MECHANICAL AND DURABILITY PROPERTIES OF GEOPOLYMER CONCRETE – A REVIEW

Owing to the ongoing increase in human population, there is a need for more construction projects including residential buildings and other amenities. Concrete is by far the dominant material used in construction and cement is a main ingredient. Cement manufacture is an energy intensive process and emit large amounts of carbon dioxide into the atmosphere. A reduction in the amount of cement used in construction is greatly beneficial. The use of geopolymer or alkali activated materials can serve this purpose as it attempts to totally replace cement in concrete. Geopolymers are materials that consist mainly of silica and alumina materials and activated using alkali such as sodium silicate and sodium hydroxide. This paper attempts to review recent articles on the production and properties of geopolymers and alkali activated materials. Different hardened, structural, and durability properties are studied. These include; compressive strength, flexural strength, modulus of elasticity, ultrasonic pulse velocity, shrinkage, expansion, creep, weight loss, carbonation, sulfate, and corrosion

COVID-19 IN LEBANON: DEMOGRAPHICS AND DISTRIBUTION

COVID-19 pandemic has emerged over more than 200 countries leading to more than 117 million infection cases and more than 2.6 million deaths. Lebanon is one of the countries affected by this disease especially in the second half of 2020 reaching its peak early this year. In this study, we studied the impact of multiple factors on this surge and analyzed the positive tests among different age groups over a period of one year (from March 2020 to February 2021). Data was collected from one medical center in Beirut where more than 20,000 PCR tests were done using RT-PCR method between March 2020 and February 2021 and analyzed the pattern of increase of the rate of positivity over this period. The SARS-CoV-2 positivity rate was 13% over a period of one year. The highest number of positive PCR tests was in patients aged between 20 and 39 years. Furthermore, the number of positive tests was low in the first 4 months, which was followed by a dramatic increase in July 2020 reaching a peak in January 2021. Lebanon is among the countries affected lately by the COVID-19 pandemic with most cases arising after August 2020 affected by the blast of Beirut and emergence of new variants resulting in higher positivity rate. Moreover, our data shows a distribution of age similar to other countries and suggest its role in the rapid increase of positivity rate

Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers

<p>Abstract</p> <p>Background</p> <p>Limited research exists on researchers' knowledge transfer and exchange (KTE) in the eastern Mediterranean region (EMR). This multi-country study explores researchers' views and experiences regarding the role of health systems and policy research evidence in health policymaking in the EMR, including the factors that influence health policymaking, barriers and facilitators to the use of evidence, and the factors that increase researchers' engagement in KTE.</p> <p>Methods</p> <p>Researchers who published health systems and policy relevant research in 12 countries in the EMR (Bahrain, Egypt, Iran, Jordan, Lebanon, Libya, Morocco, Oman, Palestine, Sudan, Syria, and Yemen) were surveyed. Descriptive analysis and Linear Mixed Regression Models were performed for quantitative sections and the simple thematic analysis approach was used for open-ended questions.</p> <p>Results</p> <p>A total of 238 researchers were asked to complete the survey (response rate 56%). Researchers indicated transferring results to other researchers (67.2%) and policymakers in the government (40.5%). Less than one-quarter stated that they produced policy briefs (14.5%), disseminated messages that specified possible actions (24.4%), interacted with policymakers and stakeholders in priority-setting (16%), and involved them in their research (19.8%). Insufficient policy dialogue opportunities and collaboration between researchers and policymakers and stakeholders (67.9%), practical constraints to implementation (66%), non-receptive policy environment (61.3%), and politically sensitive findings (57.7%) hindered the use of evidence. Factors that increase researchers' engagement in KTE activities in the region were associated with involving policymakers and stakeholders at various stages such as priority-setting exercises and provision of technical assistance.</p> <p>Conclusions</p> <p>Researchers in the EMR recognize the importance of using health systems evidence in health policymaking. Potential strategies to improve the use of research evidence emphasize two-way communication between researchers and policymakers. Findings are critical for the upcoming World Health Report 2012, which will emphasize the significance of conducting and translating health research to inform health policies.</p

A national cross-sectional study on nurses' intent to leave and job satisfaction in Lebanon: implications for policy and practice

<p>Abstract</p> <p>Background</p> <p>Lebanon is perceived to be suffering from excessive nurse migration, low job satisfaction, poor retention and high turnover. Little is known about the magnitude of nurse migration and predictors of intent to leave. The objective of this study is to determine the extent of nurses' intent to leave and examine the impact of job satisfaction on intent to leave. Intent to leave was explored to differentiate between nurses who intend to leave their current hospital and those intending to leave the country.</p> <p>Methods</p> <p>A cross-sectional design was used to survey nurses currently practicing in Lebanese hospitals. A total of 1,793 nurses employed in 69 hospitals were surveyed. Questions included those relating to demographic characteristics, intent to leave, and the McCloskey Mueller Satisfaction Scale. Univariate descriptive statistics were conducted on sample's demographic characteristics including gender, age, marital status and educational level. Bivariate associations between intent to leave and demographic characteristics were tested using Pearson Chi-square. Differences in satisfaction scores between nurses with and without intent to leave were tested using t-test and ANOVA f-test. A multinomial logistic regression model was created to predict intent to leave the hospital and intent to leave the country.</p> <p>Results</p> <p>An alarming 67.5% reported intent to leave within the next 1 to 3 years, many of whom disclosed intent to leave the country (36.7%). Within nurses who reported an intent to leave the hospital but stay in Lebanon, 22.1% plan to move to a different health organization in Lebanon, 29.4% plan to leave the profession and 48.5% had other plans. Nurses reported being least satisfied with extrinsic rewards. A common predictor of intent to leave the hospital and the country was dissatisfaction with extrinsic rewards. Other predictors of intent to leave (country or hospital) included age, gender, marital status, degree type, and dissatisfaction with scheduling, interaction opportunities, and control and responsibility.</p> <p>Conclusion</p> <p>Study findings demonstrate linkages between job satisfaction, intent to leave, and migration in a country suffering from a nursing shortage. Findings can be used by health care managers and policy makers in managing job satisfaction, intent to leave and nurse migration.</p

Use of health systems evidence by policymakers in eastern mediterranean countries: views, practices, and contextual influences

BACKGROUND: Health systems evidence can enhance policymaking and strengthen national health systems. In the Middle East, limited research exists on the use of evidence in the policymaking process. This multi-country study explored policymakers’ views and practices regarding the use of health systems evidence in health policymaking in 10 eastern Mediterranean countries, including factors that influence health policymaking and barriers and facilitators to the use of evidence. METHODS: This study utilized a survey adapted and customized from a similar tool developed in Canada. Health policymakers from 10 countries (Algeria, Bahrain, Jordan, Lebanon Oman, Pakistan, Palestine, Sudan, Tunisia, and Yemen) were surveyed. Descriptive and bi-variate analyses were performed for quantitative questions and thematic analysis was done for qualitative questions. RESULTS: A total of 237 policymakers completed the survey (56.3% response rate). Governing parties, limited funding for the health sector and donor organizations exerted a strong influence on policymaking processes. Most (88.5%) policymakers reported requesting evidence and 43.1% reported collaborating with researchers. Overall, 40.1% reported that research evidence is not delivered at the right time. Lack of an explicit budget for evidence-informed health policymaking (55.3%), lack of an administrative structure for supporting evidence-informed health policymaking processes (52.6%), and limited value given to research (35.9%) all limited the use of research evidence. Barriers to the use of evidence included lack of research targeting health policy, lack of funding and investments, and political forces. Facilitators included availability of health research and research institutions, qualified researchers, research funding, and easy access to information. CONCLUSIONS: Health policymakers in several countries recognize the importance of using health systems evidence. Study findings are important in light of changes unfolding in some Arab countries and can help undertake an analysis of underlying transformations and their respective health policy implications including the way evidence will be used in policy decisions

Eliciting policymakers' and stakeholders' opinions to help shape health system research priorities in the Middle East and North Africa region

Evidence-informed decisions can strengthen health systems. Literature suggests that engaging policymakers and other stakeholders in research priority-setting exercises increases the likelihood of the utilization of research evidence by policymakers. To our knowledge, there has been no previous priority-setting exercise in health policy and systems research in countries of the Middle East and North Africa (MENA) region. This paper presents the results of a recent research priority-setting exercise that identified regional policy concerns and research priorities related to health financing, human resources and the non-state sector, based on stakeholders in nine low and middle income countries (LMICs) of the MENA region. The countries included in this study were Algeria, Egypt, Jordan, Lebanon, Morocco, Palestine, Syria, Tunisia and Yemen. This multi-phased study used a combination of qualitative and quantitative research techniques. The overall approach was guided by the listening priority-setting approach, adapted slightly to accommodate the context of the nine countries. The study was conducted in four key phases: preparatory work, country-specific work, data analysis and synthesis, and validation and ranking. The study identified the top five policy-relevant health systems research priorities for each of the three thematic areas for the next 3-5 years. Study findings can help inform and direct future plans to generate, disseminate and use research evidence for LMICs in the MENA region. Our study process and results could help reduce the great chasm between the policy and research worlds in the MENA region. It is hoped that funding agencies and countries will support and align financial and human resources towards addressing the research priorities that have been identifie

Multi-faceted approach to promote knowledge translation platforms in eastern Mediterranean countries: climate for evidence-informed policy

Senior policymakers, stakeholders and researchers from Algeria, Bahrain, Egypt, Iran, Jordan, Lebanon, Oman, Sudan, Syria, Tunisia, and Yemen participated in this study. Despite the complexity of policymaking processes in countries from this region, the absence of a structured process for decision making, and the limited engagement of policymakers and researchers in knowledge translation (KT) activities, there are windows of opportunity for moving towards more evidence informed policymaking. A recurring positive theme was the development of new national strategic plans. Findings emphasized the complexity of policymaking. Donors, political regimes, economic goals and outdated laws were identified as key drivers

The impact of accreditation of primary healthcare centers: successes, challenges and policy implications as perceived by healthcare providers and directors in Lebanon

BACKGROUND: In 2009, the Lebanese Ministry of Public Health (MOPH) launched the Primary Healthcare (PHC) accreditation program to improve quality across the continuum of care. The MOPH, with the support of Accreditation Canada, conducted the accreditation survey in 25 PHC centers in 2012. This paper aims to gain a better understanding of the impact of accreditation on quality of care as perceived by PHC staff members and directors; how accreditation affected staff and patient satisfaction; key enablers, challenges and strategies to improve implementation of accreditation in PHC. METHODS: The study was conducted in 25 PHC centers using a cross-sectional mixed methods approach; all staff members were surveyed using a self-administered questionnaire whereas semi-structured interviews were conducted with directors. RESULTS: The scales measuring Management and Leadership had the highest mean score followed by Accreditation Impact, Human Resource Utilization, and Customer Satisfaction. Regression analysis showed that Strategic Quality Planning, Customer Satisfaction and Staff Involvement were associated with a perception of higher Quality Results. Directors emphasized the benefits of accreditation with regards to documentation, reinforcement of quality standards, strengthened relationships between PHC centers and multiple stakeholders and improved staff and patient satisfaction. Challenges encountered included limited financial resources, poor infrastructure, and staff shortages. CONCLUSIONS: To better respond to population health needs, accreditation is an important first step towards improving the quality of PHC delivery arrangement system. While there is a need to expand the implementation of accreditation to cover all PHC centers in Lebanon, considerations should be given to strengthening their financial arrangements as well