Research Papers | Dr. Wael Haddara

A policy-oriented framework for understanding violent extremism

Mar 20, 2017

Authors: Wael Haddara

Journal: New England Journal of Public Policy

Volume: 29

Issue:1

Description:

Violent extremism represents a serious challenge to open and democratic societies. This article presents a framework for understanding violent extremism in the context of “lone-wolf” attacks in Western societies. The framework combines social, political, and psychological factors and highlights the importance of integrating the available evidence from multiple disciplines to develop cogent, effective policy. Specifically, in addition to a broad survey of motivational factors, the article draws on terror management theory to provide insight into the interaction between religiosity and violence.

Soft tissue oxygenation and risk of mortality (STORM): An early marker of critical illness?

Apr 11, 2015

Authors: Biniam Kidane, Sami A Chadi, Anthony Di Labio, Fran Priestap, Wael Haddara, Tina Mele, John M Murkin

Journal: Journal of Critical Care

Volume: 30

Issue: 2

Publisher: WB Saunders

Original Link:

sciencedirect.com/science/article/abs/pii/S0883944114004572

https://doi.org/10.1016/j.jcrc.2014.11.004 Get rights and content

Abstract

Purpose

Tissue oxygen saturation (StO₂) is a noninvasive measure that reflects changes in tissue perfusion. Rapid response teams (RRTs) assess sick inpatients to determine need for intensive care unit (ICU) admission. This determination is subjective based on parameters such as systolic blood pressure, heart rate, and pulse oximetry. Our objective was to determine if parameters readily available at RRT bedside assessment (vital signs and StO₂) can predict ICU admission and inhospital mortality.

Materials and methods

All inpatients assessed by RRT at a tertiary Canadian hospital were consecutively sampled for 3 months. After clinical assessment, the RRT physician (blinded to StO₂) made the ultimate ICU admission decision.

Results

In 134 included patients, mean age was 65.5 ± 15.2 years, and 53% (n = 71) were males. There were 49 ICU admissions (36.6%) and 31 mortalities (23.1%). Two multivariable models significantly predicted ICU admission and inhospital mortality. The only independent predictor of ICU admission was pulse oximetry (adjusted odds ratio, 0.88; 95% confidence interval, 0.80-0.96; P = .007). Tissue oxygen saturation did not predict ICU admission but was the only independent predictor of mortality (adjusted odds ratio, 1.06; 95% confidence interval, 1.01-1.12; P = .04).

Conclusions

Tissue oxygen saturation may identify critical illness in patients who would not traditionally meet ICU admission criteria and thus may identify patients who benefit from closer monitoring.

Are we all on the same page? A discourse analysis of interprofessional collaboration.

Oct 1, 2013

Authors: Wael Haddara, Lorelei Lingard

Journal Academic Medicine

Volume 88

Issue 10

Publisher LWW

Description:

Purpose Interprofessional collaboration (IPC) has become a dominant idea in both medical education and clinical care as reflected in its incorporation into competency-based educational frameworks and hospital accreditation models. This study examined the published literature to explore whether a shared IPC discourse underpins these current efforts.

Method Using a critical discourse analysis methodology informed by Michel Foucault’s approach, the authors analyzed an archive of 188 texts published from 1960 through 2011. The authors identified the texts through a search of PubMed and CINAHL.

Results The authors identified two major discourses in IPC: utilitarian and emancipatory. The utilitarian discourse is characterized by a positivist, experimental approach to the question of whether IPC is useful in patient care and, if so, what features best promote successful outcomes. This discourse uses the language …

Oral and intravenous thyroxine (T4) achieve comparable serum levels for hormonal resuscitation protocol in organ donors: a randomized double-blinded study

Oct 1, 2010

Authors: Michael D Sharpe, Barbara van Rassel, Wael Haddara

Journal: Canadian Journal of Anesthesia/Journal canadien d’anesthésie

Volume: 60

Issue: 10

Publisher: Springer US

Description:

Background

Thyroxine (T4) administration is advocated in the management of organ donors; however, the bioavailability of oral thyroxine is unknown in this patient population.

Objective

The primary objective of this study was to compare the percentage of the study time (from study drug administration to organ procurement) that patients in the oral vs the intravenous group required inotropic support. Secondary objectives included plasma levels of T3 and T4 and number of organs donated following oral vs intravenous T4 administration.

Design

Randomized double-blinded study.

Setting

Adult medical-surgical intensive care unit.

Patients

Thirty-two adult solid organ donors.

Interventions

Patients were randomized to …

Categorizing patients in a forced-choice triad task: the integration of context in patient management

Jun 11, 2009

Authors: Sarah L Devantier, John Paul Minda, Mark Goldszmidt, Wael Haddara

Journal: PloS one

Volume: 4

Issue: 6

Publisher: Public Library of Science

Description:

Background Studies of experts’ problem-solving abilities have shown that experts can attend to the deep structure of a problem whereas novices attend to the surface structure. Although this effect has been replicated in many domains, there has been little investigation into such effects in medicine in general or patient management in particular. Methodology/Principal Findings We designed a 10-item forced-choice triad task in which subjects chose which one of two hypothetical patients best matched a target patient. The target and its potential matches were related in terms of surface features (e.g., two patients of a similar age and gender) and deep features (e.g., two diabetic patients with similar management strategies: a patient with arthritis and a blind patient would both have difficulty with self-injected insulin). We hypothesized that experts would have greater knowledge of management categories and would be more likely to choose deep matches. We contacted 130 novices (medical students), 11 intermediates (medical residents), and 159 experts (practicing endocrinologists) and 15, 11, and 8 subjects (respectively) completed the task. A linear mixed effects model indicated that novices were less likely to make deep matches than experts (t(68) = −3.63, p = .0006), while intermediates did not differ from experts (t(68) = −0.24, p = .81). We also found that the number of years in practice correlated with performance on diagnostic (r = .39, p = .02), but not management triads (r = .17, p = .34). Conclusions We found that experts were more likely than novices to match patients based on deep features, and that this pattern held for both diagnostic and …

TB and Adrenal Insufficiency

Sep 28, 2004

Authors: Wael MR Haddara, Stan HM van Uum

Journal: Cmaj

Volume: 171

Issue: 7

Publisher: CMAJ

Description:

Ronik Kanani and Aleixo Muise1 de-scribe a case of intra-abdominal peritonitis associated with abdominal pain and hypotension secondary to intra-abdominal tuberculosis (TB). The clinical presentation in this case is suspicious for adrenal insufficiency. TB is one of the leading causes of adrenal insufficiency worldwide, but the presence of TB may be difficult to diagnose. In a large retrospective study of autopsy results in Hong Kong, Lam and Lo2 found active TB in 6.5% of cases; however, in more than 70% of these patients, TB was diagnosed only at autopsy. Adrenal insufficiency was found in 6% of the patients with active TB. It may also be difficult to identify TB as the cause of adrenal insufficiency, as illustrated by Serter and associates.