Breast cancer (BC) is a disease that has improved prospects for survival if detected and treated early. Delayed help-seeking behavior, with poor survival as a consequence, is an important public health issue in the Middle East. More than 75% of breast cancer patients in the United Arab Emirates (UAE) seek medical advice after experiencing a sign or symptom of the disease and many seek such advice late. Our aim was to explore factors influencing delayed presentation for treatment after self-discovery of symptoms consistent with breast cancer in Arab women in the United Arab Emirates (UAE), and to explore facilitators and barriers of women’s health seeking behavior in the complex religiously dominated society of the UAE. A qualitative descriptive approach using semi-structured interviews was used. We interviewed nineteen BC survivors aged 35–70 who have experienced delayed presentation to treatment after symptomatic recognition of BC. The time interval between initial experience of symptoms consistent with BC, and taking action to seek medical help was between three months to three years. The key themes that emerged from the interviews were varying responses to symptom recognition, fear of societal stigmatization, and concerns regarding abandonment by spouse because of BC. Culture has a strong influence on the decisions of women in the UAE society. The lack of awareness about signs and symptoms of BC and routine screening has an important effect on symptom appraisal and subsequently decision making regarding options for treatment.

ObjectiveTo explore and compare barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia.DesignA qualitative interview study with thematic analysis of transcripts.Participants67 patients with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58 years (range 24–82 years). The number of women diagnosed at early stages of cancer almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a painful lump and 10% had atypical symptoms.SettingUniversity hospital setting in Singapore and Malaysia.ResultsPatients revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more advanced cancer compared to Chinese and Indian patients.ConclusionsThere are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between Singapore and Malaysia despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals.

BackgroundADHD is a common neurodevelopmental disorder that persists into adulthood. Its symptoms cause impairments in a number of social domains, one of which is employment. We wish to produce a consensus statement on how ADHD affects employment.MethodsThis consensus development conference statement was developed as a result of a joint international meeting held in July 2010. The consensus committee was international in scope (United Kingdom, mainland Europe, United Arab Emirates) and consisted of individuals from a broad range of backgrounds (Psychiatry, Occupational Medicine, Health Economists, Disability Advisors). The objectives of the conference were to discuss some of the occupational impairments adults with ADHD may face and how to address these problems from an inclusive perspective. Furthermore the conference looked at influencing policy and decision making at a political level to address impaired occupational functioning in adults with ADHD and fears around employing people with disabilities in general.ResultsThe consensus was that there were clear weaknesses in the current arrangements in the UK and internationally to address occupational difficulties. More so, Occupational Health was not wholly integrated and used as a means of making positive changes to the workplace, but rather as a superfluous last resort that employers tried to avoid. Furthermore the lack of cross professional collaboration on occupational functioning in adults with ADHD was a significant problem.ConclusionsFuture research needs to concentrate on further investigating occupational functioning in adults with ADHD and pilot exploratory initiatives and tools, leading to a better and more informed understanding of possible barriers to employment and potential schemes to put in place to address these problems.

Injury is a leading cause of morbidity and mortality in the United Arab Emirates (UAE). The UAE is a rapidly developing country with fast economic growth, demographical and environmental changes that are associated with new hazards emerging at a similar pace. The UAE as a federal entity has federal and local systems responsible for safety policy, regulations and enforcement. To set priorities for safety promotion and injury prevention, it is necessary to have data on the most frequent external causes of injury and the main individual, equipment and environmental risk factors that contribute to injury. However good quality data for injury prevention are scarce. The aim of this paper is to describe the scale of injury as a public health problem in the UAE, and the development of safety policies, regulations and promotion efforts with special emphasis on traffic, occupational and child safety.

Pathologists eligible for inclusion in the study were identified from the membership lists of the Royal College of Pathologists from 1974 to 1987, establishing a population of 4,512 members. Overall mortality was lower among the study group compared with the general population of England and Wales, although there were significantly more deaths due to suicide (observed 13, expected 4.9, SMR 265, 95% CI 141-454). Excess deaths due to cancer of the lymphatic and hemopoietic system were noted but they were not significantly increased. An excess of brain cancer death was marginally significant for male pathologists (observed 6, expected 2.5, SMR 240, 95% CI 88-522). Six of the 9 (66.7%) cases of all types of brain tumors reported in total were among hematologists, although this sub-specialty comprises approximately 16% of all pathologists.