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

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

Health behaviors of Lebanese school-age children and health promotion - Focus on links between health promotion in schools and adolescent smoking : effects of family, friends and school

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.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

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&rsquo; 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

A cross-sectional survey on community pharmacists readiness to fight COVID-19 in a developing country: knowledge, attitude, and practice in Lebanon

Abstract Background Lebanon, a developing Middle Eastern country, was hit by the COVID-19 pandemic that occurred amid a severe national economic crisis. Community pharmacists are responsible for dispensing appropriate medications and products in addition to counseling, informing and educating the public, and promoting disease prevention and infection control. Objective This study aimed to assess community pharmacists' knowledge, attitude, and practice towards the COVID-19 pandemic and evaluate behavior changes and safety measures. Methods An anonymous and standardized online questionnaire in English was disseminated via social media platforms to Lebanese community pharmacists. The questionnaire consisted of 95 items designed as Likert-scales and multiple-choice questions divided into four different sections: socio-demographic characteristics, knowledge-based, attitude-based, and pharmacy practice questions. Descriptive statistical analysis was used to summarize the demographic characteristics, and indices were created for knowledge, attitude, and practice by computing the correct answers for each section. Results A total of 310 questionnaires were completed. Around 61% have expressed their fear of getting infected with COVID-19 due to occupational exposure. The respondents were able to answer 80–90% of the knowledge-based questions of the survey. A more careful/anxious attitude, but not knowledge, was associated with overall better practice (p = 0.03). Also, respondents stated that they are dispensing protective equipment items such as masks (87%), gloves (60%), and sanitizers (77%) in small quantities due to limited availability. Conclusion Our findings revealed an adequate level of knowledge and good practice towards COVID-19 among Lebanese community pharmacists. Their fears of contracting the virus and compromising the safety of those around them are justified. However, their supply of protective equipment is limited

Moderating effect of work fatigue on the association between resilience and posttraumatic stress symptoms: a cross-sectional multi-country study among pharmacists during the COVID-19 pandemic

Abstract Introduction In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists’ resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic. Methods A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS. Results A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = − 0.33; p < .001 and Beta = − 0.21; p = .001), mental (Beta = − 0.29; p < .001 and Beta = − 0.18; p = .006) and emotional (Beta = − 0.31; p < .001 and Beta = − 0.17; p = .008) work fatigue, higher resilience was significantly related to lower PTSS levels. However, for pharmacists with high levels of physical/mental/emotional work fatigue, the association between resilience and PTSS became non-significant. Conclusion This study highlights the complex relationship between work-related fatigue, resilience, and PTSS in pharmacists. It emphasizes the need to address work-related fatigue for pharmacists’ psychological well-being during crises, offering insights for tailored support and interventions

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

Exposure and Connectedness to Natural Environments: An Examination of the Measurement Invariance of the Nature Exposure Scale (NES) and Connectedness to Nature Scale (CNS) Across 65 Nations, 40 Languages, Gender Identities, and Age Groups

International audienceDetachment from nature is contributing to the environmental crisis and reversing this trend requires detailed monitoring and targeted interventions to reconnect people to nature. Most tools measuring nature exposure and attachment were developed in high-income countries and little is known about their robustness across national and linguistic groups. Therefore, we used data from the Body Image in Nature Survey to assess measurement invariance of the Nature Exposure Scale (NES) and the Connectedness to Nature Scale (CNS) across 65 nations, 40 languages, gender identities, and age groups (N = 56,968). While multi-group confirmatory factor analysis (MG-CFA) of the NES supported full scalar invariance across gender identities and age groups, only partial scalar invariance was supported across national and linguistic groups. MG-CFA of the CNS also supported full scalar invariance across gender identities and age groups, but only partial scalar invariance of a 7-item version of the CNS across national and linguistic groups. Nation-level associations between NES and CNS scores were negligible, likely reflecting a lack of conceptual clarity over what the NES is measuring. Individual-level associations between both measures and sociodemographic variables were weak. Findings suggest that the CNS-7 may be a useful tool to measure nature connectedness globally, but measures other than the NES may be needed to capture nature exposure cross-culturally