CORRELATES OF SELF-ESTEEM AMONG THE LEBANESE POPULATION: A CROSS-SECTIONAL STUDY

Background: To the best of our knowledge, no studies have been conducted in order to assess the correlation of these factors with the self-esteem in Lebanon. Therefore, this study aims to assess risk factors associated with self- esteem among a representative sample of the Lebanese population. Subjects and methods: A cross-sectional, conducted between November 2017 and March 2018, enrolled 789 participants. Selfesteem was measured using the Rosenberg scale. An exploratory factor analysis was executed to detect patterns of risk factors associated with self-esteem from our sample. A cluster analysis was then performed with the identified factor scores to identify the different profiles of the participants. Results: Relationship management (Beta=0.117), emotional awareness(Beta=0.074) and personal accomplishment (Beta=0.064)were associated with a higher self-esteem, whereas high depression (Beta=-0.102), alexithymia (Beta=-0.077), burnout depersonalization(Beta=-0.078), suicidal ideation (Beta=-0.391) were associated with a lower self-esteem. Factor 1 (High emotional intelligence & low depersonalization) (Beta=1.819) was associated with increased self-esteem, whereas Factor 2 (High suicidal ideation, high alcohol dependence, high depression and anxiety) and Factor 3 (Highburnout, high stress and high alexithymia) were associated with decreased self-esteem (Beta=-1.380 and Beta=-0.751) respectively. Being widowed (Beta=-2.332), belonging to cluster 1 (People with emotional dysregulation) (Beta=-2.850) and cluster 2 (People in distress) (Beta=-3.660) were significantly associated with decreased self-esteem. Conclusions: Depression, anxiety, burnout, stress, low emotional intelligence, alexithymia, suicide ideation, alcohol dependence and many other factors can be prevented, or reduced, by interventions that improve self-esteem

Descriptive assessment of graduates' perceptions of pharmacy-related competencies based on the Lebanese pharmacy core competencies framework

Background: Pharmacists possess a unique and complex body of knowledge, skills, attitudes, and behaviors necessary to enable them to optimize health outcomes. Pharmacy organizations publish routinely updated versions of professional competencies that help pharmacy schools integrate advances into their curricula. In Lebanon, no national framework for pharmacy education is officially adopted yet. In 2017, the Official Pharmacists’ Association in Lebanon [OPL - Order of Pharmacists of Lebanon] took the initiative to develop a pharmacy core competency framework. Objective: The primary objective of this survey was to evaluate graduates' perceptions of pharmacy-related competencies “taught” across Lebanese pharmacy schools/faculties, based on the suggested Lebanese Pharmacy Competencies Framework. This study also explored the association between graduates' demographics, university attributes, and self-assessed competency performance. Methods: A cross-sectional study involving pharmacists who graduated from Lebanese universities was performed through a 40-minute online questionnaire distributed over social media platforms and groups of pharmacists. Results: Pharmacists perceived their competence as moderate upon graduation, the lowest scores being in fundamental knowledge and medicine supply; the highest reported scores were in personal skills and safe/rational use of medicines. Moreover, females, younger graduates, PharmD holders, and pharmacists working in hospitals/clinical settings and academia had the highest perception of their competencies. Pharmacists in the public sector and medical laboratory directors had the lowest perception of competence. Conclusions: When comparing the taught curriculum to the suggested Lebanese Pharmacy Competency Framework, all domains need to be improved to optimize the perception, education, and practice of pharmacists. It is essential to emphasize fundamental knowledge, medicines supply, and public health competencies in undergraduate curricula and improve continuing professional education

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

Body Appreciation Around the World: Measurement Invariance of the Body Appreciation Scale-2 (BAS-2) Across 65 Nations, 40 Languages, Gender Identities, and Age

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset – with data collected between 2020 and 2022 – to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research

Association between culture and the preference for, and perceptions of, 11 routes of medicine administration: A survey in 21 countries and regions

Medicines can be taken by various routes of administration. These can impact the effects and perceptions of medicines. The literature about individuals' preferences for and perceptions of the different routes of administration is sparse, but indicates a potential influence of culture. Our aim was to determine: (i) any association between one's culture and one's preferred route of medicine administration and (ii) individual perceptions of pain, efficacy, speed of action and acceptability when medicines are swallowed or placed in the mouth, under the tongue, in the nose, eye, ear, lungs, rectum, vagina, on the skin, or areinjected. A cross-sectional, questionnaire-based survey of adults was conducted in 21 countries and regions of the world, namely, Tunisia, Ghana, Nigeria, Turkey, Ethiopia, Lebanon, Malta, Brazil, Great Britain, United States, India, Serbia, Romania, Portugal, France, Netherlands, Japan, South Korea, Hong Kong, mainland China and Estonia, using the Inglehart–Welzel cultural map to ensure coverage across all cultures. Participants scored the pain/discomfort, efficacy, speed of onset and acceptability of the different routes of medicine administration and stated their preferred route. Demographic information was collected. A total of 4435 participants took part in the survey. Overall, the oral route was the most preferred route, followed by injection, while the rectal route was the least preferred. While the oral route was the most preferred in all cultures, the percentage of participants selecting this route varied, from 98% in Protestant Europe to 50% in the African-Islamic culture. A multinomial logistic regression model revealed a number of predictors for the preferred route. Injections were favoured in the Baltic, South Asia, Latin America and African-Islamic cultures while dermal administration was favoured in Catholic Europe, Baltic and Latin America cultures. A marked association was found between culture and the preference for, and perceptions of the different routes by which medicines are taken. This applied to even the least favoured routes (vaginal and rectal). Only women were asked about the vaginal route, and our data shows that the vaginal route was slightly more popular than the rectal one

Association between culture and the preference for, and perceptions of, 11 routes of medicine administration : a survey in 21 countries and regions

Medicines can be taken by various routes of administration. These can impact the effects and perceptions of medicines. The literature about individuals’ preferences for and perceptions of the different routes of administration is sparse, but indicates a potential influence of culture. Our aim was to determine: (i) any association between one’s culture and one’s preferred route of medicine administration and (ii) individual perceptions of pain, efficacy, speed of action and acceptability when medicines are swallowed or placed in the mouth, under the tongue, in the nose, eye, ear, lungs, rectum, vagina, on the skin, or areinjected. A cross-sectional, questionnaire-based survey of adults was conducted in 21 countries and regions of the world, namely, Tunisia, Ghana, Nigeria, Turkey, Ethiopia, Lebanon, Malta, Brazil, Great Britain, United States, India, Serbia, Romania, Portugal, France, Netherlands, Japan, South Korea, Hong Kong, mainland China and Estonia, using the Inglehart–Welzel cultural map to ensure coverage across all cultures. Participants scored the pain/discomfort, efficacy, speed of onset and acceptability of the different routes of medicine administration and stated their preferred route. Demographic information was collected. A total of 4435 participants took part in the survey. Overall, the oral route was the most preferred route, followed by injection, while the rectal route was the least preferred. While the oral route was the most preferred in all cultures, the percentage of participants selecting this route varied, from 98% in Protestant Europe to 50% in the African-Islamic culture. A multinomial logistic regression model revealed a number of predictors for the preferred route. Injections were favoured in the Baltic, South Asia, Latin America and African-Islamic cultures while dermal administration was favoured in Catholic Europe, Baltic and Latin America cultures. A marked association was found between culture and the preference for, and perceptions of the different routes by which medicines are taken. This applied to even the least favoured routes (vaginal and rectal). Only women were asked about the vaginal route, and our data shows that the vaginal route was slightly more popular than the rectal one.peer-reviewe

Comportements de santé des enfants et des adolescents d'âge scolaire libanais et promotion de la santé. Focus sur les liens entre la promotion de la santé dans les écoles et l'usage de tabac par les adolescents : effets de la famille, des amis et de l'école

CONTEXTE : De nombreux facteurs contribuent au tabagisme chez les jeunes. La famille est l'environnement où les comportements sociaux sont adoptés. Les liens avec les parents servent de facteur de protection pour la déviance des adolescents. Les pairs affectent les comportements en influençant normes et valeurs, et en établissant une identité sociale et culturelle. Les écoles développent des stratégies pour faire de la vie saine une compétence pour l'élève. Plusieurs pays adoptent la promotion de la santé dans les écoles. OBJECTIFS : Décrire la consommation de cigarettes et pipes à eau des jeunes Libanais et évaluer l'influence de la famille, les amis et l'école. Pour évaluer le rôle de l'école, la Promotion de la santé a été abordée. MÉTHODES : Une étude d'observation transversale prospective a été menée d'octobre 2016 à avril 2017. 32 des 61 écoles approchées ont accepté de participer. Deux questionnaires ont été utilisés, un pour les administrateurs scolaires et un pour les élèves. Les administrateurs ont rempli le questionnaire de promotion de la santé. Les élèves un questionnaire issu HBSC. Les âges étaient de 11 à 20 ans. Les écoles concernées ont approuvé l'étude. Les moyennes et les écarts-types ont été utilisés pour les variables continues et les tableaux de fréquence pour les variables catégorielles. Le Chi-carré a été réalisé pour révéler les associations entre le tabagisme et des variables telles que le sexe, la région et le statut socio-économique. Toutes les valeurs de p rapportées étaient à double face avec l'ensemble alpha à une signification de 0,05. RESULTATS : 7117 élèves ont été étudiés (54,43% de filles), répartis entre le complémentaire (58,44%) et le secondaire (41,56%). La prévalence de l'expérimentation du tabac, de la pipe à eau et des deux simultanément était respectivement de 24,93%, 34,06% et 22,8%. Dans le cas de l'expérimentation du tabac, les risques étaient plus faibles chez les filles (OR=0,53), mais plus élevés chez les élèves des classes sociales supérieures, et chez les adolescents sans parents (OR=2,37) ou avec un parent (OR=1,49) par rapport à deux parents. L'expérimentation de la cigarette a été évaluée en fonction de la famille, des amis et de l'école; elle est plus susceptible de se produire chez les adolescents d'une famille de 1 enfant (OR=1,09), dont les parents fument (OR=1,62) et qui ont un statut socioéconomique élevé (OR= 1,13). Les résultats étaient statistiquement significatifs entre le tabagisme et le contact avec des amis plus de 3-4 jours (valeur P <0,0001). Plus la performance à l'école est faible, plus les chances d'expérimenter la cigarette sont grandes. Des résultats similaires ont été rapportés concernant l'expérimentation de la pipe à eau. Certains consomment la pipe à eau moins d'une fois par semaine (6,42%), d'autres 1 à 2 fois par semaine (7,26%) et plus de 3 fois par semaine (5,78%). Pour ce qui est de fumer tous les jours, les chances étaient plus élevées chez les garçons (OR= 3,21), chez ceux qui avaient un statut socio-économique plus élevé (OR=1,84) et chez ceux qui avaient un père fumeur (RC=1,66). Pour la pipe à eau, les chances étaient plus élevées chez les garçons (OR=1,46), sans parents (OR=3,60), avec de bonnes relations faciles avec le sexe opposé (OR=1,28), ceux ayant un contact élevé avec des amis et de faibles performances scolaires. Les risques de consommation élevée de pipe à eau = 3 fois par semaine étaient plus élevées chez les adolescents ayant de faibles performances scolaires. CONCLUSION : L'étude a révélé des taux alarmants de consommation de produits du tabac chez les adolescents libanais, malgré les programmes de prévention dans les écoles. Cette augmentation est probablement due à l'utilisation de la pipe à eau dans la société et de l'idée fausse qu'elle n'est pas aussi nocive que les cigarettes. Les effets de la famille, les amis et les écoles ne doivent pas être négligés. Les résultats soulèvent des implications pour élaborer des programmes de prévention du tabagisme au Liban.BACKGROUND: Adolescent behavior predicts health behaviors and status in adulthood. Many factors contribute to young people's smoking. Family is an important context for the development of the child, the environment in which social behaviors are adopted. Bonds with parents serve as a protective factor for adolescent deviance. Peers affect health behaviors by influencing norms and values, and establishing a social and cultural identity. Schools develop new strategies to make healthy living a skill for the student. Many countries adopt health promotion in schools. OBJECTIVES: Describe the Lebanese youth's consumption of cigarettes and waterpipes, and assess the influence of family, friends, and school. To assess the school roles, Health Promotion was tackled. METHODS: A prospective cross-sectional observational study conducted from October 2016 till April 2017. Convenient sampling method was followed; 32 out of 61 schools approached accepted to participate. Two questionnaires were used, one for school administrators and one for students. Administrators filled the health promotion questionnaire of 26 questions. Students filled the adapted HBSC questionnaire of 61 questions. Ages ranged from 11 to 20 years old, including students from 6th till 12th grade. The schools involved approved the study design. A proposal was sent prior to enrollment. The study did not pose any risk to the participants. Data were stripped of personal information. The investigator performed the interviews. Means and standard deviations (SD) were used for continuous variables, and frequency tables for the categorical variables. Chi-square was performed to reveal associations between smoking and variables like gender, region, and socio-economic status. All reported p-values were two-sided with the alpha set at a significance of 0.05. To decrease confounding bias, multiple logistic regressions were carried out, after ensuring sample adequacy. RESULTS: 7117 students were studied (54.43% females), they were distributed between intermediate classes (58.44%) and high school (41.56%). The prevalence of experimentation of cigarette smoking, waterpipe smoking and both behaviors were 24.93%, 34.06% and 22.8%, respectively. For smoking experimentation, the odds were lower among females (OR=0.53), but higher among students of higher classes, and higher among adolescents with no parents (OR=2.37) or one parent (OR=1,49) versus two parents. Cigarette experimentation was assessed in terms of family, friends and school; cigarette smoking experimentation is more likely to occur among adolescent in a family of 1 child (OR=1.09), having parents who smoke (OR=1.62) and of high socio-economic status (OR= 1.13). Results were statistically significant between smoking and contact with friends of more than 3-4 days (P-value <0.0001). The lower the performance at school, the more the odds of cigarette smoking experimentation. Similar results were reported regarding waterpipe experimentation. Some consumed waterpipe at low frequency less than once per week (6.42%), others 1-2 times per week (7.26%) and more than 3 times per week (5.78%). For daily smoking habit, the odds of cigarette smoking were higher among males (OR=3.21), those with higher socio-economic status (OR=1.84), and if the father smokes (OR=1.66). Regarding waterpipe, the odds were higher among males (OR=1.46), with no parents (OR=3.60), with good and easy relations with the opposite sex (OR=1.28), those with high contact with friends, and low school performance. The odds of high waterpipe consumption = 3 times per week were higher among adolescents with low school performance. CONCLUSION: The study revealed alarming rates of use of tobacco products for Lebanese adolescents, despite the prevention programs at the schools. Family, friends and schools effects are not to be neglected. The results raise important policy implications for the development of smoking prevention programs for the youth in Lebanon