On the scene: American University of Beirut Medical Center, Beirut, Lebanon.

PubMed

Mouro, Gladys; Tashjian, Hera; Daaboul, Tania; Kozman, Katia; Alwan, Farah; Shamoun, Anthony

2011-01-01

American University of Beirut Medical Center is the first Magnet hospital in the Middle East. In this article, authors reflect back on the journey to excellence, specifically in establishing shared governance in a challenging cultural and organizational milieu. Perspectives from nurses at different levels are included to highlight their experiences throughout the journey. Evolution of the organization's shared governance model is described and initiatives of the councils are illustrated.

Prevalence of malnutrition and its correlates in older adults living in long stay institutions situated in Beirut, Lebanon.

PubMed

El Zoghbi, Mohamad; Boulos, Christa; Awada, Sanaa; Rachidi, Samar; Al-Hajje, Amal; Bawab, Wafaa; Saleh, Nadine; Salameh, Pascale

2014-01-01

Malnutrition represents an important issue in older adults; unfortunately, there is lack of data concerning this topic in Lebanon. This paper aims to provide a description of nutritional status and its correlates in older adults living in long stay institutions situated in Beirut. This cross-sectional study was conducted in three long stay institutions in Beirut in 2012. The study population was composed of people aged 65 years and above, having a score of Folstein Mini Mental State Examination (MMSE) greater than 14 and without renal failure requiring dialysis. Subjects meeting inclusion criteria filled out a questionnaire consisting of nutritional status scale (Mini Nutritional Assessment: MNA) and several other parts (demographic, self-assessment of the state health, smoking and alcohol, physical dependence, quality of life, frailty, depression, social isolation and loneliness). Data were entered and analyzed using the statistical software SPSS (Statistical Package for Social Sciences), version 17.0 (Chicago, IL, USA). Among 111 older adults (55 men and 56 women), 14 (12.6%) were malnourished, 54 (48.7%) were at risk of malnutrition and 43 (38.7%) had an adequate nutritional status. Multivariate analysis showed that physical exercise, depression, frailty and cognitive function were independent correlates of nutritional status of older adults. This model explained 42.2% (adjusted R2 = 0.422) of the older adults nutritional status variability. We found a moderate percentage of malnutrition in older adults living in long stay institutions situated in Beirut, and the correlates of malnutrition in older adults were low physical exercise, depression, frailty and low cognitive function.

Determinants of caesarean section in Lebanon: geographical differences.

PubMed

Carayol, Marion; Zein, Ali; Ghosn, Nada; Du Mazaubrun, Christiane; Breart, Gérard

2008-03-01

This study, based on the Lebanese National Perinatal Survey which included 5231 women, examined the relations between the caesarean section (CS) rate and the characteristics of mothers, children, antenatal care and maternity units in two geographical zones of Lebanon (Beirut-Mount Lebanon and the rest of the country) and then looked at geographical variations. This analysis concerned 3846 women with singleton pregnancies and livebirths at low risk of CS, after exclusion of women with a previous CS, non-cephalic fetal presentations, or delivery before 37 weeks' gestation. The principal end point was caesarean delivery. The relations between the factors studied and CS were estimated by odds ratios (OR), both crude and adjusted, using logistic regression. The rate of CS was higher in the Beirut-Mount Lebanon zone than elsewhere (13.4% vs. 7.6%). After adjustment, several factors remained associated with caesarean delivery in each zone. Common factors were primiparity, gestational age > or = 41 weeks and antenatal hospitalisation. Factors identified only in the Beirut-Mount Lebanon zone were obstetric history and insurance coverage, whereas for the other zones we only found major risk factors for obstetric disease: maternal age > or = 35 years, number of antenatal consultations > or = 4 and birthweight < or = 2500 g. The multivariable analysis of the overall population, adjusting for zone of delivery and other variables, shows that zone was one of the principal factors associated with the risk of caesarean delivery in Lebanon (OR = 1.80 [95% CI 1.09, 2.95]). In conclusion, the CS rates in Lebanon were high, with geographical differences that were associated with access to care and with obstetric practices.

Sexual stigma, psychological well-being and social engagement among men who have sex with men in Beirut, Lebanon.

PubMed

Wagner, Glenn J; Aunon, Frances M; Kaplan, Rachel L; Karam, Rita; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

2013-01-01

This qualitative study sought to explore sexual identity development among men who have sex with men in Beirut, Lebanon; the stigma experienced by these men; and how their psychological well-being and social engagement are shaped by how they cope with this stigma. Semi-structured interviews were conducted with 31 men who have sex with men and content analysis was used to identify emergent themes. While many men reported feeling very comfortable with their sexual orientation and had disclosed their sexual orientation to family, most men struggled at least somewhat with their sexuality, often because of perceived stigma from others and internal religious conflict about the immorality of homosexuality. Most participants described experiencing verbal harassment or ridicule or being treated as different or lesser than in social relationships with friends or family. Mechanisms for coping with stigma included social avoidance (trying to pass as heterosexual and limiting interaction with men who have sex with men to the internet) or withdrawal from relationships in an attempt to limit exposure to stigma. Findings suggest that effective coping with both internal and external sexual stigma is central to the psychological well-being and social engagement of men who have sex with men in Beirut, much as has been found in Western gay communities.

Women's perceptions of reproductive health in three communities around Beirut, Lebanon.

PubMed

Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda

2005-05-01

The aim of this study was to elicit definitions of the concept of reproductive health among women in three communities around Beirut, Lebanon, as part of the reproductive health component of a larger Urban Health Study. The communities were characterised by poverty, rural-urban mobility and heterogeneous refugee and migrant populations. A random sample of 1,869 women of reproductive age completed a questionnaire, of whom a sub-sample of 201 women were randomly selected. The women's understanding of good reproductive health included three major themes, which were expressed differently in the three communities. Their understanding included good physical and mental health, and underscored the need for activities promoting health. Their ability to reproduce and raise children, practise family planning and birth spacing, and go through pregnancy and motherhood safely were central to their reproductive duties and their social status. Finally, they saw reproductive health within the context of economic status, good marital relations and strength to cope with their lives. These findings point to the need to situate interventions in the life course of women, their health and that of their husbands and families; the importance of reproduction not only from a health services point of view, but also as regards women's roles and responsibilities within marriage and their families; and taking account of the harsh socio-economic conditions in their communities.

A qualitative exploration of sexual risk and HIV testing behaviors among men who have sex with men in Beirut, Lebanon.

PubMed

Wagner, Glenn J; Aunon, Frances M; Kaplan, Rachel L; Rana, Yashodhara; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

2012-01-01

Men who have sex with men (MSM) may account for most new HIV infections in Lebanon, yet little is known about the factors that influence sexual risk behavior and HIV testing in this population. Qualitative interviews were conducted with 31 MSM living in Beirut, and content analysis was used to identify emergent themes. Mean age of the participants was 28.4 years, and all identified as either gay (77%) or bisexual (23%). Half reported not using condoms consistently and one quarter had not been HIV-tested. Many described not using condoms with a regular partner in the context of a meaningful relationship, mutual HIV testing, and a desire to not use condoms, suggesting that trust, commitment and intimacy play a role in condom use decisions. Condoms were more likely to be used with casual partners, partners believed to be HIV-positive, and with partners met online where men found it easier to candidly discuss HIV risk. Fear of infection motivated many to get HIV tested and use condoms, but such affect also led some to avoid HIV testing in fear of disease and social stigma if found to be infected. Respondents who were very comfortable with their sexual orientation and who had disclosed their sexuality to family and parents tended to be more likely to use condoms consistently and be tested for HIV. These findings indicate that similar factors influence the condom use and HIV testing of MSM in Beirut as those observed in studies elsewhere of MSM; hence, prevention efforts in Lebanon can likely benefit from lessons learned and interventions developed in other regions, particularly for younger, gay-identified men. Further research is needed to determine how prevention efforts may need to be tailored to address the needs of men who are less integrated into or do not identify with the gay community.

A Qualitative Exploration of Sexual Risk and HIV Testing Behaviors among Men Who Have Sex with Men in Beirut, Lebanon

PubMed Central

Wagner, Glenn J.; Aunon, Frances M.; Kaplan, Rachel L.; Rana, Yashodhara; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

2012-01-01

Men who have sex with men (MSM) may account for most new HIV infections in Lebanon, yet little is known about the factors that influence sexual risk behavior and HIV testing in this population. Qualitative interviews were conducted with 31 MSM living in Beirut, and content analysis was used to identify emergent themes. Mean age of the participants was 28.4 years, and all identified as either gay (77%) or bisexual (23%). Half reported not using condoms consistently and one quarter had not been HIV-tested. Many described not using condoms with a regular partner in the context of a meaningful relationship, mutual HIV testing, and a desire to not use condoms, suggesting that trust, commitment and intimacy play a role in condom use decisions. Condoms were more likely to be used with casual partners, partners believed to be HIV-positive, and with partners met online where men found it easier to candidly discuss HIV risk. Fear of infection motivated many to get HIV tested and use condoms, but such affect also led some to avoid HIV testing in fear of disease and social stigma if found to be infected. Respondents who were very comfortable with their sexual orientation and who had disclosed their sexuality to family and parents tended to be more likely to use condoms consistently and be tested for HIV. These findings indicate that similar factors influence the condom use and HIV testing of MSM in Beirut as those observed in studies elsewhere of MSM; hence, prevention efforts in Lebanon can likely benefit from lessons learned and interventions developed in other regions, particularly for younger, gay-identified men. Further research is needed to determine how prevention efforts may need to be tailored to address the needs of men who are less integrated into or do not identify with the gay community. PMID:23029103

Prevalence of Autism Spectrum Disorder in Nurseries in Lebanon: A Cross Sectional Study.

PubMed

Chaaya, Monique; Saab, Dahlia; Maalouf, Fadi T; Boustany, Rose-Mary

2016-02-01

In Lebanon, no estimate for autism prevalence exists. This cross-sectional study examines the prevalence of Autism spectrum disorder (ASD) in toddlers in nurseries in Beirut and Mount-Lebanon. The final sample included 998 toddlers (16-48 months) from 177 nurseries. We sent parents the Modified Checklist for Autism in Toddlers (M-CHAT) for screening, and a self-administered questionnaire (associated factors). We imputed missing M-CHAT data with successful answers. Since there were no follow-up interviews for the M-CHAT, we used the positive predictive value (0.058) from a large study for prevalence estimates. ASD prevalence was 1 in 66 children (comparable to US). Ratios were: male/female: 1.05; Beirut/Mount-Lebanon: 1.2. Using a more representative sample and ascertaining results are needed for better prevalence estimates in Lebanon.

Lebanon: country profile.

PubMed

Marfleet, P

1988-05-01

A brief profile of Lebanon's economy, people, health, culture and political situation is presented. Lebanon has an estimated 3.5 million people, with a Maronite Christian elite, a Muslim Shiite majority, and Muslim Sunnis and Druze groups. The infant mortality is estimated at 41/1000; literacy is 69% among women and 86% among men; life expectancy was 66 years, 10 years ago. The economy, previously thriving on banking, manufacturing and agriculture, is now decimated, and Lebanon's once active tourist industry, based on elegant facilities in Beirut and neighboring beaches and ski slopes, is the victim of 15 years of civil strife. Israel has invaded, supporting Maronite Christians, Syria has invaded in support Muslim and Druze militias, and Iran has aggressively supported Shiite factions.

An exploratory study of HIV risk behaviours and testing among male sex workers in Beirut, Lebanon

PubMed Central

Aunon, Frances M.; Wagner, Glenn J.; Maher, Rabih; Khouri, Danielle; Kaplan, Rachel L.; Mokhbat, Jacques

2015-01-01

Male sex workers (MSW) are a particularly high-risk subset of men who have sex with men in Lebanon and report higher numbers of sex partners and lower rates of condom use. The purpose was to explore the factors influencing sexual risk behaviors and HIV testing among MSW. Qualitative interviews were conducted with 16 MSW living in Beirut and working in bathhouses (hammam) or as escorts; content analysis identified emergent themes. Escorts reported more consistent condom use with clients and HIV testing than hammam MSW, with influential factors including HIV risk knowledge and perceived risk susceptibility, job security, and internalized stigma and related feelings of self-worth and fatalism regarding health and HIV risk. In contrast, both groups of MSW typically opted not to condoms with nonclient sex partners, in an effort to differentiate sex for work versus pleasure. The uptake of HIV testing was limited by concerns about the confidentiality of the test results and fear of repercussions of a positive test result for their health and employment. The respondents described an insular existence within the sex work culture, in part to limit exposure to stigma, which has implications for access to support as well as the influence of peer norms regarding sexual risk behavior and health seeking behaviors such as HIV testing. Further research is needed to tailor prevention and HIV testing efforts to reflect the distinct sexual health “cultures” that distinguish these two populations of MSW in Lebanon. PMID:25950906

Women's Perceptions of Reproductive Health in Three Communities around Beirut, Lebanon

PubMed Central

Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda

2006-01-01

The aim of this study was to elicit definitions of the concept of reproductive health among women in three communities around Beirut, Lebanon, as part of the reproductive health component of a larger Urban Health Study. The communities were characterised by poverty, rural-urban mobility and heterogeneous refugee and migrant populations. A random sample of 1,869 women of reproductive age completed a questionnaire, of whom a sub-sample of 201 women were randomly selected. The women's understanding of good reproductive health included three major themes, which were expressed differently in the three communities. Their understanding included good physical and mental health, and underscored the need for activities promoting health. Their ability to reproduce and raise children, practise family planning and birth spacing, and go through pregnancy and motherhood safely were central to their reproductive duties and their social status. Finally, they saw reproductive health within the context of economic status, good marital relations and strength to cope with their lives. These findings point to the need to situate interventions in the life course of women, their health and that of their husbands and families; the importance of reproduction not only from a health services point of view, but also as regards women's roles and responsibilities within marriage and their families; and taking account of the harsh socio-economic conditions in their communities. A 2005 Reproductive Health Matters. All rights reserved. PMID:16035595

Types of cultural capital and self-rated health among disadvantaged women in outer Beirut, Lebanon

PubMed Central

Khawaja, Marwan; Mowafi, Mona

2007-01-01

Aims Our study extends research on the social determinants of health by exploring the association between a new, potentially very significant dimension, cultural capital by type and self-rated health among low-income women living in outer Beirut, Lebanon. Methods Self-rated general health was assessed using household data from a cross-sectional survey of 1869 women, conducted in 2003. Three types of cultural capital were included: watching cultural TV programs, producing art (e.g., drawing, theatre performance) and consuming art or literature (e.g., attending exhibits, reading literary books). Associations between self-rated health status and types of cultural capital were assessed using odds ratios from binary logistic regression models. Results With the exception of art production, lack of cultural capital increased the odds of self-perceived poor health status adjusting for socio-demographics and other risk factors. The adjusted odds ratios were 1.86 (95% CI: 1.07 to 3.22) for watching cultural TV programs and 1.52 (95% CI: 1.12 to 2.06) for consuming art. As expected, health risk factors, age, social support and community of residence were also associated with health status. Conclusions Two types of cultural capital were strong predictors of self perceived health status among women living in poor urban communities, regardless of social capital, income and other relevant risk factors. PMID:17852992

Lebanon: Background and U.S. Relations

DTIC Science & Technology

2010-08-03

Syrian President Basher al Asad, and both sides have spoken positively about turning a new page in Syrian-Lebanese relations. Despite the public... Basher al-Assad visited Beirut along with His 45 “Lebanon, Syria Sign String of Accords,” Middle East

Cultures of Engagement in Challenging Circumstances: Four Lebanese Primary Schools in Urban Beirut

ERIC Educational Resources Information Center

Nabhani, Mona; Busher, Hugh; Bahous, Rima

2012-01-01

This study of four private primary schools in Beirut, Lebanon, investigated why the children in the schools appeared to out-perform their peers in other schools. The study investigated the cultures that teachers and principals constructed in schools with children and their parents, wondering whether they would exhibit characteristics said to…

Prevalence and Correlates of Complementary and Alternative Medicine Use among Patients with Lung Cancer: A Cross-Sectional Study in Beirut, Lebanon

PubMed Central

Anouti, Bilal; Haibe, Yolla

2017-01-01

Patients with lung cancer are increasingly seeking complementary and alternative medicine (CAM) to improve their physiological and psychological well-being. This study aimed to assess CAM use among lung cancer patients in Lebanon. Using a cross-sectional design, 150 lung cancer patients attending the Basile Cancer Institute at the American University of Beirut Medical Center were interviewed. Participants completed a questionnaire addressing sociodemographic characteristics, lung cancer condition, and use of CAM. The main outcome of interest was “use of any CAM therapy since diagnosis.” Prevalence of CAM use was 41%. The most commonly used CAM modality among study participants was “dietary supplements/special foods.” Results of the multiple logistic regression analyses showed that CAM use was positively associated with Lebanese nationality and paying for treatment out of pocket and was negatively associated with unemployment and having other chronic diseases. About 10% of patients used CAM on an alternative base, 58% did not disclose CAM use to their physician, and only 2% cited health professionals as influencing their choice of CAM. This study revealed a prevalent CAM use among lung cancer patients in Lebanon, with a marginal role for physicians in guiding this use. Promoting an open-communication and a patient-centered approach regarding CAM use is warranted. PMID:28912824

Prevalence of Autism Spectrum Disorder in Nurseries in Lebanon: A Cross Sectional Study

ERIC Educational Resources Information Center

Chaaya, Monique; Saab, Dahlia; Maalouf, Fadi T.; Boustany, Rose-Mary

2016-01-01

In Lebanon, no estimate for autism prevalence exists. This cross-sectional study examines the prevalence of Autism spectrum disorder (ASD) in toddlers in nurseries in Beirut and Mount-Lebanon. The final sample included 998 toddlers (16-48 months) from 177 nurseries. We sent parents the Modified Checklist for Autism in Toddlers (M-CHAT) for…

Types of cultural capital and self-rated health among disadvantaged women in outer Beirut, Lebanon.

PubMed

Khawaja, Marwan; Mowafi, Mona

2007-01-01

This study extends research on the social determinants of health by exploring the association between a new, potentially very significant dimension, cultural capital by type, and self-rated health among low-income women living in outer Beirut, Lebanon. Self-rated general health was assessed using household data from a cross-sectional survey of 1869 women, conducted in 2003. Three types of cultural capital were included: watching cultural TV programs, producing art (e.g. drawing, theatre performance), and consuming art or literature (e.g. attending exhibitions, reading literary books). Associations between self-rated health status and types of cultural capital were assessed using odds ratios from binary logistic regression models. With the exception of art production, lack of cultural capital increased the odds of self-perceived poor health status adjusting for sociodemographics and other risk factors. The adjusted odds ratios were 1.86 (95% CI 1.07-3.22) for not watching cultural TV programs and 1.52 (95% CI 1.12-2.06) for not consuming art. As expected, health-risk factors, age, social support, and community of residence were also associated with health status. Two types of cultural capital were strong predictors of self-perceived health status among women living in poor urban communities, regardless of social capital, income, and other relevant risk factors.

Prevalence of vitamin D deficiency in adults presenting for bariatric surgery in Lebanon.

PubMed

Aridi, Hanaa Dakour; Alami, Ramzi S; Fouani, Tarek; Shamseddine, Ghassan; Tamim, Hani; Safadi, Bassem

2016-02-01

Vitamin D deficiency is common among obese patients presenting for bariatric surgery in Europe and North America. The prevalence of vitamin D deficiency in this patient population in Lebanon and the Middle East has not been studied. The aim of this study was to determine the rate of vitamin D deficiency in a cohort of patients presenting for bariatric surgery in Lebanon. American University of Beirut Medical Center, Beirut, Lebanon. Data was extracted from a prospective database of patients presenting for bariatric surgery at the American University of Beirut Medical Center from July 2011 until June 2014. The prevalence of vitamin D deficiency was determined using established cut-offs followed by analysis of the relationship between low vitamin D and certain patient characteristics. More than two thirds of all patients (68.9%) were vitamin D deficient (≤19.9 ng/mL), whereas 22.6% had insufficient levels (20-29.9 ng/mL) and only 8.6 % had sufficient levels (≥30 ng/mL). Vitamin D levels were inversely associated with BMI>50 kg/m(2). Low vitamin D levels were also correlated with younger age, male gender, lack of physical exercise, and nonsunny season. No association was shown between 25-hydroxyvitamin D deficiency and type 2 diabetes mellitus, cardiovascular disease, osteoarticular disease, hypertension, or depression. Vitamin D deficiency is prevalent among patients with Class II or Class III obesity presenting for bariatric surgery in Lebanon. These findings emphasize the need for careful attention when evaluating patients before bariatric surgery and the importance of providing patients with adequate supplementation. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Prevalence of allergic diseases in children in Beirut: comparison to worldwide data.

PubMed

Ramadan, F M; Khoury, M N; Hajjar, T A; Mroueh, S M

1999-01-01

To report on the prevalence of allergic rhinitis and atopic eczema in school children in Beirut, Lebanon, and compare the prevalence rates of allergic diseases in Beirut to the rest of the world. A random sample of school children aged 13-14 years completed the ISAAC written and video questionnaires. Data was entered using a special program prepared by ISAAC and analyzed using SPSS version 6.0. The prevalence rates of allergic rhinitis and rhinoconjunctivitis were 25.5% and 15.9% respectively. Atopic eczema was more common among males, with a total prevalence rate of 11%. The prevalence rates of allergic diseases in childhood was along the 50th percentile worldwide. The prevalence rates of uncontrolled asthma was very high while that of allergic rhinitis was low as compared to the rest of the world.

Consanguineous marriage and reproduction in Beirut, Lebanon.

PubMed

Khlat, M

1988-08-01

Effects of consanguineous marriages on couples' fertility and on offspring mortality were investigated in Beirut through a population-based health survey of 2,752 households. A multistage random sampling procedure was used, and information was obtained from all ever-married women in the household about their reproductive performance and genealogical relationship with spouse; demographic and socioeconomic information was also recorded. Twenty-five percent of all marriages were between relatives, and the spouses were first cousins in approximately 57% of all consanguineous marriages. Total pregnancies, live births, and living children were significantly higher among consanguineous couples than among nonconsanguineous ones, as was the proportion dead among children ever born. However, no difference remained in either fertility or mortality, when allowance was made for socioeconomic status, religious affiliation, and marriage duration. The issue of confounding is discussed, and the lack of significant pattern in the final analysis is interpreted as resulting from a long-term practice of consanguineous marriages.

Intellectual Development of Students at the Secondary-College Interface in Lebanon.

ERIC Educational Resources Information Center

Za'rour, George I.; Gholam, Ghada K.

1981-01-01

Assesses the level of intellectual development in proportional, combinatorial, and correlational reasoning and the ability to control variables in beginning sophomore students (N=207) at the American University of Beirut, Lebanon. Compares this level with their performance on achievement tests in mathematics, biology, chemistry, and physics. (CS)

Lebanon in the Middle East Subordinate System.

DTIC Science & Technology

1983-06-03

hostility relationship will be borrowed from Kenneth E. Boulding’s pioneering work on "National Images and International systems.ŗ This framework...Quarantine). 3 6 The pioneer American missionary arrived at Beirut in 1823; Pliny Fish, member of the American Board of Commissioners for Foreign...majority in Lebanon’s resident population. Economists and private research institutes conducted research and studies on Lebanese demography . They

The Interfaculty Graduate Environmental Sciences Program of the American University of Beirut: An ESD Initiative in the Arab World

ERIC Educational Resources Information Center

Zurayk, Rami; El-Fadel, Mutasem; Nuwayhid, Iman

2010-01-01

The American University of Beirut's Interfaculty Graduate Environmental Sciences Program was launched in 1997 as a means of addressing salient issues on the environment and development in Lebanon and the Arab World using an interdisciplinary approach. The programme adopts a student-centred learning approach and aims to develop critical and systems…

HIV Prevalence and Demographic Determinants of Unprotected Anal Sex and HIV Testing among Male Refugees Who have Sex with Men in Beirut, Lebanon.

PubMed

Tohme, Johnny; Egan, James E; Stall, Ron; Wagner, Glenn; Mokhbat, Jaques

2016-12-01

Men who have sex with men (MSM), the same as refugees are at higher risk for health issues including HIV infection. With the large influx of refugees to Lebanon, and to better understand HIV transmission in this setting, we explored the socio-demographic correlates of condom use and HIV testing among MSM refugees in Beirut, by surveying and testing 150 participants. 67 % self-identified as gay, 84.6 % of respondents reported unprotected anal intercourse (UAI) in the prior 3 months, and 56.7 % with men of positive or unknown HIV status (UAIPU). 2.7 % tested positive for HIV, and 36 % reported having engaged in sex work. Men in a relationship and men who self-identified as gay had higher odds of UAI, of ever been tested, but lower odds of UAIPU. HIV prevention and testing promotion efforts targeting MSM refugees need to account for how men self-identify in relation to their sexual behavior and relationship status. Such efforts also should place emphasis on MSM of lower socio-economic status.

Household food insecurity is associated with a higher burden of obesity and risk of dietary inadequacies among mothers in Beirut, Lebanon.

PubMed

Jomaa, Lamis; Naja, Farah; Cheaib, Ruba; Hwalla, Nahla

2017-06-12

Mixed evidence exists with respect to the association between household food insecurity (HFIS) and obesity in low-to-middle income countries (LMICs), particularly among women. This study aimed to measure socioeconomic correlates of HFIS and explores its association with dietary intake and odds of obesity among mothers in Lebanon, a middle-income country undergoing nutrition transition. A cross-sectional study was conducted among a representative sample of households (n = 378) in Beirut, Lebanon. Surveys were completed with mothers of children <18 years. HFIS was measured using a locally-validated, Arabic-translated Household Food Insecurity Access Scale (HFIAS). Dietary intake was assessed using the multiple pass 24-h recall method. Associations between HFIS (food vs food insecure) and socio-demographic characteristics were reported using crude and adjusted odds ratios. The odds of consuming <2/3rd Dietary Reference Intakes (DRIs) for nutrients among mothers from food secure and food insecure households were explored. In addition, logistic regression analyses were conducted to explore the association of HFIS with obesity (BMI ≥ 30 kg/m2) and at-risk waist circumference (WC ≥ 80 cm) among mothers. HFIS was found among 50% of study sample and was inversely associated with household income and mother's educational level, even after adjusting for other socioeconomic variables (p < 0.01). Mothers in food insecure households reported consuming significantly less dairy products, fruits, and nuts yet more breads and sweets; and they had higher odds of consuming <2/3rd the DRI's for key micronutrients (potassium, folate, and vitamin C) compared to secure ones. Adjusting for socioeconomic correlates, food insecure mothers had 1.73 odds of obesity (95% CI: 1.02-2.92) compared to food secure mothers. High HFIS prevalence was reported among urban Lebanese households. Mothers from food insecure households had a high risk of dietary inadequacy and obesity. Adequate

Psychiatric disorders among adolescents from Lebanon: prevalence, correlates, and treatment gap.

PubMed

Maalouf, Fadi T; Ghandour, Lilian A; Halabi, Fadi; Zeinoun, Pia; Shehab, Al Amira Safa; Tavitian, Lucy

2016-08-01

Adolescence is a critical age for the development of psychiatric disorders. Although Lebanon, a low-to-middle income country, has suffered from decades of war and political instability, the burden of psychiatric disorders among adolescents in Lebanon remains unclear. This study aims to estimate the prevalence of psychiatric disorders among adolescents in the Lebanese capital, Beirut, and to study the correlates and treatment seeking behavior associated with these disorders. Through a multistage cluster sampling design, 510 adolescents, aged 11-17 years were recruited from a household sample in Beirut in 2012. Parents and adolescents completed a battery of self-reported questionnaires and interviews including the Development and Well-being Assessment (DAWBA), the Peer-Relations Questionnaire (PRQ), and a demographic/clinical information questionnaire. Logistic regression models were used to study the correlates of psychiatric disorders. The 30-day prevalence of psychiatric disorders was 26.1 %, with anxiety disorders (13.1 %) and ADHD (10.2 %) being the most prevalent disorders. Only 6 % of those with disorders reported seeking professional help. Parental marital status, not attending school, having a chronic medical condition, having a family history of psychiatric disorders, as well as propensity to bullying and to being victimized by peers emerged as correlates of having psychiatric disorders. A clear treatment gap is evident with a high 30-day prevalence of psychiatric disorders among adolescents in Beirut coupled with a very low percentage seeking treatment. Scaling up mental health services and addressing potential barriers to seeking care would be important to close this gap.

Re-evaluation and updating of the seismic hazard of Lebanon

NASA Astrophysics Data System (ADS)

Huijer, Carla; Harajli, Mohamed; Sadek, Salah

2016-01-01

This paper presents the results of a study undertaken to evaluate the implications of the newly mapped offshore Mount Lebanon Thrust (MLT) fault system on the seismic hazard of Lebanon and the current seismic zoning and design parameters used by the local engineering community. This re-evaluation is critical, given that the MLT is located at close proximity to the major cities and economic centers of the country. The updated seismic hazard was assessed using probabilistic methods of analysis. The potential sources of seismic activities that affect Lebanon were integrated along with any/all newly established characteristics within an updated database which includes the newly mapped fault system. The earthquake recurrence relationships of these sources were developed from instrumental seismology data, historical records, and earlier studies undertaken to evaluate the seismic hazard of neighboring countries. Maps of peak ground acceleration contours, based on 10 % probability of exceedance in 50 years (as per Uniform Building Code (UBC) 1997), as well as 0.2 and 1 s peak spectral acceleration contours, based on 2 % probability of exceedance in 50 years (as per International Building Code (IBC) 2012), were also developed. Finally, spectral charts for the main coastal cities of Beirut, Tripoli, Jounieh, Byblos, Saida, and Tyre are provided for use by designers.

Social capital, women's autonomy and smoking among married women in low-income urban neighborhoods of Beirut, Lebanon.

PubMed

Afifi, Rema A; Nakkash, Rima T; Khawaja, Marwan

2010-01-01

We sought to examine the associations between social capital, women's empowerment, and smoking behavior among married women in three low-income neighborhoods in Beirut, Lebanon. Data from currently married women aged 15 to 59 years in the 2003 Urban Health Study were used. The dependent variable was cigarette smoking. The main independent variables were five social capital items and three women's empowerment indices. Other socioeconomic variables as well as mental distress, happiness, and community of residence were included as covariates. Bivariate associations were conducted on all variables using chi-square tests. Adjusted odds ratios from binary logistic regression models were then modeled on smoking behavior separately for younger and older women. More than one third (35.9%) of married women reported smoking cigarettes. At the bivariate level, a variety of socioeconomic and demographic variables predicted smoking. With respect to social capital, women who lacked trust and were dissatisfied with the number friends or relatives living nearby were more likely to smoke. As for women's autonomy, high decision making and high mobility were associated with smoking. When analyzed multivariately, social capital items were statistically significant for younger women but not for older women. And the mobility variables were significant for older women but not younger women. Our results support the conclusion that determinants of women's tobacco use are multilayered, and include social capital and women's autonomy. Our results also suggest that younger and older married women may be influenced by differential determinants. Reasons for these differences are explored. Interventions may need to be tailored to each age group separately. Copyright 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Consanguinity in Lebanon: prevalence, distribution and determinants.

PubMed

Barbour, Bernadette; Salameh, Pascale

2009-07-01

The union of individuals with a common ancestor may lead to serious health consequences in their offspring. Consanguinity is high in Middle Eastern communities; it was around 26% in 1988. The objective of this study was to determine the prevalence of consanguinity in Beirut and other Lebanese regions, and its associated factors in different subgroups. The cross-sectional study was performed on a convenience sample of married women in Lebanon. The women were administered a standardized questionnaire in a face-to-face interview by independent enquirers. Among 1556 women, the overall prevalence of consanguineous marriages was 35.5%, and the consanguinity coefficient was 0.020; 968 marriages (62.2%) were not consanguineous, 492 (31.6%) were first cousin, 61 (3.9%) were second cousin and 36 (2.3%) had lower degrees of consanguinity. Beirut suburb dwelling, low education subgroups, women working in the home and non-Christian religion presented the highest rates of consanguinity (p<0.05). Consanguinity is associated with couples' nulliparity and child chronic morbidity. Factors that could affect consanguinity are having consanguineous parents, having a favourable opinion towards consanguinity, choosing a spouse for religious reasons, particularly in Islam, woman having a low education, woman working in the home and women thinking that consanguinity would not lead to serious diseases. Consanguinity is therefore still a prevailing problem in Lebanon. Specific health education, and genetic counselling in particular, are suggested to explain the consequences of consanguinity to the general population and to help couples make informed choices.

Influenza-associated severe acute respiratory infections in 2 sentinel sites in Lebanon-September 2015 to August 2016.

PubMed

Saleh, Majd; Bazzi, Lara; Ismail, Ebstissam; Mroueh, Lina; Jammal, Nisrine; Elkholy, Amgad; Mrad, Pamela; Samadi, Ahmad Al; Hijazi, Ahmad; Abiad, Firass; Nsouli, Ghazi; Rady, Alissar; Khan, Wasiq; Malik, Mamunur; Zalloua, Pierre; Ammar, Walid; Ghosn, Nada

2018-05-01

Given the sparse information on the burden of influenza in Lebanon, the Ministry of Public Health established a sentinel surveillance for severe acute respiratory infections (SARI) to identify the attribution of influenza to reported cases. We aim to highlight the proportion of influenza-associated SARI from September 1st, 2015 to August 31st, 2016 in 2 Lebanese hospitals. The study was conducted in 2 sentinel sites located in Beirut suburbs and southern province of Lebanon. WHO's 2011 standardized SARI case definition was used. Data from September 1, 2015 to August 31, 2016 were reviewed, and all-cause hospital admission numbers were obtained. Nasopharyngeal swabs were collected and tested by RT-PCR. Descriptive and bivariate analyses were conducted using STATA 13. The 2 sentinel sites reported 746 SARI cases during the studied time frame: 467 from the southern province site and 279 from the Beirut suburbs site. SARI reports peaked between January and March 2016. All, except 4, cases were sampled, and a co-dominance of influenza B (43%) and influenza A (H1N1) (41%) was evident. A high proportion of cases was reported in children <2 years 274 (37%). The proportional contribution of influenza-associated SARI to all-cause hospital admissions was high in children <2 years in the south (4.5% [95% CI: 3.1-6.5]) and in children <5 years in Beirut (0.7% [95% CI: 0.6-0.8]). This is the first study to highlight the proportion of influenza-associated SARI in 2 hospitals in Lebanon. The findings will be beneficial for supporting respiratory prevention and immunization program policies. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

This is who we are: building community for HIV prevention with young gay and bisexual men in Beirut, Lebanon.

PubMed

Mutchler, Matt G; McDavitt, Bryce Way; Tran, Tu N; Khoury, Cynthia El; Ballan, Ellie; Tohme, Johnny; Kegeles, Susan M; Wagner, Glenn

2017-09-18

Young gay men in Beirut are at significantly elevated risk of HIV infection compared with the general Lebanese population. Despite nascent HIV prevention efforts in the region, there is a need for effective community-level HIV prevention interventions tailored for young gay men. This qualitative study examined internal dynamics within Beirut's gay community as a basis for developing community-level interventions. Peer ethnographers were trained to collect field notes on conversations between young gay men in public spaces in Beirut, and conducted follow-up focus groups with young gay men. Analyses revealed three major themes: (1) the need for safe spaces in which to socialise, (2) the importance of being able to locate and connect with other young gay men, and (3) ambivalence regarding a gay community that was supportive in some ways but also fragmented and often judgemental. Study findings also confirm the existence of external threats to community such as stigma, cultural and familial norms regarding heterosexuality and criminalisation of refugee status. Understanding such community dynamics and the environmental context is central to designing effective community-based HIV prevention programmes.

Using open-ended data to enrich survey results on the meanings of self-rated health: a study among women in underprivileged communities in Beirut, Lebanon.

PubMed

Salem, Mylene Tewtel; Abdulrahim, Sawsan; Zurayk, Huda

2009-12-01

This study extends the debate on self-rated health by using different sources of data in the same study to explore the meanings of self-rated health among women who live in socio-economically disadvantaged communities in Beirut, Lebanon. Using data from the Urban Health Study, a cross-sectional household survey of 1,869 women between 15 and 59 years of age, multiple logistic regression models were developed to assess factors associated with self-rated health. Also, open-ended data was used to analyze women's explanations of their self-rated health ratings. Self-rated health was found to be a complex concept, associated not only with physical health but also with a combination of social, psychological, and behavioral factors. This open-ended analysis revealed new meanings of self-rated health that are often not included in self-rated health epidemiologic research, such as women's experiences with pain and fatigue, as well as exposure to financial stressors and the legacy of wars. We argue that triangulating survey and open-ended data provides a better understanding of the context-specific social and cultural meanings of self-rated health.

Data from a public school health project in Beirut.

PubMed

Saab, B R; Shararah, N; Makarem, M; Sarrù, E; Usta, J; Khogali, M

1996-01-01

The health status of 2778 elementary students enrolled in twenty-five government schools in Beirut was evaluated. Parents completed special forms relating to demographic information, socioeconomic status, the students' medical and vaccination history, and the presence of certain medical conditions in the family. A complete physical examination of each student was carried out. Seventy-six percent of the children belonged to families with a monthly income between US $118-237. The most common medical problems encountered were poor dentition (53%), incomplete immunization (22-63%) for the various vaccines, enuresis (9%), pediculosis (8%), and defective vision (6%). It was also noticed that 72% of the students have at least one member in the family who smokes. The data presented in this study show the need for fluoridation of public water; provision of accessible and affordable medical and dental care; carrying vaccination campaigns and introducing health education in elementary schools in Lebanon.

[Analysis of the quality of data issued from Beirut's hospitals in order to measure short-term health effects of air pollution].

PubMed

Mrad Nakhlé, M; Farah, W; Ziade, N; Abboud, M; Gerard, J; Zaarour, R; Saliba, N; Dabar, G; Abdel Massih, T; Zoghbi, A; Coussa-Koniski, M-L; Annesi-Maesano, I

2013-12-01

The effects of air pollution on human health have been the subject of much public health research. Several techniques and methods of analysis have been developed. Thus, Beirut Air Pollution and Health Effects (BAPHE) was designed to develop a methodology adapted to the context of the city of Beirut in order to quantify the short-term health effects of air pollution. The quality of data collected from emergency units was analyzed in order to properly estimate hospitalizations via these units. This study examined the process of selecting and validating health and pollution indicators. The different sources of data from emergency units were not correlated. BAPHE was therefore reoriented towards collecting health data from the emergency registry of each hospital. A pilot study determined the appropriate health indicators for BAPHE and created a classification methodology for data collection. In Lebanon, several studies have attempted to indirectly assess the impact of air pollution on health. They had limitations and weaknesses and offered no recommendations regarding the sources and quality of data. The present analysis will be useful for BAPHE and for planning further studies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Social Relations in Lebanon: Convoys Across the Life Course

PubMed Central

Antonucci, Toni C.; Ajrouch, Kristine J.; Abdulrahim, Sawsan

2015-01-01

Objectives: This study systematically analyzed convoys of social relations to investigate the ways in which gender and income shape patterns of social relations across the life course in Lebanon. Methods: Data were drawn from a representative sample of adults aged 18 and older in Greater Beirut, Lebanon (N = 500). Multiple linear regression and multilevel models were conducted to examine main and interactive effects of age, gender, and income on social relations. Results: Findings indicate main effects of age, income, and gender on network structure and relationship quality. Older age was associated with larger network size, greater proportion of kin in network, higher positive and lower negative relationship quality. Higher income was associated with larger network size and decreased contact frequency. Female gender was also associated with decreased contact frequency. Gender interacted with income to influence network size and network composition. Higher income was associated with a larger network size and higher proportion of kin for women. Discussion: Findings suggest diversity in the experience of social relations. Such nuance is particularly relevant to the Lebanese context where family is the main source of support in old age. Policy makers and program planners may need to refrain from viewing social relations simplistically. PMID:24501252

HIV Prevalence and Demographic Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut, Lebanon

PubMed Central

Wagner, Glenn J.; Tohme, Johnny; Hoover, Matthew; Frost, Simon; Ober, Allison; Khouri, Danielle; Iguchi, Martin; Mokhbat, Jacques

2014-01-01

The limited epidemiological data in Lebanon suggest that HIV incident cases are predominantly among men who have sex with men (MSM). We assessed the prevalence of HIV and demographic correlates of condom use and HIV testing among MSM in Beirut. Respondent-driven sampling was used to recruit 213 participants for completion of a behavioral survey and an optional free rapid HIV test. Multivariate regression analysis was used to examine demographic correlates of unprotected anal sex and any history of HIV testing. Nearly half (47%) were under age 25 years and 67% self-identified as gay. Nearly two-thirds (64%) reported any unprotected anal intercourse (UAI) with men in the prior 3 months, including 23% who had unprotected anal intercourse with men whose HIV status was positive or unknown (UAIPU) to the participant. Three men (1.5% of 198 participants tested) were HIV-positive; 62% had any history of HIV testing prior to the study and testing was less common among those engaging in UAIPU compared to others (33% vs. 71%). In regression analysis, men in a relationship had higher odds of having UAI but lower odds of UAIPU and any university education was associated with having UAI; those with any prior history of HIV testing were more likely to be in a relationship and have any university education. HIV prevention efforts for MSM need to account for the influence of relationship dynamics and promotion of testing needs to target high-risk MSM. PMID:24752791

The status of pediatric cardiology at a tertiary center in Lebanon.

PubMed

Arabi, Mariam; Majdalani, Marianne; El Hajj, Maria Atoui; Nemer, Georges; Sawaya, Fadi; Obeid, Mounir; Bitar, Fadi F

2011-01-01

Cardiac disease, both congenital and acquired, contributes significantly to morbidity and mortality in children. This article describes the status of pediatric cardiology at the Children's Heart Center in the American University of Beirut Medical Center. It addresses the available clinical services as well as the research and educational activities that are present at a tertiary center in Lebanon, a developing country with a population of 4 million. Lebanon has witnessed major developments in the field of pediatric cardiology over the past few years. About 650 babies are born with heart disease every year, with more than 425 needing treatment. Nearly all types of interventional catheterization procedures are currently being performed. About 300 open and closed pediatric cardiac surgeries are performed per year in Lebanon. In 2008, the in-hospital surgical mortality rate at our center was 2.6%, reflecting the good level of care in the treatment of children with congenital heart disease (CHD) in Lebanon. Basic research in the field of pediatric cardiology is emerging at our center. Our team has been studying the effect of chronic hypoxemia on the neonatal myocardium in an animal model of chronic hypoxia, as well as the study of molecular basis of CHD. Appropriate identification of cardiac disease, its epidemiology, and outcome is of utmost importance in guiding adequate care. Centralization of facilities is important to improve results and level of care.

Why are breastfeeding rates low in Lebanon? a qualitative study

PubMed Central

2011-01-01

Background Breastfeeding is a cost-effective public health intervention that reduces infant morbidity and mortality in developing countries. In Lebanon, breastfeeding exclusivity and continuation rates are disappointingly low. This qualitative study aims at identifying barriers and promoters of breastfeeding in the Lebanese context by exploring mothers' perceptions and experiences in breastfeeding over a one year period. Methods We conducted focus group discussions in three hospitals in Beirut, Lebanon, and followed up 36 breastfeeding mothers with serial in-depth interviews for one year post-partum or until breastfeeding discontinuation. Results Themes generated from baseline interviews revealed several positive and negative perceptions of breastfeeding. Longitudinal follow up identified insufficient milk, fear of weight gain or breast sagging, pain, sleep deprivation, exhaustion, or maternal employment, as reasons for early breastfeeding discontinuation. Women who continued breastfeeding for one year were more determined to succeed and overcome any barrier, relying mostly on family support and proper time management. Conclusions Increasing awareness of future mothers about breast feeding difficulties, its benefits to children, mothers, and society at large may further promote breastfeeding, and improve exclusivity and continuation rates in Lebanon. A national strategy for early intervention during school years to increase young women's awareness may improve their self-confidence and determination to succeed in breastfeeding later. Moreover, prolonging maternity leave, having day-care facilities at work, creation of lactation peer support groups and hotlines, and training of doctors and nurses in proper lactation support may positively impact breastfeeding exclusivity and continuation rates. Further research is needed to assess the effectiveness of proposed interventions in the Lebanese context. PMID:21878101

Using ambient vibration measurements for risk assessment at an urban scale: from numerical proof of concept to Beirut case study (Lebanon)

NASA Astrophysics Data System (ADS)

Salameh, Christelle; Bard, Pierre-Yves; Guillier, Bertrand; Harb, Jacques; Cornou, Cécile; Gérard, Jocelyne; Almakari, Michelle

2017-04-01

of this method, using ambient vibration measurements both at ground level and within buildings, is illustrated with an example application for the city of Beirut (Lebanon).[Figure not available: see fulltext.

Inadequacies of death certification in Beirut: who is responsible?

PubMed Central

Sibai, Abla M.; Nuwayhid, Iman; Beydoun, May; Chaaya, Monique

2002-01-01

OBJECTIVE: To assess the completeness of data on death certificates over the past 25 years in Beirut, Lebanon, and to examine factors associated with the absence of certifiers' signatures and the non-reporting of the underlying cause of death. METHODS: A systematic 20% sample comprising 2607 death certificates covering the 1974, 1984, 1994, 1997 and 1998 registration periods was retrospectively reviewed for certification practices and missing data. FINDINGS: The information on the death certificates was almost complete in respect of all demographic characteristics of the deceased persons except for occupation and month of birth. Data relating to these variables were missing on approximately 95% and 78% of the certificates, respectively. Around half of the certificates did not carry a certifier's signature. Of those bearing such a signature, 21.6% lacked documentation of the underlying cause of death. The certifier's signature was more likely to be absent on: certificates corresponding to the younger and older age groups than on those of persons aged 15-44 years; those of females than on those of males; those of persons who had been living remotely from the registration governorate than on those of other deceased persons; and those for which there had been delays in registration exceeding six months than on certificates for which registration had been quicker. For certificates that carried the certifier's signature there was no evidence that any of the demographic characteristics of the deceased person was associated with decreased likelihood of reporting an underlying cause of death. CONCLUSION: The responsibility for failure to report causes of death in Beirut lies with families who lack an incentive to call for a physician and with certifying physicians who do not carry out this duty. The deficiencies in death certification are rectifiable. However, any changes should be sensitive to the constraints of the organizational and legal infrastructure governing death

Knowledge, attitudes and awareness regarding fertility preservation among oncologists and clinical practitioners in Lebanon.

PubMed

Ghazeeri, Ghina; Zebian, Dina; Nassar, Anwar H; Harajly, Sally; Abdallah, Alain; Hakimian, Stephanie; Skaiff, Bassem; Abbas, Hussein A; Awwad, Johnny

2016-06-01

Fertility preservation (FP) aims to help individuals overcome the infertility associated with cancer treatments such as chemotherapy and radiation. The objective of this study was to assess the awareness, attitudes and knowledge of oncologists' and clinical practitioners' (CPs) about fertility preservation and its options in Lebanon. This was a cross-sectional study with surveys carried out between March 2012 and February 2013 on CPs at the American University of Beirut Medical Centre and Saint Jude's Children Cancer Centre as well as all registered oncologists in Lebanon. Ninety percent of CPs (n = 88) and 94% of oncologists (n = 53) agreed that fertility preservation should be discussed with patient before their cancer treatment. Our data showed a gender bias in relation to patients being informed of their FP options, as well as conflicting knowledge of FP options available in Lebanon among oncologists. The CPs were more likely to have accurate knowledge of FP options and treatment than oncologists. A proactive approach is required to: (1) increase the awareness and knowledge of FP; (2) improve attitudes towards FP; and (3) encourage its communication between CPs, oncologists and patients in Lebanon. Increased education programs, awareness campaigns and development of dedicated FP centres are needed.

Implementation of a SenseMaker® research project among Syrian refugees in Lebanon

PubMed Central

Bakhache, Nour; Michael, Saja; Roupetz, Sophie; Garbern, Stephanie; Bergquist, Harveen; Davison, Colleen; Bartels, Susan

2017-01-01

ABSTRACT The Syrian conflict has displaced over 1.2 million Syrians into Lebanon. As a result of displacement, some Syrian families are turning to child marriage as a coping mechanism. The prevalence of early marriage has reportedly increased and the average age of marriage decreased during the crisis. The aim of the project was to understand the underlying factors contributing to child marriage among Syrian refugees in Lebanon using Cognitive Edge’s SenseMaker®. This manuscript explores the process of implementing this novel research tool in a humanitarian setting. Twelve interviewers conducted SenseMaker® interviews with married and unmarried Syrian girls, Syrian parents, as well as married and unmarried men. Participants were asked to share a story about the lives of Syrian girls in Lebanon and to self-interpret the narratives by answering follow-up questions in relation to the story provided. Data collection occurred across three locations: Beirut, Beqaa, and Tripoli. In total 1422 narratives from 1346 unique participants were collected over 7 weeks. Data collection using SenseMaker® was efficient, capable of electronically capturing a large volume of quantitative and qualitative data. SenseMaker® limitations from a research perspective include lack of skip logic and inability to adjust font size on the iOS app. SenseMaker® was an efficient mixed methods data collection tool that was well received by participants in a refugee setting in Lebanon. The utility of SenseMaker® for research could be improved by adding skip logic and by being able to adjust font size on the iOS app. PMID:28857014

Multiple Intelligences and ESL Teaching and Learning: An Investigation in KG II Classrooms in One Private School in Beirut, Lebanon

ERIC Educational Resources Information Center

Ghamrawi, Norma

2014-01-01

This study examined teachers' use of the Multiple Intelligences Theory on vocabulary acquisition by preschoolers during English as a second language (ESL) classes in a K-12 school in Lebanon. Eighty kindergartners (KG II, aged 5 years) and eight teachers constituted the sample. The study used mixed methods, including observations of videotaped…

Sexual Stigma, Psychological Well-Being and Social Engagement among Men Who Have Sex with Men in Beirut, Lebanon

PubMed Central

Wagner, Glenn J.; Aunon, Frances M.; Kaplan, Rachel L.; Karam, Rita; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

2013-01-01

This qualitative study sought to explore the sexual identity development of men who have sex with men (MSM) in Beirut, the stigma experienced by these men, and how their psychological well-being and social engagement are shaped by how they cope with this stigma. Semi-structured interviews were conducted with 31 MSM, and content analysis was used to identify emergent themes. While many men reported feeling very comfortable with their sexual orientation and had disclosed their sexual orientation to family, most men struggled at least somewhat with their sexuality, often because of perceived stigma from others and internal religious conflict about the immorality of homosexuality. Most participants described experiencing verbal harassment or ridicule, or being treated as different or lesser than in social relationships with friends or family. Mechanisms for coping with stigma included social avoidance (trying to pass as heterosexual; limiting interaction with MSM to the internet) or withdrawal from relationships in an attempt to limit exposure to stigma. Our findings suggest that effective coping with both internal and external sexual stigma is central to the psychological well-being and social engagement of MSM in Beirut, much like what has been found in Western gay communities. PMID:23730919

Suicide risk factors among trans feminine individuals in Lebanon

PubMed Central

Kaplan, Rachel L.; Nehme, Simon; Aunon, Frances; de Vries, David; Wagner, Glenn

2016-01-01

Transgender women are disproportionately affected by high rates of depression and suicide attempts. It is therefore important to identify factors that influence suicidal risk, particularly in the Middle East where little research has examined the mental health of transgender women. We examined risk factors associated with suicide attempts among 54 trans feminine individuals in Beirut, Lebanon. Data were collected using interviewer-administered questionnaires and analyzed using bivariate statistics. Twenty-five (46%) participants reported having ever attempted suicide. Among them, only one participant received some kind of counseling in response to the attempted suicide. Low general social support, low social integration, and low support from peers were significantly associated with a history of attempted suicide, as were being more open about transgender identity in public and any hormone use (past or current). These findings suggest that progression in gender transition can have unintended consequences related to mental health and suicide risk, while social support systems can mitigate the impact of mental health problems. Some of these findings mirror other contexts around the globe and can inform mental health services for trans feminine individuals in Lebanon, the greater Middle East region, and other international settings. PMID:27616943

Lupus nephritis in Lebanon.

PubMed

Uthman, I W; Muffarij, A A; Mudawar, W A; Nasr, F W; Masri, A F

2001-01-01

This is a retrospective study of the clinicopathological characteristics of 50 systemic lupus erythematosus patients with nephritis who underwent a kidney biopsy and were admitted to the American University of Beirut Medical Center, in Lebanon, between 1979 and 1999. There were 43 females and seven males, with a median age of 24 y. Renal histology slides from these patients were assessed according to the World Health Organization classification, and were distributed as follows: class I (n = 3, 6%); class II (n = 14, 28%); class III (n = 11, 22%); class IV (n = 19, 38%); class V (n = 1, 2%); class VI (n = 2, 4%). All the patients received oral prednisone, in addition the following treatments were used: pulse intravenous (i.v.) cyclophosphamide (n = 23, 46%); azathioprine (n = 22, 44%); pulse i.v. steroids (n = 19, 38%); chloroquine sulfate (n = 17, 34%); methotrexate (n = 5, 10%); and plasmapheresis (n = 2, 4%). The median duration of follow-up was 5 y (range 1-33 y). On their last evaluation, out of 37 patients who were followed, 20 patients (54%) had controlled disease, eight patients (22%) were still on active medical treatment, four patients (11%) were on chronic hemodialysis, and five patients (13%) had died. Unlike three other Arab populations studies from Kuwait, United Arab Emirates and Saudi Arabia, where the most frequent histopathologic abnormality was class III, diffuse proliferative LN (class IV) was the most common type of lupus nephritis in Lebanon, similarly to reports from USA, France, Netherlands, South Africa, Thailand and Taiwan.

Levels and indoor-outdoor relationships of PM 10 and soluble inorganic ions in Beirut, Lebanon

NASA Astrophysics Data System (ADS)

Saliba, N. A.; Atallah, M.; Al-Kadamany, G.

2009-03-01

PM 10, which is considered among the major indoor and outdoor pollutants, was measured in several residential homes and corresponding outdoor environments in the Great Beirut area over the summer and winter seasons of 2005. Few studies on PM 10 levels indoors in Beirut are restricted to short-term periods in public places. In this study, 78 PM 10 samples were collected on Teflon filters using an active sampler at a flow rate of 5 L/min. PM 10 mass concentrations were determined by gravimetric analysis, and inorganic chemical speciation was carried out using ion chromatography. Outdoors, PM 10 elevated mass concentrations correlated well with high traffic density. The observed high intra-site temporal variation (minimum of 34 and a maximum of 120 μg/m 3) was attributed to the dynamic air masses passing over the Eastern Mediterranean region. Indoors, PM 10 levels were highly affected by outdoor levels, but were enhanced over those of outdoors when smoking activities were recorded. In winter, the overall average outdoor concentration dropped by 19%, whereas the average indoor concentration increased by 50% over the ones calculated for the summer. Ventilation and air exchange rates were found to be approximately equal to unity during summer since most doors and windows remain open. This rate drops to almost half during winter. As for particulate ions namely nitrates and sulfates, the former showed concentrations that are higher than the values reported in the region in both winter and summer seasons, suggesting high emissions from local vehicles. However, SO 42- average concentrations were comparable to values reported in other studies conducted in Eastern Mediterranean sites. Soluble particulate nitrates and sulfates exhibited similar indoor and outdoor levels in non-smoking homes (IO ~ 1), but in smoking homes the drop in nitrate concentrations reached around 70%, indicating a high anionic reactivity with tobacco smokes.

Prenatal and neonatal Group B Streptococcus screening and serotyping in Lebanon: incidence and implications.

PubMed

Seoud, Muheiddine; Nassar, Anwar H; Zalloua, Pierre; Boghossian, Nansi; Ezeddine, Jihad; Fakhoury, Hassan; Abboud, Joseph; Melki, Imad; Araj, George; Nacouzi, Ghinwa; Sanyoura, May; Yunis, Khalid

2010-03-01

The study aimed at determining the prevalence, risk factors, perinatal transmission, and serotypes of Group B Streptococcus (GBS) among pregnant women and their newborns in Beirut, Lebanon. This was a cross-sectional study of all pregnant women admitted from February to September 2006 to three major hospitals. Overall, 137 of 775 (17.7%) mothers and 50 of 682 newborns (7.3%) tested positive for GBS. Maternal colonization was not associated with maternal age, household income, gravidity, intrapartum fever, preterm labor, or premature rupture of membrane. Transmission rate was 40/120 (30%). Serotype 5 (24.1%) was the most common followed by serotype 1a (15.0%), 3 (14.4%), 2 (11.8%) and 1b (7.5%). Pregnant women in Lebanon appear to have a relatively high prevalence of GBS colonization with no identifiable risk factors for its acquisition. These results could provide basis for the institution of a national policy for universal maternal GBS screening to reduce neonatal morbidity and mortality.

Epidemiology of hepatitis B and hepatitis C in Lebanon.

PubMed

Abou Rached, Antoine; Abou Kheir, Selim; Saba, Jowana; Ammar, Walid

2016-03-01

Hepatitis B and C are two potentially life threatening liver infections. Lebanon is ranked as a zone of moderate endemicity. This study aimed to determine the prevalence of hepatitis B and C in Lebanon and their distribution according to age, region and sex. This national prospective cross-sectional study was conducted from January 2011 till December 2012 in the six Lebanese Governorates in collaboration with municipalities, the Ministry of Public Health, Health Centres and dispensaries. An upcoming screening for hepatitis B and C was announced? in different districts of each Governorate. All individuals presenting to local laboratory, not known to have chronic hepatitis, were asked for a blood sample and answered a questionnaire addressing sex, age, place of birth and residence. Screening tests were "Abbots" for hepatitis B and "Human Hexagon" for hepatitis C. PCR testing was used to confirm the positivity of the previous tests. Of 31147 individuals screened, 542 had a rapid test positive for HBV (prevalence 1.74%, 95% CI 1.6-1.89) with a male to female ratio of 1.08. This prevalence was higher in the South and Nabatieh (1.9%) compared to Beirut (0.73%). Of 31,147 individuals screened, 64 had a rapid test positive for HCV (prevalence 0.21%, 95% CI 0.16-0.27) with a male to female ratio of 0.85. This prevalence was higher in Nabatieh (0.61%) compared to Mount Lebanon (0.08%). The prevalence of HBV and HCV in Lebanon is 1.74% and 0.21%, respectively with a higher prevalence in South and Nabatieh districts. These data rank Lebanon amongst countries with low endemicity for both viruses. Decrease in the prevalence of HBV is due to awareness campaign as well as success of the MOPH National Hepatitis Program in vaccinating all new born since 1998 and in screening and vaccinating high risk groups. Copyright © 2016 Arab Journal of Gastroenterology. Published by Elsevier B.V. All rights reserved.

Consanguinity and family clustering of male factor infertility in Lebanon.

PubMed

Inhorn, Marcia C; Kobeissi, Loulou; Nassar, Zaher; Lakkis, Da'ad; Fakih, Michael H

2009-04-01

To investigate the influence of consanguineous marriage on male factor infertility in Lebanon, where rates of consanguineous marriage remain high (29.6% among Muslims, 16.5% among Christians). Clinic-based, case-control study, using reproductive history, risk factor interview, and laboratory-based semen analysis. Two IVF clinics in Beirut, Lebanon, during an 8-month period (January-August 2003). One hundred twenty infertile male patients and 100 fertile male controls, distinguished by semen analysis and reproductive history. None. Standard clinical semen analysis. The rates of consanguineous marriage were relatively high among the study sample. Patients (46%) were more likely than controls (37%) to report first-degree (parental) and second-degree (grandparental) consanguinity. The study demonstrated a clear pattern of family clustering of male factor infertility, with patients significantly more likely than controls to report infertility among close male relatives (odds ratio = 2.58). Men with azoospermia and severe oligospermia showed high rates of both consanguinity (50%) and family clustering (41%). Consanguineous marriage is a socially supported institution throughout the Muslim world, yet its relationship to infertility is poorly understood. This study demonstrated a significant association between consanguinity and family clustering of male factor infertility cases, suggesting a strong genetic component.

Prevalence of consanguineous marriages among shi'a populations of Lebanon.

PubMed

El-Kheshen, Ghadir; Saadat, Mostafa

2013-09-01

In genetics, a consanguineous marriage means union between couples who are related as second cousins or closer. The present cross-sectional study was carried out in order to illustrate the prevalence and types of consanguineous marriages in the Shi'a population living in widespread territories in Lebanon including the Bekaa Valley, the south of Lebanon and the southern suburb of Beirut. Data on types of marriages were collected using a simple questionnaire. The total number of couples in the study was 1203. Consanguineous marriage was classified by the degree of relationship between couples. The overall frequency of consanguinity was found to be 28.4%, with first cousin marriages (21.3%) being the most common type followed by first cousins once removed (5.5%), then double first cousins (0.8%). The frequencies of second cousin and beyond second cousin marriages were the same at 0.4% of all the marriages. The mean inbreeding coefficient (α) was estimated at about 0.0161 for the population. There were no significant differences between the three studied territories for frequencies of different types of marriages (p>0.1), nor were there significant differences between the rural and urban areas (p>0.1).

The effect of education of women and urbanization on actual and desired fertility and on fertility control in Lebanon.

PubMed

Zurack, H C

1977-07-01

The influence of education of women and urbanization on actual and desired fertility and on fertility control in Lebanon was examined. Data were used from 1 study conducted in the Nabatieh district of South Lebanon in the summer of 1976 and from a 2nd study conducted in 1970 in an area on the outskirts of the capital city of Beirut. The total number of completed interviews in the Nabatieh sample was 1054. This population consisted mostly of Shiites with Christian and Sunni minorities. The urban sample consisted of 1545 Shiite and 1459 Maronite. The examination revealed that: 1) among the rural sample, a relatively high level of education (beyond the primary level) is necessary to induce a substantial decrease in average children ever born; 2) a comparison of rural and urban samples showed the effect of the education variable was dependent on religious affiliation - the Shiite women at low levels of education demonstrated higher fertility than Maronite women, but they responded more to an improvement in education in the urban area; 3) women urban residents showed lower fertility than women rural dwellers, controlling for religion and age; 4) the rural study conducted 5 years after the urban study showed a lower level of desired fertility; and 5) the Shiite women (who are a majority of the women in South Lebanon) revealed a tendency to use modern contraceptive methods, particularly the oral contraceptive, suggesting a receptivity in the area to the Lebanon Family Planning Associations project of Community Based Family Planning Services.

Organic Food Market Segmentation in Lebanon

NASA Astrophysics Data System (ADS)

Tleis, Malak; Roma, Rocco; Callieris, Roberta

2015-04-01

Organic farming in Lebanon is not a new concept. It started with the efforts of the private sector more than a decade ago and is still present even with the limited agricultural production. The local market is quite developed in comparison to neighboring countries, depending mainly on imports. Few studies were addressed to organic consumption in Lebanon, were none of them dealt with organic consumers analysis. Therefore, our objectives were to identify the profiles of Lebanese organic consumer and non organic consumer and to propose appropriate marketing strategies for each segment of consumer with the final aim of developing the Lebanese organic market. A survey, based on the use of closed-ended questionnaire, was addressed to 400 consumers in the capital, Beirut, from the end of February till the end of March 2014. Data underwent descriptive analyses, principal component analyses (PCA) and cluster analyses (k-means method) through the statistical software SPSS. Four cluster were obtained based on psychographic characteristics and willingness to pay (WTP) for the principal organic products purchased. "Localists" and "Health conscious" clusters constituted the largest proportion of the selected sample, thus were the most critical to be addressed by specific marketing strategies emphasizing the combination of local and organic food and the healthy properties of organic products. "Rational" and "Irregular" cluster were relatively small groups, addressed by pricing and promotional strategies. This study showed a positive attitude among Lebanese consumer towards organic food, where egoistic motives are prevailing over altruistic motives. High prices of organic commodities and low trust in organic farming, remain a constraint to levitating organic consumption. The combined efforts of the public and the private sector are required to spread the knowledge about positive environmental payback of organic agriculture and for the promotion of locally produced organic goods.

HIV Risk, Prevalence, and Access to Care Among Men Who Have Sex with Men in Lebanon.

PubMed

Heimer, Robert; Barbour, Russell; Khouri, Danielle; Crawford, Forrest W; Shebl, Fatma; Aaraj, Elie; Khoshnood, Kaveh

2017-11-01

Little is known about HIV prevalence and risk among men who have sex with men (MSM) in much of the Middle East, including Lebanon. Recent national-level surveillance has suggested an increase in HIV prevalence concentrated among men in Lebanon. We undertook a biobehavioral study to provide direct evidence for the spread of HIV. MSM were recruited by respondent-driven sampling, interviewed, and offered HIV testing anonymously at sites located in Beirut, Lebanon, from October 2014 through February 2015. The interview questionnaire was designed to obtain information on participants' sociodemographic situation, sexual behaviors, alcohol and drug use, health, HIV testing and care, and experiences of stigma and discrimination. Individuals not reporting an HIV diagnosis were offered optional, anonymous HIV testing. Among the 292 MSM recruited, we identified 36 cases of HIV (12.3%). A quarter of the MSM were born in Syria and recently arrived in Lebanon. Condom use was uncommon; 65% reported condomless sex with other men. Group sex encounters were reported by 22% of participants. Among the 32 individuals already aware of their infection, 30 were in treatment and receiving antiretroviral therapy. HIV prevalence was substantially increased over past estimates. Efforts to control future increases will have to focus on reducing specific risk behaviors and experience of stigma and abuse, especially among Syrian refugees.

Preventing thalassemia in Lebanon: successes and challenges in a developing country.

PubMed

Abi Saad, Michele; Haddad, Anthony G; Alam, Elie S; Aoun, Sanaa; Maatouk, Pascale; Ajami, Najat; Khairallah, Therese; Koussa, Suzanne; Musallam, Khaled M; Taher, Ali T

2014-01-01

Thalassemia continues to be a major health burden. The chronicity of the disease and the high cost of life-long treatment make prevention strategies crucial in the management of this disease. In this article, we revisit different successful prevention strategies, and underline the Lebanese model. The Chronic Care Center (CCC), Beirut, is the only specialized center in Lebanon for the treatment and prevention of thalassemia. The current number of patients registered up to August 2013 was 724, representing cases from all over Lebanon. In 1994, the center launched a national prevention program following the World Health Organization (WHO) recommendations. The major activities of the program include awareness campaigns, screening for thalassemia carriers in the general population and high risk groups, registry of new cases and follow-up on the mandatory premarital law (established at the same time). Screening programs showed a carrier rate of around 2.3% in the general population, and 4.0-41.0% in high risk groups. The major pitfall in the law is that only persons with a mean corpuscular volume (MCV) of >70.0 fL are asked to perform further hemoglobin (Hb) testing. A significant decrease in the number of new cases of thalassemia patients in Lebanon reflects the efforts deployed in the prevention of the disease. However, some limitations are faced in reaching a complete eradication of the disease, mainly due to the fact that abortion is illegal and due to pitfalls and incorrect implementation of the premarital law.

Perceptions and practices regarding herbal medicine prescriptions among physicians in Greater Beirut.

PubMed

Ala Aeddine, Nada; Khayat, Mohamed; Alawieh, Hanaa; Adibilly, Siham; Adib, Salim

2014-01-01

This survey aimed at assessing the perceptions of physicians regarding the appropriateness of prescribing herbal medicines (HM), their prescribing patterns and their knowledge regarding the interaction between HM and conventional drugs. No data are currently available in Lebanon concerning the frequency of HM prescription and indications. HM poorly prescribed can affect the overall quality of health among patients taking conventional drugs. This descriptive survey study was conducted in the Greater Beirut area in Lebanon during May-June 2009. All Primary Health Care (PHC) physicians in private community-based solo practice were identified from the Lebanese Order of Physicians listing, contacted and invited to participate. Those who agreed had to complete a pre-piloted face-to-face questionnaire. Of two hundred twelve participating physicians, 45% routinely prescribed HM to their patients. Between 64 to 67% prescribers believed that HM have more benefits, faster results and fewer side effects than conventional drugs. In addition, 58% thought that HM were less expensive, and 76% that they were easier to take than conventional drugs. More importantly, in a series of eight questions concerning the physicians' knowledge about the possible mechanism of drug-herb interactions, the general tendency was towards poor knowledge. A good percentage of PHC physicians who routinely prescribe HM do not know their mechanism of action or their possible interactions with the conventional drugs. Knowledge about mechanism of drug-herb interactions should be an integral part of the medical curriculum. The knowledge about HM should be an integral part of the medical curriculum as they are frequently prescribed by PHC physicians.

Why are breastfeeding rates low in Lebanon? A qualitative study.

PubMed

Nabulsi, Mona

2011-08-30

Breastfeeding is a cost-effective public health intervention that reduces infant morbidity and mortality in developing countries. In Lebanon, breastfeeding exclusivity and continuation rates are disappointingly low. This qualitative study aims at identifying barriers and promoters of breastfeeding in the Lebanese context by exploring mothers' perceptions and experiences in breastfeeding over a one year period. We conducted focus group discussions in three hospitals in Beirut, Lebanon, and followed up 36 breastfeeding mothers with serial in-depth interviews for one year post-partum or until breastfeeding discontinuation. Themes generated from baseline interviews revealed several positive and negative perceptions of breastfeeding. Longitudinal follow up identified insufficient milk, fear of weight gain or breast sagging, pain, sleep deprivation, exhaustion, or maternal employment, as reasons for early breastfeeding discontinuation. Women who continued breastfeeding for one year were more determined to succeed and overcome any barrier, relying mostly on family support and proper time management. Increasing awareness of future mothers about breast feeding difficulties, its benefits to children, mothers, and society at large may further promote breastfeeding, and improve exclusivity and continuation rates in Lebanon. A national strategy for early intervention during school years to increase young women's awareness may improve their self-confidence and determination to succeed in breastfeeding later. Moreover, prolonging maternity leave, having day-care facilities at work, creation of lactation peer support groups and hotlines, and training of doctors and nurses in proper lactation support may positively impact breastfeeding exclusivity and continuation rates. Further research is needed to assess the effectiveness of proposed interventions in the Lebanese context.

77 FR 58912 - Designation of One (1) Individual Pursuant to Executive Order 13582 of August 17, 2011, “Blocking...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-24

...; alt. DOB 31 Aug 1955; alt. DOB 31 Aug 1958; POB Al Basuriyah, Lebanon; alt. POB Beirut, Lebanon; Passport 042833 (Lebanon); Secretary General of HIZBALLAH (individual) [SDT] [SYRIA]. Dated: September 13...

Violent behavior among adolescents in post-war Lebanon: the role of personal factors and correlation with other problem behaviors.

PubMed

Sibai, Tarek; Tohme, Rania A; Beydoun, Hind A; Kanaan, Nabil; Sibai, Abla Mehio

2009-03-01

Adolescent violence is a significant public health problem. The primary objective of this study is to assess the prevalence and correlates of violent behavior among adolescent students in Lebanon. A cross-sectional study was conducted among a representative sample of 827 secondary students enrolled in public and private schools in Beirut. Using a series of multiple logistic regression techniques, socio-demographic variables which significantly associated with violent behavior were included as potential confounders in building the models for risk behavior. Nearly 42 and 17% of adolescents reported being involved in physical fights and weapon carrying, respectively. Boys were significantly more likely to use violence than girls. Whereas associations with physical fights were stronger for socio-economic variables and perceived rank in class, weapon carrying was significantly associated with problem behaviors, such as unintentional injury, substance abuse and sexual activity, with effect measures being stronger than those estimated for physical fighting. Compared with other countries, the rates of violent behavior in Lebanon are relatively high. The results from this study are discussed in light of the political ecology of Lebanon which may contribute to a culture that perpetrates violent behavior and may have influenced the clustering pattern of risk behaviors.

Research in action: mammography utilization following breast cancer awareness campaigns in Lebanon 2002-05.

PubMed

Adib, S M; Sabbah, M A; Hlais, S; Hanna, P

2009-01-01

Four consecutive annual surveys of 1200 women each were conducted in Lebanon in connection with the National Breast Cancer Awareness campaigns (2002-05) to measure the prevalence of mammography utilization and the impact of these campaigns, and to highlight regional and demographic differences. The utilization of mammography in the previous 12 months was low and increased only slightly over 4 years (from 11% to 18%). In the 2005 campaign, it was twice as high (25%) in greater Beirut than in mostly rural areas, and among women aged 40-59 years (about 21%) compared with younger (12%) or older (11%) women. In each wave, repeat mammograms were less common than first time screening.

Candida profiles and antifungal resistance evolution over a decade in Lebanon.

PubMed

Araj, George Farah; Asmar, Rima George; Avedissian, Aline Zakaria

2015-09-27

Infection with and antifungal resistance of Candida species have been on the rise globally. Relevant data on these pathogens are relatively few in our region, including Lebanon, thus warranting this study. This retrospective study of Candida spp. profiles and their in vitro antifungal susceptibility was based on analysis requests for 186 Candida non-albicans and 61 C. albicans during three periods (2005-2007, 2009-2011, and 2012-2014) over the span of the last 10 years at the American University of Beirut Medical Center (AUBMC), a major tertiary care center in Lebanon. Identification of Candida was done using the API 20C AUX system, and the E-test was used to determine the minimum inhibitory concentrations (MICs) of antifungal agents. Among the 1,300-1,500 Candida isolates recovered yearly, C. albicans rates decreased from 86% in 2005 to around 60% in 2014. Simultaneously, the non-albicans rates increased from 14% in 2005 to around 40% in 2014, revealing 11 species, the most frequent of which were C. tropicalis, C. glabrata, and C. parapsilosis. All these demonstrated high resistance (35%-79%) against itraconazole, but remained uniformly susceptible (100%) to amphotericin B. Though C. albicans and the other species maintained high susceptibility against fluconazole and voriconazole, their MIC90 showed an elevated trend over time, and C. glabrata had the highest resistance rates. The observed rise in resistance among Candida spp. in Lebanon mandates the need for close surveillance and monitoring of antifungal drug resistance for both epidemiologic and treatment purposes.

Social Relations in Lebanon: Convoys Across the Life Course.

PubMed

Antonucci, Toni C; Ajrouch, Kristine J; Abdulrahim, Sawsan

2015-10-01

This study systematically analyzed convoys of social relations to investigate the ways in which gender and income shape patterns of social relations across the life course in Lebanon. Data were drawn from a representative sample of adults aged 18 and older in Greater Beirut, Lebanon (N = 500). Multiple linear regression and multilevel models were conducted to examine main and interactive effects of age, gender, and income on social relations. Findings indicate main effects of age, income, and gender on network structure and relationship quality. Older age was associated with larger network size, greater proportion of kin in network, higher positive and lower negative relationship quality. Higher income was associated with larger network size and decreased contact frequency. Female gender was also associated with decreased contact frequency. Gender interacted with income to influence network size and network composition. Higher income was associated with a larger network size and higher proportion of kin for women. Findings suggest diversity in the experience of social relations. Such nuance is particularly relevant to the Lebanese context where family is the main source of support in old age. Policy makers and program planners may need to refrain from viewing social relations simplistically. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Demographic and Psychosocial Profile of Smoking Among Pregnant Women in Lebanon: Public Health Implications

PubMed Central

Chaaya, Monique; Awwad, Johnny; Campbell, Oona M.R.; Sibai, Abla; Kaddour, Afamia

2006-01-01

Objectives To assess the prevalence and determinants of smoking prior to and during pregnancy in Lebanon. Methods A cross-sectional study using two structured instruments. One instrument included information on demographic characteristics, smoking patterns in the index pregnancy and previous pregnancies, use of prenatal health services, stressful life events, and social support during pregnancy. The second was the Arabic General Health Questionnaire (GHQ-12). Women who delivered in 11 randomly selected hospitals in Beirut and its suburbs within 24 hours were asked to consent to participate in the study. The total sample interviewed was 576 women. Results The prevalence of pre-pregnancy smoking was 32% and 20% for smoking in pregnancy. Considering argileh smoking, the prevalence of tobacco use in pregnancy increased to 27% in Beirut and 25% in the suburbs. Pre-pregnancy smoking was associated with older maternal age [OR = 1.08, 95% CI (1.03, 1.14)], low and medium education [OR = 2.22, 95% CI (1.22, 4.04)], increased psychiatric distress [OR = 3.11, 95% CI (1.77, 5.46)], and a husband who smoked [OR = 5.00, 95% CI (2.98, 8.39)]. Continued smoking during pregnancy was associated with low and medium education [OR = 3.77, 95% CI (1.31, 10.8)], younger age [OR = 1.11, 95% CI (1.02–1.20)], and a heavy pre-pregnancy smoking pattern [OR = 13.9, 95% CI (1.40, 137.4)]. Conclusion Policies and programs to eliminate or reduce smoking during pregnancy should be targeted toward young and less educated females and involving the spouse. Obstetricians should promote smoking cessation during pregnancy using evidence-based methods. PMID:14509413

A qualitative analysis of multi-level barriers to HIV testing among women in Lebanon.

PubMed

Clark, Kirsty A; Keene, Danya E; Pachankis, John E; Fattal, Omar; Rizk, Nesrine; Khoshnood, Kaveh

2017-09-01

While the number of HIV cases in the Middle East and North Africa region is low compared to other regions, recent studies show that incidence is increasing especially among high-risk populations; in particular, little is known about women and HIV in the region. Through semi-structured interviews with sexual healthcare providers and staff at non-governmental organisations, we sought to understand barriers to HIV testing among women in Lebanon. Using snowball sampling, key informants were recruited from greater Beirut (12 physicians, 9 non-governmental organisation staff). Data were analysed using a grounded theory framework. Findings identified barriers to HIV testing among women at each level of an adapted social-ecological model (i.e. social-cultural barriers, policy barriers, interpersonal healthcare provider barriers and intrapersonal barriers). Primary findings include the culture of sex as taboo; lack of sexual health education among women; fear of disclosing HIV testing and diagnosis; financial barriers linked to stigmatising insurance policies; and provider attitudes towards women. Findings can be used to inform HIV-related sexual health interventions at multiple levels for women in Lebanon and the greater region.

Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family.

PubMed

Adra, Marina Gharibian; Hopton, John; Keady, John

2015-12-01

Located in two care homes in Lebanon, the study explores the perspectives of quality of life for a sample of older residents, care staff and family caregivers. Quality of life for older people living in care homes is traditionally reported in the literature as a Westernised construct and so far little is known about its meanings from an Arabic cultural perspective and context. There is also a knowledge gap about the conditions of older people living in care homes in Lebanon. The study was a qualitative exploration of perspectives of quality of life of older residents, care staff and family caregivers. Two care homes for older people situated in Beirut took part in the study. Between 2010 and 2011 semi-structured interviews were undertaken with a sample of 20 residents, eight family caregivers and 11 care staff. Data were analysed using the constant comparative method. Four categories emerged from this analytical process: (i) maintaining family connectedness; (ii) engaging in worthwhile activities; (iii) maintaining and developing significant relationships; and (iv) holding and practicing spiritual beliefs. The emergence of these categories confirmed the complex, interrelated and multidimensional nature of quality of life for residents and other stakeholders. The findings supplement an emerging body of knowledge about the composition of quality of life for older residents in Lebanon. Improving the quality of life of older residents will require action in respect of all of the domains identified in study. Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care. © 2015 John Wiley & Sons Ltd.

Chemical characteristics of PM2.5-0.3 and PM0.3 and consequence of a dust storm episode at an urban site in Lebanon

NASA Astrophysics Data System (ADS)

Borgie, Mireille; Ledoux, Frédéric; Dagher, Zeina; Verdin, Anthony; Cazier, Fabrice; Courcot, Lucie; Shirali, Pirouz; Greige-Gerges, Hélène; Courcot, Dominique

2016-11-01

Located on the eastern side of the Mediterranean Basin at the intersection of air masses circulating between three continents, the agglomeration of Beirut, capital of Lebanon is an important investigating area for air pollution and more studies are needed to elucidate the composition of the smallest particles classified as carcinogenic to humans. PM2.5-0.3 and PM0.3 samples were collected during the spring-summer period in an urban background site of Beirut, after a dust storm episode occurred, and their chemical composition was determined. Our findings showed that components formed by gas to particle conversion (SO42 - and NH4+) and related to combustion processes are mainly found in the PM0.3 fraction. Typical crustal (Ca2+, Fe, Ti, Mg2+), sea-salt (Na+, Cl-, Mg2+, Sr) species, and NO3- are mainly associated with the PM2.5-0.3 fraction. We have also evidenced that the dust episode which occurred in Lebanon in May 2011 originated from the Iraqian and Syrian deserts, which are the least studied, and had a direct influence on the composition of PM2.5-0.3 during the beginning of the first sampling period, and then an indirect and persistent influence by the re-suspension of deposited dust particles. Moreover, PAHs concentrations were much higher in PM0.3 than in PM2.5-0.3 and their composition appeared influenced by diesel (buses, trucks and generator sets) and gasoline (private cars) emissions.

Towards a phenomenology of civil war: Hobbes meets Benjamin in Beirut.

PubMed

De Cauter, Lieven

2011-01-01

Based on interviews with Beirut intellectuals and architects, this essay endeavours to trace the contours for a phenomenology or anthropology of civil war. Thomas Hobbes serves as a guide, with his idea of civil war representing a relapse into the ‘state of nature’; as absence of sovereignty resulting in a ‘war of everybody against everybody’. The effects of ever-latent civil war in Beirut are far-reaching: the fragmentation of urban space and the disappearance of public space, the loss of memory and the fragmentation of time, even the reification of language. In the collective imagination and in the arts, Beirut appears as a ghost town, a spectral city with a spectral civility. What we discover is a city, its inhabitants, its social behaviour, but also its art and literature, in the grip of post-traumatic stress syndrome. From all this, we take home two things: first, any city can (at least in principle) relapse into a similar state of nature — Beirut can become a paradigm of latent civil war; and second, the traumatic modernity of Beirut mirrors the traumatic artistic expressions of modernism — the shock of modernity is also always a modernity of shock.

TUBERCULOSIS BURDEN IN LEBANON: EVOLUTION AND CURRENT STATUS.

PubMed

Araj, George F; Saade, Antoine; Itani, Lina Y; Avedissian, Aline Z

2016-01-01

In the absence of surveillance data and consolidated information about tuberculosis (TB) and its drug resistance burden in Lebanon, this retrospective study was conducted to shed light on TB and its other relevant aspects over the last 15 years in this country. To generate the TB data for this retrospective study, two main sources were used: 1) the records of patients in the National Tuberculosis Program (NTP); 2) the results of the Clinical Microbiology Laboratory (CML) at the American University of Beirut Medical Center (AUBMC). The TB data review pertained to its epidemiological aspect, implementation of the directly observed therapy strategy (DOTS) all over, the gender distribution, the impact of high risk groups (non-national population, Syrian refugees, patients with multi-drug resistance-TB [MDR-TB] and the inmate population) on the trend of TB in Lebanon between 1999 and 2013. Reviewed also are TB in children, extrapulmonary tuberculosis and the mycobacterium other than tuberculosis (MOTT). During the last 15 years, 7548 TB cases were diagnosed and evaluated at the NTP. After the decreasing of TB incidence from 13/100 000 population in 2001 to 9/100 000 in 2006, the incidence started to increase in 2007, reaching 20/100 000 in 2013, mostly due to increased cases among non-national population. Fluctuations in TB rates over the years were seen among children, inmates, MDR-TB, and HIV patients. MOTT isolates recovery rates also fluctuated during the study period, M. simiae being the most common. After the decreasing trends of TB incidence between 1999 and 2006, Lebanon has been experiencing an increasing incidence in tuberculosis population since 2007. This is mainly attributed to the dramatic increase of TB patients among non-nationals and the influx of Syrian refugees. The ongoing collaboration between the public and private sectors, improvements of the surveillance system and TB control are important factors for successful elimination of TB in this country.

HIV prevalence and demographic determinants of condomless receptive anal intercourse among trans feminine individuals in Beirut, Lebanon

PubMed Central

Kaplan, Rachel L; McGowan, Justine; Wagner, Glenn J

2016-01-01

Introduction Growing evidence suggests increased HIV incidence in the Middle East and North Africa among “key populations.” To date, epidemiological data have not accurately included and measured HIV prevalence and risk among trans feminine individuals in the region. Through the lens of the Gender Affirmation Framework, we assessed demographic correlates of risk behaviour and the prevalence of HIV among trans feminine individuals in Lebanon. Methods Long-chain referral sampling was used to recruit 53 participants for completion of a behavioural survey and optional free rapid HIV tests. Data were collected using interviewer-administered questionnaires. A multivariable logistic regression model was used to identify demographic determinants of HIV risk behaviour. Results Fifty-seven percent of participants reported condomless receptive anal intercourse (CRAI) with male partner(s) in the last three months, 40% of whom reported not knowing the HIV status of the partner(s). Of the participants tested for HIV as part of the study or via self-report, four (10%) were HIV positive; 13 declined HIV testing. Forty percent of the sample had no prior history of HIV testing. A history of trauma such as sexual abuse/assault was reported by almost half of the participants (49%). Sixty-eight percent reported experiencing physical violence and 32% police arrest, because of gender identity or presentation. A staggering 98% reported having experienced gender identity or gender presentation-related discrimination. Sixty-six percent of the sample reported current sex work; sex work was correlated with CRAI but was not significant in multivariate analysis. In regression analysis, “openness”/“outness” about transgender identity at work or school was significantly associated with CRAI. Surprisingly, a history of sexual abuse/assault was negatively correlated with CRAI, suggesting the need for further inquiry. Conclusions The results of this study provide implications for how to

Sectarianism and the problem of overpopulation: political representations of reproduction in two low-income neighbourhoods of Beirut, Lebanon.

PubMed

Premkumar, Ashish; Salem, Karma; Akhtar, Sarah; Deeb, Mary E; Messersmith, Lisa J

2012-01-01

The role of confessionalism in the Lebanese healthcare sector, especially since the resolution of the Lebanese civil war (1975-1990), has yet to discussed at length in reproductive health research. Using biopolitical and structural violence models to describe how community leaders in two low-income neighbourhoods in Beirut describe reproductive healthcare - specifically through judgments of perceived sect size vis-à-vis perceived use of birth control measures - this paper attempts to provide critical analysis of the state of reproductive health in this setting. By using a theoretical model of analysis, which we refer to as the political anatomy of reproduction, we hope to unmask how confessionalism is perpetuated through discussions of reproductive health and how public health and medical communities can challenge this technique of power.

The 1983 Beirut Airport terrorist bombing. Injury patterns and implications for disaster management.

PubMed

Frykberg, E R; Tepas, J J; Alexander, R H

1989-03-01

The casualty profile and results of the medical care provided for the survivors of the terrorist truck bombing of the U.S. Marine Corps facility in Beirut, Lebanon, in 1983 were reviewed to determine the factors that influenced casualty survival. This explosion resulted in 346 casualties, of whom 234 (68%) were immediately killed. The spectrum of injury was determined in 85 survivors using the Injury Severity Score (ISS). There were seven (6.3%) deaths among the 112 immediate survivors. All deaths occurred among the 19 (17%) victims who were critically injured (ISS greater than 15), giving a mortality in this population of 37 per cent. Six (86%) of the seven deaths were associated with an initial delay in treatment. Head injury was the most common fatal injury among both immediate fatalities (71.4%) and immediate survivors (57%). Thoracic injury and burns each accounted for 29 per cent of survivor deaths. Triage efficiency, as determined by the rates of overtriage (80%) and undertriage (0), did not appear adversely to affect mortality. Critical analysis of disasters such as this can contribute to improvements in preparation and casualty care in the event of future disasters.

Demographic and psychosocial profile of smoking among pregnant women in Lebanon: public health implications.

PubMed

Chaaya, Monique; Awwad, Johnny; Campbell, Oona M R; Sibai, Abla; Kaddour, Afamia

2003-09-01

To assess the prevalence and determinants of smoking prior to and during pregnancy in Lebanon. A cross-sectional study using two structured instruments. One instrument included information on demographic characteristics, smoking patterns in the index pregnancy and previous pregnancies, use of prenatal health services, stressful life events, and social support during pregnancy. The second was the Arabic General Health Questionnaire (GHQ-12). Women who delivered in 11 randomly selected hospitals in Beirut and its suburbs within 24 hours were asked to consent to participate in the study. The total sample interviewed was 576 women. The prevalence of pre-pregnancy smoking was 32% and 20% for smoking in pregnancy. Considering argileh smoking, the prevalence of tobacco use in pregnancy increased to 27% in Beirut and 25% in the suburbs. Pre-pregnancy smoking was associated with older maternal age [OR = 1.08, 95% CI (1.03, 1.14)], low and medium education [OR = 2.22, 95% CI (1.22,4.04)], increased psychiatric distress [OR = 3.11, 95% CI (1.77,5.46)], and a husband who smoked [OR = 5.00, 95% CI (2.98,8.39)]. Continued smoking during pregnancy was associated with low and medium education [OR = 3.77, 95% CI (1.31, 10.8)], younger age [OR = 1.11, 95% CI (1.02-1.20)], and a heavy pre-pregnancy smoking pattern [OR = 13.9, 95% CI (1.40,137.4)]. Policies and programs to eliminate or reduce smoking during pregnancy should be targeted toward young and less educated females and involving the spouse. Obstetricians should promote smoking cessation during pregnancy using evidence-based methods.

Breastfeeding knowledge, attitude, perceived behavior, and intention among female undergraduate university students in the Middle East: the case of Lebanon and Syria.

PubMed

Hamade, Haya; Naja, Farah; Keyrouz, Sarah; Hwalla, Nahla; Karam, Jeanette; Al-Rustom, Lea; Nasreddine, Lara

2014-06-01

The Middle East has one of the lowest rates of exclusive breastfeeding in the world, highlighting the need to promote breastfeeding in this region. Young adults represent a key population of interest, since decisions about infant-feeding appear to be made before children are even conceived. To examine breastfeeding knowledge, attitude, and perceived behavior among female undergraduate students in Lebanon and Syria and determine factors associated with intention to breastfeed in this population. This cross-sectional study was conducted in 2010/11 in Damascus and Beirut. Four universities were selected in each city. A multicomponent questionnaire was administered to a convenience sample of participants (n = 194 from Beirut and n = 199 from Damascus). The questionnaire included breastfeeding knowledge (measured by the Infant Feeding Knowledge Test Form), attitude (Iowa Infant Feeding Attitude Scale), perceived behavior (Breastfeeding Behavior Questionnaire), and intention (Infant Feeding Intention Scale). Factors associated with intention to breastfeed were examined by multivariate linear regression analysis. The participants had an average breastfeeding knowledge level (mean score, 10.39 +/- 2.09) and neutral perceived behavior (mean score, 22.00 +/- 3.68), while having relatively positive attitudes (mean score, 58.12 +/- 6.49). Knowledge gaps and negative perceptions were identified, particularly linked to breastfeeding in public and among working mothers. Breastfeeding intention was found to be significantly associated with knowledge and attitude in Lebanon (beta = 0.103 and beta = 0.230, respectively), and with perceived behavior in Syria (beta = -0.135). By revealing specific knowledge gaps and misconceptions and identifying country-specific disparities in the predictors of the intention to breastfeed, the findings of this study may provide a basis for devising culture-specific interventions aimed at promoting breastfeeding.

Developing a logic model for youth mental health: participatory research with a refugee community in Beirut

PubMed Central

Afifi, Rema A; Makhoul, Jihad; El Hajj, Taghreed; Nakkash, Rima T

2011-01-01

Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory research. This paper describes a process leading to the development of a logic model for a youth mental health promotion intervention using a participatory approach in a Palestinian refugee camp in Beirut, Lebanon. First, a needs assessment, including quantitative and qualitative data collection was carried out with children, parents and teachers. The second phase was identification of a priority health issue and analysis of determinants. The final phase in the construction of the logic model involved development of an intervention. The process was iterative and resulted in a more grounded depiction of the pathways of influence informed by evidence. Constructing a logic model with community input ensured that the intervention was more relevant to community needs, feasible for implementation and more likely to be sustainable. PMID:21278370

Trends in mammography utilization for breast cancer screening in a Middle-Eastern country: Lebanon 2005-2013.

PubMed

Haddad, Fady G; Kourie, Hampig Raphael; Adib, Salim M

2015-12-01

In Lebanon, annual national breast awareness campaigns were started in 2002 during the international breast month of October to promote the utilization of mammography for women aged ≥ 40. The impact of the campaigns has been assessed periodically since 2003. Results of 2003-2005 campaigns have been published previously. To measure the prevalence of two behavioral outcomes of interest: ever-use of mammography, and repeat mammography in the previous 12 months among ever-users. The prevalence was described by region and age group. The aim was to document the effectiveness of the program towards reaching a nationally defined goal of 80% screening coverage. The survey's sampling frame was developed incrementally, and since 2005 it has included women aged ≥ 40 from all areas of Lebanon. The sample size has also increased incrementally from 1200 in 2005 to 2400 in 2013. Results have been tabulated biannually and presented as historical trends with regional and demographic variations covering a 9-year period. In all six consecutive surveys presented here, the mean age of participating women was about 50 years. Year-by-year increases in utilization indicators were detected, with consistent differences in favor of the more urban areas in and around the capital city Beirut and its suburbs (Greater Beirut or GB). By 2013, ever-utilization had reached 43% (41-45) and recent mammography 20% (18-22) nationwide. Utilization was significantly more important in the age group 50-59 compared with the age group 40-49 or ≥ 60. While recent rates have increased nationwide, they have reached a plateau of about 25% in GB and are tending to the same level in other areas. While initial progress was slow, it has been accelerating in the last 4-5 years, indicating that the message is being accepted by a larger audience of targeted women at each iteration. However, concern remains that women between 40 and 50 and those >60 are not responding as well as desired to the screening message

Lebanon

DTIC Science & Technology

2001-12-11

members of Hamas (Islamic Resistance Movement) from the occupied territories into southern Lebanon. Lebanon refused to allow the deportees to leave...the Israeli security strip and enter Lebanese-controlled territory. The last of the deportees returned to Israeli prisons on December 15, 1993. 10/20

Prevalence and determinants of albuminuria in a cohort of diabetic patients in Lebanon.

PubMed

Taleb, Nadine; Salti, Haytham; Al-Mokaddam, Mona; Merheb, Marie; Salti, Ibrahim; Nasrallah, Mona

2008-01-01

Few data are available on the extent of albuminuria in diabetic populations in the Middle East generally and in Lebanon specifically. We conducted this study to determine the prevalence of albuminuria and its major risk factors in a cohort of diabetic patients in Lebanon. Diabetic patients followed in the outpatient department at the American University of Beirut Medical Center (AUBMC) were included in a prospective observational study. AUBMC is a tertiary referral center and the outpatient department typically handles patients of low socioeconomic status with advanced disease. Patients were classified according to their urinary albumin-to-creatinine ratio (ACR) as having normoalbuminuria (ACR<30 mg/g creatinine), microalbuminuria (ACR=30 to <300 mg/g creatinine), or macroalbuminuria (ACR > or =300 mg/g creatinine). The three groups were compared to analyze the association between albuminuria and its risk factors. In addition, independent predictors of albuminuria were determined using multivariate logistic regression and presented as an odds ratio. Microalbuminuria and macroalbuminuria were present in 33.3% and 12.7% of 222 patients (mean age 56.4 years, mean deviation of diabetes 8.6 years, 58.7% women, 43.8% obese), respectively. Factors significantly associated with microalbuminuria included glycemic control, insulin use, and total and LDL cholesterol. Those associated with macroalbuminuria included in addition to glycemic control and insulin use, duration of diabetes, hypertension, elevated mean arterial pressure (MAP), and presence of neuropathy, retinopathy and peripheral vascular disease by bivariate analysis. Only glycemic control was an independent risk factor for both in addition to MAP and retinopathy for macroalbuminuria by multivariate analysis. Albuminuria is highly prevalent among this cohort of diabetic patients in Lebanon. Both glycemic control and blood pressure need to be better targeted in its management.

Feminine hygiene practices among female patients and nurses in Lebanon.

PubMed

Attieh, Elie; Maalouf, Samer; Roumieh, Dina; Abdayem, Pamela; AbiTayeh, Georges; Kesrouani, Assaad

2016-05-23

Inappropriate feminine hygiene practices are related to vulvovaginitis. We investigated the prevalence of personal hygiene habits among Lebanese women as well as their awareness of adequate practices. Consists of a cross-sectional observational study. Female patients and nurses at Hotel-Dieu de France University Hospital in Beirut- Lebanon filled a questionnaire about their intimate hygiene habits and knowledge of proper practices. The study included 249 women. 21.3 % of the 136 nurses and 38.9 % of the 113 patients reported a history of vulvovaginitis. The majority of women took an intimate bath at least twice daily. 14 % of nurses and 17 % of patients douched.20. Seven percent of the nurses and 43.4 % of the patients used wet wipes. 1.5 % of nurses and 4.4 % of patients used feminine deodorant sprays. There was a significant lack of awareness mainly among patients about suitable hygiene practices as well for their adverse effects. Education provided by nurses, and other healthcare providers is essential to promote reproductive health among Lebanese women.

Study protocol: Mother and Infant Nutritional Assessment (MINA) cohort study in Qatar and Lebanon.

PubMed

Naja, Farah; Nasreddine, Lara; Al Thani, Al Anoud; Yunis, Khaled; Clinton, Michael; Nassar, Anwar; Farhat Jarrar, Sara; Moghames, Patricia; Ghazeeri, Ghina; Rahman, Sajjad; Al-Chetachi, Walaa; Sadoun, Eman; Lubbad, Nibal; Bashwar, Zelaikha; Bawadi, Hiba; Hwalla, Nahla

2016-05-04

The Middle East and North Africa region harbors significant proportions of stunting and wasting coupled with surging rates of non-communicable diseases (NCDs). Recent evidence identified nutrition during the first 1000 days of life as a common denominator not only for optimal growth but also for curbing the risk of NCDs later in life. The main objective of this manuscript is to describe the protocol of the first cohort in the region to investigate the association of nutrition imbalances early in life with birth outcomes, growth patterns, as well as early determinants of non-communicable diseases. More specifically the cohort aims to 1) examine the effects of maternal and early child nutrition and lifestyle characteristics on birth outcomes and growth patterns and 2) develop evidence-based nutrition and lifestyle guidelines for pregnant women and young children. A multidisciplinary team of researchers was established from governmental and private academic and health sectors in Lebanon and Qatar to launch the Mother and Infant Nutritional Assessment 3-year cohort study. Pregnant women (n = 250 from Beirut, n = 250 from Doha) in their first trimester are recruited from healthcare centers in Beirut, Lebanon and Doha, Qatar. Participants are interviewed three times during pregnancy (once every trimester) and seven times at and after delivery (when the child is 4, 6, 9, 12, 18, and 24 months old). Delivery and birth data is obtained from hospital records. Data collection includes maternal socio-demographic and lifestyle characteristics, dietary intake, anthropometric measurements, and household food security data. For biochemical assessment of various indicators of nutritional status, a blood sample is obtained from women during their first trimester. Breastfeeding and complementary feeding practices, dietary intake, as well as anthropometric measurements of children are also examined. The Delphi technique will be used for the development of the nutrition and lifestyle

Social, Relational and Network Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut, Lebanon.

PubMed

Wagner, Glenn J; Hoover, Matthew; Green, Harold; Tohme, Johnny; Mokhbat, Jacques

2015-07-01

Social, relational and network determinants of condom use and HIV testing were examined among 213 men who have sex with men (MSM) in Beirut. 64% reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% had HIV-tested. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Multi-level social factors influence sexual health in MSM.

"This Is a Field That's Open, Not Closed": Multilingual and International Writing Faculty Respond to Composition Theory

ERIC Educational Resources Information Center

Arnold, Lisa R.

2016-01-01

This article reports on the results of a qualitative, interview-based study in which multilingual writing faculty based at the American University of Beirut, in Beirut, Lebanon, read and responded to "core" texts of composition scholarship primarily published in North America, for a North American audience. This study is premised on the…

HIV prevalence and demographic determinants of condomless receptive anal intercourse among trans feminine individuals in Beirut, Lebanon.

PubMed

Kaplan, Rachel L; McGowan, Justine; Wagner, Glenn J

2016-01-01

Growing evidence suggests increased HIV incidence in the Middle East and North Africa among "key populations." To date, epidemiological data have not accurately included and measured HIV prevalence and risk among trans feminine individuals in the region. Through the lens of the Gender Affirmation Framework, we assessed demographic correlates of risk behaviour and the prevalence of HIV among trans feminine individuals in Lebanon. Long-chain referral sampling was used to recruit 53 participants for completion of a behavioural survey and optional free rapid HIV tests. Data were collected using interviewer-administered questionnaires. A multivariable logistic regression model was used to identify demographic determinants of HIV risk behaviour. Fifty-seven percent of participants reported condomless receptive anal intercourse (CRAI) with male partner(s) in the last three months, 40% of whom reported not knowing the HIV status of the partner(s). Of the participants tested for HIV as part of the study or via self-report, four (10%) were HIV positive; 13 declined HIV testing. Forty percent of the sample had no prior history of HIV testing. A history of trauma such as sexual abuse/assault was reported by almost half of the participants (49%). Sixty-eight percent reported experiencing physical violence and 32% police arrest, because of gender identity or presentation. A staggering 98% reported having experienced gender identity or gender presentation-related discrimination. Sixty-six percent of the sample reported current sex work; sex work was correlated with CRAI but was not significant in multivariate analysis. In regression analysis, "openness"/"outness" about transgender identity at work or school was significantly associated with CRAI. Surprisingly, a history of sexual abuse/assault was negatively correlated with CRAI, suggesting the need for further inquiry. The results of this study provide implications for how to address sexual health among trans feminine

76 FR 72502 - Removal From the List of Specially Designated Nationals and Blocked Persons of Certain Entities...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

..., Kayseri, Turkey; Incilipinar Mah., Kibris Cad., Zeugma Is Merkezi, No: 13-14, 27090 Sehitkamil, Gaziantep... Address [email protected] ; Email Address [email protected] [LIBYA2] 13. GLAHCO HOTELS AND TOURISM..., SAR Bldg, Beirut, Lebanon; Registration ID 30199 (Lebanon) issued 13 Oct 1973; SWIFT/BIC NACBLBBE...

"We Dared To Venture": The Story of Lebanese American University.

ERIC Educational Resources Information Center

Ghosn, Ghassan

1995-01-01

Traces the history of education for girls in Lebanon and that of the school which is now known as the American University of Beirut, Lebanon. Focuses on the development of engineering education as well as the strategies used by the school during the civil war. (DDR)

Cross-cultural adaptation and psychometric properties of an Arabic language version of the Brief Illness Perception Questionnaire in Lebanon.

PubMed

Saarti, Stéphanie; Jabbour, Hicham; El Osta, Nada; Hajj, Aline; Khabbaz, Lydia Rabbaa

2016-01-01

Patients' positive illness perceptions (IPs) significantly contribute to treatment success. The Brief Illness Perception Questionnaire (Brief IPQ) is widely used in various diseases for assessing IPs. It was developed in English-speaking countries and studies on it in Arab countries are scarce. This observational cross-sectional study aimed to cross-culturally adapt the Brief IPQ English version into a modern Arabic language version and determine its psychometric properties in a sample of Lebanese cardiac disease patients. This study was approved by the Institutional Review Board of Saint Joseph University of Beirut, Lebanon. A convenience sample of 30 patients with cardiac disease were recruited during routine visits to cardiologists' offices in Beirut, Lebanon. Inclusion criteria were at least one cardiac disease for at least 6 months with no acute episode or exacerbation of the disease during the 6 preceding months, age ≥ 18 years, and the ability to read and comprehend Arabic. The pre-final version of the Brief IPQ Arabic version was tested for face and content validity. The meaning, comprehensibility, and acceptability were studied by individual interviews. For discriminant validity and internal consistency of the Brief IPQ Arabic version (Brief IPQ-Ar), 100 patients were recruited in a similar manner using the same inclusion criteria. To assess reproducibility, 30 patients, selected randomly from the 100 patients, filled the questionnaire a second time, 3-4 weeks after its first administration and under the same conditions. Psychometric properties of the Brief IPQ-Ar among Lebanese patients suffering from cardiac diseases. Semantic equivalence between the Brief IPQ-Ar questions and patients' descriptions was 100%. Cronbach's alpha was 0.717, which shows good internal consistency. Reproducibility was satisfactory (ICC values>0.776). Moreover, the Brief IPQ-Ar discriminated participants according to the type of cardiac disease and treatment

Cross-cultural adaptation and psychometric properties of an Arabic language version of the Brief Illness Perception Questionnaire in Lebanon.

PubMed

Saarti, Stéphanie; Jabbour, Hicham; Osta, Nada El; Hajj, Aline; Khabbaz, Lydia Rabbaa

2016-01-01

Background Patients' positive illness perceptions (IPs) significantly contribute to treatment success. The Brief Illness Perception Questionnaire (Brief IPQ) is widely used in various diseases for assessing IPs. It was developed in English-speaking countries and studies on it in Arab countries are scarce. Objectives, Setting and design This observational cross-sectional study aimed to cross-culturally adapt the Brief IPQ English version into a modern Arabic language version and determine its psychometric properties in a sample of Lebanese cardiac disease patients. This study was approved by the Institutional Review Board of Saint Joseph University of Beirut, Lebanon. Participants A convenience sample of 30 patients with cardiac disease were recruited during routine visits to cardiologists' offices in Beirut, Lebanon. Inclusion criteria were at least one cardiac disease for at least 6 months with no acute episode or exacerbation of the disease during the 6 preceding months, age≥18 years, and the ability to read and comprehend Arabic. The pre-final version of the Brief IPQ Arabic version was tested for face and content validity. The meaning, comprehensibility, and acceptability were studied by individual interviews. For discriminant validity and internal consistency of the Brief IPQ Arabic version (Brief IPQ-Ar), 100 patients were recruited in a similar manner using the same inclusion criteria. To assess reproducibility, 30 patients, selected randomly from the 100 patients, filled the questionnaire a second time, 3-4 weeks after its first administration and under the same conditions. Main outcome measures Psychometric properties of the Brief IPQ-Ar among Lebanese patients suffering from cardiac diseases. Results Semantic equivalence between the Brief IPQ-Ar questions and patients' descriptions was 100%. Cronbach's alpha was 0.717, which shows good internal consistency. Reproducibility was satisfactory (ICC values>0.776). Moreover, the Brief IPQ-Ar discriminated

Social, Relational and Network Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut, Lebanon

PubMed Central

Wagner, Glenn J.; Hoover, Matthew; Green, Harold; Tohme, Johnny; Mokhbat, Jacques

2014-01-01

Social, relational and network determinants of condom use and HIV testing were examined among 213 men who have sex with men (MSM) in Beirut. 64% reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% had HIV-tested. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Multi-level social factors influence sexual health in MSM. PMID:26535073

Psycho-social Correlates of Condom Use and HIV Testing among MSM Refugees in Beirut, Lebanon.

PubMed

Tohme, Johnny; Egan, James E; Friedman, Mackey R; Stall, Ron

2016-12-01

MSM refugees have to deal with personal challenges and social/structural adversaries based on their refugee status on top of their sexual identity. To better customize interventions beside this population, we explored psycho-social and structural correlates of condom use and HIV testing in Lebanon by surveying and testing 150 participants. 67 % self-identified as gay. 84.6 % reported any unprotected anal intercourse (UAI) with men in the prior 3 months. Those who engaged in UAI, were lest comfortable with a doctor, didn't know where to get free HIV testing, experienced discrimination based on their refugee status and spent more time with their refugee peers, were less inclined to have seen a doctor in the past 12 month or knew where to get free HIV testing. Ever having been HIV tested was associated with being comfortable with medical doctors, knowing where to get HIV testing and spending time with other peer refugees. HIV prevention and testing promotion efforts targeting MSM refugees need to account for structural barriers, while fighting discrimination is crucial for a healthy sexual identity development.

Nutritional situation among Syrian refugees hosted in Iraq, Jordan, and Lebanon: cross sectional surveys.

PubMed

Hossain, S M Moazzem; Leidman, Eva; Kingori, James; Al Harun, Abdullah; Bilukha, Oleg O

2016-01-01

Ongoing armed conflict in Syria has caused large scale displacement. Approximately half of the population of Syria have been displaced including the millions living as refugees in neighboring countries. We sought to assess the health and nutrition of Syrian refugees affected by the conflict. Representative cross-sectional surveys of Syrian refugees were conducted between October 2 and November 30, 2013 in Lebanon, April 12 and May 1, 2014 in Jordan, and May 20 and 31, 2013 in Iraq. Surveys in Lebanon were organized in four geographical regions (North, South, Beirut/Mount Lebanon and Bekaa). In Jordan, independent surveys assessed refugees residing in Za'atri refugee camp and refugees residing among host community nationwide. In Iraq, refugees residing in Domiz refugee camp in the Kurdistan region were assessed. Data collected on children aged 6 to 59 months included anthropometric indicators, morbidity and feeding practices. In Jordan and Lebanon, data collection also included hemoglobin concentration for children and non-pregnant women aged 15 to 49 years, anthropometric indicators for both pregnant and non-pregnant women, and household level indicators such as access to safe water and sanitation. The prevalence of global acute malnutrition among children 6 to 59 months of age was less than 5 % in all samples (range 0.3-4.4 %). Prevalence of acute malnutrition among women 15 to 49 years of age, defined as mid-upper arm circumference less than 23.0 cm, was also relatively low in all surveys (range 3.5-6.5 %). For both children and non-pregnant women, anemia prevalence was highest in Za'atri camp in Jordan (48.4 % and 44.8 %, respectively). Most anemia was mild or moderate; prevalence of severe anemia was less than or equal to 1.1 % in all samples of children and women. Despite the ongoing conflict, results from all surveys indicate that global acute malnutrition is relatively low in the assessed Syrian refugee populations. However, prevalence of anemia

Teachers Helping Teachers: A Professional Development Model That Promotes Teacher Leadership

ERIC Educational Resources Information Center

Ghamrawi, Norma

2013-01-01

This mixed methods study reports on the outcomes of a professional development model (PDM) developed by a K-12 private school in Beirut, Lebanon, after 3 years of its employment. Specifically, an evaluation of this PDM is provided with special emphasis on its potential of developing teacher leaders at school. The PDM embraces a constructivist…

Near East/South Asia, Report No. 2822.

DTIC Science & Technology

1983-09-15

Events ( Marj ’Uyun Lebanon Voice of Hope, 6 Sep 83) 51 Mufti on Lebanon Appeals To End Fighting (Shaykh Hasan Khalid; Beirut Domestic...the other hand, the department of the waqf (religious property) headed by Shaykh Hasan Tahbub. These two institutions, and the latter in particular...1400 GMT 5 Sep 83 [Appeal by the mufti of Lebanon, Shaykh Hasan Khalid, to the Lebanese to stop fighting; date not given—read by announcer

A 27-year experience with infective endocarditis in Lebanon.

PubMed

El-Chakhtoura, Nadim; Yasmin, Mohamad; Kanj, Souha S; Baban, Tania; Sfeir, Jad; Kanafani, Zeina A

Although rare, infective endocarditis (IE) continues to cause significant morbidity and mortality. Previous data from the American University of Beirut Medical Center (AUBMC) had shown predominance of streptococcal infection. As worldwide studies in developed countries show increasing trends in Staphylococcus aureus endocarditis, it becomes vital to continually inspect local data for epidemiological variations. We reviewed all IE cases between 2001 and 2014, and we performed a comparison to a historical cohort of 86 IE cases from 1987 to 2001. A total of 80 patients were diagnosed with IE between 2001 and 2014. The mean age was 61 years. The most commonly isolated organisms were streptococci (37%), compared to 51% in the previous cohort. S. aureus accounted for 11%. Only one S. aureus isolate was methicillin-resistant. In the historical cohort, 26% of cases were caused by S. aureus. Enterococci ranked behind staphylococci with 22% of total cases, while in the previous cohort, enterococcal IE was only 4%. Compared to previous data from AUBMC, the rates of streptococcal and staphylococcal endocarditis have decreased while enterococcal endocarditis has increased. This study reconfirms that in Lebanon, a developing country, we continue to have a low predominance of staphylococci as etiologic agents in IE. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Earth Observations taken during Expedition 16/STS-120 Joint Operations

NASA Image and Video Library

2007-10-26

ISS016-E-008436 (26 Oct. 2007) --- Beirut Metropolitan Area, Lebanon is featured in this image photographed by an Expedition 16 crewmember on the International Space Station. The capital of Lebanon, Beirut is located along the southeastern shoreline of the Mediterranean Sea. According to geologists, the metropolitan area is built on a small peninsula composed mainly of sedimentary rock deposited over the past 100 million years or so. The growth of the city eastwards is bounded by foothills of the more mountainous interior of Lebanon (sparsely settled greenish brown region visible at upper right). While this sedimentary platform is stable, the country of Lebanon is located along a major transform fault zone, or region where the African and Arabian tectonic plates are moving laterally in relation to (and against) each other. This active tectonism creates an earthquake hazard for the country. The Roum Fault, one of the fault strands that is part of the transform boundary, is located directly to the south of the Beirut metropolitan area. Other distinctive features visible in this image include the Rafic Hariri Airport at lower right, the city sports arena at center, and several areas of green and open space (such a large golf course at center). Also visible in the image are several plumes of sediment along the coastline -- the most striking of which are located near the airport. The general lack of vegetation in the airport may promote higher degrees of soil transport by surface water runoff or wind.

Middle Eastern masculinities in the age of new reproductive technologies: male infertility and stigma in Egypt and Lebanon.

PubMed

Inhorn, Marcia C

2004-06-01

Worldwide, male infertility contributes to more than half of all cases of childlessness; yet, it is a reproductive health problem that is poorly studied and understood. This article examines the problem of male infertility in two Middle Eastern locales, Cairo, Egypt, and Beirut, Lebanon, where men may be at increased risk of male infertility because of environmental and behavioral factors. It is argued that male infertility may be particularly problematic for Middle Eastern men in their pronatalist societies; there, both virility and fertility are typically tied to manhood. Thus, male infertility is a potentially emasculating condition, surrounded by secrecy and stigma. Furthermore, the new reproductive technology called intracytoplasmic sperm injection (ICSI), designed specifically to overcome male infertility, may paradoxically create additional layers of stigma and secrecy, due to the complex moral and marital dilemmas associated with Islamic restrictions on third-party donation of gametes.

Evaluating a community based participatory approach to research with disadvantaged women in the southern suburbs of Beirut.

PubMed

Kobeissi, Loulou; Nakkash, Rima; Ghantous, Zeina; Saad, Maya Abou; Yassin, Nasser

2011-10-01

This manuscript presents the evaluation of a 3 year community-based participatory research (CBPR) approach involving the testing of a psychosocial intervention to improve reproductive and mental health of married women in a disadvantaged community in Beirut, Lebanon. The community-based participatory approach involved a community advisory committee (CAC), a local women committee (LWC), and university researchers. The evaluation of the CBPR approach followed qualitative assessment which included: analysis of compiled field notes and minutes of meetings of CAC and LWC throughout the 3 years of the intervention, and focus group discussions and individual interviews conducted with the CAC and the LWC members following completion of the trial. The CBPR approach confirmed feasibility, cultural adequacy, as well as representation of community needs. Five main emerging themes came out of the FGD and interviews with CAC and LWC. The community and women involved viewed that the CBPR approach allowed for a good understanding of the community, they felt ownership of the study, acknowledged that participation gave the women voices, and established trust, and acknowledged the challenges faced. This manuscript describes how the community was involved, reports on their evaluation of the CBPR process, and discusses challenges to CBPR in this particular context.

Cross-cultural adaptation and psychometric properties of an Arabic language version of the Brief Illness Perception Questionnaire in Lebanon

PubMed Central

Saarti, Stéphanie; Jabbour, Hicham; El Osta, Nada; Hajj, Aline; Khabbaz, Lydia Rabbaa

2016-01-01

Background Patients’ positive illness perceptions (IPs) significantly contribute to treatment success. The Brief Illness Perception Questionnaire (Brief IPQ) is widely used in various diseases for assessing IPs. It was developed in English-speaking countries and studies on it in Arab countries are scarce. Objectives, Setting and design This observational cross-sectional study aimed to cross-culturally adapt the Brief IPQ English version into a modern Arabic language version and determine its psychometric properties in a sample of Lebanese cardiac disease patients. This study was approved by the Institutional Review Board of Saint Joseph University of Beirut, Lebanon. Participants A convenience sample of 30 patients with cardiac disease were recruited during routine visits to cardiologists’ offices in Beirut, Lebanon. Inclusion criteria were at least one cardiac disease for at least 6 months with no acute episode or exacerbation of the disease during the 6 preceding months, age≥18 years, and the ability to read and comprehend Arabic. The pre-final version of the Brief IPQ Arabic version was tested for face and content validity. The meaning, comprehensibility, and acceptability were studied by individual interviews. For discriminant validity and internal consistency of the Brief IPQ Arabic version (Brief IPQ-Ar), 100 patients were recruited in a similar manner using the same inclusion criteria. To assess reproducibility, 30 patients, selected randomly from the 100 patients, filled the questionnaire a second time, 3–4 weeks after its first administration and under the same conditions. Main outcome measures Psychometric properties of the Brief IPQ-Ar among Lebanese patients suffering from cardiac diseases. Results Semantic equivalence between the Brief IPQ-Ar questions and patients’ descriptions was 100%. Cronbach's alpha was 0.717, which shows good internal consistency. Reproducibility was satisfactory (ICC values>0.776). Moreover, the Brief IPQ

Harboring illnesses: On the association between disease and living conditions in a Palestinian refugee camp in Lebanon

PubMed Central

HABIB, RIMA R.; BASMA, SHIRAZ H.; YERETZIAN, JOUMANA S.

2007-01-01

This research examined the association between the domestic built environment in a Palestinian refugee camp in Beirut, Lebanon, and the presence of illness among household members. Data on the domestic built environment, socio-demographics and health were collected in 860 households. The association between the presence of illness among household members and three environmental indices, namely infrastructure and services, housing conditions, and crowding was evaluated. These indices were based on a number of items that reflected the existing problems in the domestic built environment. The main finding was the positive association between poor housing conditions and the presence of illness among household members. Households with 8-15 housing problems were twice more likely to report the presence of illness than those with less than four housing problems (OR = 2.08, 95% CI = 1.40-3.11). This research contributes to the understanding of the influence of the built environment on the health of a refugee population. PMID:16546804

The Psychological Attitude of Patients toward Health Practitioners in Lebanon

PubMed Central

Ayoub, Fouad; Fares, Youssef; Fares, Jawad

2015-01-01

Background: Patients often complain about their doctor's attitude toward them. They describe the interaction that they have with some doctors as quick, cold, discourteous, or hardhearted. Although this does not apply to all Lebanese doctors, it does apply to some. Aims: The purpose of this study was to (1) examine the general perception of satisfaction, trust, and openness that Lebanese patients hold toward the work, office, personal, and social characteristics of their doctors — physician or dentist; and (2) identify the aspects on which a Lebanese health practitioner should focus to improve his/her practice. Materials and Methods: A convenient sample of 450 individuals from an area housing nine hospitals and hundreds of private clinics in Greater Beirut were surveyed regarding the qualities of their health practitioners. They were asked to complete a nine-page, 85-item, anonymous, and voluntary questionnaire that dealt with the medical and dental practice in Lebanon. Participants were older than 18 years and mentally competent. None was physicians, dentists, or nurses. The questionnaire was open-ended and initially pretested and piloted among a random sample. Results: Four hundred-fifteen (92%) individuals responded. Participants were from different ages, genders, geographical areas, educational backgrounds, and professions. The doctor traits most preferred by the Lebanese public were found to be: Empathy (90%), professionalism (87%), miscellaneous traits (86%), and academics (81%). Conclusion: The results support the conventional wisdom that the idealized perception of a doctor as a care-giving, compassionate, knowledgeable, well-appearing, and healthy role model still holds true within the Lebanese community. PMID:26713291

Perceptions and Attitudes of Cancer Patients and Caregivers Towards Enrollment in Clinical Trials in Lebanon.

PubMed

Salem, Rana; Matar, Charbel; Assi, Rita; Alameddine, Raafat; Temraz, Sally; Shamseddine, Ali; Mukherji, Deborah

2017-12-02

The rates of participation in oncology clinical trials (CTs) are relatively lower in the Middle East compared to other areas in the world. Many social and cultural factors underlie the patients' reluctance to participate. To probe the knowledge, attitudes, and perceptions of patients with cancer and their caregivers regarding participation in CTs at our tertiary referral center in Lebanon, we interviewed 210 patients and caregivers visiting the outpatient clinics in the Naef Basile Cancer Institute at the American University of Beirut. A questionnaire was derived from literature and administered in Arabic. The study was approved by the Institutional Review Board (IRB). Two hundred individuals agreed to answer the questionnaire. The majority of participants (90.5%) were Lebanese with the remaining being non-Lebanese Arabs. Eighty-nine participants (45%) were aware of the concepts of CTs. Eighty-two respondents (41%) would participate in phase I CTs. Twenty-nine individuals (14.5%) agree to be enrolled in CTs with the approval of their family members only. One hundred twenty-nine subjects (64.5%) stated that they would refuse enrollment in a CT where they might receive placebo. Eighty-eight (44%) of participants considered that medical records could be reviewed for research without consent while 54% agreed that samples collected during clinical workup could be used for research without the consent of the patient. There are several social and demographic correlates for participation in CTs. Raising awareness and overcoming barriers of misconception are keys to promote participation in CTs in Lebanon.

Experiencing the "SPIRIT of PLACE" as a Design Task: the Street of Hamra in the Heart of Beirut

NASA Astrophysics Data System (ADS)

El-Khoury, N.

2013-07-01

The aim of this paper is to introduce a subject related to the concept of re-use of historic places and their contemporary architecture settings. In this research, we examine a particular case study of the street of Hamra, located in the heart of Beirut, Lebanon. Hamra street has a particular character with a specific heritage and local spirit, and it is important to preserve this heritage value as part of any new architectural design intervention. In able to test our intentions of strengthening this strong relation between the specific heritage and any new architectural intervention, we used a method that relies on students' experiments in the case of a design studio. It is an experimental approach where the students of the architecture and design school of the Lebanese American University, were asked as a constraint in their concept, to integrate part of the heritage that characterizes Hamra: "the spirit of place" into their design while using information and communication technologies (ICTs). As a first step, they had to get familiar with the concept of heritage in its general meaning, then they studied the history, the heritage of Hamra and the urban fabric. They had to observe and collect data and then to focus on a main idea that will define the concept of their architectural design. As a second step, results were presented and compared. After analyzing the results, this experimental research showed that it is important to consider the "spirit of place" while designing a space.

Lebanon.

PubMed

1988-04-01

General notes about Lebanon are presented: political history, government, population, geography, economy and foreign relations. Lebanon lies on the eastern shore of the Mediterranean, and is composed of a coastal plain bound on the east by high mountains. The population numbers about 2.5 million, although no census has been taken since 1932. 6 different types of Christian sects and 3 of Muslims contribute to instability. The strife has been aggravated by invasions by Israel against Palestinians encamped there, and by Syria as part of an Arab peace-keeping force. Despite constant civil war since the 1950s, the Lebanese government has continued to function, a parliamentary constitutional system with a judicial system based on the Napoleonic code. Amendments to the 1926 constitution have mandated that representation in the National Assembly and among top government positions be apportioned based on distribution of significant religious groups. Political parties in Lebanon are extremely complex, and include parties loyal to clan or local leaders, those ranging from the right to left, those resembling Arab parties in other nations, and those dedicated to religious sects. The economy is normally based on agriculture, and on commerce and banking in the primary coastal cities, but is in decline currently.

State of family medicine practice in Lebanon

PubMed Central

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession. PMID:27453843

Dietary patterns and odds of Type 2 diabetes in Beirut, Lebanon: a case–control study

PubMed Central

2012-01-01

Background In Lebanon, Type 2 diabetes (T2D) has a major public health impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. Diet is an important environmental factor in the development and prevention of T2D. Dietary patterns may exert greater effects on health than individual foods, nutrients, or food groups. The objective of this study is to examine the association between dietary patterns and the odds of T2D among Lebanese adults. Methods Fifty-eight recently diagnosed cases of T2D and 116 population-based age, sex, and place of residence matched control participants were interviewed. Data collection included a standard socio-demographic and lifestyle questionnaire. Dietary intake was evaluated by a semi-quantitative 97-item food frequency questionnaire. Anthropometric measurements including weight, height, waist circumference, and percent body fat were also obtained. Dietary patterns were identified by factor analysis. Multivariate logistic regression analysis was used to evaluate the associations of extracted patterns with T2D. Pearson correlations between these patterns and obesity markers, energy, and nutrient intakes were also examined. Results Four dietary patterns were identified: Refined Grains & Desserts, Traditional Lebanese, Fast Food and Meat & Alcohol. While scores of the “Refined Grains & Desserts” had the highest correlations with energy (r = 0.74) and carbohydrates (r = 0.22), those of the “Fast Food” had the highest correlation with fat intake (r = 0.34). After adjustment for socio-demographic and lifestyle characteristics, scores of the Refined Grains & Desserts and Fast Food patterns were associated with higher odds of T2D (OR: 3.85, CI: 1.13-11.23 and OR: 2.80, CI: 1.14-5.59; respectively) and scores of the Traditional Lebanese pattern were inversely associated with the odds of T2D (OR: 0.46, CI: 0.22-0.97). Conclusions The findings of this study

Molecular analysis of Acinetobacter baumannii strains isolated in Lebanon using four different typing methods.

PubMed

Rafei, Rayane; Dabboussi, Fouad; Hamze, Monzer; Eveillard, Matthieu; Lemarié, Carole; Gaultier, Marie-Pierre; Mallat, Hassan; Moghnieh, Rima; Husni-Samaha, Rola; Joly-Guillou, Marie-Laure; Kempf, Marie

2014-01-01

This study analyzed 42 Acinetobacter baumannii strains collected between 2009-2012 from different hospitals in Beyrouth and North Lebanon to better understand the epidemiology and carbapenem resistance mechanisms in our collection and to compare the robustness of pulsed field gel electrophoresis (PFGE), multilocus sequence typing (MLST), repetitive sequence-based PCR (rep-PCR) and blaOXA-51 sequence-based typing (SBT). Among 31 carbapenem resistant strains, we have detected three carbapenem resistance genes: 28 carried the blaOXA-23 gene, 1 the blaOXA-24 gene and 2 strains the blaOXA-58 gene. This is the first detection of blaOXA-23 and blaOXA-24 in Lebanon. PFGE identified 11 types and was the most discriminating technique followed by rep-PCR (9 types), blaOXA-51 SBT (8 types) and MLST (7 types). The PFGE type A'/ST2 was the dominant genotype in our collection present in Beyrouth and North Lebanon. The clustering agreement between all techniques was measured by adjust Wallace coefficient. An overall agreement has been demonstrated. High values of adjust Wallace coefficient were found with followed combinations: PFGE to predict MLST types  = 100%, PFGE to predict blaOXA-51 SBT = 100%, blaOXA-51 SBT to predict MLST = 100%, MLST to predict blaOXA-51 SBT = 84.7%, rep-PCR to predict MLST = 81.5%, PFGE to predict rep-PCR = 69% and rep-PCR to predict blaOXA-51 SBT = 67.2%. PFGE and MLST are gold standard methods for outbreaks investigation and population structure studies respectively. Otherwise, these two techniques are technically, time and cost demanding. We recommend the use of blaOXA-51 SBT as first typing method to screen isolates and assign them to their corresponding clonal lineages. Repetitive sequence-based PCR is a rapid tool to access outbreaks but careful interpretation of results must be always performed.

Update on liver transplants in Lebanon.

PubMed

Faraj, Walid; Haydar, Ali; Nounou, Ghina El; Naaj, Abdallah Abou El; Khoury, Ghattas; Jabbour, Samar; Khalife, Mohamed

2015-09-01

Objective-To review all liver transplants performed at the American University of Beirut Medical Center from 1998 to present. Materials and Methods-From 1998 to present, 21 liver transplants (15 into adults and 6 into children) were performed at the American University of Beirut Medical Center. Of the 21 transplants, 5 were living related liver transplants. Results-Patient survival was 76% at 1, 5, and 10 years. Five recipients died at a median of 9 (range, 1-56) days after transplant. Causes of death included 1 case of severe cellular rejection, 1 case of portal and hepatic artery thrombosis, 1 case of intraoperative cardiac arrest, and 2 cases of primary nonfunction. Two biliary complications and 2 major vascular complications also occurred. All 16 survivors are well, with normal findings on liver function tests at a median follow-up time of 93 (range, 10-185) months after transplant. Conclusions-Although our numbers are small, the 10-year survival rate is comparable to reported rates for other series around the world. Deceased organ donations must be encouraged so that we can perform more transplants. As a source of organs, living related liver transplant is important; however, it cannot replace deceased donation.

Patterns and predictors of tobacco smoking cessation: a hospital-based study of pregnant women in Lebanon.

PubMed

Yunis, Kalid; Beydoun, Hind; Nakad, Pascale; Khogali, Mustafa; Shatila, Faysal; Tamim, Hala

2007-01-01

To describe patterns of cigarette and narghile (hubble-bubble or water-pipe) smoking before and during pregnancy and identify predictors of successful smoking cessation. A survey was conducted on 4660 pregnant women who delivered single live births between September 1st, 2001 and December 31st, 2002 at five hospitals in Beirut, Lebanon. Women were classified into four groups according to patterns of tobacco use before and during pregnancy: 1) consistent non-users, 2) successful quitters, 3) unsuccessful quitters and 4) consistent users. High education (OR = 2.03, 95% CI: 0.99-4.15), adequate prenatal care (OR = 1.72, 95% CI: 1.02-2.91) and mild smoking at baseline (OR = 2.35, 95% CI: 1.36-4.09) were main determinants of successful cigarette smoking cessation, whereas successful quitters of narghile use were more likely to be nulliparous (OR = 1.80, 95% CI: 1.08-2.99) or to have a nonsmoking partner (OR = 7.57, 95 % CI: 2.31-24.78). Different populations should be targeted when designing smoking cessation interventions for cigarette and narghile users.

Lebanon: Blaming the Victims.

ERIC Educational Resources Information Center

Esseff, John A.

1987-01-01

Traces the history of Lebanon and its involvement with Syria, Israel, and the Palestinians. Provides a commentary on living conditions and political factions within Lebanon. States that external forces have intruded upon the Lebanese people, compounding their own problems, and confusing private issues with the political and religious struggles of…

Earth observations taken from shuttle Discovery during STS-85 mission

NASA Image and Video Library

1997-08-15

STS085-505-078 (7 - 19 August 1997) --- This large-format photograph, taken from the Earth-orbiting Space Shuttle Discovery with a 250mm lens, shows most of Lebanon, from the Israeli border to just south of Tripoli. The main distinction is that between the forested coastal mountain ranges which receive rainfall regularly off the Mediterranean, and the yellow-brown "rainshadow" deserts inland (east) of the mountains. Damascus, capital of Syria lies just outside the view bottom right. The biblical and classical cities of Acre (bottom), Tyre, Sidon and Beirut (top, on promontory) all lie on the coast. The Bekaa valley and the Litani River lie inland of the Lebanon Mountains east of Beirut. The agricultural area in the south of the photograph is part of Israel and borders the Golan Heights.

Health issues in the Arab American community. Male infertility in Lebanon: a case-controlled study.

PubMed

Kobeissi, Loulou; Inhorn, Marcia C

2007-01-01

The impact of risk factors, such as consanguinity and familial clustering, reproductive infections, traumas, and diseases, lifestyle factors and occupational and war exposures on male infertility, was investigated in a case-controlled study conducted in Lebanon. One-hundred-twenty males and 100 controls of Lebanese, Syrian or Lebanese-Palestinian descents were selected from two in-vitro fertilization (IVF) clinics located in Beirut, Lebanon. All cases suffered from impaired sperm count and function, according to World Health Organization guidelines for semen analysis. Controls were the fertile husbands of infertile women. Data were collected using a semi-structured interview, laboratory blood testing and the results of the most recent semen analysis. Univariate, bivariate and multivariate logistic regression analyses were used for data analysis, along with checks for effect modification and control of confounders. Consanguinity and the familial clustering of male infertility cases, as well as reproductive illnesses and war exposures were independently significant risk factors for male infertility. The odds of having infertility problems in the immediate family were 2.6 times higher in cases than controls. The odds of reproductive illness were 2 times higher in cases than controls. The odds of war exposures were 1.57 times higher in cases than controls. Occupational exposures, such as smoking and caffeine intake, were not shown to be important risk factors. This case-controlled study highlights the importance of investigating the etiology of male infertility in Middle Eastern communities. It suggests the need to expand research on male reproductive health in the Middle East in order to improve the prevention and management of male infertility and other male reproductive health problems.

Drought or humidity oscillations? The case of coastal zone of Lebanon

NASA Astrophysics Data System (ADS)

Shaban, Amin; Houhou, Rola

2015-10-01

There is discrepancy in classifying Lebanon according to the different climatic zones; however, it is often described as a semi-arid region. Lately, Lebanon has been witnessing climatic oscillations in the meteorological parameters. The impact of these oscillations on water sector has been reflected also on energy-food nexus. Yet, there are a number of studies obtained to identify the climate of Lebanon, and they show contradictory results; especially these studies elaborated different datasets and applied diverse methods which often modeled only on large-scale regions. Therefore, the analysis of climatic data depended on complete and long-term climatic records that can be applied to assess the existing climatic status of Lebanon, as well as to assure whether Lebanon is under drought, humidity or it is oscillating between both. This study utilized considerable datasets, from different sources including the remotely sensed systems (e.g. TRMM). These datasets were interpolated and analyzed statistically according to De Martonne Aridity Index. Aiming to affirm the climatic attribute of Lebanon; however, ten climatic stations were investigated. They are with representative geographic setting and diverse time series in the coastal zone of Lebanon were investigated. Even though, Lebanon is known as a semi-arid region, yet results in this study show that the studied zone does not evidence any drought, since around 70% of the investigated years are characterized by semi-humid to humid climate. This climatic figure is well pronounced since rainfall rate exceeds 900 mm, average temperature rate is about 19 °C, and snow remains for a couple of months annually.

Etiologic agents of dermatophyte infection in Lebanon.

PubMed

Araj, George F; Racoubian, Eddie S; Daher, Nemat K

2004-01-01

Dermatophytes are common and cause important human fungal infections in many parts of the world, including Lebanon. The prevalence of these fungi, however, tends to vary with time and geographic location. In our region, studies on the prevalence of dermatophytoses and the distribution of the various dermatophyte species involved are rare. In Lebanon, only one study was published on this subject over the last forty years. This study was undertaken to shed light on the types and prevalence of dermatophytes recovered at the American University of Beirut Medical Center (AUBMC), and to compare the findings with those of the only study from the same hospital published in the early 1960s. Records from the clinical microbiology section were reviewed for the patients on whom dermatophyte cultures were requested between 1996 and 2002. All positive cultures were identified and analyzed. Among 1631 submitted specimens for culture (one per patient), 208 (12.7%) yielded 11 species of dermatophytes, dominated by Trichophyton spp. (89.9%), followed by Microsporum spp. (9.1%), Epidermophyton floccosum (0.4%) and Trichosporum beigelii (0.4%). The male to female ratio was almost 1:1, and the age range was 1 to 77 yrs for both sexes; 14% were children (< or = 15 yrs). The most commonly recovered species were: T. tonsurans (54.8%), T. mentagrophytes (24.5%), M. canis (7.7%), T. rubrum (5.3%) and T. verrucosum (4%). The distribution of infection according to body sites was : tinea unguium (44.2%), tinea corporis (43.2%), tinea capitis (7.7%) and tinea pedis (4.8%). Compared to the previous study from AUBMC in 1962, the current study showed an overall lower prevalence of dermatophytoses (12.7 vs 18.5%, p = 0.001) and variations in the prevalence rates of the dermatophyte species involved (dominated by T. tonsurans and T. mentagrophytes in the current study compared to E. floccosum and T. rubrum recovered in 1962). Based on the source of infection the current study showed higher

Postgraduate Educational Program for Primary Care Physicians in Remote Areas in Lebanon

ERIC Educational Resources Information Center

Saab, Bassem Roberto; Kanaan, Nabil; Hamadeh, Ghassan; Usta, Jinan

2003-01-01

Introduction: Continuing medical education (CME) is a requirement in many developed countries. Lebanon lacks such a rule; hence, the dictum "once a doctor always a doctor" holds. This article describes a pioneering postgraduate educational program for primary care physicians in remote areas of Lebanon. Method: The Lebanese Society of…

Reproductive tract infections (RTIs) among married non-pregnant women living in a low-income suburb of Beirut, Lebanon.

PubMed

Ramia, Sami; Kobeissi, Loulou; El Kak, Faysal; Shamra, Sarah; Kreidieh, Khalil; Zurayk, Huda

2012-09-17

This study aimed to identify reproductive tract infections (RTIs) in married, non-pregnant women, aged 18 to 49 years, living in a low-income suburb of Beirut, and to investigate the relationship between demographic and socioeconomic factors and these infections. Among 1,015 women recruited for the study, 502 were found eligible and 441 were medically examined. Appropriate specimens were collected for Nisseria gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, candidiasis, and bacterial vaginosis. The results showed a relatively high prevalence of RTIs (28.2%). The prevalence rates of different agents were as follows: 22.9% of the women were positive for T. vaginalis, 8.8% for candidiasis, 4.5% for bacterial vaginosis, and 1% for N. gonorrhea; none of the women were positive for C. trachomatis. Regression analysis showed that women between the ages of 30 and 39 were twice more likely to have T. vaginalis as compared to younger women. Furthermore, women whose husbands were taxi drivers were at higher risk of acquiring T. vaginalis (OR = 2.2) as compared with women whose husbands occupation was listed as skilled/unskilled. This conclusion can be drawn for the odds of developing any RTI (OR = 2.15). Moreover, those participants with the lowest income were twice as likely to have any RTI compared to those with higher incomes. This study shows a relatively high prevalence of RTIs (T. vaginalis mainly). It urges further in-depth research on cultural practices and economic factors to understand the pattern of sexual behavior in this community.

The Library Technician Programme in Lebanon

ERIC Educational Resources Information Center

Rafidi, Samia

1973-01-01

A description of the library technician program established by the Beirut College for Women in February 1970: its curriculum, professional staff, students, and reactions produced by the program is presented. (Author/SJ)

Ethnic differences in weight loss behavior among secondary school students in Beirut: the role of weight perception.

PubMed

Mehio-Sibai, Abla; Kanaan, Nabil; Chaaya, Monique; Rahal, Boushra; Abdullah, Ahmad; Sibai, Tarek

2003-01-01

Assessing the prevalence of weight loss attempts in Beirut, Lebanon, a country characterized by a diversity of ethnic and religious groups and examining the interplay between ethnicity, body mass index (BMI) and weight perception and their relationship to weight loss behavior. A school-based survey of risk behaviors conducted among secondary students (grade 10-12) in 1997. Subjects consisted of 827 boys and girls, aged 15 to 23 years, the majority of whom were Moslems (65.4%). Multiple logistic regression was used to estimate the association between ethnicity and weight perception with the likelihood of trying to lose weight controlling for BMI and a number of potential covariates. The prevalence of weight loss attempts was 19.1% and 42.6% in boys and girls respectively. Christians were more likely to perceive themselves as overweight and to attempt weight loss than Moslems across all BMI levels, however this trend was significant in the underweight category. While controlling for BMI did not change appreciably the results observed, after controlling for weight perception, ethnic differences in weight-loss behavior disappeared. Findings of the study suggest that whereas actual weight may constitute only partially the driving force for differentials by ethnicity, the perception of body weight acts as a mediating factor in the relationship between ethnicity and weight loss behavior. Understanding the disparities in weight management behavior across various adolescent groups is key to develop culturally appropriate educational and intervention programs for the youths.

Chemical speciation and source apportionment of Non-Methane Volatile Organic Compounds (NMVOCs) in a Middle Eastern country

NASA Astrophysics Data System (ADS)

Salameh, Therese; Sauvage, Stéphane; Afif, Charbel; Borbon, Agnès; Locoge, Nadine

2014-05-01

NMVOCs, emitted from various sources, are of particular interest since they contribute to the formation of tropospheric ozone, PAN and secondary organic aerosols resulting in negative impacts on human health, climate and on the environment. To identify abatement measures, a profound knowledge of emission sources and their composition is a prerequisite. Air pollution in the Middle East region remains difficult to assess and understand because of a lack of ground-based measurements and the limited information on NMVOC chemical speciation and source apportionment. Based on a large database of NMVOC observations obtained in Beirut, the capital of Lebanon (a developing country in the Middle East region, located in Western Asia on the eastern shore of the Mediterranean Sea), the overall objective of this work is to apportion the sources of NMVOCs encountered in Lebanon. First, source profiles were determined with field measurements close to the main potential emitters namely the road transport, gasoline vapour, power generation and solvent uses. The results obtained are compared to other studies held in other regions and are used to assess the emission inventory developed for Lebanon. Secondly, two intensive field campaigns were held in a receptor site in Beirut during summer 2011 and winter 2012 in order to obtain a large time resolved dataset. The PMF analysis of this dataset was applied to apportion anthropogenic sources in this area. In both seasons, combustion (road transport and power generation) and gasoline evaporation, especially in winter, were the main sources contributing to the NMVOCs in Beirut. The results will support model implementation especially by completing the emission inventory established for the year 2010 by Waked et al. 2012 according to the EEA/EMEP guidelines because of the lack of Lebanon-specific emission factor.

Etiology, seasonality, and clinical characterization of viral respiratory infections among hospitalized children in Beirut, Lebanon.

PubMed

Finianos, Mayda; Issa, Randi; Curran, Martin D; Afif, Claude; Rajab, Maryam; Irani, Jihad; Hakimeh, Noha; Naous, Amal; Hajj, Marie-Joelle; Hajj, Pierre; El Jisr, Tamima; El Chaar, Mira

2016-11-01

Acute respiratory tract viral infections occur worldwide and are one of the major global burdens of diseases in children. The aim of this study was to determine the viral etiology of respiratory infections in hospitalized children, to understand the viral seasonality in a major Lebanese hospital, and to correlate disease severity and the presence of virus. Over a 1-year period, nasal and throat swabs were collected from 236 pediatric patients, aged 16-year old or less and hospitalized for acute respiratory illness. Samples collected were tested for the presence of 17 respiratory viruses using multiplex real-time RT-PCR. Pathogens were identified in 165 children (70%) and were frequently observed during fall and winter seasons. Co-infection was found in 37% of positive samples. The most frequently detected pathogens were human Rhinovirus (hRV, 23%), Respiratory Syncytial Virus (RSV, 19%), human Bocavirus (hBov, 15%), human Metapneumovirus (hMPV, 10%), and human Adenovirus (hAdV, 10%). A total of 48% of children were diagnosed with bronchiolitis and 25% with pneumonia. While bronchiolitis was often caused by RSV single virus infection and hAdV/hBoV coinfection, pneumonia was significantly associated with hBoV and HP1V1 infections. No significant correlation was observed between a single viral etiology infection and a specific clinical symptom. This study provides relevant facts on the circulatory pattern of respiratory viruses in Lebanon and the importance of using PCR as a useful tool for virus detection. Early diagnosis at the initial time of hospitalization may reduce the spread of the viruses in pediatric units. J. Med. Virol. 88:1874-1881, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Lessons from psychiatry in the Arab world--a Lebanese trainee psychiatrist's qualitative views on the provision of mental healthcare services for Palestinian refugees in Lebanon and an interview with a consultant psychiatrist on the effects of the Arab spring on the mental health of Libyans.

PubMed

Hankir, Ahmed; Sadiq, Asad

2013-09-01

In this manuscript, a Lebanese trainee psychiatrist qualitatively analyses and discusses the provision of mental healthcare services for Palestinian refugees in Lebanon. There are more than 250,000 Palestinian people sporadically dispersed in the refugee camps in Sidon, Beirut and other major cities in the Levant. Displacement, conflict, trauma, unemployment and poverty are but some of the myriad factors that influence Palestinian refugee mental health. This article traces the historical, political and socioeconomic determinants of health for Palestinians exiled in Lebanon and describes the pivotal role that the non-Govenmental Organisation Medical Aid for Palestinians is playing in helping to alleviate the psychiatric distress of Palestinian sufferers of mental illness. The latter half of the manuscript contains an interview with a consultant psychiatrist about his experiences volunteering in the war-torn lands of Libya post Arab Spring. He expounds on how he feels mental healthcare services in Libya are woefully inadequate and broaches on his perception of how the resilience and the 'family-centric' model of the Libyan people has conferred a certain degree of protection towards developing severe psychiatric illness.

Symptoms of reproductive tract infections and mental distress among women in low-income urban neighborhoods of Beirut, Lebanon.

PubMed

Khawaja, Marwan; Kaddour, Afamia; Zurayk, Huda; Choueiry, Nathalie; El-Kak, Faysal

2009-10-01

The aim of this study was to examine the association between symptoms of reproductive tract infections (RTIs) and mental distress among women residing in three low-income urban neighborhoods in Greater Beirut. A cross-sectional survey of currently married women aged 15-49 years (n = 1506) from the 2003 Urban Health Study was undertaken. The dependent variables were complaining of vaginal discharge, pelvic pain, and pain during intercourse. The main independent variable was mental distress, measured using the General Health Questionnaire-12 (GHQ). Other variables included decision-making power, "comfort" with husband, age, education, income, household wealth, employment, community of residence, displacement by war, presence of chronic disease, reported reproductive health problem, membership in any group, receipt of favor last month, and smoking. Analysis was conducted using logistic regression models on the complaint of any symptom of RTIs and on individual complaints. Forty-two percent of the interviewed women reported at least one symptom of RTIs. Vaginal discharge was the most commonly reported symptom, with 33% of currently married women complaining from it. Mental distress was significantly associated with any reported RTI symptom (odds ratio [OR] = 1.41; 95% confidence interval [CI] = 1.09-1.83), pelvic pain (OR = 2.38; CI = 1.71-3.30), vaginal discharge (OR = 1.35; CI = 1.03-1.77), and pain during intercourse (OR = 2.37; CI = 1.66-3.40) after adjusting for demographic, socioeconomic, and health risk factors. A significant association between mental distress and reported RTI symptoms was established by this study. A new approach to gynecological morbidity is needed, one that integrates biomedical and psychosocial factors into a unified framework.

Aging in Lebanon: Challenges and Opportunities

PubMed Central

Abdulrahim, Sawsan; Ajrouch, Kristine J.; Antonucci, Toni C.

2015-01-01

This spotlight offers a unique window into factors affecting aging in Lebanon. As a bridge between east and west, both geographically and culturally, Lebanon has the fastest growing older adult population in the Arab region, but few societal resources to address its needs. In a country with a history of political instability and war, but also a culture with strong family values, aging adults in Lebanon are vulnerable in some ways and advantaged in others. Outmigration of youth is an important determinant of the wellbeing of the elderly. While often advantaged by remittances sent by their children, older Lebanese adults have less access to instrumental social and personal support previously provided by young adults in the family. How Lebanon manages these challenges is likely to foreshadow the future aging experience for much of the Arab region. PMID:25326343

Renewable Energy Resources in Lebanon

NASA Astrophysics Data System (ADS)

Hamdy, R.

2010-12-01

The energy sector in Lebanon plays an important role in the overall development of the country, especially that it suffers from many serious problems. The fact that Lebanon is among the few countries that are not endowed with fossil fuels in the Middle East made this sector cause one third of the national debt in Lebanon. Despite the large government investments in the power sector, demand still exceeds supply and Lebanon frequently goes through black out in peak demand times or has to resort to importing electricity from Syria. The Energy production sector has dramatic environmental and economical impacts in the form of emitted gasses and environment sabotage, accordingly, it is imperative that renewable energy (RE) be looked at as an alternative energy source. Officials at the Ministry of Energy and Water (MEW) and Lebanese Electricity (EDL) have repeatedly expressed their support to renewable energy utilization. So far, only very few renewable energy applications can be observed over the country. Major efforts are still needed to overcome this situation and promote the use of renewable energy. These efforts are the shared responsibility of the government, EDL, NGO's and educational and research centers. Additionally, some efforts are being made by some international organizations such as UNDP, ESCWA, EC and other donor agencies operating in Lebanon. This work reviews the status of Energy in Lebanon, the installed RE projects, and the potential projects. It also reviews the stakeholders in the field of RE in Lebanon Conclusion In considering the best R.E. alternative, it is important to consider all potential R.E. sources, their costs, market availability, suitability for the selected location, significance of the energy produced and return on investment. Several RE resources in Lebanon have been investigated; Tides and waves energy is limited and not suitable two tentative sites for geothermal energy are available but not used. Biomass resources badly affect the

Early Marriage and Barriers to Contraception among Syrian Refugee Women in Lebanon: A Qualitative Study.

PubMed

Cherri, Zeinab; Gil Cuesta, Julita; Rodriguez-Llanes, Jose M; Guha-Sapir, Debarati

2017-07-25

The Syrian conflict has displaced five million individuals outside their country with Lebanon hosting the largest numbers per capita. Around 24% of Syrian refugees fleeing to Lebanon are women of reproductive age (15-49). Yet, a better understanding of the sexual and reproductive health needs of Syrian refugee women in Lebanon is required to improve provided services. Eleven focus group discussions were conducted in four regions of Lebanon with 108 Syrian refugee women of reproductive age. Thematic analysis was used to examine the data. Interviewed women were mainly adults. They believed that, in Lebanon, they were subjected to early marriage compared to the norm in Syria due to their financial situation and uncertainty. Cost was reported as the main barrier to use contraception in Lebanon but some Syrian refugee women were not aware of free services covering sexual and reproductive health. In general, marriage, pregnancy, and family planning behavior of Syrian refugee women in Lebanon slightly differed from those in Syria pre-conflict in terms of age of marriage, conception subsequent to marriage, and contraception method. Hence, interventions to increase awareness of subsidized sexual and reproductive health services, including free contraceptives at primary health care centers, and those targeting protection from early marriage of Syrian refugee women in Lebanon are strongly recommended.

Early Marriage and Barriers to Contraception among Syrian Refugee Women in Lebanon: A Qualitative Study

PubMed Central

Guha-Sapir, Debarati

2017-01-01

The Syrian conflict has displaced five million individuals outside their country with Lebanon hosting the largest numbers per capita. Around 24% of Syrian refugees fleeing to Lebanon are women of reproductive age (15–49). Yet, a better understanding of the sexual and reproductive health needs of Syrian refugee women in Lebanon is required to improve provided services. Eleven focus group discussions were conducted in four regions of Lebanon with 108 Syrian refugee women of reproductive age. Thematic analysis was used to examine the data. Interviewed women were mainly adults. They believed that, in Lebanon, they were subjected to early marriage compared to the norm in Syria due to their financial situation and uncertainty. Cost was reported as the main barrier to use contraception in Lebanon but some Syrian refugee women were not aware of free services covering sexual and reproductive health. In general, marriage, pregnancy, and family planning behavior of Syrian refugee women in Lebanon slightly differed from those in Syria pre-conflict in terms of age of marriage, conception subsequent to marriage, and contraception method. Hence, interventions to increase awareness of subsidized sexual and reproductive health services, including free contraceptives at primary health care centers, and those targeting protection from early marriage of Syrian refugee women in Lebanon are strongly recommended. PMID:28757595

Comparison of the OHIP-14 and GOHAI as measures of oral health among elderly in Lebanon.

PubMed

El Osta, Nada; Tubert-Jeannin, Stephanie; Hennequin, Martine; Bou Abboud Naaman, Nada; El Osta, Lana; Geahchan, Negib

2012-10-30

The respective abilities of the GOHAI and OHIP-14 to discriminate between aged patients with different levels of oral diseases have rarely been studied in developing countries. The aim of this study was to compare the discriminative abilities of the OHIP-14 and the GOHAI in an elderly Lebanese population, and particularly to identify persons with different masticatory function. A sample of elderly, aged 65 years or more, living independently was recruited in two primary care offices in Beirut, Lebanon. Data were collected by means of personal interview and clinical examination. The Arabic OHIP-14 and GOHAI questionnaires were used after cultural adaptation for use in Lebanon. The internal consistency, reproducibility and concurrent validity were verified. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile respectively and logistic regressions were conducted using socio-demographic, clinical and subjective explanatory variables. Two hundred and six participants were included; mean age was 72 years and 60% were women. Good psychometric properties were observed for both questionnaires for internal consistency (Cronbach's alpha>0.88), reproducibility (ICC>0.86) and concurrent validity. Strong correlations were found between GOHAI and OHIP-14 scores but a high prevalence of subjects with no impact was observed using the OHIP-14. Both questionnaires were able to discriminate between participants according to age, perception of temporomandibular joint (TMJ) pain or functional status as represented by the number of dental Functional Units (FU). GOHAI was more discriminant since it identified participants with high dental care needs: high numbers of decayed teeth, low numbers of teeth and socially deprived status. Lebanese elderly with high dental care needs and impaired oral health were identified more easily with the GOHAI. These results may guide the choice of dental

Outcome of chromosomally abnormal pregnancies in Lebanon: obstetricians' roles during and after prenatal diagnosis.

PubMed

Eldahdah, Lama T; Ormond, Kelly E; Nassar, Anwar H; Khalil, Tayma; Zahed, Laila F

2007-06-01

To better understand obstetrician experiences in Lebanon when disclosing abnormal amniocentesis results. Structured interviews with 38 obstetricians identified as caregivers from the American University of Beirut Medical Center Cytogenetics Laboratory database of patients with abnormal amniocentesis results between 1999 and 2005. Obstetricians were primarily male, Christian, and with an average of 14 years of experience. They reported doing most pre-amniocentesis counseling, including discussion of risk for common autosomal aneuplodies (95%), and procedure-related risk (95%). Obstetricians reported that 80% of patients at risk for aneuploidy underwent amniocentesis. The study population reported on 143 abnormal test results (124 autosomal abnormalities). When disclosing results, obstetricians reportedly discussed primarily physical and cognitive features of the diagnosis. They varied in levels of directiveness and comfort in providing information. Our records showed that 59% of pregnancies with sex chromosome abnormalities were terminated compared to 90% of those with autosomal aneuploidies; various reasons were proposed by obstetricians. This study is among the few to assess prenatal diagnosis practices in the Middle East, with a focus on the role of the obstetrician. Given the influence of culture and social norms on prenatal decision-making, it remains important to understand the various impacts on clinical practice in many nations. (c) 2007 John Wiley & Sons, Ltd.

Heart health in Lebanon and considerations for addressing the burden of cardiovascular disease.

PubMed

Deek, Hiba; Newton, Phillip; Inglis, Sally; Kabbani, Samer; Noureddine, Samar; Macdonald, Peter S; Davidson, Patricia M

2015-01-01

Lebanon is a small country located at the western boundary of the Middle East. Approximately 40% of health care in Lebanon is financed by the public sector. Cardiovascular diseases in Lebanon are scarcely addressed in the literature raising the need for baseline data on these health condition to be better treated. To (1) aggregate and define the burden of cardiovascular disease in Lebanon and (2) describe implications for policy, practice and research to improve health outcomes in Lebanon. An integrative review was conducted of both peer-reviewed papers and unpublished reports. CINAHL, Medline, Google Scholar and Academic Search Complete were searched along with the websites of The World Health Organization, Ministry of Public Health Lebanon and Central Intelligence Agency of Lebanon. No year limit was applied to our search. The search yielded 28 peer-reviewed articles and 15 reports. Cardiovascular diseases are the leading cause of morbidity and mortality in Lebanon and is also the primary cause of hospital admission. A range of social, political, economic and cultural factors explain the burden of cardiovascular diseases, some of these risks are culture specific such as the arghile smoking and the high rates of familial hypercholesterolemia. Workforce shortage produced by high rates of migrating nurses also has an implication on the patients' outcomes. Conclusion: Much of the presented data are sourced from the gray literature; more research, using systematic and prospective data collection methods, are needed to inform health services planning, delivery and evaluation. Primary care needs to be enhanced to produce better outcomes for a population with high profile of cardiovascular risk factors.

Comparative performance of PCR-based assay versus microscopy and culture for the direct detection of Mycobacterium tuberculosis in clinical respiratory specimens in Lebanon.

PubMed

Araj, G F; Talhouk, R S; Itani, L Y; Jaber, W; Jamaleddine, G W

2000-09-01

American University of Beirut Medical Center, Lebanon. To assess the performance of a polymerase chain reaction (PCR) using primers that flank 542 bp within IS6110 in Mycobacterium tuberculosis (TB) vs. microscopy and BACTEC culture, in the diagnosis of tuberculosis. A total of 82 clinical respiratory pulmonary specimens and 73 samples from BACTEC vials were tested by the three methods. Of 24 smear-positive culture-positive (SP-CP) and 11 smear-negative culture-positive (SN-CP) TB specimens, PCR detected 83% and 64%, respectively. Among 17 specimens yielding mycobacteria other than tuberculosis (MOTT), the PCR was positive in 33% SP-CP and 14% SN-CP specimens. Among the 73 BACTEC vials, PCR was positive in 36 of 38 (95%) yielding culture-positive TB, and in one of 20 (5%) yielding culture positive MOTT. None of the 30 smear-negative culture-negative (SN-CN) clinical specimens and 15 of the CN vials were positive by PCR. The overall sensitivity of PCR was 77% and 95% for TB detection in respiratory specimens and BACTEC vials, respectively, and the specificity was 94% in both. Because a substantial number of TB cases are missed, especially in SN-CP specimens, a PCR-based assay utilizing these primers cannot be used reliably, alone, in clinical laboratory diagnosis of mycobacterial respiratory infections.

Aging in Lebanon: Challenges and Opportunities.

PubMed

Abdulrahim, Sawsan; Ajrouch, Kristine J; Antonucci, Toni C

2015-08-01

This spotlight offers a unique window into factors affecting aging in Lebanon. As a bridge between east and west, both geographically and culturally, Lebanon has the fastest growing older adult population in the Arab region, but few societal resources to address its needs. In a country with a history of political instability and war, but also a culture with strong family values, aging adults in Lebanon are vulnerable in some ways and advantaged in others. Outmigration of youth is an important determinant of the wellbeing of the elderly. While often advantaged by remittances sent by their children, older Lebanese adults have less access to instrumental social and personal support previously provided by young adults in the family. How Lebanon manages these challenges is likely to foreshadow the future aging experience for much of the Arab region. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Intake of Nutritional Supplements among People Exercising in Gyms in Beirut City.

PubMed

El Khoury, D; Antoine-Jonville, S

2012-01-01

The use of nutritional supplements among exercisers in gyms has been never investigated in the Middle East. The aim of the current study was to assess the prevalence intake of nutritional supplements and the potential influencing factors among people exercising in gyms in Beirut city. In this cross-sectional study, 512 exercisers, aged between 20 and 50 years, were randomly selected from gyms. The intake of nutritional supplements was reported among 36.3% (95% confidence interval 32.2-40.5) of participants, with a weak presence of medical supervision. Patterns of supplement use differed by gender and age. Men and younger exercisers were found to focus on supplements associated with performance enhancement and muscle building, while women and older exercisers were more concerned with health-promoting products such as vitamins, minerals, and herbal supplements. An appropriate dissemination of accurate and scientifically sound information regarding the benefits and side effects of nutritional supplements is highly recommended in the sports environment in Beirut city.

Intake of Nutritional Supplements among People Exercising in Gyms in Beirut City

PubMed Central

El Khoury, D.; Antoine-Jonville, S.

2012-01-01

The use of nutritional supplements among exercisers in gyms has been never investigated in the Middle East. The aim of the current study was to assess the prevalence intake of nutritional supplements and the potential influencing factors among people exercising in gyms in Beirut city. In this cross-sectional study, 512 exercisers, aged between 20 and 50 years, were randomly selected from gyms. The intake of nutritional supplements was reported among 36.3% (95% confidence interval 32.2–40.5) of participants, with a weak presence of medical supervision. Patterns of supplement use differed by gender and age. Men and younger exercisers were found to focus on supplements associated with performance enhancement and muscle building, while women and older exercisers were more concerned with health-promoting products such as vitamins, minerals, and herbal supplements. An appropriate dissemination of accurate and scientifically sound information regarding the benefits and side effects of nutritional supplements is highly recommended in the sports environment in Beirut city. PMID:22506105

Salmonella burden in Lebanon.

PubMed

Malaeb, M; Bizri, A R; Ghosn, N; Berry, A; Musharrafieh, U

2016-06-01

Salmonellosis is a disease that represents a major public health concern in both developing and developed countries. The aim of this article is to evaluate the public health burden of Salmonella illness in Lebanon. The current scope of the Salmonella infection problem was assessed in relation to disease incidence and distribution with respect to age, gender and district. Factors that provide a better understanding of the magnitude of the problem were explored and highlighted. Data reported to the Epidemiologic Surveillance Department at the Lebanese Ministry of Public Health between 2001 and 2013 was reviewed. Information obtained was compared to information reported regionally and globally. The estimated true incidence was derived using multipliers from the CDC and Jordan. A literature review of all published data from Lebanon about Salmonella susceptibility/resistance patterns and its serious clinical complications was conducted. The estimated incidence was 13·34 cases/100 000 individuals, most cases occurred in the 20-39 years age group with no significant gender variation. Poor and less developed districts of Lebanon had the highest number of cases and the peak incidence was in summer. Reflecting on the projected incidence derived from the use of multipliers indicates a major discrepancy between what is reported and what is estimated. We conclude that data about Salmonella infection in Lebanon and many Middle Eastern and developing countries lack crucial information and are not necessarily representative of the true incidence, prevalence and burden of illness.

Cross-cultural perspectives on decision making regarding noninvasive prenatal testing: A comparative study of Lebanon and Quebec.

PubMed

Haidar, Hazar; Vanstone, Meredith; Laberge, Anne-Marie; Bibeau, Gilles; Ghulmiyyah, Labib; Ravitsky, Vardit

2018-01-01

Noninvasive prenatal testing (NIPT), based on the detection of cell-free fetal DNA in maternal blood, has transformed the landscape of prenatal care by offering clinical benefits (noninvasive, high specificity and sensitivity, early detection of abnormalities) compared to existing prenatal screening tests. NIPT has expanded rapidly and is currently commercially available in most of the world. As NIPT spreads globally, culturally sensitive and ethically sound implementation will require policies that take into consideration the social and cultural context of prenatal testing decisions. In a Western context, the main ethical argument for providing access and public funding of prenatal tests is the promotion of reproductive autonomy (also referred to as "procreative liberty" and "reproductive freedom"), by enabling pregnant women and couples to access information about the fetus in order to choose a certain course of action for pregnancy management (continuation of pregnancy and preparation for birth or termination). So how is the framework of reproductive autonomy operationalized in non-Western cultural contexts? We used Quebec, Canada, and Beirut, Lebanon, for case studies to explore what ethical considerations related to reproductive autonomy should guide the implementation of the test in various cultural contexts. To answer this question, we conducted a qualitative study to (1) explore the perceptions, values, and preferences of pregnant women and their partners about NIPT and (2) examine how these values and perceptions influence reproductive autonomy and decision making in relation to NIPT in these two different cultural settings, Lebanon and Quebec. Our findings may guide health care professionals in providing counseling and in helping women and their partners make better informed prenatal testing decisions. Further, at a policy level, such understanding might inform the development of local guidelines and policies that are appropriate to each context.

Terrorist Innovations in Weapons of Mass Effect, Phase 2

DTIC Science & Technology

2012-01-01

Beirut, Lebanon to Ankara, Turkey.1 They demanded the release of the three surviving Munich terrorists. The hijacked airplane was flown to Zagreb ...Yugoslavia. The West German government complied immediately and the three were flown to Zagreb , where they boarded the hijacked plane. The plane then was

Islamic Radicalization and the Global Islamist Movement: Protecting U.S. National Interests by Understanding and Countering Islamist Grand Strategy with U.S. Policy

DTIC Science & Technology

2013-05-01

28 Taqiyya and Kit’man: The Use of Deception ............................................................30...65 Us -versus-Them: The Dehumanization of “the Other” .................................................66...terrorism” was first used by President Reagan in 1984 in reaction to the bombing of the Marine barracks in Beirut, Lebanon. President Bush adopted the term

From Beirut to Khobar Towers: Improving the Combating Terrorism Program

DTIC Science & Technology

1998-04-01

of Defense’s Force Protection problems ? Hadn’t we learned our “lessons” following the catastrophic loss of 241 Marines in the 1983 Beirut bombing...and formulated 79 recommendations to improve DOD efforts to combat terrorism. In response to the Task Force’s report, US Air Force leadership directed...Prince Sultan Air Base, Saudi Arabia, would resolve several security vulnerabilities, but this action would create additional problems because US assets

Comparison Of Semi-Automatic And Automatic Slick Detection Algorithms For Jiyeh Power Station Oil Spill, Lebanon

NASA Astrophysics Data System (ADS)

Osmanoglu, B.; Ozkan, C.; Sunar, F.

2013-10-01

After air strikes on July 14 and 15, 2006 the Jiyeh Power Station started leaking oil into the eastern Mediterranean Sea. The power station is located about 30 km south of Beirut and the slick covered about 170 km of coastline threatening the neighboring countries Turkey and Cyprus. Due to the ongoing conflict between Israel and Lebanon, cleaning efforts could not start immediately resulting in 12 000 to 15 000 tons of fuel oil leaking into the sea. In this paper we compare results from automatic and semi-automatic slick detection algorithms. The automatic detection method combines the probabilities calculated for each pixel from each image to obtain a joint probability, minimizing the adverse effects of atmosphere on oil spill detection. The method can readily utilize X-, C- and L-band data where available. Furthermore wind and wave speed observations can be used for a more accurate analysis. For this study, we utilize Envisat ASAR ScanSAR data. A probability map is generated based on the radar backscatter, effect of wind and dampening value. The semi-automatic algorithm is based on supervised classification. As a classifier, Artificial Neural Network Multilayer Perceptron (ANN MLP) classifier is used since it is more flexible and efficient than conventional maximum likelihood classifier for multisource and multi-temporal data. The learning algorithm for ANN MLP is chosen as the Levenberg-Marquardt (LM). Training and test data for supervised classification are composed from the textural information created from SAR images. This approach is semiautomatic because tuning the parameters of classifier and composing training data need a human interaction. We point out the similarities and differences between the two methods and their results as well as underlining their advantages and disadvantages. Due to the lack of ground truth data, we compare obtained results to each other, as well as other published oil slick area assessments.

Provision of safe domestic water for the promotion and protection of public health: a case study of the city of Beirut, Lebanon.

PubMed

Korfali, Samira Ibrahim; Jurdi, Mey

2009-04-01

Securing adequate safe drinking water and proper sanitation is a major challenge facing the developing world. The "Water for Life Decade" emphasizes the importance of upgrading national water quality and sanitation services. This study assessed the domestic water profile in the city of Beirut. Samples were collected from three types of household water sources (municipality, private wells, and vended water bottles) and assessed for their physiochemical and microbiological profile. At the same time, a cross-sectional survey assessing water consumption patterns and the prevalence of water-borne diseases was conducted. The results showed a deficient water quality profile in all three water sources. The measured physiochemical and bacteriological parameters reflected the high frequency of water-borne diseases. Action to secure a safe domestic water supply is essential. The plan should guarantee the protection of water sources, ensure sufficient treatment of domestic water and upgrade the national program for potable water quality control. Periodic quality monitoring and legislating the chaotic water-vending sector are indispensable. Additionally, the deterioration of private well sources by sea and wastewater infiltration necessitates the enforcement of legislation associated with the use and management of private wells. Consumer awareness and active contributions to promote and protect public health are important.

Relationship between Nature of Science Understandings and Argumentation Skills: A Role for Counterargument and Contextual Factors

ERIC Educational Resources Information Center

Khishfe, Rola

2012-01-01

The study investigated the relationship of high school students' understandings about nature of science (NOS) aspects and their argumentation skills in relation to two controversial socioscientific issues. The study was conducted in five schools selected from different geographical areas in Beirut, Lebanon. Participants were 219 grade 11 students.…

Dietary exposure to pesticide residues from foods of plant origin and drinks in Lebanon.

PubMed

Nasreddine, Lara; Rehaime, Maria; Kassaify, Zeina; Rechmany, Roula; Jaber, Farouk

2016-08-01

This study assesses the dietary exposure of Lebanese adults to 47 pesticide residues from both foods of plant origin and drinks. The study was conducted using the Total Diet Study protocol in two different areas of Lebanon: Greater Beirut (urban) and Keserwan (semi-rural). A total of 1860 individual foods were collected, prepared, and cooked prior to analysis. Composite samples of similar foods were analyzed, following the QuEChERS Multiresidue method. Eighteen residues were detected/quantified on at least one composite sample, with 66.7 % of the results being quantifiable and 33.3 % detectable. Quantifiable levels ranged between 10.3 and 208 μg/kg. For the composite samples where residues were detected, 55 % had one residue, while 45 % had 2-4 residues. The most frequently detected/quantified pesticide residues included Chlorpyrifos, Procymidone, Primiphos methyl, Dimethoate, and Dieldrin. The dietary exposure assessment was conducted using the deterministic approach with two scenarios: (1) the lower bound (LB) approach and (2) the upper bound (UB) approach. Using the LB approach, mean estimated daily exposures were far below the acceptable daily intakes (ADIs) for all investigated residues. Using the UB approach, which tends to overestimate exposure, mean estimated daily exposures were below the ADIs for all residues except for Dieldrin (semi-rural: 128.7 % ADI; urban: 100.7 % ADI). Estimates of mean exposure to Diazinon reached 50.3 % of ADI in the urban diet and 61.9 % in the semi-rural diet. Findings of this study identify specific pesticide residues as monitoring priorities for which more comprehensive and sensitive analyses are needed in order to refine exposure assessment.

Dietary patterns and odds of Type 2 diabetes in Beirut, Lebanon: a case-control study.

PubMed

Naja, Farah; Hwalla, Nahla; Itani, Leila; Salem, Maya; Azar, Sami T; Zeidan, Maya Nabhani; Nasreddine, Lara

2012-12-27

In Lebanon, Type 2 diabetes (T2D) has a major public health impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. Diet is an important environmental factor in the development and prevention of T2D. Dietary patterns may exert greater effects on health than individual foods, nutrients, or food groups. The objective of this study is to examine the association between dietary patterns and the odds of T2D among Lebanese adults. Fifty-eight recently diagnosed cases of T2D and 116 population-based age, sex, and place of residence matched control participants were interviewed. Data collection included a standard socio-demographic and lifestyle questionnaire. Dietary intake was evaluated by a semi-quantitative 97-item food frequency questionnaire. Anthropometric measurements including weight, height, waist circumference, and percent body fat were also obtained. Dietary patterns were identified by factor analysis. Multivariate logistic regression analysis was used to evaluate the associations of extracted patterns with T2D. Pearson correlations between these patterns and obesity markers, energy, and nutrient intakes were also examined. Four dietary patterns were identified: Refined Grains & Desserts, Traditional Lebanese, Fast Food and Meat & Alcohol. While scores of the "Refined Grains & Desserts" had the highest correlations with energy (r = 0.74) and carbohydrates (r = 0.22), those of the "Fast Food" had the highest correlation with fat intake (r = 0.34). After adjustment for socio-demographic and lifestyle characteristics, scores of the Refined Grains & Desserts and Fast Food patterns were associated with higher odds of T2D (OR: 3.85, CI: 1.13-11.23 and OR: 2.80, CI: 1.14-5.59; respectively) and scores of the Traditional Lebanese pattern were inversely associated with the odds of T2D (OR: 0.46, CI: 0.22-0.97). The findings of this study demonstrate direct associations of the Refined Grains

The Qartaba Anticline (central Mount Lebanon): Implications for the tectonic evolution of onshore Lebanon

NASA Astrophysics Data System (ADS)

Asmar, Chloe; Grasemann, Bernhard; Nader, Fadi; Tari, Gabor

2013-04-01

The area of Lebanon includes three major physiographic elements (Mount Lebanon, the Anti-Lebanon mountain chain, and the Bekaa Valley in between). The western Lebanese ranges (Mount Lebanon) stretch along the coast of the Mediterranean Sea. The prominent Qartaba Anticline is located on the western side of the northern Mount Lebanon. The studied part of this anticline (~20 km long, ~5 km wide) represents a large-scale box-fold structure bounded by two SW- and NE-vergent monoclines. The mechanism and timing of folding of the Qartaba Anticline are still debated and are not well understood. During several field visits hundreds of structural measurements were made in the study area in order to better constrain the three-dimensional shape of the Qartaba structure. The data show that the eastern and western flanks of the anticline represent oppositely verging monoclines with average dip values increasing from around 15° at the outer limits of the structure to 30° towards the middle of the flanks and reaching values up to 90° at the uppermost flanks. The strata become more or less horizontal on the top of the structure, a few hundreds meters away from the limbs of the monoclines. Therefore the whole structure resembles a large scale box-fold. Although several generations of brittle faults cross cut the Qartaba structure, no large scale faults have been identified in the field, which could be interpreted as directly related to the folding process itself. Instead, the folding and the limb rotation are strongly associated with dissolution-precipitation deformation mechanisms showing multi-generations of axial plane stylolites at high angles to the bedding planes within the hinge zones of the flanking monoclines. Pronounced stratigraphic boundaries, such as the one between the Middle to Upper Jurassic Kesrouane and Bhannes Formations, have been taken as reference surfaces in previous reports in order to construct structural and isopach contour maps of the Qartaba structure

Teacher Nomination of "Mathematically Gifted Children with Specific Learning Difficulties" at Three State Schools in Jordan

ERIC Educational Resources Information Center

Al-Hroub, Anies; Whitebread, David

2008-01-01

In this article, Anies Al-Hroub, assistant professor of educational psychology and special educational needs at the American University of Beirut in Lebanon, and David Whitebread, senior lecturer in psychology and education in the University of Cambridge Faculty of Education, discuss the identification, by teachers, of children who are gifted in…

Better Teachers.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Hamburg (West Germany). Inst. for Education.

This publication examines an in-service teacher training program in Beirut, Lebanon sponsored by the Unesco Institute of Education and set up by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). The program provides professional training for unqualified Palestine refugee teachers working in schools…

Predicting falls using two instruments (the Hendrich Fall Risk Model and the Morse Fall Scale) in an acute care setting in Lebanon.

PubMed

Nassar, Nada; Helou, Nancy; Madi, Chantal

2014-06-01

To assess the predictive value of two instruments (the Morse Fall Scale (MFS) and the Heindrich II Fall Risk Model (HFRM)] in a Middle Eastern country (Lebanon) and to evaluate the factors that are related to falls. A prospective observational cross-sectional design was used. Falls and fall-related injuries in the acute care settings contribute a substantial health and economic burden on patients and organisations. Preventing falls is a priority for most healthcare organisations. While the risk of falling cannot be eliminated, it can be significantly reduced through accurate assessment of patients' risk of falling. Data from 1815 inpatients at the American University of Beirut Medical Center (AUBMC) in Lebanon were evaluated using two instruments to predict falls: the MFS and the HFRM. The incidence of falls was 2·7% in one year. The results indicate that while the instruments were significantly correlated, the HFRM was more sensitive in predicting falls than the MFS. The internal consistency of both scales was moderate, but inter-rater reliability was high. Patients using antiepileptic drugs and assistance devises had higher odds of falling. Although both instruments were easy to use in a Middle Eastern country, the HFRM rather than the MFS is recommended for inpatients in an acute care setting as it had higher sensitivity and specificity. It is recommended that while the HFRM had adequate sensitivity, it is not seamless, and as such, nurses should not rely entirely on it. Rather, nurses should use their expert clinical judgement, their ethical obligations and cultural considerations to implement a safer environment of care for the patient. © 2013 John Wiley & Sons Ltd.

Lebanon: A Case of History Education in a Sectarian Society

ERIC Educational Resources Information Center

Yoder, Paul J.

2015-01-01

This paper synthesizes the extant literature on history education in Lebanon. The sectarian nature of the country and the recent civil war make the case of Lebanon a unique and compelling one. Three emerging understandings underscore the complexity of history education in Lebanon and demonstrate the ways in which history is used to undercut…

State of family medicine practice in Lebanon.

PubMed

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession.

75 FR 47899 - Designation of Two Entities and Seven Individuals Pursuant to Executive Order 13224

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

...; Passport A0023862 (Iran) (individual) [SDGT] 5. MORTEZAVI, Hasan (a.k.a. MORTEZAVI, Ali Hassan; a.k.a. MORTEZAVI, Majid; a.k.a. MORTEZAVI, Majid Mirali; a.k.a. ``ALI, Hassan''); DOB 28 Apr 1961; POB Ghazvin.... ZAHEDI, Ali Reza), Beirut, Lebanon; DOB 1944; POB Esfahan, Iran; nationality Iran (individual) [SDGT] 9...

No Teacher Left Behind: Subject Leadership that Promotes Teacher Leadership

ERIC Educational Resources Information Center

Ghamrawi, Norma

2010-01-01

This article presents some of the findings derived from a two-year qualitative study compromised of 51 semi-structured interviews with principals, subject leaders and classroom teachers belonging to three private K-12 schools in Beirut, Lebanon. In the context of investigating teacher leadership, this study highlights the aspects of the role of…

Teachers' Views of Professional Learning and Collaboration in Four Urban Lebanese Primary Schools

ERIC Educational Resources Information Center

Bahous, Rima; Busher, Hugh; Nabhani, Mona

2016-01-01

This study to investigate how teachers develop their skills and knowledge to construct enthusiastic student learning and what part school principals play in that development was carried out in four primary schools serving disadvantaged communities in Beirut. In the absence of rich research in Lebanon on this topic, western literature was used to…

The Use of a Performance Assessment for Identifying Gifted Lebanese Students: Is DISCOVER Effective?

ERIC Educational Resources Information Center

Sarouphim, Ketty M.

2009-01-01

The purpose of this study was to investigate the effectiveness of DISCOVER, a performance- based assessment in identifying gifted Lebanese students. The sample consisted of 248 students (121 boys, 127 girls) from Grades 3-5 at two private schools in Beirut, Lebanon. Students were administered DISCOVER and the Raven Standard Progressive Matrices…

Toxic and essential elements in Lebanese cheese.

PubMed

Bou Khozam, Rola; Pohl, Pawel; Al Ayoubi, Baydaa; Jaber, Farouk; Lobinski, Ryszard

2012-01-01

Concentrations of 20 minor, trace and ultratrace elements relevant to human health (Ag, Al, As, Cd, Co, Cr, Cu, Fe, Hg, Li, Mn, Mo, Ni, Pb, Sb, Se, Si, Sn, V) were determined in four different varieties of the most consumed cheese in Lebanon (Halloumi, Double Crème, Baladi, Labneh) sampled at five different provinces (Grand Beirut, South of Lebanon, North of Lebanon, Mount of Lebanon and Beka'a) during the wet and dry seasons. The analyses were carried out by double focussing sector field inductively coupled plasma-mass spectrometry (ICP-MS) in order to avoid errors due to polyatomic interferences. Levels of toxic elements (As, Cd, Pb) were generally below the WHO permissible levels in dairy products. Concentrations of most elements were considerably affected by the type of cheese, the geographical site and the season of sampling.

Financing and Political Economy of Higher Education: The Case of Lebanon

ERIC Educational Resources Information Center

Nahas, Charbel

2011-01-01

This paper assesses the adequacy, efficiency, and equity of higher education in Lebanon in both the public and private sectors, while highlighting challenges that are specific to Lebanon. It concludes by discussing various approaches and strategies to remedy the challenges facing higher education in Lebanon.

12-MONTH PREVALENCE AND TREATMENT OF MENTAL DISORDERS IN LEBANON

PubMed Central

Karam, Elie G.; Mneimneh, Zeina N.; Karam, Aimee N.; Fayyad, John A.; Nasser, Soumana C.; Chatterji, Somnath; Kessler, Ronald C.

2007-01-01

SUMMARY Background: Mental disorders are thought to account for a significant portion of disease burden throughout the world. However, no national studies have been conducted to assess this assumption in the Arab world. Methods: As part of the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative, a nationally representative psychiatric epidemiological survey of n = 2857 adults (ages 18+) was carried out in Lebanon (the Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation: LEBANON). Twelve-month prevalence and severity of DSM-IV disorders and treatment were assessed with the WHO Composite International Diagnostic Interview (CIDI, Version 3.0). Information was also obtained about socio-demographics and exposure to traumatic events in the Lebanon wars. Findings: One-sixth (17.0%) of respondents met criteria for at least one 12-month DSM-IV/CIDI disorder, 27.0% of whom were classified serious and an additional 36.0% moderate. Nearly half of respondents had a history of exposure to war-related traumatic events. Significantly elevated odd-ratios (OR) of mood, anxiety and impulse-control disorders were associated with two (OR = 2.0-3.6) or more (OR = 2.2-9.1) war-related traumatic events, resulting in substantially higher proportions of moderate or severe 12-month mental disorders among respondents exposed to multiple war-related traumata (16.8-20.4%) than other respondents (3.3-3.5%). Only 10.9% of respondents with 12-month disorders obtained treatment. Two-thirds of treatment was provided in the general medical sector. Interpretation: Mental disorders are common in Lebanon. Prevalence is similar to WMH surveys in Western Europe. Unmet need for treatment is considerably higher in Lebanon than in Western countries. PMID:16564362

76 FR 39038 - Proposed Establishment of Class E Airspace; Lebanon, PA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

...-0558; Airspace Docket No. 11-AEA-13] Proposed Establishment of Class E Airspace; Lebanon, PA AGENCY... action proposes to establish Class E Airspace at Lebanon, PA, to accommodate new Standard Instrument... amendment to Title 14, Code of Federal Regulations (14 CFR) part 71 to establish Class E airspace at Lebanon...

National survey of blindness and low vision in Lebanon

PubMed Central

Mansour, A; Kassak, K.; Chaya, M.; Hourani, T.; Sibai, A.; Alameddine, M

1997-01-01

AIMS—To survey level of blindness and low vision in Lebanon.
METHODS—A population survey was undertaken in 10 148 individuals to measure the prevalence and identify the causes of blindness in Lebanon.
RESULTS—The prevalence of blindness was 0.6% and that of low vision 3.9%. The major causes of blindness were cataract (41.3%) and uncorrected large refractive error (12.6%).
CONCLUSION—Most causes of blindness in Lebanon can be controlled by various educational and medical programmes.

 PMID:9486035

School Counseling in Lebanon: Past, Present, and Future

ERIC Educational Resources Information Center

Ayyash-Abdo, Huda; Alamuddin, Rayane; Mukallid, Samar

2010-01-01

This article examines the status of school counseling in Lebanon. An overview that points out some weakness in the educational system, such as high dropout and repetition rates, is presented. Calls for counseling have been voiced partly because of the psychological consequences of social change, such as political instability in Lebanon. A sample…

Women in the Media: The Beirut Consultation. (Beirut, Lebanon, February 19-24, 1978).

ERIC Educational Resources Information Center

World Association for Christian Communication, London (England).

This report presents a summary of the experiences shared and presentations at a meeting attended by 20 women from different cultures, backgrounds, and situations who met to consider the role of women in the media, the responsible use of media, and the image of women portrayed there. Their main task was to find ways of helping the three sponsoring…

The tobacco industry’s thwarting of marketing restrictions and health warnings in Lebanon

PubMed Central

Nakkash, R; Lee, K

2009-01-01

Aims: This article outlines how the tobacco industry has undermined tobacco control efforts in Lebanon since the early 1970s. Methods: An analysis of online and on-site tobacco industry documents, reviews of newspapers, policy and other documents, and interviews with key policy makers were conducted. Results: Findings reveal how the weakness of tobacco control legislation in Lebanon has been the product of an effective tobacco industry strategy to weaken the content and scope of regulation, and delay adoption and implementation. Conclusions: The tobacco industry has built and maintained strong alliances that were and are regularly mobilised to effectively oppose regulation. Despite ratification of the World Health Organization Framework Convention on Tobacco Control in 2005, Lebanon's tobacco control track remains weak. Public health professionals and the government should work hard to oppose such tobacco industry tactics. PMID:19633145

Criminal Acts against Civil Aviation, 1986

DTIC Science & Technology

1986-01-01

AS/Auckland, NZ I M AA Knife & Alleged UnknownPol Explosive Asylu 06-11-79 Delta L-1011 New York/Ft. Lauder . 1 M S Knife & Alleged Cuba Gun 06-20-79...India Lahore/Prisoner Release/ Money 07-21-84 MEA B-707 Abu Dhabi, UAE/Beirut, Lebanon Abu Dhabi, UAE 07-29-84 Aeropostal DC-9 Caracas/Curacao

Incidence of sepsis following transrectal ultrasound guided prostate biopsy at a tertiary-care medical center in Lebanon

PubMed Central

Shahait, Mohammed; Degheili, Jad; El-Merhi, Fadi; Tamim, Hani; Nasr, Rami

2016-01-01

ABSTRACT Background Urosepsis is a rare but life-threatening complication following transrectal ultrasound (TRUS) guided needle prostate biopsy. Despite the technological and pharmacological improvements, the problem of bacterial urosepsis after prostate biopsy remains. A strategy for preventing urosepsis following TRUS prostate biopsy in areas with high prevalence of resistant strains or patients presenting risk factors is lacking. Objectives The aim of this study was to assess the prevalence of urosepsis, as well its predictors, following TRUS guided needle biopsy of the prostate in a tertiary care medical center in Lebanon. Materials and Methods We carried out a retrospective study on all patients who underwent TRUS prostate biopsy at the American University of Beirut Medical Center between January 1, 2011 and June 31, 2013. Patients’ hospital charts were reviewed. Data collected included demographic information, pre-procedure disease specific information, as well as post-procedure information. Predictors of urosepsis following TRUS were assessed. Results In total, 265 patients were included in this study, where the prevalence of urosepsis following TRUS prostate biopsy was found to be 9.4%. The significant independent predictors of urosepsis were found to be: age with an OR=0.93 (95% CI: 0.88–1.00, p-value=0.03), and hypertension comorbidity with an OR=3.25 (95% CI: 1.19–8.85, p-value=0.02). Conclusion We found a high prevalence of urosepsis among patients who have undergone TRUS prostate biopsy, and identified two significant risk factors. The results of this study highlight the importance of implementing strategies for prevention of urosepsis following TRUS prostate biopsy. PMID:27136468

Bluetongue virus in Lebanon.

PubMed

El Hage, J; Lorusso, A; Carmine, I; Di Gennaro, A; Portanti, O; Olivieri, S; Casaccia, C; Pisciella, M; Teodori, L; Sghaier, S; Savini, G

2013-10-01

Since 2000, several incursions of bluetongue virus (BTV) occurred in the Mediterranean Basin involving European and surrounding Countries. The Middle East represents one of the most important gateways for the access of BTV in Europe. Limited data on the BTV situation in this area are available. In this perspective, an epidemiological survey on the presence of BTV in Lebanon was conducted. Of the 181 serum samples tested, 97 (mean = 53.6%; 95% CI: 46.3-60.7) resulted positive when tested for the presence of BTV antibodies by c-ELISA, of these 42 (mean = 42%; 95% CI: 32.8-51.8) serum samples were from sheep and 55 (mean = 67.9%; 95% CI: 57.1-77.1) serum samples were from goats. Fourteen blood samples (14/110; mean = 12.7%; 95% CI: 7.8-20.3), 6 (6/66; mean = 9.1%; 95% CI: 4.4-18.5) from sheep and 8 (8/44; mean = 18.2%; 95% CI: 9.6-32.0) from goats, were positive by qRT-PCR. The results with serum-neutralization assay and typing performed by RT-PCR confirmed that six BTV serotypes are currently circulating in Lebanon, and these serotypes are as follows: 1, 4, 6, 8, 16 and 24. This study is the first report that confirms the presence and circulation of BTV in Lebanon. © 2013 Blackwell Verlag GmbH.

78 FR 46487 - Continuation of the National Emergency With Respect to Lebanon

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

...--Continuation of the National Emergency With Respect to Lebanon #0; #0; #0; Presidential Documents #0; #0; #0;#0... With Respect to Lebanon On August 1, 2007, by Executive Order 13441, the President declared a national emergency with respect to Lebanon pursuant to the International Emergency Economic Powers Act (50 U.S.C...

International Agendas and Local Manifestations: Universities in Cairo, Beirut and Jerusalem after World War I

ERIC Educational Resources Information Center

Huber, Valeska

2015-01-01

This article traces the influence of international networks in three Middle Eastern universities from the 1920s onwards: the American University of Beirut, the American University in Cairo and the Hebrew University in Jerusalem. It shows how American, internationalist, imperial and religious actors competed and how the universities were placed in…

'My pain was stronger than my happiness': experiences of caesarean births from Lebanon.

PubMed

Kabakian-Khasholian, Tamar

2013-11-01

the rising trends in caesarean section have been partially attributed to women's requests. Many studies in developed and very few in developing countries have attempted to understand this phenomenon. This qualitative study explores experiences of women having caesarean section on demand in a middle-income country with a private health-care system. an inductive qualitative design, using face-to-face semi-structured interviews. women were identified and recruited through a perinatal database and selected obstetricians' clinics in the Greater Beirut area in Lebanon. a purposive sample of women who had a caesarean childbirth within the four months preceding the interview, were visited for an interview at home using a semi-structured interview guide. Thematic content analysis was conducted on a sub-sample of 22 women who requested a caesarean birth. lack of information about caesarean sections fosters women's fear from labour pain and acts as the main impetus for women to consider caesareans as the pain free alternative. Findings reveal health-care providers' role in reinforcing beliefs about caesarean sections being the way for pain free deliveries by overestimating the safety of the procedure and disregarding postpartum health issues. caesarean birth is presented to women as a safe option for 'pain free' childbirth. This needs to be considered within the cultural context of understanding safety and pain as well as the dynamics of power in maternity care. Health-care professionals need to explore these dimensions and promote women's informed choice as well as encouraging the normality of birth. Copyright © 2012 Elsevier Ltd. All rights reserved.

Consumer Knowledge, Attitudes and Salt-Related Behavior in the Middle-East: The Case of Lebanon

PubMed Central

Nasreddine, Lara; Akl, Christelle; Al-Shaar, Laila; Almedawar, Mohamad M.; Isma’eel, Hussain

2014-01-01

Sodium intake is high in Lebanon, a country of the Middle East region where rates of cardiovascular diseases are amongst the highest in the world. This study examines salt-related knowledge, attitude and self-reported behaviors amongst adult Lebanese consumers and investigates the association of socio-demographic factors, knowledge and attitudes with salt-related behaviors. Using a multicomponent questionnaire, a cross-sectional study was conducted in nine supermarkets in Beirut, based on systematic random sampling (n = 442). Factors associated with salt-related behaviors were examined by multivariate regression analysis. Specific knowledge and attitude gaps were documented with only 22.6% of participants identifying processed foods as the main source of salt, 55.6% discerning the relationship between salt and sodium, 32.4% recognizing the daily limit of salt intake and 44.7% reporting being concerned about the amount of salt in their diet. The majority of participants reported behavioral practices that increase salt intake with only 38.3% checking for salt label content, 43.7% reporting that their food purchases are influenced by salt content and 38.6% trying to buy low-salt foods. Knowledge, attitudes and older age were found to significantly predict salt-related behaviors. Findings offer valuable insight on salt-related knowledge, attitude and behaviors in a sample of Lebanese consumers and provide key information that could spur the development of evidence-based salt-reduction interventions specific to the Middle East. PMID:25401502

The Civil Aviation Sector in Lebanon. Part 1; Institutional Reforms

NASA Technical Reports Server (NTRS)

Baaj, M. Hadi

2002-01-01

Civil aviation is one of the key contributors to a successful economic system. This has been recognized within Lebanon, which is undertaking developing a new civil aviation strategy encompassing a program of organizational reform, coordinated internationally, to meet the challenges of the new century. Such strategy is vital, as it will provide a coherent vision for the sector, compliment the extensive investments deployed by Lebanon in its aviation infrastructure, and guide future planning and investments. The proposed Civil Aviation Strategy for Lebanon has two major components: (1) institutional reform aiming at creating effective overall legal and regulatory frameworks in-line with current international best practice; and (2) implementation of liberalization measures and open skies policy. This paper aims to: (1) present Lebanon's current institutional arrangements; (2) review the institutional arrangements in key select countries (in order to define current trends in best institutional practice); (3) discuss the proposed institutional reform (which are at the basis of Lebanon's Draft Civil Aviation Reform Law) while showing that they conform with the identified best institutional trends; and (4) outline an implementation plan. The Draft Law has been approved by the Council of Ministers and now awaits Parliamentary endorsement.

76 FR 59503 - Establishment of Class E Airspace; Lebanon, PA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-27

... at Lebanon, PA, to accommodate new Standard Instrument Approach Procedures that have been developed... of the airport. This action enhances the safety and management of Instrument Flight Rules (IFR... support new standard instrument approach procedures developed at Keller Brothers Airport, Lebanon, PA. The...

Health care for older persons: a country profile--Lebanon.

PubMed

Abyad, A

2001-10-01

Lebanon is a small country, comparable in size to New Hampshire. It is currently estimated that 8% of the population is age 65 and older. The Lebanese population has witnessed a clear demographic transition in the past few decades. Our culture demands respect for older people and values highly the natural bonds of affection between all members of the family. The healthcare system in the country is an adaptation of the European model. Despite the large number of physicians (approximately 10,000) there is a shortage of primary care and geriatric physicians. There are 36 nursing homes in Lebanon, with a total of 6,000 beds, but most of them are understaffed, with the exception of three nursing homes that offer relatively comprehensive services including rehabilitative, preventive, and curative services. The Ain Wizen Elderly Care Centre is well recognized for the program it operates for older people, which is a good model for the region and for Lebanon in terms of services, training, and research. Demographic changes and social and economic developments in Lebanon have created new realities in the unprecedented growth of the older population. Lebanon, like other developing countries, needs to define the policies and programs that will reduce the burden of an aging population on its society and economy. There is a need to ensure the availability of health and social services for older persons and to promote older persons' continuing participation in a socially and economically productive life.

An Ethnographic Study of the Computational Strategies of a Group of Young Street Vendors in Beirut.

ERIC Educational Resources Information Center

Jurdak, Murad; Shahin, Iman

1999-01-01

Examines the computational strategies of 10 young street vendors in Beirut by describing, comparing, and analyzing computational strategies used in solving three types of problems: (1) transactions in the workplace; (2) word problems; and (3) computation exercises in a school-like setting. Indicates that vendors' use of semantically-based mental…

76 FR 50535 - Waiver of Restriction on Assistance to Lebanon

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

... DEPARTMENT OF STATE [Public Notice: 7555] Waiver of Restriction on Assistance to Lebanon Pursuant to Section 7086(c)(2) of the Department of State, Foreign Operations, and Related Programs... States to waive the requirements of Section 7086(c)(1) of the Act with respect to Lebanon and I hereby...

Epidemiology and clinical characteristics of traumatic brain injury in Lebanon

PubMed Central

Abou-Abbass, Hussein; Bahmad, Hisham; Ghandour, Hiba; Fares, Jawad; Wazzi-Mkahal, Rayyan; Yacoub, Basel; Darwish, Hala; Mondello, Stefania; Harati, Hayat; El Sayed, Mazen J.; Tamim, Hani; Kobeissy, Firas

2016-01-01

Abstract Background: Traumatic brain injury (TBI) is a debilitating medical and emerging public health problem that is affecting people worldwide due to a multitude of factors including both domestic and war-related acts. The objective of this paper is to systematically review the status of TBI in Lebanon – a Middle Eastern country with a weak health system that was chartered by several wars and intermittent outbursts of violence - in order to identify the present gaps in knowledge, direct future research initiatives and to assist policy makers in planning progressive and rehabilitative policies. Methods: OVID/Medline, PubMed, Scopus databases and Google Scholar were lastly searched on April 15th, 2016 to identify all published research studies on TBI in Lebanon. Studies published in English, Arabic or French that assessed Lebanese patients afflicted by TBI in Lebanon were warranting inclusion in this review. Case reports, reviews, biographies and abstracts were excluded. Throughout the whole review process, reviewers worked independently and in duplicate during study selection, data abstraction and methodological assessment using the Downs and Black Checklist. Results: In total, 11 studies were recognized eligible as they assessed Lebanese patients afflicted by TBI on Lebanese soils. Considerable methodological variation was found among the identified studies. All studies, except for two that evaluated domestic causes such as falls, reported TBI due to war-related injuries. Age distribution of TBI victims revealed two peaks, young adults between 18 and 40 years, and older adults aged 60 years and above, where males constituted the majority. Only three studies reported rates of mild TBI. Mortality, rehabilitation and systemic injury rates were rarely reported and so were the complications involved; infections were an exception. Conclusion: Apparently, status of TBI in Lebanon suffers from several gaps which need to be bridged through implementing more basic

Emergency response to mass casualty incidents in Lebanon.

PubMed

El Sayed, Mazen J

2013-08-01

The emergency response to mass casualty incidents in Lebanon lacks uniformity. Three recent large-scale incidents have challenged the existing emergency response process and have raised the need to improve and develop incident management for better resilience in times of crisis. We describe some simple emergency management principles that are currently applied in the United States. These principles can be easily adopted by Lebanon and other developing countries to standardize and improve their emergency response systems using existing infrastructure.

Neurosurgery in Lebanon: History, Development, and Future Challenges.

PubMed

Fares, Youssef; Fares, Jawad

2017-03-01

Lebanon stands out as the one of the first countries in the Middle East and the Arab world to practice the medical specialty of neurosurgery. In addition, Lebanon has one of the best reputations for neurosurgery in this region. This article documents the history and current status of Lebanese neurosurgery. Residency and fellowship trainings are also highlighted, and political, socioeconomic, and academic challenges for the future of the profession are presented. Copyright © 2016 Elsevier Inc. All rights reserved.

Planning dental manpower in Lebanon: scenarios for the year 2015.

PubMed

Doughan, B; Kassak, K; Bourgeois, D

2005-01-01

The requirements for dentists in Lebanon for the year 2015 were estimated using the World Health Organization/World Dental Federation planning model. The aim was to help decision- and policy-makers in Lebanon to plan strategically for the supply of dental personnel in line with the recommendations of the Oral Health National Plan guidelines from 1995. Assumptions based on previous research in selected populations were taken to support the simulation. The number of dentists required for Lebanon in the year 2015 was estimated to be 2715 while the projected supply will be 6176. Urgent measures are needed to reduce the potential oversupply of dentists in this country.

Attitudes toward Students with Disabilities at Notre Dame University, Lebanon

ERIC Educational Resources Information Center

Van Loan, Amira

2013-01-01

Disability issues in Lebanon are not being addressed on a national scale. Among the myriad of underrepresented groups, individuals with disabilities in Lebanon continue to be marginalized in education, employment, health care, politics, and all aspects of society. The focus of this project investigation was to identify the attitudes of faculty…

Area Handbook Series: Lebanon: A Country Study

DTIC Science & Technology

1989-01-01

government surveys most Lebanese were adequately sheltered and fed. Known for their ingenuity and resourcefulness in trading and in entrepreneurship ...proceedings in 1985. In 1985 Bank Al Mashrek also bough’ two branches of the Brit- ish Standard Chartered Bank. Banque Libano- Franchise bought the...closed their Beirut operations, the former handing over its business to Banque Sabbag et Franchise pour le Moyen Orient. By the end of 1986, only

Catholic School Principals' Leadership Perspectives in Lebanon: A Case Study of Mount Lebanon

ERIC Educational Resources Information Center

Younes, Jean Eias

2011-01-01

This qualitative case study investigated the leadership perspectives of 13 Lebanese Catholic school principals and 4 educational leaders in the Governorate of Mount Lebanon via personal interviews, observations, and documents. It focused on whether Catholic school principals are able to act as revolutionary or transformational change agents to…

The determinants of intention to smoke waterpipe among adolescents in Lebanon: a national household survey.

PubMed

Schröder, Claudia; Chaaya, Monique; Saab, Dahlia; Mahfoud, Ziyad

2016-03-01

The phenomenon of waterpipe smoking (WPS) among adolescents has become eminent, and it is especially prevalent in Lebanon. Unlike cigarette smoking, WPS is parentally and socially acceptable. This study aims at examining the association between intention to smoke waterpipe in the next 6 months, and knowledge, attitudes and parental and social influences. This is a secondary data analysis from a national survey in 2007 on 1028 households. This study addresses 258 non-smoking adolescents and their parents. Consent was sought and the study was approved by the Institutional Review Board at the American University of Beirut. Face-to-face interviews were conducted. Descriptive analysis, crude and adjusted odds ratios (ORs) were generated. At the bivariate level, late adolescence, mothers without university education, prior adolescents' WPS experiences, best friends' and parents' WPS habits and adolescents' and parents' lower attitude scores were associated with smoking intention. In the adjusted model, adolescents' beliefs about positive effects, best friends' similar habits and prior smoking remained significant (respective ORs [95% confidence interval ]: 1.81 [1.33-2.45], 2.51 [1.24-5.10], 4.91 [2.35-10.36]). Parents' perceived attitude against smoking was protective (OR: 0.57 [0.39-0.83]). Adolescents' intention to smoke is highly influenced by parents' permissive attitudes and peer pressure. Interventions targeting these two groups and limiting access to smoking by adolescents should be instigated. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Associations between poor living conditions and multi-morbidity among Syrian migrant agricultural workers in Lebanon

PubMed Central

Mikati, Diana; Hojeij, Safa; El Asmar, Khalil; Chaaya, Monique; Zurayk, Rami

2016-01-01

Background: Syrian migrant farmworkers are among the most marginalized populations in Lebanon, living in poverty, lacking basic legal protections and frequent targets of discrimination. These realities produce living conditions that undermine their basic health and wellbeing. This study explores associations between household living conditions and acute and chronic health problems among Syrian migrant agricultural workers in the Bekaa region of Lebanon. Methods: A survey was carried out in summer of 2011 with a sample of 290 migrant agriculture workers and members of their household living in a migrant farmworker camp. The survey assessed participants living conditions, assets and health conditions. Regression analyses were carried out to examine associations between multi-morbidity and quality of household and neighborhood living conditions. Results: The mean age for the population was 20 years. Forty-seven percent of participants reported health problems. Almost 20% reported either one acute or chronic illness, 15% reported two health problems and 13% reported three or more. The analysis showed a significant positive association between multi-morbidity and poor housing and infrastructure conditions among study participants. Conclusion: The situation for migrant communities in Lebanon has likely further deteriorated since the study was conducted, as hundreds of thousands of new migrants have entered Lebanon since the outbreak of the Syrian armed conflict in 2011. These findings should inspire multi-faceted community development initiatives that provide basic minimums of neighborhood infrastructure and housing quality for Syrian migrant informal settlements across Lebanon, safeguarding the health and wellbeing of community residents. PMID:27402635

Reaction of Armenian Children to Wartime Stress in Lebanon.

ERIC Educational Resources Information Center

Der-Karabetian, Aghop

The psychological reaction of children to wartime stress has been studied at some length but with equivocal results. To compare the reactions of 52 Armenian children who had experienced the 1975-1977 Lebanese Civil War in Beirut with the reactions of 39 Armenian children who did not experience the war, the children participated in structured…

Is the Department of State Accountability Review Board Process adequate

DTIC Science & Technology

2017-05-25

of calculated terror campaigns, psychological conflict waged by nation or sub- group against nation, with an ever- broadening range of targets...the attack.11 However, the most politically significant attack occurred on November 4, when a large group of students and militants again stormed...the terrorist group Islamic Jihad carried out an attack against the US Embassy in Beirut, Lebanon. The bomb partially destroyed the U.S. Embassy and

The Syrian Intervention in Lebanon 1975-76: A Failure of Strategy

DTIC Science & Technology

2002-07-01

Zahle, Deir al- Qamar , and Zgharta as key tactical targets. Strongholds adjacent to Beirut, such as Damour, could block PLO forces from the south, and...Highway. Deir al- Qamar was the hometown of Cammille Chamoun, and Zgharta the 41 Rabinovich, 47-48. 21

Challenges in Estimating Vaccine Coverage in Refugee and Displaced Populations: Results From Household Surveys in Jordan and Lebanon

PubMed Central

Roberton, Timothy; Weiss, William; Doocy, Shannon

2017-01-01

Ensuring the sustained immunization of displaced persons is a key objective in humanitarian emergencies. Typically, humanitarian actors measure coverage of single vaccines following an immunization campaign; few measure routine coverage of all vaccines. We undertook household surveys of Syrian refugees in Jordan and Lebanon, outside of camps, using a mix of random and respondent-driven sampling, to measure coverage of all vaccinations included in the host country’s vaccine schedule. We analyzed the results with a critical eye to data limitations and implications for similar studies. Among households with a child aged 12–23 months, 55.1% of respondents in Jordan and 46.6% in Lebanon were able to produce the child’s EPI card. Only 24.5% of Syrian refugee children in Jordan and 12.5% in Lebanon were fully immunized through routine vaccination services (having received from non-campaign sources: measles, polio 1–3, and DPT 1–3 in Jordan and Lebanon, and BCG in Jordan). Respondents in Jordan (33.5%) and Lebanon (40.1%) reported difficulties obtaining child vaccinations. Our estimated immunization rates were lower than expected and raise serious concerns about gaps in vaccine coverage among Syrian refugees. Although our estimates likely under-represent true coverage, given the additional benefit of campaigns (not captured in our surveys), there is a clear need to increase awareness, accessibility, and uptake of immunization services. Current methods to measure vaccine coverage in refugee and displaced populations have limitations. To better understand health needs in such groups, we need research on: validity of recall methods, links between campaigns and routine immunization programs, and improved sampling of hard-to-reach populations. PMID:28805672

Teaching for Citizenship in Lebanon: Teachers Talk about the Civics Classroom

ERIC Educational Resources Information Center

Akar, Bassel

2012-01-01

"National and Civic Education" is a program of study compulsory across all grade levels in Lebanon aimed at promoting social cohesion and active citizenship. A sample of 19 civics teachers in Lebanon across four of the six governorates participated in semi-structured interviews. The conversations delved into their conceptions of…

Implementing opioid substitution in Lebanon: Inception and challenges.

PubMed

El-Khoury, Joseph; Abbas, Zeinab; Nakhle, Pascale E; Matar, Marie-Therese

2016-05-01

Opioid Substitution Treatment (OST) is a firmly established method of treating and managing dependence to opioids in Europe, the US and rest of the developed world. It has a solid evidence base and a positive safety track record. Dissemination of its practice, in parallel to the acceptance of harm reduction as an effective approach, is still timid in low and middle Income countries. After years of advocacy on the parts of clinicians and the voluntary sector, the government of Lebanon launched a national opioid substitution program in 2011 using buprenorphine as the substance of substitution. Lebanon is one of the first countries in the MENA region to establish such a program despite a difficult socio-political context. This paper provides the background of harm reduction efforts in the region and presents the outline of the program from inception to present date. Challenges and recommendations for the future are also discussed. The Lebanese experience with opioid substitution is encouraging so far and can be used as a template for others in the region who might be contemplating broadening the range of services available to tackle addiction to heroin and related substances. Copyright © 2016 Elsevier B.V. All rights reserved.

End-of-life issues as perceived by Lebanese judges.

PubMed

Adib, Salim M; Kawas, Sami H; Hajjar, Theresa A

2003-05-01

to assess the attitudes of judges in Beirut, Lebanon, regarding end-of-life issues such as assisted suicide and withholding or withdrawing life-sustaining treatment. 85% of all currently acting and in-training judges and public prosecutors in Beirut (N=135) were surveyed using a mailed questionnaire that assessed attitudes toward intervention in five hypothetical cases. The associations of attitudes, on a scale from least to most 'sympathetic' toward assisting those who desire to end their lives, were measured by a variety of personal, social and professional variables. younger individuals, and those who have not yet been formally appointed as judges, were significantly more sympathetic to withdrawal or withholding of life-sustaining devices when patients or their proxies requested it, and more in support of assisted suicide. Gender, religious denomination, religious practice, and personal experience with prolonged illness leading to death among close friends or family, were generally not significant predictors of respondents' attitudes. Years of experience as a judge correlated strongly with age and may have contributed to its predictive effect. a relatively more sympathetic attitude among younger judges, many of them women, and among trainees, may reflect a historical evolution in younger age-groups in Lebanon today. A survey of opinions in the public may help reach a more conclusive understanding in this regard. In any case, judges in Lebanon will remain important partners in the debate, as they will continue to be the final interpreters of the letter of the law in end-of-life issues.

Prevalence and determinants of complementary and alternative medicine use among infertile patients in Lebanon: a cross sectional study

PubMed Central

2012-01-01

Background Complementary and alternative medicine (CAM) is widely used for the treatment of infertility. While the Middle East and North Africa region has been shown to house one of the fastest growing markets of CAM products in the world, research describing the use of CAM therapies among Middle-Eastern infertile patients is minimal. The aim of this study is to examine the prevalence, characteristics and determinants of CAM use among infertile patients in Lebanon. Methods A cross sectional survey design was used to carry out face-to-face interviews with 213 consecutive patients attending the Assisted Reproductive Unit at a major academic medical center in Beirut. The questionnaire comprised three sections: socio-demographic and lifestyle characteristics, infertility-related aspects and information on CAM use. The main outcome measure was the use of CAM modalities for infertility treatment. Determinants of CAM use were assessed through the logistic regression method. Results Overall, 41% of interviewed patients reported using a CAM modality at least once for their infertility. There was a differential by gender in the most commonly used CAM therapies; where males mostly used functional foods (e.g. honey & nuts) (82.9%) while females mostly relied on spiritual healing/prayer (56.5%). Factors associated with CAM use were higher household income (OR: 0.305, 95% CI: 0.132–0.703) and sex, with females using less CAM than males (OR: 0.12, 95% CI: 0.051–0.278). The older patients were diagnosed with infertility, the lower the odds of CAM use (p for trend <0.05). Almost half of the participants (48%) were advised on CAM use by their friends, and only 13% reported CAM use to their physician. Conclusions The considerably high use of CAM modalities among Lebanese infertile patients, added to a poor CAM use disclosure to physicians, underscore the need to integrate CAM into the education and training of health professionals, as well as enhance infertile patients' awareness

Determinants of the nutritional status of older adults in urban Lebanon.

PubMed

Mitri, Rosy; Boulos, Christa; Adib, Salim M

2017-03-01

To assess the nutritional status, and its association with sociodemographic factors, health and functional status of community-dwelling older adults living in the Greater Beirut area. This was a cross-sectional study involving 905 randomly selected community dwelling older adults aged ≥65 years living in Greater Beirut (Beirut and surrounding suburbs). Participants completed a standardized questionnaire on sociodemographic factors, health characteristics, and functional and nutritional status, based on the Mini Nutritional Assessment. Among the older adults who participated in the study, 2.8% (95% CI 0.01-0.03) were malnourished, and 45.5% (95% CI 0.42-0.48) were at risk of malnutrition. Sociodemographic variables were not associated with the nutritional status. Variables significantly associated with poorer nutritional status were: poor perception of general health (OR 1.58, 95%CI 1.28-1.97), more chronic diseases (OR 2.05, 95% CI1.26-3.33), poor perception of oral health (OR 1.36, 95% CI 1.14-1.61), depressive disorders (OR 1.76, 95% CI 1.30-2.40), higher body mass index (OR 1.98, 95% CI1.67-2.34) and disability (OR 5.80, 95% CI 1.96-17.11). The present study showed an unacceptable risk of malnutrition among Lebanese older adults, independent of age, sex and socioeconomic status. The presence of comorbidities, treated or not, affecting general and oral health emerged as major determinants of poor nutrition. Geriatr Gerontol Int 2017; 17: 424-432. © 2016 Japan Geriatrics Society.

The lived experience of parents of children admitted to the pediatric intensive care unit in Lebanon.

PubMed

Majdalani, Marianne N; Doumit, Myrna A A; Rahi, Amal C

2014-02-01

Family caregivers have a significant responsibility in the care of their child in the Pediatric Intensive Care Unit (PICU). Parents staying with their child in the PICU have particular needs that should be acknowledged and responded to by clinicians. Several studies have been conducted in the USA and Europe to try to understand the experience of family caregivers of children admitted to the Pediatric Intensive Care Unit. There are no such studies in Lebanon or the Middle East where the culture and support systems differ from other countries. To understand the lived experience of Lebanese parents of children admitted to the PICU in a tertiary hospital in Beirut. Phenomenological study. The study followed purposeful sampling in which 10 parents (mother or father) of children admitted to PICU were interviewed. Data were analyzed following the hermeneutical process as described by Diekelmann and Ironside (1998). A constitutive pattern "Journey into the unknown" which constitutes an overarching theme and four major themes with subthemes emerged from the data. These were: We are human beings with dignity "; "looking for a healthier environment"; Dependence on God and "The need to be in the loop" reveal the parents' journey into the unknown. This qualitative study adds to the knowledge that would help health care workers understand the experience of Lebanese parents with a child in PICU and to highlight the significance of this experience to them. The findings could be used to inform the development of a PICU parental satisfaction instrument for the sample group. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cesarean Sections Among Syrian Refugees in Lebanon from December 2012/January 2013 to June 2013: Probable Causes and Recommendations

PubMed Central

Huster, Karin M.J.; Patterson, Njogu; Schilperoord, Marian; Spiegel, Paul

2014-01-01

Introduction: There are nearly 3 million Syrian refugees, with more than 1 million in Lebanon. We combined quantitative and qualitative methods to determine cesarean section (CS) rates among Syrian refugees accessing care through United Nations High Commissioner for Refugees (UNHCR)-contracted hospitals in Lebanon and possible driving factors. Methods: We analyzed hospital admission data from UNHCR’s main partners from December 2012/January 1, 2013, to June 30, 2013. We collected qualitative data in a subset of hospitals through semi-structured informant interviews. Results: Deliveries accounted for almost 50 percent of hospitalizations. The average CS rate was 35 percent of 6,366 deliveries. Women expressed strong preference for female providers. Clinicians observed that refugees had high incidence of birth and health complications diagnosed at delivery time that often required emergent CS. Discussion: CS rates are high among Syrian refugee women in Lebanon. Limited access and utilization of antenatal care, privatized health care, and male obstetrical providers may be important drivers that need to be addressed. PMID:25191143

[SEASONAL VARIATION OF MICROVOLT T-WAVE ALTERNANS IN PATIENTS WITH CARDIOVASCULAR DISEASE AND HEALTHY SUBJECTS].

PubMed

Halabi, Gh; Bulanova, N; Aleksandrova, S; Ivanov, G; Aleksandrova, M

2018-05-01

Objective - to access seasonal variation of microvolt T-wave alternans of ECG dispersion mapping in patients with cardiovascular disease and healthy subjects. ECG data of the three groups of healthy subjects have been compared: inhabitants of Beirut, Lebanon (n=51), inhabitants of Moscow, Russia (n=94) and ECG data of healthy subjects (n=44) from the testing ECG database of the PTB - The National Metrology Institute of Germany as well as a group of patients with cardiovascular disease (n=138), inhabitants of Beirut, Lebanon. Microvolt T-wave alternans of ECG dispersion mapping was evaluated in three points - Tbeginning, Tmaximum, Tend. In healthy subjects, the seasonal variation of ECG dispersion mapping microvolt T-wave alternans was nonexistent. Myocardial lesion is characterized by an increase in Tbeg, Tmax, Tend in relation to the healthy individuals. Tbeg values are minimal in winter and summer and increase in spring and autumn. Tend values were reversed - they were maximal in winter and summer, decreasing in spring-autumn period. Seasonal variation of Tmax - Tbeg, and Tmax -Tend was detected: Tmax - Tbeg increased in the winter-summer period and decreased in spring and autumn, Tmax-Tend - increased in the spring-autumn period in relation to the winter-summer period. In patients with cardiovascular disease, in contrast to the healthy, there is a seasonal variation in microvolt T-wave alternans of ECG dispersion mapping, with the maximum differences in the winter and spring seasons, which should be taken into account when applying the method in clinical practice.

Bouguer gravity and crustal structure of the Dead Sea transform fault and adjacent mountain belts in Lebanon

NASA Astrophysics Data System (ADS)

Kamal; Khawlie, Mohamad; Haddad, Fuad; Barazangi, Muawia; Seber, Dogan; Chaimov, Thomas

1993-08-01

The northern extension of the Dead Sea transform fault in southern Lebanon bifurcates into several faults that cross Lebanon from south to north. The main strand, the Yammouneh fault, marks the boundary between the Levantine (eastern Mediterranean) and Arabian plates and separates the western mountain range (Mount Lebanon) from the eastern mountain range (Anti-Lebanon). Bouguer gravity contours in Lebanon approximately follow topographic contours; i.e., positive Bouguer anomalies are associated with the Mount Lebanon and Anti-Lebanon ranges. This suggests that the region is not in simple isostatic compensation. Gravity observations based on 2.5-dimensional modeling and other available geological and geophysical information have produced the following interpretations. (1) The crust of Lebanon thins from ˜35 km beneath the Anti-Lebanon range, near the Syrian border, to ˜27 km beneath the Lebanese coast. No crustal roots exist beneath the Lebanese ranges. (2) The depth to basement is ˜3.5-6 km below sea level under the ranges and is ˜8-10 km beneath the Bekaa depression. (3) The Yammouneh fault bifurcates northward into two branches; one passes beneath the Yammouneh Lake through the eastern part of Mount Lebanon and another bisects the northern part of the Bekaa Valley (i.e., Mid-Bekaa fault). The Lebanese mountain ranges and the Bekaa depression were formed as a result of transtension and later transpression associated with the relative motion of a few crustal blocks in response to the northward movement of the Arabian plate relative to the Levantine plate.

3 CFR - Continuation of the National Emergency With Respect to Lebanon

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to Lebanon Presidential Documents Other Presidential Documents Notice of July 29, 2013 Continuation of the National Emergency With Respect to Lebanon On August 1, 2007, by Executive Order 13441, the President declared a national emergency with...

Community pharmacy in Lebanon: A societal perspective

PubMed Central

Droubi, Fida

2016-01-01

Objective: To assess patients’ attitudes towards the community pharmacist’s role and determine their negative and positive reactions towards community pharmacists in Lebanon. Methods: A cross-sectional study, conducted between January and April 2016, was designed to assess the general public satisfaction with the services provided by the community pharmacies. It was carried out, using a proportionate random sampling of Lebanese community pharmacies from each district. Two sided statistical tests were used to compare between group percentages, Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution, and Student’s t-test for quantitative variables of normal distribution and homogeneous variances. The ANOVA test was used to compare between three groups or more, and Pearson correlation coefficient were used to correlate between quantitative variables. Results: a total of 565 participants completely answered the survey questions with a response rate of 94%. The bivariate analysis showed that the patient perception index was positively and significantly correlated with the patient level of expectation index, the overall pharmacy experience and the patient’s reason for visiting the pharmacy (p<0.001 for all 3 variables) but was negatively correlated with the barriers for asking questions significantly (p=0.032). On the other hand, this perception index was significantly and positively associated with the number of pharmacy visits, the age categories, the level of education and the family monthly income (p<0.05 for all variables). Conclusion: Public perception and attitude toward community pharmacist in Lebanon is poor despite highly qualified pharmacists. Aspects of pharmacy services most relevant to patients were respect, empathy, a friendly staff, listening carefully, giving quality time, responding quickly to their needs and respecting their privacy. The ministry of Health in Lebanon, along with the Lebanese Order of

President Reagan’s commitment of Peacekeepers in Lebanon, 1983

DTIC Science & Technology

2015-05-21

2008-10/25-years-later-we-came-peace. 5 Douglas Lute, Briefing to the Author, Brussels, September 2014. 5 such as Egypt , France and the United... God , published in 2013, examines how conflict in Lebanon allowed Iran to “aggregate under one roof a variety of militant Shi’a groups in Lebanon.”7...7 Matthew Levitt, Hezbollah, The Global Footprint of Lebanon’s Party of God (Washington

Attitudes Toward Placebo Use in Lebanon.

PubMed

Abou-Mrad, Fadi; Tarabey, Lubna

2015-05-01

Placebo use, both in clinical trials and patient care, is a problematic ethical issue surrounded by opposing arguments from those who advocate its use versus those who do not. This problematic aspect of placebo is more challenging in Lebanon where religious ideologies dominate people's beliefs, and where laws that guide medical care are vague. This paper aims to highlight the cultural ideologies that dominate medical care and the perspectives of people associated with the field. The method relied on semi-structured interviews with religious leaders, representatives of society and healthcare professionals. Panel discussions incorporating healthcare professionals, academics, scientists and medical researchers were also organized. The legal environment in Lebanon is characterized by lack of an appropriate legislative guideline that categorically clarifies the value of the human person in medical care. There is a lack of a common ethical standard within a society characterized by social and political dissent. The culturally upheld principles and actual application of the principles of ethics surrounding patient autonomy were overviewed. Medical practitioners failed to agree to a general outline that should guide the use of placebo where it became evident that each practitioner adopted a subjective framework which ultimately undermines patient autonomy. The paper proposes that until a new legislative code that clarifies ethical principles properly guiding medical care is coined, the process of placebo use will continue to be subject to the paternalistic assessments of medical professionals. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Maternal Health Care Utilization Among Syrian Refugees in Lebanon and Jordan.

PubMed

Tappis, Hannah; Lyles, Emily; Burton, Ann; Doocy, Shannon

2017-09-01

Purpose The influx of Syrian refugees into Jordan and Lebanon over the last 5 years presents an immense burden to national health systems. This study was undertaken to assess utilization of maternal health services among Syrian refugees in both countries. Description A cross-sectional survey of Syrian refugees living in urban and rural (non-camp) settings was conducted using a two-stage cluster survey design with probability proportional to size sampling in 2014-2015. Eighty-six percent of surveyed households in Lebanon and 88% of surveyed households in Jordan included women with a live birth in the last year. Information from women in this sub-set of households was analyzed to understand antenatal and intrapartum health service utilization. Assessment A majority of respondents reported seeking antenatal care, 82% and 89% in Jordan and Lebanon, respectively. Women had an average of at least six antenatal care visits. Nearly all births (98% in Jordan and 94% in Lebanon) took place in a health facility. Cesarean rates were similar in both countries; approximately one-third of all births were cesarean deliveries. A substantial proportion of women incurred costs for intrapartum care; 33% of Syrian women in Jordan and 94% of Syrian women in Lebanon reported paying out of pocket for their deliveries. The proportion of women incurring costs for intrapartum care was higher in Jordan both countries for women with cesarean deliveries compared to those with vaginal deliveries; however, this difference was not statistically significant in either country (Jordan p-value = 0.203; Lebanon p-value = 0.099). Conclusion Syrian refugees living in Jordan and Lebanon had similar levels of utilization of maternal health services, despite different health systems and humanitarian assistance provisions. As expected, a substantial proportion of households incurred out-of-pocket costs for essential maternal and newborn health services, making cost a major factor in care

Ethnopharmacological survey of medicinal plants used in traditional medicine by the communities of Mount Hermon, Lebanon.

PubMed

Baydoun, Safaa; Chalak, Lamis; Dalleh, Helena; Arnold, Nelly

2015-09-15

Medicinal plant species in Lebanon are experiencing severe threats because of various environmental conditions, human expansion footprints and recent growing global demand. Organized research and information on indigenous medicinal plants and knowledge have been very limited and little efforts have been invested to develop a complete inventory for native medicinal plants and associated traditional knowledge in the country. Recognized as a key biodiversity area of the Mediterranean Basin, Mount Hermon hosts important richness of medicinal plants that has been traditionally used in treatment of many illnesses since generations. Novel knowledge gathered by the present investigation is important in preserving indigenous knowledge of Mount Hermon community and revitalizing traditional herbal medicines. Ethnopharmacological information was collected by semi-structured interviews with 53 native informants (herbalists, traditional healers, midwives and local adult villagers) in 13 towns and villages surrounding Mount Hermon. The interviews were conducted through guided field visits and discussion groups whilst collecting plants specimens. Taxonomical identification of plant species was based on the determination keys of the "New Flora of Lebanon and Syria" and specimens were deposited at the herbarium of the Research Center for Environment and Development at Beirut Arab University. The results obtained indicate that 124 plant species of Mount flora are still used in traditional medicine by the local communities as an important source of primary health care and treatment of a wide range of different illnesses. These species belonged to 42 families and 102 genera. Compositae (19 species), Labiatae (18 species), Rosaceae (11) and Umbelliferae (11) formed the dominant families. Informants' Consensus Factor (FIC) analysis revealed that among the 14 illness categories used, respiratory (0.94), gastrointestinal and renal (0.93), genital systems (0.92) had the highest FIC values

Wings of Hope: The US Air Force and Humanitarian Airlift Operations

DTIC Science & Technology

1997-01-01

Islamic pilgrims en route to Mecca became stranded in Beirut, Lebanon. Thirteen Air Force C-54s flew them to the holy city in time for their religious...of supplies easier. 17 Overseas facilities also proved necessary. For example, bases in Panama refueled aircraft en route to South America. Airfields...relief sup- plies. Nov Following the devastation of British Honduras (now Belize ) by Hurricane Hattie, U.S. airlifters brought in communications equip

School-Parent Relations in Lebanon

ERIC Educational Resources Information Center

El Majzoub, Nada

2013-01-01

Lebanon is a nation whose history may be depicted as continuous social, political, and sectarian conflict due to European political meddling and a protracted civil war. Although finding common ground in this complex milieu over the past several decades has been challenging, political and educational reforms have been enacted. The role of parents…

Cost of work-related injuries in insured workplaces in Lebanon.

PubMed Central

Fayad, Rim; Nuwayhid, Iman; Tamim, Hala; Kassak, Kassem; Khogali, Mustafa

2003-01-01

OBJECTIVE: To estimate the medical and compensation costs of work-related injuries in insured workplaces in Lebanon and to examine cost distributions by worker and injury characteristics. METHODS: A total of 3748 claims for work injuries processed in 1998 by five major insurance companies in Lebanon were reviewed. Medical costs (related to emergency room fees, physician consultations, tests, and medications) and wage and indemnity compensation costs were identified from the claims. FINDINGS: The median cost per injury was US dollars 83 (mean, US dollars 198; range, US dollars 0-16,401). The overall cost for all 3748 injuries was US dollars 742,100 (76% of this was medical costs). Extrapolated to all injuries within insured workplaces, the overall cost was US dollars 4.5 million a year; this increased to US dollars 10 million-13 million when human value cost (pain and suffering) was accounted for. Fatal injuries (three, 0.1%) and those that caused permanent disabilities (nine, 0.2%) accounted for 10.4% of the overall costs and hospitalized injuries (245, 6.5%) for 45%. Cost per injury was highest among older workers and for injuries that involved falls and vehicle incidents. Medical, but not compensation, costs were higher among female workers. CONCLUSION: The computed costs of work injuries--a fraction of the real burden of occupational injuries in Lebanon--represent a considerable economic loss. This calls for a national policy to prevent work injuries, with a focus on preventing the most serious injuries. Options for intervention and research are discussed. PMID:12973643

Health equity in Lebanon: a microeconomic analysis

PubMed Central

2010-01-01

Background The health sector in Lebanon suffers from high levels of spending and is acknowledged to be a source of fiscal waste. Lebanon initiated a series of health sector reforms which aim at containing the fiscal waste caused by high and inefficient public health expenditures. Yet these reforms do not address the issues of health equity in use and coverage of healthcare services, which appear to be acute. This paper takes a closer look at the micro-level inequities in the use of healthcare, in access, in ability to pay, and in some health outcomes. Methods We use data from the 2004/2005 Multi Purpose Survey of Households in Lebanon to conduct health equity analysis, including equity in need, access and outcomes. We briefly describe the data and explain some of its limitations. We examine, in turn, and using standardization techniques, the equity in health care utilization, the impact of catastrophic health payments on household wellbeing, the effect of health payment on household impoverishment, the equity implications of existing health financing methods, and health characteristics by geographical region. Results We find that the incidence of disability decreases steadily across expenditure quintiles, whereas the incidence of chronic disease shows the opposite pattern, which may be an indication of better diagnostics for higher quintiles. The presence of any health-related expenditure is regressive while the magnitude of out-of-pocket expenditures on health is progressive. Spending on health is found to be "normal" and income-elastic. Catastrophic health payments are likelier among disadvantaged groups (in terms of income, geography and gender). However, the cash amounts of catastrophic payments are progressive. Poverty is associated with lower insurance coverage for both private and public insurance. While the insured seem to spend an average of almost LL93,000 ($62) on health a year in excess of the uninsured, they devote a smaller proportion of their

Hashish in Morocco and Lebanon: A comparative study.

PubMed

Afsahi, Kenza; Darwich, Salem

2016-05-01

In the 1960s and the 1970s, Morocco and Lebanon became major producers of hashish for export to markets in West and Central Europe, Africa and the Middle East. By using a comparative approach, this paper aims to evaluate changes in production in the traditional areas of cannabis cultivation in the Rif (Morocco) and the Beqaa (Lebanon) and to better understand the role that these countries play in current trends in the global cultivation and consumption of cannabis. The comparative approach takes in account the historical and institutionnal context, and the perception of cannabis in those two country. We rely on primary field research done in the Rif (from 2002) and in the Beqaa (from 1995) in the form of interviews and observations with farmers and intermediaries. Acreage and production estimates of hashish for both countries have been triangulated from different sources. Maghreb and Middle East have a long history of consumption, production and marketing of cannabis. Over the past 12 centuries, migration, trade and different spiritual practices and trends have led to the expansion of cannabis markets. This long period is marked by stages and rifts caused by foreign interference, a worldwide prohibition of cannabis at the beginning of the 20th century and increased global demand in the 1960s and the 1970s. Morocco and Lebanon are among the most important producers of hashish to be exported for trade for the last fifty years. The global prohibition of cannabis and the global sustained demand have created opportunities for poor farmers in the Rif and the Beqaa regions to survive and get wealthy. It is difficult to understand the reasons why areas producing cannabis are steadily increasing. If the Rif and the Beqaa share some features (such are marginalized areas of production, repressive legislation, huge international demand, range of comparable tasks and Mediterranean climate suitable for growing cannabis, etc.) then a comparison between the two countries makes it

Cutaneous non-tuberculous Mycobacterial infections: a clinical and histopathological study of 17 cases from Lebanon.

PubMed

Abbas, O; Marrouch, N; Kattar, M M; Zeynoun, S; Kibbi, A G; Rached, R A; Araj, G F; Ghosn, S

2011-01-01

Only a few studies characterized cutaneous non-tuberculous Mycobacterium (NTM) infections in this region of the world. Objective  The aim of this study was to describe the epidemiological, clinical and histological findings of cutaneous NTM infections in Lebanon. Retrospective study of 17 patients (19 histological specimens) diagnosed with cutaneous NTM infections and confirmed by culture-based partial sequencing of the 16S rRNA gene at the American University of Beirut Medical Center between 2005 and 2008. Of 17 cases, 14 were caused by Mycobacterium marinum. All patients were immunocompetent except for one. Clinically, the most common presentation was multiple sporotrichoid lesions over an extremity (8/17). Many patients had peculiar presentations including bruise-like patches, herpetiform lesions, annular ulcerated plaques, symmetrical nodules over the buttocks and locally disseminated lesions with surrounding pale halo. Almost all patients cleared their infection on either minocycline or clarithromycin monotherapies. Histologically, a dermal small vessel proliferation with mixed inflammation (granulation tissue-like changes) was identified in 58% of specimens. The most common type of granulomatous inflammation was the suppurative (47%) followed by the tuberculoid (30%), sarcoidal (11%), and palisading (5%) types. Lichenoid granulomatous dermatitis was noted in 42% of cases. Special staining highlighted mycobacteria in only two specimens. The incidence of cutaneous NTM infections is high in our area. Many patients had peculiar clinical presentations. Our study is the second to report the common presence of granulation tissue-like changes as a good histological indicator of cutaneous NTM infections. Minocycline and clarithromycin remain the drugs of choice in our area. © 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.

War Memories and the Refusal of Male Dominance in Shakir's "Oh, Lebanon"

ERIC Educational Resources Information Center

Al-Momani, Hassan Ali Abdullah

2017-01-01

This study investigates the role of the war memories in the construction of the female gender identity in Evelyin Shakir's "Oh, Lebanon," in which the female protagonist refuses to belong to her Arab identity when she lives in the United States because of the brutal war memories she witnesses in Lebanon. Such memories make the…

Caprine arthritis encephalitis virus: prevalence and risk factors in Lebanon.

PubMed

Tabet, E; Hosri, C; Abi-Rizk, A

2015-12-01

An epidemiological survey, accompanied by a serological analysis,was conducted on samples taken from Lebanese goat herds in order to determine the prevalence of infection with the caprine arthritis encephalitis virus (CAEV) in Lebanon. The results of the survey provided information on various livestock production, animal health and herd management factors. Serum samplesfrom 952 goats, including the local breeds (Baladi and Damascene) and imported breeds (Alpine and Saneen), were taken from 60 farms distributed throughout Lebanon and tested for the presence of anti-CAEV antibodies. The data obtained were analysed using a statistical model to assess CAEV infection risk factors in Lebanon. In total, 125 samples proved to be positive, representing a prevalence in selected individuals of 13.1% and in selected herds of 51.7%. The Bekaa region had the highest number of herds with seropositive goats (90% of herds); the level was lower in Mount Lebanon, the North and the South (54%, 34% and 33%, respectively). The prevalence in relation to the livestock production system was 70% in herds in intensive systems, 54% in semi-intensive systems and 45% in extensive systems. The indigenous breeds were more resistant and tolerant of CAEV than the imported breeds. This study confirms the presence of CAEV in Lebanese goat herds and identifies the different livestock production practices likely to favour the rapid spread of the virus.

Slowly but Surely: Small Steps toward Establishing Gifted Education Programs in Lebanon

ERIC Educational Resources Information Center

Sarouphim, Ketty M.

2015-01-01

The purpose of this article is to shed light on the state of gifted education in Lebanon and to describe the efforts underway to establish programs for gifted learners in the country. The article starts with a description of the Lebanese system of education followed by research conducted in Lebanon on an instrument called Discovering Intellectual…

Socioeconomic differences in smoking in Jordan, Lebanon, Syria, and Palestine: A cross-sectional analysis of national surveys

PubMed Central

Abdulrahim, Sawsan

2018-01-01

Introduction The association between education and wealth, as fundamental determinants of health, and smoking is well-established. Yet, social inequalities have received little attention in the expanding field of tobacco research in the Arab region. In this study, we examine inequalities in cigarette smoking by education and wealth in four Arab countries. Methods Utilizing the most recently available population-level data sets (Syria 2009 PAPFAM, Jordan 2012 DHS, Palestine 2010 Family Health Survey, and Lebanon 2004 PAPFAM), we tested the association between cigarette smoking and education and wealth–controlling for age, marital status, and region of residence–for each country, and among men and women depending on data availability. Results Cigarette smoking prevalence among Arab men is high– 51.3% in Syria, 39.7% in Palestine, and 42.1% in Lebanon; among women, prevalence is 8.4% in Syria, 10.9% in Jordan, and 24.3% Lebanon. Cigarette smoking shows the expected patterns inequalities by education among men in Syria, Palestine, and Lebanon, and among women in Jordan and Lebanon. On the other hand, wealth does not show a clear pattern in its association with cigarette smoking and, in some cases (men in Palestine and women in Syria) the behavioral risk is higher among the wealthiest. Conclusions Available data from 2004–2012 show that cigarette smoking among men and women in the four Arab countries is predominant among those with limited access to education as a fundamental cause. The weak or absent negative association between wealth and cigarette smoking suggests that access to material resources does not precipitate a reduction in the consumption of tobacco. PMID:29381734

Wilson’s disease in Lebanon and regional countries: Homozygosity and hepatic phenotype predominance

PubMed Central

Barada, Kassem; El Haddad, Aline; Katerji, Meghri; Jomaa, Mustapha; Usta, Julnar

2017-01-01

AIM To determine the phenotypes and predominant disease-causing mutations in Lebanese patients with Wilson’s disease, as compared to regional non-European data. METHODS The clinical profile of 36 patients diagnosed in Lebanon was studied and their mutations were determined by molecular testing. All patients underwent full physical exam, including ophthalmologic slit-lamp examination ultrasound imaging of the liver, as well as measurement of serum ceruloplasmin and 24-h urinary-Cu levels. In addition, genetic screening using PCR followed by sequencing to determine disease-causing mutations and polymorphisms in the ATP7B gene was carried on extracted DNA from patients and immediate family members. Our phenotypic-genotypic findings were then compared to reported mutations in Wilson’s disease patients from regional Arab and non-European countries. RESULTS Patients belonged to extended consanguineous families. The majority were homozygous for the disease-causing mutation, with no predominant mutation identified. The most common mutation, detected in 4 out of 13 families, involved the ATP hinge region and was present in patients from Lebanon, Egypt, Iran and Turkey. Otherwise, mutations in Lebanese patients and those of the region were scattered over 17 exons of ATP7B. While the homozygous exon 12 mutation Trp939Cys was only detected in patients from Lebanon but none from the regional countries, the worldwide common mutation H1069Q was not present in the Lebanese and was rare in the region. Pure hepatic phenotype was predominant in patients from both Lebanon and the region (25%-65%). Furthermore, the majority of patients, including those who were asymptomatic, had evidence of some hepatic dysfunction. Pure neurologic phenotype was rare. CONCLUSION Findings do not support presence of a founder effect. Clinical and genetic screening is recommended for family members with index patients and unexplained hepatic dysfunction. PMID:29085216

Bedouin in Lebanon: Social discrimination, political exclusion, and compromised health care.

PubMed

Chatty, Dawn; Mansour, Nisrine; Yassin, Nasser

2013-04-01

Global inequalities in health have long been associated with disparities between rich and poor nations. The middle-income countries of the Levant (Lebanon, Syria and Jordan) have developed models of health care delivery that mirror the often complex make-up of their states. In Lebanon, which is characterized by political clientelism and sectarian structures, access to health care is more contingent on ethnicity and religious affiliation than on poverty. This case study of the Bedouin of the Middle Bekaa Valley of Lebanon is based on interviews with policymakers, health care providers and the Bedouin as part of a study funded by the European Commission between 2006 and 2010. The study explores the importance of considering social discrimination and political exclusion in understanding compromised health care. Three decades after the Declaration of Alma Ata (1978), which declared that an acceptable level of health care for all should be attained by the year 2000, the Bedouin community of Lebanon remains largely invisible to the government and, thus, invisible to national health care policy and practice. They experience significant social discrimination from health practitioners and policymakers alike. Their unfair treatment under the health system is generally disassociated from issues of wealth or poverty; it is manifested in issues of access and use, discrimination, and resistance and agency. Overcoming their political exclusion and recognizing the social discrimination they face are steps that can be taken to protect and promote equal access to basic reproductive and child health care. This case study of the Bedouin in Lebanon is also relevant to the health needs of other marginalized populations in remote and rural areas. Copyright © 2013. Published by Elsevier Ltd.

Financial Burden of Cancer Drug Treatment in Lebanon.

PubMed

Elias, Fadia; Khuri, Fadlo R; Adib, Salim M; Karam, Rita; Harb, Hilda; Awar, May; Zalloua, Pierre; Ammar, Walid

2016-01-01

The Ministry of Public Health (MOPH) in Lebanon provides cancer drugs free of charge for uninsured patients who account for more than half the total caseload. Other categories of cancer care are subsidized under more stringent eligibility criteria. MOPH's large database offers an excellent opportunity to analyze the cost of cancer treatment in Lebanon. Using utilization and spending data accumulated at MOPH during 20082013, the cost to the public budget of cancer drugs was assessed per case and per drug type. The average annual cost of cancer drugs was 6,475$ per patient. Total cancer drug costs were highest for breast cancer, followed by chronic myeloid leukemia (CML), colorectal cancer, lung cancer, and NonHodgkin's lymphoma (NHL), which together represented 74% of total MOPH cancer drug expenditure. The annual average cancer drug cost per case was highest for CML ($31,037), followed by NHL ($11,566). Trastuzumab represented 26% and Imatinib 15% of total MOPH cancer drug expenditure over six years. Sustained increase in cancer drug cost threatens the sustainability of MOPH coverage, so crucial for socially vulnerable citizens. To enhance the bargaining position with pharmaceutical firms for drug cost containment in a small market like Lebanon, drug price comparisons with neighboring countries which have already obtained lower prices may succeed in lowering drug costs.

Epidemiology of hip fractures in Lebanon: a nationwide survey.

PubMed

Maalouf, G; Bachour, F; Hlais, S; Maalouf, N M; Yazbeck, P; Yaghi, Y; Yaghi, K; El Hage, R; Issa, M

2013-10-01

Hip fractures are a reliable indicator of osteoporosis. Despite their importance, few studies have assessed their epidemiology in Lebanon and the Middle East. Hip fracture incidence rates in Lebanon approximate those of Northern countries, and show the same characteristics, particularly the exponential increase with age, higher incidence in women, and a recent trend of rate leveling in women but not in men. A national database of hip fracture cases admitted to hospitals in Lebanon in 2007 was created. Crude and age-adjusted incidence rates were calculated at 5-year intervals for individuals over age 50. These rates were also standardized to the 2000 United States population, and compared to those of other countries. Projected incidence rates in Lebanon in 2020 and 2050 were also calculated. A total of 1199 patients were included in the study. The crude annual incidence rate in individuals over 50 was 147 per 100,000 individuals, 132 per 100,000 males and 160 per 100,000 females, with a female-to-male ratio of 1.2. The age-standardized annual incidence rates (per 100,000) were 180 in males and 256 in females. Assuming unchanged healthcare parameters, the projected crude incidence rates for people over 50 are expected to reach 174 and 284 per 100,000 in 2020 and 2050 respectively. Lebanese hip fracture rates are lower than Northern countries, but show many similar characteristics such as an exponential increase with age, a higher incidence in women, and clues of a leveling of rates in women but not in men. Numbers are expected to increase substantially in the coming decades. Level IV. Epidemiological study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The tobacco industry's thwarting of marketing restrictions and health warnings in Lebanon.

PubMed

Nakkash, R; Lee, K

2009-08-01

This article outlines how the tobacco industry has undermined tobacco control efforts in Lebanon since the early 1970s. An analysis of online and on-site tobacco industry documents, reviews of newspapers, policy and other documents, and interviews with key policy makers were conducted. Findings reveal how the weakness of tobacco control legislation in Lebanon has been the product of an effective tobacco industry strategy to weaken the content and scope of regulation, and delay adoption and implementation. The tobacco industry has built and maintained strong alliances that were and are regularly mobilised to effectively oppose regulation. Despite ratification of the World Health Organization Framework Convention on Tobacco Control in 2005, Lebanon's tobacco control track remains weak. Public health professionals and the government should work hard to oppose such tobacco industry tactics.

Making sense of child, early and forced marriage among Syrian refugee girls: a mixed methods study in Lebanon

PubMed Central

Bartels, Susan Andrea; Michael, Saja; Roupetz, Sophie; Garbern, Stephanie; Kilzar, Lama; Bergquist, Harveen; Bakhache, Nour; Davison, Colleen; Bunting, Annie

2018-01-01

Introduction The Syrian conflict has resulted in over 2.3 million child refugees in the Middle East and the prevalence of early marriage has reportedly increased among displaced Syrian families. This study explores the underlying factors contributing to child marriage among Syrian refugees in Lebanon with the goal of informing community-based strategies to address the issue. Methods In July–August 2016, trained interviewers collected self-interpreted stories in Lebanon using Cognitive Edge’s SenseMaker, a mixed-method data collection tool. Participants included married and unmarried Syrian girls, Syrian parents as well as married and unmarried men. Each participant shared a story about the experiences of Syrian girls and then interpreted the story by plotting their perspectives on a variety of questions. Patterns in the responses were analysed in SPSS and the accompanying qualitative narratives were reviewed to facilitate interpretation of the quantitative results. Results 1422 self-interpreted stories from 1346 unique participants were collected with 40% of shared stories focused on (n=332) or mentioning (n=245) child marriage. Quantitative data summarised the different perspectives of female and male participants. Syrian girls and mothers were more likely to share stories about protection/security and/or education and were more likely to report that girls were overprotected. Male participants were more likely to share stories about financial security as well as sexual exploitation of girls and more often reported that girls were not protected enough. Despite these gendered perspectives, many of the shared narratives highlighted similar themes of financial hardship, lack of educational opportunities and safety concerns around sexual and gender-based violence (SGBV). Conclusions A complex myriad of factors contribute to early marriage including poverty, lack of educational opportunities and concerns about SGBV. Sexual exploitation under the guise of marriage

The social context of tobacco products use among adolescents in Lebanon (MedSPAD-Lebanon).

PubMed

Bejjani, Naim; El Bcheraoui, Charbel; Adib, Salim M

2012-03-01

Current data from the Middle East suggest a rapid increase in the incidence of smoking water-pipes (narguileh in Lebanon) in parallel with cigarettes. The social context in which these two behaviors are initiated and associated has not been studied. Data from a standardized questionnaire to measure the prevalence and practices related to cigarettes and narguileh consumption in a representative sample of 1097 children in grade 9 were extracted and analyzed for elements of the social context in which consumption occurs. Among surveyed children (mean age 14.6), 3.9% were "frequent" cigarette smokers (more than nine times ever). Presence of parents and/or siblings who smoke is a key factor for initiation. Narguileh use is a social phenomenon, rarely smoked alone (<4%) with 19% of the surveyed children being "frequent" narguileh smokers (more than nine times ever). Almost half of these students (42%) have all their friends smoking narguileh. Further analysis confirmed that narguileh use is now an accepted familial and social phenomenon, with restrictions apparently decreasing. These results necessitate drawing strategies to address this public health concern that is becoming more prevalent in Lebanon and elsewhere in the Middle East. Copyright © 2012 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Y-Chromosomal Diversity in Lebanon Is Structured by Recent Historical Events

PubMed Central

Zalloua, Pierre A.; Xue, Yali; Khalife, Jade; Makhoul, Nadine; Debiane, Labib; Platt, Daniel E.; Royyuru, Ajay K.; Herrera, Rene J.; Hernanz, David F. Soria; Blue-Smith, Jason; Wells, R. Spencer; Comas, David; Bertranpetit, Jaume; Tyler-Smith, Chris

2008-01-01

Lebanon is an eastern Mediterranean country inhabited by approximately four million people with a wide variety of ethnicities and religions, including Muslim, Christian, and Druze. In the present study, 926 Lebanese men were typed with Y-chromosomal SNP and STR markers, and unusually, male genetic variation within Lebanon was found to be more strongly structured by religious affiliation than by geography. We therefore tested the hypothesis that migrations within historical times could have contributed to this situation. Y-haplogroup J∗(xJ2) was more frequent in the putative Muslim source region (the Arabian Peninsula) than in Lebanon, and it was also more frequent in Lebanese Muslims than in Lebanese non-Muslims. Conversely, haplogroup R1b was more frequent in the putative Christian source region (western Europe) than in Lebanon and was also more frequent in Lebanese Christians than in Lebanese non-Christians. The most common R1b STR-haplotype in Lebanese Christians was otherwise highly specific for western Europe and was unlikely to have reached its current frequency in Lebanese Christians without admixture. We therefore suggest that the Islamic expansion from the Arabian Peninsula beginning in the seventh century CE introduced lineages typical of this area into those who subsequently became Lebanese Muslims, whereas the Crusader activity in the 11th–13th centuries CE introduced western European lineages into Lebanese Christians. PMID:18374297

Contribution to the knowledge of Saprinus Erichson, 1834 of forensic relevance from Lebanon (Coleoptera, Histeridae).

PubMed

Shayya, Salman; Dégallier, Nicolas; Nel, André; Azar, Dany; Lackner, Tomáš

2018-01-01

Many histerid beetles are necrophilous on carrion during both active and advanced stages of decomposition. In this study, 13 species of Saprinus were recorded on carrion from Lebanon, containing eight that are new for the Lebanese fauna. The following Saprinus species are newly recorded from Lebanon: 1) Saprinus (S.) caerulescens caerulescens (Hoffmann, 1803); 2) S. (S.) calatravensis Fuente, 1899; 3) S. (S.) chalcites (Illiger, 1807); 4) S. (S.) godet (Brullé, 1832); 5) S. (S.) maculatus (P. Rossi, 1792); 6) S. (S.) strigil Marseul, 1855; 7) S. (S.) submarginatus J. Sahlberg, 1913; and 8) S. (S.) tenuistrius sparsutus Solsky, 1876. The peak activity was recorded, key for the species is provided, and habitus images and male genitalia are illustrated in order to facilitate their taxonomic identifications. Saprinus species are diverse and common on animal carcass; they were likewise collected from a human cadaver in Lebanon. Preliminary comments on biology and distribution of the studied species are given. Our paper represents the first faunistic study on Histeridae from Lebanon. A rigorous research program regarding the biology of Saprinus in Lebanon and the neighbouring countries would greatly improve the knowledge of the diversity, activity, and possible forensic value of Saprinus .

Cesarean sections among Syrian refugees in Lebanon from december 2012/january 2013 to june 2013: probable causes and recommendations.

PubMed

Huster, Karin M J; Patterson, Njogu; Schilperoord, Marian; Spiegel, Paul

2014-09-01

There are nearly 3 million Syrian refugees, with more than 1 million in Lebanon. We combined quantitative and qualitative methods to determine cesarean section (CS) rates among Syrian refugees accessing care through United Nations High Commissioner for Refugees (UNHCR)-contracted hospitals in Lebanon and possible driving factors. We analyzed hospital admission data from UNHCR's main partners from December 2012/January 1, 2013, to June 30, 2013. We collected qualitative data in a subset of hospitals through semi-structured informant interviews. Deliveries accounted for almost 50 percent of hospitalizations. The average CS rate was 35 percent of 6,366 deliveries. Women expressed strong preference for female providers. Clinicians observed that refugees had high incidence of birth and health complications diagnosed at delivery time that often required emergent CS. CS rates are high among Syrian refugee women in Lebanon. Limited access and utilization of antenatal care, privatized health care, and male obstetrical providers may be important drivers that need to be addressed.

Near East/South Asia Report.

DTIC Science & Technology

1983-07-25

Beirut in what was taken at the time as a sign of confidence in Lebanon’s economic future {An-Nahar Arab Report & MEMO, May lOand September 6,1982...leave Qatar after completing her tour of duty had to be treated for shock when she discovered her $10,000 savings were lost in the collapse of Doha...risks and save financial and adminis- trative costs. These steps are peaked by the central bank announcement of a new policy to nationalize foreign

Factors influencing dyslipidemia in statin-treated patients in Lebanon and Jordan: results of the Dyslipidemia International Study

PubMed Central

Azar, Sami T; Hantash, Hadi Abu; Jambart, Selim; El-Zaheri, Mohamed M; Rachoin, Rachoin; Chalfoun, Amal; Lahoud, Layla; Okkeh, Osama; Bramlage, Peter; Brudi, Philippe; Ambegaonkar, Baishali M

2014-01-01

Background Cardiovascular disease is the leading cause of death and disability worldwide. Therefore, as part of the Dyslipidemia International Study (DYSIS), we have analyzed the prevalence of lipid abnormalities and risk factors for dyslipidemia in statin-treated patients in Lebanon and Jordan. Methods This cross-sectional, multicenter study enrolled 617 patients at 13 hospitals in Lebanon and Jordan. Patients were at least 45 years old and had been treated with statins for at least 3 months. Multivariate logistic regression analysis was used to determine patient characteristics contributing to dyslipidemia during statin therapy. Results Our findings indicated that 55.9% of statin-treated patients (mean age 60.3 years, 47% female) in Lebanon and Jordan did not achieve goal levels for low-density lipoprotein cholesterol which were dependent on Systematic Coronary Risk Evaluation (SCORE) risk, and 70% of patients (76% men and 63.3% of women) were at very high cardiovascular risk. Low-density lipoprotein cholesterol goals were not achieved in 67.2% of those with very high cardiovascular risk. The most commonly prescribed statin was atorvastatin (44.6%), followed by simvastatin (27.7%), rosuvastatin (21.2%), fluvastatin (3.3%), pravastatin (3%), and lovastatin (0.2%). Approximately half of the population was treated with a statin dose potency of 4, equaling 40 mg of simvastatin. In Lebanon and Jordan, the strongest independent associations with low-density lipoprotein cholesterol not at goal were current smoking (odds ratio [OR] 1.96; 95% confidence [CI] 1.25–3.08), diabetes mellitus (OR 2.53; 95% CI 1.70–3.77), and ischemic heart disease (OR 2.26; 95% CI 1.45–3.53), while alcohol consumption was associated with reduced risk (OR 0.12; 95% CI 0.03–0.57). Conclusion We observed that many patients in Lebanon and Jordan experienced persistent dyslipidemia during statin treatment, supporting the notion that novel lipid-lowering strategies need to be developed. Also

78 FR 23625 - Waiver of Restriction on Assistance to the Central Government of Lebanon

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

... DEPARTMENT OF STATE [Public Notice 8282] Waiver of Restriction on Assistance to the Central Government of Lebanon Pursuant to Section 7031(b)(3) of the Department of State, Foreign Operations, and... United States to waive the requirements of Section 7031(b)(1) of the Act with respect to Lebanon and I...

78 FR 56767 - Waiver of Restriction on Assistance to the Central Government of Lebanon

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-13

... DEPARTMENT OF STATE [Public Notice 8469] Waiver of Restriction on Assistance to the Central Government of Lebanon Pursuant to Section 7031(b)(3) of the Department of State, Foreign Operations, and... United States to waive the requirements of Section 7031(b)(1) of the Act with respect to Lebanon, and I...

Rethinking the social history in the era of biolegitimacy: global health and medical education in the care of Palestinian and Syrian refugees in Beirut, Lebanon.

PubMed

Premkumar, Ashish; Raad, Kareem; Haidar, Mona H

2016-01-01

The critiques leveled towards medical humanitarianism by the social sciences have yet to be felt in medical education. The elevation of biological suffering, at the detriment of sociopolitical contextualization, has been shown to clearly impact both acute and long-term care of individuals and communities. With many medical students spending a portion of their educational time in global learning experiences, exposure to humanitarianism and its consequences becomes a unique component of biomedical education. How does the medical field reconcile global health education with the critiques of humanitarianism? This paper argues that the medical response to humanitarian reason should begin at the level of a social history. Using experiential data culled from fieldwork with Palestinian and Syrian refugees in Lebanon, the authors argue that an expanded social history, combined with knowledge derived from the social sciences, can have significant clinical implications. The ability to contextualize an individual's disease and life within a complex sociopolitical framework means that students must draw on disciplines as varied as anthropology, sociology, and political history to further their knowledge base. Moreover, situating these educational goals within the framework of physician advocacy can build a strong base in medical education from both a biomedical and activist perspective.

Promoting women entrepreneurs in Lebanon: the experience of UNIFEM.

PubMed

Husseini, R

1997-02-01

The work of the United Nations Development Fund for Women (UNIFEM) in West Asia began in 1994 with a regional program to strengthen women-owned enterprises in Jordan, Syria, and Lebanon. In Lebanon, a survey of 100 women entrepreneurs, as well as nontraditional credit programs and banks, was conducted prior to program design. A second survey assessed micro-entrepreneurs' demands for financial and other services. Since gender analysis was a new concept in Lebanon, UNIFEM organized a gender awareness workshop for representatives of government, nongovernmental organizations, and the banking sector, followed by a strategic planning workshop. The surveys confirmed that women were concentrated mainly in the less profitable economic sectors, producing handicrafts and food products or running small service or trading companies. Women were less likely than men to get bank loans or to register their businesses. Women's problems accessing credit--the main obstacle limiting their ability to develop their businesses--were compounded by their lack of information, male-oriented collateral requirements, and discriminatory banking regulations. UNIFEM decided to channel counseling of women entrepreneurs on legal matters, marketing, and credit sources through the Ministry of Social Affairs. It is expected that knowledge of gender-related employment issues and the use of gender-specific analysis will become integral to the Ministry's program as a result.

Health Knowledge, Attitudes, Practices, and Beliefs of Lebanese and Palestinian School Children in Lebanon

ERIC Educational Resources Information Center

Fuddah, Hanin; Zeitoun, Samar

2017-01-01

The indicators for health risk factors among school children in Lebanon associated with increased mortality and morbidity were higher than the global percentage based on WHO (2014) statistics. Knowing that the Ministry of Education in Lebanon has been trying to include health education in the national school curriculum since the last reform in…

Community Resilience and the Impact of Stress: Adult Response to Israel's Withdrawal from Lebanon

ERIC Educational Resources Information Center

Kimhi, Shaul; Shamai, Michal

2004-01-01

Against the background of the Israeli withdrawal from Lebanon, we investigated the relationship between perceived community resilience and the effect of stress and life satisfaction. The research sample included 741 adults, aged 18-85. The participants were divided into four groups, three of which live close to the Israel-Lebanon border and were…

Contribution to the knowledge of Saprinus Erichson, 1834 of forensic relevance from Lebanon (Coleoptera, Histeridae)

PubMed Central

Shayya, Salman; Dégallier, Nicolas; Nel, André; Azar, Dany; Lackner, Tomáš

2018-01-01

Abstract Many histerid beetles are necrophilous on carrion during both active and advanced stages of decomposition. In this study, 13 species of Saprinus were recorded on carrion from Lebanon, containing eight that are new for the Lebanese fauna. The following Saprinus species are newly recorded from Lebanon: 1) Saprinus (S.) caerulescens caerulescens (Hoffmann, 1803); 2) S. (S.) calatravensis Fuente, 1899; 3) S. (S.) chalcites (Illiger, 1807); 4) S. (S.) godet (Brullé, 1832); 5) S. (S.) maculatus (P. Rossi, 1792); 6) S. (S.) strigil Marseul, 1855; 7) S. (S.) submarginatus J. Sahlberg, 1913; and 8) S. (S.) tenuistrius sparsutus Solsky, 1876. The peak activity was recorded, key for the species is provided, and habitus images and male genitalia are illustrated in order to facilitate their taxonomic identifications. Saprinus species are diverse and common on animal carcass; they were likewise collected from a human cadaver in Lebanon. Preliminary comments on biology and distribution of the studied species are given. Our paper represents the first faunistic study on Histeridae from Lebanon. A rigorous research program regarding the biology of Saprinus in Lebanon and the neighbouring countries would greatly improve the knowledge of the diversity, activity, and possible forensic value of Saprinus. PMID:29670426

Case Study of Lebanon: Can the U.S. Build Upon Socio-Economic Influences in Order to Foster Good Citizenship versus Insurgency?

DTIC Science & Technology

2007-12-01

of Syria Lebanon. At this point in Lebanese history, they were actually a largely Christian enclave, but an expansion of Lebanon that would include...Lebanon established a government based upon an unwritten National Pact. The Pact required the president to be Christian and its prime minister to be...establishment of an independent Christian state on Mount Lebanon, the second the creation of a radical, hostile state on the Syrian western border

An assessment of antenatal care among Syrian refugees in Lebanon.

PubMed

Benage, Matthew; Greenough, P Gregg; Vinck, Patrick; Omeira, Nada; Pham, Phuong

2015-01-01

After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1-2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. Standards of antenatal care are not being met for pregnant Syrian refugee women in

Barriers to breastfeeding in Lebanon: A policy analysis.

PubMed

Akik, Chaza; Ghattas, Hala; Filteau, Suzanne; Knai, Cecile

2017-08-01

Although the issue of breastfeeding in Lebanon has risen on the political agenda, the country does not meet international recommendations for early breastfeeding practices. This study analysed barriers to dissemination, implementation, and enforcement of key policies to improve early breastfeeding practices. We conducted interviews with stakeholders in breastfeeding policy in Lebanon and used a framework approach for analysing data. We found a disconnect between policy endorsement and translation on the ground, weak engagement of professional associations and governmental institutions, undue influence by the breast milk substitute industry, and competing priorities-most notably the current refugee crisis. This study highlights the potential policy opportunities to counter these barriers and points to the role of international organisations and grassroots advocacy in pushing, monitoring, and implementing policies that protect breastfeeding, where government capacity is limited, and the private sector is strong.

A National Peace Education Program in Lebanon: Exploring the Possibilities from the Leaders' Perspectives

ERIC Educational Resources Information Center

Tannous, Joseph M.; Oueijan, Harvey N.

2011-01-01

This document reports the findings of a doctoral project regarding peace education in Lebanon. The emergence of Lebanon from a long civil war necessitates the existence of a peace program that will educate the new generations for a culture of peace. In this study, we tried to explore the potential of the development of a unified peace program…

Educating Children with Down Syndrome in Lebanon: An Exploratory Study of Urban Mothers' Perspective

ERIC Educational Resources Information Center

Hatoum, Rima J.

2010-01-01

In view of the fact that Lebanon does not currently have a special education infrastructure, the purpose of this exploratory qualitative study was to understand the phenomenon of educating children with Down syndrome (DS) in Lebanon in terms of the meanings mothers ascribe to it and their description of their experience. The intent was to develop…

Cherishing the past: 100 years of nursing education at the American University of Beirut.

PubMed

Huijer, Huda Abu-Saad; Balian, Sossy A; Arevian, Mary

2006-10-01

This article describes the foundation and the development of nursing education at the American University of Beirut, the first professional school in the country and the region, across 100 years (1905-2005). It talks about the early years, pioneering achievements (1905-1940), the school's leadership in nursing from 1940 to 1976, the war years from 1976 to 1993, and postwar global vision (1993-2005). Furthermore, it gives special tribute to the dedication and hard work of the founders, Ms. Jane Elizabeth Van Zandt and Ms. Mary Bliss Dale, and all the directors whose endeavors and wisdom have helped the development of the school from diploma to bachelor and master's programs.

Pharmacists' views and reported practices in relation to a new generic drug substitution policy in Lebanon: a mixed methods study.

PubMed

El-Jardali, Fadi; Fadlallah, Racha; Morsi, Rami Z; Hemadi, Nour; Al-Gibbawi, Mounir; Haj, Magda; Khalil, Suzan; Saklawi, Youssef; Jamal, Diana; Akl, Elie A

2017-02-17

Governments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy. We used a cross-sectional mixed methods approach composed of self-administered questionnaires and semi-structured interviews. The study population consisted of community pharmacists in Lebanon. We randomly approached one pharmacy personnel from each selected community pharmacy. We conducted descriptive analyses to assess responses to questionnaire and regression analyses to understand associations between responses and respondent demographics. We analyzed qualitative data thematically. Out of 204 invited community pharmacies, 153 pharmacies participated (75% response rate). The majority of respondents (64%) were in favor of generic drug substitution; however, less than half (40%) indicated they have substituted brand drugs for generic equivalents. Moreover, 57% indicated that the existing pricing system discourages them from performing generic drug substitution. Most respondents indicated that physicians are overusing the "non-substitutable" option (84%) and that there are technical problems with processing the new prescription form (78%). Less than half (47%) reported that the MOPH is performing regular audits on the forms collected by the pharmacy. While 45% of the respondents indicated that consumers have accepted most of the generic substitutions, 21% perceived the increase in generic drug dispensing to be significant. Findings suggested a potentially significant association between being informed about

Strategic Anslysis of Two Joint Contingency Operations: Lebanon 1958 and Dominican Republic 1965

DTIC Science & Technology

1989-01-01

political aims in Lebanon 1958 and the Dominican Republic 1965. The study uses the Strategic Analysis Model, developed at the Command and General Staff...employment and be followed by political negotiations with participation by all factions. U UNCLASS IFIED STRATEGIC ANALYSIS OF TWO JOINT CONTINGENCY...United States use of military power to achieve political aims in Lebanon 1958 and the Dominican Republic 1965. The study uses the Strategic Analysis

Educational Disparities and Conflict: Evidence from Lebanon

ERIC Educational Resources Information Center

Tfaily, Rania; Diab, Hassan; Kulczycki, Andrzej

2013-01-01

This article examines the impact of Lebanon's civil war (1975-1991) on disparities in education among the country's main religious sects and across various regions. District of registration is adopted as a proxy for religious affiliation through a novel, detailed classification to assess sectarian differentials by region and regional differentials…

A 5-year survey of biopsy proven kidney diseases in Lebanon: significant variation in prevalence of primary glomerular diseases by age, population structure and consanguinity

PubMed Central

Karnib, Hussein H.; Gharavi, Ali G.; Aftimos, Georges; Mahfoud, Ziyad; Saad, Reem; Gemayel, Elias; Masri, Badiaa; Assaad, Shafika; Badr, Kamal F.; Ziyadeh, Fuad N.

2010-01-01

Background. Differences in epidemiology of kidney disease across the Middle East may arise from variations in indication for biopsy, environmental exposure and socio-economic status. The Lebanese population is composed of different ethnicities, with distinct ancestry and religion, enabling comparison of their effect on the prevalence of kidney disease within a confined geographic setting and uniform practices. Here we report 5 years’ detailed epidemiology of renal diseases, based on histological diagnosis, in a sample from three large pathology centres in Lebanon. Methods. Records of renal biopsies analysed at the American University of Beirut Medical Center, Hotel Dieu de France Hospital and the Institut National de Pathologie from January 2003 till December 2007 were retrospectively examined. We recorded the following data for each patient: age, gender, indication for renal biopsy and histopathological diagnosis. Religious affiliation and parents’ consanguinity were recorded when feasible. Results. The mean age at renal biopsy was 36.76 ± 20 years (range 1–84). The most common diagnosis was mesangioproliferative glomerulonephritis (GN; 20%), followed by focal segmental glomerulosclerosis (13.2%). While there were no differences in age, gender or indications for biopsy among different religious affiliations, mesangioproliferative GN was significantly more frequent among Muslims (P = 0.039) and offspring of consanguineous unions (P = 0.036). On the other hand, focal segmental glomerulosclerosis was most prevalent in Christians (P < 0.001). Conclusions. Variation in the distribution of diagnoses between Muslim and Christian groups likely reflects differences in population structure and ancestry. In particular, the increased prevalence of mesangioproliferative GN among offspring of consanguineous unions in Muslims suggests a recessive genetic component to this disease which may be identified via homozygosity mapping. These findings have important

Zionism and Southern Lebanon: A Historical Perspective on Six Decades of Controversy

DTIC Science & Technology

1979-06-01

of different religions and thus actually worked against the purpose of the mandatory regime, which had been intended to educate the Syrians in the art...Palestine, be turned over to Lebanon, 203 Presu :-bly the refugees, ninety percent of whom were Muslims, would be settled in that region, 20 :erger, The...of Shamir resulted in the deaths of’ three women and brought more Israeli air 244 . -eIrei--w attacks on Lebanon. A seaborne raid on th4 saeitw of

Sleep patterns and disorders among university students in Lebanon.

PubMed

Assaad, Shafika; Costanian, Christy; Haddad, Georges; Tannous, Fida

2014-01-01

Insufficient sleep is a significant public health issue with adverse medical consequences. Sleep disturbances are common among university students and have an effect on this group's overall health and functioning. The aim of this study was to investigate sleep habits and disorders in a population of university students across Lebanon. This was a cross-sectional study carried out in 2012 among 735 students aged 18-25 yrs. old, enrolled at six universities across Lebanon. The Pittsburg Sleep Quality Index (PSQI) was used to assess sleep quality and habits. Less than half of the total study population (47.3%) were good sleepers (PSQI<5). Upon bivariate analysis, males experienced more sleep difficulties than females (57.8% vs. 40.8%). The majority (60%) of males vs. 40% of females had trouble performing daily activities more than once per week (P=0.02). Results of the multivariate analysis revealed that reporting poor sleep quality was strongly associated with daytime dysfunction and sleep- enhancing medication use especially more than once per week. This is the first study to describe the nature of sleep problems among university students in Lebanon. This study suggests that sleep problems among Lebanese college students were common and such problems may interfere with daily performance. Findings from this study have important implications for programs intended to improve academic performance by targeting sleep habits of students.

Reading Interests of Unrwa Students in Lebanon.

ERIC Educational Resources Information Center

Adams, Effie Kaye

A reading attitude and interest inventory consisting of 10 questions was administered to more than 300 male students in preparatory classes in two schools at Saida, Lebanon, and in the Siblin Teacher Training Institute nearby. The students were refugees from Palestine who were offered free schooling through the United Nations Relief and Works…

Cybertechnology Ethics of University Students in Lebanon: Assessing University Students' Activities and Perceptions of Cybertechnology Ethics in Lebanon

ERIC Educational Resources Information Center

Jabbour, Khayrazad Kari

2011-01-01

Use of internet technologies is widespread in Lebanon. Technology has a revolutionary impact on our lives, behavior, and in particular a strong impact on our students. Part of our students every day routine is to use the computer and the Internet to play, learn, and communicate. Although most students use the computer and the Internet on a daily…

Flood Hazard Mapping Assessment for Lebanon

NASA Astrophysics Data System (ADS)

Abdallah, Chadi; Darwich, Talal; Hamze, Mouin; Zaarour, Nathalie

2014-05-01

Of all natural disasters, floods affect the greatest number of people worldwide and have the greatest potential to cause damage. In fact, floods are responsible for over one third of people affected by natural disasters; almost 190 million people in more than 90 countries are exposed to catastrophic floods every year. Nowadays, with the emerging global warming phenomenon, this number is expected to increase, therefore, flood prediction and prevention has become a necessity in many places around the globe to decrease damages caused by flooding. Available evidence hints at an increasing frequency of flooding disasters being witnessed in the last 25 years in Lebanon. The consequences of such events are tragic including annual financial losses of around 15 million dollars. In this work, a hydrologic-hydraulic modeling framework for flood hazard mapping over Lebanon covering 19 watershed was introduced. Several empirical, statistical and stochastic methods to calculate the flood magnitude and its related return periods, where rainfall and river gauge data are neither continuous nor available on a long term basis with an absence of proper river sections that under estimate flows during flood events. TRMM weather satellite information, automated drainage networks, curve numbers and other geometrical characteristics for each basin was prepared using WMS-software and then exported into HMS files to implement the hydrologic modeling (rainfall-runoff) for single designed storm of uniformly distributed depth along each basin. The obtained flow hydrographs were implemented in the hydraulic model (HEC-RAS) where relative water surface profiles are calculated and flood plains are delineated. The model was calibrated using the last flood event of January 2013, field investigation, and high resolution satellite images. Flow results proved to have an accuracy ranging between 83-87% when compared to the computed statistical and stochastic methods. Results included the generation of

The Cultural Meaning of Cardiac Illness and Self-Care Among Lebanese Patients With Coronary Artery Disease.

PubMed

Dumit, Nuhad Yazbik; Magilvy, Joan Kathy; Afifi, Rima

2016-07-01

Cardiac disease is the leading cause of death in Lebanon, accounting for 22% to 26% of total deaths in the country. A thorough understanding of perceptions of cardiac illness and related self-care management is critical to the development of secondary prevention programs that are specific to the Lebanese culture. To explore the cultural perceptions of cardiac illness and the associated meaning of self-care among Lebanese patients. Using a qualitative descriptive method, semistructured interviews were conducted with a purposive sample of 15 Lebanese cardiac patients recruited from a medical center in Beirut, Lebanon. The qualitative descriptive analysis yielded one overarching and two other themes describing perceptions of cardiac illness and self-care within the Lebanese cultural context. The overarching cultural theme was, "Lebanese cardiac patients were unfamiliar with the term concept and meaning of self-care." Lebanese cardiac patients thanked God and accepted their fate (Theme I). The participants considered their cardiac incident a life or death warning (Theme II). Health care providers need to consider patients' cultural perception of illness while planning and evaluating cardiac self-care programs. © The Author(s) 2015.

The nutritional status of children of displaced families in Beirut.

PubMed

Shaar, K H; Shaar, M A

1993-04-01

The nutritional status of children of displaced families in Greater Beirut was investigated in 1986 (a sample of 146 households) and in 1991 (137 households). Data on demographic variables, nutrient intake (calories, protein, and iron), and anthropometric measurements were collected. Iron intake was only 50-57% of the RDA for the 1-3 age group, and 35.6% and 32.0% of all children consumed < 60% of the RDA for iron in 1986 and 1991, respectively. Main sources of protein were dairy products, milk and eggs. The lower nutrient intake in 1991 compared to 1986 was negatively related to social class. Anthropometric measurements showed an increased past and recent undernutrition of the children in 1991 as compared to both the 1986 child sample and the NCHS standard child population. Severe inflation and marked increase in food prices were reflected in dietary intake and growth of the children. Food aid programmes, government subsidy of bread, and partial wage correction were possible stabilizing factors for the most destitute groups but not for the total population of displaced children.

Assessment of Dietary Intake Patterns and Their Correlates among University Students in Lebanon

PubMed Central

Salameh, Pascale; Jomaa, Lamis; Issa, Carine; Farhat, Ghada; Salamé, Joseph; Zeidan, Nina; Baldi, Isabelle

2014-01-01

Introduction: Unhealthy dietary habits are major risk factors for chronic diseases, particularly if adopted during early years of adulthood. Limited studies have explored the food consumption patterns among young adults in Lebanon. Our study aimed to examine common dietary patterns and their correlates among a large sample of university student population in Lebanon, focusing on correlation with gender and body mass index (BMI). Methods: A cross-sectional study was carried out on 3384 students, using a proportionate cluster sample of Lebanese students from both public and private universities. A self-administered food frequency questionnaire was used to assess dietary intake of university students. Factor analysis of food items and groups, cluster analysis of dietary patterns, and multivariate regressions were carried out. Results: Three dietary patterns were identified among university youth namely a vegetarian/low calorie dietary pattern (characterized mainly by consumption of plant-based food while avoiding “western” food, composite dishes, and bread); a mixed dietary pattern (characterized by high consumption of plant-based food, followed by composite dishes, bread, and a low consumption of western type food); and finally, a westernized dietary pattern (characterized by high consumption of white bread and western food, and a strong avoidance of plant food and composite dishes). We observed significant differences between males and females in terms of their reported food intake and dietary patterns. Females were particularly more prone to adopt the vegetarian/low calorie diet than males (ORa = 1.69; p < 0.001), while males were more likely to adopt a westernized diet (ORa = 1.51; p < 0.001), seemingly in private universities (p = 0.053). Students with high income and obese students (BMI ≥ 30 kg/m2) were more likely to consume vegetarian/low calorie diets (p < 0.05). Conclusion: Male university students reported a higher

A roadmap to parity in mental health financing: the case of Lebanon.

PubMed

Yehia, Farah; Nahas, Ziad; Saleh, Shadi

2014-09-01

Inadequate access to mental health (MH) services in Lebanon, where prevalence is noteworthy, is a concern. Although a multitude of factors affects access to services, lack of financial coverage of MH services is one that merits further investigation. This study aims at providing a systematic description of MH financing systems with a special focus on Lebanon, presenting stakeholder viewpoints on best MH financing alternatives/strategies and recommending options for enhancing financial coverage. A comprehensive review of existing literature on MH financing systems was conducted, with a focus on the system in Lebanon. In addition, key stakeholders were interviewed to assess MH organizational and financing arrangements. Finally, a national round table was organized with the aim of discussing findings (from the review and interviews) and developing an action roadmap. Taxation and out-of-pocket payments are the most common MH financing sources worldwide and in the Eastern Mediterranean Region. In Lebanon, all funding entities, except private insurance and mutual funds, cover inpatient and outpatient MH services, albeit with inconsistencies in levels of coverage. The national roundtable recommended two main MH financing enhancements: (i) creating a knowledge-sharing committee between insurers and MH specialists, and (ii) convincing labor unions/representatives to lobby for MH coverage as part of the negotiated benefit package. There are concerns regarding the equity, effectiveness and efficiency of the MH financing system in Lebanon. The fragmented system in Lebanon leads to differences in MH coverage across different financing intermediaries, which is inequitable. The fact that one out of four Lebanese suffer a mental disorder throughout their lives and very low percentages of those obtain treatment signals a problem in effectiveness. As for efficiency, the inefficient fragmentation of MH financing among seven intermediaries is a problematic characteristic of the

Characterization of influenza outbreaks in Lebanon during the 2013/14 and 2014/15 seasons.

PubMed

Saito, R; Akinobu, H; Shaker, R A; Akel, I S; Assaf-Casals, A; Lteif, M; Odagiri, T; Inaba, R; Soudani, N; Khafaja, S; Ghanem, S T; Rajab, M; Shobugawa, Y; Dbaibo, G S; Zaraket, H

2016-10-02

Despite the significant burden of influenza outbreaks, active disease monitoring has been largely absent in the Middle East, including Lebanon. In this study we characterized influenza virus in 440 nasopharyngeal swabs collected from patients with acute respiratory infections during two influenza seasons in Lebanon. Influenza A(H3N2) was dominant in the 2013/14 season while the A(H1N1)pdm09 and B/Yamagata strains were most prevalent in the 2014/15 season. All tested isolates were susceptible to 4 neuraminidase inhibitors (oseltamivir, zanamivir, peramivir and laninamivir). Genetic analysis of the haemagglutinin gene revealed multiple introductions of influenza viruses into Lebanon from different geographic sources during each season. Additionally, large data gaps were identified in the Middle East region, as indicated by the lack of current influenza sequences in the database from many countries in the region.

Prevalence and degree of bother of pelvic floor disorder symptoms among women from primary care and specialty clinics in Lebanon: an exploratory study.

PubMed

Ghandour, Lilian; Minassian, Vatche; Al-Badr, Ahmed; Abou Ghaida, Rami; Geagea, Sandra; Bazi, Tony

2017-01-01

The prevalence of pelvic floor disorders (PFD) and their impact on quality of life of women vary among different populations. The purpose of this study was to assess the prevalence of symptoms of PFD, and their degree of bother in a convenience sample of Lebanese women, and to evaluate health-care seeking (HCS) behavior related to PFD. Women visiting clinics in a University Medical Center in Beirut, Lebanon, completed the self-filled validated Arabic version of the Global Pelvic Floor Bother Questionnaire (PFBQ). Data covering demographics, comorbidities, and HCS behavior related to PFD were collected. Total individual PFBQ scores, individual PFD symptom scores and HCS behavior were correlated to demographic data and comorbidities. The study participants included 900 women. PFBQ scores were significantly higher in women of older age, women with a lower level of education, women with higher vaginal parity, and women who engaged in heavy lifting/physical activity. BMI >25 kg/m 2 was the strongest independent risk factor for the presence of PFD symptoms. The overall prevalence of urinary incontinence was 42 %. Anal incontinence was the most bothersome PFD. Almost two thirds of the women reported HCS due to any aspect of PFD. Among symptomatic women who believed that their PFD warranted HCS, financial concern was the most common obstacle irrespective of age and educational level. In this convenience sample of Lebanese women, PFD symptoms were common and were significantly correlated with demographic characteristics and self-reported comorbidities. The key reason for not seeking health care related to PFD was financial concern.

Sociological Transition and Breast Cancer in the Arab World: the Experience of Lebanon

PubMed Central

Lakkis, Najla A; Adib, Salim M; Hamadeh, Ghassan; Jarrah, Rana El; Osman, Mona H

2017-01-01

Background: Breast cancer is the leading cause of cancer death among females in Lebanon. This study aimed at analyzing its epidemiology in the country over time. Methods: Data were extracted from the Lebanese National Cancer Registry (NCR) for the years 2004 through 2010. Age-standardized and age-specific incidence rates for cancers per 100,000 population were calculated. Results: Breast cancer ranked first, accounting for an average of 37.6% of all new female cancer cases in Lebanon during the period of 2004-2010. Breast cancer was found to have been increasing faster than other hormone-related women’s cancers (i.e. of the ovaries and corpus uteri). The breast cancer age-standardized incidence rates (world population) (ASRw) increased steadily from 2004 (71.0) to 2010 (105.9), making the burden comparable to that in developed countries, reflecting the influence of sociological and reproductive patterns transitioning from regional norms to global trends. The age-specific incidence rates for breast cancer rose steeply from around age 35-39 years, to reach a first peak in the age group 45-49 years, and then dropped slightly between 50 and 64 years to rise again thereafter and reach a second peak in the 75+ age group. Five-year age-specific rates among Lebanese women between 35 and 49 years were among the highest observed worldwide in 2008. Conclusion: Breast cancer is continuously on the rise in Lebanon. The findings of this study support the national screening recommendation of starting breast cancer screening at the age of 40 years. It is mandatory to conduct an in-depth analysis of contributing factors and develop consequently a comprehensive National Breast Cancer Control strategy. PMID:28612586

Associations between poor living conditions and multi-morbidity among Syrian migrant agricultural workers in Lebanon.

PubMed

Habib, Rima R; Mikati, Diana; Hojeij, Safa; El Asmar, Khalil; Chaaya, Monique; Zurayk, Rami

2016-12-01

Syrian migrant farmworkers are among the most marginalized populations in Lebanon, living in poverty, lacking basic legal protections and frequent targets of discrimination. These realities produce living conditions that undermine their basic health and wellbeing. This study explores associations between household living conditions and acute and chronic health problems among Syrian migrant agricultural workers in the Bekaa region of Lebanon. A survey was carried out in summer of 2011 with a sample of 290 migrant agriculture workers and members of their household living in a migrant farmworker camp. The survey assessed participants living conditions, assets and health conditions. Regression analyses were carried out to examine associations between multi-morbidity and quality of household and neighborhood living conditions. The mean age for the population was 20 years. Forty-seven percent of participants reported health problems. Almost 20% reported either one acute or chronic illness, 15% reported two health problems and 13% reported three or more. The analysis showed a significant positive association between multi-morbidity and poor housing and infrastructure conditions among study participants. The situation for migrant communities in Lebanon has likely further deteriorated since the study was conducted, as hundreds of thousands of new migrants have entered Lebanon since the outbreak of the Syrian armed conflict in 2011. These findings should inspire multi-faceted community development initiatives that provide basic minimums of neighborhood infrastructure and housing quality for Syrian migrant informal settlements across Lebanon, safeguarding the health and wellbeing of community residents. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

Medication safety knowledge, attitudes and practices among community pharmacists in Lebanon.

PubMed

Hajj, Aline; Hallit, Souheil; Ramia, Elsy; Salameh, Pascale

2018-01-01

The effectiveness of a national post-marketing surveillance program depends directly on the active participation of all health professionals. There is no current comprehensive and active pharmacovigilance program available in Lebanon. To assess the knowledge, attitudes, and practices (KAP) among community pharmacists in Lebanon with respect to potential pharmacovigilance and adverse-drug-reaction reporting in Lebanon. A cross-sectional descriptive study, using a self-administered KAP questionnaire and conducted between March and July 2016, included 1857 pharmacists practicing in community settings. Statistical analysis included χ 2 test for dichotomous or multinomial qualitative variables, and Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution. The majority of responders had good knowledge concerning the concept and purpose of pharmacovigilance as well as adverse drug reactions (how to report these/the importance of reporting adverse events/the definition of an adverse event and pharmacovigilance). Concerning community pharmacists' attitudes and practice towards pharmacovigilance, the majority described having a positive attitude towards their role in adverse drug reaction reporting and this activity was even seen as one of their core duties. The questionnaire revealed a lack of practice and training regarding pharmacovigilance. Nonetheless, the pharmacists agreed on the Order of Pharmacists in Lebanon and the Ministry of Health's role in promoting this practice and helping them be more involved in reporting adverse drug reactions (ADRs). The pharmacists thought that they are well positioned regarding patient-safety practice in their pharmacies and the results were not statistically different between pharmacy employers and employees. Lebanese pharmacists have the required knowledge and positive attitude to start reporting ADRs, were aware of ADRs occurring with various medicines post-marketing, yet were currently not

Implementation of palliative care in Lebanon: past, present, and future.

PubMed

Daher, Michel; Estephan, Elie; Abu-Saad Huijer, Huda; Naja, Zoher

2008-01-01

The goal of palliative care (PC) is to relieve suffering. PC is an urgent humanitarian need worldwide for people with cancer and other chronic fatal diseases. PC in Lebanon has made some important strides in the last decade but it is still in its infancy. More attention needs to be given in the near future to the implementation of the recommendations already listed by previous meetings and workshops. In order to do so, it is necessary to change the legislative system in Lebanon in order to recognize and to integrate this new discipline. Education and training of health professionals in PC should be provided by medical and nursing schools throughout the country. Postgraduate education in medicine and nursing and ensuing certification should be made available. Ideally, PC services should be provided from the time of diagnosis of life-threatening illness, adapting to the increasing needs of cancer patients and their families as the disease progresses into the terminal phase. They should also provide support to families in their bereavement. It is as important and essential to involve policy makers in the development of pain relief and PC services and clinics which meet the needs of the population in Lebanon. Effective PC services should be integrated into the existing health system at all levels of care, especially community and home-based care. They involve the public and the private sector and are adapted to the specific cultural, social and economic setting. In order to respond to the cancer priority needs in a community and make the best use of scarce resources, PC services should be strategically linked to cancer prevention, early detection and treatment services. The time will come for Lebanon to form the National Council for Pain Relief and Palliative Care as an advocacy and coordination body for pain relief and PC in the near future. To that effect, we believe the future is near.

Hard Fighting: Israel in Lebanon and Gaza

DTIC Science & Technology

2011-01-01

mines . Hezbollah itself also proved an unexpectedly formidable adversary. During the years leading up to the Second Lebanon War, Hezbollah forces...hitting Hamas positions and detonating mines and IEDs. IDF engineers used armored D-9 bulldozers to clear paths through the remaining IEDs. Armored...discipline; cellular structure; small formations (squads) • Weapons: small arms; RPGs; mortars; short- range rockets; IEDs/ mines • Command and control

Community pharmacy in Lebanon: A societal perspective.

PubMed

Iskandar, Katia; Hallit, Souheil; Raad, Etwal Bou; Droubi, Fida; Layoun, Nelly; Salameh, Pascale

2017-01-01

To assess patients' attitudes towards the community pharmacist's role and determine their negative and positive reactions towards community pharmacists in Lebanon. A cross-sectional study, conducted between January and April 2016, was designed to assess the general public satisfaction with the services provided by the community pharmacies. It was carried out, using a proportionate random sampling of Lebanese community pharmacies from each district. Two sided statistical tests were used to compare between group percentages, Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution, and Student's t-test for quantitative variables of normal distribution and homogeneous variances. The ANOVA test was used to compare between three groups or more, and Pearson correlation coefficient were used to correlate between quantitative variables. a total of 565 participants completely answered the survey questions with a response rate of 94%. The bivariate analysis showed that the patient perception index was positively and significantly correlated with the patient level of expectation index, the overall pharmacy experience and the patient's reason for visiting the pharmacy (p<0.001 for all 3 variables) but was negatively correlated with the barriers for asking questions significantly (p=0.032). On the other hand, this perception index was significantly and positively associated with the number of pharmacy visits, the age categories, the level of education and the family monthly income (p<0.05 for all variables). Public perception and attitude toward community pharmacist in Lebanon is poor despite highly qualified pharmacists. Aspects of pharmacy services most relevant to patients were respect, empathy, a friendly staff, listening carefully, giving quality time, responding quickly to their needs and respecting their privacy. The ministry of Health in Lebanon, along with the Lebanese Order of Pharmacists should educate the pharmacist about

Mesotheliomas in Lebanon: Witnessing a Change in Epidemiology.

PubMed

Kattan, Joseph; Eid, Roland; Kourie, Hampig Raphael; Farhat, Fadi; Ghosn, Marwan; Ghorra, Claude; Tomb, Roland

2016-01-01

Mesotheliomas are relatively rare tumors in Lebanon. The only previous study goes back to 14 years ago, when we published epidemiological characteristics of mesotheliomas in Lebanon, showing that the pleural location accounted for the vast majority of cases, with clear evidence of asbestos exposure from the Eternit factory of Chekka region. The objective of this current study was to estimate the incidence of mesothelioma in the past decade and to identify its epidemiological, clinical and therapeutic characteristics, making comparisons with our first study published in 2001. Between 2002 and 2014, patients diagnosed with malignant mesothelioma at Hotel-Dieu de France University Hospital were investigated. Epidemiological data focusing on asbestos exposure history were collected from medical records and interviews with the families. A total of 26 patients were diagnosed with mesothelioma, 21 of which were successfully investigated. The mean age of these 21 patients is 62.5 (19-82). Only 3 (14.29%) are women. 18 (85.71%) were smokers. Among the 21 available mesotheliomas, 15 (71.4%) are pleural, while 5 (23.8%) are peritoneal and 1 (4.8%) pericardial. Only 60% of patients with pleural mesothelioma and 50% of those with an obvious exposure to asbestos lived and/or worked in Chekka region. The mean time of asbestos exposure in patients with mesothelioma is 24.5 (1-50) years and the mean latency is 37.4 (4-61) years. Of the 21 patients, 10 (47.6%) underwent surgery during their treatment, 16 (76.2%) received chemotherapy and 3 (14.3%) received best supportive care. Compared to the previous study (1991-2000), substantial changes in the epidemiology of mesothelioma in Lebanon were observed, such as an increase in peritoneal localizations and a lower correlation with Chekka region asbestos contamination.

Sodium intake reduction efforts in Lebanon

PubMed Central

Almedawar, Mohamad M.; Nasreddine, Lara; Olabi, Ammar; Hamade, Haya; Awad, Elie; Toufeili, Imad; Arnaout, Samir

2015-01-01

Sodium intake reduction efforts in Lebanon are quite recent and have just started to take effect on the national level. Starting out from an academic institution, the Lebanese Action on Sodium and Health (LASH) campaign was established to counter the increasing prevalence of hypertension and associated adverse health effects. The campaign’s strategy was based on four pillars: research, health communication, advocacy, and monitoring. The LASH group set out with determining: baseline sodium intake of the population, main sources of sodium intake, and the knowledge, attitudes, and behaviors (KAB) of the population as a situation analysis that prompts for action. This gave LASH tangible evidence of the magnitude of the problem and the need for the government, the food industry, and the consumers, to be mobilized to take part in devising a solution. Currently, Lebanon is at a stage of technically working to reduce the sodium content in the major sources of sodium, namely local bread and bread-like products. The next steps will include implementation of a plan for monitoring industry compliance, while studying other food targets, including dairy products and processed meat. Meanwhile, the health communication plan is ongoing and the Salt Awareness Week is celebrated every year with media appearances of LASH researchers to raise the issue to the public eye. PMID:26090328

Maternal mortality ratio in Lebanon in 2008: a hospital-based reproductive age mortality study (RAMOS).

PubMed

Hobeika, Elie; Abi Chaker, Samer; Harb, Hilda; Rahbany Saad, Rita; Ammar, Walid; Adib, Salim

2014-01-01

International agencies have recently assigned Lebanon to the group H of countries with "no national data on maternal mortality," and estimated a corresponding maternal mortality ratio (MMR) of 150 per 100,000 live births. The Ministry of Public Health addressed the discrepancy perceived between the reality of the maternal mortality ratio experience in Lebanon and the international report by facilitating a hospital-based reproductive age mortality study, sponsored by the World Health Organization Representative Office in Lebanon, aiming at providing an accurate estimate of a maternal mortality ratio for 2008. The survey allowed a detailed analysis of maternal causes of deaths. Reproductive age deaths (15-49 years) were initially identified through hospital records. A trained MD traveled to each hospital to ascertain whether recorded deaths were in fact maternal deaths or not. ICD10 codes were provided by the medical controller for each confirmed maternal deaths. There were 384 RA death cases, of which 13 were confirmed maternal deaths (339%) (numerator). In 2008, there were 84823 live births in Lebanon (denominator). The MMR in Lebanon in 2008 was thus officially estimated at 23/100,000 live births, with an "uncertainty range" from 153 to 30.6. Hemorrhage was the leading cause of death, with double the frequency of all other causes (pregnancy-induced hypertension, eclampsia, infection, and embolism). This specific enquiry responded to a punctual need to correct a clearly inadequate report, and it should be relayed by an on-going valid surveillance system. Results indicate that special attention has to be devoted to the management of peri-partum hemorrhage cases. Arab, postpartum hemorrhage, development, pregnancy management, verbal autopsy

Immunity to chickenpox among school adolescents in Lebanon and options for vaccination.

PubMed Central

Musharrafieh, U. M.; Nuwayhid, I. A.; Hamadeh, G. N.; Steitieh, S. W.; Bizri, A. R. N.

2002-01-01

Varicella infections cause substantial morbidity and mortality in adolescents and adults. The primary infection, chickenpox, results in lifelong immunity to chickenpox. A seroprevalence study carried on adolescents 15-18 years of age attending schools in Lebanon showed 96.6% immunity to varicella. The positive predictive value for immunity to chickenpox based on history alone was 97.4%, whereas the negative predictive value was 4.5%. Coming from a bigger family was a statistically significant predictor of immunity to chickenpox. In a developing country like Lebanon the merits and limitations of implementing universal varicella vaccination is discussed in relation to seroprevalence and socioeconomic factors. PMID:12558345

Third-party reproductive assistance around the Mediterranean: comparing Sunni Egypt, Catholic Italy and multisectarian Lebanon.

PubMed

Inhorn, Marcia C; Patrizio, Pasquale; Serour, Gamal I

2010-12-01

The article examines religious and legal restrictions on third-party reproductive assistance in three Mediterranean countries: Sunni Egypt, Catholic Italy and multisectarian Lebanon. In Egypt, assisted reproduction treatments are permitted, but third parties are banned, as in the rest of the Sunni Islamic world. Italy became similar to Egypt with a 2004 law ending third-party reproductive assistance. In multisectarian Lebanon, however, the Sunni/Catholic ban on third-party reproductive assistance has been lifted, because of Shia rulings emanating from Iran. Today, third-party reproductive assistance is provided in Lebanon to both Muslims and Christians, unlike in neighbouring Egypt and Italy. Such comparisons point to the need for understanding the complex interactions between law, religion, local moralities and reproductive practices for global bioethics. Copyright © 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Sociological Transition and Breast Cancer in the Arab World: the Experience of Lebanon

PubMed

A Lakkis, Najla; Adib, Salim M; Hamadeh, Ghassan; El Jarrah, Rana; H Osman, Mona

2017-05-01

Background: Breast cancer is the leading cause of cancer death among females in Lebanon. This study aimed at analyzing its epidemiology in the country over time. Methods: Data were extracted from the Lebanese National Cancer Registry (NCR) for the years 2004 through 2010. Age-standardized and age-specific incidence rates for cancers per 100,000 population were calculated. Results: Breast cancer ranked first, accounting for an average of 37.6% of all new female cancer cases in Lebanon during the period of 2004-2010. Breast cancer was found to have been increasing faster than other hormone-related women’s cancers (i.e. of the ovaries and corpus uteri). The breast cancer age-standardized incidence rates (world population) (ASRw) increased steadily from 2004 (71.0) to 2010 (105.9), making the burden comparable to that in developed countries, reflecting the influence of sociological and reproductive patterns transitioning from regional norms to global trends. The age-specific incidence rates for breast cancer rose steeply from around age 35-39 years, to reach a first peak in the age group 45-49 years, and then dropped slightly between 50 and 64 years to rise again thereafter and reach a second peak in the 75+ age group. Five-year age-specific rates among Lebanese women between 35 and 49 years were among the highest observed worldwide in 2008. Conclusion: Breast cancer is continuously on the rise in Lebanon. The findings of this study support the national screening recommendation of starting breast cancer screening at the age of 40 years. It is mandatory to conduct an in-depth analysis of contributing factors and develop consequently a comprehensive National Breast Cancer Control strategy. Creative Commons Attribution License

Assessment of reproductive health and violence against women among displaced Syrians in Lebanon

PubMed Central

2014-01-01

Background The current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population. Methods We conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes. Results We interviewed 452 Syrian refugee women ages 18–45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n = 74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health. Conclusions This study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence. PMID:24552142

Guidelines for breast cancer screening in Lebanon Public Health Communication.

PubMed

Adib, Salim M; El Saghir, Nagi S; Ammar, Walid

2009-01-01

The accumulation of national epidemiological data since the late 1990s has led to the adoption of evidence-based guidelines for breast cancer screening in Lebanon (2006). Almost 50% of breast cancer patients in Lebanon are below the age of 50 years and the age-adjusted incidence rate is estimated at 69 new cases per 100,000 per year (2004). This official notification calls for breast self-examination (BSE) every month starting age 20, and a clinical breast examination (CBE) performed by a physician every three years between the ages of 20 and 40 years. Starting age 40, and for as long as a woman is in good health, an annual CBE and mammography are recommended. Women with known genetic family history of breast cancer should start screening 10 years earlier than the first young patient in the family, or earlier depending on medical advice. The Breast Cancer National Task Force (BCNTF) recommends certification of mammography centers and continued training of personnel to assure high quality mammograms, and to minimize unnecessary investigations and surgeries.It recommends that a national program should record call-backs of women for annual screening and follow-up data on abnormal mammograms. BCNTF encourages the adoption of these guidelines and monitoring of their results, as well as follow-up of breast cancer epidemiology and registry in Lebanon, and scientific progress in early breast cancer detection to determine needs for modifications in the future.

Diversity and distribution of ticks from domestic ruminants in Lebanon.

PubMed

Dabaja, Mayssaa Fawaz; Tempesta, Maria; Bayan, Ali; Vesco, Gesualdo; Vesco, Gesualdo; Greco, Grazia; Torina, Alessandra; Blanda, Valeria; La Russa, Francesco; Scimeca, Salvatore; Ezzedine, Mohamad; Mortada, Hussein; Raoult, Didier; Fournier, Pierre Edouard; Mortada, Mohamad

2017-06-30

Ticks (Acari: Ixodidae) are ectoparasites infesting livestock in every geographic area in the world and they are vectors of several viral, bacterial, and protozoan pathogens to animals and humans worldwide. A deep knowledge of the geographical distribution of these arthropods would have a key role in the control of tick-borne diseases. Few data are available about tick presence in domestic ruminants in Lebanon. The study aimed at providing an analysis of tick presence and distribution in Lebanon. Ticks were collected from cattle, sheep, and goats farms distributed in 6 Lebanese provinces between June and September 2014. A total of 272 adult hard ticks were randomly collected from domestic ruminants (cattle, sheep, and goats) located at 37 Lebanese farms, distributed among 30 villages. Ticks belonged to 4 Ixodidae genera: Rhipicephalus (72.4%), Haemaphysalis (11.4%), Dermacentor (8.1%), and Hyalomma (8.1%). They included the following species: Rhipicephalus annulatus (50.7%), Rhipicephalus turanicus (18.8%), Hyalomma anatolicum (8.1%), Haemaphylasis punctata (11.4%), Dermacentor marginatus (8.1%), Rhipicephalus sanguineus (2.5%), and Rhipicephalus bursa (0.4%). Rhipicephalus turanicus and H. anatolicum were found on cattle, sheep, and goats, R. annulatus on cattle and sheep, R. sanguineus, D. marginatus and Hea. punctata on sheep and goats, while R. bursa was collected only on sheep. Tick species involved in pathogen transmission were found and some of the identi ed species were recorded in Lebanon for the rst time.

Lessons learned: A comparative study of the integration experiences of Armenian and Palestinian refugees in Lebanon

DTIC Science & Technology

2017-06-01

design is based on two comparative case studies, examining Palestinian and Armenian refugees in Lebanon, respectively. These two cases are particularly...A COMPARATIVE STUDY OF THE INTEGRATION EXPERIENCES OF ARMENIAN AND PALESTINIAN REFUGEES IN LEBANON by Pascal Ghobeira June 2017 Thesis...REPORT DATE June 2017 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE LESSONS LEARNED: A COMPARATIVE STUDY OF THE

Monitoring the snowpack volume in a sinkhole on Mount Lebanon using time lapse Photogrammetry

NASA Astrophysics Data System (ADS)

Abou Chakra, C.; Gascoin, S.; Somma, J.; Drapeau, L.; Fanise, P.

2017-12-01

Lebanon is one of the richest country in the Middle East for water resources, thanks to its mountain ranges that trigger precipitation from the moist air masses coming from the Mediterranean Sea. Snowpack acts as natural water storage in winter and supply fresh water during spring and summer. Yet, Lebanon is facing a serious water scarcity problem due to: i) decreasing amount of precipitation and climate change; ii) major growth of population of original residence and large number of refugees during regional wars. Therefore, continuous and systematic monitoring of the Lebanese water resources is becoming crucial. The Mount Lebanon is made of karstic depressions named "sinkholes". It is important to monitor the snowmelt process inside these sinkholes because of their key role as "containers" of seasonal snow. By isolating the snowpack from sun radiation and wind, they slow down the natural melting process and sublimation, thus delaying as well the low water flow period. An observatory is set up to monitor the snowpack evolution in a pilot sinkhole located in Mount Lebanon. The system uses three time-lapse cameras and structure-from-motion principles to reconstruct the snow volume within the sinkhole. The approach is validated by standard topographic surveys. The results indicate that snow depth can be retrieved with an accuracy between 20 and 60 cm (residuals standard deviation) and a low bias of 50 cm after coregistration of the digital elevation models.

The Qartaba Structure: An Active Backthrust In Central Mt-Lebanon.

NASA Astrophysics Data System (ADS)

Elias, Ata Richard

2016-04-01

The Qartaba structure in central Mt-Lebanon is a 15x5km box fold running parallel to the restraining bend of the sinsitral Yammouneh Fault, the main fault of the central segment of the Dead Sea Transform. The Qartaba structure has long been described as a "horst" and associated with Mesozoic normal faulting. However, the Qartaba anticline is suitably oriented with the direction of maximum compression along the restraining bend. Jurassic carbonate rocks form the core of this anticline culminating at ~1953m asl to the east, of the highest structural elevation of the Mt-Lebanon range indicating important tectonic uplift rate. The fold is asymmetric. The western limb is steep and bordered by the Lebanese Flexure, a prominent continuous monocline of Upper Jurassic to Mid Cretaceous rocks, running along the western flank of Mt-Lebanon. The eastern limb of the anticline has a very steep dip, and forms a 200m high cliff well marked in the topography. Its Jurassic layers are almost vertical and end up overhanging Lower Cretaceous beds. Our study suggest that the Qartaba structure is a growing anticline, built by active thrusting over a west dipping thrust fault that cuts the surface at the base of the eastern limb of the anticline. The fault plane can be seen dipping 30-35 degrees to the west. At depth, this thrust is likely to connect with the blind thrust ramp of the Mt-Lebanon Flexure. The Qartaba backthrust with a dip to the west, is opposite to the general vergence of similar structures in the area. On some of the segments of the steep cliff forming the faulted eastern limb, a fresh scarp with smooth and polished surfaces bearing vertical slickensides can be followed over ~700m along the base of the cliff. It corresponds with the location of the thrust fault tip. Talus accumulation over the steep eastern limb covers most of the cliff base, and may be masking further extent of this scarp. We interpret this scarp as the freeface of a co-seismic rupture on the underlying

Prevalence of hepatitis B infection markers in Lebanese children: the need for an expanded programme on immunization.

PubMed Central

Nabulsi, M. M.; Araj, G. F.; Nuwayhid, I.; Ramadan, M.; Ariss, M.

2001-01-01

This multi-centre, cross-sectional study was designed to reveal the present status of hepatitis B infection markers among Lebanese children, and provide recommendations regarding childhood immunization policies. A total of 841 children, aged between 6 months and 6.5 years, were enrolled from Lebanon's five districts. Their sera were tested for hepatitis B surface antigen and hepatitis B core IgG. The overall prevalence of hepatitis B virus infection markers was 0.8% with increasing age-specific rates from 0% at 6 months to 1.3 % at > 5 years. There was no statistically significant association between the presence of hepatitis B markers and family characteristics or risk factors for infection. The highest prevalence rates were among children from Beirut suburbs (2.9 %) and South Lebanon (1.6%). The risk of horizontal transmission of hepatitis B to uninfected children increased substantially after the age of 2 years. An expanded programme on immunization that integrates hepatitisB vaccine during the first year of life is needed. PMID:11349979

Prevalence of hepatitis B infection markers in Lebanese children: the need for an expanded programme on immunization.

PubMed

Nabulsi, M M; Araj, G F; Nuwayhid, I; Ramadan, M; Ariss, M

2001-04-01

This multi-centre, cross-sectional study was designed to reveal the present status of hepatitis B infection markers among Lebanese children, and provide recommendations regarding childhood immunization policies. A total of 841 children, aged between 6 months and 6.5 years, were enrolled from Lebanon's five districts. Their sera were tested for hepatitis B surface antigen and hepatitis B core IgG. The overall prevalence of hepatitis B virus infection markers was 0.8% with increasing age-specific rates from 0% at 6 months to 1.3 % at > 5 years. There was no statistically significant association between the presence of hepatitis B markers and family characteristics or risk factors for infection. The highest prevalence rates were among children from Beirut suburbs (2.9 %) and South Lebanon (1.6%). The risk of horizontal transmission of hepatitis B to uninfected children increased substantially after the age of 2 years. An expanded programme on immunization that integrates hepatitisB vaccine during the first year of life is needed.

Attitudes of Teachers and Headteachers towards Inclusion in Lebanon

ERIC Educational Resources Information Center

Khochen, Maha; Radford, Julie

2012-01-01

In the Arabic region, the drive towards inclusive practices in mainstream schools is at a relatively early stage, although, in Lebanon, the recent initiative of the National Inclusion Project (NIP), a project managed by a consortium of four organisations aimed at addressing the exclusion experienced by people with a disability, has the potential…

Mental health care in the Lebanon War, 1982.

PubMed

Noy, S; Levy, R; Solomon, Z

1984-04-01

Lessons in mental health care learned from the October 1973 War were applied in the Lebanon War 1982. A three-echelon system of management was followed according to the practices prevalent in Western armies. The clinical pictures were essentially similar to those observed in other wars. Combat stress reactions (CSR) comprised 15 to 20% of the total casualties during the active phase of the war; the rate of late reactions was 30 to 40% of the total CSR. Treatment on the battlefield was more effective than treatment following airlift to the rear, in returning soldiers to their units. The role of stress in causing CSR, and the importance of leadership and cohesion in its prevention were evident. The important lessons learned from the Lebanon War are discussed and include: 1) the need for a broad definition of CSR; 2) the importance of forward unit intervention; 3) the necessity of mobility and divisibility of mental health treatment units; 4) fighting units should not be dispersed immediately after combat; and 5) the management of stress reactions to be the responsibility not only of the mental health services, but of all sections of the medical corps, both in treatment and prevention.

Socioeconomic differences in smoking in Jordan, Lebanon, Syria, and Palestine: A cross-sectional analysis of national surveys.

PubMed

Abdulrahim, Sawsan; Jawad, Mohammed

2018-01-01

The association between education and wealth, as fundamental determinants of health, and smoking is well-established. Yet, social inequalities have received little attention in the expanding field of tobacco research in the Arab region. In this study, we examine inequalities in cigarette smoking by education and wealth in four Arab countries. Utilizing the most recently available population-level data sets (Syria 2009 PAPFAM, Jordan 2012 DHS, Palestine 2010 Family Health Survey, and Lebanon 2004 PAPFAM), we tested the association between cigarette smoking and education and wealth-controlling for age, marital status, and region of residence-for each country, and among men and women depending on data availability. Cigarette smoking prevalence among Arab men is high- 51.3% in Syria, 39.7% in Palestine, and 42.1% in Lebanon; among women, prevalence is 8.4% in Syria, 10.9% in Jordan, and 24.3% Lebanon. Cigarette smoking shows the expected patterns inequalities by education among men in Syria, Palestine, and Lebanon, and among women in Jordan and Lebanon. On the other hand, wealth does not show a clear pattern in its association with cigarette smoking and, in some cases (men in Palestine and women in Syria) the behavioral risk is higher among the wealthiest. Available data from 2004-2012 show that cigarette smoking among men and women in the four Arab countries is predominant among those with limited access to education as a fundamental cause. The weak or absent negative association between wealth and cigarette smoking suggests that access to material resources does not precipitate a reduction in the consumption of tobacco.

The workforce trends of nurses in Lebanon (2009–2014): A registration database analysis

PubMed Central

Chamoun, Nariman; Btaiche, Rachel; El Arnaout, Nour; Richa, Nathalie; Samaha-Nuwayhid, Helen

2017-01-01

Background Analysis of the nursing registration databases is a highly informative approach that provides accurate and reliable information supporting evidence based decisions relevant to the nursing workforce planning, management and development. This study presents the first systematic analysis of the nursing registration database in Lebanon. It Reports on the workforce distribution and trends using an updated version of the Order of Nurses in Lebanon (ONL) databases. Methods This study presents a secondary data analysis of a de-identified subset of the updated ONL registration database. The workforce participation status of ONL registered nurses was categorized as active and eligible. For active nurses sectors and sub-sectors of employment were defined. Eligible nurses were categorized as unemployed, working outside nursing and working abroad. SPSS was used to conduct descriptive analysis to present workforce trends of Lebanese nurses for year 2009–2014 as frequencies, percentages and percentage changes. Results Increases in the size of the Active (35%) and Eligible (86%) nurses were observed over the past six years. The majority of nurses fell in the below 35 years age group (60% in 2014). The hospital sector remained the principle employer, with 87% of Lebanese nurses working in hospitals in 2014. A 173% increases was reported for nurses working abroad. Discussion Despite the growth of the Active nursing workforce, the skewed distribution of nurses in the below 35 age group and the growth in the Eligible category, especially for nurses living abroad, raise concerns on the longevity of nurses in the profession and the reasons for their attrition from the workforce. Conclusion There is a need to investigate the push and pull factors that are affecting nurses and the design of policies and interventions that would encourage nurses to remain active in Lebanon. Furthermore, policies and interventions that would create employment opportunities outside hospitals

Early Admission Call-Up: A Strategy and Marketing Perk for Attracting Better Students to a College in Lebanon

ERIC Educational Resources Information Center

Naimy, Viviane; Nasser, Ramzi

2009-01-01

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…

Factors influencing dyslipidemia in statin-treated patients in Lebanon and Jordan: results of the Dyslipidemia International Study.

PubMed

Azar, Sami T; Hantash, Hadi Abu; Jambart, Selim; El-Zaheri, Mohamed M; Rachoin, Rachoin; Chalfoun, Amal; Lahoud, Layla; Okkeh, Osama; Bramlage, Peter; Brudi, Philippe; Ambegaonkar, Baishali M

2014-01-01

Cardiovascular disease is the leading cause of death and disability worldwide. Therefore, as part of the Dyslipidemia International Study (DYSIS), we have analyzed the prevalence of lipid abnormalities and risk factors for dyslipidemia in statin-treated patients in Lebanon and Jordan. This cross-sectional, multicenter study enrolled 617 patients at 13 hospitals in Lebanon and Jordan. Patients were at least 45 years old and had been treated with statins for at least 3 months. Multivariate logistic regression analysis was used to determine patient characteristics contributing to dyslipidemia during statin therapy. Our findings indicated that 55.9% of statin-treated patients (mean age 60.3 years, 47% female) in Lebanon and Jordan did not achieve goal levels for low-density lipoprotein cholesterol which were dependent on Systematic Coronary Risk Evaluation (SCORE) risk, and 70% of patients (76% men and 63.3% of women) were at very high cardiovascular risk. Low-density lipoprotein cholesterol goals were not achieved in 67.2% of those with very high cardiovascular risk. The most commonly prescribed statin was atorvastatin (44.6%), followed by simvastatin (27.7%), rosuvastatin (21.2%), fluvastatin (3.3%), pravastatin (3%), and lovastatin (0.2%). Approximately half of the population was treated with a statin dose potency of 4, equaling 40 mg of simvastatin. In Lebanon and Jordan, the strongest independent associations with low-density lipoprotein cholesterol not at goal were current smoking (odds ratio [OR] 1.96; 95% confidence [CI] 1.25-3.08), diabetes mellitus (OR 2.53; 95% CI 1.70-3.77), and ischemic heart disease (OR 2.26; 95% CI 1.45-3.53), while alcohol consumption was associated with reduced risk (OR 0.12; 95% CI 0.03-0.57). We observed that many patients in Lebanon and Jordan experienced persistent dyslipidemia during statin treatment, supporting the notion that novel lipid-lowering strategies need to be developed. Also, social programs aimed at combating the

Israeli Deterrence And the 2nd Lebanon War

DTIC Science & Technology

2017-04-06

06 April 2017 DISTRIBUTION A. Approved for public release: distribution unlimited. Disclaimer The views expressed in this academic...which often replaces the government.119 Views are divided whether Hezbollah is first a Lebanese entity or an Iranian envoy.120 Nevertheless...proxy who can deter an Israeli attack on its nuclear facilities.131 Iran views Syria as a channel for aid to the Shiite population in Lebanon and

An annotated checklist of the horse flies (Diptera: Tabanidae) of Lebanon with remarks on ecology and zoogeography: Pangoniinae and Chrysopsinae

USDA-ARS?s Scientific Manuscript database

Knowledge of the horse fly fauna (Diptera: Tabanidae) of Lebanon is fragmentary while in most neighboring countries it has been fairly well researched. Therefore USDA-CMAVE scientists and Israeli scientists worked cooperatively to survey the species of horse flies in the Lebanon. Chrysops flavipes ...

Epidemiology and clinical characteristics of traumatic brain injury in Lebanon: A systematic review.

PubMed

Abou-Abbass, Hussein; Bahmad, Hisham; Ghandour, Hiba; Fares, Jawad; Wazzi-Mkahal, Rayyan; Yacoub, Basel; Darwish, Hala; Mondello, Stefania; Harati, Hayat; El Sayed, Mazen J; Tamim, Hani; Kobeissy, Firas

2016-11-01

Traumatic brain injury (TBI) is a debilitating medical and emerging public health problem that is affecting people worldwide due to a multitude of factors including both domestic and war-related acts. The objective of this paper is to systematically review the status of TBI in Lebanon - a Middle Eastern country with a weak health system that was chartered by several wars and intermittent outbursts of violence - in order to identify the present gaps in knowledge, direct future research initiatives and to assist policy makers in planning progressive and rehabilitative policies. OVID/Medline, PubMed, Scopus databases and Google Scholar were lastly searched on April 15, 2016 to identify all published research studies on TBI in Lebanon. Studies published in English, Arabic or French that assessed Lebanese patients afflicted by TBI in Lebanon were warranting inclusion in this review. Case reports, reviews, biographies and abstracts were excluded. Throughout the whole review process, reviewers worked independently and in duplicate during study selection, data abstraction and methodological assessment using the Downs and Black Checklist. In total, 11 studies were recognized eligible as they assessed Lebanese patients afflicted by TBI on Lebanese soils. Considerable methodological variation was found among the identified studies. All studies, except for two that evaluated domestic causes such as falls, reported TBI due to war-related injuries. Age distribution of TBI victims revealed two peaks, young adults between 18 and 40 years, and older adults aged 60 years and above, where males constituted the majority. Only three studies reported rates of mild TBI. Mortality, rehabilitation and systemic injury rates were rarely reported and so were the complications involved; infections were an exception. Apparently, status of TBI in Lebanon suffers from several gaps which need to be bridged through implementing more basic, epidemiological, clinical and translational research in

Cost-benefit analysis: newborn screening for inborn errors of metabolism in Lebanon.

PubMed

Khneisser, I; Adib, S; Assaad, S; Megarbane, A; Karam, P

2015-12-01

Few countries in the Middle East-North Africa region have adopted national newborn screening for inborn errors of metabolism by tandem mass spectrometry (MS/MS). We aimed to evaluate the cost-benefit of newborn screening for such disorders in Lebanon, as a model for other developing countries in the region. Average costs of expected care for inborn errors of metabolism cases as a group, between ages 0 and 18, early and late diagnosed, were calculated from 2007 to 2013. The monetary value of early detection using MS/MS was compared with that of clinical "late detection", including cost of diagnosis and hospitalizations. During this period, 126000 newborns were screened. Incidence of detected cases was 1/1482, which can be explained by high consanguinity rates in Lebanon. A reduction by half of direct cost of care, reaching on average 31,631 USD per detected case was shown. This difference more than covers the expense of starting a newborn screening programme. Although this model does not take into consideration the indirect benefits of the better quality of life of those screened early, it can be argued that direct and indirect costs saved through early detection of these disorders are important enough to justify universal publicly-funded screening, especially in developing countries with high consanguinity rates, as shown through this data from Lebanon. © The Author(s) 2015.

Informal politics and inequity of access to health care in Lebanon

PubMed Central

2012-01-01

Introduction Despite the importance of political institutions in shaping the social environment, the causal impact of politics on health care access and inequalities has been understudied. Even when considered, research tends to focus on the effects of formal macro-political institutions such as the welfare state. We investigate how micro-politics and informal institutions affect access to care. Methods This study uses a mixed-methods approach, combining findings from a household survey (n = 1789) and qualitative interviews (n = 310) in Lebanon. Multivariate logistic regression was employed in the analysis of the survey to examine the effect of political activism on access to health care while controlling for age, sex, socioeconomic status, religious commitment and piety. Results We note a significantly positive association between political activism and the probability of receiving health aid (p < .001), with an OR of 4.0 when comparing individuals with the highest political activity to those least active in our sample. Interviews with key informants also reveal that, although a form of “universal coverage” exists in Lebanon whereby any citizen is eligible for coverage of hospitalization fees and treatments, in practice, access to health services is used by political parties and politicians as a deliberate strategy to gain and reward political support from individuals and their families. Conclusions Individuals with higher political activism have better access to health services than others. Informal, micro-level political institutions can have an important impact on health care access and utilization, with potentially detrimental effects on the least politically connected. A truly universal health care system that provides access based on medical need rather than political affiliation is needed to help to alleviate growing health disparities in the Lebanese population. PMID:22571591

KAMEDO Report No. 92: Evacuation of Swedes from Lebanon--observational studies in connection with the war in Lebanon in summer 2006.

PubMed

Kulling, Per; Sigurdsson, Susannah; Hamberger, Bertil

2008-01-01

A large-scale armed conflict between Hezbollah and Israel in July 2006 caused the evacuation of a large number of Swedish residents from Lebanon. This report describes the evacuation throughout its various stages. Swedish authorities were prepared for an event of this type from the experience of the 2004 Asian tsunami disaster. Lessons learned from the management and medical care during the evacuations are presented in this report.

Y-chromosome R-M343 African Lineages and Sickle Cell Disease reveal structured assimilation in Lebanon

PubMed Central

Haber, Marc; Platt, Daniel E; Khoury, Simon; Badro, Danielle A; Abboud, Miguel; Smith, Chris Tyler; Zalloua, Pierre A

2012-01-01

We have sought to identify signals of assimilation of African male lines in Lebanon by exploring the association of sickle cell disease in Lebanon with Y-chromosome haplogroups that are informative of the disease origin and its exclusivity to the Muslim community. A total of 732 samples were analyzed including 33 sickle cell disease patients from Lebanon genotyped for 28 binary markers and 19 short tandem repeats on the non-recombinant segment of the Y chromosome. Genetic organization was identified using populations known to have influenced the genetic structure of the Lebanese population, in addition to African populations with high incidence of sickle cell disease. Y-chromosome haplogroup R-M343 sub-lineages distinguish between sub-Saharan African and Lebanese Y chromosomes. We detected a limited penetration of sickle cell disease into Lebanese R-M343 carriers, restricted to Lebanese Muslims. We suggest that this penetration brought the sickle cell gene along with the African R-M343, probably with the Saharan caravan slave trade. PMID:20981037

Digital Literacies and Generational Micro-Cultures: Email Feedback in Lebanon

ERIC Educational Resources Information Center

De Coursey, Christina; Dandashly, Nadine

2015-01-01

This study reports on the introduction of email feedback, in a private university in Lebanon with marked generational differences and a traditional instructor culture focused on grammar correction. The instructor profile showed insufficient ELT training and a disjuncture between those with low and those with long service. Instructors were trained,…

Organizational Support of Technology Integration in One School in Lebanon

ERIC Educational Resources Information Center

Zgheib, Rosine S.

2013-01-01

Technology has been at the center of heated debates in educational settings driving schools to compete for the best technological equipments. However, in Lebanon there is a lag in technology integration matching twenty first century advances. Several barriers related to teacher attitudes, lack of technical skills and organizational constraints to…

A Model for the Education of Gifted Learners in Lebanon

ERIC Educational Resources Information Center

Sarouphim, Ketty M.

2010-01-01

The purpose of this paper is to present a model for developing a comprehensive system of education for gifted learners in Lebanon. The model consists of three phases and includes key elements for establishing gifted education in the country, such as raising community awareness, adopting valid identification measures, and developing effective…

Urban atmospheric pollution in the Eastern Mediterranean : lessons from the TRANSEMED initiative

NASA Astrophysics Data System (ADS)

Borbon, Agnes; Salameh, Therese; Gaimoz, Cecile; Sauvage, Stephane; Locoge, Nadine; Oztürk, Fatma; Cetin, Banu; Keles, Melek; Afif, Charbel

2016-04-01

The East Mediterranean Basin (EMB) is a highly sensitive environment under considerable pressures. Future decadal projections point to the EMB as a possible hot spot of poor air quality and predict a continual and gradual warming in the region, much stronger than other regions. The increase and accumulation of anthropogenic emissions of gaseous and particulate pollutants from surrounding urban areas, are suspected as one of the key compounding factors of those environmental impacts. The quantification of emission distribution is a challenge, and even more in cities of the EMB where local emission data are sparse. While some highly resolved inventories have been developed at the regional scale in the EMB area for Beirut and Istanbul, their uncertainties are unknown. The paucity of observations in this region, especially for VOCs and PM composition, is a strong limitation to the achievement of evaluated and accurate emission inventories. As part of the TRANSEMED initiative (https://charmex.lsce.ipsl.fr/index.php/sister-projects/transemed.html), one of our objectives is to develop a systematic source-receptor methodology for emission inventory evaluation. We combine existing and newly collected observations and complementary source-receptor approaches (ie., urban enhancement emission ratios, multivariate models like PMF) in representative areas of the EMB: Beirut (Lebanon), Istanbul (Turkey), Cairo (Egypt) and, more recently, Athens (Greece). Over the past five years a very detailed database of ambient and near-source observations has been built-up especially regarding the composition of gaseous organic carbon. Results show (i) the extremely high levels of pollution for organics, (ii) the dominance of traffic emissions on VOC concentration levels, (iii) the relative poor spatial variability of speciated hydrocarbon traffic emissions regardless of the region, and (iv) the high uncertainty on global emission inventories when compared to observations. For the latter, and

The safety and quality of childbirth in the context of health systems: mapping maternal health provision in Lebanon

PubMed Central

DeJong, Jocelyn; Akik, Chaza; El Kak, Faysal; Osman, Hibah; El-Jardali, Fadi

2010-01-01

Objective to provide basic information on the distribution (public/private and geographically) and the nature of maternity health provision in Lebanon, including relevant health outcome data at the hospital level in order to compare key features of provision with maternal/neonatal health outcomes. Design a self-completion questionnaire was sent to private hospitals by the Syndicate of Private Hospitals in collaboration with the study team and to all public hospitals in Lebanon with a functioning maternity ward by the study team in cooperation with the Ministry of Public Health. Setting childbirth in an institutional setting by a trained attendant is almost universal in Lebanon and the predominant model of care is obstetrician-led rather than midwife-led. Yet due to a 15-year-old civil war and a highly privatised health sector, Lebanon lacks systematic or publically available data on the organisation, distribution and quality of maternal health services. An accreditation system for private hospitals was recently initiated to regulate the quality of hospital care in Lebanon. Participants in total, 58 (out of 125 eligible) hospitals responded to the survey (46% total response rate). Only hospital-level aggregate data were collected. Measurements the survey addressed the volume of services, mode of payment for deliveries, number of health providers, number of labour and childbirth units, availability of neonatal intensive care units, fetal monitors and infusion rate regulation pumps for oxytocin, as well as health outcome data related to childbirth care and stillbirths for the year 2008. Findings the study provides the first data on maternal health provision from a survey of all eligible hospitals in Lebanon. More than three-quarters of deliveries occur in private hospitals, but the Ministry of Public Health is the single most important source of payment for childbirth. The reported hospital caesarean section rate is high at 40.8%. Essential equipment for safe maternal

Predictors of breast-feeding in a developing country: results of a prospective cohort study.

PubMed

Al-Sahab, Ban; Tamim, Hala; Mumtaz, Ghina; Khawaja, Marwan; Khogali, Mustafa; Afifi, Rima; Nassif, Yolla; Yunis, Khalid A

2008-12-01

Data on the prevalence and predictors of breast-feeding remain scarce in Lebanon. Moreover, no study has previously addressed the effect of the paediatrician's sex on breast-feeding. The present study aimed to assess the prevalence and predictors of breast-feeding at 1 and 4 months of infant age while exploring the potential role of the sex of the paediatrician. Prospective cohort study. Predictors of breast-feeding significant at the bivariate level were tested at 1 and 4 months through two stepwise regression models. Infants were enrolled through the clinics and dispensaries of 117 paediatricians located in Beirut, Lebanon, and its suburbs. A total of 1,320 healthy newborn infants born between August 2001 and February 2002 were prospectively followed during the first year. Breast-feeding rates at 1 and 4 months were 56.3 % and 24.7 %, respectively. Early discharge, high parity and religion were significantly associated with higher breast-feeding rates at 1 and 4 months of age. Maternal age proved significant only at 1 month, while maternal working status and sex of the paediatrician were significant at 4 months. A novel finding of our study was the positive effect of female paediatricians on breast-feeding continuation until 4 months of age (OR = 1.49; 95 % CI 1.03, 2.15). Breast-feeding rates are low at 1 and 4 months of infant age in Beirut. Further research to investigate the interactions between female physicians and lactating mothers in maintaining breast-feeding in other populations is warranted. The results constitute the basis for designing interventions targeting policy makers, health professionals and mothers.

Attitudes towards domestic violence in Lebanon: a qualitative study of primary care practitioners

PubMed Central

Usta, Jinan; Feder, Gene; Antoun, Jumana

2014-01-01

Background Domestic violence (DV) is highly prevalent in the developing and developed world. Healthcare systems internationally are still not adequately addressing the needs of patients experiencing violence. Aim To explore physicians’ attitudes about responding to DV, their perception of the physician’s role, and the factors that influence their response. Design and setting Qualitative study using individual interviews among primary care practitioners working in Lebanon. Method Primary care clinicians practising for >5 years and with >100 patient consultations a week were interviewed. Physicians were asked about their practice when encountering women disclosing abuse, their opinion about the engagement of the health services with DV, their potential role, and the anticipated reaction of patients and society to this extended role. Results Physicians felt that they were well positioned to play a pivotal role in addressing DV; yet they had concerns related to personal safety, worry about losing patients, and opposing the norms of a largely conservative society. Several physicians justified DV or blamed the survivor rather than the perpetrator for triggering the violent behaviour. Moreover, religion was perceived as sanctioning DV. Conclusion Perceived cultural norms and religious beliefs seem to be major barriers to physicians responding to DV in Lebanon, and possibly in the Arab world more generally. Financial concerns also need to be addressed to encourage physicians to address DV. PMID:24868068

Impact of war, religiosity and ideology on PTSD and psychiatric disorders in adolescents from Gaza Strip and South Lebanon.

PubMed

Khamis, Vivian

2012-06-01

This study investigated the extent to which differences in the types of war trauma, economic pressure, religiosity and ideology accounted for variation in PTSD and psychiatric disorders among adolescents from Gaza Strip and South Lebanon. Participants were 600 adolescents aged 12-16 years. They were selected from the public school system in the highly war exposed areas. Questionnaires were administered in an interview format with adolescents at school by two trained psychologists. Results indicated that the various types of trauma had differential effects on the psychological status of adolescents in both countries. Economic pressure was more predictive of PTSD and psychological distress in adolescents from Gaza. Differences in religiosity and ideology did not account for similar variation in stress response among adolescents from Gaza and South Lebanon. While higher levels of religiosity evidenced the greatest levels of depression and anxiety in adolescents from Gaza, religiosity had an attenuated effect on adolescents from South Lebanon. Ideology was negatively associated with depression and anxiety in Gaza strip adolescents, whereas it did not play a role for adolescents from South Lebanon. The clinical and research implications of these conclusions are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Typing and comparative genome analysis of Brucella melitensis isolated from Lebanon.

PubMed

Abou Zaki, Natalia; Salloum, Tamara; Osman, Marwan; Rafei, Rayane; Hamze, Monzer; Tokajian, Sima

2017-10-16

Brucella melitensis is the main causative agent of the zoonotic disease brucellosis. This study aimed at typing and characterizing genetic variation in 33 Brucella isolates recovered from patients in Lebanon. Bruce-ladder multiplex PCR and PCR-RFLP of omp31, omp2a and omp2b were performed. Sixteen representative isolates were chosen for draft-genome sequencing and analyzed to determine variations in virulence, resistance, genomic islands, prophages and insertion sequences. Comparative whole-genome single nucleotide polymorphism analysis was also performed. The isolates were confirmed to be B. melitensis. Genome analysis revealed multiple virulence determinants and efflux pumps. Genome comparisons and single nucleotide polymorphisms divided the isolates based on geographical distribution but revealed high levels of similarity between the strains. Sequence divergence in B. melitensis was mainly due to lateral gene transfer of mobile elements. This is the first report of an in-depth genomic characterization of B. melitensis in Lebanon. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A national study on nurses’ retention in healthcare facilities in underserved areas in Lebanon

PubMed Central

2013-01-01

Background Nursing shortages and maldistribution are priority issues for healthcare systems around the globe. Such imbalances are often aggravated in underserved areas, especially in developing countries. Despite the centrality of this issue, there is a dearth of studies that examine the retention of nurses in underserved areas in the Middle East Region. This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon. Methods This study uses a non-experimental cross-sectional design to survey nurses working in underserved areas of Lebanon. Underserved areas in Lebanon were identified using WHO definition. A total of 103 health facilities (hospitals and primary healthcare centers) located in these areas were identified and all nurses working at these facilities received a copy of the survey questionnaire. The questionnaire included five sections: demographic, work-life, career plan, job satisfaction, and assessment of work environment. Analysis included univariate and bivariate (chi-square, Student’s t-test and ANOVA) tests to describe the respondents and examine the significance between nurses’ characteristics and their intent to stay. A logistic regression model was constructed to identify factors associated with nurses’ intent to stay in underserved areas. Results A total of 857 nurses from 63 Primary Healthcare (PHC) centers and hospitals responded to the questionnaire (75.5% response rate). Only 35.1% of nurses indicated their intent to stay in their current job over the coming one to three years. Surveyed nurses were most satisfied with relationship with co-workers and least satisfied with extrinsic rewards. Rural nurses working in PHC centers were more satisfied than their hospital counterparts on all aspects of work and had significantly higher intention to stay (62.5% compared to 31.5% in hospitals, P < 0.001). Regression analysis revealed that nurses less likely to report intent to

Prevalence and correlates of coronary heart disease: first population-based study in Lebanon.

PubMed

Zeidan, Rouba Karen; Farah, Rita; Chahine, Mirna N; Asmar, Roland; Hosseini, Hassan; Salameh, Pascale; Pathak, Atul

2016-01-01

Lebanon is experiencing a growing epidemic of coronary heart diseases (CHDs), as most low- and middle-income countries currently are. However, this growth can be attenuated if effective preventive strategies are adopted. To provide the first national population-based prevalence of CHD and to describe the profile of Lebanese adults with prevalent CHD. We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and older using a questionnaire that captured the presence of CHDs and their risk factors (RFs). Our study showed that 13.4% of the Lebanese population aged ≥40 years suffer from a prevalent CHD. CHD seemed to appear more prematurely than in developed countries, and males seemed to be more subject to CHD than females until a certain age. CHD was associated with older age, male sex, a lower economic situation, hypercholesterolemia, hypertension, having a family history of premature cardiovascular diseases, and suffering from diabetes. However, smoking and waist circumference did not seem to have an independent effect on CHD, but rather an effect mediated by biological RFs. This is the first nationwide endeavor conducted in Lebanon to assess the prevalence of CHD. This study also confirms the relevance of the classic RFs of CHD and their applicability to the Lebanese population, thus allowing for prevention strategies.

First data on Pneumocystis jirovecii colonization in patients with respiratory diseases in North Lebanon

PubMed Central

Khalife, S.; Aliouat, E.M.; Aliouat-Denis, C.M.; Gantois, N.; Devos, P.; Mallat, H.; Dei-Cas, E.; Dabboussi, F.; Hamze, M.; Fréalle, E.

2015-01-01

Pneumocystis colonization may play a role in transmission and local inflammatory response. It was explored in patients with respiratory diseases in North Lebanon. Overall prevalence reached only 5.2% (95% CI 2.13–10.47) but it was higher (17.3%) in the subpopulation of patients with chronic obstructive pulmonary disease (COPD). COPD was the only factor associated with a significantly increased risk of colonization. mtLSU genotyping revealed predominance of genotype 2, identified in five patients (71.4%), including one patient who had co-infection with genotype 3. These first data in North Lebanon confirm Pneumocystis circulation among patients with respiratory diseases and the potential for transmission to immunocompromised patients. PMID:26042187

Continuing Education of Nurses in Lebanon: Evaluation and Unmet Needs

ERIC Educational Resources Information Center

Salameh, Pascale R.; Barbour, Bernadette

2006-01-01

In the nursing profession it is necessary for a nurse to engage in continuing education to keep up to date. In Lebanon efforts to establish such continuing education are being made. However, a cross-sectional study conducted on a representative sample of 254 nurses found that 60 per cent attend an insufficient number of continuing education…

Tracking Drop-out Students in Palestinian Refugee Camps in Lebanon

ERIC Educational Resources Information Center

Al-Hroub, Anies

2015-01-01

This research paper examines the perceptions of students on the school drop-out problem in Palestinian refugee camps in Lebanon regarding (a) the social and economic causes associated with the phenomenon of school drop-out; (b) the educational policies and practices used in UNRWA schools and their relationship to student drop-out; and (c) the role…

Aging gracefully in Greater Beirut: are there any gender-based differences?

PubMed

Mitri, Rosy N; Boulos, Christa M; Adib, Salim M

2017-06-01

The implications of rapid aging of the Lebanese population are under-researched. No national studies have so far investigated the living conditions and the health status of urban Lebanese elderly across gender. This was a cross-sectional study involving 905 randomly selected community dwelling elderly aged ≥65 years living in Greater Beirut. Gender differences were assessed among participants who completed a standardized questionnaire on socio-demographic factors, nutritional, health, and functional characteristics. The sample included 533 men (59%) and 372 women (41%). Elderly were regrouped into 'younger elderly' (≤70 years), and 'older elderly' (>70 years) which represented respectively 44.3% and 55.7% of the total population. Women, regardless of their age, were less educated and more likely to live alone. Moreover, poor nutritional status, self-perceived health, absence of physical activity, comorbidity, polymedication and depression were significantly higher among women. 'Older elderly' women became significantly more functionally disabled compared with men of their age. This study evidenced that Lebanese elderly women were disadvantaged regarding their socio-economic, health and functional status. It is requested a nationwide effort to improve the socio-economic status and the health of Lebanese elderly, especially women. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Survey of Leafhopper Species in Almond Orchards Infected with Almond Witches'-Broom Phytoplasma in Lebanon

PubMed Central

Hammad, Efat Abou-Fakhr; El-Mohtar, Choaa; Abou-Jawdah, Yusuf

2011-01-01

Leafhoppers (Hemiptera: Auchenorrhyncha: Cicadellidae) account for more than 80% of all “Auchenorrhynchous” vectors that transmit phytoplasmas. The leafhopper populations in two almond witches'-broom phytoplasma (AlmWB) infected sites: Tanboureet (south of Lebanon) and Bourj El Yahoudieh (north of Lebanon) were surveyed using yellow sticky traps. The survey revealed that the most abundant species was Asymmetrasca decedens, which represented 82.4% of all the leafhoppers sampled. Potential phytoplasma vectors in members of the subfamilies Aphrodinae, Deltocephalinae, and Megophthalminae were present in very low numbers including: Aphrodes makarovi, Cicadulina bipunctella, Euscelidius mundus, Fieberiella macchiae, Allygus theryi, Circulifer haematoceps, Neoaliturus transversalis, and Megophthalmus scabripennis. Allygus theryi (Horváth) (Deltocephalinae) was reported for the first time in Lebanon. Nested PCR analysis and sequencing showed that Asymmetrasca decedens, Empoasca decipiens, Fieberiella macchiae, Euscelidius mundus, Thamnottetix seclusis, Balclutha sp., Lylatina inexpectata, Allygus sp., and Annoplotettix danutae were nine potential carriers of AlmWB phytoplasma. Although the detection of phytoplasmas in an insect does not prove a definite vector relationship, the technique is useful in narrowing the search for potential vectors. The importance of this information for management of AlmWB is discussed. PMID:21864154

Gender and sexual health in clinical practice in Lebanon

PubMed Central

El-Kak, F.; Jurdi, R.; Kaddour, A.; Zurayk, H.

2006-01-01

This study examines the readiness of obstetricians/gynecologists (Ob/Gyns) in Lebanon to provide sexual consultation, their degree of comfort when discussing issues of sexual health, and their attitudes regarding assessment, treatment, and referral. Data on these concepts were collected through face-to-face interviews with 286 randomly selected Ob/Gyns. Most Ob/Gyns reported feeling comfortable discussing sexuality during consultations, which they attributed much more to professional experience than to training. Most Ob/Gyns reported giving proper time for management of sexual health issues and follow-up, as these issues are brought up frequently by their women clients. However, results suggest that only one-third (31%) of Lebanese Ob/Gyns nearly always take the initiative in asking patients about their sexual health. Moreover, almost 45% of participating Ob/Gyns did not recognize a strong relationship between reproductive health and sexual functioning. Gender was not found to be an important predictor for any of the indicators measured in the present study. Ob/Gyns in Lebanon are significant consultants on various sexual issues, and they need better postgraduate training, continuing medical education, and access to medical congress resources on the topic of sexuality and its relationship to reproductive health. PMID:15548405

Acceptance of prenatal diagnosis for genetic disorders in Lebanon.

PubMed

Zahed, L; Nabulsi, M; Bou-Ghanim, M; Usta, I

1999-12-01

Acceptance of prenatal diagnosis and termination of pregnancy in the case of an affected fetus may vary from one country to another, depending on the health system, religious belief, cultural and educational backgrounds of the population. Following a previous study on couples at risk for a haemoglobin disorder in Lebanon, we have here interviewed 90 couples at risk for a variety of genetic disorders, in order to assess their acceptance of prenatal diagnosis and the variables that might influence their choice. Overall, 54 per cent of couples said they would request diagnosis in their next pregnancy, while 26 per cent were opposed to such a procedure. In 87. 5 per cent of cases, the reason for refusal was because of religious conviction against termination of pregnancy. Refusal of prenatal diagnosis was also related to a lower socio-economic background and poorer education. Only 12 per cent of couples were properly aware of their genetic risk. Therefore, for prevention of genetic disorders, the emphasis in countries such as Lebanon has probably to be placed on public awareness about genetic risks, the risks of consanguinity, availability of services, while taking into consideration the personal beliefs of the individuals. Copyright 1999 John Wiley & Sons, Ltd.

Smuggling as the “key to a combined market”: British American Tobacco in Lebanon

PubMed Central

Nakkash, R; Lee, K

2008-01-01

Objectives: To understand the strategy of British American Tobacco (BAT) and other transnational tobacco companies (TTCs) to gain access to the Lebanese market, which has remained relatively closed under monopoly ownership and political instability. Methods: Analysis of internal industry documents, local language secondary sources and industry publications. Results: TTCs have relied on legal and illegal channels to supply the Lebanese market since at least the 1970s. Available documents suggest smuggling has been an important component of BAT’s market entry strategy, transported in substantial quantities via middlemen for sale in Lebanon and neighbouring countries. TTCs took advantage of weak and unstable governance, resulting in uncertainty over the Regie’s legal status, and continued to supply the contraband trade despite appeals by the government to cease undermining its revenues. Since the end of the civil war in the early 1990s, continued uncertainty about the tobacco monopoly amid political instability has encouraged TTCs to seek a legal presence in the country, while continuing to achieve substantial sales through contraband. Conclusion: Evidence of the complicity of TTCs in cigarette smuggling extends to Lebanon and the Middle East where this trade has especially benefited from weak governance and chronic political instability. The regional nature of TTC strategy supports strong international cooperation under the Framework Convention on Tobacco Control to tackle the problem. PMID:18818226

Stakeholders' perspectives on the regulation and integration of complementary and alternative medicine products in Lebanon: a qualitative study

PubMed Central

2011-01-01

Background The regulation of the markets for Complementary and Alternative Medicine (CAM) products presents a global challenge. There is a dearth of studies that have examined or evaluated the regulatory policies of CAM products in the Eastern Mediterranean Region (EMR). We investigate the regulatory frameworks and the barriers for the proper regulation and integration of CAM products in Lebanon, as an example of an EMR country with a weak public infrastructure. Methods We utilized a qualitative study design involving a series of semi-structured interviews with stakeholders of the CAM market in Lebanon. Snowball sampling was used to identify interviewees; interviews continued until the "saturation" point was reached. A total of 16 interviews were carried out with decision makers, representatives of professional associations, academic researchers, CAM product importers, policy makers and a media representative. Interviews were transcribed and thematic analysis of scripts was carried out. Results There was a consensus among all stakeholders that the regulation of the market for CAM products in Lebanon needs to be strengthened. Thematic analysis identified a number of impediments jeopardizing the safety of public consumption and hindering the integration of CAM therapies into mainstream medicine; including: weak infrastructure, poor regulation, ineffective policies and politics, weak CAM awareness and sub-optimal coordination and cooperation among stakeholders. With respect to policy instruments, voluntary instruments (self regulation) were deemed ineffective by stakeholders due to poor awareness of both users and providers on safe use of CAM products. Stakeholders' rather recommended the adoption of a combination of mixed (enhancing public awareness and integration of CAM into medical and nursing curricula) and compulsory (stricter governmental regulation) policy instruments for the regulation of the market for CAM products. Conclusions The current status quo with

Perception of ageism and self-esteem among Lebanese elders at home and abroad.

PubMed

El Bcheraoui, Charbel; Adib, Salim; Chapuis-Lucciani, Nicole

2015-01-01

Discrimination against old age leads to depressive symptoms and lower self-esteem. This issue is not studied in the Lebanese society where a demographic transition is taking place and the population is aging. We assess the perception of age discrimination among Lebanese and its relation to self-esteem. We interviewed a convenience sample of 320 Lebanese elders (mean age 69.3 years +/- 6.2; 55% males) living in an urban setting (Beirut) and a rural setting (Ras-Baalbeck) a well as those who immigrated to Dakar using a preestablished questionnaire. Perception of age discrimination and socio-demographic information were collected; self-esteem was measured using the Toulouse scale. Results: More elders living in Beirut (OR = 9.7, 95% CI = 3.5-26.6) and Ras-Baalbeck (OR = 11.42, 95% CI = 3.95-33.1) perceived age-related discrimination than those living in Dakar. This perception was significantly associated to lower self-esteem (OR = 2.2, 95% CI = 1.3-3.6). Supporting emotionally vulnerable elders should be a target for policy makers in Lebanon. It is important to preserve a better quality of life for elders still playing a major role in families.

Influences of history, geography, and religion on genetic structure: the Maronites in Lebanon

PubMed Central

Haber, Marc; Platt, Daniel E; Badro, Danielle A; Xue, Yali; El-Sibai, Mirvat; Bonab, Maziar Ashrafian; Youhanna, Sonia C; Saade, Stephanie; Soria-Hernanz, David F; Royyuru, Ajay; Wells, R Spencer; Tyler-Smith, Chris; Zalloua, Pierre A; Adhikarla, Syama; Adler, Christina J; Balanovska, Elena; Balanovsky, Oleg; Bertranpetit, Jaume; Clarke, Andrew C; Comas, David; Cooper, Alan; Der Sarkissian, Clio S I; Dulik, Matthew C; Erasmus, Christoff J; Gaieski, Jill B; GaneshPrasad, ArunKumar; Haak, Wolfgang; Hobbs, Angela; Javed, Asif; Jin, Li; Kaplan, Matthew E; Li, Shilin; Martínez-Cruz, Begoña; Matisoo-Smith, Elizabeth A; Melé, Marta; Merchant, Nirav C; Mitchell, R John; Owings, Amanda C; Parida, Laxmi; Pitchappan, Ramasamy; Quintana-Murci, Lluis; Renfrew, Colin; Lacerda, Daniela R; Santos, Fabrício R; Schurr, Theodore G; Soodyall, Himla; Swamikrishnan, Pandikumar; Valampuri John, Kavitha; Santhakumari, Arun Varatharajan; Vieira, Pedro Paulo; Ziegle, Janet S

2011-01-01

Cultural expansions, including of religions, frequently leave genetic traces of differentiation and in-migration. These expansions may be driven by complex doctrinal differentiation, together with major population migrations and gene flow. The aim of this study was to explore the genetic signature of the establishment of religious communities in a region where some of the most influential religions originated, using the Y chromosome as an informative male-lineage marker. A total of 3139 samples were analyzed, including 647 Lebanese and Iranian samples newly genotyped for 28 binary markers and 19 short tandem repeats on the non-recombinant segment of the Y chromosome. Genetic organization was identified by geography and religion across Lebanon in the context of surrounding populations important in the expansions of the major sects of Lebanon, including Italy, Turkey, the Balkans, Syria, and Iran by employing principal component analysis, multidimensional scaling, and AMOVA. Timing of population differentiations was estimated using BATWING, in comparison with dates of historical religious events to determine if these differentiations could be caused by religious conversion, or rather, whether religious conversion was facilitated within already differentiated populations. Our analysis shows that the great religions in Lebanon were adopted within already distinguishable communities. Once religious affiliations were established, subsequent genetic signatures of the older differentiations were reinforced. Post-establishment differentiations are most plausibly explained by migrations of peoples seeking refuge to avoid the turmoil of major historical events. PMID:21119711

JPRS Report, Near East and South Asia, Lebanon

DTIC Science & Technology

1992-08-18

Tannus al- Naddaf . For the Greek Catholic seat in Zahlah: Ghassan Dib al- Naddaf , Ilyas Joseph Skaf. For the Sunni seat in Zahlah: Muhammad ’Ali al...Sunni seat in Mount Lebanon-al-Shuf: ’Ali Muhammad ’Ala’-al-Din. In a related matter, the name of Husayn Dib al- Naddaf was reported erroneously as a...candidate in the edition published two days ago. The candidate’s correct name is Ghassan Dib al- Naddaf for the Greek Catholic seat in Zahlah

Genomic attributes of extended-spectrum β-lactamase-producing Escherichia coli isolated from patients in Lebanon.

PubMed

Tokajian, Sima; Salloum, Tamara; Eisen, Jonathan A; Jospin, Guillaume; Farra, Anna; Mokhbat, Jacques E; Coil, David A

2017-03-01

Extended-spectrum β-lactamase-producing (ESBL) Escherichia coli are a public threat worldwide. This study aimed at analyzing the genomic and functional attributes of nine ESBLs taken from rectal swabs. Samples were isolated from patients admitted for gastrointestinal and urological procedures at the University Medical Center-Rizk Hospital (UMCRH) in Lebanon. Illumina paired-end libraries were prepared and sequenced. The isolates were distributed into five lineages: ST131, ST648, ST405, ST73 and ST38, and harbored bla OXA-1 , bla TEM-1B , bla TEM-1C and aac(6')Ib-cr. ST131 isolates were carriers of stx2 converting I phage. This is the first comprehensive genomic analysis performed on ESBLs in Lebanon.

ATTITUDES TOWARDS AND PRACTICE OF SEXUALITY AMONG UNIVERSITY STUDENTS IN LEBANON.

PubMed

Salameh, P; Zeenny, R; Salamé, J; Waked, M; Barbour, B; Zeidan, N; Baldi, I

2016-03-01

Sexuality is still a taboo in Middle Eastern countries, and Lebanon is no exception. This study's objective was to evaluate attitudes towards sexuality and its practice among university students in Lebanon and assess their respective correlates. The cross-sectional study was carried out among students selected from seventeen universities across Lebanon. The participants received a self-administered standardized questionnaire that assessed their attitudes towards sexuality. It included questions on socio-demographic factors, risk-taking, risky behaviours and sexuality-related questions. Among 3384 students, 2700 (79.8%) answered the questions on sexuality. Around 15% had engaged in sexual activity, while 20% were regularly sexually active. Among males, 34.8% had never had sexual activity, 29.9% had tried it and 35.3% were regularly sexually active. Among females the results were respectively 85.1%, 5.3% and 9.6% (p<0.001). Only 36% regularly used condoms during their relationships. A liberal attitude towards sex, male sex, motives for risky behaviours, current cigarette smoking and problematic alcohol consumption were associated with sexual activity. Realizing that risky behaviours are dangerous, health concerns related to sexual relationships and a liberal attitude towards sex were associated with regular condom use. However, being bothered by condoms and female sex were inversely associated with condom use. Finally, participants who had motives for, and those who felt excited about risky behaviours, and those reporting current cigarette and waterpipe smoking and problematic alcohol consumption (β=0.600; p=0.002) embraced a more liberal attitude towards sex. Conversely, females (β=-7.58; p<0.001) and individuals who considered risky behaviours as dangerous reported an unfavourable attitude towards sexuality. A substantial proportion of Lebanese university students have regular sexual activity, but a low percentage use condoms for protection. Interventions are

A Cross-Cultural Comparison of Knowledge and Stigma Associated with Autism Spectrum Disorder among College Students in Lebanon and the United States

ERIC Educational Resources Information Center

Obeid, Rita; Daou, Nidal; DeNigris, Danielle; Shane-Simpson, Christina; Brooks, Patricia J.; Gillespie-Lynch, Kristen

2015-01-01

Although misconceptions associated with ASD are apparent worldwide, they may differ across cultures. This study compares knowledge and stigma associated with ASD in a country with limited autism resources, Lebanon, and a country with substantial autism resources, the United States (US). College students in the US (N = 346) and Lebanon (N = 329)…

Burden and treatment patterns of invasive fungal infections in hospitalized patients in the Middle East: real-world data from Saudi Arabia and Lebanon

PubMed Central

Alothman, Adel F; Althaqafi, Abdulhakeem O; Matar, Madonna J; Moghnieh, Rima; Alenazi, Thamer H; Farahat, Fayssal M; Corman, Shelby; Solem, Caitlyn T; Raghubir, Nirvana; Macahilig, Cynthia; Charbonneau, Claudie; Stephens, Jennifer M

2017-01-01

Objectives The objective of this study was to document the burden and treatment patterns associated with invasive fungal infections (IFIs) due to Candida and Aspergillus species in Saudi Arabia and Lebanon. Methods A retrospective chart review study was conducted using data recorded from 2011 to 2012 from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of IFI due to Candida or Aspergillus, which was culture proven or suspected based on clinical criteria. Hospital data were abstracted for a random sample of patients to capture demographics, treatment patterns, hospital resource utilization, and clinical outcomes. Descriptive results were reported. Results Five hospitals participated and provided data on 102 patients with IFI (51 from Lebanon and 51 from Saudi Arabia). The mean age of the patients was 55 years, and 55% were males. Comorbidities included diabetes (41%), coronary artery disease (24%), leukemia (19%), moderate-to-severe renal disease (16%), congestive heart failure (15%), and chronic obstructive pulmonary disease (15%). Twenty percent of patients received corticosteroids prior to admission and 26% had received chemotherapy in the past 90 days. Inpatient mortality was 42%, and the mean hospital length of stay was 32.4±28.6 days. Fifty-five percent of patients required intensive care unit admission (17.2±14.1 days), 37% required mechanical ventilation (13.7±13.2 days), and 11% required dialysis (14.6±14.2 days). The most commonly used first-line antifungal was fluconazole. Conclusion Patients with IFI in Saudi Arabia and Lebanon frequently have multiple medical comorbidities and may not have traditionally observed IFI risk factors. Efforts to increase use of rapid diagnostic tests and appropriate antifungal treatments may impact the substantial mortality and high length of stay observed in these patients. PMID:28203095

Maternal smoking: determinants and associated morbidity in two areas in Lebanon.

PubMed

Bachir, Rana; Chaaya, Monique

2008-05-01

This study assessed the factors related to smoking during pregnancy in two areas in Lebanon, and the association of smoking to selected maternal and newborn health related factors. This was a secondary analysis of data on 538 women who delivered in nine hospitals in two areas in Lebanon. Women were interviewed about their smoking practices, and on demographic and psychosocial variables. 396 women were followed up and re-interviewed about their smoking status, and the mother's and baby's health after delivery. Smoking during pregnancy included both cigarettes and narghile smoking. About 25.7% of women were smoking some kind of tobacco during pregnancy. Older women, Muslim women, women with poor education, those who had financial difficulty, nervousness, lower support, and delay in seeking prenatal care were more likely to smoke during pregnancy. Women who smoked during pregnancy were more likely to have a low birth weight baby and to stop breastfeeding. It is important to address smoking among women in general, and not only during pregnancy. We discuss the role of public and private sectors in smoking cessation and interventions.

Substance abuse In Middle Eastern adolescents living in two different countries: spiritual, cultural, family and personal factors.

PubMed

Badr, Lina Kurdahi; Taha, Asma; Dee, Vivien

2014-08-01

It is estimated that the percentage of students using illicit substances by sixth grade has tripled over the last decade not only in developed countries but in developing countries as well probably due to the transition to a more Western society. Although much has been done to understand the mechanisms underlying substance abuse, few studies have been conducted with minority ethnic and religious groups such as Middle Eastern Youth. The primary goal of this study was to determine whether there are differences in factors contributing to substance abuse in adolescents from Lebanon versus the U.S.A. and to decipher the role of spirituality, religion, and culture among other factors that may influence substance abuse. A correlational cross-sectional design was used with adolescents living in two different countries: Los Angeles, California and Beirut, Lebanon. Muslim adolescents had significantly less rates of alcohol and substance use than Christians in both Lebanon and Los Angeles. More years lived in the U.S.A. increases the likelihood of abuse for both Muslims and Christians. Attachment to God and family was negatively associated with substance abuse. These results among others facilitate a better understanding of the influence of culture, religion, family and personal factors on substance abuse. Culturally sensitive interventions could benefit from the findings of this pilot study.

Focus Groups Investigating Mental Health Attitudes and Beliefs of Parents and Teachers in South Lebanon: Are They Culturally Determined?

PubMed

Doumit, Myrna A A; Farhood, Laila F; Hamady, Carmen

2018-05-01

The wars that Lebanon had endured led to a devastating number of deaths, injuries, and displacements. Such tragedies have detrimentally affected its civilians psychologically. To identify knowledge, attitudes, and practices of teachers and parents concerning child/adolescent mental health. Using purposeful sampling, five focus groups were conducted with teachers and parents of students from elementary, middle, and secondary levels in two private hub schools in South Lebanon. A total of 27 teachers and 18 parents participated separately in focus groups. Three themes emerged: (a) Mental health care is a priority for overall health, (b) Mental illness is a cultural taboo, and (c) There is a need for better education and cultural understanding about mental health. This is the first study in Lebanon directly targeted at parents' and teachers' mental health concerns. Such findings will add to transcultural nursing knowledge about the importance of mental health care.

Kidney cancer in Lebanon: a specific histological distribution?

PubMed

Khafaja, Sarah; Kourie, Hampig Raphael; Matar, Dany; Sader-Ghorra, Claude; Kattan, Joseph

2015-01-01

Kidney cancer is the third most frequent urologic cancer in Lebanon after prostate and bladder cancer, accounting for 1.5% of all diagnosed cancers. In this paper, we report the histologic characteristics and distribution of kidney cancer, never described in Lebanon or the Middle East. Pathology results of operated kidney cancer were collected during a two year period (2010-2011) from two different Lebanese hospitals (Hotel-Dieu de France University Hospital and Saint Joseph Hospital). A total of 124 reports were reviewed and analyzed according to WHO classification of 2009. The 124 patients diagnosed with kidney cancer had a median age of 62.4 [18-86], 75% being men and 25% women. Some 71 % of the lesions were renal cell carcinoma (RCC), 25.8% had a urothelial histology, 1.6% were lymphomas and 1.6% were metastases to the kidney. Patients having RCC had a median age of 60.3 [18-85], 77.3% were men and 22.7% women. Of the RCCs, 59.1% were clear cell carcinoma, 22.7% papillary, 11.4% chromophobic, 3.4% rom the collecting ducts of Bellini and 3.4% were not otherwise classified. Histological distribution of Lebanese kidney cancer seems unusual when compared to the literature. The percentage of urothelial renal pelvis tumors is strikingly high. Moreover, clear cell carcinoma accounts for only 59.1% of RCCS in contrast to the 75% described elsewhere, while papillary carcinoma represents more than 22.7% compared to 10%.

Design and implementation of a hospital information system for the Palestine Red Crescent Society in Lebanon.

PubMed

Rossi, L; Materia, E; Hourani, A; Yousef, H; Racalbuto, V; Venier, C; Osman, M

2009-01-01

A case-mix hospital information system was designed and implemented in Palestine Red Crescent Society hospitals in order to support the network of Palestinian hospitals in Lebanon and to improve the health of refugees in the country. The system is based on routine collection of essential administrative and clinical data for each episode of hospitalization, relying on internationally accepted diagnostic codes. It is a computerized, user-friendly information system that is a stepping-stone towards better hospital management and evaluation of quality of care. It is also a useful model for the development of hospital information systems in Lebanon and in the Near East.

Fracture liaison service: report on the first successful experience from the Middle East.

PubMed

Bachour, Falah; Rizkallah, Maroun; Sebaaly, Amer; Barakat, Angelique; Razzouk, Hiba; El Hage, Rawad; Nasr, Riad; El Khoury, Mirvat; Maalouf, Ghassan

2017-09-19

This study aims to assess for the first time in the Middle East, the clinical benefits of an FLS model established in a hospital in Beirut, Lebanon. It shows a significant 54% relative risk reduction in re-fracture incidence, confirming the patient-oriented benefit of diffusing this system in the Middle East region. Few hospitals in Lebanon applied Fracture Liaison Service (FLS) program. A type A FLS is established at Bellevue hospital in Beirut in July 2013. This study aims to assess its clinical benefits and efficacy. Patients aged 50 years and above presenting to our hospital with minimal trauma fracture from July 2012 till June 2014 are enrolled. These are divided into two groups, before (group A) and after (group B) FLS implementation. Both groups are compared for re-fracture incidence, bone health assessment; osteoporosis treatment maintenance, and death in a 2-year follow-up. Nighty-eight patient composing group B are compared to 100 patients in the group A. Around 65% of patients in the FLS group underwent Dexa osteodensitometry following their fracture compared to 28% in the comparator group (p < 0.001). About 54% of patients in group B maintained osteoporosis treatment compared to 26% in group A (p < 0.001). Sixteen percent of patients died in the FLS study group compared to 16% of patients in the comparator group (p = 0.950). A second fracture, happened in 8.2% of patients in the FLS study group compared to 18% of the patients in the comparator group p = 0.004. Number needed to treat reached 10.2 patients. The statistical analysis results go with the overwhelming evidence concerning FLS importance in promoting bone health assessment and osteoporosis treatment in fracture patients. It also confirms the clinical value and the patient-oriented benefit of an implementation of such a system.

Total lead concentration in new decorative enamel paints in Lebanon, Paraguay and Russia.

PubMed

Clark, C Scott; Speranskaya, Olga; Brosche, Sara; Gonzalez, Hebe; Solis, Daniela; Kodeih, Naji; Roda, Sandy; Lind, Caroline

2015-04-01

Lead concentrations in new enamel decorative paints were determined in three countries in different areas of the world where data were not previously available. The average total lead concentration of the enamel decorative paints purchased in Lebanon, Paraguay and Russia was 24,500ppm (ppm, dry weight), more than 270 times the current limit of 90ppm in Canada and in the United States. Sixty-three percent of these paints contained concentrations greater than 90ppm. Fifty-nine percent contained concentrations greater than 600ppm, the current limit in some countries. The maximum concentrations found were 236,000ppm in Lebanon, 169,000ppm in Paraguay and 52,900ppm in Russia. An average of 29% of the samples contained exceedingly high lead concentrations, >=10,000ppm. Five brands of paint were sampled in each of Lebanon and Paraguay and seven in Russia. Three colors from each brand were analyzed. For five of the six samples of the two brands in Lebanon with affiliations outside the country, the lead concentrations ranged from 1360ppm to 135,000ppm. In Lebanon the maximum concentration in the Egypt-affiliated brand (Sipes) was 135,000ppm and the maximum for the USA-affiliated brand (Dutch Boy) was 32,400ppm. Lead was not detected in any paints from the three of the four brands of paint purchased in Paraguay that had headquarters/affiliations in other countries (Brazil-Coralit), Germany (Suvinil) and USA (Novacor)). Two of the three paints from each of the other Paraguay brands contained high levels of lead with the maximum concentrations of 108,000 and 168,000ppm; one of these brands was manufactured under a license from ICI in the Netherlands. All of the paints purchased in Russia were from Russian brands and were manufactured in Russia. All three paints from one brand contained below detection levels of lead. The maximum levels of lead in the other six brands in Russia ranged from 3230 to 52,900ppm. The two brands with the highest lead concentration, TEKS and LAKRA

Self-Reported Factors That Influence Choice of College-Bound Students in Lebanon

ERIC Educational Resources Information Center

Abou-Nassif, Samir M.

2011-01-01

The number of students entering universities in Lebanon has steadily increased in the past ten years. This trend makes it imperative that the different stakeholders, like students, parents, schools, universities, and education officials, understand what influences the decision of a student to choose a specific college. Understanding these factors…

Social Networks and Health Among Older Adults in Lebanon: The Mediating Role of Support and Trust

PubMed Central

Antonucci, Toni C.; Ajrouch, Kristine J.; Abdulrahim, Sawsan

2015-01-01

Objectives. Despite a growing body of literature documenting the influence of social networks on health, less is known in other parts of the world. The current study investigates this link by clustering characteristics of network members nominated by older adults in Lebanon. We then identify the degree to which various types of people exist within the networks. This study further examines how network composition as measured by the proportion of each type (i.e., type proportions) is related to health; and the mediating role of positive support and trust in this process. Method. Data are from the Family Ties and Aging Study (2009). Respondents aged ≥60 were selected (N = 195) for analysis. Results. Three types of people within the networks were identified: Geographically Distant Male Youth, Geographically Close/Emotionally Distant Family, and Close Family. Having more Geographically Distant Male Youth in one’s network was associated with health limitations, whereas more Close Family was associated with no health limitations. Positive support mediated the link between type proportions and health limitations, whereas trust mediated the link between type proportions and depressive symptoms. Discussion. Results document links between the social networks and health of older adults in Lebanon within the context of ongoing demographic transitions. PMID:25324295

Aero-medical evacuation from the second Israel-Lebanon war: a descriptive study.

PubMed

Schwartz, Dagan; Resheff, Avram; Geftler, Alex; Weiss, Aviram; Birenbaum, Erez; Lavon, Ophir

2009-05-01

The second Lebanon war started as a limited operation and progressed to a large-scale campaign. Most of the fighting took place in mountainous villages and small towns inhabited with civilians. The Israeli Defense Forces (IDF) Airborne rescue and evacuation unit is charged with air evacuation of soldiers and civilians in times of peace, limited conflict, and war. We describe this unit's activities in the second Lebanon war, analyzing injury, treatment, and evacuation characteristics Data were collected from flight medical reports, debriefings of aero-medical team members (usually immediately upon return from mission), ground units medical reports and debriefings, and hospital records. 725 IDF soldiers were injured and 117 killed either in Lebanon or near the Israeli-Lebanese border during the war. A total of 338 (46%) were evacuated in 95 airlifts (averaging 4.5 evacuees per airlift) from the fighting zones or the border. Air evacuation used dedicated helicopters with advanced care capacities, and most victims were evacuated straight from the battlefield, as the fighting was ensuing. Many wounded first received advanced medical care upon the arrival of the aero-medical teams. In military operations within civilian populated areas with threats to ground transport, air evacuation can sometimes be the only readily available option. Providing timely ground advanced medical care proved difficult in many instances. Thus, for many, the rescue helicopter was the first point of access to such care. Aero-medical aircrafts and personnel faced threats from gunfire and missiles, causing both delays in evacuation and a high average number of evacuees per airlift. This article proposes ways of coping with situations in which similar rescue and evacuation problems are likely.

The effect of taxation on tobacco consumption and public revenues in Lebanon.

PubMed

Salti, Nisreen; Chaaban, Jad; Nakkash, Rima; Alaouie, Hala

2015-01-01

Tobacco consumption rates in Lebanon are among the highest worldwide. The country ratified the Framework Convention on Tobacco Control in 2005. A law was passed in 2011 which regulates smoking in closed public spaces, bans advertising, and stipulates larger warnings. Despite international evidence confirming that increasing taxation on tobacco products lowers tobacco consumption, no such policy has yet been adopted: a cigarette pack costs on average US$1.50. To date no studies in Lebanon have addressed the welfare and public finance effects of increasing taxes on tobacco products. Using the 2005 national survey of household living conditions, we estimate an almost ideal demand system to generate price elasticities of demand for tobacco. Using estimated elasticities and a conservative scenario for expected smuggling, we simulate the consumption and tax revenue effects of a change in the price of tobacco under various tax schemes. Increasing taxes on all tobacco products so as to double the price of imported cigarettes would lower their consumption by 7% and consumption of domestically produced cigarettes by over 90%. Young adults (ages 15-30) are more sensitive: consumption would drop by 9% for imported cigarettes and by 100% for domestic cigarettes. Government revenues would increase by approximately 52%. The estimated elasticities indicate that an increase in taxes on all tobacco products would lead to a reduction in consumption and an increase in government revenue. Evidence from Lebanon on the effectiveness of increased taxation may help initiate national debate on the need to raise taxes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A Cross-Cultural Comparison of Knowledge and Stigma Associated with Autism Spectrum Disorder Among College Students in Lebanon and the United States.

PubMed

Obeid, Rita; Daou, Nidal; DeNigris, Danielle; Shane-Simpson, Christina; Brooks, Patricia J; Gillespie-Lynch, Kristen

2015-11-01

Although misconceptions associated with ASD are apparent worldwide, they may differ across cultures. This study compares knowledge and stigma associated with ASD in a country with limited autism resources, Lebanon, and a country with substantial autism resources, the United States (US). College students in the US (N = 346) and Lebanon (N = 329) completed assessments of knowledge and stigma associated with ASD before and after an online ASD training. Although students in the US exhibited higher overall knowledge and lower stigma towards ASD, certain misconceptions were more apparent in the US than in Lebanon. Participation in the training was associated with decreased stigma and increased knowledge in both countries. Thus, online training may be useful for increasing understanding about ASD internationally.

The Sexual Health of Women in Lebanon: Are There Differences by Sexual Orientation?

PubMed

Gereige, Jessica D; Zhang, Li; Boehmer, Ulrike

2018-01-01

From studies conducted in Western countries (United States, United Kingdom, and Australia), we know that the sexual health of sexual minority women (SMW) differs in key ways from that of heterosexual women (HSW). To date, the sexual health of SMW living in the Middle East and North Africa region has not been studied. The purpose of this study was to compare the sexual health of SMW and HSW living in Lebanon. SMW and HSW living in Lebanon (N = 95) completed an anonymous, self-administered survey. SMW's risk perceptions and health promoting and sexual behaviors were compared to those of HSW. We examined differences by sexual orientation by using t tests and Fisher's exact tests. The 45 SMW and 50 HSW had similar demographic characteristics. Significantly more SMW had heard of human papillomavirus, but only 22% of women from both groups knew of its association with abnormal Papanicolaou tests. Cervical cancer screening rates were similar in SMW and HSW, although remarkably low (42%) compared with rates in Western countries. Significantly more SMW (18%) reported difficulty with access to care than HSW (0%). Forty-four percent of SMW reported discomfort in disclosing their sexual orientation to their healthcare provider and 61% reported that healthcare providers lacked sensitivity toward lesbian, gay, bisexual, and transgender needs. Unwanted sexual contact occurred more frequently in SMW (53%) than HSW (23%). The sexual health of women is affected by sociocultural factors. SMW living in Lebanon have unique health needs that should be addressed within their sociocultural context.

The use and abuse of female domestic workers from Sri Lanka in Lebanon.

PubMed

Abu-habib, L

1998-03-01

Women who migrate from Sri Lanka to become domestic workers in Lebanon face gender, class, and race discrimination that often results in abuse, yet the predicament of these women is largely ignored by local and international humanitarian and human rights agencies. Public consciousness about the plight of Asian domestic workers in the Persian Gulf region was raised in 1990 when domestic workers were repatriated in the wake of the Gulf War. In Lebanon, nearly half of the work permits granted to foreigners in 1997 were to women from Sri Lanka. This migration began in the 1970s and is sanctioned by the Sri Lanka government because of the economic benefits accruing from wages sent home by these women. Lebanese families procure domestic positions through an employment agency that arranges transportation and entry for the Sri Lankan women. These women, especially minors, often have to bribe Sri Lankan government agents to falsify travel documents. Upon arrival in Lebanon, the women have no support systems or job security. Most employment contracts last 3 years and pay $100/month with no benefits or protection from local labor laws. Domestic workers are made vulnerable by employers who withhold salaries or travel documents. Upon return to Sri Lanka, former domestic workers face social disapproval and marital problems. To redress this situation, the governments of sending and receiving countries must take action to protect female migrant workers, and nongovernmental organizations must publicize the plight of these women and take action to address the abuses they face.

Intention to stay of nurses in current posts in difficult-to-staff areas of Yemen, Jordan, Lebanon and Qatar: a cross-sectional study.

PubMed

El-Jardali, Fadi; Murray, Susan F; Dimassi, Hani; Jamal, Diana; Abualrub, Raeda; Al-Surimi, Khaled; Clinton, Michael; Dumit, Nuhad Y

2013-11-01

The nursing workforce shortages in difficult-to-staff areas have implications not only for quality of care but also for population health outcomes. An understanding of attrition and of retention is important to inform policies on the nursing workforce. This paper draws on questionnaire survey data from nurses working in difficult-to-staff areas in four countries in the Eastern Mediterranean Region (Yemen, Jordan, Lebanon and Qatar). It aims to identify the specific and common factors associated with nurses' intention to stay in their current post for the coming 1-3 years in three countries with an internally trained nursing workforce and in a fourth where the workforce is externally recruited. Nurses working in 'difficult to staff' areas in Yemen, Jordan, Lebanon and Qatar were surveyed. A conceptual model composed of 6 dimensions based on that of the World Health Organization was constructed with 'intent to stay' (Career Decisions) as the main outcome. Regression models were constructed for each of the dimensions in the conceptual model with 'intent to stay' as the dependent variable for each of the study countries. Subsequently, a collective model that combined Lebanon, Jordan and Yemen was constructed to identify common factors that are associated with intent to stay. Factors associated with intent to stay differed for study countries. Marriage was positively associated with intent to stay in Lebanon and Jordan whereas years of experience were positively significant for Lebanon and Yemen. Shorter commuting time was significantly associated with intent to stay in Jordan whereas a preference for village life was significant for Lebanon. Job satisfaction was significantly associated with intent to stay in all study countries. Nurses in Lebanon, Jordan and Qatar who indicated that they would choose nursing if they had the opportunity to choose a career all over again were significantly more likely to intend to stay in their current post. Studies of nurses working in

Real-life Experience for Integration of PET-CT in the Treatment of Hodgkin Lymphoma in Lebanon.

PubMed

Sakr, Riwa; Massoud, Marcel; Kerbage, Fouad; Rached, Layale; Zeghondy, Jean; Akoury, Elie; Nasr, Fady; Chahine, Georges

2017-07-01

Hodgkin lymphoma (HL) is a highly curable disease; < 80% of patients will achieve long-term survival. Positron emission tomography-computed tomography (PET-CT) has played a major role in the evaluation of both disease staging and response and has become an essential component in tailoring patients' treatment. We report the effect of integrating PET-CT into the management of HL in Lebanon. We analyzed the data regarding the usage of PET-CT at diagnosis, during treatment (interim PET), and at the end of treatment. We also analyzed the PET-CT findings from 2009 to 2015. The first PET-CT system was introduced in Lebanon in April 2002 but was not used for the evaluation of HL. Early in 2009, we started to incorporate PET-CT into the treatment of HL. By the end of 2009, 70% of patients were undergoing PET-CT at diagnosis and at the end of treatment. This proportion remained constant until 2013, when an increase occurred, with ≤ 94% of patients undergoing PET-CT at diagnosis. The usage of CT at diagnosis decreased significantly from 70% before 2009 to 52% after 2015. In contrast, CT usage at the end of treatment has fluctuated from 10% in 2009 to 0% in 2012, 2013, and 2014 and 11.76% in 2015. Functional imaging techniques are increasing in popularity compared with anatomic imaging. The usage of PET-CT has emerged as a highly valuable staging and follow-up method in the treatment of HL 8 years after the introduction of PET in Lebanon. PET was used first to improve the staging, then to evaluate the treatment response, and, recently, to tailor therapy according to the response. Copyright © 2017 Elsevier Inc. All rights reserved.

Has the Educational System in Lebanon Contributed to the Growing Sectarian Divisions?

ERIC Educational Resources Information Center

Baytiyeh, Hoda

2017-01-01

The sectarian structure of the Lebanese political system has contributed to periods of sectarian violence and wars over the past four decades. This article highlights the origin of sectarianism in Lebanon and discusses how public and religious schools in the country have reinforced sectarian divisions in the Lebanese society. This is a conceptual…

Are women engineers in Lebanon prepared for the challenges of an engineering profession?

NASA Astrophysics Data System (ADS)

Baytiyeh, Hoda

2013-08-01

This study investigates the status of women engineers in the Middle East, considering women engineers in Lebanon as a case study. The author investigated the following questions: What are the influences behind females' decisions to choose engineering as their major course of study? What are the motives behind this decision? What are the perceptions of females regarding the essential skills for a successful engineering career? An online survey consisting of Likert-scale items was completed by 327 female engineers who graduated from universities in Lebanon and now work in various locations around the world. A genuine interest in the field appeared to be the main influence in the participants' decisions to choose engineering profession. The potential for professional growth was the leading motivator for choosing engineering. Although participants reported that they possessed adequate theoretical knowledge and technical skills before graduation, in the actual practice of engineering, they noted weaknesses in creativity and innovation.

Teacher Evaluation Processes in Lebanon's Catholic Schools: A Problem-Based Learning Project

ERIC Educational Resources Information Center

Wakim, Antonio Joseph

2013-01-01

Teacher effectiveness has been on the decline in Catholic schools in Lebanon due to many factors, including, the lack of efficiency and competency of teachers and the lack of professional development opportunities. Much of this is due to the absence of an effective teacher evaluation system. As a result, many unqualified teachers are becoming…

Burden of methicillin-resistant Staphylococcus aureus pneumonia among hospitalized patients in Lebanon and Saudi Arabia.

PubMed

Althaqafi, Abdulhakeem O; Matar, Madonna J; Moghnieh, Rima; Alothman, Adel F; Alenazi, Thamer H; Farahat, Fayssal; Corman, Shelby; Solem, Caitlyn T; Raghubir, Nirvana; Macahilig, Cynthia; Haider, Seema; Stephens, Jennifer M

2017-01-01

The objective of this study is to describe the real-world treatment patterns and burden of suspected or confirmed methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in Saudi Arabia and Lebanon. A retrospective chart review study evaluated 2011-2012 data from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of MRSA pneumonia, which was culture proven or suspected based on clinical criteria. Hospital data were abstracted for a random sample of patients to capture demographics (eg, age and comorbidities), treatment patterns (eg, timing and use of antimicrobials), hospital resource utilization (eg, length of stay), and clinical outcomes (eg, clinical status at discharge and mortality). Descriptive results were reported using frequencies or proportions for categorical variables and mean and standard deviation for continuous variables. Chart-level data were collected for 93 patients with MRSA pneumonia, 50 in Saudi Arabia and 43 in Lebanon. The average age of the patients was 56 years, and 60% were male. The most common comorbidities were diabetes (39%), congestive heart failure (30%), coronary artery disease (29%), and chronic obstructive pulmonary disease (28%). Patients most frequently had positive cultures from pulmonary (87%) and blood (27%) samples. All isolates were sensitive to vancomycin, teicoplanin, and linezolid, and only one-third of the isolates tested were sensitive to ciprofloxacin. Beta-lactams (inactive therapy for MRSA) were prescribed 21% of the time across all lines of therapy, with 42% of patients receiving first-line beta-lactams. Fifteen percent of patients did not receive any antibiotics that were considered to be MRSA active. The mean hospital length of stay was 32 days, and in-hospital mortality was 30%. The treatment for MRSA pneumonia in Saudi Arabia and Lebanon may be suboptimal with inactive therapy prescribed a substantial proportion of the time. The information gathered

Distributed and localized horizontal tectonic deformation as inferred from drainage network geometry and topology: A case study from Lebanon

NASA Astrophysics Data System (ADS)

Goren, Liran; Castelltort, Sébastien; Klinger, Yann

2016-04-01

Partitioning of horizontal deformation between localized and distributed modes in regions of oblique tectonic convergence is, in many cases, hard to quantify. As a case study, we consider the Dead Sea Fault System that changes its orientation across Lebanon and forms a restraining bend. The oblique deformation along the Lebanese restraining bend is characterized by a complex suite of tectonic structures, among which, the Yammouneh fault, is believed to be the main strand that relays deformation from the southern section to the northern section of the Dead Sea Fault System. However, uncertainties regarding slip rates along the Yammouneh fault and strain partitioning in Lebanon still prevail. In the current work we use the geometry and topology of river basins together with numerical modeling to evaluate modes and rates of the horizontal deformation in Mount Lebanon that is associated with the Arabia-Sinai relative plate motion. We focus on river basins that drain Mount Lebanon to the Mediterranean and originate close to the Yammouneh fault. We quantify a systematic counterclockwise rotation of these basins and evaluate drainage area disequilibrium using an application of the χ mapping technique, which aims at estimating the degree of geometrical and topological disequilibrium in river networks. The analysis indicates a systematic spatial pattern whereby tributaries of the rotated basins appear to experience drainage area loss or gain with respect to channel length. A kinematic model that is informed by river basin geometry reveals that since the late Miocene, about a quarter of the relative plate motion parallel to the plate boundary has been distributed along a wide band of deformation to the west of the Yammouneh fault. Taken together with previous, shorter-term estimates, the model indicates little variation of slip rate along the Yammouneh fault since the late Miocene. Kinematic model results are compatible with late Miocene paleomagnetic rotations in western

Burns in the Lebanon War 1982: "the blow and the cure".

PubMed

Eldad, A; Torem, M

1990-03-01

There were 70% more burns in the October 1973 war than in the Six Day War of 1967. This increase caused great concern and emphasized the need for better personal and crew protection against burns. Some of these measures were already implemented by the outbreak of the 1982 war in Lebanon. Analysis of the burn injuries of this war is the subject of this short report.

Students' Perceptions of Higher Education Quality at Notre Dame University-Louaize in Lebanon

ERIC Educational Resources Information Center

Saad, Nada

2013-01-01

Understanding how students perceive quality of education and identifying the most important quality factors from their perspectives represent a first stage for quality improvement and customer satisfaction in higher education. The purpose of this project was to investigate how higher education students in Lebanon perceived the concept of quality…

Nationalist Narratives, Boundaries and Social Inclusion/Exclusion in Palestinian Camps in South Lebanon

ERIC Educational Resources Information Center

Fincham, Kathleen

2012-01-01

This article explores how in the contexts of exile and statelessness and in the absence of Palestinian institutions, such as schools, Palestinian youth in south Lebanon construct their identities through nationalist narratives of shared history, kinship, culture and religion. Although these narratives help to construct shared notions of…

On Progress of Mass Tertiary Education: Case of Lebanon, Kenya and Oman

ERIC Educational Resources Information Center

Liu, Zhimin; Mutinda, Gladys

2016-01-01

Mass higher education is a huge force to be reckoned with and its existence, already in the expansion of tertiary institutions is undeniable. This study will focus on three countries: Lebanon, Kenya and Oman. The purpose of this study is to evaluate mass tertiary education progress in these countries. It will synthesize data results of gross…

The Employment Situation of People with Disabilities in Lebanon: Challenges and Opportunities

ERIC Educational Resources Information Center

Wehbi, Samantha; El-Lahib, Y.

2007-01-01

This article presents the findings of a study on the employment situation of people with disabilities in a rural region in Lebanon. The study was conducted as one of the activities of a community development project that saw the establishment of a job centre for people with disabilities. The majority of the study's 200 participants were…

Assessing Lebanon's wildfire potential in association with current and future climatic conditions

Treesearch

George H. Mitri; Mireille G. Jazi; David McWethy

2015-01-01

The increasing occurrence and extent of large-scale wildfires in the Mediterranean have been linked to extended periods of warm and dry weather. We set out to assess Lebanon's wildfire potential in association with current and future climatic conditions. The Keetch-Byram Drought Index (KBDI) was the primary climate variable used in our evaluation of climate/fire...

Assessment of reproductive health and violence against women among displaced Syrians in Lebanon.

PubMed

Reese Masterson, Amelia; Usta, Jinan; Gupta, Jhumka; Ettinger, Adrienne S

2014-02-20

The current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population. We conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes. We interviewed 452 Syrian refugee women ages 18-45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n = 74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health. This study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence.

Dealing with pollution from conflict: Analysis of discourses around the 2006 Lebanon oil spill.

PubMed

Takshe, Aseel A; Huby, Meg; Frantzi, Sofia; Lovett, Jon C

2010-01-01

In July 2006 a war between Lebanon and Israel resulted in severe environmental damage in Lebanon from Israeli bombing raids. An attack on the Lebanese Jiyyeh Power Plant released 15,000 tons of heavy fuel oil into the Mediterranean Sea. Remarkably, a clean-up operation was effected despite a continued state of war and lack of capacity in the Lebanese government. Civil society environmentalists played a key role in dealing with the pollution and complying with pollution-control legislation. In this study we use Q-methodology to analyse discourses on the effectiveness of pollution legislation during times of conflict using the Jiyyeh oil spill as an example. We interviewed 35 people from eight different stakeholder groups involved in environmental issues. Five distinct discourses were generated covering compensation schemes, need for new legislation, role of stakeholders during wartime and strengthening government ministries. Copyright 2009 Elsevier Ltd. All rights reserved.

Developing an interministerial substance use response strategy for Lebanon: process, content and lessons learned.

PubMed

Hajal, Sandra; Kik, Nour; El Chammay, Rabih; Ammar, Walid

2017-05-01

Evidence on substance use in Lebanon shows an increase in usage, limited availability and accessibility to evidence-based services, and high level of stigma and discrimination. In line with the "Mental Health and Substance Use Strategy for Lebanon 2015-2020", the Ministry of Public Health initiated the process of developing a strategy focused on substance use response to address these challenges in collaboration with the Ministries of Education and Higher Education, Interior and Municipalities, Justice and Social Affairs. The result of this process was a strategy launched jointly by the ministries including six domains of action covering the whole spectrum of substance use response with strategic objectives addressing the challenges identified through stakeholders' consultations. The following key principles adopted throughout the process contributed to the successful development of the strategy: building on evidence and international frameworks, maximizing the participation of all stakeholders, prioritising national consensus, maintaining flexibility and maximizing transparency.

Acute spinal cord injuries in the Lebanon War, 1982.

PubMed

Ohry, A; Rozin, R

1984-04-01

Our experience with 17 patients with spinal cord injuries (SCI) acquired in the Lebanon War, 1982, is described. The SCI were due to gunshot wounds in 12 patients and to other causes in 5. Two laparotomies and one thoracotomy were performed. Corticosteroids were not seen to influence recovery, nor was laminectomy, which was performed in three cases. Complications such as pressure sores, hydronephrosis, ileus and deep vein thrombosis were rare or did not occur. Three high quadriplegics died. Based on our experience, we recommend conservative treatment and rehabilitation in acute SCI.

Supply-demand 3D dynamic model in water resources evaluation: taking Lebanon as an example

NASA Astrophysics Data System (ADS)

Fang, Hong; Hou, Zhimin

2017-05-01

In this paper, supply-demand 3D dynamic model is adopted to create a measurement of a region’s capacity to provide available water to meet the needs of its population. First of all, we draw a diagram between supply and demand. Then taking the main dynamic factors into account, we establish an index to evaluate the balance of supply and demand. The three dimension vector reflects the scarcity of industrial, agricultural and residential water. Lebanon is chosen as the object of case study, and we do quantitative analysis of its current situation. After data collecting and processing, we calculate the 3D vector in 2012, which reveals that agriculture is susceptible to water scarcity. Water resources of Lebanon are “physical rich” but “economic scarcity” according to the correlation chart and other statistical analysis.

Community-Based Noncommunicable Disease Care for Syrian Refugees in Lebanon

PubMed Central

Sethi, Stephen; Jonsson, Rebecka; Skaff, Rony; Tyler, Frank

2017-01-01

ABSTRACT In the sixth year of the Syrian conflict, 11 million people have been displaced, including more than 1.1 million seeking refuge in Lebanon. Prior to the crisis, noncommunicable diseases (NCDs) accounted for 80% of all deaths in Syria, and the underlying health behaviors such as tobacco use, obesity, and physical inactivity are still prevalent among Syrian refugees in Lebanon. Humanitarian agencies initially responded to the acute health care needs of refugees by delivering services to informal settlements via mobile medical clinics. As the crisis has become more protracted, humanitarian response plans have shifted their focus to strengthening local health systems in order to better address the needs of both the host and refugee populations. To that end, we identified gaps in care for NCDs and launched a program to deliver chronic disease care for refugees. Based on a participatory needs assessment and community surveys, and building on the success of community health programs in other contexts, we developed a network of 500 refugee outreach volunteers who are supported with training, supervision, and materials to facilitate health promotion and disease control for community members, target NCDs and other priority conditions, and make referrals to a primary health care center for subsidized care. This model demonstrates that volunteer refugee health workers can implement community-based primary health activities in a complex humanitarian emergency. PMID:28928227

Community-Based Noncommunicable Disease Care for Syrian Refugees in Lebanon.

PubMed

Sethi, Stephen; Jonsson, Rebecka; Skaff, Rony; Tyler, Frank

2017-09-27

In the sixth year of the Syrian conflict, 11 million people have been displaced, including more than 1.1 million seeking refuge in Lebanon. Prior to the crisis, noncommunicable diseases (NCDs) accounted for 80% of all deaths in Syria, and the underlying health behaviors such as tobacco use, obesity, and physical inactivity are still prevalent among Syrian refugees in Lebanon. Humanitarian agencies initially responded to the acute health care needs of refugees by delivering services to informal settlements via mobile medical clinics. As the crisis has become more protracted, humanitarian response plans have shifted their focus to strengthening local health systems in order to better address the needs of both the host and refugee populations. To that end, we identified gaps in care for NCDs and launched a program to deliver chronic disease care for refugees. Based on a participatory needs assessment and community surveys, and building on the success of community health programs in other contexts, we developed a network of 500 refugee outreach volunteers who are supported with training, supervision, and materials to facilitate health promotion and disease control for community members, target NCDs and other priority conditions, and make referrals to a primary health care center for subsidized care. This model demonstrates that volunteer refugee health workers can implement community-based primary health activities in a complex humanitarian emergency. © Sethi et al.

Lebanon's 2011 ICT Education Reform Strategy and Action Plan: Curriculum Success or Abeyance

ERIC Educational Resources Information Center

Awada, Ghada; Diab, Hassan

2016-01-01

The purpose of the present study was to investigate the effectiveness of Lebanon's Education Reform Strategy and Action Plan (LERSAP) set in 2011 as a form of the educational reform the curriculum underwent through focusing on promoting and employing the information communication technology (ICT) tools. The LERSAP was launched to equip teachers…

Israel’s Second Lebanon War: A Failure of Afghan Model Warfare?

DTIC Science & Technology

2007-05-10

Israeli experience in the Second Lebanon War will be compared against the American experience in Afghanistan as analyzed by Dr. Stephen Biddle in his...Biddle’s arguments regarding the so-called “Afghan Model” reinforces the validity of the conclusions Dr. Biddle derives regarding the U.S. success in...an irregular guerilla force. 2 Stephen Biddle , Afghanistan and the Future of Warfare

Process evaluation of a community-based mental health promotion intervention for refugee children

PubMed Central

Nakkash, Rima T.; Alaouie, Hala; Haddad, Pascale; El Hajj, Taghreed; Salem, Heba; Mahfoud, Ziyad; Afifi, Rema A.

2012-01-01

Public health interventions are complex in nature and composed of multiple components. Evaluation of process and impact is necessary to build evidence of effectiveness. Process evaluation involves monitoring extent of implementation and comparison against the program plan. This article describes the process evaluation of the ‘Qaderoon’ (We are Capable) intervention; a community-based mental health promotion intervention for children living in a Palestinian refugee camp of Beirut, Lebanon. The manuscript describes the context of Palestinian refugees in Lebanon, the intervention, the process evaluation plan and results. The process evaluation was guided by the literature and by a Community Youth Committee. Findings indicated that attendance was 54 and 38% for summer and fall sessions, respectively. Session objectives and activities were commonly achieved. Over 78.4% of activities were reported to be implemented fully as planned. Over 90% of the children indicated high satisfaction with the sessions. Contextual facilitators and challenges to implementing the intervention are discussed. The most challenging were maintaining attendance and the actual implementation of the process evaluation plan. Findings from process evaluation will strengthen interpretation of impact evaluation results. PMID:21908850

Undertaking the first online sexuality survey among private university students in Lebanon – Process, challenges, and lessons learned.

PubMed

Yasmine, Rola; Ghandour, Lilian; El Kak, Faysal

2016-01-01

The taboo surrounding reproductive and sexual health in the Middle East and North African (MENA) region, specifically among unmarried youth, has resulted in an incomplete and inaccurate documentation of the status of youth sexual and reproductive health (SRH). Documenting regional research processes and successes can support SRH researchers in promoting evidence-based services and local policies. This paper describes the process, challenges and lessons learned during the first online research study in the MENA to assess university students’ sexual practices, values and perceptions. An online survey was completed by 2,182 university students attending the 4th largest private university in Lebanon. An online SRH survey among Arab youth must be carefully developed with the cultural context and its prevailing issues in mind. Careful attention must be paid to any translation process specifically regarding tone and choice of certain sexual terms. The online program/software must be thoroughly piloted for possible technical flaws, language support, and web browser compatibility. Inter-disciplinary collaboration between the research team, IT and IRB offices is crucial in order to conduct an ethicallyappropriate technically-functional online survey. Online survey methods hold great promise for surveying SRH and other sensitive topics in Lebanon and the MENA.

Knowledge, attitude, and behavior of students regarding 'mad cow disease'.

PubMed

Harakeh, Steve; Soweid, Rema Adel Afifi; Nassar, Nabil T; Zananiri, Nathalie S; Tfaily, Rania; Rola, Ali Hassan; Allam, Shirine; Bassim, Mark; Aram, Bouraa Bou; Harkous, Bissan; Nashawi, Tarek

2003-08-01

The aim of the current study is to assess the knowledge, attitude and behavior of students enrolled at the American University of Beirut (AUB) in Lebanon, towards mad cow disease (MCD). Three hundred and fifty-six students (199 males and 157 females), ranging in age between 17 and 25 years were randomly selected from various majors and were asked to fill out a self-administered questionnaire. It was found that 99.7% of students had heard about MCD and 85.8% knew that the cow is the host for bovine spongiform encephalopathy (BSE). Seventy five percent reported that animals contract the disease through the consumption of meat and bone meal. Thirty-seven percent wrongly believed that MCD cases were reported in Lebanon and 89% were not satisfied with the measures undertaken by the Lebanese government to curb the disease. Eighty four percent were concerned about the disease and 72% stated having modified their eating habits accordingly. Moreover, students majoring in biology and other health-related majors knew significantly more about MCD compared with students majoring in non-health related majors. A surprising finding was that females were more likely to modify their eating habits than males. Hence, this study provides an insight into the knowledge, attitude, and behavior of AUB students towards MCD. A limitation of this study is that our sample is not representative of all university students in Lebanon. Future surveys should also target students enrolled in other universities in the country.

Symptom Prevalence of PTSD, Anxiety, Depression, Effect of Exposure and Mediating Factors on a Population From Southern Lebanon

DTIC Science & Technology

2006-04-01

the American University of Beirut interviewed 256 randomly selected persons in heir homes and workplaces. The sample consisted of men and women over...reported to be working, compared to 27.2% of women (p≤ .0001). Of the males, 56.3% reported being married, compared to 62.5% of the females (p≤ .0025...International Neuropsychiatric Interview, the prevalence of PTSD was found to be 23.5%. Women , persons over 65 years and those with lower education were at

Violence Against Displaced Syrian Women in Lebanon.

PubMed

Usta, Jinan; Masterson, Amelia Reese; Farver, JoAnn M

2016-10-01

This study used focus group discussions to explore 29 Syrian women's experiences of being displaced refugees in Lebanon. Women reported intimate partner violence (IPV), harassment, and community violence. They experienced difficult living conditions characterized by crowding and lack of privacy, adult unemployment, and overall feelings of helplessness. Most frequently, they used negative coping strategies, including justification and acceptance of IPV and often physically harmed their own children due to heightened stress. Some sought support from other Syrian refugee women. Although the study did not address the root causes of IPV, the results shed light on women's experiences and indicate that training them in positive coping strategies and establishing support groups would help them face IPV that occurs in refugee settings.

The workforce trends of nurses in Lebanon (2009-2014): A registration database analysis.

PubMed

Alameddine, Mohamad; Chamoun, Nariman; Btaiche, Rachel; El Arnaout, Nour; Richa, Nathalie; Samaha-Nuwayhid, Helen

2017-01-01

Analysis of the nursing registration databases is a highly informative approach that provides accurate and reliable information supporting evidence based decisions relevant to the nursing workforce planning, management and development. This study presents the first systematic analysis of the nursing registration database in Lebanon. It Reports on the workforce distribution and trends using an updated version of the Order of Nurses in Lebanon (ONL) databases. This study presents a secondary data analysis of a de-identified subset of the updated ONL registration database. The workforce participation status of ONL registered nurses was categorized as active and eligible. For active nurses sectors and sub-sectors of employment were defined. Eligible nurses were categorized as unemployed, working outside nursing and working abroad. SPSS was used to conduct descriptive analysis to present workforce trends of Lebanese nurses for year 2009-2014 as frequencies, percentages and percentage changes. Increases in the size of the Active (35%) and Eligible (86%) nurses were observed over the past six years. The majority of nurses fell in the below 35 years age group (60% in 2014). The hospital sector remained the principle employer, with 87% of Lebanese nurses working in hospitals in 2014. A 173% increases was reported for nurses working abroad. Despite the growth of the Active nursing workforce, the skewed distribution of nurses in the below 35 age group and the growth in the Eligible category, especially for nurses living abroad, raise concerns on the longevity of nurses in the profession and the reasons for their attrition from the workforce. There is a need to investigate the push and pull factors that are affecting nurses and the design of policies and interventions that would encourage nurses to remain active in Lebanon. Furthermore, policies and interventions that would create employment opportunities outside hospitals, especially in the Community sector, are recommended.

They aren't all first cousins: Bedouin marriage and health policies in Lebanon.

PubMed

Mansour, Nisrine; Chatty, Dawn; El-Kak, Faysal; Yassin, Nasser

2014-01-01

Fertility and consanguineous marriages among the Bedouin tribes of the Middle East have long generated interest particularly around health outcomes and social relations. In particular, Bedouin in Lebanon have increasingly embraced the Lebanese national bio-medical health system in the past two decades, while Lebanese policy-makers' responses continue to be minimal and ill-informed. This paper investigates the mismatch between policy-makers' formulations of Bedouin consanguineous marriages and the Bedouins's actual reproductive practices and discusses the implications of these formulations on the Bedouins's access to health services. The findings are drawn from the data collected as part of the Bedouin Health Project, an EU-funded five-year study (2005-2010), aiming at assessing access to reproductive and child health care among the Bedouin in Lebanon. The data was collected from 6 clusters representing the main Bedouin informal and unrecognized settlements in the Bekaa Valley of Lebanon. The data consists of 111 socioeconomic questionnaires with Bedouin women users of local public, private, and nongovernmental reproductive and child health-focused clinics, in addition to 40 in-depth interviews with Bedouin women across the clusters and 17 semi-structured interviews with policy-makers. The findings suggest a gap between the perceptions of policy-makers and the incidence of consanguineous marriages and reproductive practices among the Bedouin. While there was no national data available for the Bedouin populations, policy-makers relied on a constructed 'Bedouin reproductive profile' that portrayed them as 'a problematic health group'. The national policy formulation of the Bedouin reproductive profile has an exclusionary impact on the Bedouin population as they are ignored from any targeted health policies or provided with politically motivated palliative care provision. These findings highlight the importance of addressing stereotyping and discrimination among health

Demonstration of the Effectiveness of Augmented Reality Telesurgery in Complex Hand Reconstruction in Gaza

PubMed Central

Luck, Joshua; Billingsley, Michael L.; Heyes, Richard; Smith, Oliver J.; Mosahebi, Afshin; Khoussa, Abu; Abu-Sittah, Ghassan; Hachach-Haram, Nadine

2018-01-01

Summary: Augmented reality (AR) is defined as “a technology that superimposes a computer-generated image on a user’s view of the real world, thus providing a composite view.”1 This case report describes how emerging AR telesurgery technologies may be used to facilitate international surgeon–surgeon collaboration and training. Here, we illustrate how a remote surgeon in Beirut, Lebanon, was able to offer assistance to a surgeon in Gaza, Palestine, during a complex hand reconstruction case following a bomb-blast injury in an 18-year-old male. We discuss the implications of AR technology on the future of global surgery and how it may be used to reduce structural inequities in access to safe surgical care. PMID:29707463

Geographic epidemiology in a small area: cancer incidence in Baakline, Lebanon, 2000-2008.

PubMed

Adib, S M; Tabbal, N; Hamadeh, R; Ammar, W

2013-04-01

Aggregate data of the National Clr cac gi s in Lebanon cannot discriminate cance r incidence i n small areas. Trained community members surveyed the permanent population of the Baakline municipality using the verbal autopsy approach. We surveyed 1042 households with at least 1 member living permanently in Baakline during 2000-2008. Data covered 4330 persons yielding 34,143 years of observation and 56 new cases of cancer were reported. Median age at diagnosis varied significantly between men (77 years) and women (56 years). The most common types were lung cancer (20%) followed by colorectal (12.5%) and breast (9%). Estimated crude cancer incidence rate was 164 cases/100,000 persons/year, significantly higher in men (194) than women (130), and much lower overall than the national figure (218). The permanent Baakline population is older than that of Lebanon itself, yet the cancer incidence rate is markedly lower than the national figure. This finding pleads for serious efforts to preserve the low environmental contamination and the healthy lifestyles in food and tobacco abstinence that have protected the population so far.

Population ageing in Lebanon: current status, future prospects and implications for policy.

PubMed Central

Sibai, Abla Mehio; Sen, Kasturi; Baydoun, May; Saxena, Prem

2004-01-01

During the past three decades, fast declines in fertility and mortality in Lebanon have created a compressed demographic transition, a growing trend towards survival into later life, and a larger proportion of elderly people in the population. Projections show that people aged 65 years and over are expected to constitute 10.2% of the population by 2025. Nevertheless, changes to the structure and composition of the population remain unmatched by any corresponding increase in support measures either through formal channels such as pension plans or through health or socioeconomic security measures such as the provision of subsidies for health care, home help or any form of nursing care. This means that an older person is forced to be dependent upon family support if it exists. We examine demographic trends of population ageing in Lebanon between 1970 and 1995 and provide projections until 2025. Variations in population ageing within the country are also considered. We also assess health care and social policy implications of demographic changes in the context of health and economic sector reforms initiated recently by the state, and explore their impact upon the expanding population of elderly people. PMID:15112011

A national study on nurses' retention in healthcare facilities in underserved areas in Lebanon.

PubMed

El-Jardali, Fadi; Alameddine, Mohamad; Jamal, Diana; Dimassi, Hani; Dumit, Nuhad Y; McEwen, Mary K; Jaafar, Maha; Murray, Susan F

2013-09-30

Nursing shortages and maldistribution are priority issues for healthcare systems around the globe. Such imbalances are often aggravated in underserved areas, especially in developing countries. Despite the centrality of this issue, there is a dearth of studies that examine the retention of nurses in underserved areas in the Middle East Region. This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon. This study uses a non-experimental cross-sectional design to survey nurses working in underserved areas of Lebanon. Underserved areas in Lebanon were identified using WHO definition. A total of 103 health facilities (hospitals and primary healthcare centers) located in these areas were identified and all nurses working at these facilities received a copy of the survey questionnaire. The questionnaire included five sections: demographic, work-life, career plan, job satisfaction, and assessment of work environment. Analysis included univariate and bivariate (chi-square, Student's t-test and ANOVA) tests to describe the respondents and examine the significance between nurses' characteristics and their intent to stay. A logistic regression model was constructed to identify factors associated with nurses' intent to stay in underserved areas. A total of 857 nurses from 63 Primary Healthcare (PHC) centers and hospitals responded to the questionnaire (75.5% response rate). Only 35.1% of nurses indicated their intent to stay in their current job over the coming one to three years. Surveyed nurses were most satisfied with relationship with co-workers and least satisfied with extrinsic rewards. Rural nurses working in PHC centers were more satisfied than their hospital counterparts on all aspects of work and had significantly higher intention to stay (62.5% compared to 31.5% in hospitals, P < 0.001). Regression analysis revealed that nurses less likely to report intent to stay were younger, unmarried

Developing Effective Earthquake Risk Reduction Strategies: The Potential Role of Academic Institutions in Lebanon

ERIC Educational Resources Information Center

Baytiyeh, Hoda

2015-01-01

Lebanon faces the risk of powerful earthquakes with potentially devastating effects. However, the Lebanese people in general have not yet recognized this risk, as current educational programs and government officials have failed to inform them about it. This article discusses the essential role that Lebanese institutions of higher education should…

High Resolution Regional Climate Modeling for Lebanon, Eastern Mediterranean Coast

NASA Astrophysics Data System (ADS)

Katurji, Marwan; Soltanzadeh, Iman; Kuhnlein, Meike; Zawar-Reza, Peyman

2013-04-01

The Eastern Mediterranean coast consists of Lebanon, Palestine, Syria, Israel and a small part of southern Turkey. The region lies between latitudes 30 degrees S and 40 degrees N, which makes its climate affected by westerly propagating wintertime cyclones spinning off mid-latitude troughs (December, January and February), while during summer (June, July and August) the area is strongly affected by the sub-tropical anti-cyclonic belt as a result of the descending air of the Hadley cell circulation system. The area is considered to be in a transitional zone between tropical to mid-latitude climate regimes, and having a coastal topography up to 3000 m in elevation (like in the Western Ranges of Lebanon), which emphasizes the complexity of climate variability in this area under future predictions of climate change. This research incorporates both regional climate numerical simulations, Tropical Rainfall Measuring Mission (TRMM) satellite derived and surface rain gauge rainfall data to evaluate the Regional Climate Model (RegCM) version 4 ability to represent both the mean and variance of observed precipitation in the Eastern Mediterranean Region, with emphasis on the Lebanese coastal terrain and mountain ranges. The adopted methodology involves dynamically down scaling climate data from reanalysis synoptic files through a double nesting procedure. The retrospective analysis of 13 years with both 50 and 10 km spatial resolution allows for the assessment of the model results on both a climate scale and specific high intensity precipitating events. The spatial averaged mean bias error in precipitation rate for the rainy season predicted by RegCM 50 and 10 km resolution grids was 0.13 and 0.004 mm hr-1 respectively. When correlating RegCM and TRMM precipitation rate for the domain covering Lebanon's coastal mountains, the root mean square error (RMSE) for the mean quantities over the 13-year period was only 0.03, while the RMSE for the standard deviation was higher by one

Initial Data on the Molecular Epidemiology of Cryptosporidiosis in Lebanon

PubMed Central

Osman, Marwan; El Safadi, Dima; Benamrouz, Sadia; Guyot, Karine; Dei-Cas, Eduardo; Aliouat, El Moukhtar; Creusy, Colette; Mallat, Hassan; Hamze, Monzer; Dabboussi, Fouad; Viscogliosi, Eric; Certad, Gabriela

2015-01-01

Cryptosporidium spp. represent a major public health problem worldwide and infect the gastrointestinal tract of both immunocompetent and immunocompromised persons. The prevalence of these parasites varies by geographic region, and no data are currently available in Lebanon. To promote an understanding of the epidemiology of cryptosporidiosisin this country, the main aim of this study was to determine the prevalence Cryptosporidium in symptomatic hospitalized patients, and to analyze the genetic diversity of the corresponding isolates. Fecal specimens were collected in four hospitals in North Lebanon from 163 patients (77 males and 86 females, ranging in age from 1 to 88 years, with a mean age of 22 years) presenting gastrointestinal disorders during the period July to December 2013. The overall prevalence of Cryptosporidium spp. infection obtained by modified Ziehl-Neelsen staining and/or nested PCR was 11%, and children <5 years old showed a higher rate of Cryptosporidium spp. The PCR products of the 15 positive samples were successfully sequenced. Among them, 10 isolates (66.7%) were identified as C. hominis, while the remaining 5 (33.3%) were identified as C. parvum. After analysis of the gp60 locus, C. hominis IdA19, a rare subtype, was found to be predominant. Two C. parvum subtypes were found: IIaA15G1R1 and IIaA15G2R1. The molecular characterization of Cryptosporidium isolates is an important step in improving our understanding of the epidemiology and transmission of the infection. PMID:25950832

[Hospitalization due to skin diseases at Hôtel-Dieu de France Hospital (Beirut), 1998-2007].

PubMed

Maatouk, Ismaël; Moutran, Roy; Tomb, Roland

2012-01-01

This study aims to determine retrospectively the nature and frequency of dermatological diseases leading to hospitalization at Hôtel-Dieu de France Hospital (HDF) in Beirut, between 1998 and 2007 and to compare them with literature data. For the patients who were hospitalized in dermatology at HDF, we studied: demographics, diagnosis of hospitalization, length of stay, service, mode of financial support, in-hospital evolution, diagnostic tests and treatment. The data were processed by SPSS program. Alopecia areata, psoriatic erythroderma, acute urticaria and vasculitic purpura are the top four diagnoses (85% of hospitalizations). The third of the patients was admitted to same day care. The financial support of the hospitalization is based primarily on public insurance (57.6%). Corticosteroids are the most widely used treatment for patients in dermatology hospital with a frequency of 59.8%. The number of hospitalizations peaked at 44 in 2002 and since then has been declining (11 hospitalizations in 2007). Pathologies encountered in hospital are different from those encountered during consultation. Management of skin diseases on an outpatient basis is often insufficient. In the literature, no profile of skin diseases leading to hospitalization is similar to our study.

Syrian Refugee Women’s Health in Lebanon, Turkey, and Jordan and Recommendations for Improved Practice

PubMed Central

Samari, Goleen

2017-01-01

Since 2011, an estimated nine million Syrian refugees have fled to neighboring countries, and over four million have fled to neighboring countries of Lebanon, Turkey, and Jordan. Seventy five percent of Syrian refugees are women and children. In times of conflict, women’s health disproportionately suffers. Based on an assessment of academic literature and international policy and development reports, this study explores the vulnerabilities of Syrian women and girls in Lebanon, Turkey, and Jordan, and how these countries approach Syrian refugee women’s health care. In all settings, sexual and gender-based violence, reduced use of modern contraceptives, menstrual irregularity, unplanned pregnancies, preterm birth, and infant morbidity are ongoing issues. Recommendations for improved practice include taking a multilevel approach to eliminate social and service delivery barriers that prevent access to care, conducting thorough needs assessments, and creating policy and programmatic solutions that establish long term care for Syrian refugee women. PMID:29051840

A qualitative study exploring child marriage practices among Syrian conflict-affected populations in Lebanon.

PubMed

Mourtada, Rima; Schlecht, Jennifer; DeJong, Jocelyn

2017-01-01

Recent reports have suggested that child marriage among Syrians may be increasing as a result of displacement and conflict. This study sought to gather qualitative data about the factors that promote child marriage practices among Syrian refugees in Al Marj area in the Bekaa valley, Lebanon, where the majority of Syrian refugees have settled in Lebanon. The second aim of this study was to generate recommendations on how to mitigate the drivers and consequences of child marriage practices based on the findings. Eight focus group discussions were conducted separately with married and unmarried young women and mothers and fathers of married and unmarried women. Furthermore, researchers conducted 11 key informant interviews with service providers and stakeholders to understand how conflict and displacement influenced marriage practices of Syrian refugees in Al Marj community. Although child marriage was a common practice in pre-conflict Syria, new factors seem to contribute to a higher risk of child marriage among Syrian refugees in Lebanon. Respondents cited conflict- and displacement-related safety issues and feeling of insecurity, the worsening of economic conditions, and disrupted education for adolescent women as driving factors. Service providers, young women, and parents also reported changes in some marriage practices, including a shorter engagement period, lower bride price, change in cousin marriage practices, and a reduced age at marriage. Recommendations for interventions to mitigate the drivers of child marriage and its negative consequences should be built on a clear understanding of the local refugee context and the drivers of child marriage in refugee settings. Interventions should involve multiple stakeholders, they should be adjusted to target each specific context, age group and marital status. For these interventions to be effective, they should be addressed concurrently, and they should be delivered in a culturally sensitive and practical manner.

Characteristics of incident female breast cancer in Lebanon, 1990-2013: Descriptive study of 612 cases from a hospital tumor registry.

PubMed

Chahine, Georges; El Rassy, Elie; Khazzaka, Aline; Saleh, Khalil; Rassy, Nathalie; Khalife, Nadine; Atallah, David

2015-06-01

Despite the fact that breast cancer is a major health issue, very few studies describe its characteristics in the Arab world or the Middle East, particularly in Lebanon. We report in this article a retrospective pilot study of the characteristics of breast cancer in Lebanon. The pathological characteristics of 624 patients diagnosed between 1990 and 2013 randomly chosen from the archives of an oncology clinic affiliated to Hotel Dieu de France Hospital are analyzed. The mean age at diagnosis is 54.6±13.4 years with 43% diagnosed before the age of 50 years. The infiltrative ductal carcinoma represents the major pathological subtype. One third of the tumors had a size of more than 2 cm at diagnosis. Estrogen-receptors are positive in more than 50% of our patients and Her2-neu is overexpresssed in 30%. Luminal A represents 45.5% and the triple negative subgroup constitutes only 8.3%. Breast cancer in Lebanon is evolving to a more indolent disease. Therefore, public awareness and institution of screening programs are required. These programs should be based on national epidemiological data and necessitate the activation of the national cancer registry. Copyright © 2015 Elsevier Ltd. All rights reserved.

Post-Traumatic Stress Disorder in Adolescents in Lebanon as Wars Gained in Ferocity: A Systematic Review

PubMed Central

Shaar, Khuzama Hijal

2013-01-01

Significance for public health Post traumatic stress disorder (PTSD) in adolescents has been implicated in developmental impairments, mental and scholastic problems, alcohol and drug abuse, and antisocial behavior in its victims among others. Absence of review studies regarding the prevalence of PTSD in adolescents in Lebanon, a country plagued by decades of civil strife and external occupation and invasion, is noted. Such information may reinforce the need to develop national public health policies to identify PTSD in children and adolescents, provide them with counseling and treatment, and formulate prevention strategies to protect vulnerable youth from devastations of war. For decades, Lebanon was war-torn by civil strife, and occupation and invasion by neighboring countries. In time, these wars have escalated in intensity from sniping, barricading streets and random shelling of residential quarters to the use of rockets, aerial bombing, and heavy artillery. Adverse mental health effects are noted in times of war with post traumatic stress disorder (PTSD) as a main outcome. The aim of this study was to carry out a systematic review of published studies documenting the prevalence of PTSD in the adolescent population of Lebanon, to investigate the increase in these rates with the escalation of war intensity, and to examine PTSD determinants. A search strategy was developed for online databases (PubMed and Google Scholar) between inception to the first week of January 2013. Search terms used were PTSD, adolescents and Lebanon. Eleven studies reporting PTSD in adolescents met the inclusion criteria for a total number of 5965 adolescents. Prevalence rates of PTSD ranged from 8.5% to 14.7% for the civil war, 3.7% for adolescents with sensory disabilities, 21.6% for the Grapes of Wrath War, and 15.4% to 35.0% for the 2006 July War. Some increase in PTSD rates in time is noted. Type of trauma such as bereavement, injury, house destruction, and economic problems, low

Post-traumatic stress disorder in a sample of Syrian refugees in Lebanon.

PubMed

Kazour, Francois; Zahreddine, Nada R; Maragel, Michel G; Almustafa, Mustafa A; Soufia, Michel; Haddad, Ramzi; Richa, Sami

2017-01-01

Lebanon is the main hosting country for the Syrian crisis, with more than one million Syrian refugees. The objective of this study was to determine the prevalence of post-traumatic stress disorder (PTSD), and identify its possible predictors, in a sample of Syrian refugees living in camps in Lebanon. We conducted a household survey on Syrian refugees between 18 and 65years old in 6 camps of the Central Bekaa region, using the Mini International Neuropsychiatric Interview (M.I.N.I.) as a diagnostic tool. Among the 452 respondents, we found a lifetime prevalence of PTSD of 35.4%, and a point prevalence of 27.2%. The lifetime prevalence of SUD was 1.99% and the point prevalence 0.66%. Multivariate logistic regression could not identify any predictor of current PTSD among a list of demographic variables, but identified the Syrian hometown as a significant predictor of lifetime PTSD (p=.013), with refugees from Aleppo having significantly more PTSD than those coming from Homs (adjusted OR 2.14, 95% CI [1.28, 3.56], p=.004). PTSD was a real mental health issue in our sample of adult Syrian refugees in Central Bekaa camps, unlike SUD. Copyright © 2016 Elsevier Inc. All rights reserved.

Rhabdomyosarcoma treatment and outcome at a multidisciplinary pediatric cancer center in Lebanon.

PubMed

Salman, Maysaa; Tamim, Hani; Medlej, Fouad; El-Ariss, Tarek; Saad, Fatima; Boulos, Fouad; Eid, Toufic; Muwakkit, Samar; Khoury, Nabil; Abboud, Miguel; Saab, Raya

2012-05-01

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. Outcome of patients treated on standard protocols, in a multidisciplinary cancer center setting outside of clinical trials, is not well reported. We reviewed characteristics and outcome of 23 pediatric patients treated at a single, multidisciplinary cancer center in Lebanon, between April 2002 and December 2010. Median follow-up was 41 months. The most commonly affected primary site was the head and neck (48%, n = 11). Nineteen tumors (82.6%) were of embryonal histology. Tumor size was ≥5 cm in eight (34.8%) patients. Sixteen patients (69.6%) had localized disease, and one (4.4%) had metastatic disease. Fifteen (65.2%) had Group III tumors. All patients received chemotherapy, for a duration ranging 21-51 weeks. Upfront surgical resection was performed in 10 patients (43.5%). Eighteen patients (78.3%) received radiation therapy. The 5-year overall and disease-free survival rates were 83% and 64%, respectively. Relapse correlated with absence of surgery. Treatment of childhood RMS in a multidisciplinary cancer center in Lebanon results in similar survival to that in developed countries when similar protocols are applied. There was a higher incidence of local relapse, but those were salvageable with further therapy and surgical local control.

High genetic diversity with moderate differentiation in Juniperus excelsa from Lebanon and the eastern Mediterranean region

PubMed Central

Douaihy, Bouchra; Vendramin, Giovanni G.; Boratyński, Adam; Machon, Nathalie; Bou Dagher-Kharrat, Magda

2011-01-01

Background and aims Juniperus excelsa is an important woody species in the high mountain ecosystems of the eastern Mediterranean Basin where it constitutes the only coniferous species found at the tree line. The genetic diversity within and among J. excelsa populations of the eastern Mediterranean Basin is studied in the light of their historical fragmentation. Methodology Nuclear microsatellites originally developed for Juniperus communis and J. przewalskii were tested on 320 individuals from 12 different populations originating from Lebanon, Turkey, Cyprus, Greece and the Ukraine. Principal results Among the 31 nuclear microsatellite primers tested, only three produced specific amplification products, with orthology confirmed by sequence analysis. They were then used for genetic diversity studies. The mean number of alleles and the expected heterozygosity means were Na=8.78 and He=0.76, respectively. The fixation index showed a significant deviation from Hardy–Weinberg equilibrium and an excess of homozygotes (FIS=0.27–0.56). A moderate level of genetic differentiation was observed among the populations (FST=0.075, P<0.001). The most differentiated populations corresponded to old vestigial stands found at the tree line (>2000 m) in Lebanon. These populations were differentiated from the other populations that are grouped into three sub-clusters. Conclusions High levels of genetic diversity were observed at species and population levels. The high level of differentiation in the high-mountain Lebanese populations reflects a long period of isolation or possibly a different origin. The admixture observed in other populations from Lebanon suggests a more recent separation from the Turkish–southeastern European populations. PMID:22476474

Incidence and severity of maxillofacial injuries during the Second Lebanon War among Israeli soldiers and civilians.

PubMed

Levin, Liran; Zadik, Yehuda; Peleg, Kobi; Bigman, Galya; Givon, Adi; Lin, Shaul

2008-08-01

To analyze the incidence and severity of maxillofacial injuries in the Second Lebanon War, that occurred during the summer of 2006, among Israeli soldiers and civilians. This is a retrospective cohort study of patients recorded in the Israel National Trauma Registry during the Second Lebanon War. Data refer to all general hospitals throughout the country. Data were analyzed according to the etiology of the injury, severity of trauma using the Injury Severity Score, trauma location, and duration of hospital stay. Cases with multiple injuries that included maxillofacial injuries were separated and further analyzed according to the above parameters. Patients with only dental injuries and superficial facial soft tissue lacerations were excluded because they were referred to the military dental clinics and not to general hospitals. Maxillofacial injuries were found in 36 (6.4%) of the 565 wounded. Patients with maxillofacial injuries ranged in age from 20 to 44 years (mean age, 25.5 +/- 5.7 years). Greater than 50% of the injuries required more than 3 hospitalization days. Mortality rate of the maxillofacial injured was 2.8%. Most of the maxillofacial injuries (33; 91.7%) were combined with other organ injuries; 9 (25%) patients also had dental injuries. In the Second Lebanon War, the incidence and severity of true maxillofacial injuries, without dental injuries alone, were relatively low compared with previous reports of other conflicts. However, because most injuries involved multiple organs, special attention is required when planning and providing emergency, as well as secondary and tertiary medical care to war wounded.

High genetic diversity with moderate differentiation in Juniperus excelsa from Lebanon and the eastern Mediterranean region.

PubMed

Douaihy, Bouchra; Vendramin, Giovanni G; Boratyński, Adam; Machon, Nathalie; Bou Dagher-Kharrat, Magda

2011-01-01

Juniperus excelsa is an important woody species in the high mountain ecosystems of the eastern Mediterranean Basin where it constitutes the only coniferous species found at the tree line. The genetic diversity within and among J. excelsa populations of the eastern Mediterranean Basin is studied in the light of their historical fragmentation. Nuclear microsatellites originally developed for Juniperus communis and J. przewalskii were tested on 320 individuals from 12 different populations originating from Lebanon, Turkey, Cyprus, Greece and the Ukraine. Among the 31 nuclear microsatellite primers tested, only three produced specific amplification products, with orthology confirmed by sequence analysis. They were then used for genetic diversity studies. The mean number of alleles and the expected heterozygosity means were N(a)=8.78 and H(e)=0.76, respectively. The fixation index showed a significant deviation from Hardy-Weinberg equilibrium and an excess of homozygotes (F(IS)=0.27-0.56). A moderate level of genetic differentiation was observed among the populations (F(ST)=0.075, P<0.001). The most differentiated populations corresponded to old vestigial stands found at the tree line (>2000 m) in Lebanon. These populations were differentiated from the other populations that are grouped into three sub-clusters. High levels of genetic diversity were observed at species and population levels. The high level of differentiation in the high-mountain Lebanese populations reflects a long period of isolation or possibly a different origin. The admixture observed in other populations from Lebanon suggests a more recent separation from the Turkish-southeastern European populations.

Spread of imipenem-resistant Acinetobacter baumannii co-expressing OXA-23 and GES-11 carbapenemases in Lebanon.

PubMed

Hammoudi, D; Moubareck, C Ayoub; Hakime, N; Houmani, M; Barakat, A; Najjar, Z; Suleiman, M; Fayad, N; Sarraf, R; Sarkis, D Karam

2015-07-01

The acquisition of carbapenemases by Acinetobacter baumannii is reported increasingly worldwide, but data from Lebanon are limited. The aims of this study were to evaluate the prevalence of imipenem-resistant A. baumannii in Lebanon, identify resistance determinants, and detect clonal relatedness. Imipenem-resistant A. baumannii were collected from nine Lebanese hospitals during 2012. Antimicrobial susceptibility, the cloxacillin effect, and ethylenediaminetetraacetic acid (EDTA) synergy were determined. Genes encoding carbapenemases and insertion sequence ISAba1 were screened via PCR sequencing. ISAba1 position relative to genes encoding Acinetobacter-derived cephalosporinases (ADCs) and OXA-23 was studied by PCR mapping. Clonal linkage was examined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Out of 724 A. baumannii isolated in 2012, 638 (88%) were imipenem-resistant. Of these, 142 were analyzed. Clavulanic acid-imipenem synergy suggested carbapenem-hydrolyzing extended-spectrum β-lactamase. A positive cloxacillin test indicated ADCs, while EDTA detection strips were negative. Genotyping indicated that 90% of isolates co-harbored blaOXA-23 and blaGES-11. The remaining strains had blaOXA-23, blaOXA-24, blaGES-11, or blaOXA-24 with blaGES-11. ISAba1 was located upstream of blaADC and blaOXA-23 in 97% and 100% of isolates, respectively. ERIC-PCR fingerprinting revealed 18 pulsotypes spread via horizontal gene transfer and clonal dissemination. This survey established baseline evidence of OXA-23 and GES-11-producing A. baumannii in Lebanon, indicating the need for further surveillance. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Domestic violence against women during pregnancy: the case of Palestinian refugees attending an antenatal clinic in Lebanon.

PubMed

Hammoury, N; Khawaja, M; Mahfoud, Z; Afifi, R A; Madi, H

2009-03-01

To determine the factors associated with domestic violence against pregnant Palestinian refugee women residing in Lebanon and currently using the United Nation Relief and Work Agency's (UNRWA) primary healthcare services. This was a cross-sectional study conducted at a polyclinic of primary healthcare of the UNRWA in South Lebanon during the years 2005-2006. The sample was 351 pregnant women who were 15-42 years of age and not accompanied by their husbands or relatives. All women were invited by the midwife to participate in the study during their visit to the clinic for their first checkup or during a follow-up visit. The Abuse Assessment Screen instrument was used to screen for past and recent history of physical and emotional abuse among the participants. Domestic violence was significantly associated with education, gestational age, fear of husband or someone else in the house, and unintended pregnancy. The odds of abuse for women with an elementary or lower education were 6.86 (95% CI 1.2-38.1) and for women with an intermediate or secondary education 6.84 (95% CI 1.4-33.3) compared with women with a university education. The odds of abuse during pregnancy for women whose husbands did not desire their pregnancy were 3.80 (95% CI 1.5-9.7) compared with other women. Domestic violence against women in Lebanon was associated with educational level, gestational age, fear of husband or someone else in the house, and unintended pregnancy.

The Case of Educational Gerontology in Lebanon: A Harbinger of Empowerment, Emancipation and Social Change?

ERIC Educational Resources Information Center

Hachem, Hany; Nikkola, Eeva; Zaidan, Amani

2017-01-01

Context: In Lebanon, older adults face socioeconomic challenges that are expected to worsen due to an increase in older adult population, chronic governmental neglect, institutionalised ageism and a lack of educational and social gerontologists. Consequently, local older adults are in dire need for social change, which can be initiated through…

Survival Pattern of Hodgkin Lymphoma Patients in the Last 25 Years in Lebanon.

PubMed

Massoud, Marcel; Kerbage, Fouad; Nehme, Joseph; Sakr, Riwa; Rached, Layale; Zeghondy, Jean; Nasr, Fady; Chahine, Georges

2017-07-01

After the emergence of combination chemotherapy in 1960s, survival of patients with Hodgkin lymphoma (HL) has dramatically improved worldwide. We lack studies that document the favorable evolution of survival regarding this disease in Lebanon. To compare the overall survival in HL over 3 different decades in Lebanon. We retrospectively reviewed the charts of 196 patients diagnosed with HL, treated and followed from 1990 to 2015 in our center. Patients were divided into 3 groups according to period of analysis: group A (1990-1999), group B (2000-2009), and group C (2010-2015). We studied the characteristics and survival patterns of patients in each group. The male-to-female sex ratio was 1.06. The median age at diagnosis was 33 years in group A, 30.4 in group B, and 33.12 in group C (P = .6). Results showed variations in the subtypes of the disease according to the following: nodular-sclerosis HL 59.5% in group A, 76.2% in group B, and 85.4% in group C. Mixed cellularity HL 21.6% in group A, 2.4% in group B, and 73.7% in group C (P = .0001). Patients presented with localized disease in 58.6%, 73.7%, and 56.4% in groups A, B, and C, respectively (P = .173). Complete remission was achieved in 76.5% in group A, 85.3% in group B, and 69.5% in group C (P = .007). The survival rate at 5 years in group A was 91%, 94% in group B, and 100% in group C. The survival of patients with HL has dramatically improved over the past 25 years in Lebanon. These results resemble those achieved in Western countries due to the fast adoption of new molecular imaging technologies at diagnosis and follow-up and the rapid approval of new drugs for relapse in the Lebanese market. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical and epidemiological characteristics of norovirus gastroenteritis among hospitalized children in Lebanon

PubMed Central

Melhem, Nada M; Zaraket, Hassan; Kreidieh, Khalil; Ali, Zeinab; Hammadi, Moza; Ghanem, Soha; Hajar, Farah; Haidar, Amjad; Inati, Adlette; Rajab, Mariam; Fakhouri, Hassan; Ghanem, Bassam; Baasiri, Ghassan; Dbaibo, Ghassan

2016-01-01

AIM To assess the burden of norovirus (NoV) and to determine the diversity of circulating strains among hospitalized children in Lebanon. METHODS Stool samples were collected from children presenting with acute gastroenteritis to six major hospitals in Lebanon. A total of 739 eligible stool samples, testing negative for diarrhea caused by rotavirus as a possible viral pathogen, were collected between January 2011 and June 2013. A standardized questionnaire including demographic, epidemiological and clinical observations was used at the time of hospitalization of children presenting with diarrhea. Viral RNA was extracted from stool samples followed by reverse transcription polymerase chain reaction and nucleotide sequencing of a fragment of the viral protein 1 capsid gene. Multiple sequence alignments were carried out and phylogenetic trees were constructed using the MEGA 6 software. RESULTS Overall, 11.2% of stool samples collected from children aged < 5 years tested positive for NoV genogroups I (GI) and II (GII). GII accounted for 10.6% of the gastroenteritis cases with only five samples being positive for GI (0.7%). The majority of hospitalized children showed symptoms of diarrhea, dehydration, vomiting and fever. Upon sequencing of positive samples and based on their clustering in the phylogenetic tree, 4/5 of GI gastroenteritis cases were designated GI.3 and one case as GI.4. GII.4 was predominantly detected in stool of our study participants (68%). We report a JB-15/KOR/2008 GII.4 Apeldoorn 2008-like variant strain circulating in 2011; this strain was replaced between 2012 and 2013 by a variant sharing homology with the Sydney/NSW0514/2012/AUS GII.4 Sydney 2012 and Sydney 2012/FRA GII.4 strains. We also report the co-circulation of non-GII.4 genotypes among hospitalized children. Our data show that NoV gastroenteritis can occur throughout the year with the highest number of cases detected during the hot months. CONCLUSION The majority of NoV-associated viral

Whose History and Who Is Denied? Politics and the History Curriculum in Lebanon and Australia

ERIC Educational Resources Information Center

Maadad, Nina; Rodwell, Grant

2016-01-01

This paper seeks to explain and develop a better understanding of the relationship between the History curriculum and the consequences of political motive. It compares the History curricula of Australia and Lebanon, and is relevant to understanding the purpose of the History curricula in the two countries as well as, more generally, other…

Situation Report--Argentina, Colombia, Cyprus, Kuwait, Lebanon, Libyan Arab Republic, Oman, Syrian Arab Republic, and Uruguay.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to pupulation and family planning in nine foreign countries are presented in these situation reports. Countries included are Argentina, Colombia, Cyprus, Kuwait, Lebanon, Libyan Arab Republic, Oman, Syrian Arab Republic, and Uruguay. Information is provided under two topics, general background and family planning situation, where…

Pharmacy manpower in Lebanon: An exploratory look at work-related satisfaction.

PubMed

Salameh, Pascale; Hamdan, Iman

2007-09-01

Pharmacy is a dynamic, growing, and increasingly diverse profession. It has a new patient orientation, especially in developed countries. There is a paucity of work examining pharmacists' satisfaction and professionalization in developing nations, such as Lebanon. The purpose this study is to explore the Lebanese pharmacists' professional satisfaction and applicable needs regarding their profession. Specific objectives aimed to examine Lebanese pharmacists' satisfaction and determine whether the Lebanese Order of Pharmacists helps pharmacists to meet their professional needs. This study is a cross-sectional descriptive analysis of Lebanese pharmacists working in all pharmacy practicing environments in Lebanon. A random sample was drawn from the list of registered pharmacists provided by the Lebanese Order of Pharmacists. Selected individuals were visited and interviewed in their workplace. Pharmacists who had no registered address were contacted and interviewed face to face. Newly graduated pharmacists seemed more likely to work in community pharmacies or as medical representatives. Most interviewed pharmacists had no difficulty finding a job, but they all thought that the Order of Pharmacists should get more involved in advising and providing job opportunities, because the market is currently saturated. Most were financially satisfied, especially owners of community pharmacies. Although half of the pharmacists were psychologically satisfied, a great number of community, hospital, and medical representative pharmacists were not physically satisfied. Further research is necessary for a thorough evaluation of Lebanese pharmacists' professional satisfaction and its specific determinants, with the ultimate goal of finding adequate solutions for their needs.

Blood Lead Concentrations in 1–3 Year Old Lebanese Children: A Cross-sectional study

PubMed Central

Nuwayhid, Iman; Nabulsi, Mona; Muwakkit, Samar; Kouzi, Sarah; Salem, George; Mikati, Mohamed; Ariss, Majd

2003-01-01

Background Childhood lead poisoning has not made the list of national public health priorities in Lebanon. This study aims at identifying the prevalence and risk factors for elevated blood lead concentrations (B-Pb ≥ 100 μg/L) among 1–3 year old children. It also examines the need for universal blood lead screening. Methods This is a cross-sectional study of 281 well children, presenting to the pediatric ambulatory services at the American University of Beirut Medical Center in 1997–98. Blood was drawn on participating children for lead analysis and a structured questionnaire was introduced to mothers asking about social, demographic, and residence characteristics, as well as potential risk factors for lead exposure. Children with B-Pb ≥ 100 μg/L were compared to those with B-Pb < 100 μg/L. Results Mean B-Pb was 66.0 μg/L (median 60.0; range 10–160; standard deviation 26.3) with 39 (14%) children with B-Pb ≥ 100 μg/L. Logistic regression analysis showed that elevated B-Pb was associated with paternal manual jobs (odds ratio [OR]: 4.74), residence being located in high traffic areas (OR: 4.59), summer season (OR: 4.39), using hot tap water for cooking (OR: 3.96), exposure to kohl (OR: 2.40), and living in older buildings (OR: 2.01). Conclusion Lead screening should be offered to high-risk children. With the recent ban of leaded gasoline in Lebanon, emphasis should shift to other sources of exposure in children. PMID:12780938

Symptom clusters at midlife: A four-country comparison of checklist and qualitative responses

PubMed Central

Sievert, Lynnette Leidy; Obermeyer, Carla Makhlouf

2011-01-01

Objectives The purpose of this study was to examine the frequency and clustering of somatic symptoms as reported by women aged 45-55 years in four countries, to compare women's responses to open-ended questions with those derived from structured checklists, and to assess the extent to which bodily symptoms grouped with emotional complaints. Methods The Decisions at Menopause Study (DAMES) recruited 1,193 women from the general population in Beirut, Lebanon; Rabat, Morocco; Madrid, Spain; and central Massachusetts. Women participated in semi-structured interviews about health, menopause, and bodily changes at midlife. Women's responses to symptom checklists and their statements in response to open-ended questions were analyzed through factor analysis and textual analysis. Results There was considerable consistency between the frequencies of quantitative and qualitative responses, and the analyses of qualitative data illustrate the extent to which women associate somatic and emotional complaints. In open-ended responses, women in Massachusetts and Spain did not often cluster somatic symptoms together with emotional symptoms. In Morocco, dizziness, fatigue, and headaches were clustered with emotional symptoms. Women in Lebanon explicitly associated shortness of breath, chest pain, palpitations, dizziness, fatigue, gastro-intestinal complaints, headaches, and, to a lesser extent, joint pain and numbness with emotional symptoms. Conclusions The number of volunteered symptom responses was small because respondents were relatively healthy; however, the extent and pattern of association between somatic and emotional symptoms varied across sites. Certain somatic symptoms may be more likely to communicate psychosocial distress in particular cultures. These results have implications for patterns of health care utilization. PMID:22042326

Health after childbirth: patterns of reported postpartum morbidity from Lebanon.

PubMed

Kabakian-Khasholian, Tamar; Shayboub, Rawan; Ataya, Alexandra

2014-03-01

The postpartum period is under-researched in low and middle income countries. The scarce literature reveals heavy burden of ill health experienced in that period and under utilisation of health services. Understanding the postpartum morbidity burden and identifying the care-seeking behaviours is essential to improve service delivery. This paper examines reported postpartum morbidity, care seeking behaviour and whether postpartum morbidity is associated with method of birth. A cross sectional study of women delivering in 18 private hospitals from two regions in Lebanon was undertaken. Women in their second or third trimester of pregnancy, visiting private obstetric clinics affiliated with participating hospitals were interviewed for baseline information. Reported postpartum morbidity was assessed in an interview conducted at women's homes from 40 days up to six months postpartum. Of the 269 women recruited, physical postpartum health problems were reported by 93.6% and psychological health problems by 84.4% of women, with more health problems being reported beyond two months postpartum. Women were less likely to seek professional care for psychological health problems. Reporting postpartum health problems was not associated with method of birth. A heavy burden of postpartum morbidity is experienced by women with gaps in utilisation of relevant health services. Efforts should be directed towards the organisation and delivery of comprehensive maternity care services. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Contribution to the food products' analysis: A research and evaluation on the hemolytic effect of some pesticides used in Lebanon.

PubMed

Al-Alam, Josephine; Millet, Maurice; Chbani, Asma; Fajloun, Ziad

2015-01-01

Pesticides are a real concern for the society as their use has become critical, leading sometimes to their accumulation as residues in fruits and vegetables. After examining the pesticides sold in Northern Lebanon, this study is focused on the analysis and identification of pesticides residues in fruits and vegetables that are harvested in this region and treated with the locally sold pesticides. Results show: first, (i) a use of Zineb by the name of another pesticide Micronized Sulfur to avoid prosecution; (ii) a significant presence of Metalaxyl in lemons and oranges; (iii) a significant presence of Trifluralin in strawberries; and (iv) a significant presence of Zineb in lemons and tomatoes. Second, with the use of hemolytic tests on human blood results show: (i) a critical concentration and a significant hemolytic effect of some pesticides used in Lebanon; and (ii) an absence of hemolytic effect in the collected fractions of the different analyzed fruit extracts containing pesticides. Finally, this work is the first step for pesticides' analysis in vegetables and fruits in Lebanon, initiating a wider analytical study in order to control and examine the use of pesticides which, according to our results, could have an adverse effect on human health over a long term.

LIBS, Raman spectroscopy, and optical microscopy analyses of superficial encrustations on ancient tesserae in Lebanon

NASA Astrophysics Data System (ADS)

Tomkowska, Anna; Chmielewski, Krzysztof; Skrzyczanowski, Wojciech; Mularczyk-Oliwa, Monika; Ostrowski, Roman; Strzelec, Marek

2017-07-01

The aim of research was determination of composition and nature of superficial deposits, cumulated at the selected mosaic's tesserae from Lebanon. Selected were three series of objects from different locations, namely from the seaside and mountain archaeological sites as well as from the mosaics exposed in the city center. Analyzed were stone and ceramic tesserae. The selection of objects was dictated by wide diversification of factors influencing the state of preservation and composition of deposits in given location. Investigations were performed including LIBS, FT-IR, Raman spectroscopy and optical 3D microscopy. The experimental results included composition and kind of deposit at the tesserae surfaces, and composition of tesserae itself. Compounds in the superficial deposits were identified. Confirmed was occurrence of different encrustations in dependence on geographic localization of a given sample. The interpretation of results was supported by multivariate statistical techniques, especially by the factor analysis. Performed analyses constitute the pioneer realization in terms of determination of deposits composition at the surface of mosaics from the Lebanon territory.

Cervical cancer screening among Lebanese women.

PubMed

Bou-Orm, I R; Sakr, R E; Adib, S M

2018-02-01

Cervical cancer is a very common malignancy amongst women worldwide. Pap smear is an effective and inexpensive screening test in asymptomatic women. The aim of this paper was to assess the prevalence of Pap smear screening for cervical cancer among Lebanese women and to determine associated sociodemographic and psychosocial characteristics. This national survey included 2255 women, selected by multi-stage random cluster sampling across Lebanon. A questionnaire about practices and perceptions related to cervical cancer screening was developed based on the "Health Belief Model". The weighted national prevalence of "ever-use" of the Pap smear for screening purposes was 35%. Most important determinants of screening behavior were: residence within Greater Beirut, higher socio-economic status and educational attainment, marriage status, presence of a health coverage, awareness of Pap smear usefulness, knowing someone who had already done it, and a balance between perceived benefits and perceived barriers to Pap smear screening. Regular information campaigns regarding the availability and effectiveness of the test should be devised, targeting in priority the sexually vulnerable women in Lebanon. Moreover, healthcare providers should be encouraged to discuss with their patients the opportunity of obtaining a Pap smear. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Ethical Considerations in HIV/AIDS Biobehavioral Surveys That Use Respondent-Driven Sampling: Illustrations From Lebanon

PubMed Central

DeJong, Jocelyn; Mahfoud, Ziyad; Khoury, Danielle; Barbir, Farah

2009-01-01

Respondent-driven sampling is especially useful for reaching hidden populations and is increasingly used internationally in public health research, particularly on HIV. Respondent-driven sampling involves peer recruitment and has a dual-incentive structure: both recruiters and their peer recruits are paid. Recent literature focusing on the ethical dimensions of this method in the US context has identified integral safeguards that protect against ethical violations. We analyzed a study of 3 groups in Lebanon who are at risk for HIV (injection drug users, men who have sex with men, female sex workers) and the ethical issues that arose. More explicit attention should be given to ethical issues involved in research implementing respondent-driven sampling of at-risk populations in developing countries, where ethical review mechanisms may be weak. PMID:19608961

Outdoor air pollution and cardiovascular diseases in Lebanon: a case-control study.

PubMed

Nasser, Zeina; Salameh, Pascale; Dakik, Habib; Elias, Elias; Abou Abbas, Linda; Levêque, Alain

2015-01-01

Outdoor air pollution is increasingly considered as a serious threat for cardiovascular diseases (CVD). The aim of this study is to investigate the association between outdoor pollutants and cardiovascular diseases among adults in Lebanon and to examine the possible moderator effect of cigarette smoking status on this association. A multicenter case-control study was conducted between October 2011 and October 2012. Cases were hospitalized patients diagnosed with CVD by a cardiologist while the control group subjects were free of any cardiac diseases. Information on sociodemographic characteristics, tobacco consumption, self-rated global health, pollution exposure, and other risk factors was collected using a questionnaire. The results of the logistic regression revealed that living near busy highway (OR 5.04, 95% CI (4.44-12.85), P < 0.001) and close to local diesel generator (OR 4.76, 95% CI (2.07-10.91), P < 0.001) was significantly associated with CVD. The association between the CVD and exposure to outside pollutants differed by cigarette smoking status. A clear difference was noted between nonsmokers and current smokers OR 4.6, 95% CI (1.10-19.25) and OR 10.11, 95% CI (7.33-20.23), respectively. Forthcoming studies are needed to clarify the potential link between outdoor air pollution and cardiovascular diseases in Lebanon. Public health interventions must be implemented to reduce air pollution and to improve air quality.

Health system resilience: Lebanon and the Syrian refugee crisis

PubMed Central

Ammar, Walid; Kdouh, Ola; Hammoud, Rawan; Hamadeh, Randa; Harb, Hilda; Ammar, Zeina; Atun, Rifat; Christiani, David; Zalloua, Pierre A

2016-01-01

Background Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis. Methods We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system. Results In studying the case of Lebanon we used input–process–output–outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them. Conclusion Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved. PMID:28154758

Infection Control Measures in Private Dental Clinics in Lebanon

PubMed Central

Sfeir, Charles

2017-01-01

Purpose Evaluate infection control knowledge, attitude, and practice in Lebanese private dental clinics. Materials and Methods A survey including 46 questions related to routine safety procedures was sent to 1150 Lebanese dentists between July 1st and 2nd, 2015. The study sample was selected from the database of registered dentists based on a proportional random sampling ensuring equitable representation of the 5 geographic regions of Lebanon. A subset of 29 questions was used to generate an overall score of compliance (excellent, good, fair, and poor). Comparisons according to gender, type, region, and years of practice were performed. Results 417 dentists returned the completed questionnaires. 96% expressed concern about infection transmission, 90.6% were vaccinated against Hepatitis B, and 61.8% asked routinely about patients medical history. Only 43% used protective eyewear. Although most dentists (65%) used autoclaves, dry heat was still used. Significant correlations were found between gender and use of personal protective equipment. Less compliance was shown by clinicians with fewer years of experience. In the overall compliance questionnaire, the mean percentage of correct answers was roughly 54% with <5% of the practitioners scoring “excellent.” Conclusions. The study found inadequacy of compliance in private Lebanese dental clinics necessitating improved educational training and sustained monitoring by regulatory bodies. PMID:28642792

Smuggling as the "key to a combined market": British American Tobacco in Lebanon.

PubMed

Nakkash, R; Lee, K

2008-10-01

To understand the strategy of British American Tobacco (BAT) and other transnational tobacco companies (TTCs) to gain access to the Lebanese market, which has remained relatively closed under monopoly ownership and political instability. Analysis of internal industry documents, local language secondary sources and industry publications. TTCs have relied on legal and illegal channels to supply the Lebanese market since at least the 1970s. Available documents suggest smuggling has been an important component of BAT's market entry strategy, transported in substantial quantities via middlemen for sale in Lebanon and neighbouring countries. TTCs took advantage of weak and unstable governance, resulting in uncertainty over the Regie's legal status, and continued to supply the contraband trade despite appeals by the government to cease undermining its revenues. Since the end of the civil war in the early 1990s, continued uncertainty about the tobacco monopoly amid political instability has encouraged TTCs to seek a legal presence in the country, while continuing to achieve substantial sales through contraband. Evidence of the complicity of TTCs in cigarette smuggling extends to Lebanon and the Middle East where this trade has especially benefited from weak governance and chronic political instability. The regional nature of TTC strategy supports strong international cooperation under the Framework Convention on Tobacco Control to tackle the problem.

Validity and reliability of the Arabic version of the Household Food Insecurity Access Scale in rural Lebanon.

PubMed

Naja, Farah; Hwalla, Nahla; Fossian, Talar; Zebian, Dina; Nasreddine, Lara

2015-02-01

To assess the validity and reliability of the Arabic version of the Household Food Insecurity Access Scale (HFIAS) in rural Lebanon. A cross-sectional study on a sample of households with at least one child aged 0-2 years. In a one-to-one interview, participants completed an adapted Arabic version of the HFIAS. In order to evaluate the validity of the HFIAS, basic sociodemographic information, anthropometric measurements of the mother and child, and dietary intake data of the child were obtained. In order to examine reproducibility, the HFIAS was re-administered after 3 months. Rural Lebanon. Mother and child pairs (n 150). Factor analysis of HFIAS items revealed two factors: 'insufficient food quality' and 'insufficient food quantity'. Using Pearson's correlation, food insecurity was inversely associated with mother's and father's education levels, number of cars and electrical appliances in the household, income, weight-for-age and length-for-age of the child and the child's dietary adequacy. In contrast, mother's BMI and crowding index were positively associated with food insecurity scores (P < 0·05 for all correlations). Cronbach's α of the scale was 0·91. A moderate correlation was observed between the two administrations of the questionnaire (intra-class correlation = 0·58; P < 0·05). Our findings indicated that the adapted Arabic version of the HFIAS is a valid and reliable tool to assess food insecurity in rural Lebanon, lending further evidence to the utility of the HFIAS in assessing food insecurity in culturally diverse populations.

Perceived Online Education Barriers of Administrators and Faculty at a U.S. University in Lebanon

ERIC Educational Resources Information Center

El Turk, Sahar; Cherney, Isabelle D.

2016-01-01

The purpose of this quantitative study was to identify the perceived barriers obstructing the implementation of online education by administrators and faculty at the School of Arts and Sciences of a U.S. university located in Lebanon. The aim of this study was to offer a solution to the most important perceived barriers to online education that…

Education for Social Cohesion Attempts in Lebanon: Reflections on the 1994 and 2010 Education Reforms

ERIC Educational Resources Information Center

Shuayb, Maha

2016-01-01

Following the end of the Lebanese civil war, education was put forward as a major means for rebuilding Lebanon and promoting social cohesion and unity. A huge education development plan was launched in 1994 culminating in a new national curriculum in 1997 and the production of new textbooks. Although the quality of education improved in public…

High burden of rheumatic diseases in Lebanon: a COPCORD study.

PubMed

Chaaya, Monique; Slim, Zeinab N; Habib, Rima R; Arayssi, Thurayya; Dana, Rouwayda; Hamdan, Omar; Assi, Maher; Issa, Zeinab; Uthman, Imad

2012-04-01

To estimate the prevalence of rheumatic diseases in Lebanon and to explore their distribution by geographic location, age, and gender.   Using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology, a random sample of 3530 individuals aged 15 and above was interviewed from the six Lebanese governorates. Positive respondents were evaluated by rheumatologists using the internationally accepted classification criterion of the American College of Rheumatology for the diagnosis of rheumatic diseases. Prevalence rates of current and past musculoskeletal problems were 24.4% and 8.4%, respectively. Shoulder (14.3%), knee (14.2%) and back (13.6%) were the most common pain sites. Point prevalence of rheumatic diseases was 15.0%. The most frequent types of rheumatic diseases were of mechanical origin, namely soft tissue rheumatism (5.8%) and osteoarthritis (4.0%). Rheumatoid arthritis (1.0%) and spondylathropathies (0.3%) constituted the most common inflammatory diseases. Coastal areas had the lowest prevalence of all diseases except for fibromyalgia. All diseases showed an increasing prevalence pattern with age and a higher prevalence among women than men. This is the first study to give population-based estimates of rheumatic diseases in Lebanon. The high burden calls for public health attention for early detection, control and prevention of these conditions. Point prevalence of individual diseases was within the range of results from other COPCORD surveys with some variations that can be attributed to differences in methodology and geo-ethnic factors. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

Wide spread of OXA-23-producing carbapenem-resistant Acinetobacter baumannii belonging to clonal complex II in different hospitals in Lebanon.

PubMed

Al Atrouni, Ahmad; Hamze, Monzer; Jisr, Tamima; Lemarié, Carole; Eveillard, Matthieu; Joly-Guillou, Marie-Laure; Kempf, Marie

2016-11-01

To investigate the molecular epidemiology of Acinetobacter baumannii strains isolated from different hospitals in Lebanon. A total of 119 non-duplicate Acinetobacter strains were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and partial rpoB gene sequencing. Antibiotic susceptibility testing was performed by disc diffusion method and all identified carbapenem-resistant isolates were investigated by PCR assays for the presence of the carbapenemase-encoding genes. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were used for molecular typing. Of the 119 A. baumannii isolates, 76.5% were resistant to carbapenems. The most common carbapenemase was the OXA-23-type, found in 82 isolates. The study of population structure using MLST revealed the presence of 30 sequence types (STs) including 18 new ones, with ST2 being the most commonly detected, accounting for 61% of the isolates typed. PFGE performed on all strains of ST2 identified a major cluster of 53 isolates, in addition to three other minor clusters and ten unique profiles. This study highlights the wide dissemination of highly related OXA-23-producing carbapenem-resistant A. baumannii belonging to the international clone II in Lebanon. Thus, appropriate infection control measures are recommended in order to control the geographical spread of this clone in this country. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Hydrogeology of the carbonate rocks of the Lebanon Valley, Pennsylvania

USGS Publications Warehouse

Meisler, Harold

1963-01-01

The Lebanon Valley, which is part of the Great Valley in southeastern Pennsylvania, is underlain by carbonate rocks in the southern part and by shale in the northern part. The carbonate rocks consist of alternating beds of limestone and dolomite of Cambrian and Ordovician age. Although the beds generally dip to the south, progressively younger beds crop out to the north, because the rocks are overturned. The stratigraphic units, from oldest to youngest, are: the Buffalo Springs Formation, Snitz Creek, Schaefferstown, Millbach, and Richland Formations of the Conococheague Group; the Stonehenge, Rickenbach, Epler, and Ontelaunee Formations of the Beekmantown Group; and the Annville, Myerstown, and Hershey Limestones.

Implementation of the Social Decision-Making Skills Curriculum on Primary Students (Grades 1-3) in Lebanon

ERIC Educational Resources Information Center

El Hassan, Karma; Mouganie, Zeina

2014-01-01

This study investigated the effect of the Social Decision-Making Skills Curriculum (SDSC) on the emotional intelligence and the prosocial behaviors of primary students in Grades 1-3, in a private school in Lebanon. Students were trained in social problem-solving and social decision-making skills through the implementation of the SDSC. Participants…

Extrahuman Epidemiology of Acinetobacter baumannii in Lebanon

PubMed Central

Rafei, Rayane; Hamze, Monzer; Pailhoriès, Hélène; Eveillard, Matthieu; Marsollier, Laurent; Joly-Guillou, Marie-Laure; Dabboussi, Fouad

2015-01-01

The presence of Acinetobacter baumannii outside hospitals is still a controversial issue. The objective of our study was to explore the extrahospital epidemiology of A. baumannii in Lebanon. From February 2012 to October 2013, a total of 73 water samples, 51 soil samples, 37 raw cow milk samples, 50 cow meat samples, 7 raw cheese samples, and 379 animal samples were analyzed by cultural methods for the presence of A. baumannii. Species identification was performed by rpoB gene sequencing. Antibiotic susceptibility was investigated, and the A. baumannii population was studied by two genotyping approaches: multilocus sequence typing (MLST) and blaOXA-51 sequence-based typing (SBT). A. baumannii was detected in 6.9% of water samples, 2.7% of milk samples, 8.0% of meat samples, 14.3% of cheese samples, and 7.7% of animal samples. All isolates showed a susceptible phenotype against most of the antibiotics tested and lacked carbapenemase-encoding genes, except one that harbored a blaOXA-143 gene. MLST analysis revealed the presence of 36 sequence types (STs), among which 24 were novel STs reported for the first time in this study. blaOXA-51 SBT showed the presence of 34 variants, among which 21 were novel and all were isolated from animal origins. Finally, 30 isolates had new partial rpoB sequences and were considered putative new Acinetobacter species. In conclusion, animals can be a potential reservoir for A. baumannii and the dissemination of new emerging carbapenemases. The roles of the novel animal clones identified in community-acquired infections should be investigated. PMID:25616788

A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan.

PubMed

El-Jardali, Fadi; Fadlallah, Racha

2017-08-16

Improving quality of care and patient safety practices can strengthen health care delivery systems, improve health sector performance, and accelerate attainment of health-related Sustainability Development Goals. Although quality improvement is now prominent on the health policy agendas of governments in low- and middle-income countries (LMICs), including countries of the Eastern Mediterranean Region (EMR), progress to date has not been optimal. The objective of this study is to comprehensively review existing quality improvement and patient safety policies and strategies in two selected countries of the EMR (Lebanon and Jordan) to determine the extent to which these have been institutionalized within existing health systems. We used a mixed methods approach that combined documentation review, stakeholder surveys and key informant interviews. Existing quality improvement and patient safety initiatives were assessed across five components of an analytical framework for assessing health care quality and patient safety: health systems context; national policies and legislation; organizations and institutions; methods, techniques and tools; and health care infrastructure and resources. Both Lebanon and Jordan have made important progress in terms of increased attention to quality and accreditation in national health plans and strategies, licensing requirements for health care professionals and organizations (albeit to varying extents), and investments in health information systems. A key deficiency in both countries is the absence of an explicit national policy for quality improvement and patient safety across the health system. Instead, there is a spread of several (disjointed) pieces of legal measures and national plans leading to fragmentation and lack of clear articulation of responsibilities across the entire continuum of care. Moreover, both countries lack national sets of standardized and applicable quality indicators for performance measurement and benchmarking

Building clinical practice in the Palestine Red Crescent operation theatres in Lebanon: reflections from the perspective of an expatriate nurse.

PubMed

Tjoflåt, I; Karlsen, B

2013-12-01

This paper, based on the experience of the first author as an expatriate nurse, aims to describe and discuss some aspects of collaboration that contributed to the building of clinical practice when implementing an operating theatre programme in the Palestine Red Crescent Society (PRCS) hospitals in Lebanon. The operation theatre programme lasted for 8 months: 6 months in 2008 and 2 months in 2009. The programme was part of the partnership project 'Quality of care in the five PRCS hospitals in Lebanon' between the International Committee of the Red Cross and the PRCS Lebanon (PRCS-L) branch. The essential aspects that may have contributed to the building of clinical practice in the operation theatre programme included the expatriate nurse and the Palestine Red Crescent operating theatre nurses working together over time as colleagues, the socio-cultural pedagogic perspective selected for the implementation and the collaboration with the management of the hospitals and counterparts in the PRCS-L branch. One should also note the human and structural issues that seemed to influence the implementation of the programme in a more negative way. This experience may provide insight for other nurses into the importance of working as colleagues, selecting an appropriate pedagogic perspective and establishing productive collaboration with all partners when building clinical practice during a humanitarian mission. © 2013 International Council of Nurses.

GPS Measurements of Crustal Deformation in Lebanon: Implication for Current Kinematics of the Sinaï Plate.

NASA Astrophysics Data System (ADS)

Vergnolle, M.; Jomaa, R.; Brax, M.; Menut, J. L.; Sursock, A.; Elias, A. R.; Mariscal, A.; Vidal, M.; Cotte, N.

2016-12-01

The Levant fault is a major strike-slip fault bounding the Arabia and the Sinaï plates. Its kinematics, although understood in its main characteristics, remains partly unresolved in its quantification, especially in the Lebanese restraining bend. We present a GPS velocity field based on survey GPS data acquired in Lebanon (1999, 2002, 2010) and on continuous GPS data publicly available in the Levant area. To complete the measurements along the Levant fault, we combine our velocity field with previously published velocity fields. First, from our velocity field, we derive two velocity profiles, across the Lebanese fault system, which we analyze in terms of elastic strain accumulation. Despite the uncertainty on the locking depth of the main strand of the Levant fault, small lateral fault slip rates (2-4mm/yr) are detected on each profile, with a slight slip rate decrease (<1mm/yr) from south to north. The latter is consistent with published results south and north of Lebanon. Small compression (<0.5mm/yr), with most part of it located across Mount Lebanon, is also suggested. Second, we analyze the combined GPS velocity field in the Sinaï tectonic framework. We evaluate how well the Sinaï plate motion is described with an Euler pole. Due to heterogeneous velocity errors (5 times smaller for cGPS velocities wrt sGPS velocities), a unique pole estimation using all the data provides good statistical results. However, the residuals show systematic deviations at central and northern sGPS stations. Using only the velocities at these stations, the estimated pole is significantly different from the unique pole at 95% confidence level. This analysis highlights the difficulty to robustly resolve the rigid Sinaï plate motion while the uncertainties on the velocities are heterogeneous. New sGPS measurements on existing sites should improve the solution and help to conclude.

Seeking maternal care at times of conflict: the case of Lebanon.

PubMed

Kabakian-Khasholian, Tamar; Shayboub, Rawan; El-Kak, Faysal

2013-01-01

Providing quality maternity care within the emergency care packages for internally displaced populations in war-affected areas is somewhat challenging, although very essential. In this retrospective study, we describe the experiences and health care seeking behaviors of 1,015 pregnant and postpartum women during the 2006 war in Lebanon. Women reported interruptions in regular maternity care and experienced more complications during this period. Availability of health services and experiences of complications were the most important determinants of health care seeking behaviors. Maternal health services should be a part of any comprehensive emergency responsiveness plan, catering to women's needs in war-affected areas.

Users' reaction to the drought of 2014 in Lebanon; quantifying the effects

NASA Astrophysics Data System (ADS)

Farajalla, Nadim; Haydamous, Patricia; El Hajj, Rana

2016-04-01

A drought that Lebanon witnessed during the water cycle of 2013-2014 seemed to mimic the expected decrease in precipitation projected in one of the 2020 scenarios reported in Lebanon's second national communication to the United Nations Framework Convention on Climate Change. Nationally, data and assessment studies on drought impacts are generally lacking, and thus, this drought presented an opportunity to quantify drought effects. In the aim of understanding the effect drought has on the Lebanese economy, and its different sectors, a survey was conducted to set a baseline of the changes in the direct cost of water as well as other impacts that might have resulted on the water users. The survey reached out to different sectors to include the touristic establishments, industries, agriculture holders, and households. The sample selection and the data collection underwent several controls in order to ensure unbiased data. Moreover, a descriptive analysis was produced from the survey results, using STATA and Microsoft Excel. The main results have shown a shift of dependency towards water tankers during the drought season as opposed to the normal higher dependency on the public networks and private wells. Moreover, the cost incurred in general showed an average of 32% increase to the previous water bills across the different sectors, this in return is expected to have ripple effects on the national economy accounting for around 13.5% of GDP. However, the survey showed that little was done in terms of long term adaptation on the consumers' side, where most of the adaptation done included awareness campaigns for an economized water usage on the short term. The survey brought forward the un-preparedness of the country to react to such extreme events due to the absence of drought preparedness and management plan. . The results highlight the projected losses the country will have if no proper adaptation measures were taken. These impacts were caused by a one-year drought

Incidence and severity of ocular and adnexal injuries during the Second Lebanon War among Israeli soldiers and civilians.

PubMed

Barak, Adiel; Elhalel, Amir; Pikkel, Joseph; Krauss, Eli; Miller, Benjamin

2011-12-01

To analyze the incidence and severity of ocular and adnexal injuries in the Second Lebanon War among Israeli soldiers and civilians. Retrospective cohort study. All patients recorded in the Israeli National Trauma Registry during the Second Lebanon War (July-August, 2006). Retrieval of all data relevant to ocular and adnexal injuries sustained during the study period, and differentiation between those associated with combat/terrorist and other events. Analysis of data according to the severity of trauma , anatomical location of the injury, and whether the patients were military personnel or civilians. A total of 69 war-related ocular trauma patients (58 military personnel and 11 civilians) were registered during the 34 days of war. The injuries involved the anterior segment injury (n = 25), posterior segment (n = 29) and the periocular region (n = 15, all severe). Twenty-seven of the patients had open-globe injuries, of which 18 involved intraocular foreign bodies, and 27 patients had closed-globe injuries. The rate of ocular injuries was 7% among all registered wounded military personnel and 1.2% among all injured civilians. The incidence and severity of ocular and adnexal injuries among military personnel during the Second Lebanon War were consistent with previous reports from American sources of ocular injuries sustained in Iraq and Afghanistan. The rates of ocular injury associated with wartime events sustained by civilians has not been investigated before, and it was relatively low, probably as a result of stringent government-mandated building regulations for passive defense that are discussed.

Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): the case for Lebanon.

PubMed

Saade, Georges; Warren, Charles W; Jones, Nathan R; Asma, Samira; Mokdad, Ali

2008-09-01

The purpose of this paper is to use data collected in the 2001 and 2005 Lebanon Global Youth Tobacco Survey (GYTS) to monitor articles in the WHO Framework Convention on Tobacco Control (WHO FCTC). This information is necessary to enhance the capacity of the Ministry of Health and relevant organizations to design, implement, and evaluate tobacco control and prevention programs in Lebanon, especially among adolescents. The GYTS is a school-based survey which uses a two-stage sample design to produce representative, independent, cross-sectional estimates. The GYTS was conducted in 2001 and 2005 in Lebanon to produce representative national estimates. Data in this report are limited to students aged 13-15 years. In total, 5035 students from 50 schools participated in 2001; and 3341 students from 50 schools participated in 2005. The data in this report show that, in 2005, 8.6% of the students currently smoked cigarettes, but 33.9% currently smoked narguileh. Half of current smokers wanted to stop smoking and 6 in 10 have tried to stop during the past year but have failed. In 2005, exposure to SHS at home (78.4%) and in public places (74.4%) was very high; while 85.2% thought smoking should be banned in public places. Nearly 9 in 10 students who usually buy their cigarettes in stores were not refused purchase because of their age. Overall, only half of the students in Lebanon reported that during the past school year they had been taught about the dangers of smoking. Data in this report can be used as baseline measures for future evaluation of the tobacco control programs implemented by the Ministry of Health with particular attention to youth. The key for the Lebanese parliament is to develop, endorse, implement and enforce these new tobacco control laws and use the data from GYTS to monitor progress toward achieving the goals of the WHO FCTC. One key component of tobacco control needs to be the monitoring of Narguileh use among youth, a new emergency.

Food insecurity among Iraqi refugees living in Lebanon, 10 years after the invasion of Iraq: data from a household survey.

PubMed

Ghattas, Hala; Sassine, AnnieBelle J; Seyfert, Karin; Nord, Mark; Sahyoun, Nadine R

2014-07-14

Iraqi refugees in Lebanon are vulnerable to food insecurity because of their limited rights and fragile livelihoods. The objective of the present study was to assess household food insecurity among Iraqi refugees living in Lebanon, almost 10 years after the invasion of Iraq. A representative survey of 800 UN High Commissioner for Refugees-registered refugee households in Lebanon was conducted using multi-stage cluster random sampling. We measured food insecurity using a modified US Department of Agriculture household food security module. We collected data on household demographic, socio-economic, health, housing and dietary diversity status and analysed these factors by food security status. Hb level was measured in a subset of children below 5 years of age (n 85). Weighted data were used in univariate and multivariate analyses. Among the Iraqi refugee households surveyed (n 630), 20·1% (95% CI 17·3, 23·2) were found to be food secure, 35·5% (95% CI 32·0, 39·2) moderately food insecure and 44·4% (95% CI 40·8, 48·1) severely food insecure. Severe food insecurity was associated with the respondent's good self-reported health (OR 0·3, 95% CI 0·2, 0·5), length of stay as a refugee (OR 1·1, 95% CI 1·0, 1·2), very poor housing quality (OR 3·3, 95% CI 1·6, 6·5) and the number of children in the household (OR 1·2, 95% CI 1·0, 1·4), and resulted in poor dietary diversity (P< 0·0001). Anaemia was found in 41% (95% CI 30·6, 51·9) of children below 5 years of age, but was not associated with food insecurity. High food insecurity, low diet quality and high prevalence of anaemia in Iraqi refugees living in Lebanon call for urgent programmes to address the food and health situation of this population with restricted rights.

Genetic heterogeneity of Beta thalassemia in Lebanon reflects historic and recent population migration.

PubMed

Makhoul, N J; Wells, R S; Kaspar, H; Shbaklo, H; Taher, A; Chakar, N; Zalloua, P A

2005-01-01

Beta thalassemia is an autosomal recessive disorder characterized by reduced (beta(+)) or absent (beta(0)) beta-globin chain synthesis. In Lebanon it is the most predominant genetic defect. In this study we investigated the religious and geographic distribution of the beta-thalassemia mutations identified in Lebanon, and traced their precise origins. A total of 520 beta-globin chromosomes from patients of different religious and regional backgrounds was studied. Beta thalassemia mutations were identified using Amplification Refractory Mutation System (ARMS) PCR or direct gene sequencing. Six (IVS-I-110, IVS-I-1, IVS-I-6, IVS-II-1, cd 5 and the C > T substitution at cd 29) out of 20 beta-globin defects identified accounted for more than 86% of the total beta-thalassemia chromosomes. Sunni Muslims had the highest beta-thalassemia carrier rate and presented the greatest heterogeneity, with 16 different mutations. Shiite Muslims followed closely with 13 mutations, whereas Maronites represented 11.9% of all beta-thalassemic subjects and carried 7 different mutations. RFLP haplotype analysis showed that the observed genetic diversity originated from both new mutational events and gene flow from population migration. This study provides information about the types and distribution of beta-thalassemia mutations within each religious group and geographic region, which is essential for the implementation of screening and prevention programs.

Attitudes towards domestic violence in Lebanon: a qualitative study of primary care practitioners.

PubMed

Usta, Jinan; Feder, Gene; Antoun, Jumana

2014-06-01

Domestic violence (DV) is highly prevalent in the developing and developed world. Healthcare systems internationally are still not adequately addressing the needs of patients experiencing violence. To explore physicians' attitudes about responding to DV, their perception of the physician's role, and the factors that influence their response. Qualitative study using individual interviews among primary care practitioners working in Lebanon. Primary care clinicians practising for >5 years and with >100 patient consultations a week were interviewed. Physicians were asked about their practice when encountering women disclosing abuse, their opinion about the engagement of the health services with DV, their potential role, and the anticipated reaction of patients and society to this extended role. Physicians felt that they were well positioned to play a pivotal role in addressing DV; yet they had concerns related to personal safety, worry about losing patients, and opposing the norms of a largely conservative society. Several physicians justified DV or blamed the survivor rather than the perpetrator for triggering the violent behaviour. Moreover, religion was perceived as sanctioning DV. Perceived cultural norms and religious beliefs seem to be major barriers to physicians responding to DV in Lebanon, and possibly in the Arab world more generally. Financial concerns also need to be addressed to encourage physicians to address DV. © British Journal of General Practice 2014.

Older Adults, in Lebanon, Committed to Learning: Contextualizing the Challenges and the Benefits of Their Learning Experience

ERIC Educational Resources Information Center

Hachem, Hany; Vuopala, Essi

2016-01-01

The University for the Third Age, a relatively new concept in Lebanon, provides educational and social opportunities for older adults. The goal of later-life educational institutions supposedly covers more than a mere provision of learning. This being said, highlighting the significance of rewards associated with older adult learning--and the…

Symptoms of post-traumatic stress disorder among battered women in Lebanon: an exploratory study.

PubMed

Khadra, Christelle; Wehbe, Nancy; Lachance Fiola, Jacinthe; Skaff, Wadih; Nehmé, Mona

2015-01-01

Intimate partner violence against women is common in Lebanon and can lead to major health problems. However, the incidence of symptoms of post-traumatic stress disorder (PTSD) in battered women has not been extensively explored in the Lebanese cultural context. The objectives of this study were as follows: (a) to determine the prevalence of PTSD symptoms among women in Lebanon who have been physically abused by their partners, (b) to assess whether the rate of PTSD symptoms varied according to sociodemographic variables, and (c) to reveal other attributes that might be risk factors for developing symptoms of PTSD. Of the 95 physically abused women who met inclusion criteria, 85 completed a questionnaire including sociodemographic questions, the physical abuse subscale of the Composite Abuse Scale (CAS), and the PTSD Checklist-Civilian Version (PCL-C). Results showed a high prevalence of PTSD symptoms (97%), positively correlated with physical violence (r = .719). Lower education level and recent abuse were correlated with symptom severity, as were the number of problematic habitual behaviors in the abusive partner and the use of psychotherapy. Increased involvement of health care professionals in the detection of women at risk, with referral to appropriate resources, is suggested to improve prevention and management efforts. © The Author(s) 2014.

Pilot-based assessment of the economics of recycling construction demolition waste.

PubMed

Srour, Issam M; Chehab, Ghassan R; El-Fadel, Mutasem; Tamraz, Sandy

2013-11-01

The significant amount of waste generated from construction demolition has become a chronic problem in many developing countries. Using data obtained from demolition contractors and various other sources, this paper proposes a framework for proper handling of construction demolition waste (CDW) to serve as a decision support tool in countries suffering from the lack of national CDW management guidelines. The framework is then demonstrated through a case study in the city of Beirut, Lebanon, and a sensitivity analysis is carried out to examine the economic feasibility of developing a recycling facility. The analysis showed that in order for a facility to be feasible, a gate fee should be charged in the presence of a market for recycled aggregates. The results confirm the significance of instigating and implementing legislation to control illegal dumping, constructing, and managing engineered landfills, and establishing markets for recycled CDW.

Snow observations in Mount Lebanon (2011-2016)

NASA Astrophysics Data System (ADS)

Fayad, Abbas; Gascoin, Simon; Faour, Ghaleb; Fanise, Pascal; Drapeau, Laurent; Somma, Janine; Fadel, Ali; Bitar, Ahmad Al; Escadafal, Richard

2017-08-01

We present a unique meteorological and snow observational dataset in Mount Lebanon, a mountainous region with a Mediterranean climate, where snowmelt is an essential water resource. The study region covers the recharge area of three karstic river basins (total area of 1092 km2 and an elevation up to 3088 m). The dataset consists of (1) continuous meteorological and snow height observations, (2) snowpack field measurements, and (3) medium-resolution satellite snow cover data. The continuous meteorological measurements at three automatic weather stations (MZA, 2296 m; LAQ, 1840 m; and CED, 2834 m a.s.l.) include surface air temperature and humidity, precipitation, wind speed and direction, incoming and reflected shortwave irradiance, and snow height, at 30 min intervals for the snow seasons (November-June) between 2011 and 2016 for MZA and between 2014 and 2016 for CED and LAQ. Precipitation data were filtered and corrected for Geonor undercatch. Observations of snow height (HS), snow water equivalent, and snow density were collected at 30 snow courses located at elevations between 1300 and 2900 m a.s.l. during the two snow seasons of 2014-2016 with an average revisit time of 11 days. Daily gap-free snow cover extent (SCA) and snow cover duration (SCD) maps derived from MODIS snow products are provided for the same period (2011-2016). We used the dataset to characterize mean snow height, snow water equivalent (SWE), and density for the first time in Mount Lebanon. Snow seasonal variability was characterized with high HS and SWE variance and a relatively high snow density mean equal to 467 kg m-3. We find that the relationship between snow depth and snow density is specific to the Mediterranean climate. The current model explained 34 % of the variability in the entire dataset (all regions between 1300 and 2900 m a.s.l.) and 62 % for high mountain regions (elevation 2200-2900 m a.s.l.). The dataset is suitable for the investigation of snow dynamics and for the forcing

Syrian Refugees: Are They a Non Traditional Threat to Water Supplies in Lebanon and Jordan

DTIC Science & Technology

2016-09-01

THREAT TO WATER SUPPLIES IN LEBANON AND JORDAN? 5. FUNDING NUMBERS 6. AUTHOR(S) Stephen J. Klingseis 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS...ES) Naval Postgraduate School Monterey, CA 93943-5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING /MONITORING AGENCY NAME(S) AND...INTENTIONALLY LEFT BLANK ix LIST OF ACRONYMS AND ABBREVIATIONS MWI Ministry of Water and Irrigation NGO non-governmental organization OECD

Learning the Nation in Exile: Constructing Youth Identities, Belonging and "Citizenship" in Palestinian Refugee Camps in South Lebanon

ERIC Educational Resources Information Center

Fincham, Kathleen

2012-01-01

This paper examines the ways in which "Palestine" and "Palestinianess" are culturally, socially and symbolically produced and regulated through formal and non-formal institutional sites in Palestinian camps in south Lebanon. It argues that although institutional power, processes and outcomes help to construct shared notions of…

A national cross-sectional study on nurses' intent to leave and job satisfaction in Lebanon: implications for policy and practice

PubMed Central

El-Jardali, Fadi; Dimassi, Hani; Dumit, Nuhad; Jamal, Diana; Mouro, Gladys

2009-01-01

Background Lebanon is perceived to be suffering from excessive nurse migration, low job satisfaction, poor retention and high turnover. Little is known about the magnitude of nurse migration and predictors of intent to leave. The objective of this study is to determine the extent of nurses' intent to leave and examine the impact of job satisfaction on intent to leave. Intent to leave was explored to differentiate between nurses who intend to leave their current hospital and those intending to leave the country. Methods A cross-sectional design was used to survey nurses currently practicing in Lebanese hospitals. A total of 1,793 nurses employed in 69 hospitals were surveyed. Questions included those relating to demographic characteristics, intent to leave, and the McCloskey Mueller Satisfaction Scale. Univariate descriptive statistics were conducted on sample's demographic characteristics including gender, age, marital status and educational level. Bivariate associations between intent to leave and demographic characteristics were tested using Pearson Chi-square. Differences in satisfaction scores between nurses with and without intent to leave were tested using t-test and ANOVA f-test. A multinomial logistic regression model was created to predict intent to leave the hospital and intent to leave the country. Results An alarming 67.5% reported intent to leave within the next 1 to 3 years, many of whom disclosed intent to leave the country (36.7%). Within nurses who reported an intent to leave the hospital but stay in Lebanon, 22.1% plan to move to a different health organization in Lebanon, 29.4% plan to leave the profession and 48.5% had other plans. Nurses reported being least satisfied with extrinsic rewards. A common predictor of intent to leave the hospital and the country was dissatisfaction with extrinsic rewards. Other predictors of intent to leave (country or hospital) included age, gender, marital status, degree type, and dissatisfaction with scheduling

Motivation to quit smoking and acceptability of shocking warnings on cigarette packages in Lebanon

PubMed Central

Layoun, Nelly; Salameh, Pascal; Waked, Mirna; Aoun Bacha, Z; Zeenny, Rony M; El Hitti, Eric; Godin, Isabelle; Dramaix, Michèle

2017-01-01

Introduction Health warnings on tobacco packages have been considered an essential pillar in filling the gap of knowledge and communicating the health risks of tobacco use to consumers. Our primary objective was to report the perception of smokers on the textual health warnings already appearing on tobacco packages in Lebanon versus shocking pictures about the health-related smoking consequences and to evaluate their impact on smoking behaviors and motivation. Methods A pilot cross-sectional study was undertaken between 2013 and 2015 in five hospitals in Lebanon. Participants answered a questionnaire inquiring about sociodemographic characteristics, chronic respiratory symptoms, smoking behavior and motivation to quit smoking. Only-text warning versus shocking pictures was shown to the smokers during the interview. Results Exactly 66% of the participants reported that they thought shocking pictorial warnings would hypothetically be more effective tools to reduce/quit tobacco consumption compared to only textual warnings. Also, 31.9% of the smokers who were motivated to stop smoking reported that they actually had stopped smoking for at least 1 month secondary to the textual warnings effects. A higher motivation to quit cigarette smoking was seen among the following groups of smokers: males (odds ratio [OR] =1.8, P=0.02), who had stopped smoking for at least 1 month during the last year due to textual warning (OR =2.79, P<0.001), who considered it very important to report health warning on cigarette packs (OR =1.92, P=0.01), who had chronic expectoration (OR =1.81, P=0.06) and who would change their favorite cigarette pack if they found shocking images on the pack (OR =1.95, P=0.004). Conclusion Low-dependent smokers and highly motivated to quit smokers appeared to be more hypothetically susceptible to shocking pictorial warnings. Motivation to quit was associated with sensitivity to warnings, but not with the presence of all chronic respiratory symptoms. PMID

Patient-Physician Communication in the Era of Mobile Phones and Social Media Apps: Cross-Sectional Observational Study on Lebanese Physicians’ Perceptions and Attitudes

PubMed Central

Jabak, Suha; Sasso, Roula; Chamoun, Yara; Tamim, Hani

2018-01-01

Background The increased prevalence of virtual communication technology, particularly social media, has shifted the physician-patient relationship away from the well-established face-to-face interaction. The views and habits of physicians in Lebanon toward the use of online apps and social media as forms of patient communication have not been previously described. Objective The aim of this study is to describe the views of Lebanese physicians toward the use of social media and other online apps as means of patient communication. Methods This was a cross-sectional observational study using an online survey that addressed physicians’ perceptions on the use of virtual communication in their clinical practice. The study took place between April and June 2016, and was directed toward physicians at the American University of Beirut Medical Center. Results A total of 834 doctors received the online survey, with 238 physicians completing the survey. Most of the participants were from medical specialties. Most responders were attending physicians. Less than half of the respondents believed that Web-based apps and social media could be a useful tool for communicating with patients. Email was the most common form of professional online app, followed by WhatsApp (an instant messaging service). The majority of participants felt that this mode of communication can result in medicolegal issues and that it was a breach of privacy. Participants strictly against the use of virtual forms of communication made up 47.5% (113/238) of the study sample. Conclusions The majority of physicians at the American University of Beirut Medical Center are reluctant to use virtual communication technology as a form of patient communication. Appropriate policy making and strategies can allow both physicians and patients to communicate virtually in a more secure setting without fear of breaching privacy and confidentiality. PMID:29625955

Hyperopic laser in situ keratomileusis: comparison of femtosecond laser and mechanical microkeratome flap creation.

PubMed

Antonios, Rafic; Arba Mosquera, Samuel; Awwad, Shady T

2015-08-01

To evaluate and compare the refractive predictability and stability of laser in situ keratomileusis (LASIK) flap creation performed with a femtosecond laser and with a mechanical microkeratome to correct mild to moderate hyperopia. American University of Beirut Medical Center, Beirut, Lebanon. Retrospective case series. Patients who had hyperopic LASIK treatment using the Amaris excimer laser were included. Eyes in which the LDV femtosecond laser was used for flap creation were compared with eyes in which the Moria M2 microkeratome was used. The microkeratome group comprised 53 eyes and the femtosecond laser group, 72 eyes. Baseline characteristics were similar between groups (P > .05). The mean spherical equivalent (SE) deviation from target 1 week postoperatively was -0.08 diopter (D) ± 0.58 (SD) in the femtosecond laser group and -0.06 ± 0.87 D in the microkeratome group (P = .92). Thereafter, the mean SE deviation from target increased gradually and by 6 months postoperatively was +0.30 ± 0.50 D and +0.70 ± 0.71 D, respectively (P = .001). The correlation between the achieved and the attempted SE refraction was better in the femtosecond laser group (R(2) = 0.806) than the microkeratome group (R(2) = 0.671). Using the same nomogram, the short-term refractive outcomes of hyperopic LASIK with flap creation performed with the femtosecond laser were comparable to those for the microkeratome; however, the femtosecond group showed significantly better stability over the 6-month follow-up and better predictability, as reflected by a lower standard deviation and stronger Pearson correlation. Dr. Arba Mosquera is an employee of Schwind eye-tech-solutions GmbH and Co. KG. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Burden and treatment patterns of invasive fungal infections in hospitalized patients in the Middle East: real-world data from Saudi Arabia and Lebanon.

PubMed

Alothman, Adel F; Althaqafi, Abdulhakeem O; Matar, Madonna J; Moghnieh, Rima; Alenazi, Thamer H; Farahat, Fayssal M; Corman, Shelby; Solem, Caitlyn T; Raghubir, Nirvana; Macahilig, Cynthia; Charbonneau, Claudie; Stephens, Jennifer M

2017-01-01

The objective of this study was to document the burden and treatment patterns associated with invasive fungal infections (IFIs) due to Candida and Aspergillus species in Saudi Arabia and Lebanon. A retrospective chart review study was conducted using data recorded from 2011 to 2012 from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of IFI due to Candida or Aspergillus , which was culture proven or suspected based on clinical criteria. Hospital data were abstracted for a random sample of patients to capture demographics, treatment patterns, hospital resource utilization, and clinical outcomes. Descriptive results were reported. Five hospitals participated and provided data on 102 patients with IFI (51 from Lebanon and 51 from Saudi Arabia). The mean age of the patients was 55 years, and 55% were males. Comorbidities included diabetes (41%), coronary artery disease (24%), leukemia (19%), moderate-to-severe renal disease (16%), congestive heart failure (15%), and chronic obstructive pulmonary disease (15%). Twenty percent of patients received corticosteroids prior to admission and 26% had received chemotherapy in the past 90 days. Inpatient mortality was 42%, and the mean hospital length of stay was 32.4±28.6 days. Fifty-five percent of patients required intensive care unit admission (17.2±14.1 days), 37% required mechanical ventilation (13.7±13.2 days), and 11% required dialysis (14.6±14.2 days). The most commonly used first-line antifungal was fluconazole. Patients with IFI in Saudi Arabia and Lebanon frequently have multiple medical comorbidities and may not have traditionally observed IFI risk factors. Efforts to increase use of rapid diagnostic tests and appropriate antifungal treatments may impact the substantial mortality and high length of stay observed in these patients.

Clinical research ethics review process in Lebanon: efficiency and functions of research ethics committees - results from a descriptive questionnaire-based study.

PubMed

Atallah, David; Moubarak, Malak; El Kassis, Nadine; Abboud, Sara

2018-01-11

Clinical trials conducted in Lebanon are increasing. However, little is known about the performance of research ethics committees (RECs) in charge of reviewing the research protocols. This study aimed to assess the level of adherence to the ethics surrounding the conduct of clinical trials and perceptions of team members regarding roles of the RECs during the conduct of clinical trials in Lebanon. The research question was: Are RECs adherent to the ethics surrounding the conduct of clinical trials (chapters II and IV in 'Standards and Operational Guidance for Ethics Review of Health-related Research with Human Participants' in Lebanon?' This was a quantitative and descriptive questionnaire-based study conducted among RECs of university hospitals in Lebanon. The questionnaire had to be completed online and included general questions in addition to items reflecting the different aspects of a REC performance and effectiveness. All the questionnaire was assigned a total score of 175 points. General information and questions assigned point values/scores were analysed using descriptive statistics: frequency and percentage, mean score ± standard deviation. Ten RECs participated in the study (52 persons: four chairs, one vice-president, 47 ordinary members). Forty-seven (90.4%) had previous experience with clinical research and 30 (57.7%) had a diploma or had done a training in research ethics. Forty-one percent confirmed that they were required to have a training in research ethics. All RECs had a policy for disclosing and managing potential conflicts of interest for its members, but 71.8% of participants reported the existence of such a policy for researchers. Thirty-three point three percent reported that the RECs had an anti-bribery policy. The questionnaire mean score was 129.6 ± 22.3/175 points reflecting thus an excellent adherence to international standards. Inadequate training of REC members and the lack of anti-bribery policies should be resolved to

Applying knowledge translation tools to inform policy: the case of mental health in Lebanon.

PubMed

Yehia, Farah; El Jardali, Fadi

2015-06-06

Many reform efforts in health systems fall short because the use of research evidence to inform policy remains scarce. In Lebanon, one in four adults suffers from a mental illness, yet access to mental healthcare services in primary healthcare (PHC) settings is limited. Using an "integrated" knowledge framework to link research to action, this study examines the process of influencing the mental health agenda in Lebanon through the application of Knowledge Translation (KT) tools and the use of a KT Platform (KTP) as an intermediary between researchers and policymakers. This study employed the following KT tools: 1) development of a policy brief to address the lack of access to mental health services in PHC centres, 2) semi-structured interviews with 10 policymakers and key informants, 3) convening of a national policy dialogue, 4) evaluation of the policy brief and dialogue, and 5) a post-dialogue survey. Findings from the key informant interviews and a comprehensive synthesis of evidence were used to develop a policy brief which defined the problem and presented three elements of a policy approach to address it. This policy brief was circulated to 24 participants prior to the dialogue to inform the discussion. The policy dialogue validated the evidence synthesized in the brief, whereby integrating mental health into PHC services was the element most supported by evidence as well as participants. The post-dialogue survey showed that, in the following 6 months, several implementation steps were taken by stakeholders, including establishing national taskforce, training PHC staff, and updating the national essential drug list to include psychiatric medications. Relationships among policymakers, researchers, and stakeholders were strengthened as they conducted their own workshops and meetings after the dialogue to further discuss implementation, and their awareness about and demand for KT tools increased. This case study showed that the use of KT tools in Lebanon to

Genetic Structure and Diversity of the Endangered Fir Tree of Lebanon (Abies cilicica Carr.): Implications for Conservation

PubMed Central

Awad, Lara; Fady, Bruno; Khater, Carla; Roig, Anne; Cheddadi, Rachid

2014-01-01

The threatened conifer Abies cilicica currently persists in Lebanon in geographically isolated forest patches. The impact of demographic and evolutionary processes on population genetic diversity and structure were assessed using 10 nuclear microsatellite loci. All remnant 15 local populations revealed a low genetic variation but a high recent effective population size. FST-based measures of population genetic differentiation revealed a low spatial genetic structure, but Bayesian analysis of population structure identified a significant Northeast-Southwest population structure. Populations showed significant but weak isolation-by-distance, indicating non-equilibrium conditions between dispersal and genetic drift. Bayesian assignment tests detected an asymmetric Northeast-Southwest migration involving some long-distance dispersal events. We suggest that the persistence and Northeast-Southwest geographic structure of Abies cilicica in Lebanon is the result of at least two demographic processes during its recent evolutionary history: (1) recent migration to currently marginal populations and (2) local persistence through altitudinal shifts along a mountainous topography. These results might help us better understand the mechanisms involved in the species response to expected climate change. PMID:24587219

Educational Attainment and Attitudes towards War in Muslim Countries Contemplating War: The Cases of Jordan, Lebanon, Pakistan, and Turkey

ERIC Educational Resources Information Center

Shafiq, M. Najeeb; Ross, Karen

2009-01-01

This study addresses the little understood relationship between educational attainment and public attitudes towards war in four predominantly Muslim countries contemplating war: Jordan, Lebanon, Pakistan, and Turkey. The multivariate analysis using public opinion data suggests that the educational attainment of respondents has no statistically…

Fibromyalgia: epidemiology and risk factors, a population-based case-control study in Lebanon.

PubMed

Moukaddem, Afaf; Chaaya, Monique; Slim, Zeinab F N; Jaffa, Miran; Sibai, Abla Mehio; Uthman, Imad

2017-02-01

To investigate the epidemiology of fibromyalgia (FM) and assess its risk factors. Using data from the 2009 Community Oriented Program for Control of Rheumatic Diseases (COPCORD) study conducted in Lebanon, a population-based case control study was performed. The sample included 34 FM patients, frequency matched with 136 controls free from any musculoskeletal complaints and randomly sampled from the population. The controls were frequency matched with cases by age and gender. The 34 female FM cases were prevalent cases which existed for a long period of time and all those who consulted a doctor were previously misdiagnosed. Family history of joint problems (OR = 4.93, 95% CI: 1.56-15.58) and working status (OR = 2.69, 95% CI: 1.04-6.93) were significant risk factors for FM, after adjusting for body mass index, distress level, smoking status and residence location. This was the first study to address the epidemiology of FM in Lebanon and the region. The chronic nature of FM that is characterized by frequent bouts of intense disabling pain and symptoms constitutes a significant health and economic burden. Clustering of cases in coastal areas was partially explained by other factors such as body mass index, distress level, smoking and work status. The high burden of FM found in our study calls for further investigation of potential risk factors of this condition. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Summer 2006 war on Lebanon: a lesson in community resilience.

PubMed

Nuwayhid, Iman; Zurayk, Huda; Yamout, Rouham; Cortas, Chadi S

2011-01-01

The internally displaced persons (IDPs) during the July 2006 war in Lebanon exhibited a high level of community resilience, affirmed by relief agencies and public health professionals. Data from personal observations, interviews, meetings and published material were used to examine factors contributing to this resilience. Findings suggested that community resilience is a process rather than an outcome. The sense of a collective identity, prior experience with wars and social support networks have contributed to building up IDP's resilience over time, while community cohesiveness, adequate public health interventions, social solidarity and a connected political leadership helped to sustain it during and shortly after the war. This paper examines implications for public health professionals and argues for a paradigm shift in disaster relief practice.

Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index

PubMed Central

Farhat, Mirna H; Shamseddine, Ali I; Tawil, Ayman N; Berjawi, Ghina; Sidani, Charif; Shamseddeen, Wael; Barada, Kassem A

2008-01-01

AIM: To study the factors that may affect survival of cholangiocarcinoma in Lebanon. METHODS: A retrospective review of the medical records of 55 patients diagnosed with cholangio-carcinoma at the American University of Beirut between 1990 and 2005 was conducted. Univariate and multivariate analyses were performed to determine the impact of surgery, chemotherapy, body mass index, bilirubin level and other factors on survival. RESULTS: The median survival of all patients was 8.57 mo (0.03-105.2). Univariate analysis showed that low bilirubin level (< 10 mg/dL), radical surgery and chemotherapy administration were significantly associated with better survival (P = 0.012, 0.038 and 0.038, respectively). In subgroup analysis on patients who had no surgery, chemotherapy administration prolonged median survival significantly (17.0 mo vs 3.5 mo, P = 0.001). Multivariate analysis identified only low bilirubin level < 10 mg/dL and chemotherapy administration as independent predictors associated with better survival (P < 0.05). CONCLUSION: Our data show that palliative and postoperative chemotherapy as well as a bilirubin level < 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma. PMID:18506930

Effect of inherited structures on strike-slip plate boundaries: insight from analogue modelling of the central Levant Fracture System, Lebanon

NASA Astrophysics Data System (ADS)

Ghalayini, Ramadan; Daniel, Jean-Marc; Homberg, Catherine; Nader, Fadi

2015-04-01

Analogue sandbox modeling is a tool to simulate deformation style and structural evolution of sedimentary basins. The initial goal is to test what is the effect of inherited and crustal structures on the propagation, evolution, and final geometry of major strike-slip faults at the boundary between two tectonic plates. For this purpose, we have undertaken a series of analogue models to validate and reproduce the structures of the Levant Fracture System, a major NNE-SSW sinistral strike-slip fault forming the boundary between the Arabian and African plates. Onshore observations and recent high quality 3D seismic data in the Levant Basin offshore Lebanon demonstrated that Mesozoic ENE striking normal faults were reactivated into dextral strike-slip faults during the Late Miocene till present day activity of the plate boundary which shows a major restraining bend in Lebanon with a ~ 30°clockwise rotation in its trend. Experimental parameters consisted of a silicone layer at the base simulating the ductile crust, overlain by intercalated quartz sand and glass sand layers. Pre-existing structures were simulated by creating a graben in the silicone below the sand at an oblique (>60°) angle to the main throughgoing strike-slip fault. The latter contains a small stepover at depth to create transpression during sinistral strike-slip movement and consequently result in mountain building similarly to modern day Lebanon. Strike-slip movement and compression were regulated by steady-speed computer-controlled engines and the model was scanned using a CT-scanner continuously while deforming to have a final 4D model of the system. Results showed that existing normal faults were reactivated into dextral strike-slip faults as the sinistral movement between the two plates accumulated. Notably, the resulting restraining bend is asymmetric and segmented into two different compartments with differing geometries. One compartment shows a box fold anticline, while the second shows an

Cost-effectiveness of increasing cervical cancer screening coverage in the Middle East: An example from Lebanon.

PubMed

Sharma, Monisha; Seoud, Muhieddine; Kim, Jane J

2017-01-23

Most cervical cancer (CC) cases in Lebanon are detected at later stages and associated with high mortality. There is no national organized CC screening program so screening is opportunistic and limited to women who can pay out-of-pocket. Therefore, a small percentage of women receive repeated screenings while most are under-or never screened. We evaluated the cost-effectiveness of increasing screening coverage and extending intervals. We used an individual-based Monte Carlo model simulating HPV and CC natural history and screening. We calibrated the model to epidemiological data from Lebanon, including CC incidence and HPV type distribution. We evaluated cytology and HPV DNA screening for women aged 25-65years, varying coverage from 20 to 70% and frequency from 1 to 5years. At 20% coverage, annual cytologic screening reduced lifetime CC risk by 14% and had an incremental cost-effectiveness ratio of I$80,670/year of life saved (YLS), far exceeding Lebanon's gross domestic product (GDP) per capita (I$17,460), a commonly cited cost-effectiveness threshold. By comparison, increasing cytologic screening coverage to 50% and extending screening intervals to 3 and 5years provided greater CC reduction (26.1% and 21.4, respectively) at lower costs compared to 20% coverage with annual screening. Screening every 5years with HPV DNA testing at 50% coverage provided greater CC reductions than cytology at the same frequency (23.4%) and was cost-effective assuming a cost of I$18 per HPV test administered (I$12,210/YLS); HPV DNA testing every 4years at 50% coverage was also cost-effective at the same cost per test (I$16,340). Increasing coverage of annual cytology was not found to be cost-effective. Current practice of repeated cytology in a small percentage of women is inefficient. Increasing coverage to 50% with extended screening intervals provides greater health benefits at a reasonable cost and can more equitably distribute health gains. Novel HPV DNA strategies offer greater

Type distribution of lymphomas in Lebanon: five-year single institution experience.

PubMed

Sader-Ghorra, Claude; Rassy, Marc; Naderi, Samah; Kourie, Hampig Raphael; Kattan, Joseph

2014-01-01

Lymphomas represent the fifth most frequent cancer in Lebanon. However, little is known concerning epidemiologic characteristics and distribution of lymphoid neoplasms according to the 2008 WHO classification. We conducted a retrospective study of lymphoma cases diagnosed from 2008 till 2012 at Hotel-Dieu de France University Hospital. A total of 502 new cases of lymphoma were diagnosed at our institution during a five year period: 119 cases (24%) were Hodgkin lymphomas (HL) and 383 cases (76%) were non-Hodgkin lymphomas (NHL). HLs were equally distributed in both sexes with a mean age at diagnosis of 30 years. Among NHL, 87% (332 cases) were B cell lymphomas, 9% (34 cases) were T cell lymphomas and 4%(17 cases) were classified as precursor lymphoid neoplasms. Among B cell lymphomas, 44% (147 cases) were diffuse large B cell lymphomas (DLBCL), 20% (65 cases) follicular lymphomas and 8% (27 cases) mantle cell lymphomas. DLBCL were equally distributed in both sexes with a mean age of 58 years. Follicular lymphomas were characterized by a male predominance (57%) and a mean age of 60 years. Mantle cell lymphomas showed a pronounced male predominance (85%) with a mean age of 60 years in men and 70 years in women. Some 72% of patients having T cell lymphomas were men, with a mean age of 57 years in men and 45 years in women, while 65% of patients having precursor lymphoid neoplasms were women with a mean age of 22 years in women and 30 years in men. The lymphoma subtype distribution in Lebanon is unique when compared to other countries from around the world. In fact, Hodgkin and follicular lymphomas are more frequent than in most Far Eastern, European and American countries, while T-cell lymphomas and DLBCL are less frequent.

The retention of health human resources in primary healthcare centers in Lebanon: a national survey

PubMed Central

2012-01-01

Background Critical shortages of health human resources (HHR), associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC) sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon. Methods A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory). A total of 755 providers completed the questionnaire (60.5% response rate). Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit. Results Two out of five respondents indicated likelihood to quit their jobs within the next 1–3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%), better job opportunities outside the country (35.1%) and lack of professional development (33.7%). A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit. Conclusions The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits and allied health

A societal cost-of-illness study of hemodialysis in Lebanon.

PubMed

Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Salameh, Pascale; Evers, Silvia M A A

2016-12-01

Renal failure is a growing public health problem, and is mainly treated by hemodialysis. This study aims to estimate the societal costs of hemodialysis in Lebanon. This was a quantitative, cross-sectional cost-of-illness study conducted alongside the Nutrition Education for Management of Osteodystrophy trial. Costs were assessed with a prevalence-based, bottom-up approach, for the period of June-December 2011. The data of 114 patients recruited from six hospital-based units were collected through a questionnaire measuring healthcare costs, costs to patients and family, and costs in other sectors. Recall data were used for the base-case analysis. Sensitivity analyses employing various sources of resources use and costs were performed. Costs were uprated to 2015US$. Multiple linear regression was conducted to explore the predictors of societal costs. The mean 6-month societal costs were estimated at $9,258.39. The larger part was attributable to healthcare costs (91.7%), while costs to patient and family and costs in other sectors poorly contributed to the total costs (4.2% and 4.1%, respectively). In general, results were robust to sensitivity analyses. Using the maximum value for hospitalization resulted in the biggest difference (+15.5% of the base-case result). Female gender, being widowed/divorced, having hypertension comorbidity, and higher weekly time on dialysis were significantly associated with greater societal costs. Information regarding resource consumption and cost were not readily available. Rather, they were obtained from a variety of sources, with each having its own strengths and limitations. Hemodialysis represents a high societal burden in Lebanon. Using extrapolation, its total annual cost for the Lebanese society is estimated at $61,105,374 and the mean total annual cost ($18,516.7) is 43.70% higher than the gross domestic product per capita forecast for 2015. Measures to reduce the economic burden of hemodialysis should be taken, by promoting

Readiness of healthcare providers for eHealth: the case from primary healthcare centers in Lebanon.

PubMed

Saleh, Shadi; Khodor, Rawya; Alameddine, Mohamad; Baroud, Maysa

2016-11-10

eHealth can positively impact the efficiency and quality of healthcare services. Its potential benefits extend to the patient, healthcare provider, and organization. Primary healthcare (PHC) settings may particularly benefit from eHealth. In these settings, healthcare provider readiness is key to successful eHealth implementation. Accordingly, it is necessary to explore the potential readiness of providers to use eHealth tools. Therefore, the purpose of this study was to assess the readiness of healthcare providers working in PHC centers in Lebanon to use eHealth tools. A self-administered questionnaire was used to assess participants' socio-demographics, computer use, literacy, and access, and participants' readiness for eHealth implementation (appropriateness, management support, change efficacy, personal beneficence). The study included primary healthcare providers (physicians, nurses, other providers) working in 22 PHC centers distributed across Lebanon. Descriptive and bivariate analyses (ANOVA, independent t-test, Kruskal Wallis, Tamhane's T2) were used to compare participant characteristics to the level of readiness for the implementation of eHealth. Of the 541 questionnaires, 213 were completed (response rate: 39.4 %). The majority of participants were physicians (46.9 %), and nurses (26.8 %). Most physicians (54.0 %), nurses (61.4 %), and other providers (50.9 %) felt comfortable using computers, and had access to computers at their PHC center (physicians: 77.0 %, nurses: 87.7 %, others: 92.5 %). Frequency of computer use varied. The study found a significant difference for personal beneficence, management support, and change efficacy among different healthcare providers, and relative to participants' level of comfort using computers. There was a significant difference by level of comfort using computers and appropriateness. A significant difference was also found between those with access to computers in relation to personal beneficence and

Highly Pathogenic Avian Influenza H5N1 Clade 2.3.2.1c Virus in Lebanon, 2016.

PubMed

El Romeh, Ali; Zecchin, Bianca; Fusaro, Alice; Ibrahim, Elias; El Bazzal, Bassel; El Hage, Jeanne; Milani, Adelaide; Zamperin, Gianpiero; Monne, Isabella

2017-06-01

We report the phylogenetic analysis of the first outbreak of H5N1 highly pathogenic avian influenza virus detected in Lebanon from poultry in April 2016. Our whole-genome sequencing analysis revealed that the Lebanese H5N1 virus belongs to genetic clade 2.3.2.1c and clusters with viruses from Europe and West Africa.

Prevalence of and risk factors associated with cesarean section in Lebanon - A retrospective study based on a sample of 29,270 women.

PubMed

Zgheib, Sandy M; Kacim, Mohammad; Kostev, Karel

2017-12-01

During the last decades, there has been an alarming and dramatic increase in the number of cesarean births in both developed and undeveloped countries. This increase has not been clinically justified but, nevertheless, has raised an important number of issues. The aim of this study was to determine the risk factors associated with the high cesarean section rates in Lebanon. This study is based on a sample of 29,270 Lebanese women who were pregnant between 2000 and 2015. Among these, 14,327 gave birth by cesarean section and 14,943 gave birth vaginally. To identify the risk factors of cesarean section, logistic regression was applied as a statistical method using the SPSS statistical package. Of the 29,270 pregnant women included in the study, 49% had cesarean sections while 51% gave birth vaginally. Repeat cesarean section accounted for 23% while vaginal birth after cesarean accounted for only 0.2% of deliveries. In addition, weekdays were associated with a preference of providers to carry out more cesarean sections. According to an analysis of our data using logistic regression, the risk factors associated with the increase in cesarean section rates were advanced maternal age, elective cesarean section, malpresentation of fetus, multiple birth, prolonged pregnancy, prolonged labor, and fetal distress. Based on these results, it is recommended that a new health policy be implemented to reduce the number of unnecessary cesarean deliveries in Lebanon. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Seroprevalence of Anti-Toxoplasma gondii Antibodies Among Lebanese Pregnant Women.

PubMed

Nahouli, Hasan; El Arnaout, Nour; Chalhoub, Elias; Anastadiadis, Elie; El Hajj, Hiba

2017-12-01

Toxoplasma gondii, the causative agent of toxoplasmosis, is a zoonotic obligate intracellular protozoan parasite responsible for the infection of almost one-third of the world's population. T. gondii is particularly threatening for primo-infected pregnant women and may lead, following vertical transplacental transmission, to spontaneous abortion, miscarriage, or severe manifestations in the newborn. The aim of this study was to provide an updated estimate of the seroprevalence of anti-T. gondii antibodies among a group of Lebanese pregnant women and its seroconversion rate. This is a retrospective cohort study, in which medical records of 11,000 pregnant women were screened. These women visited a private Obstetrics and Gynecology clinic located in Beirut, the capital of Lebanon, during the period of January 1994 till September 2015. Serological results of anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) results of 2456 Lebanese pregnant women who fulfilled the inclusion criteria were included in the analysis. Seropositivity and seroconversion rates for women with repeated tests were reported according to age and area of residence. The overall anti-T. gondii IgG and IgM seropositivity among 2456 Lebanese pregnant women was 82.6% and 1.8% respectively. The highest IgG seropositivity is among the age group of 35-44 years (87.81%) and at the governorate of "Mount Lebanon" (82.95%). Sixty-four seroconversions were detected and two abortions due to T. gondii infection during pregnancy were recorded. The seroprevalence of anti-T. gondii IgG among the screened pregnant women in Lebanon is the highest in the Arab region. These results highlight the importance of running a national sample survey to estimate the real potential burden of this infection and its impact on maternal and fetal health.

Students' attitude and smoking behaviour following the implementation of a university smoke-free policy: a cross-sectional study.

PubMed

Chaaya, Monique; Alameddine, Maysam; Nakkash, Rima; Afifi, Rima A; Khalil, Joanna; Nahhas, Georges

2013-01-01

In view of the high-smoking rate among university students in Lebanon and the known adverse effects of second-hand smoking, the American University of Beirut (AUB) decided to implement a non-smoking policy on campus. This study sought to examine the students' compliance and attitudes following the ban. Cross-sectional study. A private university in Lebanon. 545 randomly selected students were approached. A stratified cluster sample of classes offered in the spring semester of the 2008/2009 academic year was selected. Students completed a self-administered paper and pencil survey during class time. The main outcomes were compliance with and attitudes towards the ban. Other secondary outcomes were the perception of barriers to implementation of the ban and attitudes towards tobacco control in general. 535 students participated in the study. Smokers were generally compliant with the ban (72.7%) and for some (20%) it led to a decrease in their smoking. Students' attitude towards the ban and the enforcement of a non-smoking policy in public places across Lebanon varied according to their smoking status whereby non-smokers possessed a more favourable attitude and strongly supported such policies compared with smokers; overall, the largest proportions of students were satisfied to a large extent with the ban and considered it justified (58.6% and 57.2%, respectively). While much smaller percentages reported that the ban would help in reducing smoking to a large extent (16.7%) or it would help smokers quit (7.4%). Perceived barriers to implementation of the non-smoking policy in AUB included the lack of compliance with and strict enforcement of the policy as well as the small number and crowdedness of the smoking areas. An education campaign, smoking cessation services and strict enforcement of the policy might be necessary to boost its effect in further reducing students' cigarette use.

Exposure to the Lebanon War of 2006 and effects on alcohol use disorders: The moderating role of childhood maltreatment☆

PubMed Central

Keyes, Katherine M.; Shmulewitz, Dvora; Greenstein, Eliana; McLaughlin, Kate; Wall, Melanie; Aharonovich, Efrat; Weizman, Abraham; Frisch, Amos; Spivak, Baruch; Grant, Bridget F.; Hasin, Deborah

2013-01-01

Background Civilian populations now comprise the majority of casualties in modern warfare, but effects of war exposure on alcohol disorders in the general population are largely unexplored. Accumulating literature indicates that adverse experiences early in life sensitize individuals to increased alcohol problems after adult stressful experiences. However, child and adult stressful experiences can be correlated, limiting interpretation. We examine risk for alcohol disorders among Israelis after the 2006 Lebanon War, a fateful event outside the control of civilian individuals and uncorrelated with childhood experiences. Further, we test whether those with a history of maltreatment are at greater risk for an alcohol use disorder after war exposure compared to those without such a history. Methods Adult household residents selected from the Israeli population register were assessed with a psychiatric structured interview; the analyzed sample included 1306 respondents. War measures included self-reported days in an exposed region. Results Among those with a history of maltreatment, those in a war-exposed region for 30+ days had 5.3 times the odds of subsequent alcohol disorders compared to those exposed 0 days (95%C.I. 1.01–27.76), controlled for relevant confounders; the odds ratio for those without this history was 0.5 (95%C.I. 0.25–1.01); test for interaction: X2 = 5.28, df = 1, P = 0.02. Conclusions Experiencing a fateful stressor outside the control of study participants, civilian exposure to the 2006 Lebanon War, is associated with a heightened the risk of alcohol disorders among those with early adverse childhood experiences. Results suggest that early life experiences may sensitize individuals to adverse health responses later in life. PMID:24262650

Human papillomavirus vaccination: assessing knowledge, attitudes, and intentions of college female students in Lebanon, a developing country.

PubMed

Dany, Mohammed; Chidiac, Alissar; Nassar, Anwar H

2015-02-18

Human papillomavirus (HPV) infection is a common cause for genital warts and cervical cancer. Developing countries in the Middle East such as Lebanon are traditionally considered to be conservative societies with low incidence of sexually transmitted infections. However, nowadays, there is an unexpected increase in the incidence of HPV infections among Middle Eastern females. Thus, the objective of this study is to assess the behavioral perceptions of HPV vaccination among female students attending an academic institution in Lebanon. This cross-sectional study invited 512 students to complete a self-administered questionnaire that assessed the knowledge, attitudes, and intentions towards HPV vaccination. Data analysis included the calculation of knowledge scores ranging from 0 to 100, attitude scores ranging from most positive (1) to most negative (5), and intention scores ranging from lowest intention (0) to highest intention (10). With a response rate of n=215 (42%), 36.5% never heard of the vaccine before, and only 16.5% were already HPV vaccinated. The median knowledge score of 52.7% ± 1.71 reflects poor to moderate knowledge. Still, the median attitude score of 2.47 ± 0.05 shows a general positive attitude towards HPV vaccination where most of the participants agreed that female college students in Lebanon have a good chance of contracting HPV (62.1%) and that all gynecologists should recommend the vaccine (76.0%). Students in graduate programs, health related majors, and those who are vaccinated had significantly higher knowledge scores compared with students in undergraduate programs, non-health related majors, and HPV non-vaccinated students, respectively. Finally, the survey helped in increasing the intention to obtain HPV vaccine as the intention score increased significantly from 5.24 ± 0.27 before the students went through the survey to 6.98 ± 0.22 after the students completed the survey. Our study highlights the importance of offering guidance to

Identification of vaginal lactobacilli with potential probiotic properties isolated from women in North Lebanon.

PubMed

Al Kassaa, Imad; Hamze, Monzer; Hober, Didier; Chihib, Nour-Eddine; Drider, Djamel

2014-04-01

The aim of this work was to study the diversity of vaginal lactobacilli in Lebanese women and to evaluate the antagonism, hydrophobicity, and safety characteristics of these strains. This study was performed on samples from 135 women who visited a gynecology clinic in the north of Lebanon, between September 2012 and January 2013. From these samples, 53 different isolates of vaginal lactobacilli were collected from vaginal swabs and identified using biochemical and molecular methods. The use of genotypic Rep-PCR fingerprinting allowed for the organization of these isolates into 23 different groups. Seven of the isolated lactobacilli were antagonistic against the following vaginal pathogens: Gardnerella vaginalis CIP7074T, Staphylococcus aureus ATCC33862, Escherichia coli CIP103982, and Candida albicans ATCC10231. The antagonistic lactobacilli strains were then identified using 16S rDNA sequence. The data of this study show that the antagonistic lactobacilli were non-hemolytic, sensitive to most antibiotic tests, free of plasmid DNA, and exhibited interesting hydrophobicity and autoaggregation properties positioning them as potential candidates for probiotic design.

Determinants of the Willingness-to-Participate in an Environmental Intervention in a Beirut Neighborhood

NASA Astrophysics Data System (ADS)

El-Zein, Abbas; Nasrallah, Rola; Nuwayhid, Iman

2006-02-01

Participatory environmental management can empower communities and enhance the sustainability of environmental interventions. However, existing power structures and inequalities along class, gender, or ethnic lines could prevent part of the community from accessing the full benefits of the intervention. An analysis of determinants of the willingness-to-participate in an environmental intervention in a Beirut neighborhood is conducted. Socioeconomic, health-risk distribution, and perception of community efficacy are used as predictors. A randomly selected sample of residents was surveyed. Respondents were asked to specify the frequency with which they were willing to be involved in an intervention to address priority environmental problems in the neighborhood. Bivariate and multivariate ordinal regression analyses were conducted. Tests of significance were based on the 95% confidence intervals (CI) of the odds ratio (OR). Males versus females (OR = 4.89, P < 0.001), respiratory patients versus nonsufferers (OR = 5.65, P < 0.001), tenants versus house owners (OR = 2.98, P < 0.01), and the less educated versus the more educated (OR = 2.42, P < 0.05) were significantly more likely to be willing to participate. The reluctance of female community members to participate might be a major hindrance to community-based environmental protection and special strategies must be devised to overcome it. On the other hand, respondents suffering from an illness perceived to be related to environmental toxins are likely to be strong participants in environmental conservation efforts. Finally, the study yielded no evidence that belief or lack of it in the efficacy of community action is a good predictor of the willingness-to-participate in such action.

Remote sensing for environmental protection of the eastern Mediterranean rugged mountainous areas, Lebanon

NASA Astrophysics Data System (ADS)

Khawlie, M.; Awad, M.; Shaban, A.; Bou Kheir, R.; Abdallah, C.

Lying along the eastern Mediterranean coast with elevated mountain chains higher than 2500 m straddling its terrain, Lebanon is a country of natural beauty and is thus attracting tourism. However, with a population density exceeding 800/km 2 and a rugged steep sloping land, problems abound in the country calling for holistic-approach studies. Only remote sensing, whose use is new in Lebanon can secure such needed studies within a scientific and pragmatic framework. The paper demonstrates for the concerned themes, the innovative use of remote sensing in such a difficult terrain, giving three examples of major environmental problems in the coastal mountains. Only few studies have so far focused on those mountains, notably application of remote sensing. The rugged mountainous terrain receives considerable rain, but the water is quickly lost running on the steep slopes, or infiltrating through fractures and the karstic conduits into the subsurface. Field investigations are difficult to achieve, therefore, remote sensing helps reveal various surface land features important in reflecting water feeding into the subsurface. Optical, radar and thermal infrared remotely sensed data cover a wide spectrum serving that purpose. A map of preferential groundwater accumulation potential is produced. It can serve for better water exploitation as well as protection. Because the terrain is karstic and rugged, the subsurface water flow is difficult to discern. Any pollution at a certain spot would certainly spread around. This constitutes the second example of environmental problems facing the mountainous areas in Lebanon. An integrated approach using remote sensing and geographic information systems (GIS) gives good results in finding out the likelihood of how pollution, or contaminants, can selectively move in the subsurface. A diagnostic analysis with a GIS-type software acts as a guide producing indicative maps for the above purpose. The third example given deals with the problem

Prevalence and Risk Factors for Intestinal Protozoan Infections with Cryptosporidium, Giardia, Blastocystis and Dientamoeba among Schoolchildren in Tripoli, Lebanon.

PubMed

Osman, Marwan; El Safadi, Dima; Cian, Amandine; Benamrouz, Sadia; Nourrisson, Céline; Poirier, Philippe; Pereira, Bruno; Razakandrainibe, Romy; Pinon, Anthony; Lambert, Céline; Wawrzyniak, Ivan; Dabboussi, Fouad; Delbac, Frederic; Favennec, Loïc; Hamze, Monzer; Viscogliosi, Eric; Certad, Gabriela

2016-03-01

Intestinal protozoan infections are confirmed as major causes of diarrhea, particularly in children, and represent a significant, but often neglected, threat to public health. No recent data were available in Lebanon concerning the molecular epidemiology of protozoan infections in children, a vulnerable population at high risk of infection. In order to improve our understanding of the epidemiology of intestinal pathogenic protozoa, a cross-sectional study was conducted in a general pediatric population including both symptomatic and asymptomatic subjects. After obtaining informed consent from the parents or legal guardians, stool samples were collected in January 2013 from 249 children in 2 schools in Tripoli, Lebanon. Information obtained from a standard questionnaire included demographic characteristics, current symptoms, socioeconomic status, source of drinking water, and personal hygiene habits. After fecal examination by both microscopy and molecular tools, the overall prevalence of parasitic infections was recorded as 85%. Blastocystis spp. presented the highest infection rate (63%), followed by Dientamoeba fragilis (60.6%), Giardia duodenalis (28.5%) and Cryptosporidium spp. (10.4%). PCR was also performed to identify species and genotypes of Cryptosporidium, subtypes of Blastocystis, and assemblages of Giardia. Statistical analysis using a logistic regression model showed that contact with family members presenting gastrointestinal disorders was the primary risk factor for transmission of these protozoa. This is the first study performed in Lebanon reporting the prevalence and the clinical and molecular epidemiological data associated with intestinal protozoan infections among schoolchildren in Tripoli. A high prevalence of protozoan parasites was found, with Blastocystis spp. being the most predominant protozoans. Although only 50% of children reported digestive symptoms, asymptomatic infection was observed, and these children may act as unidentified

Prevalence and Risk Factors for Intestinal Protozoan Infections with Cryptosporidium, Giardia, Blastocystis and Dientamoeba among Schoolchildren in Tripoli, Lebanon

PubMed Central

Benamrouz, Sadia; Nourrisson, Céline; Poirier, Philippe; Pereira, Bruno; Razakandrainibe, Romy; Pinon, Anthony; Lambert, Céline; Wawrzyniak, Ivan; Dabboussi, Fouad; Delbac, Frederic; Favennec, Loïc; Hamze, Monzer; Viscogliosi, Eric; Certad, Gabriela

2016-01-01

Background Intestinal protozoan infections are confirmed as major causes of diarrhea, particularly in children, and represent a significant, but often neglected, threat to public health. No recent data were available in Lebanon concerning the molecular epidemiology of protozoan infections in children, a vulnerable population at high risk of infection. Methodology and Principal Findings In order to improve our understanding of the epidemiology of intestinal pathogenic protozoa, a cross-sectional study was conducted in a general pediatric population including both symptomatic and asymptomatic subjects. After obtaining informed consent from the parents or legal guardians, stool samples were collected in January 2013 from 249 children in 2 schools in Tripoli, Lebanon. Information obtained from a standard questionnaire included demographic characteristics, current symptoms, socioeconomic status, source of drinking water, and personal hygiene habits. After fecal examination by both microscopy and molecular tools, the overall prevalence of parasitic infections was recorded as 85%. Blastocystis spp. presented the highest infection rate (63%), followed by Dientamoeba fragilis (60.6%), Giardia duodenalis (28.5%) and Cryptosporidium spp. (10.4%). PCR was also performed to identify species and genotypes of Cryptosporidium, subtypes of Blastocystis, and assemblages of Giardia. Statistical analysis using a logistic regression model showed that contact with family members presenting gastrointestinal disorders was the primary risk factor for transmission of these protozoa. Conclusions This is the first study performed in Lebanon reporting the prevalence and the clinical and molecular epidemiological data associated with intestinal protozoan infections among schoolchildren in Tripoli. A high prevalence of protozoan parasites was found, with Blastocystis spp. being the most predominant protozoans. Although only 50% of children reported digestive symptoms, asymptomatic infection was

The analytical framework of water and armed conflict: a focus on the 2006 Summer War between Israel and Lebanon.

PubMed

Zeitoun, Mark; Eid-Sabbagh, Karim; Loveless, Jeremy

2014-01-01

This paper develops an analytical framework to investigate the relationship between water and armed conflict, and applies it to the 'Summer War' of 2006 between Israel and Lebanon (Hezbollah). The framework broadens and deepens existing classifications by assessing the impact of acts of war as indiscriminate or targeted, and evaluating them in terms of international norms and law, in particular International Humanitarian Law (IHL). In the case at hand, the relationship is characterised by extensive damage in Lebanon to drinking water infrastructure and resources. This is seen as a clear violation of the letter and the spirit of IHL, while the partial destruction of more than 50 public water towers compromises water rights and national development goals. The absence of pre-war environmental baselines makes it difficult to gauge the impact on water resources, suggesting a role for those with first-hand knowledge of the hostilities to develop a more effective response before, during, and after armed conflict. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Partisan Activism and Access to Welfare in Lebanon

PubMed Central

2014-01-01

How do welfare regimes function when state institutions are weak and ethnic or sectarian groups control access to basic services? This paper explores how people gain access to basic services in Lebanon, where sectarian political parties from all major religious communities are key providers of social assistance and services. Based on analyses of an original national survey (n= 1,911) as well as in-depth interviews with providers and other elites (n= 175) and beneficiaries of social programs (n= 135), I make two main empirical claims in the paper. First, political activism and a demonstrated commitment to a party are associated with access to social assistance; and second, higher levels of political activism may facilitate access to higher levels or quantities of aid, including food baskets and financial assistance for medical and educational costs. These arguments highlight how politics can mediate access to social assistance in direct ways and add new dimensions to scholarly debates about clientelism by focusing on contexts with politicized religious identities and by problematizing the actual goods and services exchanged. PMID:24904187

Perspectives of displaced Syrian women and service providers on fertility behaviour and available services in West Bekaa, Lebanon.

PubMed

Kabakian-Khasholian, Tamar; Mourtada, Rima; Bashour, Hyam; Kak, Faysal El; Zurayk, Huda

2017-10-01

Prior to the conflict, Syria had relatively high fertility rates. In 2010, it had the sixth highest total fertility rate in the Arab World, but it witnessed a fertility decline before the conflict in 2011. Displacement during conflict influences fertility behaviour, and meeting the contraceptive needs of displaced populations is complex. This study explored the perspectives of women and service providers about fertility behaviour of and service provision to Syrian refugee women in Bekaa, Lebanon. We used qualitative methodology to conduct 12 focus group discussions with Syrian refugee women grouped in different age categories and 13 in-depth interviews with care providers from the same region. Our findings indicate that the displacement of Syrians to Lebanon had implications on the fertility behaviour of the participants. Women brought their beliefs about preferred family size and norms about decision-making into an environment where they were exposed to both aid and hardship. The unaffordability of contraceptives in the Lebanese privatised health system compared to their free provision in Syria limited access to family planning services. Efforts are needed to maintain health resources and monitor health needs of the refugee population in order to improve access and use of services.

Trends in nutritional intakes and nutrition-related cardiovascular disease risk factors in Lebanon: the need for immediate action.

PubMed

Nasreddine, Lara; Naja, Farah A; Sibai, Abla-Mehio; Helou, Khalil; Adra, Nada; Hwalla, Nahla

2014-01-01

To examine the burden of cardiovascular disease (CVD) risk factors and their association with dietary variables in the Lebanese population while reviewing secular trends in the population's nutritional intakes and nutrition-related CVD risk factors. Data on CVD risk factors and food consumption patterns in Lebanon were collected from scholarly papers, including individual studies and systematic review articles. Electronic databases were searched using combinations of key terms. The prevalence of obesity in Lebanon followed an alarming increasing trend over time, paralleled by an escalation in the prevalence of hypertension, diabetes and hyperlipidemia. Food consumption surveys illustrate an increasing trend in energy intake and the proportion of energy derived from fat and animal products, with a concomitant decrease in carbohydrates and cereals intakes. The shift towards an atherogenic diet coupled with the alarming increase in nutrition-related cardiovascular risk factors suggest that the Lebanese population is at an increased risk for CVDs. This should alert to the importance of formulating multicomponent intervention strategies at both the individual and population levels to halt the progression of nutrition-related diseases in the country, while highlighting the need for immediate public health efforts to promote the adoption of healthy dietary habits.

The Effect of "Living Values: An Educational Program" on Behaviors and Attitudes of Elementary Students in a Private School in Lebanon

ERIC Educational Resources Information Center

El Hassan, Karma; Kahil, Rula

2005-01-01

The study examines the effect of the "Living Values Educational Program" (LVEP) on certain behaviors and attitudes related to personal intelligences (Intrapersonal & Interpersonal) in elementary school students in a private school in Lebanon. A sample of 76 second and third grade students was randomly selected. A pre-post…

Assessment of cardiopulmonary resuscitation practices in emergency departments for out-of-hospital cardiac arrest victims in Lebanon.

PubMed

Noureddine, Samar; Avedissian, Tamar; Isma'eel, Hussain; El Sayed, Mazen J

2016-01-01

The survival rate of out-of-hospital cardiac arrest (OHCA) victims in Lebanon is low. A national policy on resuscitation practice is lacking. This survey explored the practices of emergency physicians related to the resuscitation of OHCA victims in Lebanon. A sample of 705 physicians working in emergency departments (EDs) was recruited and surveyed using the LimeSurvey software (Carsten Schmitz, Germany). Seventy-five participants responded, yielding 10.64% response rate. The most important factors in the participants' decision to initiate or continue resuscitation were presence of pulse on arrival (93.2%), underlying cardiac rhythm (93.1%), the physician's ethical duty to resuscitate (93.2%), transport time to the ED (89%), and down time (84.9%). The participants were optimistic regarding the survival of OHCA victims (58.1% reporting > 10% survival) and reported frequent resuscitation attempts in medically futile situations. The most frequently reported challenges during resuscitation decisions were related to pressure or presence of victim's family (38.8%) and lack of policy (30%). In our setting, physicians often rely on well-established criteria for initiating/continuing resuscitation; however, their decisions are also influenced by cultural factors such as victim's family wishes. The findings support the need for a national policy on resuscitation of OHCA victims.

Trends in lung cancer incidence in Lebanon by gender and histological type over the period 2005-2008.

PubMed

Temraz, Sally; Charafeddine, Maya; Mukherji, Deborah; Shamseddine, Ali

2017-09-01

Lung cancer incidence rates, overall and by histologic subtypes, vary substantially by gender and smoking. This study's aim was to review data regarding trends in the number of cases of different lung-cancer histologies and relate these to smoking habits by gender in Lebanon. Lung cancer data using ICD-O, 3rd edition, from the Lebanese National Cancer Registry from 2005 to 2008 were stratified by gender for histology type for patients aged over 18years. Lung cancer cases among males were 2.5 times higher than those in females. The most common lung cancer histology type for males and females was adenocarcinoma for all observed years. The proportion of squamous cell carcinoma in incident cases was significantly higher in males than in females for the total period from 2005 to 2008, P=0.032, but not in individual years. The ratio of adenocarcinoma to squamous cell carcinoma in incident cases between 2005 and 2008 was 2:45 for males and 3:15 for females. Lung cancer histology in Lebanon is following a pattern similar to that found in most countries of North America and in Europe, where adenocarcinoma is the most prevalent subtype among both males and females. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Pain and neurological sequelae of cluster munitions on children and adolescents in South Lebanon.

PubMed

Fares, Youssef; Ayoub, Fouad; Fares, Jawad; Khazim, Rabi; Khazim, Mahmoud; Gebeily, Souheil

2013-11-01

This paper aims at evaluating the neurological repercussions arising from injuries sustained due to cluster munitions in children up to 18 years in South Lebanon following the 2006 conflict. Data on neurological and pain symptoms suffered during and after treatment because of sub-munitions in South Lebanon from August 2006 till late 2011 were prospectively recorded. Patients were divided into subcategories; children aged 12 and under and adolescents aged between 13 and 18. During the study period, there were 407 casualties, 122 (30%) of which were aged 18 years or younger. There were 116 (95%) males and six (5%) females. Average age was 14 years. 10 (8.2%), all males, died as a result of their injuries. 42 (34.4%) were children and 80 (65.6%) were adolescents. 112 had surgical treatments for their injuries. 83 out of 112 patients (74%) with non-lethal injuries had amputations, 67% children and 78% adolescents. Among those who had amputations, 31 (37.4%) suffered from phantom limb pain and 71% suffered from stump/residual limb pain. 88% of patients were diagnosed with post-traumatic stress disorder (44% children and 77% adolescents) and 41% were diagnosed with post-concussion syndrome. Four patients (3.6%) suffered from traumatic brain injuries, both penetrating and closed. Pain syndromes were found in all patients who had amputation. The injury related comorbidities together with many post-concussion syndrome cases, and fewer traumatic brain injuries lead into a high level of physical, psychosocial and economic burdens on the community.

A mixed-methods study of personality conceptions in the Levant: Jordan, Lebanon, Syria, and the West Bank.

PubMed

Zeinoun, Pia; Daouk-Öyry, Lina; Choueiri, Lina; van de Vijver, Fons J R

2017-09-01

Personality taxonomies are investigated using either etic-style studies that test whether Western-developed models fit in a new culture, or emic-style studies that derive personality dimensions from a local culture, using a psycholexical approach. Recent studies have incorporated strengths from both approaches. We combine the 2 approaches in the first study of personality descriptors in spoken Arabic. In Study 1, we collected 17,283 responses from a sample of adults in Lebanon, Syria, Jordan, and the West Bank (N = 545). Qualitative analysis revealed 9 personality dimensions: Soft-Heartedness, Positive Social Relatedness, Integrity, Humility versus Dominance, Conscientiousness, Extraversion, Emotional Stability, Intellect, and Openness . In Study 2, we converted the qualitative model into an indigenous personality inventory and obtained self-ratings of a sample of adults in the same region (N = 395). We also simultaneously obtained self-ratings on an adapted etic inventory that measures the lexical Big Five (N = 325). Psychometric and conceptual considerations yielded a robust 7-factor indigenous model: Agreeableness/Soft Heartedness, Honesty/Integrity, Unconventionality, Emotional Stability, Conscientiousness, Extraversion/Positive Social Relatedness, and Intellect . Initial validation evidence shows that 5 of the 7 factors overlapped with the Big Five, whereas Honesty/Integrity and Unconventionality did not overlap. Also, scores on the indigenous tools were better predicted by relevant demographic variables than scores on the etic tool. Our study demonstrated the viability of combining etic and emic approaches as key to the understanding of personality in its cultural context. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Social networks and health among older adults in Lebanon: the mediating role of support and trust.

PubMed

Webster, Noah J; Antonucci, Toni C; Ajrouch, Kristine J; Abdulrahim, Sawsan

2015-01-01

Despite a growing body of literature documenting the influence of social networks on health, less is known in other parts of the world. The current study investigates this link by clustering characteristics of network members nominated by older adults in Lebanon. We then identify the degree to which various types of people exist within the networks. This study further examines how network composition as measured by the proportion of each type (i.e., type proportions) is related to health; and the mediating role of positive support and trust in this process. Data are from the Family Ties and Aging Study (2009). Respondents aged ≥60 were selected (N = 195) for analysis. Three types of people within the networks were identified: Geographically Distant Male Youth, Geographically Close/Emotionally Distant Family, and Close Family. Having more Geographically Distant Male Youth in one's network was associated with health limitations, whereas more Close Family was associated with no health limitations. Positive support mediated the link between type proportions and health limitations, whereas trust mediated the link between type proportions and depressive symptoms. Results document links between the social networks and health of older adults in Lebanon within the context of ongoing demographic transitions. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The economics of tobacco in Lebanon: an estimation of the social costs of tobacco consumption.

PubMed

Salti, Nisreen; Chaaban, Jad; Naamani, Nadia

2014-05-01

Assess the socioeconomic costs of smoking in Lebanon and understand the tobacco market and identify the winners and losers from the Lebanese tobacco trade. We take a close look at the market for tobacco and related markets to identify the main stakeholders and estimate the direct costs and benefits of tobacco. We also estimate lower bounds for the costs of tobacco, in terms of lost productivity, the cost of medical treatment, lost production due to premature death, and environmental damage. The paucity of data means our cost estimates are conservative lower bounds and we explicitly list the effects that we are unable to include. We identify the main actors in the tobacco trade: the Régie (the state-owned monopoly which regulates the tobacco trade), tobacco farmers, international tobacco companies, local distributors, retailers, consumers, and advertising firms. We identify as proximate actors the Ministries of Finance and Health, employers, and patients of smoking-related illnesses. In 2008, tobacco trade in Lebanon led to a total social cost of $326.7 million (1.1% of GDP). Low price tags on imported cigarettes not only increase smoking prevalence, but they also result in a net economic loss. Lebanese policymakers should consider the overall deficit from tobacco trade and implement the guidelines presented in the Framework Convention on Tobacco Control to at once increase government revenue and reduce government outlays, and save the labor market and the environment substantial costs.

Hymen protection and the sexual practices, perceptions, and attitudes of female university students from Lebanon.

PubMed

El Kak, Faysal; El Salibi, Noura; Yasmine, Rola; Ghandour, Lilian

2017-11-01

To investigate associations between hymen protection and women's alternative sexual practices, perceptions, and attitudes. A cross-sectional online survey was administered among university students (aged 18-30 years) in Lebanon between April 30 and August 31, 2012. The present analysis focused on female students who had engaged in oral/anal sex. Among 416 included women, 163 (39.3%) reported anal/oral sex to protect their hymen. Women ever concerned with hymen protection were less likely to be non-Lebanese and not religious/spiritual, but more likely to report unwanted sexual activities, a relationship in which they felt things were moving too fast physically, and to feel guilty about sexual feelings (all P<0.01). They were two-to-three times more likely to agree that it is harder to refuse sex after the first time and that oral sex is not as big of a deal as sexual intercourse (both P<0.001). Concerned women who later engaged in vaginal sex (n=75) were less religious and more accepting of premarital sex than were those who continued to protect their hymen (n=88; all P<0.005). Women concerned about hymen-breaking engage in alternative sexual practices, yet experience pressure, guilt, worry, and indecisiveness regarding their sex-related decisions. The navigation of sexual decisions is a more vulnerable process for these women because of prevailing patriarchal values and discriminating gender norms in Lebanon. © 2017 International Federation of Gynecology and Obstetrics.

Proceedings of the International Conference on Technology in Mathematics Education (July 5-7, 2000, Beirut, Lebanon).

ERIC Educational Resources Information Center

2000

This volume contains the proceedings of the International Conference on Technology in Mathematics Education (ICTME) held at the Lebanese American University in July, 2000. The conference included a panel discussion on technology and the new curriculum, hands-on workshops, and focus group discussion centered around the themes of the effects of…

Survival and negotiation: narratives of severe (near-miss) neonatal complications of Syrian women in Lebanon.

PubMed

Wick, Livia

2017-10-01

The World Health Organization has elaborated a maternal and neonatal near-miss reporting, audit and feedback system designed to improve the quality of care during and after childbirth. As part of a four-hospital comparative study in the Middle East, this article discusses the experiences of mothers whose newborns suffered from severe complications at birth in the Rafik Hariri University Hospital, the only public hospital in Beirut. Based on in-depth home interviews several weeks after childbirth, it aims to explore the experience of neonatal near-miss events through the mothers' birth narratives. The central concerns of these vulnerable and marginalised women regarded access to neonatal care, and how to negotiate hospital bureaucracy and debt. It argues that financial and bureaucratic aspects of the near-miss event should be part of the audit system and policy-making, alongside medical issues, in the quest for equitable access to and management of quality perinatal care.

Ventilator-associated pneumonia at a tertiary-care center in a developing country: incidence, microbiology, and susceptibility patterns of isolated microorganisms.

PubMed

Kanafani, Zeina A; Kara, Layla; Hayek, Shady; Kanj, Souha S

2003-11-01

Ventilator-associated pneumonia (VAP) complicates the course of up to 24% of intubated patients. Data from the Middle East are scarce. The objective of this study was to evaluate the incidence, microbiology, and antimicrobial susceptibility patterns of isolated microorganisms in VAP in a developing country. Prospective observational cohort study. The American University of Beirut Medical Center, a tertiary-care center that serves as a major referral center for Lebanon and neighboring countries. All patients admitted to the intensive care and respiratory care units from March to September 2001, and who had been receiving mechanical ventilation for at least 48 hours, were included in the study. Results of samples submitted for culture were recorded and antimicrobial susceptibility testing of isolated pathogens was performed. Seventy patients were entered into the study. The incidence of VAP was 47%. Gram-negative bacilli accounted for 83% of all isolates. The most commonly identified organism was Acinetobacter anitratus, followed by Pseudomonas aeruginosa. Fifty percent of all gram-negative bacterial isolates were classified as antibiotic resistant. Compared with patients without VAP, patients with VAP remained intubated for a longer period and stayed in the intensive care unit longer. VAP was not associated with an increased mortality rate. Compared with other studies, the results from this referral center in Lebanon indicate a higher incidence of VAP and a high prevalence of resistant organisms. These data are relevant because they direct the choice of empiric antibiotic therapy for VAP.

Blood lead concentrations in 1-3 year old Lebanese children: a cross-sectional study.

PubMed

Nuwayhid, Iman; Nabulsi, Mona; Muwakkit, Samar; Kouzi, Sarah; Salem, George; Mikati, Mohamed; Ariss, Majd

2003-04-15

Childhood lead poisoning has not made the list of national public health priorities in Lebanon. This study aims at identifying the prevalence and risk factors for elevated blood lead concentrations (B-Pb >or= 100 microg/L) among 1-3 year old children. It also examines the need for universal blood lead screening. This is a cross-sectional study of 281 well children, presenting to the pediatric ambulatory services at the American University of Beirut Medical Center in 1997-98. Blood was drawn on participating children for lead analysis and a structured questionnaire was introduced to mothers asking about social, demographic, and residence characteristics, as well as potential risk factors for lead exposure. Children with B-Pb >or= 100 microg/L were compared to those with B-Pb < 100 microg/L. Mean B-Pb was 66.0 microg/L (median 60.0; range 10-160; standard deviation 26.3) with 39 (14%) children with B-Pb >or= 100 microg/L. Logistic regression analysis showed that elevated B-Pb was associated with paternal manual jobs (odds ratio [OR]: 4.74), residence being located in high traffic areas (OR: 4.59), summer season (OR: 4.39), using hot tap water for cooking (OR: 3.96), exposure to kohl (OR: 2.40), and living in older buildings (OR: 2.01). Lead screening should be offered to high-risk children. With the recent ban of leaded gasoline in Lebanon, emphasis should shift to other sources of exposure in children.

Community-based participatory research in complex settings: clean mind–dirty hands

PubMed Central

Makhoul, Jihad; Nakkash, Rima; Harpham, Trudy; Qutteina, Yara

2014-01-01

Despite the abundance of the literature which discusses factors supporting or inhibiting effective participation of community members in community-based research, there is a paucity of publications analysing challenges to participation in complex settings. This manuscript describes an intervention built on researcher–community partnership amid complex social conditions which challenged participation of community members at different stages of the research process. The research took place in a Palestinian refugee camp in Beirut, Lebanon and 1 of 12 in Lebanon which suffer from deteriorating social, economic and physical conditions perpetuated by state-imposed restrictions. The research team developed a community coalition which was involved in all stages of planning, designing, implementation and dissemination. In all those stages the aim was to maintain rigorous research, to follow a ‘clean mind’ approach to research, but maintain principles of community participation which necessitate ‘a dirty hand’. Despite commitment to the principles of community-based participatory research, participation of community members (including youth, parents and teachers) was affected to a great extent by the social, physical and structural conditions of the community context. Characteristics of the context where research is conducted and how it affects community members should not be overlooked since multiple factors beyond the researchers' control could interfere with the rigour of scientific research. Researchers need to develop a plan for participation with the community from the beginning with an understanding of the community forces that affect meaningful participation and address possible deterrence. PMID:23872385

OXA-48 and CTX-M-15 extended-spectrum beta-lactamases in raw milk in Lebanon: epidemic spread of dominant Klebsiella pneumoniae clones.

PubMed

Diab, Mohamad; Hamze, Monzer; Bonnet, Richard; Saras, Estelle; Madec, Jean-Yves; Haenni, Marisa

2017-11-01

Raw milk has recently been reported as a source of extended-spectrum beta-lactamase (ESBL) and carbapenemase genes. We thus investigated the prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae in raw milk in Lebanon in order to assess the risk of transfer of these bacteria to humans. A high prevalence (30.2 %) of CTX-M-15-producing K. pneumoniae was detected in raw bovine milk. Three main K. pneumoniae clones were identified by PFGE and MLST typing. Southern blot experiments revealed that one of these clones carried the blaCTX-M-15 gene chromosomally. Moreover, one OXA-48-producing K. pneumoniae ST530 and seven CTX-M-15-producing Escherichia coli sharing the same ST were also detected. These findings highlight the spread of dominant CTX-M-15-producing K. pneumoniae clones and OXA-48-producing isolates in the food chain. Milk, which is mostly consumed raw in Lebanon, may be a source of human exposure to ESBLs and carbapenemases.

Double jeopardy: assessing the association between internal displacement, housing quality and chronic illness in a low-income neighborhood.

PubMed

Habib, Rima R; Yassin, Nasser; Ghanawi, Joly; Haddad, Pascale; Mahfoud, Ziyad

2011-04-01

PURPOSE: This study analyzed associations between war-related internal displacement, housing quality and the prevalence of chronic illness in Nabaa, a low-income neighborhood on the outskirts of Beirut, Lebanon. METHODS: A cross-sectional survey of sociodemographics, household characteristics and health conditions of the study population was carried out in 2002. Using a structured questionnaire, the research team surveyed 1,151 households representing 4,987 residents of all ages. The survey was administered to a proxy respondent from each household in face-to-face interviews. A multiple logistic regression model using the generalized estimation equation method was constructed to assess the simultaneous effect of displacement and housing quality on reported ill health, while adjusting for potential confounders. RESULTS: Housing quality and internal displacement were strongly associated with occurrences of chronic illness. The most vulnerable respondents were older residents, females and internally displaced people, who reported high rates of chronic illnesses. Residents with high levels of education were less likely to report a chronic illness than those that had elementary education or less. CONCLUSION: Nabaa residents' experience of poor health was associated with inadequate housing quality. Moreover, residents who have been displaced experience worse living conditions and were more likely to experience poor health than those who were not displaced. These results reveal a need for policies to improve housing quality and alleviate war-related consequences in low-income neighborhoods.

Getting to "No": Locating Critical Peace Education within Resistance and Anti-Oppression Pedagogy at a Shi'a Islamic School in Lebanon

ERIC Educational Resources Information Center

Zakharia, Zeena

2017-01-01

This paper critically engages observations from a school that was aligned with a resistance movement in Lebanon during a post-war period of sustained political violence (2006-2007). Focusing on the pedagogical practices at one community-centered and community-led Shi'a Islamic urban school, the paper draws on extensive ethnographic data to…

Dust episodes in Beirut and their effect on the chemical composition of coarse and fine particulate matter.

PubMed

Jaafar, Malek; Baalbaki, Rima; Mrad, Raya; Daher, Nancy; Shihadeh, Alan; Sioutas, Constantinos; Saliba, Najat A

2014-10-15

Particles captured during dust episodes in Beirut originated from both the African and Arabian deserts. This particular air mixture showed an increase, over non-dust episodes, in particle volume distribution which was mostly noticed for particles ranging in sizes between 2.25 and 5 μm. It also resulted in an increase in average mass concentration by 48.5% and 14.6%, for the coarse and fine fractions, respectively. Chemical analysis of major aerosol components accounted for 93% of fine PM and 71% of coarse PM. Crustal material (CM) dominated the coarse PM fraction, contributing to 39 ± 15% of the total mass. Sea salt (SS) (11 ± 10%) and secondary ions (SI) (11 ± 7%) were the second most abundant elements. In the fine fraction, SI (36 ± 14%) were the most abundant PM constituent, followed by organic matter (OM) (33 ± 7%) and CM (13 ± 2%). Enrichment factors (EF) and correlation coefficients show that biogenic and anthropogenic sources contribute to the elemental composition of particles during dust episodes. This study emphasizes on the role played by the long-range transport of aerosols in changing the chemical composition of the organic and inorganic constituents of urban coarse and fine PM. The chemical reactions between aged urban and dust aerosols are enhanced during transport, leading to the formation of organo-nitrogenated and -sulfonated compounds. Their oligomeric morphologies are further confirmed by SEM-EDX measurements. Copyright © 2014 Elsevier B.V. All rights reserved.

Complementary feeding patterns in a developing country: a cross-sectional study across Lebanon.

PubMed

Batal, M; Boulghourjian, C; Akik, C

2010-02-01

This first, large-scale study on complementary feeding in Lebanon analysed the timing and types of food introduced to infants according to mothers' demographic and socioeconomic and infants' characteristics. A cross-sectional survey over 10 months found that the majority of infants were introduced to solid foods at or after 4 months of age. A large number of infants were given liquids other than breast or formula milk earlier. Women in employment outside the home were almost twice as likely to introduce solid foods before age 4 months. The most common starting food was cereals. More than half the children consumed starchy foods and fruits every day, but not meats and fish.

Responsiveness of Lebanon's primary healthcare centers to non-communicable diseases and related healthcare needs.

PubMed

Yassoub, Rami; Hashimi, Suha; Awada, Siham; El-Jardali, Fadi

2014-01-01

Lebanon currently faces a rise in non-communicable diseases (NCD) that is stressing the population's health and financial well-being. Preventive care is recognized as the optimal health equitable, cost-effective solution. The study aims to assess the responsiveness of primary health care centers (PHCs) to NCD, and identify the needed health arrangements and responsibilities of PHCs, the Ministry Of Public Health and other healthcare system entities, for PHCs to purse a more preventive role against NCD. Single and group interviews were conducted via a semi-structured questionnaire with 10 PHCs from Lebanon's primary health care network that have undergone recent pilot accreditation and are recognized for having quality services and facilities. This manifested administrative aspects and NCD-related services of PHCs and generated information regarding the centers' deficiencies, strengths and areas needing improvement for fulfilling a more preventive role. Administrative features of PHCs varied according to number and type of health personnel employed. Variations and deficiencies within and among PHCs were manifested specifically at the level of cardiovascular and respiratory diseases and cancer. PHCs identified the pilot accreditation as beneficial at the administrative and clinical levels; however, various financial and non-financial resources, in addition to establishing a strong referral system with secondary care settings and further arrangements with MOPH, are necessary for PHCs to pursue a stronger preventive role. The generated results denote needed changes within the healthcare system's governance, financing and delivery. They involve empowering PHCs and increasing their breadth of services, allocating a greater portion of national budget to health and preventive care, and equipping PHCs with personnel skilled in conducting community-wide preventive activities. Copyright © 2013 John Wiley & Sons, Ltd.

Quality of life and symptom prevalence as reported by children with cancer in Lebanon.

PubMed

Abu-Saad Huijer, Huda; Sagherian, Knar; Tamim, Hani

2013-12-01

To date, there are no studies on quality of life (QoL) and symptom prevalence reported by pediatric oncology patients in Lebanon. The purpose of this study was to evaluate the QoL, symptom prevalence and symptom management among a sample of pediatric oncology patients. The study design was cross-sectional. The Pediatric Quality of Life Inventory (PedsQL) cancer module and the Memorial Symptom Assessment Scale were administered in Arabic using face-to-face interviews to a convenience sample of 85 pediatric cancer patients (7-18 years) at a tertiary hospital in Lebanon. The mean age of the study group was 12.5 years with leukemia being the most common cancer (43.5%). The lowest scores on the PedsQL subscales were in nausea (score = 64.82; SD = 25.76) and worry (score = 68.14; SD = 30.07), thus indicating more problems in these areas. A comparison based on age showed significant differences in pain and hurt, nausea, and worry. In children (7-12 years), lack of appetite, pain, and nausea were mostly prevalent whereas adolescents (13-18 years) experienced lack of energy, irritability, and pain. In both age groups, pain and nausea were the most frequently treated symptoms. Overall, the participants had good health-related QoL as indicated by most of the PedsQL subscales. Symptom management was found to be inadequate and in some cases ineffective. More attention should be given to the management of symptoms in general using pharmacological and non-pharmacological techniques. Of particular importance is the importance of providing psychological support to alleviate symptom burden and improve QoL. Copyright © 2013 Elsevier Ltd. All rights reserved.

Acute stress disorder in older, middle-aged and younger adults in reaction to the second Lebanon war.

PubMed

Cohen, Miri

2008-01-01

To compare rate of acute stress disorder (ASD) and intensity of acute stress symptoms (ASS) in younger, middle-aged and older Israeli citizens exposed to missile attacks during the second Lebanon war. A telephone survey of a random sample of residents in the northern area of Israel was conducted in July 2006, during the third week of Lebanon war. Respondents were divided into groups aged 18-40, 41-69 and 70+. ASD and ASS were measured by the Acute Stress Interview questionnaire and by war-related exposure variables and demographic data. Exposure variables were similar in the three age groups. Older respondents reported lower intensity of ASS and obtained lower means for each of the symptoms criteria than the young adults, while the middle-aged adults were in between the younger and the older group. ASD criteria were met by 13.2% of the younger, 4.7% of middle-aged and 4.3% of older respondents (p > 0.05), and subsyndromal ASD was found in 20.5%, 14.1% and 4.4% (p < 0.05) respectively. Twenty-two percent of ASS variance was explained by younger age, female gender and higher perceived proximity to missile falling. Older adults reacted to the war situation with lower level of acute stress symptoms. Long-term effects of war on different age groups should be further studied.

Breast-feeding and feeding practices of infants in a developing country: a national survey in Lebanon.

PubMed

Batal, Malek; Boulghourjian, Choghik; Abdallah, Ahmad; Afifi, Rima

2006-05-01

Breast-feeding (BF) provides the ideal food for the healthy growth and development of infants. The prevalence of BF in Lebanon shows mixed results. The present study was the first large-scale, extensive survey on BF parameters in Lebanon that aimed to explore demographic, socio-economic and other fundamental issues associated with the initiation and duration of BF by Lebanese mothers. The survey was cross-sectional in design and administered over 10 months. Information on all variables was collected from mothers at health centres. Two-stage sampling was conducted to select participants. A total of 1,000 participants were randomly selected. A consent form was provided to each participant. Data were collected from 830 of these. Almost all mothers were Lebanese, married and had given birth in a hospital. About a third stated that breast milk was the first food introduced after birth. Although 55.9% started breast-feeding their newborns within a few hours after birth, and 18.3% within half an hour, 21.2% replied that they initiated BF a few days after birth. Only 4.6% of the mothers replied that they never breast-fed their infant. Timing of initiation of BF was associated with the type of delivery (vaginal/Caesarean section) and hospital-related factors (rooming-in, night feedings and frequency of mother-infant interaction). Of the mothers who breast-fed exclusively beyond 6 months, 86.7% had initiated BF a few hours following delivery, while only 13.3% had initiated BF a few days later. Compared with the exceptionally high proportion of BF initiation, exclusivity of BF was low, dropping to 52.4% at 1 month. Exclusivity of BF was also associated with place of residence (urban/rural) and negatively associated with educational level of the mother. Duration of BF was inversely associated with the use of pain killers during delivery and maternal education. Rural mothers and those who practised exclusive BF maintained BF for a longer duration. Initiation rates of BF are

Farmers' Willingness to Adopt Conservation Agriculture: New Evidence from Lebanon.

PubMed

Chalak, Ali; Irani, Alexandra; Chaaban, Jad; Bashour, Issam; Seyfert, Karin; Smoot, Kaitlyn; Abebe, Gumataw Kifle

2017-10-01

With increasing food insecurity and climate change, conservation agriculture has emerged as a sustainable alternative to intensive conventional agriculture as a source of food supply. Yet the adoption rate of conservation agriculture is still low. Our paper analyses the factors affecting farmers' willingness to adopt conservation agriculture in Lebanon. The findings show that household characteristics-years of farming and farm size affect conservation agriculture adoption. However, household characteristics alone were insufficient to explain conservation agriculture adoption. We found that farming experience, information sources, frequency of irrigation, and severity of weed infestation in the past, participation in specific trainings, and farmers' perception about the long-term impact of conservation agriculture, were key determinants of conservation agriculture adoption. Our paper encourages policymakers to invest in conservation agriculture to overcome food insecurity and environmental changes affecting food systems in the Middle East. The paper also informs agribusiness firms to view conservation agriculture as a viable alternative to strengthen their business relationship with farmers in arid and semi-arid regions.

Farmers' Willingness to Adopt Conservation Agriculture: New Evidence from Lebanon

NASA Astrophysics Data System (ADS)

Chalak, Ali; Irani, Alexandra; Chaaban, Jad; Bashour, Issam; Seyfert, Karin; Smoot, Kaitlyn; Abebe, Gumataw Kifle

2017-10-01

With increasing food insecurity and climate change, conservation agriculture has emerged as a sustainable alternative to intensive conventional agriculture as a source of food supply. Yet the adoption rate of conservation agriculture is still low. Our paper analyses the factors affecting farmers' willingness to adopt conservation agriculture in Lebanon. The findings show that household characteristics—years of farming and farm size affect conservation agriculture adoption. However, household characteristics alone were insufficient to explain conservation agriculture adoption. We found that farming experience, information sources, frequency of irrigation, and severity of weed infestation in the past, participation in specific trainings, and farmers' perception about the long-term impact of conservation agriculture, were key determinants of conservation agriculture adoption. Our paper encourages policymakers to invest in conservation agriculture to overcome food insecurity and environmental changes affecting food systems in the Middle East. The paper also informs agribusiness firms to view conservation agriculture as a viable alternative to strengthen their business relationship with farmers in arid and semi-arid regions.

Cutaneous sarcoidosis: clinicopathologic study of 76 patients from Lebanon.

PubMed

Ishak, Rim; Kurban, Mazen; Kibbi, Abdul-Ghani; Abbas, Ossama

2015-01-01

Sarcoidosis is a multi-system granulomatous disease of unknown etiology. The skin is involved in 25% of cases. Studies on cutaneous sarcoidosis from our region are lacking. This study was conducted to describe clinical and histopathologic findings in all patients diagnosed with cutaneous sarcoidosis at the American University of Beirut Medical Center between 1992 and 2010 and to compare findings with those published in the literature. Clinical charts of patients with cutaneous sarcoidosis were retrospectively reviewed. Extracutaneous lesions were classified by organ involvement. Treatment was documented. Pathology specimens were reviewed. Cutaneous sarcoidosis was diagnosed in 76 Lebanese patients, 79% of whom were women. Mean age at diagnosis was 48 years. A total of 29% of patients had systemic disease that was commonly associated with lupus pernio lesions and subcutaneous sarcoidosis. The most common cutaneous lesions were sarcoidal plaques. The histopathologic features in our series did not differ from those described in the literature, except for the documented presence of a grenz zone. Interestingly, 23% of biopsy specimens contained perineural granulomas, raising the possibility of tuberculoid or borderline tuberculoid leprosy. Foreign bodies were detected in 10% of cases (all had systemic involvement), supporting the opinion that sarcoidosis and granulomatous foreign body reaction are not mutually exclusive. The clinical and histopathologic features of cutaneous sarcoidosis patients in the present series are generally comparable with those published in the literature, with minor differences. Clinically, the most commonly seen lesion was plaque. Microscopically, cutaneous sarcoidosis may exhibit a grenz zone and may show perineural inflammation and foreign bodies. © 2014 The International Society of Dermatology.

Characterization of human Influenza Viruses in Lebanon during 2010-2011 and 2011-2012 post-pandemic seasons.

PubMed

Zaraket, Hassan; Dapat, Clyde; Ghanem, Soha; Ali, Zainab; Lteif, Mireille; Kondo, Hiroki; Dapat, Isolde C; Saito, Kousuke; Kayali, Ghazi; Suzuki, Hiroshi; Dbaibo, Ghassan; Saito, Reiko

2014-01-01

To genetically characterize human influenza viruses and their susceptibilities to antivirals during two post-pandemic seasons in Lebanon. Influenza virus was isolated from nasopharyngeal swabs that were obtained from patients with influenza-like illness during 2010-2012 and further analyzed both phenotypically and genotypically. During the 2010-2011 season, both 2009 pandemic H1N1 (H1N1p) and B viruses co-circulated with equal prevalence, while the H3N2 virus predominated during the 2011-2012 season. All H3N2 and H1N1 viruses were resistant to amantadine. Importantly, all viruses of the influenza A and B types were susceptible to the neuraminidase (NA) inhibitors oseltamivir, zanamivir, peramivir, and laninamivir. Nonetheless, all 2011-2012 H1N1p isolates had three mutations (V241I, N369K, and N386S) in the NA gene that were suggested to be permissive of the H275Y mutation, which confers resistance to oseltamivir. We also detected one H1N1p virus during the 2010-2011 season with a 4-fold decrease in susceptibility to oseltamivir due to an NA-S247N mutation. This isolate was phylogenetically distinct from other H1N1p viruses that were isolated in other regions. Influenza A viruses with reduced susceptibility to oseltamivir and mutations permissive for acquiring NA resistance-conferring mutation with minimal burden on their fitness were isolated in Lebanon. © 2014 S. Karger AG, Basel.

Ancient mitogenomes of Phoenicians from Sardinia and Lebanon: A story of settlement, integration, and female mobility.

PubMed

Matisoo-Smith, E; Gosling, A L; Platt, D; Kardailsky, O; Prost, S; Cameron-Christie, S; Collins, C J; Boocock, J; Kurumilian, Y; Guirguis, M; Pla Orquín, R; Khalil, W; Genz, H; Abou Diwan, G; Nassar, J; Zalloua, P

2018-01-01

The Phoenicians emerged in the Northern Levant around 1800 BCE and by the 9th century BCE had spread their culture across the Mediterranean Basin, establishing trading posts, and settlements in various European Mediterranean and North African locations. Despite their widespread influence, what is known of the Phoenicians comes from what was written about them by the Greeks and Egyptians. In this study, we investigate the extent of Phoenician integration with the Sardinian communities they settled. We present 14 new ancient mitogenome sequences from pre-Phoenician (~1800 BCE) and Phoenician (~700-400 BCE) samples from Lebanon (n = 4) and Sardinia (n = 10) and compare these with 87 new complete mitogenomes from modern Lebanese and 21 recently published pre-Phoenician ancient mitogenomes from Sardinia to investigate the population dynamics of the Phoenician (Punic) site of Monte Sirai, in southern Sardinia. Our results indicate evidence of continuity of some lineages from pre-Phoenician populations suggesting integration of indigenous Sardinians in the Monte Sirai Phoenician community. We also find evidence of the arrival of new, unique mitochondrial lineages, indicating the movement of women from sites in the Near East or North Africa to Sardinia, but also possibly from non-Mediterranean populations and the likely movement of women from Europe to Phoenician sites in Lebanon. Combined, this evidence suggests female mobility and genetic diversity in Phoenician communities, reflecting the inclusive and multicultural nature of Phoenician society.

Ancient mitogenomes of Phoenicians from Sardinia and Lebanon: A story of settlement, integration, and female mobility

PubMed Central

Gosling, A. L.; Platt, D.; Kardailsky, O.; Prost, S.; Cameron-Christie, S.; Collins, C. J.; Boocock, J.; Kurumilian, Y.; Guirguis, M.; Pla Orquín, R.; Khalil, W.; Genz, H.; Abou Diwan, G.; Nassar, J.; Zalloua, P.

2018-01-01

The Phoenicians emerged in the Northern Levant around 1800 BCE and by the 9th century BCE had spread their culture across the Mediterranean Basin, establishing trading posts, and settlements in various European Mediterranean and North African locations. Despite their widespread influence, what is known of the Phoenicians comes from what was written about them by the Greeks and Egyptians. In this study, we investigate the extent of Phoenician integration with the Sardinian communities they settled. We present 14 new ancient mitogenome sequences from pre-Phoenician (~1800 BCE) and Phoenician (~700–400 BCE) samples from Lebanon (n = 4) and Sardinia (n = 10) and compare these with 87 new complete mitogenomes from modern Lebanese and 21 recently published pre-Phoenician ancient mitogenomes from Sardinia to investigate the population dynamics of the Phoenician (Punic) site of Monte Sirai, in southern Sardinia. Our results indicate evidence of continuity of some lineages from pre-Phoenician populations suggesting integration of indigenous Sardinians in the Monte Sirai Phoenician community. We also find evidence of the arrival of new, unique mitochondrial lineages, indicating the movement of women from sites in the Near East or North Africa to Sardinia, but also possibly from non-Mediterranean populations and the likely movement of women from Europe to Phoenician sites in Lebanon. Combined, this evidence suggests female mobility and genetic diversity in Phoenician communities, reflecting the inclusive and multicultural nature of Phoenician society. PMID:29320542

The passage of tobacco control law 174 in Lebanon: reflections on the problem, policies and politics.

PubMed

Nakkash, R T; Torossian, L; El Hajj, T; Khalil, J; Afifi, R A

2018-06-01

Progress in tobacco control policy making has occurred worldwide through advocacy campaigns involving multiple players- civil society groups, activists, academics, media and policymakers. The Framework Convention on Tobacco Control (FCTC)-the first ever global health treaty-outlines evidence-based tobacco control policies. Lebanon ratified the FCTC in 2005, but until 2011, tobacco control policies remained rudimentary and not evidence-based. Beginning in 2009, a concerted advocacy campaign was undertaken by a variety of stakeholders with the aim of accelerating the process of adopting a strong tobacco control policy. The campaign was successful, and Law 174 passed the Lebanese Parliament in August 2011. In this article, we analyse the policy making process that led to the adoption of Law 174 using Kingdon's model. The analysis relies on primary and secondary data sources including historical records of key governmental decisions, documentation of the activities of the concerted advocacy campaign and in-depth interviews with key stakeholders. We describe the opening of a window of opportunity as a result of the alignment of the problem, policy and politics streams. Furthermore, findings revealed that despite the challenge of persistent tobacco industry interference and established power relations between the industry, its allies and policymakers; policy entrepreneurs succeeded in supporting the alignment of the streams, and influencing the passage of the law. Kingdon's multiple stream approach was useful in explaining how tobacco control became an emerging policy issue at the front of the policy agenda in Lebanon.

AGE AND REASONS OF THE FIRST DENTAL VISIT OF CHILDREN IN LEBANON.

PubMed

Daou, Maha H; Eden, Ece; El Osta, Nada

2016-01-01

The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have recommended that the child's first dental visit should be during the child's first year of life for dental disease prevention and to decrease the invasive restorative interventions. In Lebanon, no study has been conducted to determine the age and the reasons of the first dental visit of children and who requested the first dental screening. To assess at what age occurred the first dental visit in a group of Lebanese children visiting a private pediatric dental clinic and to explore the reasons for their first dental consultation. An observational cross-sectional study was conducted. During a five-year period, all children visiting the pediatric clinic were invited to participate in the study. Parents were asked about the general health status of their child, the use of antibiotics before the age of 2 years. Parents were also requested to give the dental reasons for their initial visit to a pedodontist. Two hundred and twenty children (mean age 4.24 ± 1.35 years) visited the pedodontic care office for the first time and were included in the study. All participants had visited a pediatrician before the age of 1 year. Fifty-seven (25.9%) children were referred by a dentist and 163 (74.1%) came with their parents without referral. All participants had at least one reason for the first consultation; the most common were the presence of decayed teeth (50.9%) and a dental pain perception (29.5%). All participants had visited a pediatrician at an earlier age but none was referred to a pedodontist by a pediatrician for check-up or prevention. Children came upon the decision of their parents. A dental problem was the major reason which triggered the first visit. Therefore, pediatricians in Lebanon need to keep themselves updated on recommendations regarding children oral health and be encouraged to play an important role in prompting oral health and first dental visits.

Clinical and epidemiological characteristics of norovirus gastroenteritis among hospitalized children in Lebanon.

PubMed

Melhem, Nada M; Zaraket, Hassan; Kreidieh, Khalil; Ali, Zeinab; Hammadi, Moza; Ghanem, Soha; Hajar, Farah; Haidar, Amjad; Inati, Adlette; Rajab, Mariam; Fakhouri, Hassan; Ghanem, Bassam; Baasiri, Ghassan; Dbaibo, Ghassan

2016-12-28

To assess the burden of norovirus (NoV) and to determine the diversity of circulating strains among hospitalized children in Lebanon. Stool samples were collected from children presenting with acute gastroenteritis to six major hospitals in Lebanon. A total of 739 eligible stool samples, testing negative for diarrhea caused by rotavirus as a possible viral pathogen, were collected between January 2011 and June 2013. A standardized questionnaire including demographic, epidemiological and clinical observations was used at the time of hospitalization of children presenting with diarrhea. Viral RNA was extracted from stool samples followed by reverse transcription polymerase chain reaction and nucleotide sequencing of a fragment of the viral protein 1 capsid gene. Multiple sequence alignments were carried out and phylogenetic trees were constructed using the MEGA 6 software. Overall, 11.2% of stool samples collected from children aged < 5 years tested positive for NoV genogroups I (GI) and II (GII). GII accounted for 10.6% of the gastroenteritis cases with only five samples being positive for GI (0.7%). The majority of hospitalized children showed symptoms of diarrhea, dehydration, vomiting and fever. Upon sequencing of positive samples and based on their clustering in the phylogenetic tree, 4/5 of GI gastroenteritis cases were designated GI.3 and one case as GI.4. GII.4 was predominantly detected in stool of our study participants (68%). We report a JB-15/KOR/2008 GII.4 Apeldoorn 2008-like variant strain circulating in 2011; this strain was replaced between 2012 and 2013 by a variant sharing homology with the Sydney/NSW0514/2012/AUS GII.4 Sydney 2012 and Sydney 2012/FRA GII.4 strains. We also report the co-circulation of non-GII.4 genotypes among hospitalized children. Our data show that NoV gastroenteritis can occur throughout the year with the highest number of cases detected during the hot months. The majority of NoV-associated viral gastroenteritis cases among our

Treatment seeking for posttraumatic stress in Israel Defense Forces veterans deployed in the Second Lebanon War (2006) and "Operation Cast Lead" in the Gaza Strip (2009): a comparative study.

PubMed

Levi, Ofir; Lubin, Gadi

2018-05-01

The goal of the study was to determine the long-term prevalence of combat-related treatment seeking and posttraumatic stress disorder (PTSD) in Israel's veterans deployed to the Second Lebanon War (2006) and "Operation Cast Lead" in the Gaza Strip (2009). The prevalence of treatment seeking and DSM-IV-TR diagnoses among Israel Defense Force (IDF) veterans was assessed using seven and five year's surveillance and records. The whereabouts and combat exposure of veterans during the war was determined based on the IDF's Operations Directorate records. Overall prevalence of treatment seeking was 1.32% and 0.38% in the Second Lebanon War and "Operation Cast Lead", respectively. The prevalence of treatment-seeking veterans from the Second Lebanon War and in "Operation Cast Lead" was significantly higher in soldiers deployed to high combat-exposure zones (2.19% and 3.1%, respectively), relative to low combat-exposure zones (0.24% and 0.06%, respectively), and relative to soldiers deployed elsewhere (0.26% and 0.02%, respectively). PTSD prevalence was similar among treatment-seeking veterans deployed in high combat-exposure zones in both combats. There is a gap of anywhere between 3% and 11% between treatment seeking by IDF veterans following war deployment and the actual prevalence of PTSD in this soldier population.

Air Operations in Israel’s War Against Hezbollah: Learning from Lebanon and Getting It Right in Gaza

DTIC Science & Technology

2011-01-01

alongside the 113 Steven Erlanger, “As Israel Begins to Pull Troops Out, Lebanon and the UN Prepare to Replace Them,” New York Times, August 16...engagement. Then, just before pulling abreast of the Ababil, he fired a Python 4 infrared missile using his helmet-mounted sight for high off-boresight...shock for two weeks after the Wehrmacht’s surprise attack on the Soviet Union in 1941, Nasrallah pulled himself back together fairly quickly. Shortly

First report of blaNDM-1-producing Acinetobacter baumannii isolated in Lebanon from civilians wounded during the Syrian war.

PubMed

Rafei, Rayane; Dabboussi, Fouad; Hamze, Monzer; Eveillard, Matthieu; Lemarié, Carole; Mallat, Hassan; Rolain, Jean-Marc; Joly-Guillou, Marie-Laure; Kempf, Marie

2014-04-01

The emergence of carbapenem-resistant Acinetobacter baumannii has been observed worldwide. We describe the first detection of A. baumannii carrying the blaNDM-1 gene in Lebanon, isolated from Syrian patients wounded during the civil war. Four carbapenem-resistant A. baumannii strains isolated in 2012 in the Tripoli Government Hospital, Lebanon, from civilians wounded during the Syrian war, were analysed. Susceptibility was determined by disk diffusion testing, and resistance to carbapenems was confirmed by Etest. The presence of blaOXA-23-like, blaOXA-24-like, blaOXA-58-like, blaOXA-143-like, and blaNDM was investigated by PCR. Clonal relationships were studied by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and blaOXA-51 sequence-based typing. All isolates harboured the blaNDM-1 gene and were negative for other tested carbapenemases. They all belonged to the sequence type 85 and formed a single cluster by PFGE. Finally, blaOXA-51-like gene sequencing revealed the presence of the blaOXA-94 variant in all four isolates. These findings show that Syria constitutes a reservoir for NDM-1-producing bacteria. These results also highlight the need for effective measures to stop the threatening spread of such strains. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Symptoms of acute stress in Jewish and Arab Israeli citizens during the Second Lebanon War.

PubMed

Yahav, Rivka; Cohen, Miri

2007-10-01

The "Second Lebanon War" exposed northern Israel to massive missile attacks, aimed at civilian centers, Jewish and Arab, for a period of several weeks. To assess prevalence of acute stress disorder (ASD) and acute stress symptoms (ASS) in Jewish and Arab samples, and their correlates with demographic and exposure variables. Telephone survey conducted in the third week of the second Lebanon war with a random sample of 133 Jewish and 66 Arab adult residents of northern Israel. ASD, ASS and symptoms-related impairment were measured by the Acute Stress Disorder Interview (ASDI) questionnaire, in addition to war-related exposure and demographic data. The majority of respondents experienced at least one of four symptom groups of ASD, 5.5% of the Jewish respondents and 20.3% of the Arabs met the criteria of ASD. Higher rates of Arab respondents reported symptoms of dissociation, reexperiencing and arousal, but a similar rate of avoidance was reported by the two samples. Higher mean scores of ASS and of symptoms-related impairment were reported by the Arab respondents. According to multiple regression analyses, younger age, female gender, Arab ethnicity and experiencing the war more intensely as a stressor significantly explained ASS variance, while Arab ethnicity and proximity to missiles exploding significantly explained the variance of symptoms-related impairment. A substantial rate of participants experienced symptoms of acute stress, while for only small proportion were the symptoms consistent with ASD. Higher ASD and ASS were reported by the Arab sample, calling attention to the need to build interventions to reduce the present symptoms and to help prepare for possible similar situations in the future.

Hypertension prevalence and living conditions related to air pollution: results of a national epidemiological study in Lebanon.

PubMed

Salameh, Pascale; Chahine, Mirna; Hallit, Souheil; Farah, Rita; Zeidan, Rouba Karen; Asmar, Roland; Hosseiny, Hassan

2018-04-01

Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.