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The purpose of this study, that took place in Lebanon, is to investigate the effectiveness of Portage, a home-based early intervention program for children with special needs. The sample consisted of 16 children (eight male and eight female) whose ages ranged between 1 and 3 years. Participants were provided with home-based services by a Portage home-visitor for a period of six months. Data were collected before and after the intervention. Participants' progress was evaluated in five developmental areas: communication, social-emotional, exploration, purposeful-motor activity, and sensory organization. Parents' satisfaction with the program's provisions was also examined. The results revealed significant differences in the participants' pre and post ratings, indicating improvement in the children's functional skills in all developmental areas. Also, parents' interviews revealed satisfaction with the program's services. In sum, Portage seems to be a promising home-based intervention, but further research is needed before making any claims about its wider potential.

COVID-19 caught everyone by surprise, and the situation quickly escalated from epidemic to pandemic. By February 21, 2020, the first positive case was reported in Lebanon, and following that, by March 12, 2020, the decision to close all educational institutes was put into effect. Online learning is not an approved form of education in Lebanon, which meant that none of the Lebanese universities was prepared to make a complete shift from face-to-face learning to online learning. Immediate actions were taken at the Lebanese International University starting at the level of the University Council, all the way to the level of individual departments. The approach of the Department of Biological and Chemical Sciences is best described as "break barriers, build bridges, and launch transitions". An initial assessment of strengths and weaknesses helped the department develop a model of online learning that took advantage of the readily available online tools (e.g., Google Classroom) while modifying the format of content delivery and assessment with the minimal potential for disruption by inadequate Internet, interruptions in electricity, and limited access to expensive hardware and software. A SWOT analysis of the model was done based on the survey that was given to the chemistry instructors in the department while taking into consideration the emails and comments received by students.

Despite low productivity in Lebanon's agricultural economy, neglected for finance and service sectors, land and labor potential are very high. Literature on agrarian and food crises in Lebanon remains sparse in agrarian studies journals and retains a neoliberal developmentalist emphasis on food security rather than food sovereignty. Using the framework of food regime analysis, we analyze the historical developmental trajectory of the West-Beqaa village of Machgara, and how Lebanese family farmers are impacted by adverse incorporation into global capitalism. Placing farmer testimonies in the context of greater macro-historical chronologies, we see how reflections highlight patterns of commodification of land, labor and food. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the prevalence of medical studentmistreatment in Lebanon, the framework of the incidents, and the extent of students' knowledge on mistreatment characteristics. Methods: This is a cross-sectional study conducted using an online-based survey among medical students who have performed clinical rotations in Lebanon. Results: Out of 300 respondents, 48.7% reported being subjected to mistreatment during clinical practice, which was significantly associated with gender, type of university, and family income. The two most common sources of mistreatment were patients and their families/friends (77.4%), and attending physicians (52.7%), followed by residents (49.3%). Students mostly chose to be passive and pacifying. Additionally, 64.7% of students stated they were not trained about the ideal way to handle these incidents. Conclusion: This study showed that medical student mistreatment is highly prevalent in Lebanon. It also highlighted the lack of proper education on mistreatment characteristics and the necessity for investigating its effects. [ABSTRACT FROM AUTHOR]

This article offers an ethnographic account of ongoing border conflicts in south Lebanon between members of the United Nations Interim Force in Lebanon (UNIFIL) and residents in a south Lebanese border village. It emphasizes the specific experiences of this border population with foreign intervention and land expropriations. It places UNIFIL's current intervention in a long history of Western imperialism in the region. It underlines how UNIFIL weakens the Lebanese state by taking over the sovereign functions a state typically performs. It examines current border contestations in a context of Israeli settler colonialism and its long-term role in shaping the livelihoods in south Lebanese border villages. It argues for the importance of understanding border conflicts and the work of international interventions in their specific local and historical contexts. [ABSTRACT FROM AUTHOR]

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Background: A high neutrophil-lymphocyte ratio (NLR) may be associated with worse survival in esophageal cancer (EC). Our aims were to describe the demographic and clinical data of EC in a tertiary referral center in Lebanon and to determine the prognostic value of NLR. Methods: A retrospective cohort study based on chart review of patients diagnosed with EC was conducted at the American University of Beirut Medical Center (AUBMC). The demographic characteristics, clinical presentation and outcomes were described and compared between squamous cell carcinomas (ESCC) and adenocarcinomas (EAC). Data about esophageal cancer incidence were obtained from the National Cancer Registry, the Ministry of Public Health and GLOBOCAN 2020. Cox regression analysis was performed to determine whether the NLR is an independent predictor of survival, using variables based on clinical knowledge and previously established data. Results: 110 patients were diagnosed with EC, which was the least common among other gastrointestinal malignancies. Our follow up rates reached 86.4%. The median survival was 9 months (IQR 3–25.5.) and was comparable between ESCC (median of 7 months, IQR 2–25) and EAC (median of 9 months, IQR 3–26.3), p = 0.803. Advanced stage was associated with a worse prognosis (p = 0.037). The mean NLR(±SD) was 5.20 ± 6.8, with no significant difference between EAC and ESCC (4.5 ± 3.4 vs. 5.9 ± 9.2, p = 0.420) or between early or advanced stages (5.4 ± 8.1 vs. 4.7 ± 6.8, p = 0.732). The area under the curve for the NLR was 0.560 (95% CI: 0.374–0.746, p = 0.488). After adjusting for age, gender, TNM staging and grading, cox regression analysis showed that an increased NLR was a significant predictor of mortality, with an adjusted hazard ratio of 1.095 (p = 0.011). Conclusion: EC is quite uncommon in Lebanon despite a high prevalence of smoking and obesity. Advanced stage and high NLR were associated with a negative prognostic value. [ABSTRACT FROM AUTHOR]

A key contributor to foodborne illnesses is consuming contaminated ready-to-eat foods, including raw meats. The latter is a common practice in Lebanon, a country that suffers from widespread pollution and food safety challenges. However, studies on the safety of raw meat consumption in Lebanon are limited. In this study, an attempt was made to investigate the knowledge, attitudes, and practices (KAPs) of the Lebanese population toward the potential risk associated with the consumption of raw meats, and to identify factors that affect KAP levels. An online survey (n = 577) was administered to Lebanese adults aged 18 years and above to assess their KAPs. The results showed that 74.5% of the participants consumed raw meat, 44% had good food safety knowledge, and 30.7% exhibited good practices. However, more than half of the participants (61.9%) showed a positive attitude toward food safety. There was a significant association between knowledge and attitude (p < 0.001), attitude and practices (p < 0.001), and knowledge and practices (p < 0.001), thereby indicating that an increase in food safety education could translate into better practices in this population. Accordingly, efforts to enhance education on food safety are warranted to reduce the potential risk of food poisoning associated with raw meat consumption in Lebanon. [ABSTRACT FROM AUTHOR]

visibly Muslim women in Lebanon, a small country on the eastern shores of the Mediterranean, experience significant anti-Muslim racism. Thinking through their anti-racist work, this article identifies and examines a refusal – a pre-emptive move away from power rather than against it that works to make it obsolete and survive despite it. Analysing this movement away, I argue, reveals it as a movement towards a neoliberal 'civilized', 'cultured', and consumer subject assimilating into Eurocentric modernity/coloniality while surviving in the materiality of its Muslimness. The article accordingly posits this as a form of 'messy refusal' – implicated in the cultural and epistemic reproduction of Eurocentric modernity/coloniality – and complexifies refusal's growing celebration across anti/post/decolonial and indigenous scholarship. In doing this, it contributes to rethinking anti-Islamophobia from the so-called Middle East rather than Euro-America and examining it as a longer process rather than exclusively focusing on the racist moment and site. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance is a serious threat, particularly in low- and middle-income countries (LMICs). Antifungal resistance is often underestimated in both healthcare and non-clinical settings. In LMICs, it is believed that the inappropriate use of antifungals, limited surveillance systems, and low diagnostic capacities are significant drivers of resistance. Like other LMICs, Lebanon lacks antifungal use and resistance surveillance programs, and the impact of antifungal resistance in the country remains unclear, especially during the unfolding economic crisis that has severely affected medical care and access to safe food and water. Interestingly, the widespread use of antifungals in medicine and agriculture has raised concerns about the development of antifungal resistance in Lebanon. In this light, we aimed to survey available antifungal drugs in the country and evaluate susceptibility patterns of prevalent fungal species to guide empiric treatments and develop antifungal stewardship programs in Lebanon. We noted that the economic crisis resulted in significant increases in antifungal drug prices. Additionally, a comprehensive literature search across PubMed, ScienceDirect, and Google Scholar databases identified 15 studies on fungal infections and antifungal resistance conducted from 1998 to 2023 in Lebanon. While data on antifungal resistance are limited, 87% of available studies in Lebanon focused on candidiasis, while the remaining 13% were on aspergillosis. Overall, we observed a marked antimicrobial resistance among Candida and Aspergillus species. Additionally, incidences of Candida auris infections have increased in Lebanese hospitals during the COVID-19 pandemic, with a uniform resistance to fluconazole and amphotericin-B. Taken together, a One Health approach, reliable diagnostics, and prudent antifungal use are required to control the spread of resistant fungal pathogens in healthcare and agricultural settings. [ABSTRACT FROM AUTHOR]

Lebanese cancer patients are facing a war on two fronts, between the COVID-19 pandemic and one of the most severe financial crises globally in recent times. This multicentric cross-sectional study was conducted, aiming to analyse challenges and perspective of this particularly vulnerable population. A questionnaire was prepared to assess socio-demographic data, challenges faced during the pandemic, perspectives concerning cancer and COVID-19, a scale was also validated to assess knowledge level regarding COVID-19 in this population. Patients were interviewed in chemotherapy units from four different private and public hospitals in Lebanon during December 2020 and March–June 2021. In total, 272 patients were interviewed (median age, 57 years, range, 22–90 years). Concerning salary during the pandemic, it changed negatively (45.6%), or did not change (7.7%), while 46.7% of participants did not work. Some challenges such as transportation problems (39%), inability to reach their physician by phone (16.9%), deferral of chemotherapy dates (31.6%), difficulty finding chemotherapy medications (49.6%) were more likely to be reported by patients receiving chemotherapy in public compared to private hospitals (p < 0.01 for each). Other challenges include not being able to find non-cancer-related medications (71.3%), this challenge being increased when comparing December 2020 with March–June 2021 (p < 0.02). Using a multivariate analysis, the best predictor for increased knowledge about COVID-19 was higher levels of education (p < 0.001). In conclusion, this study shows that cancer patients in Lebanon are facing many challenges that complicate different aspects of health. Perspective and challenges of these patients must be taken into consideration in order to deliver better care to our patients in these unprecedented times. [ABSTRACT FROM AUTHOR]

Contaminated, raw or undercooked vegetables can transmit parasitic infections. Here, we investigated parasitic contamination of leafy green vegetables sold in local markets in the Tripoli district, Lebanon, during two consecutive autumn seasons (2020–2021). The study involved the microscopic examination of 300 samples of five different types of vegetables (60 samples per type) and used standardized qualitative parasitological techniques for some protozoa and helminths. The results showed that 16.7% (95% interval for p: 12.6%, 21.4%) (50/300) of the vegetable samples were contaminated with at least one parasite. The most frequently detected parasite was Blastocystis spp. (8.7%; 26/300); this was followed in frequency by Ascaris spp. (3.7%; 11/300). Among the different vegetable types, lettuce (23.3%; 14/60) was the most contaminated, while arugula was the least contaminated (11.7%; 7/60). The statistical analysis did not reveal any significant association between the prevalence of parasitic contamination and the investigated risk factors, which included collection date, vegetable type, market storage status, and wetness of vegetables at the time of purchase (p > 0.05). The high prevalence of parasitic contamination also suggested the potential presence of other microbial pathogens. These findings are important because leafy green vegetables are preferentially and heavily consumed raw in Lebanon. Thus, implementing effective measures that target the farm-to-fork continuum is recommended in order to reduce the spread of intestinal pathogens. [ABSTRACT FROM AUTHOR]

Background: Little is known about the acceptance of specific populations of decision makers in Lebanon regarding surrogacy. This study aimed to explore the acceptance and attitude of Lebanese Lawyers and Medical Students regarding surrogacy. Methods: In total 248 medical students and 204 lawyers completed a questionnaire to assess socio-demographic data, attitude toward surrogacy, and three different clinical scenarios to assess patterns of thinking. Finally, we validated a scale to assess the acceptance of surrogacy in these two populations. Results: Concerning medical students, 54.8% reported they were supportive of surrogacy, 35.1% were neutral and 10.1% were against. For lawyers, 52.9% were supportive, 25% were neutral and 22.1% were against. Lawyers were more likely to be against surrogacy (p = 0.001). After conducting a multivariate analysis on the whole studied population to find predictors of acceptance of surrogacy, the best predictors were being single (OR 0.415; 95% CI 0.228, 0.753; p < 0.01), a supportive reported attitude regarding surrogacy (OR 5.464; 95% CI 3.65, 8.13; p < 0.001) and believing that surrogacy is a solution worth discussing in Lebanon (OR 4.186; 95% CI 1.709, 10.256; p < 0.01). Concerning the clinical scenarios, they showed that lawyers were more likely to oppose abortion regardless of the reason (p < 0.01). Also, in a case of gestational surrogacy, lawyers were more likely to give the right to the gestational carrier to keep the baby compared to medical students (p < 0.001). Conclusion: In conclusion, this study shows that only a minority of medical students and lawyers in Lebanon oppose surrogate pregnancy which warrants exploration of the perspective of other populations of decision makers in Lebanon to better guide legislations. [ABSTRACT FROM AUTHOR]

Solar power is an effective way to reduce the dependency on conventional fuels and mitigate the water and energy shortage issue. The main aim of the current paper is to assess and compare the techno-economic feasibility of rooftop grid-connected photovoltaic energy systems for generating electricity and generating drinkable water in Nahr El Bared, Lebanon. To this aim, the present paper first reviews previous scientific studies associated with the water resources and energy situation to summarize the current status in Lebanon. According to this review, Lebanon's water resources are highly polluted, domestic and industrial sewage is largely untreated, and intolerable agricultural practices further exacerbate the situation. Furthermore, population and economic growth and the continuous utilization of old power plants have led to an increase in the number of hours of power outages in the country. Accordingly, the proposed project aims to evaluate the viability of using solar energy as an alternative solution to the shortage of water and energy in the country. Secondly, the techno-economic performance of the proposed system in the selected region was evaluated based on the variations in financial parameters using RETScreen Experts software. The results demonstrate that 11770-13451kWh/yr could be generated from the solar system, which can help reduce the energy shortage and generate drinkable water. Furthermore, the investment was found to be economically viable and attractive for investors. This paper concludes that solar energy can be able to solve the energy shortage of electricity, reduce the country's electricity costs, and produce freshwater for drinking and domestic use in the country. [ABSTRACT FROM AUTHOR]

Faculty use of technology is a critical issue in higher education; administrators and students are expecting faculty instruction to incorporate technology in classroom and distance education. Competition is demanding technologically proficient graduates for schools and colleges. Research indicates that computer self-efficacy (CSE) may be one determinant of who uses technology and who does not. A survey of education faculty at the Lebanese University in Beirut, Lebanon, conducted in 2006, revealed varying degrees of CSE; of 127 respondents, 14 had low levels of CSE; 68 were at a moderate level, and 45 self-evaluated themselves to have high CSE. Although other barriers may deter the implementation of technology in teaching, strategies and techniques for increasing CSE should be developed. For those with low CSE, special attention must be given to enhancing their levels of CSE.

Background: COVID-19 pandemic has led to a catastrophic shortage of ICU beds. This has resulted in the need to identify patients that can be discharged early before full clinical recovery. We designed this study to determine if in changes routine tests like CBCD and CRP can be a useful complement to clinical status when deciding to discharge patients from ICU. Methods: This retrospective study was conducted in Rafic Hariri University Hospital. Levels of biomarkers measured at admission (T1) and within 3 days of outcome (T2) were collected and ratios (T2/T1) were calculated. The Odds Ratios of association between the changes in these biomarkers and outcome were estimated. Multivariate analysis and AUC for the performance of these biomarkers were also conducted. Results: We found on multivariate analysis that reduction in counts of lymphocyte and platelets and elevation in counts of neutrophils and level of CRP (T2/T1 ratio > 1) are strongly associated with mortality with respective ORs estimated at 6.74, 3.26, 5.65 and 4.34 [p-values < 0.001]. AUCs were found to lie in a range of 0.68 to 0.81 indicating fair to good performance. Other factors found to impact survival were AKI, AF and ACS [p-values < 0.01]. In contrast to other studies, risk factors didn't show an association with survival when adjusted for effects of complications and changes in biomarker levels. Conclusions: Our results confirm that inexpensive tests like lymphocyte count and CRP can be reliably used to follow COVID-19 patients in ICU and to support the decision to discharge patients. [ABSTRACT FROM AUTHOR]

The objective of the current paper is to evaluate Lebanon's wind energy generation potential as an alternative solution to the electricity supply to households and to enhance sustainable technological development. Firstly, the paper aims to investigate the appropriateness of 44 distribution function models for the evaluation of wind speed characteristics and compared them with popular models at 12 locations in Lebanon for the first time. The results showed that Wakeby and Beta distribution functions gave the best fit to the actual data for most locations. Secondly, the techno-economic and environmental feasibility assessment for 10MW grid-connected wind farms was developed based on variations in financial parameters using RETScreen Experts software. The findings demonstrate that the proposed power plant is both technically and financially feasible. It was found that Ain ed Dabaa is the most viable location for the installation of a wind farm. [ABSTRACT FROM AUTHOR]

Background: There is little information on the epidemiology of enteric pathogens in Lebanon, a low- and middle-income country that suffers from a myriad of public health challenges. To address this knowledge gap, we aimed to assess the prevalence of enteric pathogens, identify risk factors and seasonal variations, and describe associations between pathogens among diarrheic patients in the Lebanese community. Methodology and principal findings: A multicenter cross-sectional community-based study was conducted in the north of Lebanon. Stool samples were collected from 360 outpatients suffering from acute diarrhea. Based on fecal examination using the BioFire® FilmArray® Gastrointestinal Panel assay, the overall prevalence of enteric infections was 86.1%. Enteroaggregative Escherichia coli (EAEC) was the most frequently identified (41.7%), followed by enteropathogenic E. coli (EPEC) (40.8%) and rotavirus A (27.5%). Notably, two cases of Vibrio cholerae were identified, while Cryptosporidium spp. (6.9%) was the most common parasitic agent. Overall, 27.7% (86/310) of the cases were single infections, and the majority, 73.3% (224/310), were mixed infections. Multivariable logistic regression models showed that enterotoxigenic E. coli (ETEC) and rotavirus A infections were significantly more likely to occur in the fall and winter compared to the summer. Rotavirus A infections significantly decreased with age but increased in patients living in rural areas or suffering from vomiting. We identified strong associations in the co-occurrence of EAEC, EPEC, and ETEC infections and a higher percentage of rotavirus A and norovirus GI/GII infections among EAEC-positive cases. Conclusions: Several of the enteric pathogens reported in this study are not routinely tested in Lebanese clinical laboratories. However, anecdotal evidence suggests that diarrheal diseases are on the rise due to widespread pollution and the deterioration of the economy. Therefore, this study is of paramount importance to identify circulating etiologic agents and prioritize dwindling resources to control them and limit outbreaks in the future. [ABSTRACT FROM AUTHOR]

Dairy foods are a staple in Lebanon, a low- and middle-income country that has been experiencing serious challenges to food safety and antimicrobial stewardship among other issues. The microbiological acceptability of dairy products has been of increasing concern. This is partially due to the failing economy and prolonged power outages that affect the quality of raw material and disrupt the dairy cold chain, respectively. Therefore, we assessed the microbiological acceptability of Akkawi, a popular white-brined cheese in Lebanon. For this purpose, we quantified the densities of Escherichia coli (a fecal indicator) and Staphylococcus aureus in cheeses collected from Lebanese retail stores. Additionally, we evaluated the antibiotic resistance profiles of the E. coli isolated from the cheese. E. coli and S. aureus were detected in 40 (80%) and 16 (32%) of the 50 cheese samples, respectively. Notably, 40 (80%) and 16 (32%) of the samples exceeded the maximum permissible limit of E. coli and S. aureus, respectively. A high percentage of the 118 E. coli isolated from the cheeses showed resistance to clinically and agriculturally important antibiotics, while 89 (75%) isolates were classified as multidrug-resistant (MDR). Given that Akkawi can be consumed without cooking, our findings highlight serious food safety and antimicrobial resistance problems that require immediate interventions. [ABSTRACT FROM AUTHOR]

Purpose: Good pharmacy practice is an important standard that highlight the quality of services in community pharmacies. In 2018, The Order of Pharmacists in Lebanon (OPL) published their own good pharmacy practices (GPP) guidelines. The need exists for investigational studies to assess GPP implementation status and the professional conduct of on-site staff towards these standards. Methods: Data collection was carried out between February and August 2020 using a questionnaire covering: Socio-demographic variables; Indicator A (Attitude of the Community Pharmacists); Indicator B (Services and Facilities); Indicator C (Dispensing); Indicator D (Storage). Data analysis were performed on SPSS version 25, T-Test and ANOVA were used. A significant p value of < 0.001, 95% confidence interval and variables with missing data counting less than 10% were considered. Results: A total of 211 staffers from pharmacies were enrolled in the study, each representing one community pharmacy. The mean percent of adherence to GPP standards by community pharmacies in the South of Lebanon was below the recommended threshold of 75%. Only 65.09% adhered to all tested indicators (27% to Indicator A, 56.91% to Indicator B, 68.61% to Indicator C, 66.31% to Indicator D). Higher indicators were seen among providers who were aware of OPL standards (OR = 4.021), female (OR= 2.011) and being a licensed pharmacist (OR=3.506). Cronbach alpha of the overall score was 0.615. Conclusion: Further steps shall be taken to improve the compliance to GPP standards. Steps shall include, identification of the core standards, such as dispensing, provision of adequate information, monitoring of storage conditions, and ensuring the presence of a licensed pharmacist. It is highly recommended that the OPL and the Ministry of Public Health develop a "Self-assessment tool" and an efficient training program to increase community Pharmacists' awareness status. Regular assessment shall be carried to monitor the progress overtime. [ABSTRACT FROM AUTHOR]

Renewable energy in terms of solar and wind energy can be an essential part of Lebanon's strategies to add new capacity, increase energy security, address environmental concerns, and resolve the electricity crisis. In this regard, there is an urgent need to develop road maps in order to reduce the effect of global warming and enhance sustainable technological development for generating clean power in the country. Therefore, the present paper evaluates Lebanon's wind energy generation potential as an alternative solution to supply electricity to households in various locations distributed over Lebanon. In the present study, the measured data are used to evaluate the wind energy potential in Lebanon and to find suitable locations to install wind farms in the country. Accordingly, the results demonstrated that Ain ed Dabaa is the most suitable location for the installation of a wind farm. Moreover, the study aims to develop a wind energy cost analysis techno-economic model for eight conventional wind turbines and a Barber wind turbine, which was found to be very competitive. Consequently, this study showed that the implementation of a wind turbine could provide clean, economical, and continuous production of electricity in countries that suffer from daily blackouts. [ABSTRACT FROM AUTHOR]

Objective: To assess public opinion about community pharmacy services in Lebanon during the COVID-19 pandemic. Method: A cross-sectional study using an online questionnaire was conducted between April and August of 2021. A link was shared randomly among the Lebanese population using WhatsApp and Facebook. Public perceptions were explored within 3 different indicators: general services (B) dispensing (C), and storage (D). Chi-square, Student's test and ANOVA tests were used. p < 0.05 was considered statistically significant. Results: Out of 491 responses, only 9.6% scored above the 75th percentile (19.3% for the general services, 2.4% for dispensing indicator and 12.6% for storage indicator). The main concerns focused on lack of medication and reduced opening hours; however, 67.1% of respondents preferred consulting the community pharmacist instead of visiting primary health care centers, doctor's private clinic and hospitals. Higher mean values of indicators B, C and in the overall indicator were significantly found in the presence of a pharmacist compared to the support pharmacy workforce. Conclusion: The overall public perception was inadequate. Significant difference in terms of quality of services was detected in the presence and absence of a community pharmacist during the crisis. It is recommended that the Order of Pharmacist of Lebanon (OPL) and the Ministry of Public Health (MOPH) undergo further steps mainly to enforce the laws concerning dispensing and storage indicators, improve the services in terms of extending the opening hours, ensure the availability of medicines and increase public awareness. [ABSTRACT FROM AUTHOR]

Objectives: The objective of our study was to evaluate the association between the transition to menopause, body dissatisfaction, and abnormal eating habits (restrained eating, binge eating, and orthorexia nervosa) in a sample of middle-aged Lebanese women.Methods: A cross-sectional study conducted between July 2019 and January 2020 enrolled 1001 women aged 40 years and above from all Lebanese governorates. Data were collected by face-to-face interviews with all participants. The Body dissatisfaction subscale of the Eating Disorder Inventory‑second version was used to assess body dissatisfaction, whereas the Binge Eating Scale, Dutch Restrained Eating Scale, ORTO-15, Dusseldorf Orthorexia Scale (DOS), and Teruel Orthorexia Scale (TOS) were used to assess eating disorders (binge eating, restrained eating and orthorexia nervosa respectively. Multivariable analysis of covariance (MANCOVA) was used to compare multiple measures among the three menopausal phases, after adjustment over potential confounding variables (age, monthly income, body mass index, marital status, education level, and body dissatisfaction).Results: Postmenopause was significantly associated with more orthorexia nervosa tendencies (lower ORTO-15 scores) than premenopause (β = - 1.87; p = 0.022). Perimenopause was associated with more binge eating (β = 1.56; p = 0.031), and less orthorexia nervosa (as measured by the DOS) than premenopause, with this association tending to significance (β  = - 1.10; p = 0.051). Furthermore, higher body dissatisfaction was significantly associated with higher restrained eating (β = 0.02; p < 0.001), binge eating (β = 0.48; p < 0.001), and orthorexia nervosa as measured by ORTO-15 (β = - 0.17; p < 0.001) and TOS (β = 0.08; p = 0.002), but not DOS.Conclusion: Our study showed that menopausal stages are associated with some disordered eating behaviors (binge eating and orthorexia nervosa) among middle-aged women. Those results may serve as a first step towards spreading awareness among women within this age group regarding eating attitudes. Moreover, healthcare professionals should screen for the presence of disordered eating during those women's routine visits to the clinics. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is a common cause of healthcare-associated infections and chronic airway diseases in non-clinical settings. P. aeruginosa is intrinsically resistant to a variety of antimicrobials and has the ability to acquire resistance to others, causing increasingly recalcitrant infections and elevating public health concerns. We reviewed the literature on multidrug-resistant (MDR) P. aeruginosa isolated from humans (nosocomial and community-associated), animals, and the environment in Lebanon, a country that has been suffering from a surge in antimicrobial resistance (AMR). We identified 24 studies that described the epidemiology and antimicrobial susceptibility profiles of P. aeruginosa. Our analysis showed that the bacterium was predominant in lesions of patients on mechanical ventilation and in burn patients and those with diabetic foot infections and hematological malignancies. We also found that carbapenem resistance in P. aeruginosa isolates in Lebanon involved both enzymatic and non-enzymatic mechanisms but depended predominantly on VIM-2 production (40.7%). Additionally, MDR P. aeruginosa was detected in animals, where a recent study reported the emergence of carbapenemase-producing P. aeruginosa in livestock in Lebanon. Notably, no studies evaluated the contribution of MDR P. aeruginosa in the environment to human infections. Taken together, our findings highlight the need for AMR surveillance programs and a national action plan to combat resistance in Lebanon. [ABSTRACT FROM AUTHOR]

This article sets out to test an all too frequently undisputed assumption: contested politics and policy process theories or frameworks from the West, particularly the Advocacy Coalition Framework (ACF), the Multiple Streams Framework (MSF) and the Social Construction in Policy Design Framework (SCPDF), can be plausibly 'transported' to the Arab world, without misleading biases. It describes and reflects upon practices of civil society associations (CSAs) to influence post-Uprisings public policymaking in three Arab states: Lebanon, Egypt, and Tunisia. The policy issues dealt with are domestic violence against women, and wage policy in Lebanon; dealing with NGOs in Egypt; and transparency of the state in Tunisia. This assumption, of course, is far from self-evident. Concepts like 'advocacy coalition', 'problem stream', or 'policy entrepreneur' describe role patterns in contested politics and policymaking practices in the context of consolidated Western liberal democracies; a context hardly applicable to post-Uprisings Arab states. Rather, we argue that public policymaking in post-Uprisings Arab states could be understood through a 'regimes-triad approach'; i.e., a mutually dependent set of three strategic action fields—a domestic issue logic, and the logics of a national political regime, and a transnational or international geopolitical or geo-economic regime —around any policy issue. The regimes-triad context intends to correct the biases in western-canon theories of the policy process when applied to Arab states. [ABSTRACT FROM AUTHOR]

Purpose: To assess if living with a psychiatric patient, depression, anxiety, stress, fatigue, insomnia, spirituality, and religiosity would be associated with more problematic alcohol use, cigarette, and waterpipe dependence in Lebanese caregivers. Methods: A case–control study was performed in Lebanon that recruited 587 caregivers (July–September 2019). Results: Higher religiosity was associated with lower problematic alcohol use. Having low versus no income was significantly associated with more cigarette dependence. Being Christian and high anxiety were significantly associated with more waterpipe dependence, whereas higher insomnia was significantly associated with lower waterpipe dependence. Practical Implications: Family caregivers go through a lot of stress and burden and need help coping with it in a healthy way for better outcomes for them and the care recipient. [ABSTRACT FROM AUTHOR]

Background: Dental fear is a prevalent problem that can lead to poor dental health. The Kleinknecht's Dental Fear Survey (DFS) is one of the used scales to assess dental fear. The present study aims to evaluate the psychometric properties of the Lebanese Arabic version of the DFS (DFS-A) and to determine the optimal cut-off to identify dental fear as well as the correlates of dental fear in a group of Lebanese adults dental patients. Methods: A cross-sectional study was conducted among a group of 442 dental patients (18–65 years) recruited at 29 dental clinics from March to June 2019. Patients completed a questionnaire including questions about demographic characteristics, previous bad dental experience, trauma's experience period, the sensation of nausea during dental treatment, the DFS-A scale, the Lebanese Arabic version of the Modified Dental Anxiety Scale (MDAS-A), and a general question about dental fear. Results: DFS-A revealed evidence of adequate psychometric properties. DFS-A scale demonstrated high internal consistency (cronbach's alpha = 0.93). Test–retest reliability assessment demonstrated strong reproducibility of the DFS-A scale score (ICC = 0.92 with 95% CI (0.83–0.96), p value < 0.0001 (N = 30). Confirmatory factor analysis revealed a three-factor structure of the DFS-A reflecting fear associated with specific dental stimuli and procedures, patterns of dental avoidance and anticipatory anxiety, and physiologic arousal during dental treatment. A significant correlation was found between DFS-A and the MDAS-A indicating a good convergent validity. The optimal cut-off point to identify patients with and without dental fear is 41. Considering this cut-off score, the prevalence of dental fear in our sample was reported at 33.8%. Multivariable analysis showed that having previous scary and painful dental experiences, a sensation of nausea during treatment, and having dental anxiety were identified as predictors of dental fear. Conclusion: The adapted Arabic version of the DFS (DFS-A) is a valid tool to evaluate dental fear among Lebanese adult patients. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence of suicidality among the psychiatric inpatients community in Lebanon, and to elucidate the effect of religiosity and spirituality on suicidal thoughts or behaviours. A total sample of 159 patient consecutively admitted to a psychiatric hospital was interviewed. The Ask Suicide-screening Questionnaire (ASQ) was used to assess suicidal risk; the Mature Religiosity Scale (MRS) and the Spirituality Index for Well Being (SIWB) scales were used to assess religiosity and spirituality. We found that 45.6% of the participants screened positively on the ASQ, including 37.5% with acute suicidal ideation. A backward logistic regression, taking the negative/positive screening ASQ as the dependent variable, showed that a positive family history of suicide and depression were significantly associated with higher positive suicidal screening, whereas higher spirituality was significantly associated with lower positive suicidal screening. When forcing the mature religiosity scale as an independent variable, the results remained the same. Spiritual well-being might be considered an important factor to explore among psychiatric patients. Psychiatric inpatients have a high risk for suicide; the challenge remains for clinicians to identify upon admission patients that are most likely to die from suicide. A positive family history of suicide and depression was significantly associated with higher suicidality. Higher spirituality, but not religiosity, was significantly associated with lower suicidality. Spiritual well-being might be considered an important factor to explore among psychiatric patients. The challenge remains for clinicians to identify patients that are most likely to die from suicide upon admission. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) has affected millions of lives globally. However, the disease has presented more extreme challenges for developing countries that are experiencing economic crises. Studies on COVID-19 symptoms and gut health are scarce and have not fully analyzed possible associations between gut health and disease pathophysiology. Therefore, this study aimed to demonstrate a potential association between gut health and COVID-19 severity in the Lebanese community, which has been experiencing a severe economic crisis. Methods: This cross-sectional study investigated SARS-CoV-2 PCR-positive Lebanese patients. Participants were interviewed and gut health, COVID-19 symptoms, and different metrics were analyzed using simple and multiple logistic regression models. Results: Analysis of the data showed that 25% of participants were asymptomatic, while an equal proportion experienced severe symptoms, including dyspnea (22.7%), oxygen need (7.5%), and hospitalization (3.1%). The mean age of the participants was 38.3 ±0.8 years, and the majority were males (63.9%), married (68.2%), and currently employed (66.7%). A negative correlation was found between gut health score and COVID-19 symptoms (Kendall's tau-b = -0.153, P = 0.004); indicating that low gut health was associated with more severe COVID-19 cases. Additionally, participants who reported unhealthy food intake were more likely to experience severe symptoms (Kendall's tau-b = 0.118, P = 0.049). When all items were taken into consideration, multiple ordinal logistic regression models showed a significant association between COVID-19 symptoms and each of the following variables: working status, flu-like illness episodes, and gut health score. COVID-19 severe symptoms were more common among patients having poor gut health scores (OR:1.31, 95%CI:1.07–1.61; P = 0.008), experiencing more than one episode of flu-like illness per year (OR:2.85, 95%CI:1.58–5.15; P = 0.001), and owning a job (OR:2.00, 95%CI:1.1–3.65; P = 0.023). Conclusions: To our knowledge, this is the first study that showed the impact of gut health and exposure to respiratory viruses on COVID-19 severity in Lebanon. These findings can facilitate combating the pandemic in Lebanon. [ABSTRACT FROM AUTHOR]

Informed by the theorization of the modernity/(de)coloniality studies collective, this paper thinks alongside hijabi women in Lebanon – a small Arab Mediterranean country – and their lived experiences in "mainstream Lebanese society". Drawing on six-months of qualitative fieldwork through in-depth interviews and focus groups with photo-elicitation, the paper documents and analyses lived experiences of discrimination, exclusion and erasure. Identifying dehumanization, civility and progress, and a present potent wider rejection of Islam in Lebanon, it argues for a framing of participant's shared experiences as anti-Muslim racism under modernity/coloniality and highlights the need to de-exceptionalize the region and the analytical tools mobilized to understand it. [ABSTRACT FROM AUTHOR]

Purpose: To assess the influence of lifestyle factors, antipsychotic medications, and psychosis symptoms on obesity in a group of male patients with schizophrenia in Lebanon. Design/Methods: A cross‐sectional study conducted between May and July 2018 enrolling 149 male patients with chronic schizophrenia. Results: We found that 59.1% of the patients were obese/overweight. Older age and higher negative and total positive and negative syndrome scale scores were significantly associated with lower body mass index values. Practice Implications: This study shed light on some factors associated with obesity in male patients with schizophrenia, which may be targeted for the prevention and management of obesity. Some interventions were proposed such as focusing on patients' physical health, psychiatric treatment, and maintaining a healthy diet and a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Lebanon suffers from daily electricity shortages. The country has paid much attention to renewable energy sources, particularly solar, to gradually replace conventional energy. Installing a photovoltaic (PV) system becomes increasingly attractive for residential consumers due to the rising electricity tariff rates while it reduces the dependency on domestic power generators. No known study has dealt with the investigation of potential grid-connected rooftop PV systems with various suntracking modes and PV technologies in Nahr El-Bared, Lebanon. Consequently, the main objective of the current paper is to investigate the feasibility of a 5kW grid-connected PV system of various technologies (mono-crystalline silicon and polycrystalline silicon) and sun-tracking modes including fixed tilt and 2-axis systems for rooftop households in Lebanon. The Nahr El-Bared camp was the case study was of the paper. RETScreen Expert software was used to evaluate the techno-economic performance of the proposed systems. The results show that the annual electrical energy from a fixed 5kW PV panel tilted at an optimal angle ranged from 8564.47kWh to 8776.81kWh, while the annual electrical energy from the PV tracking system was within the range of 11511.67-12100.92kWh. This amount of energy output would contribute significantly to reduce the energy shortage in the country. A typical household was selected to establish a load profile and load supply during both grid availability and outage periods. The highest energy consumption that can be covered by the PV systems was recorded during the spring and summer seasons. Also, the average energy production cost ranged from 0.0239 to 0.0243$/kWh for all the proposed systems. It was concluded that a 5kW grid-connected rooftop PV system could be economically justifiable. Finally, this study tried to increase the awareness about utilizing PV sun-tracking systems and the feasibility of small-scale grid-connected rooftop PV systems in the selected regions. The results of this research can help investors in the energy and building sectors. [ABSTRACT FROM AUTHOR]

Background: Dental anxiety continues to be a widespread problem affecting adult populations. The primary aim of our study was to evaluate the psychometric properties of the Lebanese Arabic version of the Modified Dental Anxiety Scale (MDAS-A) and to identify the optimal cut-off for assessing dental anxiety and dental phobia among adults in Lebanon. In addition, we sought to assess dental anxiety and phobia as well as their correlates among Lebanese adult patients. Methods: A cross-sectional study was carried out on a sample of 451 dental adult patients aged between 18 and 65 years old. Information about demographic characteristics, previous bad dental experience, trauma's experience period, perception of a periodontal problem, sensation of nausea during dental treatment, the MDAS-A scale, and the Visual Analogue Scale for anxiety (VAS-A) were collected. Results: MDAS-A exhibited evidence of adequate psychometric properties. The optimal cut-off was 12 for dental anxiety and 14 for dental phobia. Out of the total sample, 31.5% suffered from dental anxiety while 22.4% had a dental phobia. Multivariable analysis showed that the odds of dental anxiety and phobia were higher among females compared to males. Also, patients suffering from periodontal problem perceptions, bad dental experiences during childhood and adolescence, and the sensation of nausea during dental treatment were at a higher risk of developing dental anxiety and phobia compared to their counterparts. However, a higher level of education was found to be a protective factor against dental phobia among Lebanese adult patients. Conclusion: The MDAS-A scale is a suitable tool for the routine assessment of dental anxiety and phobia among Lebanese adult patients. Identifying patients with dental anxiety at the earliest opportunity is of utmost importance for delivering successful dental care. [ABSTRACT FROM AUTHOR]

Recently the first genome sequences for 11 SARS-CoV-2 isolates from Lebanon became available. Here, we report the detection of variants within the genome of these strains. Pairwise alignment analysis using blastx was performed between these sequences and the UniProtKB data for the SARS-CoV-2 coronavirus to identify amino acid variations. Variants analysis was performed using multiple Bioinformatics tools. We noticed for the first time 18 mutations that have never been reported before. Among those, a frame shift (8651A>) in NSP4, a stop codon 6887A > T in NSP3 and two missense mutations in spike S2 were found. In addition, we found 28 variants in ORF1ab alone. A previously reported variant, 23403A > G, in the spike protein S2 was mostly seen. Two other known mutations 25563G > T in ORF3a and 14408C > T in ORF1ab were detected respectively in 6 and 8 out of the 11 isolates. Our results may help to prognose forthcoming infections in this region. [ABSTRACT FROM AUTHOR]

Background: At Makassed Hospital's open-bay intensive care unit (ICU), enhanced terminal disinfection (ETD) using hydrogen peroxide (H2O2) was performed without a predefined schedule in extensively-drug-resistant Acinetobacter baumannii (XDR-AB) outbreaks. In this study, we aimed to check for the value of the temporary closure of the ICU and the use of ETD with aerosolized H2O2 and Ag+ on minimizing the rate of XDR-AB acquisition in patients admitted to the ICU of our facility, which might consequently help us determine the optimal schedule for such procedure in this unit. Methods: This is a retrospective medical file review of patients admitted to the ICU between January 2016 and May 2018. We divided this period into numerical weeks (NW) after each closure and ETD episode. Risk factors of acquisition (RFA) were determined by comparing the characteristics of patients who acquired XDR-AB to those who didn't. The proportion of patients residing in each NW was included in the RFA analysis. Results: Out of 335 patients, 13% acquired XDR-AB. The overall incidence of XDR-AB acquisition was 14.6 cases/1000 patient days. RFA were XDR-AB contact pressure ≥ 3 days [Odds Ratio (OR) = 9.86, 95% Confidence Interval (CI) (3.65–26.64), P < 0.0001)], mechanical ventilation [OR = 4.99, 95%CI (1.76–14.15), P = 0.002)], and having a wound [OR = 3.72, 95%CI (0.99–13.96), P = 0.05)]. Patients who stayed during NW 7,11 and 14 were at risk of acquisition where the odds significantly increased by 6.5, 9.7 and 14.4 folds respectively (P = 0.03,0.01, and 0.01, respectively). We considered NW 7 as the most suitable time for temporary closure of the ICU and ETD with aerosolized H2O2. Conclusion: Contact pressure, mechanical ventilation, and presence of a wound were RFA of XDR-AB. Temporary closure of the ICU with ETD using aerosolized H2O2 decreased the rate of XDR-AB acquisition, yet this effect fades away with time. The ETD was shown to be most efficiently done when repeated every 7 calendar weeks in our open-bay ICU as part of a prevention bundle. [ABSTRACT FROM AUTHOR]

Rainfall and air temperature are major parameters of climate affecting changes in the environment. Rainfall is considered as the vital source of water around the world. In this paper, a detailed review has been conducted to highlight the main water resources in Lebanon. Furthermore, a statistical analysis of climate parameters including air temperature and rainfall amount in the Lebanese capital (Beirut) with different terrain conditions has been conducted. The climate data were collected from the meteorological service for a period of 25 years (1991–2015). The data were recorded over various periods to explore different climatic environments. The results showed that the mean air temperature and rainfall are within the ranges of 14.65°C to 17.98°C and 22.63 to 73.1 mm, respectively, during the investigation period. In addition, four distribution functions have been used to analyze the precipitation characteristics at the studied stations. Based on the results, it was observed that the Gumbel Maximum and Logistic distributions were able to provide the best fit to the actual data for the locations studied. [ABSTRACT FROM AUTHOR]

The use of Information Technology in organizations and in a business context has notably been associated with the manner in which transactions are carried out through recording, processing, and reporting of information. This often happens to organizations that have automated information systems to perform the aforesaid activities. In this regard, the study, therefore, aims to investigate the impact of the rapid growth of the Information technology to internal auditing activities and examine if there are changes that are identified in information technology evaluations that are undertaken in Lebanese Organizations. In carrying out this research, a quantitative methodology approach was deployed where a surveying technique was used to facilitate the study by use of a selfadministered questionnaire that aided in achieving these objectives. Five hundred copies of the questionnaire were randomly distributed to Lebanese organizations located across Beirut specifically to accountants and auditors. The survey results were analyzed using SPSS software to show the impact of information technology in auditing activities and the changes that have been experienced in Information technology and their implications on the accounting sector. The survey findings have been used to conclude if the internal auditors need to enhance their knowledge and skills of computerized information system (CIS) which can help improve planning, directing, supervising and reviewing the work performed. Factors that affect Auditors performance on the Information Technology evaluations were identified and their impacts assessed. The research conclusively highlighted the impact of the study on managers and auditors. [ABSTRACT FROM AUTHOR]

A hawza is the establishment responsible for the training of Shia Islam's imams, preachers, professors, and researchers. For hundreds of years, its educational model has involved the teaching of Fikh, Usul, philosophy, Quranic studies and Arabic language. Over the past few decades, the social sciences--the systematic study of man and society which had emerged in the West--have been slowly making their way into these institutions, alongside a number of other changes. This article investigates, qualitatively, the religious training of Shia men of religion in Lebanon in order to explore the changes taking place within this institution. Based on a triangulation of participant observation, interviews with professors, students, and stakeholders, as well as content analysis of certain course material, it claims a hawza in metamorphosis. While structural and material alterations have straightforwardly made their way into the institution, content and curricular ones have faced more difficulty. These changes reveal plenty about both Islamic education and Shia Islam in Lebanon's public sphere. Additionally, the article raises questions and insights regarding decolonial theory, Lebanon's future, and the geopolitics of the Arab world. [ABSTRACT FROM AUTHOR]

Keywords: Syria; public health emergency; migrants; sanitation; diarrhoea EN Syria public health emergency migrants sanitation diarrhoea 1 2 2 01/05/23 20221201 NES 221201 Lebanon has been facing public health and economic challenges, including COVID-19 (1.22 million cases and 10 702 deaths to date in a population of ~6.8 million), severe shortages in medical supplies, pollution and a precipitous devaluation of its currency.[[1], [3]] Lebanon is bordered to the north and east by Syria, a country that has been experiencing a devastating civil war, resulting in mass suffering and displacement since 2011. Refugee settlements, sewage pollution, COVID-19 and the unfolding cholera outbreak in Lebanon It is not an exaggeration to note that, without international support, COVID-19 would have exerted a higher toll on the Syrian refugees and the hosting community in Lebanon.[4],[5] Similarly, Lebanon has limited capabilities to manage sewage, including hospital effluent, and municipal water due to deficiencies in wastewater treatment plants and sustainable safe-water distribution infrastructures, which are likely facilitating the spread of cholera across the country. [Extracted from the article]

Background. A new Lebanese scale measuring medication adherence considered socioeconomic and cultural factors not taken into account by the eight-item Morisky Medication Adherence Scale (MMAS-8). Objectives were to validate the new adherence scale and its prediction of hypertension control, compared to MMAS-8, and to assess adherence rates and factors. Methodology. A cross-sectional study, including 405 patients, was performed in outpatient cardiology clinics of three hospitals in Beirut. Blood pressure was measured, a questionnaire filled, and sodium intake estimated by a urine test. Logistic regression defined predictors of hypertension control and adherence. Results. 54.9% had controlled hypertension. 82.4% were adherent by the new scale, which showed good internal consistency, adequate questions (KMO coefficient = 0.743), and four factors. It predicted hypertension control (OR = 1.217; p value = 0.003), unlike MMAS-8, but the scores were correlated (ICC average measure = 0.651; p value < 0.001). Stress and smoking predicted nonadherence. Conclusion. This study elaborated a validated, practical, and useful tool measuring adherence to medications in Lebanese hypertensive patients. [ABSTRACT FROM AUTHOR]

The transmission mechanisms of monetary policy through commercial banks captured great attention by academics and central bankers. Despite the huge volume of research, there is no absolute agreement about the impact of the change in the monetary policy on commercial banks. With reference to the bank lending channel theory, this study aims at detecting the long- and short-run impacts of four monetary policy tools exploited by the central bank of Lebanon to guide banks who are lending to the private sector. The study covered the period January 1992-December 2016 using monthly data. The aggregate credit granted to the resident private sector was used as the dependent variable, while bank capital, money supply, interest rate, and the inflows of non-resident deposits serve as independent variables. The Vector Error Correction Model (VECM) was adopted in this study as it does not require the variables to be originally stationary. This model is able to reveal the potential long-run causal relationship between exploited time series. Moreover, the Wald test was performed as a complementary test to examine the existence of short-run effects on bank credit. The Vector Error Correction Model revealed a long-run impact running from money supply, while the other three variables did not transmit changes in monetary policy towards bank credit. Besides, the Wald test has shown a short-term impact running from non-resident deposits towards bank lending. Additionally, the Granger causality test demonstrated that non-resident deposits have a causal effect on bank credit, thus it helps in predicting the future trend of bank lending. In contrast, both bank capital and interest rate didn't have any significant effect on bank lending behavior in Lebanon on both short- and long-run. The obtained results have important policy implications which suggest that if monetary policy aims at expanding (contracting) bank lending through monetary easing (tightening), it should increase (decrease) money supply to achieve a long-run impact. However, it has to encourage (discourage) the inflow of non-resident deposits to achieve a short-run impact. Additionally, the results suggest that in Lebanon, changes in bank capital and interest rate will not cause shifts in the supply of loans. [ABSTRACT FROM AUTHOR]

This comparative cross-sectional study examines the association between traffic congestion and elevation of systolic and/or diastolic blood pressure levels among a convenience sample of 310 drivers. Data collection took place during a gas station pause at a fixed time of day. Higher average systolic (142 vs 123 mm Hg) and diastolic (87 vs 78 mm Hg) blood pressures were detected among drivers exposed to traffic congestion compared with those who were not exposed (P<.001), while controlling for body mass index, age, sex, pack-year smoking, driving hours per week, and occupational driving. Moreover, among persons exposed to traffic congestion, longer exposure time was associated with higher systolic and diastolic blood pressures. Further studies are needed to better understand the mechanisms of the significant association between elevated blood pressure and traffic congestion. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction is one of the vital attributes to consider when evaluating the impact of accreditation systems. This study aimed to explore the impact of the national accreditation system in Lebanon on patient satisfaction. Methods: An explanatory cross-sectional study of six hospitals in Lebanon. Patient satisfaction was measured using the SERVQUAL tool assessing five dimensions of quality (reliability, assurance, tangibility, empathy, and responsiveness). Independent variables included hospital accreditation scores, size, location (rural/urban), and patient demographics. Results: The majority of patients (76.34%) were unsatisfied with the quality of services. There was no statistically significant association between accreditation classification and patient satisfaction. However, the tangibility dimension - reflecting hospital structural aspects such as physical facility and equipment was found to be associated with patient satisfaction. Conclusion: This study brings to light the importance of embracing more adequate patient satisfaction measures in the Lebanese hospital accreditation standards. Furthermore, the findings reinforce the importance of weighing the patient perspective in the development and implementation of accreditation systems. As accreditation is not the only driver of patient satisfaction, hospitals are encouraged to adopt complementary means of promoting patient satisfaction. [ABSTRACT FROM AUTHOR]

Particle size distribution at major on-road, roadside, and university-ground sites in Lebanon were studied in summer 2011. In a predominant old traffic fleet, it is shown that calculated PM2.5 mass emission factors (EFs) conform to those of heavy duty vehicles. When compared to roads in California, higher PM2.5 mass but similar particle number EFs are obtained for the average fleet of the on-road sites. This confirms the observed particle size distribution pattern, rich in particles in the accumulation range mainly between 0.425 and 0.675 µm with a prevalent peak at 0.475 µm. Corresponding total particle counts (TC) measured on the roadside are as high as 14,050 particles/cm3and are up to 67% higher than particle counts measured at the university-ground site. In a hot, dry and humid summer weather with consistent temperature oscillations, particle dispersion is shown to be a function of meteorological factors, mainly the effect of the boundary-layer thickness, with particle counts measured during the morning being around 40% higher than particle counts measured during the afternoon. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to investigate the work-life balance in a developing country context, through an empirical study of work - life balance in the commercial banking industry in Lebanon. The survey was comprised of 224 questionnaires out of which 133 were usable questionnaires that were returned and analyzed. Factor analysis was carried out as a data reduction technique. . Principal axis factoring was used as an extraction method and oblique rotation was used as a rotation method. Six factors were extracted using Eigenvalue greater than one criterion. Results of the structural system showed that second variable "Tension" has a substantial , negative, direct effect on work- life balance (P32 = -0.302). This direct effect is a general indication of the importance of tension as a predictor of work-life balance after taking into account all other independent variables contained in the model. "Quality of life" has positive, direct effects. The effect of quality of life is a little bit greater than the effect of Job Tension as determinant of work - life balance. This suggests that although quality of life is positively related to work life balance, the strength of the relationship lies through the intervening variable (Job tension). [ABSTRACT FROM AUTHOR]

Gender inequality is a pervasive global phenomenon, particularly in the political sphere. Previous scholarship sought explanations for the low female representation in countries' development levels, political regimes and/or electoral systems. Some scholars searched for answers within societies' religious and cultural value systems or political culture. These arguments, singularly or combined, can explain the pattern and predict broadly female representation across countries of different income levels and political systems. However, they overlook observed variations in middle income countries and cannot explain the presence of overachievers and underachievers. They also fail to explain variations within societies of the same religious family, or across political parties within the same country. Previous explanations do not fully account for observed variations in women's political participation, which begs for additional explanation, one that examines the primary institutional vehicles for individual advancement in the political world - political parties - and highlights the factors that determine parties' support for women's leadership and nomination to public office. My work on women in politics departs from prior scholarship in that it explains variations in women's leadership and nomination to public office by looking at party-level variation in religiosity across countries and political parties. Parties are the main vehicles for recruiting, selecting, and promoting women. They are gatekeepers for nominating them to public office. However, different parties offer women different opportunities. For instance, most of the five Nordic countries have social democratic parties with high shares of female legislators, indicating the important role they play in advancing women and nominating them to public office. Thus, not only do parties offer a plausible explanation for variations in female representation, but also in providing an answer to why are some parties superior to others in advancing women's political career. Party variation in religiosity is the missing link in this body of research. I have argued elsewhere that as party religiosity increases, women's leadership falls within parties' internal decision-making bodies. Party religiosity, as distinct from individual religiosity, is the extent to which religious goals penetrate political platforms. The qualitative and quantitative findings of in-depth research conducted in Lebanon, as a focused single country case-study, are robust and support the theory of party variation in religiosity and women's leadership. Further, in a separate and additional cross-national quantitative study using multiple cases, the theory is found to travel, hence allowing for generalizations and predictions. It is tested on 330 parties across 26 countries in the three continents of Asia, Africa and Europe: 13 Arab countries, seven non-Arab Muslim-majority countries, and five European countries with Christian democratic parties plus Israel, the only Jewish state in the world.' This permitted studying the influence of three world religions (Islam, Christianity and Judaism) on women's political leadership. In this article, I take the extra mile and extend the theory of party variation in religiosity from women's leadership within parties' inner structures to the logical 'outcome' of nominating women for public office. I move the research beyond the institutional party-level to the national and local levels of analyses and explore religiosity as the main explanatory variable for female party nominations to parliaments and municipalities. Other party-level characteristics of import to women's nominations include democratic practices and pluralism in membership. The main research question posed in this paper is whether municipalities - compared to parliaments - constitute a breakthrough for women in politics. Lebanon serves as a useful a case-study with its multiparty system. A single country case-study makes it possible to investigate variations in female nominations within a controlled socio-political environment, while holding constant the potential influence of the political regime and electoral system. Nonetheless, the findings of field research in Lebanon support the focus on party religiosity as an explanatory variable for female nominations. It also reveals quite different dynamics governing female nominations for municipal as opposed to parliamentary elections. These findings point to a potential breakthrough for women seeking a career in politics. This article is organized in three sections with an introduction, and concluding remarks. The introductory part covers the theoretical background motivating the main research question and lays out the variables and hypotheses to be tested. Section A examines patterns of female candidacy for parliaments. Section B focuses on women in municipalities in comparative perspective to parliaments. In Section C, 1 estimate a regression model for female nominations to parliaments and another one for municipalities. The findings support the theory of party variation in religiosity to explain variations in female nominations for municipalities. However, it is not borne out for parliaments. The concluding remarks highlight the main findings and provide supporting evidence that municipalities may very well constitute a breakthrough for women, if they choose a career in politics. Thus, responding positively to the main research question that this article poses: "Women in municipalities: Can women break through?" [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to determine the prevalence of anti-HCV among injecting drug users (IDUs) in Lebanon, to establish the current prevalence of HCV genotypes in this population and to determine whether demographic characteristics and behavioral variables differ between participants who were HCV-RNA positive and those who were HCV-RNA negative or between the different genotypes. Participants were recruited using respondentdriven sampling method. The blood samples were collected as dried blood spots and then eluted to be tested for HCV, HBV and HIV by ELISA. Anti-HCV positive samples were subjected to RNA extraction followed by qualitative detection and genotyping. Results: Among 106 IDUs, 56 (52.8%) were anti-HCV-positive. The two groups did not differ in terms of age, marital status, and nationality. As for the behavioral variable, there was a trend of increased risky behaviors among the HCVRNA positive group as compared to the HCV-RNA negative group but none of the variables reached statistical significance. Half (50%) of the 56 anti-HCV-positive were HCV-RNA positive. Genotype 3 was the predominant one (57.1%) followed by genotype 1 (21%) and genotype 4 (18%). Conclusions: The predominance of genotype 3 seems to be the predominant genotype among IDUs in Lebanon, a situation similar to that among IDUs in Western Europe. This study provides a base-line against possible future radical epidemiological variant that might occur in IDUs. [ABSTRACT FROM AUTHOR]

In this compilation of two interviews (one previously unpublished), Hashim Qasim speaks with Lebanon's ayatollah Muḥammad Ḥusayn Faḍlallah - an internationally recognized Muslim scholar, independent thinker, sometimes 'iconoclast' faqīh, mufassir and marjaﺀ al-taqlīd whose influence has transcended borders and spanned decades and generations. Faḍlallah's prolific writing has included not only works on Islamic jurisprudence, politics, thought and tradition, but also a complete exegesis of the Qurﺩan as well as diwans of Islamic poetry. Peer, associate, friend and student of some of the greatest minds and most influential figures of the Shīﺀite world including Khomeini, Abu-l-Qasim al-Khoei, Muaḥammad Baqir al-Ṣadr, and Musa al-Ṣadr, Faḍlallah has mentored and influenced countless Muslims and important personages, including senior members of Ḥizb Allah, for over half a century. In this interview Faḍlallah discusses major issues and touches upon many important recurrent themes of his overall discourse from issues faced by Muslims - including the hijab, Zionism and Islamic fundamentalism, to globalization, to world justice. [ABSTRACT FROM AUTHOR]