A systematic approach to derive natural background levels in groundwater: Application to an aquifer in North Lebanon perturbed by various pollution sources.

Several efforts have recently emerged to develop methods capable of determining groundwater natural background levels (NBLs) due to their utmost importance in assessing water quality. A recently developed systematic approach to derive NBLs is the Khadra-Stuyfzand (KS) scheme. It has a clear and standardized flow with multi-steps to eliminate biased or contaminated samples, and hence it is capable of dealing with different pollution sources as well as saltwater intrusion. This method was applied to the Koura-Tripoli-Zgharta (KTZ) Miocene aquifer of coastal North Lebanon. It derived baseline conditions for 2 physical, 16 chemical, and 3 bacteriological parameters in addition to 8 trace elements, and 83 pesticides, polynuclear aromatic hydrocarbons, and volatile organic compounds. The results revealed the extent of anthropogenic shift from background levels, and delineated the main contaminated spots. In fact, the established groundwater baseline composition is typical of limestone aquifers with oligohaline-fresh, moderate alkalinity, calcium bicarbonate water, under freshening conditions. Nonetheless, this quality is locally degraded by microbial contamination due to wastewater disposal sites, saltwater intrusion, and minor nutrient loading from agricultural activities and/or urban development. The measured concentrations of major water ions and a variety of drinking water contaminants (e.g. nutrients, pesticides, hydrocarbons, and heavy metals) are below human health benchmarks, but the microbiological content at several spots has exceeded the permissible limits which renders the water unsuitable for domestic use, and calls for prompt mitigation measures.

Perceived healthcare workforce needs in Lebanon: a step towards informed human resources planning and professional development.

BACKGROUND: Research in various countries has previously investigated the competencies required for effective management of health care organizations. Yet, limited information is available on the skills and knowledge areas, which are currently lacking among the healthcare workforce employed in environments with limited resources. AIMS: The aim of this study was to assess the perceived healthcare workforce needs at the management and clinical/practice levels in Lebanon. METHODS: We conducted an exploratory Delphi study involving two panels of health care professionals and a nationwide survey of hospital directors to assess the skills needed and the healthcare occupations and specialties that are limited. RESULTS: Based on the Delphi study, the top five needed skills/knowledge areas were: professionalism, ethics, quality management and improvement, strategic planning, and communication. The need for information management and technology skills was reported by more than 50% of urban hospitals, and highlighted by the two panels in the Delphi study. Healthcare professionals reported willingness to take continuing education courses. Hospitals further indicated the availability of financial support and willingness to collaborate with educational institutions for employee training and continuing education. CONCLUSIONS: Our findings set the ground for future research investigating healthcare workforce issues in Lebanon and support evidence-based planning for health human resources. They may inform the development of national and local policies in the country, which address the human resources needs of the health care system to meet regional and national demands. Universities, professional syndicates, and nongovernmental organizations may leverage these findings to develop continuing education training and diplomas incorporating the competencies critical for the healthcare workforce.