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This study assesses the relationship between the frequency of repeating courses and students' performance in college. The study uses cohort data from academic years 2000/2001, 2001/2002, 2002/2003 and 2003/2004. We compared those who had repeated one, two and three courses on GPA and whether a relation exists of those who graduated/did not graduate. The analysis was extended to address the difference of those who repeated once, twice and three times; one, two and three courses respectively. The most common type of repeaters were those students who repeated one course once. These students were more prone to graduate at higher rates and perform better than those who repeated one course twice. In addition, students who failed and repeated courses generally performed better than students who failed but did not repeat the courses. The results from this study indicate that the university should do away with excessive repetitions.

The purpose of this study was to determine whether an early call-up strategy helps in attracting better students to a private university in Lebanon. Early admission call-up was administered to the top 25 percentile-ranked students of main feeder schools at a private university in Lebanon. Admission data was accrued for students who applied for admission from 2000 to 2006. The early admission call-up was made in the spring of 2006 and compared to the top 25 percentile-ranked students of previous years that were not treated with the early-admission call-up. They were also compared to those below the 25 percentile score cohort group. The results showed that students who were treated with the call-up enrolled at higher rates than those at the top 25 percentile rank in previous years. It was also shown that those at the top 25 percentile score had a higher high school averages as compared to the previous years. Early admission call-up provides a strategic marketing "perk" to enrolling above average students at a private university in Lebanon.

An early admission call-up was used to attract high-achieving students to a private university in Lebanon. The call-up, which is essentially an offer of admission before the student takes any formal steps, was administered to the top 25th percentile ranked students of main feeder schools at a private university in Lebanon. Data were accrued for students who applied for admission from 2000 to 2006. The early admission call-up was made in spring of 2006, the analysis compared the top 25th percentiles academically ranked students of previous years not given the early admission call-up. In addition, the analysis compared those below the 25th percentile score subgroup. Results showed that students who were given an early admission call-up enrolled at higher rates than those at the top 25th percentile rank in previous years. It was shown that those at the top 25th percentile score had higher high school averages as compared to candidates from previous academic years. (Contains 4 tables and 2 figures.)

INTRODUCTION Since the beginning of the COVID-19 pandemic, a growing number of studies have documented more severe COVID-19 symptoms and worse outcomes among smokers compared to non-smokers. The aim of this research is to understand the views, risk perceptions, and behaviors of Lebanese adult smokers during the pandemic. METHODS We conducted 18 qualitative online structured interviews with adults who smoke cigarettes and waterpipe tobacco residing in Lebanon from November 2020 through April 2021. Participants were recruited predominantly via paid social media ads. Interviews were audio-recorded using Zoom software then transcribed verbatim. Data were analyzed thematically. RESULTS The findings showed three main themes: changes to smoking behaviors, concerns over the susceptibility and severity of COVID-19, and using coping methods to protect smokers from COVID-19. Although there was an increased risk perception of COVID-19 in relation to smoking, most participants reported an increase in smoking. Instead of being encouraged to quit, participants developed coping strategies against COVID-19 while smoking. CONCLUSIONS Smoking behavior did not seem to decrease during the COVID-19 pandemic. To support cessation initiatives and raise awareness, effective health messaging aimed at smokers is pivotal. Smoking cessation programs need to be better equipped at supporting people who smoke in finding healthier coping mechanisms during a pandemic. Moreover, policies to regulate the propagation of misinformation are required to prevent the development of a false sense of safety and protection from COVID-19. [ABSTRACT FROM AUTHOR]

Background: We analyzed the prevalence of active infection with common curable sexually transmitted infections (STIs) including N. gonorrhea, C. trachomatis, T. vaginalis, and T. pallidum, as well as active infection with HPV, herpes simplex virus types I (HSV-1) and II (HSV-2), M. hominis, M. genitalium, C. albicans, and Ureaplasma in 351 Lebanese women. Methods: A cross-sectional study, involving 351 sexually active women, 40 years or younger, who were recruited from outpatient Obstetrics and Gynecology clinic attendees between September 2016 and November 2017. Results: The prevalence of active infection was low at 0.3% for N. gonorrhea, 0.6% for HSV-2, 2.8% for C. trachomatis, and 2.9% for any curable STIs. Prevalence of active HPV infection was high assessed at 15.7% for high-risk and 12.2% for low-risk genotypes. Furthermore, the prevalence was 2.0% for M. genitalium, 6.8% for ureaplasma, 13.7% for Candida albicans, and 20.5% for M. hominis. No active infections with T. vaginalis, T. pallidum, or HSV-1 were observed. Significant age differences were noted in the prevalence of high-risk and low-risk HPV genotypes, but no such differences were noted in the prevalence of other infections. No appreciable variations were identified in the prevalence of key STIs based on smoking, marital status, or the number of sexual partners. Conclusions: The study documented active infection with substantial prevalence for multiple STIs among women attending outpatient gynecology and obstetrics clinics in Lebanon. These findings underscore the importance of strengthening STI surveillance, linkage to care, and prevention interventions in reducing STI incidence among women. [ABSTRACT FROM AUTHOR]

Collective narcissism is a belief in ingroup greatness which is contingent on external validation. A lack of research on collective narcissism amongst non‐Western contexts and minority groups remains a challenge for the field. However, here we test two types of collective narcissism (sectarian and national) as differential predictors of two dimensions of collective violence beliefs (against outgroup members and leaders) in a large, diverse, community sample from Lebanon (N = 778). We found that sectarian narcissism (narcissism related to smaller political and religious ingroup identity) predicted support for collective violence against members of different sects, while national narcissism predicted opposition to such collective violence. Neither form of collective narcissism had any significant relationship with collective violence against outgroup leaders. We controlled for both sectarian and national identification and found no significant effects in predicting either one of the two dimensions of collective violence beliefs. In this non‐Western context, in which a coherent national identity is undermined by sectarianism, national narcissism seems to be a progressive motivator for unity and social change, while sectarian narcissism is rather associated with extreme attitudes, such as support for collective violence. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the correlation between unconventional risk factors and the Systematic Coronary Risk Estimation (SCORE), and estimate the prevalence of conventional and unconventional cardiovascular (CV) risk factors in the rural Lebanese population in order to assess their CV risk.Methods: This is a retrospective descriptive study conducted between November 2017 and June 2019 among the Lebanese rural population. The risk factors were analyzed from the files of the patients who presented for the CV disease screening days organized by a non governmental organization. The CV risk estimation tool is the SCORE. The classification of socio-economic level ranges from zero (low level) to 3 (high level).Results: A total of 433 patients were included. The prevalence of hypertension, diabetes, dyslipidemia, smoking, and metabolic syndrome was 45.1%, 31.2%, 39.2%, 50% and 42.9% respectively. Only 13.6% of hypertensive patients and 6.7% of diabetics were controlled. A total of 0 or 1 point for the classification of socio-economic status was found in 62.6% of cases. A family history of CV diseases was present in 87.3% of participants. The SCORE was correlated with diabetes and metabolic syndrome (p = 0.000), without being correlated to socio-economic status (HR = − 0.104; p = 0.059) or to family history (p = 0.834).Conclusion: The socio-economic status and the family history of CV disease must be evaluated in addition to the classical risk calculation of the SCORE to better pinpoint the actual risk of the targeted population. The risk factors are prevalent but poorly controlled, hence the need for a national effort to ensure better care for the rural Lebanese population. [ABSTRACT FROM AUTHOR]

Paediatric complex wounds pose a challenge to the reconstructive surgeon due to the intricacy of reconstructive options required. Developments in microsurgery and microsurgical technique have brought free tissue transfer ever closer to the comfort zone of the reconstructive surgeon for reconstruction of paediatric traumatic complex wounds. We present our experience of microsurgical reconstruction in Lebanon for complex traumatic wounds in paediatric patients under the age of 10 years using the free anterolateral thigh (ALT) flap. The ALT flap has proven its value as a safe, adaptable, and aesthetically acceptable reconstructive option in paediatric complex trauma. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to survey students on their satisfaction with university services and programs in a coeducational Lebanese Catholic higher education institution. The study attempts to relate self-assessed knowledge of the university procedures, rules and regulations on six dimensions of satisfaction, being: academic experience, academic advisor, residential life, campus life, personal development opportunities, resources and student services. Design/methodology/approach: A cluster random selection procedure was used to select n = 870 students from within the university. Students rated 31 knowledge items and 33 satisfaction items. The study analyses student satisfaction in relation to their knowledge of procedures, rules and regulations. An Analysis of Variance (ANOVA) was run to determine differences between university class level, and knowledge level on satisfaction. In addition, a regression analysis was run to determine whether university class (freshmen, sophomore, junior, and senior level) and knowledge level (low, middle and high knowledge levels) were predictors of the satisfaction dimensions. Findings: Generally, those who assessed their knowledge (of the services) as higher were more inclined to be satisfied. In addition, seniors in general were less satisfied with programs and services than freshmen students. Self-rated knowledge and university level (freshmen, sophomores, juniors and seniors) significantly predicted satisfaction with both variables being highly associated (i.e. predicting) with satisfaction in academic advising. Originality/value: Self-enhancement theory suggests that those individuals with greater self-worth have greater affective need to feel satisfied. Increased self-worth is manifested in active roles of decision making and judgments about events that the individual experiences (Wells and Sweeney, 1986). Thus, self-worth is highly correlated with knowledge about an aspect. This study shows that knowledge is an important predictor to satisfaction--i.e. the higher the knowledge the more satisfied students are likely to be. (Contains 2 figures and 4 tables.)

Purpose - The study examines the level of satisfaction amongst Lebanese university graduates on their training/education in light of their current occupational level. Design/methodology/approach - Focus groups were interviewed to understand factors that helped graduates in their occupation. These factors were turned into a Likert-scale questionnaire in which a large sample (n=604) of university graduates from public and private universities in Lebanon were asked to report the utility of their university education and training required for their current job. Findings - Findings showed that graduates from private universities documented greater satisfaction in their education and training, especially in the fields of engineering, medicine, and information science, than did graduates from the public sector of higher education. Graduates in the low occupational status category perceived university education as important in the performance of their occupation. Research limitations/implications - The study was intended to find if graduates were satisfied with their university education. Satisfaction in that sense is used as a proxy for quality. The need to refine the concept of quality in higher education is recommended in any future study to provide a possible measure of value to higher educational training. Practical implications - Importantly, public higher education in Lebanon need to compete aggressively with private institutions to provide key "soft skills" needed at the work place. Originality/value - The paper offers some empirical data in an under-researched field.

To describe the effect of economic collapse on prenatal care. This is an observational study aiming to depict the changes that occur in prenatal care in the case of an economic collapse. Biochemical screening and ultrasound examinations, as well as medical emigration and private-public sector activity, are discussed. Starting October 2019, Lebanon experienced significant and unprecedented economic degradation leading to 81% degradation of the local currency, 85% inflation, and socio-economic suffering, and the situation is currently still deteriorating. The impact on the medical infrastructure has been global and hit all areas. The crisis is multifaceted, varied in the way it played out across public and private sectors, and did not affect them equally. Some were better prepared than others to cope with severe fiscal pressure mainly through the support of non-governmental organizations. All aspects of prenatal care are affected by the crisis. Given the multiple strains on the Lebanese health care system today, the plight of antenatal care providers needs assistance to ensure adequate follow-up of pregnancies. [ABSTRACT FROM AUTHOR]

Purpose: This study assesses HPV prevalence and genotype distribution in Lebanon, and identifies differentials in HPV infection, infection with multiple genotypes, and with high-risk genotypes, by sex, age, and year of data collection. Methods: Study participants comprised 1042 female and 160 male participants between 2006 and 2018. HPV genotyping was done by PCR and hybridization (2006–2013) or real-time PCR (2013 onwards). Diversity of HPV genotypes across gender, age groups, and years of data collection was tested by applying Shannon Diversity Index. Results: The overall HPV prevalence was 44.8% among study participants, and threefold higher in women than men. Single HPV infection was seen in two-third of HPV-positive participants. Women were less likely to be infected with multiple HPV strains, but more likely to be infected with high-risk or mixed-risk HPV genotypes. HPV-16 (11.0%, 9.8%) and HPV-53 (8.5%, 4.9%) were the most prevalent high-risk HPV genotypes in women and men, respectively, while HPV-18 prevalence was 4.9% in men and 3.1% in women, while HPV-59 prevalence was 6.6% in men and 2.1% in women. Samples collected post-2011 from women showed twice higher odds of HPV infection than those collected earlier and were threefold more likely to be infected with multiple HPV strains, and twice more likely to be infected with high-risk genotypes compared to those tested earlier. Women scored higher on Shannon index indicating high diversity in HPV types and frequency, with trend of increased diversity over time. While the odds of HPV infection remained associated with sex and temporal trend in multivariable analysis, odds of having high-risk genotypes was mainly associated with infection with multiple HPV strains. Conclusion: Our study showed high diversity in HPV genotypes and an increasing trend of infection with multiple and high-risk genotypes in recent years. Findings underscore the need for effective screening/surveillance and HPV vaccination programs. [ABSTRACT FROM AUTHOR]

Examines the policies regarding history curriculum of the seven major confessional schools in Lebanon. Using textual analysis of history books, reviews of policies, and interviews with students, educational decision makers, and history teachers, the paper argues that confessional schools have propagated their own line of discourse for history teaching without accommodating a pluralistic discourse of integration. (SM)

Background: This study examined the origin of present-day Lebanese using high-resolution HLA class I and class II allele and haplotype distributions. The study subjects comprised 152 unrelated individuals, and their HLA class I and class II alleles and two-locus and five-locus haplotypes were compared with those of neighboring and distant communities using genetic distances, neighbor-joining dendrograms, correspondence, and haplotype analyses. HLA class I (A, B, C) and class II (DRB1, DQB1) were genotyped at a high-resolution level by PCR-SSP. Results: In total, 76 alleles across the five HLA loci were detected: A*03:01 (17.1%), A*24:02 (16.5%), B*35:01 (25.7%), C*04:01 (25.3%), and C*07:01 (20.7%) were the most frequent class I alleles, while DRB1*11:01 (34.2%) and DQB1*03:01 (43.8%) were the most frequent class II alleles. All pairs of HLA loci were in significant linkage disequilibrium. The most frequent two-locus haplotypes recorded were DRB1*11:01 ~ DQB1*03:01 (30.9%), B*35:01-C*04:01 (20.7%), B*35:01 ~ DRB1*11:01 (13.8%), and A*24:02 ~ B*35:01 (10.3%). Lebanese appear to be closely related to East Mediterranean communities such as Levantines (Palestinians, Syrians, and Jordanians), Turks, Macedonians, and Albanians. However, Lebanese appear to be distinct from North African, Iberian, and Sub-Saharan communities. Conclusions: Collectively, this indicates a limited genetic contribution of Arabic-speaking populations (from North Africa or the Arabian Peninsula) and Sub-Saharan communities to the present-day Lebanese gene pool. This confirms the notion that Lebanese population are of mixed East Mediterranean and Asian origin, with a marked European component. [ABSTRACT FROM AUTHOR]

Background: Refugees are forced migrants but there is a large variation in the distance that refugees cover and there is a paucity in the evidence of how this may affect refugees' health and health care needs. Objective: We investigated the association between long-distance migration and post-traumatic stress disorder (PTSD), a serious psychiatric disorder associated with deteriorating mental and somatic health. Methods: Included from 2016–2019 were adult Syrian refugees in Lebanon and Denmark that arrived up to 12 months prior to inclusion. PTSD was assessed using the Harvard Trauma Questionnaire and the estimate of association was obtained by multiply imputing missing data and adjusting for confounding by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience and general mental well-being, reporting the bootstrap 95-percentile confidence interval (95% CI). Additionally, a number of sensitivity analyses were performed. Results: Included were 599 participants in Lebanon (mean age 35 years old, 73% being female) and 133 participants in Denmark (mean age 30 years old, 47% being female). After multiply imputing missing data and propensity score-weighted adjustment for confounding, migration to Denmark instead of Lebanon was associated with an increase in PTSD prevalence of 9 percentage point (95% CI [-1; 19] percentage point). Conclusions: Long-distance migration may be associated with an increase in PTSD prevalence in refugees. The migration could be an important factor to consider when assessing refugees' and asylum seekers' health. Practitioners should consider "long-distance migration" in refugee health screenings and in particular when assessing the risk of post-traumatic stress disorder. Future research should be designed to ultimately lead to studies of relevant interventions to lower the risk of post-traumatic stress disorder in refugees. [ABSTRACT FROM AUTHOR]

Data are lacking on the psychiatric and psycho-social profiles of Middle-Eastern people living with HIV (PLHIV). Our study aimed to establish the prevalence and correlates of mental illness in a sample of Lebanese PLHIV, and to delineate their socio-cultural reality. PLHIV, either attending a private ID clinic or a non-governmental organization, were interviewed. A total of 94 patients were included. Sixty-nine (73.4%) were found to have at least one psychiatric disorder. Only nine participants were currently receiving psychotropic medications. The most common diagnosis was major depression, occurring in half of the subjects. Homosexual or bisexual orientation predicted the presence of a current depression (p = 0.024), and ART status was negatively associated with current depression (p = 0.028). The rate of psychiatric disorders is clearly higher than that of the general population. PLHIV with a homosexual or bisexual orientation face a double stigma, perhaps making them more vulnerable to depression. Our findings need to be replicated in larger studies with more representative samples. [ABSTRACT FROM AUTHOR]

INTRODUCTION Despite the exceptionally high prevalence of tobacco use in Lebanon, few cessation programs exist. The American University of Beirut (AUB) developed one of the first smoking-cessation programs in the country in 2015, and the program became free-of-charge to patients in 2018. The program offers initial visit(s) with a primary care provider, in-person and/or telephone counseling, acupuncture, and medications. METHODS We assessed patient characteristics, treatments used, and patient outcomes in the first year of implementing the free smoking-cessation program, compared to the original program. We compared 87 smokers who initiated treatment in the free program with 47 patients in the original program. RESULTS At baseline, smokers in the free program were younger, smoked fewer cigarettes per day, and had lower CO levels than smokers in the original program. At 1 month follow-up, 72.9% were abstinent in the free program, compared with 42.2% in the original program (p<0.001). Smokers who had ≥2 primary care visits and those who had ≥1 acupuncture visits had higher rates of abstinence at 1 month and those who were prescribed bupropion had higher rates of abstinence at 12 months. CONCLUSIONS Implementation of the free smoking cessation program demonstrates preliminary efficacy, with telephone support offering potential for scalability. [ABSTRACT FROM AUTHOR]

Background: To investigate the age-dependent changes in circulating anti-Müllerian hormone (AMH) levels in healthy Arabic-speaking Lebanese women, and to correlate changes in serum AMH levels with serum FSH and LH values, and LH/FSH ratio.Methods: Cross-sectional study, involving 1190 healthy females, age 17-54 years, with regular menses and both ovaries. Serum AMH levels (ng/ml) were measured by ELISA.Results: There was an inverse proportion of AMH and subject's age, which declined from median 6.71 (2.91) ng/ml in young subjects, to 0.68 (0.45) ng/ml in subjects older than 50 years. Average yearly decrease in median AMH levels was 0.27 ng/ml/year through age 35, but then diminished to 0.12 ng/ml/year afterwards. Receiver operating characteristic curve analysis demonstrated high sensitivity and specificity of age as determinant of AMH levels. In contrast to AMH, FSH levels increased progressively from 5.89 (0.11-62.10) ng/ml in young subjects, to 38.43 (3.99-88.30) ng/ml in subjects older than 50 years. On the other hand, age-dependent changes in LH/FSH ratio paralleled those of AMH. Linear regression modeling testing the independent effect of AMH on FSH and LH, adjusted for age, showed that AMH was significant predictor of FSH and LH/FSH ratio, but not LH. This did not contribute significantly to baseline LH and FSH prediction.Conclusions: Circulating AMH levels are inversely related to age as also shown elsewhere, and are predictors of LH/FSH ratio and FSH but not LH levels in eumenorrheic females. [ABSTRACT FROM AUTHOR]

Background: With the increase in the proportion of elderly Lebanese patients, little is known about delirium's prevalence, incidence and correlated factors. Aims: To identify the prevalence, incidence and factors associated with overall and incident delirium in hospitalized elderly Lebanese patients. Methods: A convenient sample was recruited from three university hospitals affiliated to the Lebanese university faculty of medical sciences. We included patients aged more than 65 years. Baseline factors were examined upon presentation and the confusion assessment method (CAM) was used to detect prevalent delirium upon admission or within the first 48 h. Enrolled patients were then assessed every other day to detect incident delirium cases. Results: Among the 230 patients included, delirium prevalence was 17% and incidence 8.7%. We found that a history of falls (odds ratio (OR) = 5.12; p = 0.001), immobilization (OR = 7.33; p = 0.035), polypharmacy (OR = 5.07; p = 0.026) along with tachycardia (OR = 6.94; p = 0.03) and severe anemia (OR = 12.5; p = 0.005) upon admission were significant factors associated with overall delirium (incident and prevalent delirium cases). Whereas, living alone was significantly associated with lower odds for overall delirium (OR = 0.03; p = 0.02). Moreover, current smoking (OR = 14; p = 0.02), low oxygen saturation (OR = 9.6; p = 0.008) and severe anemia (OR = 8.4; p = 0.013) upon admission remained significantly associated with higher odds for incident delirium along with urine catheter placement (OR = 7.8; p = 0.015). Conclusion: Secondary to the burden of delirium and its impact on mortality among elderly population, trying to understand and adjust modifiable factors would promote more appropriate prevention strategies. [ABSTRACT FROM AUTHOR]

Introduction: Roux-Y-gastric bypass (RYGB) is highly effective in treating obesity related type II diabetes mellitus (DM). There are a few studies from the Middle East and North Africa (MENA) on the impact of RYGB on DM. Objective: The aim of our study was to evaluate the impact of RYGB on DM in our patient population. Methods: We retrospectively reviewed our database and selected obese patients with type II DM who underwent primary laparoscopic RYGB from 2005 to 2015. Complete remission (CR) of DM was defined as HbA1c < 5.7%, FBG < 100 mg/dL without medications. Partial remission (PR) was defined as HbA1c 5.7–6.4%, FBG 100–125 mg/dL without medications. Improvement was defined by a significant reduction in HbA1c (> 1%) or FBG (> 25 mg/dL) or reduction in HbA1c and FBG accompanied by discontinuing insulin. Results: Out of 245 RYGB patients, 107 had DM. In comparison, diabetic patients were older and had more hypertension and dyslipidemia. At 5 years with a follow-up (F/U) of 56%, total weight loss in diabetics (24.7%) was lower than non-diabetics (27.7%). At a mean F/U of 5.6 ± 2.7 years, range (1.4 to 10.7), there was a significant reduction in HbA1C (7.9 to 6.1%), FBG (158 to 111 mg/dL), intake of oral hypoglycemic (73.6 to 29.7%), as well as insulin therapy (15.4 to 2.2%). The rate of DM CR was 42.3%, PR 20.5%, improvement 23.1%, and no change 14.1%. Conclusion: This is the first report from the MENA region on the long-term outcomes of RYGB in the treatment of type II DM. The results are similar to those in the international literature. [ABSTRACT FROM AUTHOR]

Childhood adversities (CAs) are well reviewed in mental health and addiction research internationally. However, these variables have not been studied within the framework of addiction in the Middle East region. The present study reports the prevalence of Childhood Adversities in a sample of outpatients seeking treatment for Substance Use Disorder. We used the Adverse Childhood Experiences - International Questionnaire (ACE-IQ) to map out the prevalence of childhood adversities. The studied population was composed of a clinical outpatient sample that met criteria for substance use disorder (N = 144). Results indicated that almost all the sample reported having experienced at least 1 CA, whereby three quarters of the clinical sample reported experiencing 6 or more adversities. Childhood adversities are highly prevalent in a Lebanese substance use disorder population which raises the need for better screening strategies and more understanding of Adverse Childhood Experiences in this specific population. [ABSTRACT FROM AUTHOR]

Background: Breast cancer bears considerable morbidity and mortality and is well known to increase the risk of major depression, whereas religiosity has been reported to be protective. We searched for an association between depression and religiosity in breast cancer patients. We also sought to find an association between depression and various sociodemographic and disease variables.Methods: One hundred two patients were interviewed. Sociodemographic, cancer profile, and religiosity questionnaires were administered. We screened for depressive disorders by using the Mini-International Neuropsychiatric Interview and the Beck Depression Inventory.Results: Most of our participants (n = 79; 77.4%) had high religiosity score. The prevalences of lifetime major depression, current major depression, and major depression after cancer diagnosis were 50.9%, 30.1%, and 43.1%, respectively. We could not find a correlation between religiosity and current depression, while the association with depression after cancer diagnosis was close to but did not reach statistical significance (P = .055) and in favor of a deleterious role of religiosity. Depression was only linked to marital status and insurance coverage. No association was found with disease-related variables.Conclusions: Religiosity does not seem to be protective against depression development. The stress of cancer appears to be the main culprit in increasing the risk of depression. [ABSTRACT FROM AUTHOR]

Background: Opioid agonist therapy has been widely used to reduce harms among individuals with opioid use disorder but its effectiveness has not been evaluated in the Middle East North African (MENA) region. This study aims to evaluate the effectiveness of a program using opioid agonist therapy in combination with psychosocial support on improving psychological and social well-being, reducing arrest, and reducing risky behavior in individuals with opioid use disorder in Lebanon. Methods: A one-group pre-test post-test design study was performed at SKOUN Lebanese Addiction Centre between January 2013 and December 2014. Eighty-six out of 181 patients agreed to participate and completed the 3-month assessment and 38 concluded the 12-month assessment. Psychological (depression and anxiety, quality of life), substance dependence/abuse, behavioral (injecting behavior, sharing needles and paraphernalia), and social outcomes were evaluated at baseline, 3, and 12 months post-treatment. Results: Remarkable statistical significance improvements were observed 3 months after treatment in most outcome variables including quality of life, anxiety, substance dependence, overdose, employment, and injecting behavior. Improvements were sustained 12 months after treatment. Conclusion: Results support expanding the access to opioid agonist therapy in other MENA countries to treat substance dependence and reduce harms among individuals with opioid use disorder. [ABSTRACT FROM AUTHOR]

Background: High production levels and availability of heroin in Middle East and North African (MENA) countries have been leading to the continuous rise in injecting drug use. On the contrary, in most Western countries, the proportion of heroin injectors may be falling. Interestingly, in Lebanon heroin sniffing has been gaining popularity. We therefore aimed at exploring the characteristics of intranasal heroin use compared to intravenous heroin use in patients admitted to treatment at Skoun, Lebanese Addiction Center.Methods: Between January and September 2013, 186 heroin-dependent users participated in this study: 92 were heroin sniffers and 94 injectors. Data collection was carried out using structured questionnaires on different sociodemographic characteristics and psychological and social functioning.Results: Injectors were significantly younger and had lower levels of employment compared to heroin sniffers. Analysis of health-risk profiles revealed that although injectors were significantly at higher risk of overdose, Hepatitis C infection, and anxiety, sniffers were not risk-free. Other sociodemographic and health-risk profiles did not materialize between the two study groups.Conclusion: The study provides evidence that heroin sniffers share many common characteristics with heroin injectors and therefore do not represent a protected group of heroin users. [ABSTRACT FROM PUBLISHER]

Purpose The purpose of this study was to assess nutrient intakes in elderly living in Lebanese nursing homes (NHs).Design/methodology/approach This cross-sectional study was conducted in 36 long-term care institutions from all over Lebanon. Out of 2,094 residents, 98 (69 women and 29 men) elderly met the inclusion criteria and successfully completed the interview question. Dietary food intake was assessed using the 24-h food recall. The analysis used a Chi-square test and independent samples t-test or Mann–Whitney test, as appropriate.Findings A high percentage of elderly (reaching 100 per cent) had a low intake of energy, protein, linolenic acid, linoleic acid, fibers, vitamins and minerals, and the prevalence of nutrient inadequacy was significantly different between sexes for copper intake (p = 0.02). The results of this study highlight the nutrient inadequacies among the majority of elderly living in long-term care institutions and particularly in women and elderly residing in NHs located away from the capital Beirut.Originality/value This study is quite original; this is the first study performed nationwide in Lebanon covering not only the largest number of NHs in various locations but also elderly under custodial settings and with diverse backgrounds. [ABSTRACT FROM AUTHOR]

Background:The Faculty of Medicine at the American University of Beirut implemented a new medical curriculum, which included 90 team-based learning (TBL) sessions in years 1 and 2 of medical school. Methods:A validated team performance scale (TPS) and peer evaluation of communication skills, professionalism and personal development were collected at different time points during the two years. Grades on the individual and group readiness assurance tests and an evaluation form were collected after every TBL session. Results:Students generally positively evaluated most TBL sessions as promoters of critical thinking and appreciated the self-learning experience, though they preferred and had better individual grades on those that entailed preparation of didactic lectures. There was a sustained and cumulative improvement in teamwork skills over time. Similar improvement was noted with peer evaluations of communication skills, professionalism, and personal development over time. Conclusions:This is the first report about such a longitudinal follow-up of medical students who were exposed to a large number of TBL sessions over two years. The results support the suggestion that TBL improves medical students’ team dynamics and their perceived self-learning, problem solving and communication skills, as well as their professionalism and personal development. [ABSTRACT FROM PUBLISHER]

Introduction: Smoking prevalence rates in Lebanon are among the highest in the Eastern Mediterranean region. Few smoking cessation programs are offered in Lebanon and little is known about the preferences of Lebanese smokers for cessation treatment programs. Objective: To establish which attributes of smoking cessation programs are most important to Lebanese smokers. Methods: Smokers at the American University of Beirut were surveyed to elicit their preferences for, and tradeoffs between the attributes of a hypothetical university-based smoking cessation program. Preferences for medication type/mechanism, risk of benign side effects, availability of support, distance traveled to obtain medication, and price of complete treatment were assessed using the discrete choice experiment method. Results: The smokers' responses (N = 191) to changes in attributes were statistically significant. Smokers were willing to make trade-offs between attributes. On average, smokers were willing to pay LBP 103,000 (USD 69) for cessation support. Respondents were willing to give up LBP 105,000 (USD 70) to avoid an additional 10% risk of minor side effects and LBP 18,000 (USD 12) to avoid an addition kilometer of travel to the nearest pharmacy. Heavy smokers were the least responsive group and had the lowest demand elasticities. Conclusions: Student smokers were willing to participate in a relatively complex exercise that weighs the advantages and disadvantages of a hypothetical smoking cessation program. Overall they were less interested in the pill form of smoking cessation treatment, but they were willing to make tradeoffs to be smoke-free. [ABSTRACT FROM AUTHOR]

Background This study described the differences between elderly men and women living in Lebanese long-term care nursing homes on socio-economic, health and nutritional status. Methods This study used a cross-sectional design. Field researchers obtained data from 221 residents; 148 (67%) women and 73 (33%) men, living in 36 nursing homes. Data on health conditions; nutritional, psychological, and functional status; socio-demographic characteristics, as well as social relations were collected. The analysis used both chi-square and t-test tests. Results The majority of elderly had low socio-economic and poor health status. In comparison to men, women were significantly less educated, had lower occupational status, had no partner, relied financially on their children and relatives, and enjoyed better social relations and health behaviours. Furthermore, the prevalence of both; malnutrition, and at risk of malnutrition, were at 3.2% and 27.6% respectively. There was no statistically significant difference between women and men on Mini Nutritional Assessment, Activities of Daily Living, Geriatric Depression Scale, Body Mass Index, and chronic diseases. While women reported "good" health status compared to men, they continued to have higher prevalence of diseases and chronic pain. Conclusions This study explored the socio-demographic, health, and nutritional status of elderly residing in Lebanese nursing homes and compared these characteristics across gender. The results indicated the need of health support and institutional interventions for elderly women residents. [ABSTRACT FROM AUTHOR]

The current article aimed to determine the 12-month prevalence and correlates of DSM-IV alcohol abuse and dependence in a nationally representative sample of Lebanese adults. One thousand participants collaborated in face-to-face interviews in 2011. Prevalence of 12-month alcohol dependence was 5%, with a higher risk for those who were men, unmarried, the youngest adults (aged between 18 and 34 years old), students, participants with a liberal occupation, participants with a low income, participants with a positive family history of alcohol misuse, and smokers. Prevalence of 12-month alcohol abuse was 6.2%, with a higher risk for those who were men, students, employees, and Druze and Christians compared to Muslims. Current alcohol abuse and dependence were found to be very highly prevalent in Lebanon. [ABSTRACT FROM AUTHOR]

Background Lebanon has alarmingly high rates of tobacco use. The objective of this study is to examine the density of tobacco retail outlets and distance to schools as well as to survey retail pricing in a large district of Beirut, Lebanon. Findings We observed 100 tobacco retail outlets and collected data using iPad® technology. Store locations were recorded with Global Positioning System coordinates. The distances between all pairs of tobacco retail outlets and all schools were calculated. For 52% of tobacco outlets, the nearest distance to other tobacco retail outlets was < 50 meters and 17% were within a 100-meter radius of a school. We found a high proportion of tobacco retailers with close proximity to schools. The overall retailer density was 1.25 stores per 1,000 people. Conclusions These findings call for additional regulation including the establishment of strict density standards. [ABSTRACT FROM AUTHOR]

The purpose of this study was to formulate evidence-based recommendations on whether to deliver the team-based learning (TBL)–designed clinical pharmacology course at the American University of Beirut Faculty of Medicine (AUBFM) during the third year instead of the fourth and final year of the medical curriculum. Between June 2010 and May 2011, AUBFM offered the course to both classes simultaneously to compare their performance. The findings of this endeavor supported the introduction of the course during the third year, first because fourth-year students did not outperform third-year students despite having the advantage of an additional year of clinical experience, and second, third-year teams seemed more likely to develop into better functioning teams. The findings also suggested that simultaneous delivery of TBL sessions to both third- and fourth-year teams was less favorably recommended because of the varying learning pace of both student groups. [ABSTRACT FROM PUBLISHER]

Objective: Belief in a just world (BJW) modulates people's abilities to cope with anxiety, fear, and life transitions and thus depression and its debilitating effects. Little is known about how Belief in a just world modulates these coping abilities in elderly nursing home residents or their levels of depression either. Participants: A sample of 354 cognitively able elderly nursing home residents in Lebanon was selected for the study. Methods: This study, therefore, explored elderly belief in a just world (BJW-S) by gender and length of time in elderly homes in its relation to levels of depression as measured by the Geriatric Depression Rating Scale (GDS) and the Mini-Mental State Examination screening instrument for older adults. Results: The findings showed no main significant effects for gender or length-of-stay on level of depression. The chief significant difference found was for scores on the belief in a just world scale and levels of depression. Those who had high scores on belief in a just world scored low on depression, and vice-versa. Conclusions: Therefore, a strong belief in a just world seemed to act as a preventative or coping mechanism against depression from initial transition forward for elderly nursing home residents. [ABSTRACT FROM AUTHOR]

Background: A review of the literature clearly indicates the absence of one set of guideline in the treatment of recurrent vulvovaginal candidiasis. In Lebanon, as physicians are trained in European or American schools of medicine, locally or abroad, they may be approaching the issue of recurrent vulvovaginal candidiasis using various methods. Aims: A national survey was conducted among Lebanese gynecologists to assess therapeutic protocols most commonly adopted to treat recurrent vulvovaginal candidiasis. Background: A review of the literature clearly indicates the absence of one set of guideline in the treatment of recurrent vulvovaginal candidiasis. In Lebanon, as physicians are trained in European or American schools of medicine, locally or abroad, they may be approaching the issue of recurrent vulvovaginal candidiasis using various methods. Aims: A national survey was conducted among Lebanese gynecologists to assess therapeutic protocols most commonly adopted to treat recurrent vulvovaginal candidiasis. Results: The study confirms that different approaches are used to treat recurrent vulvovaginal candidiasis. Most gynecologists (70%) recommended fluconazole 150 mg as first-line treatment. Fluconazole alone was significantly preferred by North American trained physicians, whereas European trained ones preferred to prescribe it in combination. However different dosage regimens were used with duration of treatment ranging from 2 to 4 weeks, with or without maintenance. Conclusions: The study revealed large diversity in prescription pattern, closely related to the specialization background of the physician. There is a need to generate evidence to establish national guidelines. [ABSTRACT FROM AUTHOR]

Several theorists have contended that belief in a just world may be one way elderly rest home residents cope with anxiety, fear, and depression and thus maintain their well-being. In this study we explored belief in a just world and length of time elderly have been residing in rest homes in Lebanon in relation to their levels of self-rated quality of life. A sample of 354 cognitively able elderly people were selected from 36 nursing homes. Interview questionnaires including a translated and validated Self-beliefs in a Just World Scale (BJW-S; Lipkus, Dalbert, & Siegler, 1996) and the EuroQol Visual Analogue Scale (EQ-VAS; Brooks, 1996) that measures respondents' quality of life on a 20cm visual analogue scale. The relationship between Arabic BJW-S scores and length of stay measured on the EQ-VAS was examined using analysis of variance. The findings showed significant main effects for belief in a just world on levels of EQ-VAS, but no significant effects of length of time in rest home on levels of EQ-VAS. Residents who had strong beliefs in a just world seem to have better abilities to cope with negative life events and better self-rated feelings of well-being than did residents who did not believe the world was just and who rated their own well-being lower. [ABSTRACT FROM AUTHOR]

Many private universities around the world sustain their growth and retain students through a system of 'cost-sharing' where fees and tuition are channelled back to students in form of financial aid. Not all students are successful in obtaining financial aid solely based on need, but are also awarded aid based on their academic performance. This study questions whether a combination of financial aid types has a positive impact on graduating from a private university in Lebanon. Furthermore, this study assesses students' satisfaction with the university at large by comparing those who received a combination of financial aid with those who applied and were not granted financial aid. Findings illustrate that the frequency and amount of financial aid received by students produced greater graduation percentages. In addition, no difference appeared between graduates and those who did not complete degree requirement regarding their satisfaction with university services and programmes. [ABSTRACT FROM AUTHOR]

Information Communication Technology (ICT) devices as servers, personal computers (PCs), hubs and other artifacts that make-up these technologies have important role in the educational development in public and private schools. This paper measures the level of ICTs in Lebanese public and private schools for the academic year 2005/2006 and evaluates the effectiveness of ICT on student school performance. The number of PCs, servers, printers, hubs, UPSs, scanners, LCDs, modem/fax, and email access, were measured and ICT indicator values were calculated. No significant differences were found between private and public schools on the aggregate level of ICT or computers per school or per student. The study also evaluated the effectiveness of ICT using the aggregate measure of ICT artifacts and PCs and its effects on student secondary school performance. A two-by-two factorial design using type of school (private/public), level of ICT (high/low) and PCs (high/low) was run on the baccalaureate-passing rate. Mainly, a significant difference between public and private schools was found, but no differences between the two ICT levels (high/low) or PC levels (high/low) per student. ICT levels in private schools did not impact student performance specifically, passing the baccalaureate exams. Although ICT levels were higher in private schools, the differences were not significant at the 0.05 level. [ABSTRACT FROM AUTHOR]

This study investigates whether remedial courses in a private university in Lebanon affect the enrollment decisions of pre-admission students. This study also investigates the effectiveness of the remedial English courses on subsequent English and academic performance. Findings revealed that a large number of remedial placements discouraged students from enrolling in the university. It was also found that remedial courses were not effective in providing better performance on general academic subjects. This study is significant because remedial programmes at universities in Lebanon and the Middle East have been rarely assessed in terms of goals and general academic objectives. With the open admission policies in the majority of private universities in Lebanon, the quality of discussion on the effect of remediation at universities in Lebanon and the Middle East is almost non-existent. This paper provides a benchmark for a forum of discussion and further study to the effectiveness of general and remedial programmes in the Middle East. [ABSTRACT FROM AUTHOR]

The article examines the approaches of Jordanian, Egyptian and Lebanese Law on intellectual property rights to temporary reproduction of literary and artistic property. According to the author, reproduction of work in any means temporary or permanent includes photographic, cinematographic reproduction, electronic or digital recording. The differences between storage and memory devices are discussed, as well as the legality of temporary reproduction.

Differences between two types of organisational cultures -- American and American-based universities were studied in Lebanon. American and American-based universities are American in both academic and administrative structures. American universities operate in Lebanon; however they are subject to the laws of the State of New York, particularly in terms of the management of the institution, American-based universities are local entities subject to rules and regulations delegated through the Near East church authorities. In both types of organisations, academics share exactly the same values, beliefs' and assumptions. American higher education organisations exhibit greater cohesive administrative and academic cultures than the American based institutes (Nauffal, 2005). The study highlights the differences between the two institutional types in relation to student perceptions of quality and satisfaction with their overall educational experience, such as teaching and learning experiences, and quality, of services and facilities. [ABSTRACT FROM AUTHOR]

The article presents a study that examines the possible impact of religiosity on Lebanese Christian and Muslim college students' attitudes towards gender roles. Factor analysis indicated two preconceptualized dimensions. On the other hand, multivariate analysis of variance showed that highly religious Muslims had a lower tendency for equality between men and women while less religious Christian females showed the highest ratings on the equality religiosity levels registered the highest score on the ability dimension.

Learning style preferences and selection of university major data were obtained from a sample of 199 Lebanese high school graduates. These measures and gender were used to assess the relation between the selection of major and learning style preferences. The main assumption was that students who believe they have competencies or ability in a certain area would make choices to pursue activities in these areas in order to develop further these competencies (Holland, 1973). The perceptual and biological development of students' auditory, visual tactual and kinesthetic senses appeared to be a key factor in their way of acquiring information. Thus, fitting learning preferences to the specific content knowledge required is with little doubt a very important issue that needs to be addressed by research. This study found that learning style preferences were not homogeneous and were not homogenously distributed across majors. Overall students indicated a preference for the visual and active learning styles. Females, however, were higher than males on both reflective and verbal styles. Chi-square analyses indicated that each of the six general major areas had distinct learning style attribute profiles that distinguished them from the others. Learning style profiles, therefore, may contribute positively to student selection processes for different majors. [ABSTRACT FROM AUTHOR]

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Purpose - The study examines the level of satisfaction amongst Lebanese university graduates on their training/education in light of their current occupational level. Design/methodology/approach - Focus groups were interviewed to understand factors that helped graduates in their occupation. These factors were turned into a Likert-scale questionnaire in which a large sample (n=604) of university graduates from public and private universities in Lebanon were asked to report the utility of their university education and training required for their current job. Findings - Findings showed that graduates from private universities documented greater satisfaction in their education and training, especially in the fields of engineering, medicine, and information science, than did graduates from the public sector of higher education. Graduates in the low occupational status category perceived university education as important in the performance of their occupation. Research limitations/implications - The study was intended to find if graduates' were satisfied with their university education. Satisfaction in that sense is used as a proxy for quality. The need to refine the concept of quality in higher education is recommended in any future study to provide a possible measure of value to higher educational training. Practical implications - Importantly, public higher education in Lebanon need to compete aggressively with private institutions to provide key "soft skills" needed at the work place. Originality/value - The paper offers some empirical data in an under-researched field. [ABSTRACT FROM AUTHOR]

This study sought to analyze university graduate job attainment in Lebanon through an individualist, societal and structuralist perspectives. Differences appeared between females and males on factors that predicted occupational attainment. In concert with neo-patriarchal discourse increased occupational attainment among males was significantly predicted by fathers' occupational status. The data reported that male and female university degree type produced higher occupational attainment between male and female graduates. Further analysis would seek to understand graduate attitudes towards their occupational attainment along individualist, societal and structural dimensions. [ABSTRACT FROM AUTHOR]

Presents a study that examined the extent to which confessional school policies and practices foster inter-group learning among students in Lebanon. Background of the educational system of Lebanon; Discussion on the educational transformations under the Ta'if agreement; Analysis of the study of history and religion in the country.

We report on a Lebanese family in which two maternal cousins suffered and died very early in life from cardiac malformations. Both presented with a transposition of the great arteries associated with one or several other cardiac defects. Various minor midline defects were also observed, but there were no situs abnormalities other than a persistent left superior vena cava in one. A maternal uncle of these two babies was born cyanotic and died on the third post-natal day. Analysis of the ZIC3 gene, revealed the presence of a mutation in the second exon leading to a truncation of the protein. Surprisingly, another maternal uncle of the two affected cousins also had the mutation but was not clinically affected. To our knowledge, this is the first instance of incomplete penetrance in a male for a mutation in a chromosome X gene. [ABSTRACT FROM AUTHOR]

A correction to the article "Lebanese People Living with HIV: Psychiatric Co-morbidities and Psycho-Social Environment" in a 2021 issue is presented.