Practice of non-pharmaceutical interventions against COVID-19 and reduction of the risk of influenza-like illness: a cross-sectional population-based study

INTRODUCTION: While the widespread implementation of the non-pharmaceutical interventions was intended to contain the COVID-19 pandemic, such measures could be also effective in limiting the spread of other respiratory infections. This study aimed to examine the association between the implementation of personal protective measures and the occurrence of influenza-like illnesses (ILI) in the general population. METHODS: An online retrospective cross-sectional observational study was conducted in April 2021 to assess cases of ILI among Lebanese adults aged 18 years and above, from all Lebanese governorates during the 2020-2021 flu season. Data were collected using a convenience sampling method. In addition to their socio-demographic information, participants were asked about their frequency of implementing personal protective measures and if they have experienced symptoms of ILI in the previous 6 months. The overall score of the personal protective measures was computed. Multivariable logistic regression was performed to examine the association between participants' level of adoption of personal protective measures against COVID-19 and the occurrence of ILI. RESULTS: Among the 1019 Lebanese adults participating in this study, 352 (34.54%) of them reported symptoms of ILI between October 2020 and March 2021. Lebanese adults who wore their facemasks frequently or always were less likely to suffer from symptoms of ILI than others who did not wear the mask (aOR = 0.452, 95% CI = 0.349-0.693, p < 0.001). Similarly, adults who adopt the following protective measures washing hands (aOR = 0.608, 95% CI = 0.524-0.922, p < 0.001), respecting cough etiquette (aOR = 0.763, 95% CI = 0.598-0.918, p < 0.001), disinfecting surface (aOR = 0.892, 95% CI = 0.632-0.911, p = 0.012), avoiding crowded places (aOR = 0.739, 95% CI = 0.688-0.903, p = 0.049), respecting physical distancing (aOR = 0.646, 95% CI = 0.482-0.833, p = 0.031) on a regular basis (frequently/always) were less likely to report symptoms of influenza-like illnesses when compared with those who did not adhere at all to these measures. CONCLUSION: Our study highlighted the potential of personal protective measures against COVID-19 in reducing the transmission of respiratory infections such as ILI. Such findings might be invested during influenza season, particularly among groups at high risk of developing severe complications. Exploring trends detected by the national severe acute respiratory infection surveillance system is recommended to confirm the utility of these measures

Pharmacists as immunizers in Lebanon: a national survey of community pharmacists' willingness and readiness to administer adult immunization

BACKGROUND: Since the focus of healthcare has shifted toward prevention, pharmacists were highly encouraged to expand their practice to include immunization services. Our study aimed to assess the knowledge, attitudes and beliefs of community-based Lebanese pharmacists, in addition to their willingness to expand their practice scope to include vaccine administration. METHODS: A cross-sectional study was conducted during the phase preceding the arrival of the COVID-19 vaccine in Lebanon between 1 and 31st December 2020. Using a stratified random sampling method, data were collected from Lebanese community pharmacists (CPs) through an online survey that included information on socio-demographic characteristics, clinical experience, willingness to administer vaccines, knowledge about vaccination, attitudes towards immunization, reasons supporting utilizing pharmacists as immunizers and the requested elements to incorporate immunization in pharmacists' practice scope. Multivariable analyses were performed to identify the factors associated with knowledge. RESULTS: A total of 412 community pharmacists participated in this survey. Of the total, 66.5% of the surveyed CPs are willing to administer vaccines. The majority of them (89.8%) had an overall good level. Out of all, 92.7% showed a positive overall attitude score toward immunization, 95.4% agreed that community pharmacists can play an important role in advertising and promoting vaccination. The main needed elements for implementing immunization services in pharmacies listed by participants were: support of health authorities (99.3%), statutory allowance (82.8%), patient demand (95.4%), pharmacist's interest (96.1%) and continuous education and training workshops on immunization. Older CPs (50 years and above) [aOR = 0.703, CI 95% (0.598-0.812)] and those working in Bekaa and North have lower knowledge score than their counterparts. High educational level [aOR = 1.891, CI 95% (1.598-2.019)], previous experience in immunization [aOR = 3.123, CI 95% (2.652-4.161)] and working in urban areas [aOR = 3.640, CI 95% (2.544-4.717)] were positively associated with a good knowledge level. CONCLUSION: Most of Lebanese community pharmacists are willing to offer immunizations. The expansion of the pharmacists practice scope to include provision of immunizations required a national plan that encompasses strengthening knowledge, training, certification for eligibility to administer vaccines, enhancing pharmacovigilance and statutory reform

PLoS One

Driving anger may vary across countries due to culture. This might affect driver behavior, which, in turn, impacts the driving outcomes. This study aims to investigate the relationship between socio-demographic variables, driving anger, and the self-reported aberrant behavior among Lebanese drivers and to determine which anger dimension is linked to driving behavior. A cross-sectional study was conducted among eligible Lebanese drivers from all Lebanese governorates. Data were collected using an anonymous Arabic self-reported questionnaire that included demographic information, driving-related variables, and two scales: the Driver Behavior Questionnaire (DBQ) and the Driver Anger Scale (DAS). Four hierarchical regressions were performed taking the DBQ subscales as the dependent variable and the DAS subscales as independent variables. Out of 1102 surveyed drivers, 68.4% were males, having a mean age of 34.6 ± 12.3 years and an average driving experience of 13.5 ± 10.8 years. DBQ, DAS, and their subscales showed good reliability. Older age and female gender were negatively associated with the tendency of committing aggressive violations. However, being a professional driver and increasing annual mileage were positively associated with a higher tendency to commit aggressive violations. In addition to these factors, a higher educational level was found associated with a lower risk of driver's involvement in traffic violations. However, increased driving experience was associated with a higher tendency to commit aggressive violations. Reported driving errors were also found positively associated with older age, increasing mileage, and being a professional driver. However, larger driving experience and higher education were found protectors from erroneous behavior. Hierarchical regression showed that anger prompted by hostile gesture, discourtesy, police presence, traffic obstruction, and slow driving were positively associated with aggressive violations. All the DAS subscales were found to be positively associated with ordinary violations. traffic obstruction was also found associated with a higher tendency of drivers to commit lapses, as well as anger, which originated from police presence and slow driving which were found also positively associated with errors. Driver anger dimensions were found positively associated with aberrant driver behavior. To overcome road anger, there is a need to train drivers on coping strategies to restrain aberrant driving behavior

Quest for Highly Connected MOFPlatforms: Rare-Earth Polynuclear Clusters Versatility Meets Net Topology Needs

International audienc

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

J Pharm Policy Pract

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. 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. 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. 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

J Pharm Policy Pract

BACKGROUND: The COVID-19 pandemic has harshly burdened the healthcare systems. Health care workers (HCWs) are at substantial risk of infection and confronted several stressors as well leading them to experience burnout. This study aimed to assess the prevalence of burnout among Lebanese health HCWs and to identify its associated factors. METHODS: A cross-sectional online survey was conducted between the first of November and the end of December 2020 among Lebanese HCWs working in all active hospitals operating across the country. Data were collected using an Arabic, anonymous, self-reported questionnaire comprising four sections: (a) basic sociodemographic characteristics, (b) exposure to COVID-19 covariates, (c) occupational factors, and (d) the measurements including the Copenhagen Burnout Inventory (CBI). CBI subscale cut-off score of 50 was used to assess the prevalence of burnout among HCWs. Multinomial logistic regression analyses were performed to examine the factors associated with the different aspects of burnout. RESULTS: Out of the 1751 respondents, personal burnout (PB) was detected in its moderate and high-level aspects among 86.3% of Lebanese HCWs. Moderate and high levels of work-related burnout (WB), and client-related burnout (CB) hit 79.2% and 83.3% of HCWs, respectively. HCWs who were females, married, physicians, having a poor health status and specific living conditions (dependent child, elderly at home, family member with comorbidities, and a low income) were more likely to exhibit a high level of PB compared to no/low burnout level. Moreover, frontline HCWs, those infected by COVID-19 or those having a colleague infected by COVID-19, and those exhibiting a high perception of threat were more prone to experience a high-level PB rather than a low/no burnout. Working in a public hospital, extensive working hours, and insufficient sleeping hours were also found positively associated with high PB. However, older age and altruism were negatively associated with high PB compared to no/low PB among HCWs. As for WB, similar factors were found either positively or negatively associated with a high level of WB except health status and living conditions factors (dependent child or family member). As for CB, older age of HCWs (> 30 years) and altruism were negatively associated with high CB compared to no/low burnout level. However, working in the frontline, high threat perception, extensive working hours, insufficient sleeping hours, and low income were positively associated with high CB among HCWs compared to no/low burnout. CONCLUSION: The prevalence of burnout among Lebanese HCWs during the pandemic was significant and alarming. Enacting and implementing preventive policies and effective interventions are urgently needed to cultivate wellness among HCWs

Prevalence and correlates of burnout among physicians in a developing country facing multi-layered crises: a cross-sectional study

Abstract Burnout among physicians is a serious concern that cultivates its seeds during their education. This study assessed the prevalence of burnout among Lebanese physicians and explored its correlates and the combined effects of the pandemic and the economic crisis on burnout. A web-based cross-sectional study was conducted in December 2020 using a snowball sampling technique. Moderate and high levels of burnout hit 90.7% of the physicians where personal, work-related, and client-related burnout were detected among 80.4%, 75.63%, and 69.6% of them respectively. A strong association was found between the higher level of burnout and female gender, younger age, being single, having a dependent child, living with an elderly or a family member with comorbidities, and insufficient sleeping hours. Physicians’ specialties, working in a public health facility, limited years of professional experience, lack of previous experience in a pandemic, and extensive working hours were also associated with increased burnout. Furthermore, low income, working in the frontline, higher threat perception, and fear of COVID-19 were contributing to higher burnout. The combined effect of threat perception and financial hardship significantly increased burnout levels. The alarming burnout level detected among physicians urges health authorities to take prompt actions to enhance the physicians’ well-being

Arch Public Health

Hospital cleaners are the unsung heroes in the fight against the COVID-19 pandemic. This study aimed to assess the knowledge, attitudes, and practices (KAP) of hospital cleaners towards COVID-19 and determine factors associated with good practices. A cross-sectional study was conducted in Lebanon between the 1st and 14th November 2020. Using a snowball sampling technique, data were collected through an online survey that was sent to governmental and private hospitals. The questionnaire consisted of socio-demographic characteristics and KAP of hospital cleaners towards COVID-19. Descriptive statistics and logistic regression analysis were performed. A total of 453 cleaners completed the survey, of whom 54.3% were females. Most participants had a good level of COVID-19 knowledge (98%) and good preventive practices (89.7%). Regarding attitude, 90.7% had a positive attitude toward health facilities, 78.8% toward cleaning and disinfection, and 73.5% toward health authorities. Sociodemographic characteristics, including younger age, higher levels of education, working in private hospitals, and having more than 3 years of experience, were positively associated with good preventive practices. Our results also showed that participants who had good knowledge about COVID-19, COVID-19 prevention and treatment, cleaning and disinfection processes, and COVID-19 risk factors had a higher likelihood of positive preventive practices. Finally, a positive attitude toward health facilities, health authorities, and cleaning and disinfection was positively associated with good practices. The surveyed cleaners have a high level of knowledge and expressed positive attitudes toward health facilities and health authorities, as well as good preventive practices. Understanding the determinants of cleaning performance is critical in tailoring interventions to improve hospital cleaning