predictors varied among the different forms of victimization; however, cyber-victimization [OR = 24.5; 95% CI 5-119.5)], perceived problematic attire [OR = 8.4; 95% CI 2.2-31.9)], female gender [OR = 5.2; 95% CI 1.2-22.7)], and being overweight [OR = 0.14; 95% CI 0.01-2.6)] all predicted overall victimization. CONCLUSIONS Our findings provide a foundation for future research focusing on Arab American adolescents, an underrepresented population, more research is needed to understand the scope of bullying victimization among Arab American adolescents. PRACTICE IMPLICATIONS This study will inform future intervention research and practice to consider victimization and related factors among Arab American adolescents. Culturally sensitive and multilevel interventions are imperative to decrease bullying victimization among Arab American adolescents and prevent negative effects on their health and families.
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Affiliation(s)
- Maha Albdour
- College of Nursing, Wayne State University, MI, USA.
| | - Maher El-Masri
- Daphne Cockwell School of Nursing, Ryerson University, Canada
| | - Jun Sung Hong
- School of Social Work, Wayne State University, MI, USA
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4
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Zghal A, El-Masri M, McMurphy S, Pfaff K. Exploring the Impact of Health Care Provider Cultural Competence on New Immigrant Health-Related Quality of Life: A Cross-Sectional Study of Canadian Newcomers. J Transcult Nurs 2020; 32:508-517. [PMID: 33095098 PMCID: PMC8404719 DOI: 10.1177/1043659620967441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: New immigrants underutilize health care because of multiple barriers. Although culturally competent health care improves access, it is typically assessed by providers, not newcomers whose perceptions matter most. Methodology: Surveys that included measures of cultural competence and health-related quality of life (QOL) were completed by 117 new immigrants in Windsor, Ontario, Canada. A series of stepwise linear regression analyses were conducted to identify independent predictors of QOL and its four domains: physical health, psychological, social relationships, and environment. Results: Our adjusted results suggest that experiences of discrimination was negatively associated with overall QOL (β = −.313; p < .001) and its psychological (β = −.318; p < .001), social (β = −.177; p = .048), and environmental (β = −.408; p < .001) domains. Discussion: Discrimination negatively influences new immigrant QOL. Provider cultural competency training should emphasize the influence of provider discrimination on immigrant health and explore learners’ values and biases.
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Affiliation(s)
- Afef Zghal
- University of Windsor, Windsor, Ontario, Canada
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El-Masri M, Bornais J, Omar A, Crawley J. Predictors of Nonurgent Emergency Visits at a Midsize Community-Based Hospital System: Secondary Analysis of Administrative Health Care Data. J Emerg Nurs 2020; 46:478-487. [DOI: 10.1016/j.jen.2020.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/31/2020] [Accepted: 02/01/2020] [Indexed: 12/01/2022]
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6
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Abstract
Clinical judgment, one's ability to think like a nurse, is an essential skill for safe nursing practice. With the rise of simulation to replace clinical experiences, there is limited evidence regarding the effectiveness of simulation on the development of clinical judgment. This study explored differences in clinical judgment in maternal-newborn courses between undergraduate nursing students participating exclusively in simulation and those participating in hospital-based clinical experiences. Following completion of the clinical rotation, students participated in an evaluative maternal-newborn high-fidelity simulation experience that was recorded and evaluated using the Lasater's Clinical Judgment Rubric (2007). Lasater's Clinical Judgment Rubric scores between the simulation and clinical practice groups were compared using an independent sample t-test. There was no statistical difference in clinical judgment scores between the simulation and hospital-based clinical groups (t = -1.056, P = .295). Our findings suggest that simulation may be a comparable alternative to clinical experience in nursing education.
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Affiliation(s)
- Carol A Reid
- Department of Nursing, University of North Dakota, Grand Forks, ND, USA
| | - Jody L Ralph
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada
| | - Maher El-Masri
- College of Nursing, Wayne State University, Detroit, MI, USA
| | - Katrice Ziefle
- Department of Nursing, St. Catherine University, St. Paul, MN, USA
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Petruniak L, El-Masri M, Fox-Wasylyshyn S. Exploring the Predictors of Emergency Department Triage Acuity Assignment in Patients With Sepsis. Can J Nurs Res 2018; 50:81-88. [DOI: 10.1177/0844562118766178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and purposeEvidence suggests that septic patients, who require prompt medical attention, may be undertriaged, resulting in delayed treatment. The purpose of this study was to examine patient and contextual variables that contribute to high- versus low-acuity triage classification of patients with sepsis.MethodsData were abstracted from the medical records of 154 adult patients with sepsis admitted to hospital through a Canadian Emergency Department. Logistic regression was used to explore the predictors of triage classification.ResultsLanguage barriers or chronic cognitive impairment (odds ratio 5.7; 95% confidence interval 2.15, 15.01), acute confusion (odds ratio 3.4; confidence interval 1.3, 8.2), unwell appearance (odds ratio 3.4; 95% confidence interval 1.7, 7.0), and hypotension (odds ratio 0.98; confidence interval 0.96, 1.0) were predictive of higher acuity classification. Temperature, heart rate, respiratory rate, and contextual factors were not related to triage classification.ConclusionsSeveral patient-related factors were related to triage classification. However, the finding that temperature and heart and respiratory rates were not related to triage classification was troubling. Our findings point to a need for enhanced education for triage nurses regarding the physiological indices of sepsis. The sensitivity of the Canadian Triage Assessment Scale, used in Canadian Emergency Rooms, also needs to be examined.
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Affiliation(s)
- Leon Petruniak
- London Health Sciences Centre, Victoria Adult Emergency Department, London, Ontario, Canada
| | - Maher El-Masri
- Toldo Heath Education, University of Windsor, Windsor, Ontario, Canada
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8
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Abstract
This study was conducted to determine changes in overall costs associated with conversion to powder-free gloves including cost of workers' compensation cases for natural rubber latex (NRL)-related symptoms and health care workers' glove satisfaction. The study, a 2–year, longitudinal design with retrospective and prospective aspects, was developed to determine health care worker use of powder-free, low-protein NRL gloves, sensitization, cost, and glove satisfaction. Informed consent was obtained from 103 health care workers. Prior to glove conversion, nearly one-half (44%, 36 of 82) of the operating room staff reported symptoms related to NRL exposure. At the end of the 14–month data collection period, only 27% (22 of 82, McNemar test = .007) reported symptoms related to NRL exposure. Additionally, a cost savings of $10,000 per year for gloves was evident with reports of increased user satisfaction. This study demonstrated that conversion to the use of powder-free, low-protein NRL gloves not only reduces health care worker NRL symptoms, but also positively affects the costs of glove purchases and workers' compensation.
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Affiliation(s)
| | | | - Maher El-Masri
- University of Windsor, School of Nursing, Windsor, Canada
| | - Kim Mudd
- University of Maryland, School of Medicine, Division of Pediatric Pulmonology & Allergy, Baltimore, MD
| | - Mary Elizabeth Bollinger
- University of Maryland, School of Medicine, Division of Pediatric Pulmonology & Allergy, Baltimore, MD
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9
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Blaszak M, El-Masri M, Hirmiz K, Mathews J, Omar A, Elfiki T, Gupta R, Hamm C, Kanjeekal S, Kay A, Kulkarni S, Ghafoor A. Survival of patients with pancreatic cancer treated with varied modalities: A single-centre study. Mol Clin Oncol 2017; 6:583-588. [PMID: 28413673 DOI: 10.3892/mco.2017.1179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/12/2016] [Indexed: 12/30/2022] Open
Abstract
The present retrospective chart review examined the overall survival (OS) of patients with pancreatic ductal adenocarcinoma based on the disease stage in a sample of 296 patients with pancreatic cancer. Secondary outcome measurements included OS in chemotherapy vs. supportive treatment groups among metastatic patients, OS based on response to chemotherapy among metastatic patients, and OS and disease free survival (DFS) in surgically resected disease with vs. without adjuvant therapy. Data were analyzed using Kaplan-Meier and multivariate cox-regression analyses based on a 95% confidence interval (CI) or an α-value of 0.05. OS was significantly different based on the disease stage, with 3.63 (95% CI, 2.84-4.43), 6.57 (95% CI, 4.06-9.08) and 15.57 (95% CI, 11.79-19.35) months in the advanced, locally advanced, and localized disease groups, respectively. OS was higher in metastatic-stage patients who received chemotherapy [6.07 months (95% CI, 4.75-7.39)] compared with those who received supportive therapy alone [2.50 months (95% CI, 2.16-2.84; P<.001)]. Metastatic-stage patients with partial or stable response to chemotherapy had higher OS [10.53 months (95% CI, 6.35-14.72)] in comparison with those with progression [6.33 months (95% CI, 5.79-6.88)] or an undocumented response [3.30 months (95% CI, 1.76-4.84; P<0.001)]. In patients who underwent surgical resection of localized disease, adjuvant therapy increased the adjusted OS and DFS as compared with surgical excision alone (P=0.013; 95% CI, 0.278-0.862). Positive margins reduced OS [hazard ratio (HR) 2.670; 95% CI, 1.467-4.860]. The present single-site study has demonstrated that OS may markedly differ on the basis of the disease status at the time of diagnosis. Metastatic-stage patients with stable or partial response to chemotherapy had an increased OS, as did surgical patients with localized disease who received adjuvant treatment, after adjusting for margin status.
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Affiliation(s)
- Michael Blaszak
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
| | - Maher El-Masri
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Faculty of Nursing, University of Windsor, Windsor, Ontario, ON N9B 3P4, Canada
| | - Khalid Hirmiz
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
| | - John Mathews
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
| | - Abeer Omar
- Faculty of Nursing, University of Windsor, Windsor, Ontario, ON N9B 3P4, Canada
| | - Tarek Elfiki
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
| | - Rasna Gupta
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
| | - Caroline Hamm
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
| | - Sindu Kanjeekal
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
| | - Amin Kay
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
| | - Swati Kulkarni
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
| | - Akmal Ghafoor
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.,Windsor Regional Hospital Cancer Program, WRH Metropolitan Campus, Windsor, ON N8W 1L9, Canada
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10
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Thiele DK, Ralph J, El-Masri M, Anderson CM. Vitamin D3 Supplementation During Pregnancy and Lactation Improves Vitamin D Status of the Mother–Infant Dyad. J Obstet Gynecol Neonatal Nurs 2017; 46:135-147. [DOI: 10.1016/j.jogn.2016.02.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2016] [Indexed: 11/26/2022] Open
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Abstract
Abstract Limited research has investigated the hand hygiene practices of undergraduate nursing students. A descriptive self-report survey explored the predictors of self-perceived hand hygiene compliance using a convenience sample of 306 undergraduate nursing students enrolled at a southwestern Ontario university. Compliance was defined as the performance of hand hygiene at least 90% of the time in the moments both before and after direct patient contact. The self-reported compliance rate among study participants was 74.8%. Logistic regression analysis revealed that the independent predictors of hand hygiene compliance included concern about reprimand or discipline (odds ratio (OR) 4.324; 95% confidence interval (CI) 1.465–12.758); motivation to protect patients from infection (OR 2.418; 95% CI 1.001–5.838); number of clinical placements (OR 0.815; 95% CI 0.702–0.947) and role modelling by the clinical instructor (OR 2.227; 95% CI 1.009–4.915). Other independent predictors were the perceived barriers of busyness (OR 0.231; 95% CI 0.126–0.423), forgetfulness (OR 0.356; 95% CI 0.186–0.678) and perceptions of alcohol rub-related skin damage (OR 0.163; 95% CI 0.070–0.380). The findings of this study provide research-based evidence that could be used by educators to understand better hand hygiene practices among undergraduate nursing students.
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Affiliation(s)
- Anne Foote
- Professor, School of Nursing, St Clair College, Canada
| | - Maher El-Masri
- Professor, Faculty of Nursing, University of Windsor, Canada
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12
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Hamm CM, El-Masri M, Gupta R, Kulkarni S, Ghafoor A, Vivek P, Mathews J, Alam Y, Elfiki TA, Kanjeekal SM, Schneider K, Pan M, Hirmiz K, Springer C, Yousuf J. Outcomes of patients with triple-negative breast cancer compared to non-triple negative breast cancer: A single-center study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Rasna Gupta
- Barbara Ann Karmanos Cancer Institute, Windsor, ON, Canada
| | | | - Akmal Ghafoor
- Windsor Regional Cancer Program, Windsor, ON, Canada
| | - Pamathy Vivek
- Windsor Regional Cancer Program, Windsor, ON, Canada
| | - John Mathews
- Windsor Regional Caner Centre, Windsor, ON, Canada
| | - Yasmin Alam
- Windsor Regional Cancer Program, Windsor, ON, Canada
| | | | | | - Ken Schneider
- Windsor Regional Cancer Program, Windsor, ON, Canada
| | - Ming Pan
- Windsor Regional Cancer Program, Windsor, ON, Canada
| | - Khalid Hirmiz
- Windsor Regional Cancer Program, Windsor, ON, Canada
| | | | - Junaid Yousuf
- Cancer Centre of Southeastern Ontario at Kingston, Windsor, ON, Canada
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13
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Korniewicz D, El-Masri M. Exploring the Benefits of Double Gloving During Surgery. AORN J 2012; 95:328-36. [DOI: 10.1016/j.aorn.2011.04.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 03/19/2011] [Accepted: 04/15/2011] [Indexed: 11/16/2022]
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14
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Hamm C, El-Masri M, Poliquin G, Poliquin V, Mathews J, Kanjeekal S, Alam Y, Kulkarni S, Elfiki T. A single-centre chart review exploring the adjusted association between breast cancer phenotype and prognosis. ACTA ACUST UNITED AC 2011; 18:191-6. [PMID: 21874118 DOI: 10.3747/co.v18i4.815] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE AND METHODS Using a retrospective chart review, we investigated the differences in survival and prognostic factors between patients with triple-negative breast cancer (tnbc) and those with non-tnbc. The review included 1018 breast cancer patients who were diagnosed between 2000 and 2005 in Essex, Kent, and Lambton counties in Ontario, Canada. RESULTS Our findings indicate that, although the unadjusted results suggested that patients with tnbc were more likely than patients with non-tnbc to die [hazard ratio (hr): 2.29; 95% confidence interval (ci): 1.33 to 2.93], an adjusted survival analysis revealed no significant difference in overall survival between the groups (hr: 1.22; 95% ci: 0.63 to 2.39). The significant predictors of survival in the adjusted analysis were age, stage of cancer, and size of cancer. CONCLUSIONS Our findings support those of earlier reports, which suggest that presenting tumour size is the most important prognostic factor in tnbc. Investigations into unique screening methods to identify these tumours at an earlier stage and to prevent advanced-stage cancer in this patient subpopulation are necessary.
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Affiliation(s)
- C Hamm
- University of Western Ontario, London, ON
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15
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Abstract
A theory-testing approach to the study of delay in seeking treatment for acute myocardial infarction (AMI) was performed using a descriptive design with 135 AMI patients. Participants provided information pertaining to history of AMI, symptom congruence, responses to symptoms, cardiac symptom attribution, and AMI care-seeking delay. Structural equation modeling fit indices suggested that the independent predictors of AMI care-seeking delay were cardiac symptom attribution and emotion-focused coping. History of AMI had a direct relationship with AMI care-seeking delay, but its total effect through symptom attribution and symptom congruence was not significant. The total effect of symptom congruence on AMI care-seeking delay was significant. In conclusion, the study findings highlight the importance of targeting cardiac symptom attribution and emotion-focused coping in interventions that are aimed at reducing AMI care-seeking delay.
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16
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Korniewicz DM, Chookaew N, El-Masri M, Mudd K, Bollinger ME. Conversion to low-protein, powder-free surgical gloves: is it worth the cost? AAOHN J 2005; 53:388-93. [PMID: 16193910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study was conducted to determine changes in overall costs associated with conversion to powder-free gloves including cost of workers' compensation cases for natural rubber latex (NRL)-related symptoms and health care workers' glove satisfaction. The study, a 2-year, longitudinal design with retrospective and prospective aspects, was developed to determine health care worker use of powder-free, low-protein NRL gloves, sensitization, cost, and glove satisfaction. Informed consent was obtained from 103 health care workers. Prior to glove conversion, nearly one-half (44%, 36 of 82) of the operating room staff reported symptoms related to NRL exposure. At the end of the 14-month data collection period, only 27% (22 of 82, McNemar test = .007) reported symptoms related to NRL exposure. Additionally, a cost savings of 10,000 dollars per year for gloves was evident with reports of increased user satisfaction. This study demonstrated that conversion to the use of powder-free, low-protein NRL gloves not only reduces health care worker NRL symptoms, but also positively affects the costs of glove purchases and workers' compensation.
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17
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O'Connell KP, El-Masri M, Broyles JB, Korniewicz DM. Testing for viral penetration of non-latex surgical and examination gloves: a comparison of three methods. Clin Microbiol Infect 2004; 10:322-6. [PMID: 15059121 DOI: 10.1111/j.1198-743x.2004.00848.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Currently, there are no international standards based on microbiological methodology for testing the ability of medical examination or surgical gloves to prevent the passage of viruses. Three protocols for the direct examination of the viral barrier properties of non-latex gloves were compared with 1080 gloves (270 gloves from each of two surgical brands and two medical examination brands). In two of the methods, gloves were filled with and suspended in a nutrient broth solution, and bacteriophage phiX174 was placed either inside or outside the glove, while the entire test vessel was agitated. Gloves tested using the third method were filled with a suspension of bacteriophage and allowed to rest in a vessel containing nutrient broth. Gloves were tested directly from the manufacturer's packaging, or after being punctured intentionally or subjected to a stress protocol. The passage of bacteriophage was detected with plaque assays. Significant differences in failure rates between glove brands were apparent only among gloves that had been subjected to the stress protocol. Overall, the two methods in which bacteriophage were placed inside the gloves provided more sensitivity than the method in which bacteriophage was spiked into broth outside the gloves. Thus the placement of bacteriophage inside test gloves (or the use of pressure across the glove barrier during testing), and the use of a standardised stress protocol, will improve significantly the ability of a glove test protocol to determine the relative quality of the barrier offered by medical examination and surgical gloves. Further research is needed to provide test methods that can incorporate reproducibly both the use of bacteriophage and simulated glove use in an industrial quality control setting.
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Affiliation(s)
- K P O'Connell
- University of Maryland School of Nursing, Department of Adult Health Nursing, 655 West Lombard St., Baltimore, MD 21201, USA
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18
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Korniewicz DM, El-Masri M, Broyles JM, Martin CD, O'connell KP. Performance of latex and nonlatex medical examination gloves during simulated use. Am J Infect Control 2002; 30:133-8. [PMID: 11944004 DOI: 10.1067/mic.2002.119512] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND In response to the rise in latex allergies, gloves made from a variety of nonlatex materials have been introduced into the health care environment. To date, at least 1 study, by Rego and Roley (1999), has reported that both latex and nitrile medical examination gloves provide comparable barrier protective qualities. The purpose of our study was to determine the effects of glove stress, type of material (vinyl, nitrile, copolymer, latex), and manufacturer on the barrier effectiveness of medical examination gloves. METHOD A total of 5510 medical examination gloves (1464 nitrile, 1052 latex, 1006 copolymer, and 1988 vinyl) were divided into 2 groups: stressed and unstressed. Unstressed gloves were visually inspected and water-tested according to the Food and Drug Administration water-testing standards. Stressed gloves were manipulated according to a designated stress protocol, visually inspected, and then subjected to the same Food and Drug Administration water-testing standards. RESULTS Our limited sample size demonstrated that nitrile gloves had the lowest failure rate (1.3%), followed by latex (2.2%); vinyl and copolymer gloves had the highest failure rate (both 8.2%). With use of a logistic regression analysis adjusting for manufacturer and stress, latex examination gloves were found to be 3 times more likely to fail than nitrile gloves (odds ratio, 3.2; 95% CI, 1.37-7.50). Nitrile gloves were also found to fail significantly less often than vinyl or copolymer gloves (odds ratio, 12.60; 95% CI, 5.80-27.40). CONCLUSIONS Nitrile examination gloves are a suitable alternative to latex, whereas vinyl and copolymer examination gloves were found to be less effective barriers. Further research is indicated to determine whether nitrile gloves can provide effective barrier qualities during clinical use versus laboratory simulations.
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Affiliation(s)
- Denise M Korniewicz
- Schools of Nursing and Medicine, University of Maryland, Baltimore, MD 21201-1579, USA
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Abstract
Two families with Dyggve-Melchior-Clausen syndrome are reported. In the first family, Jews from Morocco, six of 10 siblings are affected. In the second family, a consanguineous marriage of Arabs from Gaza, two of three children are affected. A description of the skeletal changes in patients ranging in age from 4 to 25 years is presented. The radiologic signs of generalized platyspondyly with double humped end plates and the lace-like appearance of thickened iliac crests are pathognomonic and distinctive of the syndrome. The diagnostic features of the disease are compared to those of Morguio's disease, spondyloepiphyseal dysplasia tarda, and spondylometaphyseal dysplasia.
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Livni E, Lash A, El-Masri M, Englander T, Danon Y. Proceedings: Cell-mediated immunity in poliomyelitis. Isr J Med Sci 1976; 12:79. [PMID: 1254441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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