The role of the COVID-19 pandemic and economic crisis in insomnia and post-traumatic stress symptoms in the Lebanese population: A cross-sectional assessment

Based on an online cross-sectional survey, this study aimed to evaluate the role of the coronavirus disease 2019 (COVID-19) pandemic and economy-related factors in post-traumatic stress symptoms (PTSSs) and sleep in a sample of the general Lebanese population using the post-traumatic stress disorder checklist. The online survey was conducted between May 10, and May 20, 2020, and 502 Lebanese adults who have access to the internet were enrolled. Results highlighted that positive correlates of PTSS were fear of COVID-19, female gender, and waterpipe smoking;negative correlates were higher family satisfaction, higher financial wellness, older age, having access to healthcare, and never having to work. When including insomnia as an independent variable to explain PTSS, the model did not substantially change. Positive correlates of insomnia included fear of poverty, fear of COVID-19, violence at home, the number of dependent children, having a job, and having a chronic disease. Conversely, higher family satisfaction and financial wellness were associated with lower likelihood of insomnia. When entering PTSS, insomnia remained positively associated with fear of poverty, PTSS, and violence at home. However, fear of COVID-19 was no longer associated with insomnia. We concluded that both the fear of COVID-19 and the economic crisis are correlated with PTSS and insomnia. © 2023 Author(s).

Teacher Education Programs in Lebanon: Innovations in the Past Decade (2011–2021)

Several studies have investigated the nature of teacher education programs in Lebanon. These studies described the requirements of Lebanese teacher preparation programs, identified the differences and similarities among these programs, and discussed the theoretical perspectives driving them. Other studies looked into the preparation of subject matter teachers such as mathematics and science teachers, among others. Exploring the similarities and differences among these programs was motivated by the fact that there are varieties of Lebanese private universities— in addition to Lebanon's sole public university—that adopt American or French educational models to prepare teachers. Previously published studies on teacher preparation used qualitative and qualitative research designs. For example, a mixedmethod approach was used to investigate the structural and conceptual foundations of programs;another study used document analysis to identify the content of the programs, while a third analyzed course syllabi of teacher education courses to identify the types of mathematics teaching methods adopted. However, there has been no attempt to critically analyze and synthesize the extant research and identify the "innovations” that have been introduced in these programs over the past decade and in response to the pressures exerted on universities due to the COVID-19 pandemic and political turmoil in Lebanon. Consequently, the purpose of this chapter is to conduct a critical review of the literature on teacher education in Lebanon and supplement it with an analysis of the innovations implemented across a sample of the major existing teacher education programs. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

Following the COVID-19 playbook and battling another infodemic: conspiracy beliefs around human monkeypox among the Lebanese population.

INTRODUCTION: The non-endemic multicountry outbreak of monkeypox (MPX) has emphasized the issue of conspiracy theories that go viral in times of societal crisis. Now, it is the turn of MPX to join COVID-19 in the conspiracy theory realm. Social media outlets were flooded by a scourge of misinformation as soon as MPX cases began to appear with an evident cross-pollination between diverse conspiracy theories. Given the adverse consequences of conspiracy beliefs, this study aimed to assess the extent of endorsement of MPX conspiracy beliefs among the Lebanese population and to identify its associated factors. METHODS: Using a convenience sampling technique, a web-based cross section was conducted among Lebanese adults. Data were collected using an Arabic self-reported questionnaire. Multivariable logistic regression was performed to identify the factors associated with the MPX conspiracy beliefs scale. RESULTS: Conspiracy beliefs regarding emerging viruses including MPX were detected among 59.1% of Lebanese adults. Participants endorsed particularly the conspiracy theories linking the virus to a deliberate attempt to reduce the size of the global population (59.6%), gain political control (56.6%) or pharmaceutical companies' financial gain (39.3%), in addition to the manmade origin of MPX (47.5%). Remarkably, the majority of surveyed adults exhibited a negative attitude toward the government's preparedness for a potential MPX outbreak. However, a positive attitude was revealed toward the effectiveness of precautionary measures (69.6%). Female participants and those having a good health status were less likely to exhibit a higher level of conspiracy beliefs. On the contrary, divorced or widowed adults, those having a low economic situation, poor knowledge level, and negative attitude either toward the government or precautionary measures were more prone to disclose a higher level of conspiracy beliefs. Notably, participants relying on social media to get information about MPX were also more likely to have a higher level of conspiracy beliefs compared to their counterparts. CONCLUSIONS: The widespread extent of conspiracy beliefs endorsement regarding MPX among the Lebanese population urged the policymakers to find ways to reduce people's reliance on these theories. Future studies exploring the harmful impacts of conspiracy beliefs on health behaviors are recommended.

A cross-sectional study of knowledge, attitude, behaviour and preventive measures for COVID-19 infection in Lebanon.

Background: The World Health Organization has often reiterated its recommendations for the prevention of COVID-19, however, the success of these measures largely depends on public knowledge and attitudes. Aims: This study assessed the relationship between knowledge, attitude, behaviour and preventive measures for COVID-19 infection in a Lebanese population. Methods: This cross-sectional study was conducted between September and October 2020 using the snowball sampling technique and an online self-administered questionnaire. The questionnaire had 4 parts targeting sociodemographic characteristics; medical history; knowledge, attitude and practices (preventive measures and behaviours related to COVID-19); and mental health variables such as psychological distress. Two models were derived using multivariable binomial logistic regression to optimize the picture of COVID-19 correlates. Results: Our sample comprised 1119 adults. Being older, female, a regular alcohol consumer, waterpipe smoker, having low level of education, low family income, and having contact with a COVID-19 patient correlated with increased odds of ever having been diagnosed with COVID-19. Participants who had ever been diagnosed with COVID-19 had a significantly better knowledge and a higher risky practice scale [adjusted odds ratio (ORa) = 1.49; 95% CI 1.27-1.74; P < 0.001; and ORa = 1.04; 95% CI 1.01-1.08; P = 0.024, respectively]. Conclusion: The most important predictors of COVID-19 infection appear to be generally well-known among the general population, however, their knowledge and adherence to preventive measures should be continuously re-evaluated. This study highlights the need for greater awareness to improve precautionary behaviours among the public.

Knowledge and attitude towards monkeypox among the Lebanese population and their attitude towards vaccination.

Introduction: Monkeypox is a currently re-emerging disease in the world and several cases have been detected in Lebanon. For this reason, an assessment of the knowledge and attitude of the Lebanese population towards monkeypox and smallpox or monkeypox vaccines had to be done. Methods: A cross-sectional study was conducted using a questionnaire developed from previous literature among a sample of Lebanese residents. It recorded the sociodemographic characteristics and comorbidities of the participants and analyzed the patterns of knowledge and attitudes in Lebanon. Results: Among 493 participants, it was found that there is a generally low knowledge of and an average attitude toward monkeypox. However, knowledge is better with higher educational levels, COVID-19 vaccination, and residency in the south of Lebanon and poorer with marriage and residency in Beirut. Attitude is better in females but poorer with higher educational levels. Several other effectors have been devised too. As for vaccination, taking the smallpox vaccine as a proactive measure is predicted with previous COVID-19 vaccination and better attitude but not in the residents of the north of Lebanon and married Lebanese residents. Higher educational levels and a better attitude were positive predictions of taking the monkeypox vaccine whenever it is developed. Conclusion: This study revealed low level of knowledge and attitude towards monkeypox and its vaccines, which can be a rich resource when proactive measures are developed.

Covid-19 in Lebanon: Update, Challenges and Lessons Learned

Intro: The COVID-19 pandemic remains a public health problem threatening national and global health security. Early during the pandemic, countries and governments including Lebanon declared states of emergency and imposed strict public health measures including national lockdowns and nonpharmaceutical interventions (NPIs) to reduce the spread of the virus. Lebanon has been struggling with plethora of challenges at the social, economic, financial, political and healthcare levels before the start of the pandemic in the country in February 2020. Method(s): The aim of this study is to advance the evolution of the COVID-19 epidemiology in Lebanon pre- and post-vaccination as well as the gaps and challenges affecting recovery and response. We will present the evolution of total number of cases, PCR positivity rates, case-fatality rates an hospitalizations. Finding(s): We present the evolution of the clinical and melocular epidemiology of COVID-19 in Lebanon, national response prior and following the introduction of COVID-19 vaccines and the impact of the latter on the course of the pandemic in Lebanon, national challenges and successes as well as the need to reimagine a national health strategy. The COVID-19 pandemic revealed the vulnerability, gaps and needs of the Lebanese health infrastructure including epidemiologic surveillance, genomic surveillance, integrated and concerted data sharing, diagnostic capacity, community mobilization and risk communication. Conclusion(s): The COVID-19 pandemic has been an eye opener about the need to invest in systemic and equal improvement in national health strategies. This is key to prevent future pandemics and to protect global health security. National and international coordinated strategies for emergency preparedness, response and recovery are critically needed in order to support the continuous monitoring of potential threats. The national commitment to these important inherent components of a rapid response requires investment in human and technical expertise to reduce inequality in access to information and care.Copyright © 2023

Applications of the One Health concept: Current status in the Middle East

Background: The One Health concept (OHC) seeks to improve the health of plants, animals, and humans because improving animal and plant health will increase the capacity for improving human health. Many risks such as plant and animal biotechnology applications have the potential to generate new diseases that can be transmitted to humans. In this way, the health of humans, animals, and plants is interrelated and depends on one another. However, it has been difficult to apply the OHC in some countries, such as those in the Middle East. The absence of financial support in the region is a major hindrance to applying this concept in the region. The application of the OHC requires the support of specialists who can advocate the government for support in launching OHC-related projects. Here, we discuss the OHC in the context of antimicrobial resistance, zoonotic diseases, and biosafety/biosecurity, which are important public health issues. Furthermore, we describe the current status of the OHC in the Middle East and recent research conducted related to this concept. There has been recent international solidarity in the application of the OHC to reduce risks that threaten the health of organisms. Several countries jointly launched the Global Health Security Agenda in 2014 with the aim of realizing a world that is free of infectious disease-related health risks. However, no previous review articles have examined the applications of the OHC in the Middle East region. This article discusses the OHC in terms of its needs and current applications in the Middle East. Methodology: The following keywords were used in the search: "One Health," "Middle East," "medicinal plants," "viruses," "rabies," "MERS," and "antimicrobial resistance." Related papers were obtained by searching for these keywords using available search engines, such as PubMed, Google Scholar, and Google search, as well as international organization websites. Conclusion(s): The concept of One Health is relatively new and has not been applied in most countries, possibly because the value of this concept for improving human health is not well understood. The key principle defining this concept and its importance is the interdependency of plants, animals, and human health. By applying the OHC, humans can benefit from healthy plants and animals by enhancing their growing conditions, medications, and environments. This would in turn improve general human health by allowing the safe extraction of therapeutics and food resources.Copyright © 2023

Digital health literacy and online informationseeking behavior of Lebanese university students in the time of the COVID-19 pandemic and infodemic

This cross-sectional study evaluated digital health literacy (DHL) and web-based information-seeking behavior of Lebanese university students. A total of 602 students (60.1% female), 21.5 years (±4.1), participated in May-August 2020 in an online survey. We found that 76.2% used the Internet, in the past month, for COVID-19-related information. Those with a chronic health impairment more often had limited DHL for adding self-generated content (OR=0.448;95 % CI=0.185, 1.085) and for determining relevance (OR=0.276;95 %CI=0.114-0.670). Students in graduate studies had higher odds of having sufficient DHL for adding self-generated content (OR=2.328;95 % CI=1.104, 4.909) and evaluating reliability (OR=2.318;95 % CI=1.149, 4.679). Users of official sources of information had higher odds (OR=1.665;95 % CI=1.065, 2.605) of having sufficient DHL for adding self-generated content. Regular users of social media had lower odds (OR=0.576;95 % CI=0.358, 0.928) of having sufficient DHL for evaluating reliability. Self-efficacy, in this case one's potential to accomplish a search for reliable health information and adopt it in daily life, could improve with DHL. As such, health education needs to strengthen DHL competencies in university students, particularly among undergraduates, those relying on social media, and those with an existing health impairment © Copyright 2023 Author(s). This is an open access article distributed under the terms of the Creative Commons CC-BY 4.0 License (https://creativecommons.org/licenses/by/4.0/)

SYRIA-Everybody's War: The Politics of Aid in the Syria Crisis

Gabiam reviews Everybody's War: The Politics of Aid in the Syria Crisis edited by Jehan Bseiso, Michiel Hofman, and Jonathan Whittall.

Smartphone addiction and personality traits among Lebanese adults: the mediating role of self-esteem.

Smartphone usage in Lebanon is increasing constantly. Lebanese population especially university students were described to be at a higher risk of smartphone addiction compared to the general population. To our knowledge there has been no study in the literature that investigated the mediating effect of self-esteem when assessing personality traits and smartphone addiction in young adults. The aim of our study was to assess factors associated with smartphone addiction and investigate the mediating role of self-esteem in the association between smartphone addiction and personality traits. A cross-sectional study was carried out between August and September 2020, during the lockdown period imposed by the government for the COVID-19 pandemic and that coincides with the summer season vacation for most Lebanese, using a sample of community-dwelling participants aged 18 to 29 years. The snowball technique was followed for participants' recruitment. The results showed that the mean age of the participants was 22.25 ± 2.87 years, with 70.9% females. The results showed that 216 (46.9%) of the participants had smartphone addiction. Higher negative emotionality (Beta = 0.17) was significantly associated with more smartphone addiction, whereas higher self-esteem (Beta = -0.37) and household crowding index (Beta = -1.58) were significantly associated with less smartphone addiction. Self-esteem mediated the association between negative emotionality and smartphone addiction. Lebanese young adults were found to be at a high risk of smartphone addiction. These results might serve as a first step towards implementing preventive measures to reduce smartphone addiction. Improving face to face communication, as well as setting specific time for cell phone usage might help reduce the development of addictive behaviors.

Managing Creativity on a Budget: The Future of Academic Research and Development in Lebanon

The central mission of a university is the discovery, dissemination, and application of new knowledge. In this regard, research is key to a university's reputation and gradually becoming the basis of its academic and financial success. Research and innovation are critical for expanding the knowledge base and the stream of highly educated individuals who, in turn, can provide economic vigor and competitiveness to their society. Although the main focus of this chapter is on Lebanon, the challenges outlined, and solutions proposed may apply anywhere else, particularly in developing countries, since Lebanese academic research institutions are a magnified microcosm of academic centers around the world. Lebanon may be home to some of the earliest founded modern universities in the Middle East and the Arab World, with a few constantly affirming their leading position among the best universities in the world through competitive cutting-edge research. However, the preeminence of research as a substrate for academic excellence in Lebanon's universities is at risk particularly without sustained investment in public and private academic institutions. In the COVID era and when Lebanon's economy is in freefall and the government is unable to increase spending on higher education, the survival - not to mention growth - of research universities is threatened, unless purposeful national research strategies are developed that guide more investments into higher education, and unless universities become more efficient and focus their research on national priorities and goals. In light of the many economic and global challenges, a new roadmap is needed to revive the role of the university in research and development. This chapter highlights the problems that plague academic research and development in Lebanon as well the challenges faced by higher education in that regard and proposes realistic solutions to tackle these challenges. These include research strategies focused on national needs, communication about the value of research universities, proper infrastructure to provide material resources, collect and analyze data, scarcity of resources (human and material), understanding the complexities of research administration and leadership, balancing academic freedom with societal, cultural and institutional expectations, standardized performance metrics, regulatory compliance and indirect cost allocation. Once the challenges are recognized and addressed, and a national research agenda is developed, the human capital - arguably the most valuable innovation resource - can be developed to maximize the use of material resources and purpose them towards national priorities. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Impact of the COVID-19 Pandemic on Breast Cancer Patient Care: A Retrospective Study in a Tertiary Care Center in Lebanon

INTRODUCTION: The COVID-19 pandemic poses challenges to the healthcare systems including cancer treatment. We aim to evaluate the impact of lockdown during COVID-19 on breast cancer (BC) care in terms of BC stage at presentation, treatment compliance and delays, and follow-up in a tertiary care center in Lebanon. METHOD(S): This is a retrospective observational study comparing patients with BC who presented to a tertiary care center in Lebanon in the pre-COVID period (Sep 2019-Dec 2019) and during COVID (Sep 2020-Dec 2020). After receiving the IRB approval, we retrieved the charts of BC patients who had their initial presentation, were under treatment or were on follow-up during our period of interest. We extracted data from electronic medical records of patients related to demographic parameters, cause of visit, tumor description, and type of treatment received. Descriptive analysis, as well as multivariate analysis, were done using SPSS. RESULT(S): Out of the 497 patients included, 274 visited the hospital in the pre-COVID period (median age 52.5 years) and 223 patients during COVID (median age 54.7 years). More than half of patients presented for BC screening in the pre-COVID (52%), while 52% came symptomatic during COVID. Almost 54% had advanced BC at presentation in the COVID period compared to 48% pre-COVID but with no statistical significance (p=0.36). During the COVID period, almost 39% of patients had surgery, 79.7% received chemotherapy, and 21.2% received radiotherapy, but with no significant difference between the two periods. Also, no difference was found in the type of surgery done between the two periods. The mean time between the onset of symptoms and biopsy was significantly longer in the COVID period (4.8 +/- 3.5 months) than that in the pre-COVID (3.2 +/- 5.1 months). The mean time between the biopsy and first treatment was not significantly different between the two periods (1.5 +/- 2.2 months versus 2.1+/-3.8 months). For patients who received neoadjuvant chemotherapy, the mean time between the last chemotherapy and surgery was longer in the COVID period (1.9 +/- 1.4 months) than in the pre-COVID period (1.2 +/- 1.1 months). Multivariate analysis showed that age at diagnosis (p=0.014) and time to diagnosis (p=0.01) were significantly associated with the advanced stage of BC. CONCLUSION(S): This study showed that COVID pandemic has resulted in a delay in the initial presentation of patients resulting in more advanced stages at presentation. However, the management of breast cancer was not substantially impacted by the COVID-19 lockdown.

Current and Future Trends in MS Management: Near East Perspective

Objective(s): The objectives were to provide an overview of the current practices of Near East (NE) healthcare practitioners (HCPs) by probing their prescribing decisions, to report the COVID-19 impacts on neurologists' prescribing habits, and to explore the future relevance of current medication used in MS management among other newcomers Material(s) and Method(s): A cross-sectional study was carried out using an online survey from April 27, 2022, to July 5, 2022. The questionnaire was designed with the input of five neurologists representing five NE countries (Iran, Iraq, Lebanon, Jordan & Palestine). They identified several factors that play a crucial role in the optimal care of MS patients. The link was shared among neurologists using snowball sampling Result(s): The survey included 98 neurologists from the included NE countries, the majority of whom had more than 15 years of experience in the field, and 39% were seeing more than 40 MS patients a month. Effectiveness and safety balance was the most important factor considered when selecting the MS treatment. In the treatment of mild to moderate RRMS in men, Interferon beta 1a SC, Fingolimod, and Glatiramer acetate were the most commonly recommended treatments. Dimethyl fumarate substituted fingolimod in female patients. According to 80.7% of participants, interferon beta 1a SC was the safest treatment for mild to moderate RRMS. Interferon beta 1a SC was preferred over other treatments for patients with mild to moderate MS and planning for pregnancy (56.6%) or breastfeeding (60.2%). Fingolimod was not a choice for these patients. Neurologists seemed to discuss the top three treatments of Natalizumab, Ocrelizumab, and Cladribine with patients with highly active MS. Conclusion(s): Most neurologists in the NE region followed MENACTRIMS recommendations for prescribing treatment. The treatment choice also depended on the availability of DMTs in the region. Regarding the use of upcoming DMTs such as Ofatumumab, Siponimod, Ozanimod, and BTK inhibitors, there is a clear need for real-world data, long-term extension studies, and comparative studies to support their efficacy and safety profiles in treating patients with MSCopyright © 2022

Association between COVID-19 symptoms, COVID-19 vaccine, and somatization among a sample of the Lebanese adults.

Objectives: Long COVID syndrome, the poorly defined illness, has been increasingly mentioned in recent studies yet is still poorly understood especially when it comes to precipitating and modulating factors, the high prevalence of mental health problems associated with the COVID-19 pandemic has brought to light the hypothesis of the existence of a psychological component associated with the persistence of symptoms and if vaccination may serve as a modulating factor. This study aims to examine the prevalence of somatization disorders and association between persistent COVID-19 symptoms and COVID-19 vaccine with somatization among a sample of the Lebanese general population. Methods: A cross-sectional study was carried out between September and October 2021. The snowball sampling technique was picked to choose a sample that addressed all Lebanese Mohafazat. Patient Health Questionnaire-15 (PHQ-15) was used to assess somatization. Results: A total of 403 participants was enrolled in this study, with a mean age of 32.76 ± 13.24 years, 108 (26.8%) had medium somatization symptoms (PHQ-15 scores ≥10). Having persistent COVID symptoms (ß=2.15) was significantly associated with more somatization, whereas the intake of COVID vaccine (ß=-1.17) was significantly associated with less somatization. Conclusion: Long lasting COVID-19 symptoms were closely related to somatization, although the administration of the COVID-19 vaccine was associated with less somatization. However, further studies are needed to provide a better understanding of the relationship between long COVID and somatization, on one hand, and the modulating factors on the other hand.

Anxiety, depression and post-traumatic stress disorder in patients on hemodialysis in the setting of the pandemic, inflation, and the Beirut blast: a cross-sectional study.

BACKGROUND: In 2020, Lebanon has witnessed its worst economic crisis, exacerbated by the COVID-19 pandemic and a massive explosion of its capital. Amidst these stressors, this study aims at assessing the prevalence of depression, anxiety, suicidality, post-traumatic stress disorder (PTSD) and cognitive impairment in patients undergoing hemodialysis in an academic hospital destroyed by the explosion. METHODS: This cross-sectional study conducted 6 months after the blast included adults on hemodialysis, with no previous diagnoses of dementia or intellectual disability. It explores prevalence rates of psychiatric disorders, in addition to other medical and psychosocial variables such as frailty, malnutrition, sarcopenia, quality of life and religiosity. RESULTS: Forty two patients (mean age 66.1; SD: 11.2 years) undergoing hemodialysis for 6.12 years (SD:7.22 years) were included. Anxiety and depression rates reached 54.8% and 57.1% using cut-offs of 6 and 7 respectively on the Hospital Anxiety and Depression rating Scale. 9.5% of the patients reported being in the hospital at the time of the blast and 7.1% reported being injured. 33.3% screened positively for PTSD using a cut-off of 23 on the PCL-5. 26.2% had passive death wishes and 7.1% had suicide plans, however no one had attempted it. 23.8% were found cognitively impaired as shown by the Mini-Cog (<3). Around two-third of participants were moderately to severely malnourished per the GLIM criteria. One third suffered from frailty, according to the FRAIL screening tool. Around 60% suffered from sarcopenia, based on handgrip strength measures. These findings contrast with "acceptable to good" quality of life subjectively reported by participants on the Short Form 36 (SF-36) Health Survey. While one-third of participants participated in organizational religious activities, 88% reported significant subjective meaning of religion in their heart. CONCLUSIONS: Rates of depression, anxiety, PTSD, suicidality, and cognitive impairment were found to be alarming in the setting of an urban dialysis unit following a major explosion. Psychiatric disorders were found to be compounded with increased prevalence of malnutrition, frailty, and sarcopenia. These findings urge healthcare providers to implement early diagnostic and intervention strategies to improve both mental and physical wellbeing of this vulnerable population, in similar settings.

Prevalence of Latent Tuberculosis Infection among Patients Undergoing Regular Hemodialysis in Disenfranchised Communities: A Multicenter Study during COVID-19 Pandemic.

Background and Objectives: Due to their weakened immune response, hemodialysis (HD) patients with latent tuberculosis infection (LTBI) are at higher risk for active tuberculosis (TB) disease and are more subject to patient-to-patient transmission within dialysis units. Consequently, current guidelines advocate screening these patients for LTBI. To our knowledge, the epidemiology of LTBI in HD patients has never been examined before in Lebanon. In this context, this study aimed to determine LTBI prevalence among patients undergoing regular HD in Northern Lebanon and to identify potential factors associated with this infection. Notably, the study was conducted during the COVID-19 pandemic, which is likely to have catastrophic effects on TB and increase the risk of mortality and hospitalization in HD patients. Materials and Methods: A multicenter cross-sectional study was carried out in three hospital dialysis units in Tripoli, North Lebanon. Blood samples and sociodemographic and clinical data were collected from 93 HD patients. To screen for LTBI, all patient samples underwent the fourth-generation QuantiFERON-TB Gold Plus assay (QFT-Plus). Multivariable logistic regression analysis was used to identify the predictors of LTBI status in HD patients. Results: Overall, 51 men and 42 women were enrolled. The mean age of the study population was 58.3 ± 12.4 years. Nine HD patients had indeterminate QFT-Plus results and were therefore excluded from subsequent statistical analysis. Among the remaining 84 participants with valid results, QFT-Plus was positive in 16 patients, showing a positivity prevalence of 19% (95% interval for p: 11.3%, 29.1%). Multivariable logistic regression analysis showed that LTBI was significantly associated with age [OR = 1.06; 95% CI = 1.01 to 1.13; p = 0.03] and a low-income level [OR = 9.29; 95% CI = 1.62 to 178; p = 0.04]. Conclusion: LTBI was found to be prevalent in one in five HD patients examined in our study. Therefore, effective TB control measures need to be implemented in this vulnerable population, with special attention to elderly patients with low socioeconomic status.

Refugees in abject spaces, protracted ‘waiting' and spatialities of abjection during the COVID-19 pandemic

This paper engages with a reinterpretation of the concept of abject space situating it within abjection theory and the concept of ‘waiting'. It develops further the term of ‘spatialities of abjection' and discusses how the complex relationality occurring in abjection manifests in various spaces, through porous, changing, invisible boundaries but also specific temporal conditions. Doing so allows us to unpack the transformations of the abject space alternatively and simultaneously considered as a refuge and as a place of danger, factor of contamination. More importantly, the paper situates the reading of spatial abjection through a temporal lens, denoting how abject subjects are spatialized in a context of ‘political waiting' but more importantly in a situation where active ‘waiting' re-shifted to passive ‘waiting' because of the pandemic implications. To do so, we focus on the spatialities of abjection affecting Syrian refugees living in informal tented settlements (ITSs) in Lebanon during the COVID-19 crisis. While abjection, stigma and xenophobia were already occurring prior to 2019, ITSs as abject spaces and refugees as abject subjects were targeted by supplemented rules and control. Those led to more controlled encampments and immobilization, increasing their dependency and reliance on international aid.Alternate abstract:ResumenEste artículo involucra una reinterpretación del concepto de espacio abyecto situándolo dentro de la teoría de la abyección y el concepto de ‘espera'. Desarrolla aún más el término ‘espacialidades de la abyección' y discute cómo la compleja relacionalidad que ocurre en la abyección se manifiesta en varios espacios, a través de fronteras porosas, cambiantes e invisibles, pero también de condiciones temporales específicas. Hacerlo nos permite desempacar las transformaciones del espacio abyecto alternativa y simultáneamente considerado como refugio y como lugar de peligro, factor de contaminación. Más importante aún, el artículo sitúa la lectura de la abyección espacial a través de una lente temporal, denotando cómo los sujetos abyectos se espacializan en un contexto de ‘espera política', pero más importante aún en una situación en la que la ‘espera' activa cambia a ‘espera' pasiva debido a las implicaciones de la pandemia. Para ello, nos enfocamos en las espacialidades de abyección que afectan a los refugiados sirios que viven en asentamientos informales de tiendas de campaña (ITS por sus siglas en inglés) en el Líbano durante la crisis del COVID-19. Si bien la abyección, el estigma y la xenofobia ya estaban ocurriendo antes de 2019, los ITS como espacios abyectos y los refugiados como sujetos abyectos fueron objeto de normas y controles suplementarios. Estos llevaron a campamentos más controlados e inmovilización, aumentando su dependencia a la ayuda internacional.

Telepsychiatry in the Arab world: A viewpoint before and during COVID-19

Purpose: Telepsychiatry, a subset of telemedicine, has been increasingly studied to meet the growing demands for psychiatric care. The utility of telepsychiatry is relevant now more than ever as the world endures the COVID-19 global pandemic. This paper describes the prior state and the changes that the COVID-19 outbreak brought to telepsychiatry in a selected group of Arab countries of the Middle East and North Africa (MENA) region. Patients and Methods: We invited twelve early-career psychiatrists from different Arab nations to share information related to telepsychiatry in their respective countries before and during the COVID-19 pandemic. The information was collected using a semi-structured guide. This was complemented by a search for relevant articles in five search engines using terms such as "COVID-19," "telepsychiatry," and "Arab world". Results: Before the pandemic, digital mental health services were provided in several Arab countries, mainly through hotlines and messaging services. The COVID-19 pandemic has marked a major shift in digital psychiatric services in the Arab MENA world, through the transformation of many clinics and some hospitals into digital mental health systems. Many non-governmental organizations also started remote initiatives for psychological support and psychiatric counseling. Three main barriers of patient-related, healthcare-related, and system-related hurdles of using telepsychiatry emanated from the analysis. Conclusion: The use of digital mental health services varies between different Arab countries. Even though some nations have laws that regulate the provision of such services, most struggle with multifactorial barriers. As affordable and attainable solutions cannot only rely on training and recruiting more psychiatrists, telepsychiatry would help meet the exceeding demands in the Arab world, particularly after the COVID-19 outbreak. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Insights into the Positive Role of a Higher Education Institution in the Prevention of Misinformation During Pandemics: The Health Committee Model During COVID-19

In Lebanon, with COVID-19 cases escalating and national efforts exhausted in the contain-ment of the pandemic, calls were made for increased awareness, scientific literacy, and the debunking of false information. This article sheds light on the positive role that a private University can play in spreading scientifically-authenticated, health-related, awareness through the community. The Lebanese International University (LIU) has 9 campuses distributed across all Lebanese Governorates with an extensive communications platform that takes advantage of LIU's website, University Management Sys-tem, several Facebook pages with thousands of followers, and many WhatsApp groups. LIU has over 34,000 undergraduate and graduate students, in addition to a little over a thousand faculty and staff members. The University capitalized on this extensive network to play a positive role in delivering authenticated health-related information to the University's greater community. A health committee comprised of multidisciplinary educators, mostly from the fields of medicine and health sciences, was established to act as a health advisory panel to the University Council and to raise awareness among the University's larger community. An extensive health awareness campaign was launched through activities and the sharing of the material of different formats aimed at providing accurate information on infection prevention, and disseminating authentic and accurate health-related guidelines and recommendations during the pandemic. This compendium aims to summarize the role of the health committee in meeting the various challenges created by the emergence of COVID-19 in our community, and highlights its influence and future perspectives.Copyright © 2021 Bentham Science Publishers.

Refugee camps as spaces of rescue in times of Covid-19: invisible mobilities in Bourj Albarajenah

This paper aims to explore the peculiarity of the pandemic in stateless communities. Through a case study from a Palestinian refugee camp in Beirut, Lebanon, we analyse how Palestinian refugees were affected by and responded to the pandemic. We find that the legal exclusion of refugees from the state protection has generated invisible mobility, which further increased the risk of spreading the virus. Refugees have founded their own community response mechanisms of food sharing and crowdfunding. They established Aman medical centre in the camp, which has become a destination for infected, yet undocumented, residents of the city. We conclude how Palestinian refugees used this invisible mobility to save other refugees, therefore proving how refugee camps can become spaces of rescue in times of global emergency. © 2022 Pacini Editore. All rights reserved.