Parental divorce and nicotine addiction in Lebanese adolescents: the mediating role of child abuse and bullying victimization.

BACKGROUND: Lebanon ranks first amongst Middle-Eastern countries in terms of cigarette and waterpipe smoking. Understanding the mediating factors for nicotine addiction in adolescents who have experienced parental divorce is vital to take effective measures that will help in lowering its prevalence in our community. The objective of this study was to investigate the association between the increasingly concerning parental divorce and nicotine addiction in Lebanese adolescents while taking into consideration the plausible mediating effect of abuse and bullying victimization. METHODS: This was a cross-sectional survey-based study that was conducted between January and May 2019. A total of 1810 adolescents aged between 14 and 17 years was enrolled from 16 Lebanese schools. Linear regressions taking the cigarette and waterpipe dependence scores as dependent variables were conducted respectively, using the SPSS software. PROCESS v3.4 model 4 was used for mediation analysis. RESULTS: A total of 11.9% of the enrolled participants had divorced parents. Higher cigarette and waterpipe dependence were found in adolescents whose parents were divorced compared to those living together. More child psychological abuse, having divorced parents vs living together, and more child physical abuse were significantly associated with higher cigarette dependence. More child psychological and physical, and having divorced parents vs living together were significantly associated with more waterpipe dependence. In addition, all forms of abuse (except neglect) and bullying victimization had a partially mediating effect in the associations between parental divorce and nicotine dependence (cigarette and waterpipe) in adolescents. CONCLUSION: This study results may serve as a first step towards enrolling separated parents and their children in special prevention programs to help them create a protective and supportive environment.

Food neophobia in Lebanese children: scale validation and correlates.

OBJECTIVE: To validate the Food Neophobia Scale (FNS) and determine factors associated with the presence of food neophobia (FN) in a sample of Lebanese children. DESIGN: Cross-sectional study conducted between July and December 2019. SETTING: All Lebanese governorates. PARTICIPANTS: Parents of Lebanese children aged 2 to 10 years. RESULTS: Out of 850 questionnaires, 194 were excluded. The mean age of children was 5·34 ± 2·20 years (50·8 % females); 238 (36·4 %) had low neophobia scores (≤37), whereas 219 (33·5 %) and 197 (30·1 %) had, respectively, moderate (between 38 and 41) and severe neophobia scores (≥42). All items of the FNS were extracted except item 8 and yielded a two-factor solution with Eigenvalues > 1 (variance explained = 51·64 %; Kaiser-Meyer-Olkin (KMO) test = 0·746; Bartlett's sphericity test P < 0·001; αCronbach = 0·739). Children who refused initially to eat vegetables (ß = 5·51), fish (ß = 4·57), fruits (ß = 4·75) or eggs (ß = 2·99) and higher parents' instrumental feeding scores (ß = 0·3) were significantly associated with higher neophobia scores, whereas higher parents' encouragement scores (ß = -0·21) were significantly associated with lower neophobia scores in children. CONCLUSION: FN is common in children. Neophobic children tend to have lower variety in their diets. One of the ways to lower the levels of neophobia is the use of encouragement by the parents. In contrast, offering a reward to children for them to eat a certain food was associated with more signs of avoidance. More studies should be conducted to evaluate awareness levels concerning FN.

Newborn's first bath: any preferred timing? A pilot study from Lebanon.

OBJECTIVE: To try to find the most appropriate time for the newborn's first bath. This prospective randomized study was conducted in one hospital (July-September 2017). RESULTS: A higher percentage of newborns who had a skin-to-skin contact with their mothers had their bath at 24 h vs 2 h after birth (65.2% vs 33.3%; p = 0.01). A higher percentage of mothers who helped in their baby's bath had their baby's bath at 24 h vs 2 h (65.2% vs 5.9%; p < 0.001) and vs 6 h (65.2% vs 15.7%; p < 0.001) respectively. A higher mean incubation time was seen between newborns who had their bath at 2 h (2.10 vs 1.78; p = 0.002) and 6 h (2.18 vs 1.78; p = 0.003) compared to those who had their bath at 24 h respectively. A higher percentage of newborns who took their first bath 24 h after birth were calm compared to crying vigorously (38.6% vs 9.1%; p = 0.04). Delaying newborn first bath until 24 h of life was associated with benefits (reducing hypothermia and vigorous crying, benefit from the vernix caseosa on the skin and adequate time of skin-to-skin contact and mother participation in her child's bathing.

Parents' knowledge, attitude and practice towards children's vaccination in Lebanon: role of the parent-physician communication.

BACKGROUND: One of the most effective public health interventions in the world is immunization. However, some parents doubt its usefulness and safety. Many factors influence their decision to vaccinate, including their sociodemographic characteristics, their trust in the public health system, the parent-physician relationship, their level of knowledge and their attitudes towards vaccination. Our objective was to determine the factors, especially the parent-physician communication, associated with parental knowledge, attitudes and practices of their children's vaccination. METHODS: Three thousand five hundred parents (father, mother or both) of children aged between 1 month and 15 years were approached by a trained personnel who performed the data collection through personal interviews (February-April 2019). RESULTS: The response rate was 79.5%. The results of the multivariable analysis showed that a better patient-physician communication was significantly associated with higher knowledge, better attitude and practice. Better knowledge was significantly associated with better attitude, whereas better knowledge and attitude were significantly associated with better practice. CONCLUSION: Our study shows the importance of good physician-patient communication in improving knowledge, attitude and practice of parents towards their children's vaccination.

Comparative study between Fenton and intergrowth 21 charts in a sample of Lebanese premature babies.

BACKGROUND: Different charts are used to assess premature growth. The Fenton chart, based on prenatal growth, has been used in the neonates' intensive care unit (NICU) of the Notre Dame des Secours University Hospital to assess premature newborns' development. Intergrowth21 is a new multidisciplinary, multiethnic growth chart better adapted to premature growth. Our objective was to compare both charts Fenton and Intergrowth21 in order to implement Intergrowth in our unit. METHODS: We analyzed 318 files of premature babies born who were admitted to the NICU from 2010 till 2017. Anthropometric data (weight, height and head circumference) converted to percentiles was filled on both charts from birth till 1 month of age. RESULTS: The results of the linear regression, taking the weight at birth as the dependent variable, showed that the Fenton scale (R2 = 0.391) would predict the weight at birth better than the Intergrowth 21 scale (R2 = 0.257). The same applies for height and cranial perimeter at birth when taken as dependent variables. When considering the weight and height at 2 weeks, the results showed that the Intergrowth 21 scale would predict those variables better than the Fenton scale, with higher R2 values higher in favor of the Intergrowth 21 scale for both weight (0.384 vs 0.311) and height (0.650 vs 0.585). At 4 weeks, the results showed that the Fenton scale would predict weight (R2 = 0.655 vs 0.631) and height (R2 = 0.710 vs 0.643) better than the Intergrowth 21 scale. The results obtained were adjusted over the newborns' sociodemographic and clinical factors. CONCLUSION: The results of our study are controversial where the Fenton growth charts are superior to Intergrowth 21 before 2 weeks of age and at 4 weeks, whereas Intergrowth 21 charts showed higher percentiles for weight and height than Fenton charts at 2 two weeks of age. Further studies following a different design, such as a clinical trial or a prospective study, taking multiple ethnicities into account and conducted in multiple centers should be considered to enroll a more representative sample of Lebanese children and be able to extrapolate our results to the national level.

Role of Krüppel-like factor 4 and heat shock protein 27 in cancer of the larynx.

Late detection and lack of standard treatment strategies in larynx cancer patients result in high levels of mortality and poor prognosis. Prognostic stratification of larynx cancer patients based on molecular prognostic tumor biomarkers may lead to more efficient clinical management. Krüppel-like factor 4 (KLF4) and Heat Shock Protein 27 (HSP27) have an important role in tumorigenesis and are considered promising candidate biomarkers for various types of cancer. However, their role in larynx carcinoma remains to be elucidated. The present study aimed to determine KLF4 and HSP27 expression profiles in laryngeal tumors. The protein and mRNA expression levels of KLF4 and HSP27 were evaluated by immunohistochemical and reverse transcription-polymerase chain reaction analyses in 44 larynx carcinoma samples and 21 normal tissue samples, and then correlated with clinical characteristics. A differential expression of KLF4 and HSP27 was observed between normal and tumor tissues. The protein and mRNA expression levels of KLF4 were significantly decreased in larynx squamous cell carcinoma (LSCC) compared with normal tissue, whereas HSP27 was significantly overexpressed in tumor tissues compared with normal tissues, at the protein and mRNA levels. KLF4 expression decreased gradually with tumor progression whereas HSP27 expression increased. A significant difference was observed between stages I and IV. KLF4 and HSP27 exhibit opposite functions and roles in the carcinogenic process of LSCC. Their role in laryngeal cancer initiation and progression emphasizes their use as potential future targets for prognosis and treatment. KLF4 and HSP27 expression levels may act as potential biomarkers in patients with cancer of the larynx.

Krüppel-like factor 4: A new potential biomarker of lung cancer.

Lung cancer is most prevalent human cancer worldwide. However, no molecular markers are currently available for predicting lung cancer prognosis. Therefore, identifying novel biomarkers may be useful for improving clinical diagnosis and patient stratification. Krüppel-like factor 4 (KLF4) is a transcription factor with opposing roles in different human cancers. Its overexpression in several cancers is correlated with a poor prognosis. However, the expression and role of KLF4 in lung cancer remains to be elucidated. The aim of this study was to determine the profile of KLF4 expression in different types of lung cancer. The KLF4 protein expression level was tested and evaluated by immunohistochemical analysis in 47 lung tumors and normal tissues, and then correlated with clinical characteristics. A differential expression of KLF4 was observed between normal tissue and each of the lung cancer types. A significant decrease in KLF4 expression was observed in non-small-cell lung cancer (NSCLC) compared with that in normal tissue, while significant overexpression was detected in small-cell lung cancer. Furthermore, a higher rate of expression was observed in stage II, III and IV disease compared with stage I disease in NSCLC tissues. KLF4 expression was not found to be associated with age or gender. Our results suggested that the KLF4 protein level may be a potential biomarker in patients with advanced lung cancer.