Knowledge, attitude and practice of Lebanese community pharmacists with regard to self-management of low back pain

Purpose: To determine the knowledge, attitude and reported practice of Lebanese community pharmacists who advise persons who present with low back pain.Methods: This was a multi-center cross-sectional study conducted in over 300 community pharmacies across Lebanon from December 2017 to May 2018. Pharmacists working at a community pharmacy were considered eligible, and those who volunteered to participate completed the questionnaire. The questionnaire was designed for self-completion by the pharmacist and included demographic questions about the respondent, questions that assessed knowledge and attitude toward low back pain, and questions about treatment to reflect and characterize the nature of practice. The primary outcome was to determine the knowledge, attitude and reported practice of the Lebanese pharmacists advising people who presented with low back pain. The secondary outcome was to assess factors that affect knowledge, attitude, and practice.Results: The response of 320 community pharmacists was analysed. The proportion of pharmacists with good knowledge about low back pain (51. 7 %) was slightly higher than those with poor knowledge (48. 3 %). Oral therapy was the most prescribed dosage form for back pain compared to local patch and cream. Among oral dosage forms, non-steroidal anti-inflammatory drugs were the most prescribed medications (42 %). Of the patients’ referral to the physician if necessary, 73.1 % of the referrals were by pharmacists.Conclusion: Community pharmacists in Lebanon demonstrate an acceptable level of knowledge of back pain, yet major gaps still exist, particularly in terms of the quality of advice. Hence, more education is needed to provide better quality of advice. Keywords: Attitude, Knowledge, Low back pain, Reported practice, Quality of advic

The impact of COVID-19 on the mental health of Lebanese pharmacists: A national cross-sectional study

IntroductionThe COVID-19 pandemic has induced a global mental health crisis with variable consequences. This study aimed to assess the psychological impact of COVID-19 regarding anxiety, insomnia, depression, and response to trauma on pharmacists in Lebanon during COVID-19, and to identify factors contributing to psychological distress.MethodsThis was a cross-sectional study among pharmacists that involved the use of the 7-item Generalized Anxiety Disorder (GAD-7), 7-item Insomnia Severity Index (ISI), Patient Health Questionnaire 9-item depression module (PHQ-9), and Impact of Event Scale revised (IES-R) subscales. Descriptive statistical analyses were performed to determine the study distribution. The associations between the scores and the participants’ characteristics were assessed using the Chi-square test. Four binary logistic regression models were used to evaluate the association between the scores and the potential confounders, followed by four multivariable logistic regressions. An alpha of 0.05 was used to determine statistical significance.ResultsParticipants comprised 311 pharmacists from all Lebanese districts, of whom 251 (80.7%) were females and 181 (58.2%) aged between 26 and 35 years. The majority of the participants were community pharmacists (n = 178, 57.2%). A considerable proportion of participants had symptoms of anxiety (n = 128, 41.2%), insomnia (n = 64, 20.6%), depression (n = 157, 50.5%), and subjective stress (n = 227, 78.8%). Higher anxiety (aOR: 1.73, 95% CI: 1.08; 2.78, p-value: 0.02), higher depression (aOR: 3.06, 95% CI: 1.73; 5.39, p-value: 0.001), and higher stress (aOR: 1.86, 95 percent CI: 1.11; 3.14, p-value: 0.02) scores were significantly associated with pharmacists who reported that their work involves contact with infected/suspected COVID-19 patients. Interestingly, pharmacists who expressed concern about contracting COVID-19 infection had significantly higher anxiety (aOR: 2.35, 95% CI: 1.40; 3.94, p-value: 0.001) and higher depression scores (aOR: 2.64, 95% CI: 1.49; 4.67, p-value: 0.001) respectively.ConclusionThe preliminary results from pharmacists in Lebanon reflect increase in stress, burden, and frustration felt by pharmacists, creating a negative impact on their mental health and well-being during the global pandemic. As frontline healthcare workers, the role of pharmacists in the community should not be overlooked, and their mental health should be well investigated

Factors Affecting Influenza Vaccination Uptake and Attitudes among Lebanese University Students: The Impact of Vaccination Promotional Programs and COVID-19 Pandemic

Vaccination is the most effective preventative strategy against influenza, yet university students' influenza vaccination uptake remains low. This study aimed firstly to determine the percentage of university students who were vaccinated for the 2015-2016 influenza season and to identify reasons for non-vaccination, and secondly to examine the impact of external factors (on-campus/online influenza awareness campaigns and COVID-19 pandemic) on their influenza vaccination uptake and attitudes for the 2017-2018 and 2021-2022 influenza seasons. A descriptive study was conducted over three phases for three influenza seasons at a Lebanese university in the Bekaa Region. Based on data collected in 2015-2016, promotional activities were developed and implemented for the other influenza seasons. This study was conducted using an anonymous, self-administered questionnaire by students. The majority of the respondents in the three studies did not receive the influenza vaccine (89.2% in the 2015-2016 study, 87.3% in the 2017-2018 study, and 84.7% in the 2021-2022 study). Among the unvaccinated respondents, the main reason for non-vaccination was that they thought that they did not need it. The primary reason for vaccination among those who were vaccinated was that they believed they were at risk of catching influenza in a 2017-2018 study and due to the COVID-19 pandemic in the 2021-2022 study. As for attitudes towards influenza vaccination post-COVID-19, significant differences were shown among the vaccinated and unvaccinated respondents. The vaccination rates among university students remained low despite of the awareness campaigns and COVID-19 pandemic.The APC was funded by the Lebanese International University.Scopu

Investigation of micro/nano probes for Nuclear Magnetic Resonance (NMR)

Dans ce travail, nous exposons une méthode basée sur la détection localisée en couplage capacitif de la composante électrique du signal RMN via des micro/nano sondes spécifiquement développées. Dans la première étape de ce travail nous avons utilisé des NEMS à base de nanotube de carbone pour réaliser une détection du signal RMN à l'échelle nanométrique. En effet, grâce à un couplage électromécanique, nous avons caractérisé ces systèmes en émission de champ, déterminé expérimentalement leur fréquence de résonance et montré qu'ils sont capables de détecter un signal radiofréquence. Pour utiliser ces dispositifs en RMN, l'adaptation du champ statique B0 de l'aimant pour atteindre la valeur de la fréquence de Larmor d'un atome est nécessaire. L'excitation locale autour de ces systèmes permettra une caractérisation complète et fiable. Pour mettre en place cette excitation localisée, nous avons choisi, dans la deuxième étape de cette thèse, une sonde locale de champ électromagnétique à l'échelle micrométrique. D'abord, nous présentons des simulations autour de la microsonde, décrivant la propagation des champs électrique et magnétique injectée par la microsonde. Nous avons caractérisé la microsonde en mode collection. Nous montrons une décroissance de l'intensité du signal RMN, en fonction de la distance. Nous avons observé et modélisé démontrant ainsi que La microsonde est capable de détecter localement un signal RMN tandis que la bobine capte de façon globale. Nous présentons les premières expériences de l'utilisation de la microsonde en mode émission. Ces mesures nous fournissent un modèle qui décrit une excitation inhomogène, dûe à l'émission locale de la puissance (décroissance exponentielle de la puissance), proche de la microsonde. Une distribution des angles de basculement est répartie d'une façon inhomogène induisant une distribution des intensités du signal RMN autour de la microsonde. À la fin de cette thèse, nous avons réalisé deux expériences comme applications directes suite des études sur la caractérisation de la microsonde. La première consiste à imager un volume d'eau placé dans un bain d'huile de silicone. L'image est obtenue en déplaçant mécaniquement la microsonde et en réalisant pour chaque point une mesure de spectroscopie localisée. Dans la deuxième expérience, la microsonde est utilisée pour injecter dans ce volume d'eau des impulsions électromagnétiques et détecte à la suite le signal RMN. Notre étude sur la caractérisation de l'émission locale par une microsonde et la détection du signal radiofréquence par un NEMS à base de NTC, nous permet de proposer un nouveau type de dispositifs capable de détecter un signal RMN.In this work, we explain our method based on the detection localized capacitive coupling of the electric component of the NMR signal via micro/nano probes specifically developeds. In the first stage of this work we use NEMS based on carbon nanotube to achieve a detection of the NMR signal at the nanoscale. Because of an electromechanical coupling, we characterize these systems in field emission, and we determine experimentally their resonance frequency and shown that they are able to detect a radio signal. To use these devices in NMR, it is necessary to adapt the value of the static field B0 of the magnet to reach the value of the Larmor frequency. We found that a local excitement around these systems gives them a reliable characterization, to avoid disrupting the parasite measurements. To implement this localized excitation, we choose a micro-probe (coaxial cable). First, we presente simulations, describing the propagation of electric and magnetic fields transmitted by the microprobe. After we characterize in collection mode the microprobe. This study shows us a decrease of the NMR signal as a function as distance. This proves that the microprobe is able to detect an NMR signal in near field, while the coil picks up globally. We characterize the microprobe in the transmit mode . These measurements provide us with a model that describes an inhomogeneous excitation of nuclei, due to the emission of power in vicinity of the microprobe. An inhomogeneous distribution of tilt angles induces an inhomogeneous distribution of the NMR signal around the microprobe. At the end of this thesis, we conducte two applications such as direct studies on the characterization of the microprobe. The first consist to image a small volume of water placed in silicone oil sample. The image obtained by mechanically moving of the microprobe and making a localized spectroscopy. In the second experiment, the microprobe injected into this volume and detects after the NMR signal. Finally, the characterization in transmit mode of the microprobe allows us to better understand the phenomenon of the trasmission of electromagnetic waves to excite the spins of the nuclei in vicinity of the NEMS based on CNT. The latter being used as NMR probe at the nanoscale, to detect a NMR signal

Étude des micro/nano sondes pour la Résonance Magnétique Nucléaire (RMN)

In this work, we explain our method based on the detection localized capacitive coupling of the electric component of the NMR signal via micro/nano probes specifically developeds. In the first stage of this work we use NEMS based on carbon nanotube to achieve a detection of the NMR signal at the nanoscale. Because of an electromechanical coupling, we characterize these systems in field emission, and we determine experimentally their resonance frequency and shown that they are able to detect a radio signal. To use these devices in NMR, it is necessary to adapt the value of the static field B0 of the magnet to reach the value of the Larmor frequency. We found that a local excitement around these systems gives them a reliable characterization, to avoid disrupting the parasite measurements. To implement this localized excitation, we choose a micro-probe (coaxial cable). First, we presente simulations, describing the propagation of electric and magnetic fields transmitted by the microprobe. After we characterize in collection mode the microprobe. This study shows us a decrease of the NMR signal as a function as distance. This proves that the microprobe is able to detect an NMR signal in near field, while the coil picks up globally. We characterize the microprobe in the transmit mode . These measurements provide us with a model that describes an inhomogeneous excitation of nuclei, due to the emission of power in vicinity of the microprobe. An inhomogeneous distribution of tilt angles induces an inhomogeneous distribution of the NMR signal around the microprobe. At the end of this thesis, we conducte two applications such as direct studies on the characterization of the microprobe. The first consist to image a small volume of water placed in silicone oil sample. The image obtained by mechanically moving of the microprobe and making a localized spectroscopy. In the second experiment, the microprobe injected into this volume and detects after the NMR signal. Finally, the characterization in transmit mode of the microprobe allows us to better understand the phenomenon of the trasmission of electromagnetic waves to excite the spins of the nuclei in vicinity of the NEMS based on CNT. The latter being used as NMR probe at the nanoscale, to detect a NMR signal.Dans ce travail, nous exposons une méthode basée sur la détection localisée en couplage capacitif de la composante électrique du signal RMN via des micro/nano sondes spécifiquement développées. Dans la première étape de ce travail nous avons utilisé des NEMS à base de nanotube de carbone pour réaliser une détection du signal RMN à l'échelle nanométrique. En effet, grâce à un couplage électromécanique, nous avons caractérisé ces systèmes en émission de champ, déterminé expérimentalement leur fréquence de résonance et montré qu'ils sont capables de détecter un signal radiofréquence. Pour utiliser ces dispositifs en RMN, l'adaptation du champ statique B0 de l'aimant pour atteindre la valeur de la fréquence de Larmor d'un atome est nécessaire. L'excitation locale autour de ces systèmes permettra une caractérisation complète et fiable. Pour mettre en place cette excitation localisée, nous avons choisi, dans la deuxième étape de cette thèse, une sonde locale de champ électromagnétique à l'échelle micrométrique. D'abord, nous présentons des simulations autour de la microsonde, décrivant la propagation des champs électrique et magnétique injectée par la microsonde. Nous avons caractérisé la microsonde en mode collection. Nous montrons une décroissance de l'intensité du signal RMN, en fonction de la distance. Nous avons observé et modélisé démontrant ainsi que La microsonde est capable de détecter localement un signal RMN tandis que la bobine capte de façon globale. Nous présentons les premières expériences de l'utilisation de la microsonde en mode émission. Ces mesures nous fournissent un modèle qui décrit une excitation inhomogène, dûe à l'émission locale de la puissance (décroissance exponentielle de la puissance), proche de la microsonde. Une distribution des angles de basculement est répartie d'une façon inhomogène induisant une distribution des intensités du signal RMN autour de la microsonde. À la fin de cette thèse, nous avons réalisé deux expériences comme applications directes suite des études sur la caractérisation de la microsonde. La première consiste à imager un volume d'eau placé dans un bain d'huile de silicone. L'image est obtenue en déplaçant mécaniquement la microsonde et en réalisant pour chaque point une mesure de spectroscopie localisée. Dans la deuxième expérience, la microsonde est utilisée pour injecter dans ce volume d'eau des impulsions électromagnétiques et détecte à la suite le signal RMN. Notre étude sur la caractérisation de l'émission locale par une microsonde et la détection du signal radiofréquence par un NEMS à base de NTC, nous permet de proposer un nouveau type de dispositifs capable de détecter un signal RMN

Étude des micro/nano sondes pour la Résonance Magnétique Nucléaire (RMN)

Dans ce travail, nous exposons une méthode basée sur la détection localisée en couplage capacitif de la composante électrique du signal RMN via des micro/nano sondes spécifiquement développées. Dans la première étape de ce travail nous avons utilisé des NEMS à base de nanotube de carbone pour réaliser une détection du signal RMN à l'échelle nanométrique. En effet, grâce à un couplage électromécanique, nous avons caractérisé ces systèmes en émission de champ, déterminé expérimentalement leur fréquence de résonance et montré qu'ils sont capables de détecter un signal radiofréquence. Pour utiliser ces dispositifs en RMN, l'adaptation du champ statique B0 de l'aimant pour atteindre la valeur de la fréquence de Larmor d'un atome est nécessaire. L'excitation locale autour de ces systèmes permettra une caractérisation complète et fiable. Pour mettre en place cette excitation localisée, nous avons choisi, dans la deuxième étape de cette thèse, une sonde locale de champ électromagnétique à l'échelle micrométrique. D'abord, nous présentons des simulations autour de la microsonde, décrivant la propagation des champs électrique et magnétique injectée par la microsonde. Nous avons caractérisé la microsonde en mode collection. Nous montrons une décroissance de l'intensité du signal RMN, en fonction de la distance. Nous avons observé et modélisé démontrant ainsi que La microsonde est capable de détecter localement un signal RMN tandis que la bobine capte de façon globale. Nous présentons les premières expériences de l'utilisation de la microsonde en mode émission. Ces mesures nous fournissent un modèle qui décrit une excitation inhomogène, dûe à l'émission locale de la puissance (décroissance exponentielle de la puissance), proche de la microsonde. Une distribution des angles de basculement est répartie d'une façon inhomogène induisant une distribution des intensités du signal RMN autour de la microsonde. À la fin de cette thèse, nous avons réalisé deux expériences comme applications directes suite des études sur la caractérisation de la microsonde. La première consiste à imager un volume d'eau placé dans un bain d'huile de silicone. L'image est obtenue en déplaçant mécaniquement la microsonde et en réalisant pour chaque point une mesure de spectroscopie localisée. Dans la deuxième expérience, la microsonde est utilisée pour injecter dans ce volume d'eau des impulsions électromagnétiques et détecte à la suite le signal RMN. Notre étude sur la caractérisation de l'émission locale par une microsonde et la détection du signal radiofréquence par un NEMS à base de NTC, nous permet de proposer un nouveau type de dispositifs capable de détecter un signal RMN.In this work, we explain our method based on the detection localized capacitive coupling of the electric component of the NMR signal via micro/nano probes specifically developeds. In the first stage of this work we use NEMS based on carbon nanotube to achieve a detection of the NMR signal at the nanoscale. Because of an electromechanical coupling, we characterize these systems in field emission, and we determine experimentally their resonance frequency and shown that they are able to detect a radio signal. To use these devices in NMR, it is necessary to adapt the value of the static field B0 of the magnet to reach the value of the Larmor frequency. We found that a local excitement around these systems gives them a reliable characterization, to avoid disrupting the parasite measurements. To implement this localized excitation, we choose a micro-probe (coaxial cable). First, we presente simulations, describing the propagation of electric and magnetic fields transmitted by the microprobe. After we characterize in collection mode the microprobe. This study shows us a decrease of the NMR signal as a function as distance. This proves that the microprobe is able to detect an NMR signal in near field, while the coil picks up globally. We characterize the microprobe in the transmit mode . These measurements provide us with a model that describes an inhomogeneous excitation of nuclei, due to the emission of power in vicinity of the microprobe. An inhomogeneous distribution of tilt angles induces an inhomogeneous distribution of the NMR signal around the microprobe. At the end of this thesis, we conducte two applications such as direct studies on the characterization of the microprobe. The first consist to image a small volume of water placed in silicone oil sample. The image obtained by mechanically moving of the microprobe and making a localized spectroscopy. In the second experiment, the microprobe injected into this volume and detects after the NMR signal. Finally, the characterization in transmit mode of the microprobe allows us to better understand the phenomenon of the trasmission of electromagnetic waves to excite the spins of the nuclei in vicinity of the NEMS based on CNT. The latter being used as NMR probe at the nanoscale, to detect a NMR signal.MONTPELLIER-BU Sciences (341722106) / SudocSudocFranceF

Characterization of electron beams emitted from dense plasma focus machines using argon, neon and nitrogen

The measured current traces of two low energy machines namely the AECS PF-2 and INTI PF are used for studying of the produced electron beam features using the modified Lee code (RADPFV5.15REB) at different conditions. The fitting procedures between measured and computed current traces are made for each point of pressure. In the case of AECS PF-2 working with neon, the electron fluence reaches the maximum value 2.35 × 1022 electrons m-2 for 1.6 Torr and the flux achieves 2.42 × 1030 electrons m-2s-1 near 1.5 Torr. The electron number has a peak of 5.74 × 1014 at 0.9 Torr. The computed results demonstarte also the maximum value of the power flow density of 2.44 × 1016 Wm-2, and the superior damage factor of around 1.95 × 1012 Wm-2s0.5 at a pressure of 0.4 Torr. Argon presents the action of radiative cooling topping at highly magnified 6.13 × 1031 m-2s-1 at 0.9 Torr. The damage factor reaches almost 175 × 1012 Wm-2s0.5 for Ar but it is only 1.29 × 1012 Wm-2s0.5 for N2. The huge values for argon are a result of enhanced compression due to radiative cooling. In the case of INTI PF device, the electron energy extends from 58 keV (for N2) to 256 keV (for Ar). The results indicate that the electron fluence ranges from 2 × 1022 electrons m-2 for N2 to 88 × 1022 electrons m-2 for Ar

Challenges and opportunities to provide immunization services: Analysis of data from a cross‐sectional study on a sample of pharmacists in a developing country

Abstract Background and Aims Vaccine‐preventable illnesses continue to be a global health concern as immunization coverage remains below its targets. National plans emphasize on the essential role of multidisciplinary efforts and approaches to vaccination programs. Pharmacists are globally getting involved in immunization services as important members of the healthcare team. This study aimed to determine barriers, and assess challenges and possible opportunities to provide immunization in the Lebanese pharmacy practice. Methods This was a cross‐sectional study that included pharmacists from all over Lebanon, as part of a national research to assess the role of pharmacists as immunizers. All registered pharmacists in Lebanon practicing in community, hospital, or other clinical settings were considered eligible for participation. A web‐based self‐administered validated questionnaire, which is initially developed by the American Pharmacists Association, was adapted with permission. Results A total of 315 pharmacists responded to the survey. Only 23.1% declared completing an immunization training program. Over half of pharmacists (58.4%) administer vaccines to patients. A significant association between lack of support from physicians to pharmacists (adjusted odds ratio [ORa] = 2.099, 95% confidence interval [CI] = 1.290–3.414, p = 0.003) and vaccine administration was found, while cost associated with professional development and additional training (ORa = 0.533, 95% CI = 0.287–0.989, p = 0.046) was inversely associated to it. Logistic, financial, and legislative requirements as essential necessities were determined to successfully expand pharmacist‐led immunization services. Conclusions The major barriers and challenges to vaccine administration by pharmacists comprised a lack of physicians' support and expenses associated with professional development and additional training. Pharmacists administer more vaccination despite lack of support from physicians; whereas they administer less vaccination due to cost associated with professional development and further training. The scope of pharmacy practice in Lebanon is not well recognized by other healthcare providers and stakeholders to include immunization services

Pharmacy Students’ Mental Health and Resilience in COVID-19: An Assessment after One Year of Online Education

COVID-19 has impacted mental health and affected education due to the shift to remote learning. The purpose of the current study was to assess the mental health of pharmacy students one year following the onset of the pandemic. A descriptive cross-sectional questionnaire was distributed to pharmacy students. The severity of depression, anxiety, and stress was assessed by the Depression Anxiety Stress Scale (DASS-21), and resilience was assessed by the Brief Resilience Scale (BRS). COVID-19-related economic, educational, and health stressors, and students’ vaccine attitudes were surveyed. Descriptive, bivariate, and multivariable analysis were used, and a p-value of <0.05 was considered significant. A total of 561 students participated; 37% had mild-to-moderate depression, 37% had severe-to-extremely-severe anxiety, and 52% demonstrated normal stress levels. Severe depression, anxiety, and stress were associated with smoking and feeling isolated due to COVID-19. Around 40% of students had low resilience, associated with smoking, being in the third or fourth year of pharmacy study, and the consumption of caffeinated beverages. The mean score of satisfaction with online learning was 60.3 ± 21.3%. Only 5% of participants were vaccinated, of which 87% trusted the benefits of vaccines and their role in controlling the pandemic. One year after the onset of COVID-19, depression, anxiety, stress, and low resilience were observed among pharmacy students; the investigation of the long-term mental effects of the pandemic on university students is warranted

Experiential Education in Pharmacy Curriculum: The Lebanese International University Model

Experiential education is an essential component of pharmacy education in order to allow intern students to experience real conditions and training opportunities in different inpatient and outpatient settings. This paper provides a description of the pharmacy practice experiences (PPEs) in the Lebanese International University (LIU) 5-year bachelor of pharmacy (BPharm) and postgraduate doctor of pharmacy (PharmD) programs; focuses on the opportunities and challenges encountered; and presents a model for experiential education in Lebanon. Learning outcomes and thus students’ acquisition of predefined competencies are evaluated in actual practice settings through assessment tools. Our experiential education program aligns with the accreditation/certification criteria set by the Accreditation Council for Pharmacy Education (ACPE) and equips future pharmacists with the knowledge and skills to become major components in the healthcare team