Clinical and Transitional Research

​Pain Management and Palliative Care Research (Interdisciplinary). Dr. Huda Abu-Saad Huijer

I have conducted a number of funded studies in Lebanon. The first national study, funded by MPP and URB ‘Palliative Care in Lebanon; Needs Assessment for Palliative Care Services for Adults and Children’ included 15 geographically spread hospitals in the country, 1873 nurses and 1884 physicians. A total of 5 articles were published in international and national refereed journals. This was followed by two CNRS funded studies on Quality of Palliative Care in Lebanon, the Perspectives of adults with Cancer’ and ‘Quality of Palliative Care in Lebanon, the Perspectives of Children with Cancer’. These studies resulted in numerous articles in national and international refereed journals and in psychometrically testing some of the tools used in these studies. Recently two main studies were completed on ‘chronic pain in adults’ funded by Pfizer and ‘palliative care in older adults’ funded by CNRS. The results of both studies have been published or are in the process of being published in international refereed journals.

Co-Authors are: Drs. Souha Fares, Ramzi Hajjar, Georges Karam, Hussam Ghusn and others.  

Nurses' and Pediatricians' Attitudes, Perceptions, and Practices of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Adolescent Substance Use: A Multisite Cross-Study in Primary Care and School Settings (Interdisciplinary​)​ - Nour Alayan PhD, MSN, RN​​​

This project investigates a simulation-based approach to teach SBIRT in undergraduate nursing programs. It has interdisciplinary and global/regional implications to improve nurses' and doctors' skills in addressing substance use issues in primary care and beyond and prevent substance use disorders at a larger scale. 

Res​​earc​​​h Team: Dr. Nour Alayan (PI), Mrs. Tamar Avedissian (HSON), Dr. Farid Talih (AUB Psychiatry Department), Dr. Randa Hamadeh (Ministry of Public Health, Primary Care Department)​


Abnormal Blood Pressure Complexity and Fluctuation: An Indicator of Vascular Disease Independent of Mean Blood Pressure (Interdisciplinary​) - Souha Fares, PhD

Our research project is focused on the use of non-conventional blood pressure variability (BPV) metrics, specifically complexity analysis and deternded fluctuation analysis, to examine the potential role of this novel cardiovascular risk factor in the adult Lebanese population. Time series data of blood pressure and heart rate will be collected continuously over a 30-60minute period. We aim to assess whether the reduction in BP which follows bariatric surgery is in fact associated with normalization of abnormal blood pressure variability and complexity in these populations. In addition, the study will examine the effect of demographic factors (age, gender, family history) on blood pressure complexity and fluctuation among obese normotensive, pre-hypertensive, and hypertensive patients. Impact: Clinical monitoring of BPV by nontraditional indices such as those described here may provide earlier indication of subtle changes in intravascular filling and pressure many years before the onset of hypertension and its resultant vascular injury and end-organ damage. Our study will be the first study looking at fairly novel measures of BPV among obese and morbidly obese subjects, specifically complexity measures and DFA. If our hypotheses are proven to be correct, our research will help in identifying new ways to discriminate between No-HTN and HTN patients through novel analyses of physiological measurements. If the new BP variability measures prove useful in determining the influence of demographic factors in discriminating between those two groups, they may prove to be useful metrics in measurement of the efficacy of drugs under development or other treatment protocols. (Co-I: Drs. Kamal Badr, Issam Lakkis, Ramzi Alami)​ 

Improving the outcome of resuscitation of out-of-hospital cardiac arrest victims; an interdisciplinary initiative- Samar Noureddine, PhD, RN, FAHA, FAAN

Given the low survival rate of out-of-hospital cardiac arrest victims in Lebanon, this research program provides the empirical evidence needed to develop a national policy or guidelines to improve the outcomes of resuscitation practice. Surveys of physicians in emergency departments, paramedical personnel, intensive care physicians and nurses were recently completed. The results showed hesitance among some health professionals and the public to do cardiopulmonary resuscitation (CPR) in the community partly because of fear of being sued, which delays CPR provision, negatively affecting survival. This finding culminated in a proposal for an amendment of Criminal Law 567 to include at its end an added section that mimics the Good Samaritan Law by exempting any person who attempts CPR to subjects of cardiac arrest outside the hospitals, from any penalty. This amendment was officially submitted to the Lebanese Parliament for approval on May 28th, 2019.

Patient and Caregiver Dyad Engagement in Heart Failure Self-Care- Angela Massouh, PhD, MScN, CNS

This project investigates patient and dyadic determinants of self-care in Heart Failure care dyads while controlling for dyadic interdependence. Secondary aims of this study are to: 
  1. Describe the relationships among dyad determinants and self-care in a sample of HF patient-caregiver dyads.
  2. Typify distinct patterns of HF patient-caregiver dyads in terms of degree of engagement in self-care. 
  3. Compare outcomes (30-day hospital readmissions, functional status, QOL, adherence to low salt diet, perceived control, and perceived caregiver strain) of HF patients in the different dyadic types.​
  4. Establish a neurocognitive profile of the HF patient.
  5. Establish whether an association exists between the severity of HF and cognitive abilities as well as cognitive abilities and self-care.
  6. Validate the Arabic Salt Knowledge, Attitudes, and Behavioral Assessment Questionnaire.
​Researcher Team: Dr. Angela Massouh (PI), Dr. Hala Darwish (HSON), Dr. Souha Fares (HSON), Dr. Huda Abu Saad Huijer (HSON), Dr. Hadi Skouri (FM), Dr. Lara Nasreddine (FAFS), and Dr. Paula Meek (university of Colorado, Denver).