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Background: In the absence of similar studies in Lebanon, this study aimed at upgrading and validating the Lebanese specialized competencies framework for community pharmacists (SCF-CP) as a tool to transform community practice and support the professional development and career progression of community pharmacists. Methods: Content validity was assessed and improved through a team of experts. After a thorough literature review and utilizing the Delphi technique, six domains were defined in the framework, with their respective competencies and behaviors. A cross-sectional study was then carried out from March to October 2022 using an online questionnaire created on Google Forms. The snowball technique was applied to reach community pharmacists across all the Lebanese governorates. Results: The final sample included 512 community pharmacists. The construct validity of the framework was confirmed by factor analysis. The Kaiser–Meyer–Olkin measures of sampling adequacy were satisfactory for all models ranging from 0.500 to 0.956 with a significant Bartlett's test of sphericity (P < 0.001). The internal consistency of all competency domains was confirmed by Cronbach's alpha, with values ranging from 0.803 to 0.953. All competencies were significantly correlated with their respective domains (P < 0.001), and all domains were significantly correlated with each other and with the framework (P < 0.001). The participants declared being competent in all domains relating to fundamental skills, safe and rational use of medicines, pharmacy management, professional skills, public health fundamentals, and emergency preparedness and response, with some exceptions, such as compounding, management, and emergency preparedness. A higher declared competency level was associated with having more experience and receiving more than 50 patients per day. Conclusion: Our findings could demonstrate that the Lebanese specialized competency framework is a valid and reliable tool. This framework could help assess the minimum competencies that community pharmacists should possess or acquire and direct initial and continuing education for better practice. Hence, it could be adopted by the authorities and implemented in the Lebanese community pharmacy setting. [ABSTRACT FROM AUTHOR]

The trend of bringing machine learning (ML) to the Internet of Things (IoT) field devices is becoming ever more relevant, also reducing the overall energy need of the applications. ML models are usually trained in the cloud and then deployed on edge devices. Most IoT devices generate large amounts of unlabeled data, which are expensive and challenging to annotate. This paper introduces the self-learning autonomous edge learning and inferencing pipeline (AEP), deployable in a resource-constrained embedded system, which can be used for unsupervised local training and classification. AEP uses two complementary approaches: pseudo-label generation with a confidence measure using k-means clustering and periodic training of one of the supported classifiers, namely decision tree (DT) and k-nearest neighbor (k-NN), exploiting the pseudo-labels. We tested the proposed system on two IoT datasets. The AEP, running on the STM NUCLEO-H743ZI2 microcontroller, achieves comparable accuracy levels as same-type models trained on actual labels. The paper makes an in-depth performance analysis of the system, particularly addressing the limited memory footprint of embedded devices and the need to support remote training robustness. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the public’s knowledge of stroke before and after viewing an educational video about stroke risk factors, preventive measures, and alarming signs. Methods: A single-arm interventional study was conducted in Lebanon using a 3-minute video-based education about stroke. A pre- and post-structured questionnaire compared the level of knowledge about stroke. Results: The study included 685 participants. Knowledge of stroke, risk factors, warning signs, treatment, and preventive measures significantly increased post-educational video sessions. A higher baseline knowledge score was associated with a family history of stroke (Beta = 1.76) and being a healthcare professional (Beta = 3.35). Participants between 25 and 34 years (Beta=-1.39) and those with a high risk of stroke (Beta=-1.03) were significantly associated with a lower knowledge score. Conclusion: This study demonstrated the effectiveness of a video-based educational tool to raise awareness about stroke. Short, targeted audio-visual resources using lay language can convey health education messages and influence behavioral changes. The community can benefit from a large-scale educational campaign that targets different socio-economic statuses to enhance knowledge of stroke and save lives. [ABSTRACT FROM AUTHOR]

Adolescence has been identified as a particularly vulnerable age group with a high prevalence of insomnia and a heightened susceptibility to experiencing psychotic experiences, which in turn increases the risk of developing psychotic disorders. In particular, insomnia symptoms were found to be predominant among noise-sensitive adolescents exhibiting a higher level of noise annoyance. This study aimed to assess the moderating effect of insomnia severity between noise annoyance and psychotic disorders among Lebanese adolescents. A cross-sectional study was conducted among 527 Lebanese adolescents. Participants filled a self-administered online questionnaire. Insomnia moderated the association between noise annoyance and psychotic disorders. Noise annoyance was significantly associated with a higher risk of emergence of psychotic disorders. At low and moderate levels of insomnia severity, higher noise annoyance was significantly associated with higher psychotic experiences. Understanding how these variables interact provide valuable insights into the underlying mechanisms leading to psychotic disorders among adolescents. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionParental stress significantly impacts the well-being of families, and necessitates culturally sensitive tools for its assessment. The Parental Stress Scale, widely used in diverse cultural settings, lacks a validated Arabic version suitable for the Lebanese context, where unique sociopolitical and economic factors might influence parental stress differently. This study aimed to translate, culturally adapt, and validate the scale in Arabic among a Lebanese sampleFollowing the Snowball sampling method, participants (n = 502) were adult Lebanese parents who answered demographic questions and completed the Arabic version of the Parental Stress Scale and the Depression, Anxiety, and Stress Scale-8.Confirmatory Factor Analysis showed a two-factor model of the Parental Stress Scale (CFI = 0.956). We found adequate composite reliability for both the ‘Parental Stress’ (ω = 0.91/α = 0.91) and ‘Parental satisfaction’ (ω = 0.94/α = 0.94) subscales. Convergent validity and concurrent validity were demonstrated through positive correlations with measures of depression, anxiety and stress. Our translation of the scale was shown to be invariant across sexes, with fathers scoring significantly higher than mothers.Our validated Arabic version of the Parental Stress Scale offers a culturally sensitive instrument for assessing parental stress in Lebanon. This tool enables healthcare providers and researchers to identify stressors affecting Lebanese families, facilitating the development of targeted interventions to support parental mental health. [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhea, characterized by painful menstrual cramps, significantly impacts the well-being of women globally. Despite its prevalence and adverse effects, dysmenorrhea is often underdiagnosed and inadequately treated. This study aims to validate the Arabic version of the Working ability, Location, Intensity, Days of pain, and Dysmenorrhea (WaLIDD) scale among Lebanese female university students aged 18– 45. Methods: This cross-sectional study, involving 729 participants, utilized a translated WaLIDD scale and the Depression, Anxiety, and Stress Scales (DASS-8). Results: Confirmatory Factor Analysis (CFA) confirmed the one-factor structure of the WaLIDD scale, demonstrating excellent fit indices, with good internal reliability. Concurrent validity analysis revealed significant associations between higher WaLIDD scores and elevated levels of depression, anxiety, and stress. The prevalence of dysmenorrhea in the study was estimated at 7.3%. Conclusion: The study underscores the importance of the WaLIDD scale as a reliable and valid tool for assessing dysmenorrhea among Arabic-speaking populations. The successful validation of the Arabic version facilitates its application in Lebanon and potentially other Arab regions, providing a universal tool to predict and assess dysmenorrhea and its impact. Further research is encouraged to explore the scale's applicability in clinical settings and tailor interventions for improved women's well-being. [ABSTRACT FROM AUTHOR]

This paper presents the Edge Learning Machine (ELM), a machine learning framework for edge devices, which manages the training phase on a desktop computer and performs inferences on microcontrollers. The framework implements, in a platform-independent C language, three supervised machine learning algorithms (Support Vector Machine (SVM) with a linear kernel, k-Nearest Neighbors (K-NN), and Decision Tree (DT)), and exploits STM X-Cube-AI to implement Artificial Neural Networks (ANNs) on STM32 Nucleo boards. We investigated the performance of these algorithms on six embedded boards and six datasets (four classifications and two regression). Our analysis—which aims to plug a gap in the literature—shows that the target platforms allow us to achieve the same performance score as a desktop machine, with a similar time latency. ANN performs better than the other algorithms in most cases, with no difference among the target devices. We observed that increasing the depth of an NN improves performance, up to a saturation level. k-NN performs similarly to ANN and, in one case, even better, but requires all the training sets to be kept in the inference phase, posing a significant memory demand, which can be afforded only by high-end edge devices. DT performance has a larger variance across datasets. In general, several factors impact performance in different ways across datasets. This highlights the importance of a framework like ELM, which is able to train and compare different algorithms. To support the developer community, ELM is released on an open-source basis. [ABSTRACT FROM AUTHOR]

Background: The Nightmare Distress Questionnaire (NDQ), known and commonly used for its adequate psychometric properties, is the most widely used instrument for the measurement of nightmare distress. This study aimed to assess the psychometric properties of a newly translated Arabic version of the Nightmare Distress Questionnaire (NDQ-AV). Methods: A total of 546 Lebanese adolescents was recruited for this study and completed the NDQ-AV, the Insomnia Severity Index (ISI), and the eight-item Depression, Anxiety and Stress Scale (DASS-8). Results: The results of the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) supported both a one-factor model and a two-factor model of the NDQ-AV, with the latter consisting of seven items within both factors. The first factor was referred to as the "general nightmare distress and coping" while the second was named "nightmare impact and perception". The reliability of the scale was excellent (α = 0.930 and ω = 0.915). Moreover, measurement invariance was shown across gender, demonstrating that this measure performs consistently for both men and women. Additionally, the NDQ-AV scores exhibited excellent reliability alongside factorial and concurrent validity. Conclusion: In conclusion, these results support the psychometric validity of the Arabic version of the NDQ. The availability of the NDQ-AV is expected to facilitate the understanding of nightmare distress within the Lebanese context. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression are psychiatric disorders that often coexist and share some features. Developing a simple and cost-effective tool to assess anxiety and depression in the Arabic-speaking population, predominantly residing in low- and middle-income nations where research can be arduous, would be immensely beneficial. The study aimed to translate the four-item composite Patient Health Questionnaire – 4 (PHQ-4) into Arabic and evaluate its psychometric properties, including internal reliability, sex invariance, composite reliability, and correlation with measures of psychological distress. Methods: 587 Arabic-speaking adults were recruited between February and March 2023. An anonymous self-administered Google Forms link was distributed via social media networks. We utilized the FACTOR software to explore the factor structure of the Arabic PHQ-4. Results: Confirmatory factor analysis (CFA) indicated that fit of the two-factor model of the PHQ-4 scores was modest (χ2/df =.13/1 =.13, RMSEA =.001, SRMR =.002, CFI = 1.005, TLI = 1.000). Internal reliability was excellent (McDonald's omega =.86; Cronbach's alpha =.86). Indices suggested that configural, metric, and scalar invariance were supported across sex. No significant difference was found between males and females in terms of the PHQ-4 total scores, PHQ-4 anxiety scores, and PHQ-4 depression scores. The total score of the PHQ-4 and its depression and anxiety scores were significantly and moderately-to-strongly associated with lower wellbeing and higher Depression Anxiety and Stress Scale (DASS) total and subscales scores. Conclusion: The PHQ-4 proves to be a reliable, valid, and cost-effective tool for assessing symptoms related to depression and anxiety. To evaluate the practical effectiveness of the Arabic PHQ-4 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specific populations. [ABSTRACT FROM AUTHOR]

Background: The Arab world is one of the global regions the most directly concerned by, and suffering from climate change's adverse consequences. As such, there appears to be a strong need for an understanding of how Arab people may emotionally respond to climate change. Providing valid and reliable measures of climate change anxiety (CCA) can help gain a clear overview of the situation in Arab countries, and allow to intervene timely and effectively to mitigate any adverse effects on Arab people's mental health. To this end, the present study sought to validate the Arabic language version of the Climate Change Anxiety Scale (CCAS) in a sample of native Arabic-speaking adults from the general population of Lebanon. Methods: This study adopted a cross-sectional approach and enrolled 763 adults between July and September 2023. Results: A confirmatory analysis of the one-factor model showed poor fit indices as follows: CFI = 0.90, GFI = 0.83, SRMR = 0.048 and RMSEA 0.131 [90% CI 0.123, 0.138). The two-factor model showed a satisfactory fit with a high CFI of and a GFI of 0.91 and a SRMR of 0.04 and RMSEA of 0.05 [90% CI 0.04, 0.06]. Both McDonald's omega and Cronbach alpha values were high for the overall CCAS score (α = 0.96 and ω = 0.96) in the whole sample. Configural, metric and scalar invariance across gender was demonstrated. No significant difference was found between males and females in terms of total CCAS scores (24.53 ± 10.59 vs. 26.03 ± 11.17, t(761) = -1.82, p =.069). Higher CCA, functional impairment and cognitive impairment scores were significantly associated with higher depression, anxiety and stress. Conclusion: The reliability and validity of the CCAS in its Arabic version were proven. The availability of this self-report measure could offer a chance to assess CCA among Adults speaking Arabic, and to spread its future use for screening and research purposes. [ABSTRACT FROM AUTHOR]

The interplay between insomnia and PTSD symptoms remains misunderstood, and seems to be influenced by other factors like individual resilience. Our study examined the moderating role of resilience in the relationship between insomnia and PTSD symptoms among a sample of Lebanese adolescents, in the aftermath of the 2023 earthquake. This cross sectional study, conducted in April, 2 months after the earthquake, enrolled 546 Lebanese adolescents. We used the Sleep Self Report, the Resilience Scale for Adolescents and the 13-item Children’s Impact of Event Scale. The interaction insomnia severity by resilience was significantly associated with PTSD scores. At low, moderate and high resilience levels, higher insomnia severity was significantly associated with lower PTSD. Resilience moderated the relationship between insomnia and PTSD, mitigating the detrimental impact of disrupted sleep on PTSD symptoms. This data can guide healthcare administrators and psychiatric caregivers in classifying risk factors and implementing interventions to predict PTSD development. [ABSTRACT FROM AUTHOR]

Background: As climate change persists, accelerates, and intensifies, and since mitigating factors are absent, mental health impacts are expected to follow the same patterns. Therefore, it appears of utmost importance to deepen and broaden the knowledge and understanding of how and through which mechanisms climate change anxiety (CCA) may interplay with mental health outcomes. Based on the stress-vulnerability model of psychosis, the present study proposed to examine the relationship between CCA and psychotic experiences (PEs), and to test the theoretically-driven hypothesis that death anxiety acts as a mediator in this relationship. Method: This study adopted a cross-sectional approach involving a sample of young adults aged 18 to 35 years (mean age = 24.56 ± 22.49 years; 63.9% females) originating from, and residing in Lebanon. Results: The results of the mediation analysis showed that death anxiety partially mediated the association between CCA and PEs. Higher CCA was significantly associated with higher death anxiety; higher death anxiety was significantly associated with more PEs. Finally, higher CCA was directly and significantly associated with more PEs. Conclusion: Drawing from the present preliminary findings, the key tentative recommendation is that addressing death anxiety might alleviate the association between CCA and PEs. In addition, government decision-makers need to recognize the necessity of considering climate change implications on mental health in policy and decision-making. [ABSTRACT FROM AUTHOR]

Background: Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis added to the DSM-5 characterized by pathological eating habits without body image disturbances. Previous findings demonstrated a general association between high levels of perfectionism and low levels of self-esteem in association with general eating disorders. However, research is scant when it comes to ARFID specifically. Subsequently, although self-esteem is seen to moderate the association between perfectionism and general eating disorders, this research study aims to explore the same moderation but with ARFID specifically. Methods: For this study, 515 Lebanese adults from the general Lebanese population were recruited from all over Lebanon, 60.1% of which were females. The Arabic version of the Big Three Perfectionism Scale– Short Form (BTPS-SF) was used to measure self-critical, rigid and narcissistic perfectionism; the Avoidant/Restrictive Food Intake Disorder screen (NIAS) was used to score the ARFID variable; the Arabic-Single Item Self-Esteem (A-SISE) was the scale used to measure self-esteem. Results: Across the different perfectionism types, self-esteem was seen to moderate the association between narcissistic perfectionism and ARFID (Beta = − 0.22; p =.006). At low (Beta = 0.77; p <.001), moderate (Beta = 0.56; p <.001) and high (Beta = 0.36; p =.001) levels of self-esteem, higher narcissistic perfectionism was significantly associated with higher ARFID scores. Conclusion: This study brought to light some crucial clinical implications that highlight the need for interventions that help in the enhancement of self-esteem in patients with high perfectionism and ARFID. This study suggests that clinicians and healthcare professionals should focus more on risk factors influencing the development and maintenance of ARFID-like symptoms. [ABSTRACT FROM AUTHOR]

Background: There is a lack of measures and data on interpersonal mindfulness from non-Western cultures, which can hinder advances in our understanding of the construct, its conceptual representation, and its effects on human connection and relationships within different cultural settings. To fill this gap and help spark future research in this area in the Arab world, the current study aimed to examine the psychometric properties of an Arabic translation of the 27-item and the 13-item versions of the interpersonal Mindfulness Scale (IMS) in a sample of Arabic-speaking adolescents from the general population. Methods: A web-based survey was conducted in a sample of 527 Lebanese community adolescents (Mean age = 15.73 ± 1.81 years; 56% females). The IMS was translated from English into Arabic using the forward-backward translation method. Participants completed the long and short forms of the IMS, as well as the Buss–Perry Aggression Questionnaire-Short Form (BPAQ-SF), and the 5-item Brief Irritability Test. Results: Confirmatory factor analyses provided support to the four-factor structure of both the 27-item and the 13-item IMS (i.e., Presence, Awareness of Self and Others, Nonjudgmental Acceptance, and Nonreactivity). The original and the short form versions of the IMS yielded excellent internal consistency in our sample, with a Cronbach's α coefficients of 0.95 and 0.90, and McDonald's omega coefficients of 0.95 and 0.90, respectively. Multigroup comparisons suggested the factorial invariance of the Arabic 27-item and 13-item IMS between male and female participants at the metric, configural, and scalar levels. Finally, the concurrent validity of both full-length and short form of the IMS appeared to be good and comparable, as attested by patterns of correlations in expected directions with outcome variables (i.e., aggression, anger, hostility, and irritability). Conclusion: The present findings provide support for the good psychometric qualities of the Arabic translation of the IMS in both long and short forms, suggesting that these scales are suitable for use to measure interpersonal mindfulness in Arabic-speaking youth, at least in Lebanon. We expect that the IMS, in particular its shortest form, will prompt more systematic investigation of interpersonal mindfulness in the Arabic-speaking populations, especially with regard to enhancing healthy communications with others and building effective social relationships. [ABSTRACT FROM AUTHOR]

Purpose: To determine the knowledge, attitude and reported practice of Lebanese community pharmacists who advise persons who present with low back pain. Methods: This was a multi-center cross-sectional study conducted in over 300 community pharmacies across Lebanon from December 2017 to May 2018. Pharmacists working at a community pharmacy were considered eligible, and those who volunteered to participate completed the questionnaire. The questionnaire was designed for self-completion by the pharmacist and included demographic questions about the respondent, questions that assessed knowledge and attitude toward low back pain, and questions about treatment to reflect and characterize the nature of practice. The primary outcome was to determine the knowledge, attitude and reported practice of the Lebanese pharmacists advising people who presented with low back pain. The secondary outcome was to assess factors that affect knowledge, attitude, and practice. Results: The response of 320 community pharmacists was analysed. The proportion of pharmacists with good knowledge about low back pain (51. 7 %) was slightly higher than those with poor knowledge (48. 3 %). Oral therapy was the most prescribed dosage form for back pain compared to local patch and cream. Among oral dosage forms, non-steroidal anti-inflammatory drugs were the most prescribed medications (42 %). Of the patients’ referral to the physician if necessary, 73.1 % of the referrals were by pharmacists. Conclusion: Community pharmacists in Lebanon demonstrate an acceptable level of knowledge of back pain, yet major gaps still exist, particularly in terms of the quality of advice. Hence, more education is needed to provide better quality of advice. [ABSTRACT FROM AUTHOR]

Background: Research on dysmorphic concerns (DC) in Arabic-speaking contexts is hampered by the lack of validated tools. Because DC are culturally dependent, psychometrically sound measures are needed at the national level to closely and accurately investigate the construct in specific societies and populations. The purpose of the current research was to investigate the psychometric properties of Dysmorphic Concern Questionnaire (DCQ) in its Arabic translation in Lebanese adults. Methods: The study involved 515 participants (69.9% females, mean age of 27.55 ± 10.92 years) who completed a self-report, web-based questionnaire. Results: Confirmatory factor analysis indicated excellent construct validity, as the one-factor structure of the Arabic DCQ fits well with the data. McDonald's omega was 0.89 in our sample, evidencing an excellent level of internal consistency. Furthermore, the results from the multigroup analysis showed that the DCQ holds similar structural model between genders at the metric, configural, and scalar levels. Finally, DC levels correlated inversely with body appreciation and self-esteem and positively with disordered eating symptoms, thus supporting the concurrent and convergent validity of the Arabic DCQ. Conclusion: The DCQ translated into Arabic appears to have a valid self-assessment measure to capture the presence of DC manifestations. It is anticipated that the Arabic DCQ will be advantageous for healthcare professionals and researchers working with Arabic-speaking people around the world. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students. Methods: A total of 769 female participants enrolled in this cross-sectional study (mean age 21.58 ± 3.20 years). A self-administered questionnaire was distributed among university female students. The questionnaire consisted of Mindful Eating Behaviors Scale, ORTO-R, Depression Anxiety Stress Scale, and Arabic version of Academic Self-Efficacy Scale. Results: The results showed that psychological distress fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less psychological distress (β= -0.31, p =.05), with more psychological distress significantly associated with lower academic self-efficacy (β= -0.32, p =.09). Focused eating fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less focused eating (β=-0.09, p =.04), with more focused eating significantly associated with better academic self-efficacy (β = 1.40, p =.10). Orthorexia nervosa was not directly associated with academic self-efficacy in both models. Conclusion: This study shed light on important connections between orthorexia nervosa, psychological distress, mindful eating behaviors, and academic self-efficacy within the Lebanese context. The findings will have practical implications for both educational institutions and healthcare providers striving to support young female adults' overall well-being and academic success. [ABSTRACT FROM AUTHOR]

Background: Reflecting on the existing literature on suicidal ideation and Avoidant/Restrictive Food Intake Disorder (ARFID), this article investigates the complex relationship between them, hypothesizing about the possibility of dysmorphic concerns, being a mediator linking ARFID to suicidal ideation. Methods: Using a snowball sampling approach, a survey was created on Google Forms and circulated across messaging applications and social media networks (WhatsApp, Instagram, Messenger). The sample involved 515 participants recruited between February and March 2023. The questionnaire included the following scales: Nine-items Avoidant/Restrictive Food Intake Disorder screen (NIAS), Dysmorphic Concern Questionnaire (DCQ), and Columbia-Suicide Severity Rating Scale (C-SSRS). When filling the questionnaire, respondents were warned that they can experience distress when answering certain questions and received information about mental health services. Five hundred fifteen adults participated in this study, with a mean age of 27.55 ± 10.92 years and 60.1% females. Results: After adjusting over potential confounders (i.e., age, education, marital status, and household crowding index), analyses showed that dysmorphic concerns fully mediated the association between avoidant restrictive eating and suicidal ideation. Higher avoidant restrictive eating was significantly associated with more dysmorphic concerns, and higher dysmorphic concerns were significantly associated with the presence of suicidal ideation. Finally, avoidant restrictive eating was not significantly associated with suicidal ideation. Conclusion: This study highlights the potential indirect link between ARFID and suicidal ideation mediated by dysmorphic concerns. While no direct connection was observed between ARFID and suicidal ideation, the presence of dysmorphic concerns appeared to be a crucial factor in amplifying the risk of suicidal ideation in individuals with ARFID. This emphasizes the importance of addressing dysmorphic concerns alongside ARFID treatment to enhance mental health interventions and outcomes. [ABSTRACT FROM AUTHOR]

Background: Accurately measuring violent ideations would be of particular high relevance in Arab countries, which are witnessing an unprecedented increase in violence rates among adolescents because of the widespread social, economic and political unrest in the region. Therefore, the present study aimed to test the psychometric properties of an Arabic translation of the 12-item and the 7-item forms of the Violent Ideations Scale (VIS and VIS-SF) in a sample on non-clinical Arabic-speaking adolescents. Methods: Five hundred seventy-seven community adolescents (mean age of 15.90 ± 1.73 years, 56.5% females) answered an anonymous online survey comprising an Arabic translation of the Violent Ideations Scale (VIS) and a measure of physical aggression. Results: Confirmatory factor analyses (CFA) offered support for the single-factor structure of the Arabic VIS and the VIS-SF. Both the long and short forms of the scale yielded excellent internal consistency, with McDonald's ω coefficients of 0.96 and 0.94 and Cronbach's α coefficients of 0.96 and 0.94, respectively. Multi-group CFA established measurement invariance across gender groups. Finally, results revealed significant and positive correlations between the two forms of the VIS and physical aggression scores, thus supporting concurrent validity. Conclusion: Both the VIS and VIS-SF have demonstrated good psychometric properties in their Arabic versions, and suitability for sound assessment of violent ideations. We therefore expect that these measures assist clinicians in risk assessment and management of violence, and help foster research in this area in Arab countries. [ABSTRACT FROM AUTHOR]

Background: Despite the high clinical relevance of the perfectionism construct as a transdiagnostic contributor to different mental health symptoms, and the recent burgeoning of research in this area across cultures in the past two decades, the Arab region was one of the cultural settings experiencing the slowest progress in this line of research. This study aimed to make a meaningful contribution to the literature by validating an Arabic-language version of the 16-item Big Three Perfectionism Scale–Short Form (BTPS-SF). In particular, we sought to examine structure and concurrent validity, internal consistency, and measurement invariance across gender groups. Method: A web-based, convenience sampling method was adopted to collect a sample of Arabic-speaking adults from the general population of Lebanon (N = 515; aged 27.55 ± 10.92 years; 69.9% females). The forward-backward method was applied in translating the Arabic version of the BTPS-SF. Results: The examination of the internal structure, using Confirmatory Factor Analysis (CFA), demonstrated that the three-factor model (i.e., rigid, self-critical, and narcissistic perfectionism) fitted well to the data. All three factors of the Arabic 16-item BTPS-SF yielded excellent reliability estimates, with both Cronbach's alpha and McDonald's omega ranging from 0.83 to 0.86. Multi-group CFA revealed that fit indices showed no significant difference in model fit at the configural, metric, and scalar levels, thus suggesting that the factor loadings, pattern structure, and item intercepts are invariant across gender groups. Finally, BTPS-SF subscales scores correlated positively with psychological distress (i.e., depression, stress and anxiety), and inversely with subjective well-being, indicating an acceptable concurrent validity. Conclusion: The present findings allow us to conclude that the Arabic BTPS-SF permits to capture reliably and validly three main factors of perfectionism. We hope that providing this psychometrically sound scale will encourage its large use not only in empirical research, but also in clinical applications, including psychological screening and treatment monitoring. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess nutrition knowledge (NK) and willingness to seek nutritional counseling (WSNC) and their predictors among university students in Lebanon. Design/methodology/approach: A cross-sectional design was used to enroll students from two large private universities in Lebanon. Data were collected by a standardized questionnaire. NK scores on general and specific nutrition areas were computed. The predictors of NK and WSNC were determined by multivariable logistic regression analyses. Findings: A total of 370 students were included, among which 68% had good general nutritional knowledge, which appears to be associated with being a pharmacy student (adjusted OR (aOR) = 4.26 [95% confidence interval (CI) 1.55; 11.7]), and having a dietitian as a reference for nutritional information (aOR = 8.84 [95% CI 1.94; 40.3]). However, 64% of participants had a high specific nutritional knowledge score, which was related to either attending a school of arts and sciences or being a pharmacy student (aOR = 10.8 [95% CI 4.08; 28.5]). Most students (80%) had the will to seek nutritional counseling, which was positively associated with being a female (aOR = 2.01 [95% CI 1.10; 3.67]) and a pharmacy student (aOR = 2.62 [95% CI 1.15; 5.95]). The general nutritional knowledge score was significantly associated with the WSNC (aOR = 2.10 [95% CI 1.04; 4.25]). Originality/value: Higher nutritional knowledge and WSNC were found among students enrolled in health-related fields. These results underline how important nutrition education is as a strategy for inspiring college students to adopt healthy lifestyles. [ABSTRACT FROM AUTHOR]

Background: Medication errors can often occur due to the patient's inability to comprehend written or verbal medication orders. This study aimed to develop pictograms of selected medication orders and to validate the comprehension of prescription orders index and compare the comprehension scores with and without pictograms. In addition to determine the predictors that could be associated with a better or worse comprehension of prescription orders with pictograms versus that of their written counterparts. Methods: A cross-sectional study was conducted using a snowball sampling technique. Six pictograms were developed to depict specific medication orders. The comprehension of prescription orders index was constructed and validated. The study then compared the comprehension scores of prescription orders with and without pictograms, and identified the predicting factors score difference. Results: A total of 1848 participants were included in the study. The structure of the comprehension of prescription orders index was validated over a solution of four factors, with an adequate Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy of 0.711 and a significant Bartlett's test of sphericity (P < 0.001). The construct validity of the index was further confirmed by highly significant correlations between each item and the full index (P < 0.001). The study also found a significant association between the difference in comprehension scores for prescription orders with and without pictograms and several factors, including age, level of education, area of residence, number of children, and smoking status with the difference of comprehension scores (P < 0.001). Conclusion: Pictogram-based instructions of medication orders were better understood by the Lebanese population than written instructions, making the incorporation of pictograms in pharmacy practice paramount to optimize medication use by the patient and thus yielding better health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents react differently to challenging negative life events. Resilience, a dynamic characteristic of individuals, was studied to be a protective factor against such events. In order to study the resilience among Arabic-speaking adolescent populations, age-appropriate measures that are fully apprehended by younger respondents are needed. In this context, the present study aimed to examine the psychometric properties of an Arabic translation of the Resilience Scale for Adolescents (READ) in a community sample of native Arabic–speaking adolescents aged 13–18 years. Methods: A sample of 546 community Arabic-speaking adolescents from Lebanon was recruited (n = 328 females, with a mean age of 15.76 ± 1.65 years). Through an online questionnaire, participants were requested to complete the READ, Depression, Anxiety and Stress Scale (DASS-8) and the 13-item Children's Impact of Event Scale (CRIES-13). Results: Following the exploratory and confirmatory factor analysis (EFA-to-CFA) strategy, a unidimensional model of the Arabic version of the READ was met after 10 items were removed from the scale, and showed strong internal consistency (Cronbach's alpha of 0.943). Additionally, the one-factor solution of the Arabic version of the READ was identical across male and female adolescents at the three levels of invariance (Configural, Metric and Scalar). Finally, higher resilience scores were significantly correlated with lower levels of psychopathology, namely depression, anxiety, stress and PTSD, thus attesting to the concurrent validity of the Arabic READ. Conclusion: Findings lend support to the psychometric reliability and validity of the Arabic version of the READ, and therefore its suitability for use among Arabic-speaking adolescents. The availability of this tool facilitates the implementation of interventions that foster resilience, especially in adolescents who have faced a number of negative life events. [ABSTRACT FROM AUTHOR]

Background: Despite the substantial clinical relevance of irritability in the development and maintenance of several mental disorders and its negative effects on functioning, no valid and reliable measures are available yet to identify the presence and consequences of irritability as a distinct construct among the Arabic-speaking populations. To bridge this gap, and help advance this field in the under-researched Arab region, we aimed to validate an Arabic-language version of the Brief Irritability Test (BITe). Methods: Eligible participants were native Arabic-speaking non-clinical adolescents from Lebanon; 527 participants aged 15.73 ± 1.81 years (56% females) completed the survey. Results: Utilizing the Confirmatory Factor Analysis approach, we found that the five items of the Arabic BITe loaded into a single factor structure. The scale showed excellent reliability, as both Cronbach's alpha and McDonald's omega coefficient values were of 0.88. Multi-group analyses showed invariance across sex groups in our sample at the configural, metric, and scalar levels. Female adolescents exhibited higher BITe scores than their male counterparts (14.01 vs. 13.25), but this difference did not reach the statistical significance. Good concurrent validity was supported based on positive correlations between irritability scores and measures of aggression, anger and hostility (r Pearson's coefficients ranging from 0.35 to 0.42), as well as positive correlations with insomnia symptoms scores. Conclusion: The present findings allow us to conclude that the Arabic version of the BITe is a unidimensional, reliable, valid, brief, and economic self-report measure of the irritability construct for both male and female Arabic-speakers. Providing an Arabic validated version of the BITe will hopefully foster the research efforts of the Arab scientific community in this area, and promote the implementation of timely, evidence-informed and culturally-sensitive mental health interventions that appropriately address irritability-related problems and consequences among Arab young populations. [ABSTRACT FROM AUTHOR]

Background: No epidemiological data is yet available on Avoidant/Restrictive Food Intake Disorder (ARFID) in Arab countries, which may in part be due to the lack of measures available in Arabic language. This constitutes a major obstacle to further progress of our understanding of the nature, aetiology, course, treatment, and prevention of ARFID, especially as some evidence suggested that ARFID may vary across cultures and food environments. We aimed to contribute to the literature in the eating disorders field by examining the psychometric properties of an Arabic translation of the Nine Item ARFID Screen (NIAS). Method: This was a cross-sectional, web-based study. A total of 515 Lebanese community adults (mean age of 27.55 ± 10.92 years, 69.9% females) participated. The forward–backward method was adopted to translate the NIAS from English to Arabic. Results: Confirmatory Factor Analyses provided evidence for the adequate fit indices for the three-factor model (i.e., Picky eating, Fear, and Appetite) and the 9-item version of the NIAS. An adequate reliability of the Arabic NIAS was achieved, with McDonald's ω ranging from.75 to.90 for the total score and all three subscores. Multi-group analyses demonstrated measurement invariance by sex (males vs. females) and weight groups (underweight/healthy weight [BMI ≤ 25] vs. overweight/obese [BMI > 25]) at the configural, metric, and scalar levels. Adequate patterns of correlations between the NIAS and measures of disordered eating symptoms, psychological distress and well-being were seen. In particular, fear was significantly associated with non-ARFID disordered eating symptoms. Appetite and Picky eating, but not Fear, were inversely correlated with well-being. All three NIAS subscores and the total score were positively correlated with psychological distress. Conclusion: Findings provided evidence that the Arabic NIAS is a short, valid and reliable self-report measure to screen for ARFID symptoms. In light of these findings, we recommend its use for clinical and research purposes among Arabic-speaking adults. Plain English summary: Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by food avoidance or dietary restriction associated with at least one of four consequences––weight loss, nutritional deficiency, nutritional supplement dependence, and/or psychosocial impairment. The Nine Item ARFID Screen (NIAS) was developed as a screening measure to detect ARFID symptoms and has nine items with three subscales that map onto symptoms of each ARFID presentation. The NIAS have been translated into multiple languages but not yet validated in Arabic. To that end, we aimed to translate and validate the Arabic version of the NIAS in the present study, which would in turn facilitate improved research and clinical practices related to ARFID in Arabic-speaking nations. The present findings provide support for the psychometric properties of the Arabic version of the NIAS in examining ARFID in Arabic-speaking adults in Lebanon. [ABSTRACT FROM AUTHOR]

Background: Monoclonal gammopathy of undetermined significance (MGUS) is a non-malignant precursor of multiple myeloma (MM). MGUS has been suggested to be associated with a higher risk of cardiovascular diseases, including AFIB, but it is still unclear whether this association is real. Studies are lacking on the impact of atrial fibrillation on health outcomes in this population. The association of AFIB in this population is lagging and merits further investigation. Methods: The study conducted a retrospective analysis of the Nationwide Inpatient Sample (NIS) for 2018, including adult patients with primary diagnoses of MGUS and AFIB. Patients were divided into two groups based on AFIB presence. Outcomes assessed included complications, length of stay, mortality, hospital charges, and discharge disposition. Results: The study included 9007 patients with MGUS of whom 2404 had AFIB. Patients with both MGUS and AFIB had higher rates of acute kidney injury [AKI] (31.5% vs. 27.5%; p = 0.002) and pericarditis (2% vs. 1.2%; p = 0.029). They also had longer hospital stays (5 vs. 4 days; p < 0.001) and higher hospitalization costs ($43,729 vs. $41,169; p < 0.001). Conclusions: The study showed that the prevalence of AFIB in MGUS patients is high. Patients with AFIB had increased rates of complications (AKI and pericarditis) and higher mortality compared to patients without AFIB. Further studies screening for AFIB in this patient population are warranted. [ABSTRACT FROM AUTHOR]

No epidemiological prevalence data regarding psychotic-like experiences (PLEs) in children and adolescents are yet available for Arab countries. Providing age-appropriate questionnaires that are fully apprehended by younger participants can facilitate discussions on prodromal psychosis in both community and clinical settings. To address this gap and help foster future research on PLEs in these unstudied age groups, we sought to examine the psychometric properties of an Arabic translation of the Psychotic-Like Experiences Questionnaire for Children (PLEQ-C) in a community sample of children and adolescents aged 12–18 years from Lebanon. A total of 546 native Arabic-speaking Lebanese children and adolescents were enrolled in this study with a mean age of 15.90 years (SD = 1.73) and 56.5% females. The forward–backward translation method was used for the translation and adaptation of the PLEQ-C into the Arabic language. The Arabic PLEQ‐C showed good internal consistency, as revealed by McDonald’s ω and Cronbach’s α coefficients of .85. Analyses indicated that all nine items of the PLEQ-C fall onto one factor, thus replicating the originally proposed single-factor structure of the scale. Multi-group analyses revealed that configural, metric, and scalar measurement invariance was achieved across gender and age categories (12–14 years, 15–16 years, and 17–18 years). The PLEQ‐C scores showed significant positive correlations with the PQ‐B frequency and distress sub-scores, hence attesting to its convergent validity. In addition, findings confirmed the good divergent validity of the PLEQ-C, by demonstrating significant correlations with measures of depression, anxiety, stress, and insomnia. Findings preliminarily suggest that the Arabic PLEQ-C is suitable and feasible for assessing PLEs self-reported by children and adolescents in Arab settings. Such an instrument could allow for simple, quick, and effective screening and identification of community youth who need to go through comprehensive clinical interviews and benefit from clinical monitoring or early psychological intervention. [ABSTRACT FROM AUTHOR]