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Stella Major

Bio: Stella Major is an academic researcher from Cornell University. The author has contributed to research in topics: Health care & Empathy. The author has an hindex of 13, co-authored 36 publications receiving 557 citations. Previous affiliations of Stella Major include American University & Qatar Foundation.

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TL;DR: 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.

69 citations

Journal ArticleDOI
TL;DR: An alarming percentage of students of Lebanese medical schools intend to migrate for post graduate training, mainly to the US, and a minority intends to return directly to Lebanon after finishing training abroad.
Abstract: 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. 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. 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 2nd citizenship. 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. 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.

63 citations

Journal ArticleDOI
TL;DR: In Lebanon, self‐medication is highly prevalent and the influence of these factors on the development of drug‐related illnesses that lead to hospitalization is examined.
Abstract: Objective In Lebanon there is very limited restriction on drug use. Accordingly, self-medication is highly prevalent. This study examined the influence of these factors on the development of drug-related illnesses that lead to hospitalization. Methods Patients admitted to the medical and pediatric wards of a tertiary teaching center in Beirut, Lebanon, over a period of 6 months were interviewed and their charts were reviewed. Admissions attributable to adverse drug reactions or therapeutic failures were identified and characterized with respect to demographic factors, medical history, drug intake, and self-medicating behavior. The influence of these variables on the development of drug-related illnesses was examined by logistic regression. Results Of 1745 adults and 457 children, there were 177 (10.2%) and 36 (7.9%) drug-related illnesses, respectively. Adverse drug reactions accounted for 7.0% and 5.7% and therapeutic failures for 3.2% and 2.2% of adult and pediatric admissions, respectively. Self-medication was commonly practiced (52.6% of adults and 41.6% of children). Logistic regression analysis revealed that female sex increased the risk of adverse drug reaction in adults, whereas self-medication decreased the risk. In children, the risk of adverse drug reaction was increased in lower socioeconomic groups, whereas the risk of therapeutic failure was increased by a positive history of atopy or drug reaction. Conclusions These results provide the first detailed analysis of the problem of drug-related illnesses in a developing country and identify a number of related or risk factors. Despite the lack of regulation of drug dispensing and the unchecked access to drugs in Lebanon, the incidence of drug-related illnesses is not different from that in Western nations. This finding may have relevance to policies of drug regulation in other countries. Clinical Pharmacology & Therapeutics (1998) 64, 450–461; doi:

58 citations

Journal ArticleDOI
TL;DR: The steps taken to create a Web-OSCE built on women’s reproductive and sexual health which is part of the third year Obstetrics and Gynecology Clerkship curriculum, using Zoom teleconferencing are described.
Abstract: Web-Objective Structured Clinical Examination (OSCEs) were piloted for the Clinical Skills Assessment (CSA) exams in the USA two decades ago and were shown to be an acceptable way to conduct OSCEs remotely. The learners valued the process yet expressed numerous limitations.1 In response to the COVID-19 outbreak in Qatar, medical schools stopped in-person teaching creating a hiatus in clinical instruction. The Clinical Skills and Simulation Lab (CSSL) team devised and piloted a Web-OSCE to determine its feasibility in this setting, and to evaluate stakeholders’ experiences. We describe the steps taken to create a Web-OSCE built on women’s reproductive and sexual health which is part of the third year Obstetrics and Gynecology Clerkship curriculum, using Zoom teleconferencing. It mirrored the steps taken when conducting this activity in person; however, all communication relied on emails before the event, Zoom during the event with WhatsApp as a backup for connectivity between learners, Zoom hosts and faculty. ### Pre-Web-OSCE steps #### Preparing students CSSL provided by email a step-by-step instruction guide plus a pre-OSCE task for students to complete to ensure that they could access the OSCE on the day of the activity. A live Zoom session led by faculty reviewed the learning objectives, expectations and assessment and served as an open forum for students to ask questions in order to mitigate any anxiety surrounding the new modality. #### Preparing simulated patients Simulated patients (SP) were surveyed to assess their interest and technology capabilities to participate in Zoom activities. Interested SPs joined a Zoom meeting with staff members, who ensured they had adequate technical capability. SPs were selected and confirmed according to requirements of the case. Training notes and checklists were sent …

51 citations

Journal ArticleDOI
TL;DR: The magnitude and historical trends of migration of Lebanese medical graduates to the US are evaluated and high income countries should consider the consequences of their human resources policies on both low income countries' and their own healthcare systems.
Abstract: As healthcare systems around the world are facing increasing physician shortages, more physicians are migrating from low to high income countries. As an illustrative case of international migration of physicians, we evaluated the current number and historical trends of Lebanese medical graduates (LMG) in the US, and compared their characteristics to those of US medical graduates (USMG) and other international medical graduates (IMG).

45 citations


Cited by
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2,707 citations

Journal Article
TL;DR: Emily Martin has produced a powerful study of the dialectic between medical metaphors for women's reproductive processes and women's own views of those processes, exposing hidden cultural assumptions about the nature of reality.
Abstract: The Woman in the Body: A Cultural Analysis of Reproduction by Emily Martin Beacon Press, 1987 Paperback, 276 pp $1195 Winner of the 1988 Eileen Basker Memorial Prize As anthropology at its best can do, this book exposes hidden cultural assumptions about the nature of reality Martin has produced a powerful study of the dialectic between medical metaphors for women's reproductive processes and women's own views of those processes She and her associates interviewed 165 white and black women, seeking a balance between the three life stages of puberty, childbearing, and menopause 43% of her interviewees were working-class; 57% middleclass Early on Martin came up against one of the greatest dangers of studying one's own society Hearing women discuss uterine contractions as separate from the self and labor as something one "went through," and reading the same in medical texts, she at first thought that her interviews had turned up views of the body that simply reflected actual scientific fact It took her some time to realize that such scientific views are not "fact" but culturally grounded statements of an underlying ideology To get at this ideology Martin studied medical texts for the "grammar" that scientific medicine uses to describe female bodies In this medical grammar, she finds industrial society writ small The female reproductive tract is a machine designed to produce a baby; accordingly, menstruation represents failed production, connoting both a productive system that has failed to produce and one that produces only useless waste Such metaphors, disturbing to a society whose existence depends upon continued production, lead to menstruation's description in medical texts in highly negative terms: The fall in blood progesterone and estrogen, which results from regression of the corpus luteum, deprives the highly developed endometrial lining of its hormonal support Disintegration starts The endometrial arteries dilate, resulting in hemorrhage through the weakened capillary walls; the menstrual flow consists of this blood mixed with endometrial debris (quoted on p 48) (Martin contrasts this with a description of male reproductive physiology which speaks of the "remarkable" cellular transformation from spermatid to mature sperm, its "amazing" nature and "sheer magnitude") Confronting the argument that the above is not value-laden but simply a factual description of menstruation, Martin examines medical descriptions of the analogous regular shedding and replacement of the lining of the stomach, finding in a number of texts no references to degeneration, but instead a stress on the periodic "renewal" of the stomach lining Concluding that writers can choose to depict what happens to the lining of stomachs and uteruses either negatively as breakdown and decay or positively as continual production and replenishment, Martin suggests an alternative medical description of menstruation: A drop in the formerly high levels of progesterone and estrogen creates the appropriate environment for reducing the excess layers of endometrial tissue Constriction of capillary blood vessels causes a lower level of oxygen and nutrients and paves the way for a vigorous production of menstrual fluids Such a description would far more accurately reflect women's own more positive assessments of the menstrual fluid as the desired product Viewing pregnancy as the sole purpose of female reproductive organs and despising menstruation as a "waste" ignores the reality that most women do not intend to get pregnant most of the time (and so are often joyful when menstruation begins), and conceals "the true unity women have [Menstruation is] the one thing we all share" (p 112) In spite of ambivalence about the "disgusting mess," most interviewees felt that menstruation defines them as women and insisted that they wouldn't want to give it up Teens spoke of the joy of getting their periods so they could be part of the in-group that shared the women's "special secret," of mothers and sisters greeting their first menstruation with "You're a woman now! …

801 citations

Journal ArticleDOI
TL;DR: Many elderly people are hospitalised by ADR related problems; an important part of these hospitalisations can be avoided and preventability ofADR related hospitalisation might yield 7 times more people in the elderly than in the non-elderly.
Abstract: Aim: to establish the percentage hospital admission related to adverse drug reactions (ADRs) from the data available in the literature. Method: literature search in the Medline database, metaanalysis. Results: from the literature it is revealed that a considerable part of all hospital admissions are related to adverse drug reactions. However, these data are not homogenous, i.e. larger studies display a lower percentage of ADR related hospital admission, while smaller studies display a higher percentage. Subgroup analysis showed that for elderly people the odds of being hospitalised by ADR related problems is 4 times higher than for younger ones (16.6% vs. 4.1%). A considerable part of these hospitalisations can be prevented. Subgroup analysis revealed that in the elderly up to 88% of the ADR related hospitalisations are preventable; for the non-elderly this is only 24%. Comparatively more elderly people are hospitalised than younger ones. Combining these findings, twice as much elderly people are hospitalised by ADR related problems than non-elderly, while preventability of ADR related hospitalisation might yield 7 times more people in the elderly than in the non-elderly. The estimation of the costs of ADR related hospitalisations in the Health Care system in The Netherlands is discussed. Conclusion: many elderly people are hospitalised by ADR related problems; an important part of these hospitalisations can be avoided.

715 citations

Journal ArticleDOI
TL;DR: In this article, a best seller book, "death without weeping the violence of everyday life in brazil writer by" is described. But, it is not available in the format of pdf, ppt, kindle, pdf, word, txt, etc.
Abstract: Have free times? Read death without weeping the violence of everyday life in brazil writer by Why? A best seller book worldwide with wonderful worth and material is integrated with interesting words. Where? Simply here, in this website you could read online. Want download? Certainly offered, download them additionally right here. Readily available data are as word, ppt, txt, kindle, pdf, rar, and zip. Whatever our proffesion, death without weeping the violence of everyday life in brazil can be good source for reading. Discover the existing documents of word, txt, kindle, ppt, zip, pdf, as well as rar in this site. You could absolutely read online or download this book by below. Now, never miss it. death without weeping the violence of everyday life in brazil by is just one of the most effective seller publications on the planet? Have you had it? Not at all? Ridiculous of you. Currently, you could get this fantastic publication just right here. Discover them is format of ppt, kindle, pdf, word, txt, rar, and also zip. How? Simply download and install or even read online in this site. Currently, never ever late to read this death without weeping the violence of everyday life in brazil. GO TO THE TECHNICAL WRITING FOR AN EXPANDED TYPE OF THIS DEATH WITHOUT WEEPING THE VIOLENCE OF EVERYDAY LIFE IN BRAZIL, ALONG WITH A CORRECTLY FORMATTED VERSION OF THE INSTANCE MANUAL PAGE ABOVE.

699 citations

01 Jan 2013
TL;DR: This article studied the failure of the traditional, Western, and public educational system in Wisconsin to nurture, graduate, and utilize Native Americans from birth through adulthood, and found that the few Indians who did survive school accomplished this despite many barriers or whatever politically correct legislation was the popular rhetoric at the time.
Abstract: I am a researcher and graduate student of American Indian descent (Stockbridge-Munsee/Mohican). I have always been very aware of the absence of other American Indian students in postsecondary education programs; have noticed the shortage of American Indians employed as educators, professors, or administrators; and am acutely aware of the number of American Indian populations excluded from qualitative or quantitative data sets as part of mainstream research agendas that are published on the state or national level. This is the beginning of my dissertation research journey, and the data that I have studied thus far demonstrates a ten-year failure of the traditional, Western, and public educational system in Wisconsin to nurture, graduate, and utilize Native Americans from birth through adulthood. This historical failure in the Wisconsin educational systems and organizations has left the First Children and the First People of this country far behind as compared to their other minority and white counterparts (Bowman ). The extent of how far and why they are behind is what I am determined to discover. Anecdotally speaking, I knew in my heart that the few Indians who did survive school accomplished this despite many barriers or whatever politically correct legislation was the popular rhetoric at the time. But in my head I needed to ascertain, scientifically document, and understand the factors that were responsible for this shameful record regarding the education of Native American students and their underrepresentation as professionals within the educational community. In a time of attempts to abolish affirmative action and hearing the promises of leaving no children behind, I have diligently tried to set aside time to conduct research Cultural Differences of Teaching and Learning

515 citations