Dalia Jamal - Academia.edu (original) (raw)

Papers by Dalia Jamal

Indian Journal of Science and Technology, 2015

Ultrasound Scan is the most popular and cheapest imaging technique which is used as a preliminary... more Ultrasound Scan is the most popular and cheapest imaging technique which is used as a preliminary investigating tool by the doctors nowadays. In this regard, development of a computer aided assistive tool is utmost necessary to create a user friendly interface for the patients to expose them to basic treatment procedures available in case of abnormalities found in the Ultrasound Scan. An easy and better understanding of the impressions given in the scan is vital for further treatment procedures. As a first step towards creating a complete computer aided treatment assistive tool, the abnormalities detection in kidney ultrasound images is taken up as a primary goal in this paper. The most common renal problems that can be identified in the ultrasound images are renal stones or calculi, cyst and infections. A Graphical User Interface (GUI) is developed to display the count and size of calculi present in kidney. The GUI also specifies the presence of cyst. Ultrasound renal images are preprocessed and the speckle noises are removed using median filter. MATLAB software is used to perform the image processing. Segmentation is performed using Thresholding and Seeded Region growing algorithms. The algorithms are compared based on the statistical features which are extracted from the segmented images and the Seeded Region Growing algorithm is found to be the best since the Mean Square Error (MSE) and Standard Deviation (SD) are comparatively less. The appropriate treatment procedure obtained from an expert urologist is suggested in the GUI depending upon the size of the calculi.

Resumo: Duas sondagens de prospecção de carvão (DW 123 – P.T. 489 m e DW132 – P.T. 516 m) executa... more Resumo: Duas sondagens de prospecção de carvão (DW 123 – P.T. 489 m e DW132 – P.T. 516 m) executadas na Bacia Carbonífera de Moatize – Minjova (Província de Tete, Moçambique) foram estudadas usando as técnicas do poder reflector da vitrinite e dos traços de fissão da apatite, para avaliar a sua história térmica relacionada com a fase de subsidência e posterior levantamento tectónico. O PR mostra um aumento linear com a profundidade nas duas sondagens e indica um grau de incarbonização de Carvões Betuminosos na transição entre A e B. Modelação dos dados do PR indicam gradientes paleogeotérmicos entre os 40 e os 56ºC/km. Modelação inversa dos TF e do PR indica que as amostras foram aquecidas até temperaturas máximas entre os 150 e os 180ºC durante a fase de subsidência. Estas temperaturas foram atingidas até os 260 Ma., depois uma primeira fase de arrefecimento ocorreu entre os 255 e os 230 Ma. Depois desta fase seguiu-se um arrefecimento muito lento das secções representadas nas sond...

Evidence & Policy: A Journal of Research, Debate and Practice, 2014

ABSTRACT The objective of this paper is to conduct comparative analysis about the views and pract... more ABSTRACT The objective of this paper is to conduct comparative analysis about the views and practices of policy makers and researchers on the use of health systems evidence in policy making in selected Eastern Mediterranean countries. We analysed data from two self-reported surveys, one targeted at policy makers and the other at researchers. Results show a wide gap between policy makers and researchers when comparing perceptions on factors influencing the policy-making process and use of evidence in health policy making. Findings highlight specific areas for undertaking knowledge translation activities and implementing interventions to narrow the gap between policy makers and researchers.

Réanimation, 2004

Over the past few years, the widespread use of lung protective ventilatory strategies contributed... more Over the past few years, the widespread use of lung protective ventilatory strategies contributed to reduce mortality in patients with acute respiratory distress syndrome (ARDS). High-frequency oscillatory ventilation (HFOV) relies on the delivery of breaths at high frequencies and tidal volumes (VT) that are below the anatomic dead space. Since HFOV allows the use of high distending pressures and maintenance

International Journal of Nursing Studies, 2013

Background: The nursing workforce shortages in difficult-to-staff areas have implications not onl... more Background: The nursing workforce shortages in difficult-to-staff areas have implications not only for quality of care but also for population health outcomes. An understanding of attrition and of retention is important to inform policies on the nursing workforce. Objectives: This paper draws on questionnaire survey data from nurses working in difficult-tostaff areas in four countries in the Eastern Mediterranean Region (Yemen, Jordan, Lebanon and Qatar). It aims to identify the specific and common factors associated with nurses' intention to stay in their current post for the coming 1-3 years in three countries with an internally trained nursing workforce and in a fourth where the workforce is externally recruited. Methods: Nurses working in 'difficult to staff' areas in Yemen, Jordan, Lebanon and Qatar were surveyed. A conceptual model composed of 6 dimensions based on that of the World Health Organization was constructed with 'intent to stay' (Career Decisions) as the main outcome. Regression models were constructed for each of the dimensions in the conceptual model with 'intent to stay' as the dependent variable for each of the study countries. Subsequently, a collective model that combined Lebanon, Jordan and Yemen was constructed to identify common factors that are associated with intent to stay. Results: Factors associated with intent to stay differed for study countries. Marriage was positively associated with intent to stay in Lebanon and Jordan whereas years of experience were positively significant for Lebanon and Yemen. Shorter commuting time was significantly associated with intent to stay in Jordan whereas a preference for village life was significant for Lebanon. Job satisfaction was significantly associated with intent to stay in all study countries. Nurses in Lebanon, Jordan and Qatar who indicated that they would choose nursing if they had the opportunity to choose a career all over again were significantly more likely to intend to stay in their current post. Conclusions: Studies of nurses working in these areas can help national policymakers and local nursing directors better manage the sparse nursing workforce in these localities and to provide them with appropriate incentives and support to encourage them to stay.

The Analyst, 2013

The stratum corneum is the outermost layer of the skin; its barrier function is highly dependent ... more The stratum corneum is the outermost layer of the skin; its barrier function is highly dependent on the composition and the structure as well as the organization of lipids in its extracellular matrix. Ceramides, free fatty acids and cholesterol represent the major lipid classes present in this matrix. They play an important role in maintaining the normal hydration levels required for the normal physiological function. Despite the advancement in the understanding of the structure, composition and the function of the stratum corneum (SC), the concern of &amp;amp;amp;quot;dry skin&amp;amp;amp;quot; remains important in dermatology and care research. Most studies focus on the quantification of water in the skin using different techniques including Raman spectroscopy, while the studies that investigate the effect of hydration on the quality of the barrier function of the skin are limited. Raman spectroscopy provides structural, conformational and organizational information that could help elucidate the effect of hydration on the barrier function of the skin. In order to assess the effect of relative humidity on the lipid barrier function; we used Raman spectroscopy to follow-up the evolution of the conformation and the organization of three synthetic ceramides (CER) differing from each other by the nature of their polar heads (sphingosine, phytosphingosine and α hydroxyl sphingosine), CER 2, III and 5 respectively. CER III and 5 showed a more compact and ordered organization with stronger polar interactions at intermediate relative humidity values, while CER 2 showed opposite tendencies to those observed with CER III and 5.

International Journal for Quality in Health Care, 2010

Objective. The objective of this study is to conduct a baseline assessment of patient safety cult... more Objective. The objective of this study is to conduct a baseline assessment of patient safety culture in Lebanese hospitals. Design. The study adopted a cross-sectional research design and utilized the hospital survey on patient safety culture (HSOPSC). Setting. Sixty-eight Lebanese hospitals participated in the study (54% of all hospitals). Participants. A total of 6807 hospital employees participated in the study including hospital-employed physicians, nurses, clinical and non-clinical staff, and others. Main Outcome Measures. The HSOPSC measures 12 composites of patient safety culture. Two of the composites (frequency of events reported and overall perception of safety), in addition to questions on patient safety grade and number of events reported, are the four outcome variables. Results. Survey respondents were primarily employed in medical and surgical units. The dimensions with the highest positive ratings were teamwork within units, hospital management support for patient safety, and organizational learning and continuous improvement, while those with lowest ratings included staffing and non-punitive response to error. Approximately 60% of respondents reported not completing any event reports in the past 12 months and over 70% gave their hospitals an 'excellent/very good' patient safety grade. Bivariate and multivariate analysis revealed significant differences across hospitals of different size and accreditation status. Conclusions. Study findings provide evidence that can be used by policy makers, managers and leaders who are able to create the culture and commitment needed to identify and solve underlying systemic causes related to patient safety.

International Journal for Quality in Health Care, 2007

Background. In developing countries, accreditation is increasingly being used as a tool for gover... more Background. In developing countries, accreditation is increasingly being used as a tool for government regulation to guarantee quality of care. Although Lebanon is the first country in the East Mediterranean Region to develop and implement accreditation standards, little is known yet on its impact on quality of care. Objective. To assess the perceived impact of accreditation on quality of care through the lens of health care professionals, specifically nurses. This paper also investigates the perceived contributing factors that can explain change in quality of care. Methods. A cross-sectional survey design where all hospitals that successfully passed both national accreditation surveys (I and II) were included. A total of 1048 registered nurses from 59 hospitals were sampled. The survey tool, assessing quality of care and contributing factors, includes nine scales and subscales rated on five-point Likert scale. Results. The high score for the variable 'Quality Results' indicates that nurses perceived an improvement in quality during and after the accreditation process. Predictors of better Quality Results were Leadership, Commitment and Support, Use of Data, Quality Management, Staff Involvement and hospital size. The variable Quality Management, as measured by the scale Quality Management, had the greatest impact in medium-sized hospitals while the subscale measuring Staff Involvement had the greatest impact in small-sized hospitals. Conclusion. According to Lebanese nurses, hospital accreditation is a good tool for improving quality of care. In order to ensure that accreditation brings effective quality improvement practices, there is a need to assess quality based on patient outcome indicators.

Human Resources for Health, 2013

Background Nursing shortages and maldistribution are priority issues for healthcare systems aroun... more Background Nursing shortages and maldistribution are priority issues for healthcare systems around the globe. Such imbalances are often aggravated in underserved areas, especially in developing countries. Despite the centrality of this issue, there is a dearth of studies that examine the retention of nurses in underserved areas in the Middle East Region. This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon. Methods This study uses a non-experimental cross-sectional design to survey nurses working in underserved areas of Lebanon. Underserved areas in Lebanon were identified using WHO definition. A total of 103 health facilities (hospitals and primary healthcare centers) located in these areas were identified and all nurses working at these facilities received a copy of the survey questionnaire. The questionnaire included five sections: demographic, work-life, career plan, job satisfaction, and assessment ...

Precambrian Research, 2008

Marbles are minor but characteristic components of metasedimentary units within nappes in the Pan... more Marbles are minor but characteristic components of metasedimentary units within nappes in the Pan-African Mozambique Belt in NE Mozambique. Metasedimentary units remain largely undated, and carbon and strontium isotope stratigraphy of marbles has been used for indirect dating of the depositional history in this part of the Mozambique Belt. Sixty-nine samples from nine occurrences of dolomite, calcite and magnesite marbles

Implementation …, 2012

Background Limited research exists on researchers' knowledge transfer and exchange (KTE) in ... more Background Limited research exists on researchers' knowledge transfer and exchange (KTE) in the eastern Mediterranean region (EMR). This multi-country study explores researchers' views and experiences regarding the role of health systems and policy ...

Canadian Journal of Diabetes, 2009

The microencapsulation of pancreatic islets is a promising treatment for type I diabetes. Althoug... more The microencapsulation of pancreatic islets is a promising treatment for type I diabetes. Although microcapsule biocompatibility has improved, islet cell survival is still problematic. During islet isolation, the extracellular matrix (ECM) around the islet is destroyed, which negatively affects islet function and survival. Also, smaller islets have been shown to have better function and survival. Since encapsulated islets are not re-vascularized, their oxygen supply is entirely dependent upon diffusion. The use of dispersed islet cell re-aggregates of smaller diameter now allows the investigation of microcapsules of further reduced size. aim: The aim of this study is to improve microencapsulated islet cell survival, using three approaches: restoring the ECM loss, reducing the microcapsule diameter from 300 μm to 100 μm and reducing the islet diameter, using islet cell re-aggregates. It is known that dissociated islet cells have the capacity re-assemble in clusters that have the same properties of a normal islet. The first steps were to 1) characterize ECM in islets, after isolation and encapsulation, 2) produce islet cell re-aggregates and 3) evaluate the feasibility of producing 100-150 μm diameter microcapsules. Methods: The presence of ECM molecules (collagen I and IV, fibronectin and laminin) was evaluated by immunohistochemistry in islets that were cultured for different time periods, comparing encapsulated to non-encapsulated islets. Secondly, islet-like clusters were formed after dissociation of islets with trypsin and rotational incubation during 5-6 days. Different conditions were tested to achieve an optimal size. Finally, alginate-poly-L-lysine microcapsules were produced using an electrostatic pulse generator and different fabrication parameters were tested in order to achieve specific capsule diameters. results: Collagen IV and laminin were found to be present in whole pancreases used as a control, but only a minimal amount was found in isolated islets for all of the tested conditions. The other proteins under study were present for all conditions(fibronectin, collagen I). Isletlike clusters were produced and encapsulated in small microcapsules. We were able to produce microcapsules with a diameter of 132,32 ± 6,29 μm by extruding alginate through a 30G needle and reducing the alginate flow rate from 3,5mL/min to 0,3mL/min. Discussion/conclusion: This data suggests that replacing collagen IV and/or laminin in the re-aggregates might be useful. We also showed the feasibility of producing APA microcapsules of approximately 130 μm and of encapsulating islet cell re-aggregates within these microcapsules. Further research will be conducted to determine whether the use of this system improves oxygen supply to islets and islet survival.

Health Policy, 2011

Objectives: This paper describes the development and implementation of the first national hospita... more Objectives: This paper describes the development and implementation of the first national hospital performance indicators in Lebanon including its institutionalization within existing policy framework and the initiation of independent governance structure for sustainability. Methods: Guided by the Ontario Acute Care Balanced Scorecard framework, a step-wise approach was used. Guiding principles were non-punitive reporting, anonymity, voluntary participation, stakeholder involvement, consensus and feasibility. Modified Delphi technique was used, readiness assessment surveys in 52 hospitals were conducted, pilot testing and evaluation were completed in 14 hospitals. Results: Initial balanced set of 21 indicators were selected. Findings showed wide variations in indicators' measurement in hospitals including formulas and tools. Barriers to measurement included lack of quality culture, physician resistance and resources. A gradual implementation strategy was developed and selected indicators were divided into two levels. Most piloted indicators proved to be valid, feasible and reliable. The initiative was linked to the national hospital accreditation system resulting in a balanced set of 40 indicators. An independent, not-for-profit, arm's-length organization was established. Conclusions: This is among the first attempts made in the East Mediterranean Region to adapt the BSC approach and translate the experience of its development to addresses local needs and contextual reality.

Background: Intensive care unit (ICU) admission of adults with cystic fibrosis (CF) is controvers... more Background: Intensive care unit (ICU) admission of adults with cystic fibrosis (CF) is controversial because of poor outcome. This appraisal needs re-evaluation following recent changes in both CF management and ICU daily practice. Objectives were to determine long-term outcome of adults with CF admitted in ICU and to identify prognostic factors. Methods: Retrospective multicenter study of 60 ICU hospitalizations for 42 adult CF patients admitted between 2000 and 2003. Reason for ICU admission, ventilatory support provided and one-year survival were recorded. Multiple logistic analysis was used to determine predictors of mortality. Results: Prior to ICU admission, all patients (mean age 28.1 ± 8 yr) had a severe lung disease (mean FEV 1 28 ± 12% predicted; mean PaCO 2 47 ± 9 mmHg). Main reason for ICU hospitalization was pulmonary infective exacerbation (40/60). At admission, noninvasive ventilation was used in 57% of cases and was successful in 67% of patients. Endotracheal intubation was implemented in 19 episodes. Overall ICU mortality rate was 14%. One year after ICU discharge, 10 of the 28 survivors have been lung transplanted. Among recognized markers of CF disease severity, only the annual FEV 1 loss was associated with a poor outcome (HR = 1.47 [1.18-1.85], p = 0.001). SAPSII (HR =

Precambrian …, 2006

Strongly contrasting rocks were juxtaposed during the long tectonometamorphic history of the Moza... more Strongly contrasting rocks were juxtaposed during the long tectonometamorphic history of the Mozambique Orogenic Belt in northern Mozambique. The latest depositional event was expressed by accumulation of marine sediments, which were subsequently mildly metamorphosed ...

What is already known about the topic? 1. The inadequate number of healthcare providers in both d... more What is already known about the topic? 1. The inadequate number of healthcare providers in both developing and developed countries, especially in underserved areas, is one of the biggest challenges to meeting public health goals. 2. Jordan like other regional and international countries faces a shortage of nurses (23.1 registered nurses per 10,000 population) especially in females. 3. Key challenges facing the health workforce in Jordan and other countries in the region include sectoral and geographical imbalances of health workers and excessive migration.

European Journal of Pediatrics, 2009

Background The judicious prescription of antibiotics has become a central focus of professional ... more Background The judicious prescription of antibiotics has become a central focus of professional and public health measures to combat the spread of resistant organisms. Materials and methods A one-year multi-center prospective follow-up study of 1,320 healthy infants was conducted. The study aim was to determine the prevalence and identify the predictors of antibiotics misuse in viral respiratory illnesses among healthy infants in

International Journal of …, 2011

What is already known about the topic? The global shortage of nurses extends to the Eastern Medit... more What is already known about the topic? The global shortage of nurses extends to the Eastern Mediterranean Region where Lebanon has one of the poorest nurse-population ratios in the region. The characteristics of nurses' work environment can act as push or pull factors influencing nurses' decision to remain employed. Recent evidence shows that one in five bachelor prepared Lebanese nurses emigrate within 2 years of graduation.

The key characteristic of cloud computing is provision of IT infrastructure and its applications ... more The key characteristic of cloud computing is provision of IT infrastructure and its applications as a scalable service. Since this environment is conceived service-oriented, service management and delivery of comprehensive architecture for this environment are important. To provide better services in cloud computing, any proposed architecture may be based on IT service management frameworks and reference models, to improve the management of services in cloud computing. Hence, IT service management reference models and frameworks are first compared in this paper and according to the comparisons; PRM-IT may be selected among other frameworks such as ITIL v3, HP, MOF as a more complete reference and used set forth in the operational section of the proposed architecture. Also, processes of the eTOM process framework are more complete than other frameworks while considering billing & revenue management as two critical modules in cloud based accounting Also. COBIT5 used in this architecture to enrich governance capability. On the other hand, a few of recent cloud architectures compared to find out current drawbacks and pitfalls and Finally, a comprehensive architecture is being proposed for cloud to provide a nearly more effective architecture resulted by composition of these frameworks in a wise layout. This architecture is in the context of SOA.