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Massive Open Online Courses (MOOCs) in the Arab World are still in their infancy. Many Arab countries are now starting to launch their MOOC platforms; however, there are only a few who have actually implemented such systems. This paper will explore online learning, in particular the rise of MOOCs around the world and their impact on the Arab World. The purpose of this paper is to give a true picture of the development of the first MOOC platforms in the Arab World. It will analyse in detail the concept, definitions, background, and types of MOOCs (xMOOCs and cMOOCs), as well as the main MOOCs platform in the Western and Arab worlds, and a timeline of the development of MOOCs. It will then observe the status of MOOCs in the developed world, opportunities in the Middle East, and the influence of Western MOOCs on the Arab world, from many perspectives, e.g. educational, religious, cultural and social.

Introduction: The Ministry of Public Health in Lebanon is in the process of converting the surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2) to have real-time information for early detection of alerts and outbreaks and for initiating a prompt response., Objectives: This paper aimed to document the Lebanese experience in implementing DHIS-2 for the disease surveillance system. It also targets to assess the improvement of reporting rates and timeliness of the reported data and to disclose the encountered challenges and opportunities., Methodology: This is a retrospective description of processes involved in the implementation of the DHIS-2 tool in Lebanon. Initially, it was piloted for the school-based surveillance in 2014; then its use was extended in May 2017 to cover other specific surveillance systems. This included all surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries, or laboratories at the first stage. As part of the national roll-out process, the online application was developed. The customized aggregated-based datasets, organization units, user accounts, specific and generic dashboards were generated. More than 80 training sessions were conducted throughout the country targeting 1290 end-users including health officers at the national and provincial levels, focal persons who were working in all public and private hospitals, laboratories, and medical centers as well. Completeness and timeliness of reported data were compared before and after the implementation of DHIS-2. The unveiled challenges and the main lessons learned during the roll-out process were discussed., Results: For laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25 to 74%. For medical centers, an improvement of 8.1% for completeness and 9.4% in timeliness was recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74 to 87%. The main challenges faced during the implementation of DHIS-2 were mainly infrastructural and system-related in addition to poor internet connectivity, limited workforce, and frequent changes to DHIS-2 versions., Conclusion: Implementation of DHIS-2 improved timeliness and completeness for aggregated data reporting. Continued on-site support, monitoring, and system enhancement are needed to improve the performance of DHIS-2., (© 2022. The Author(s).)

Background: Rapid reviews have emerged as an approach to provide contextualized evidence in a timely and efficient manner. Three rapid review centers were established in Ethiopia, Lebanon, and South Africa through the Alliance for Health Policy and Systems Research, World Health Organization, to stimulate demand, engage policymakers, and produce rapid reviews to support health policy and systems decision-making. This study aimed to assess the experiences of researchers and policymakers engaged in producing and using rapid reviews for health systems strengthening and decisions towards universal health coverage (UHC)., Methods: Using a case study approach with qualitative research methods, experienced researchers conducted semi-structured interviews with respondents from each center (n = 16). The topics covered included the process and experience of establishing the centers, stimulating demand for rapid reviews, collaborating between researchers and policymakers, and disseminating and using rapid reviews for health policies and interventions and the potential for sustaining and institutionalizing the services. Data were analyzed using thematic analysis., Results: Major themes interacted and contributed to shape the experiences of stakeholders of the rapid review centers, including the following: organizational structural arrangements of the centers, management of their processes as input factors, and the rapid reviews as the immediate policy-relevant outputs. The engagement process and the rapid review products contributed to a final theme of impact of the rapid review centers in relation to the uptake of evidence for policy and systems decision-making., Conclusions: The experiences of policymakers and researchers of the rapid review centers determined the uptake of evidence. The findings of this study can inform policymakers, health system managers, and researchers on best practices for demanding, developing and using rapid reviews to support decision- and policymaking, and implementing the universal healthcare coverage agenda., (© 2022. The Author(s).)

Objective: To provide an overview of retractions of research papers contributed by authors from the Arab region. Method: Papers in which the first author was affiliated to an Arabian country were selected from the Retraction Watch database covering the period 1 January 1998 to 31 December 2018. The retrieved records were divided into nine categories based on the reasons for retraction. Results: The search yielded 322 retractions, and the most frequent reason for retraction was plagiarism (34.5%). The median time from publication to retraction was 14 (25%-75% percentile 5-30) months. The number of papers retracted each year as well as the number of papers published in a given year but subsequently retracted increased steadily over the 21 years. The proportion of retracted papers to the total number of published papers (0.17%) was higher than the global proportion and was the highest for Algeria (1%) and the lowest for Lebanon (0.03%). Of the countries within the Arab region, 12 out of 14 countries showed either plagiarism or duplication as the most common reason for retraction; however, the countries differed in terms of the number of retractions and the time from publishing to retraction. Conclusion: Plagiarism was the most common cause of retraction in the Arab countries. The increase in the number of papers retracted each year was probably because searches now extend farther in the past, whereas the increase in the number of papers published in a given year but subsequently retracted can be attributed to the overall increase in the number of papers published. [ABSTRACT FROM AUTHOR]

How has education for refugees been shaped by broader dynamics of educational privatization? This paper argues that the invoking of the 'refugee crisis' narrative has been a crucial force in facilitating the privatization of this sector. The urgency of crisis helps to naturalize private actors' participation in refugees' education as equal partners to host governments, multilateral agencies, and civil society. Consistent with Stephen Ball's (2012) distinction between privatization in and of education, the privatization of refugee education also advances through two dimensions: the creation of a new space -- a new 'market' -- for private actors, and the infusion of market and business principles such as 'innovation' into all aspects of education. The crisis narrative has created a new 'horizon of taken-for-granted' (Hall, 1993), where it is simply natural that private actors must participate in the assumption of the traditional responsibilities of the state in providing education for refugees.

Promoting sustainable communities aims at creating both environmentally and socially responsible living environments. This paper explores the role of affordable housing in promoting the long-term sustainability of a community within healthy living conditions by closely examining the relationship between affordable housing, urban development policies, and sustainability, with the capital of Lebanon, Beirut, serving as a case study. The first part of the paper focuses on the current building laws issued in the official newspaper in 2004 using a content analysis methodology to demonstrate the impact of the changes in the laws on the new morphology and social fabric of the city through the creation of a favorable environment for big developers, wealthy property owners, and real estate agencies and, at the expense of old city residents and low-income families. The second part of the paper uses the qualitative analysis methodology to justify the presence of large unused stock of residential units in Beirut, referring to information from multiple data sources selected based on their applicability to sustainable development, affordable housing, and urban planning in areas related to the case study, Beirut. This part then investigates the potential presented by this stock of residential units in Beirut to increase the supply of affordable housing and foster a sustainable community. This paper argues that the promoted vertical expansion of the city weighs heavily on the environment and fails to provide a diverse mix of housing units, excluding a significant portion of the community from the city. Alternative development models aligning with principles of sustainable development and challenging the current building laws can promote social inclusivity, reduce urban sprawl, and minimize environmental impacts associated with new constructions, thus preserving the city's physical and social fabric. [ABSTRACT FROM AUTHOR]

This paper aims to determine the environmental benefits associated with the implementation of a solar PV system to complement the conventional Electricité Du Liban/genset electrical system for the delivery of energy to an industrial facility. The selected case study is a juice manufacturing industrial facility located in Lebanon. Its energy demand is 6000 MWh/year. The components of the PV/hybrid energy system are the following: one 420 modules PV generator, seven three-phase grid-dependent inverters, three 1000 kW generators and one 500 kW generator. The ecoinvent database is used to model the life cycle inventory, and the IMPACT 2002+ methodology is used for the life cycle impact assessment. Results show at the assembly level that the manufacturing of the photovoltaic modules, mounting system components, inverters and cables results in harmful emissions that increase the system's environmental impacts. However, a comparative analysis between the entire life cycle of the PV/hybrid system and the conventional system indicates that the incorporation of the photovoltaic system results in a reduction in environmental impacts across all categories. The end-of-life scenario comprises landfilling/incineration and recycling of the components. Results show that the end-of-life stage poses a minor contribution to the overall life cycle impacts. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate the effectiveness of Lebanon's Education Reform Strategy and Action Plan (LERSAP) set in 2011 as a form of the educational reform the curriculum underwent through focusing on promoting and employing the information communication technology (ICT) tools. The LERSAP was launched to equip teachers with the expertise and competencies adopted to bridge the disparity between the 1997 curriculum guidelines, general and instructional objectives on the one hand and the curriculum implementation, textbooks, and pedagogical practices on the other hand. The general objectives, introductions, instructional objectives, and activities for grades 3, 6, and 9 of the Lebanese English language curriculum were analyzed using the qualitative design implemented to serve the purposes of the study and to build on the approaches that inform about the theoretical/conceptual and empirical literature on education in Lebanon. The findings of the study indicated that the synthesis of the extant literature underscored the positive effect of the ICT tools in general and that of the WebQuest, Wiki, Google Drive, and Window Live Movie Maker models in particular on improving the pedagogical practices of the teachers and on enhancing the learners' skills as well as increasing the motivation of the learners.

This paper explores urban recovery as a participatory bottom-up process that highlights the importance and social significance of spaces of shared memories in reconstituting the built as well as the sociocultural fabrics of a place. It examines the multiple modes of engaging local communities in the process of recovering and rehabilitating shared public spaces, including organizing workshops to identify a space of common social significance, co-designing and co-producing a spatial intervention, and maintaining the intervention over the long term. The paper focuses on Karantina, a neighborhood in Beirut that became the site of post-disaster recovery in the aftermath of the Beirut Port blast in August 2020, and the spatial intervention that the urban recovery team at the Beirut Urban Lab implemented in the sub-neighborhood of Al-Khodor. In doing so, the paper contributes experiences from recent work on participatory modes of engaging the local community groups in Al-Khodor. It highlights the importance of community participation in researching, designing, implementing, and maintaining spatial interventions in the near absence of an active government in a country such as Lebanon. [ABSTRACT FROM AUTHOR]

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Seismic regulations of developing countries are often grounded on rules of more experienced countries. The Lebanese regulations refer to four foreign codes, this excess of guidelines generating confusion and conflicting design choices. Moreover, the scarcity of earthquakes recorded in the Lebanese area makes it difficult to obtain suitable sets of spectrum-consistent accelerograms for dynamic analyses. Sorting through the reference regulations and the indications for their local application, this paper derives and compares all the design response spectra allowed by the Lebanese code. Consistent with the design response spectra of the two codes that are still in force (of the four referred to), some suites of spectrum-consistent accelerograms are derived. Based on the Arias intensity, a general procedure is also proposed to reduce the time duration of the accelerograms, while saving the earthquake energy content and, thus, the reliability of the results. Full-length and short-length spectrum-consistent accelerograms are thus made available for the Lebanese design. With reference to a two-dimensional model some comparisons between response-spectrum-based and earthquake-based analyses are provided, which showed that the Lebanese code allows different safety levels for earthquake-resistant buildings. The paper provides a very useful contribution to researchers and designers that are involved in the protection of the Lebanese building heritage from seismic hazards, and it also provides data and tools that can be more generally exploited in other seismic areas. [ABSTRACT FROM AUTHOR]

The present paper attempts to answer the following research questions: (1) What are students' attitudes towards distance education during COVID-19? (2) What are students' feelings and opinions towards online education? (3) What are the impacts of distance learning on students' development of their PCK skills? And (4) What is students' academic achievement in taught online science education courses? To collect data, a total sample of 117 students enrolled in undergraduate program for science teaching at the elementary level, was used. Data was collected over three semesters, during the academic years 2020/2021 and 2021/2022. The data collection tools used are: a. a questionnaire administered to students enrolled in their 2nd through the 6th semesters, at the Faculty of Education, Lebanese University, at the end of science education courses, b. students' grades in formative and summative assessments in science education courses, c. students' drawing themselves as remote learners, and d. a post-interview of a purposeful sample. Data analysis was done using interim analysis in the form of post-zoom class conferences and data validation using member check at the end of courses. Findings showed that students at the beginning of the state successive and long lockdowns were happy to learn remotely. But as time passes, they were dissatisfied with online learning, 38% of students missed the campus life and 16% lacked the interaction with their teachers and classmates. In addition, students' academic performance decreased significantly and many were concerned about the little expertise to deal with students in real classes. For 57% of students, distance learning was difficult than classroom, and 70.5% admitted that home environment was not suitable for participating in online lectures due to distractions by their families. Quality teaching and the need for evaluation the online teaching/learning process at the level of the Faculty of Education and the Lebanese University is an urgent need. [This paper was presented at ICSES Conference, Antalya, Turkey, 10-13 November 2022.]

Background/Aims: Chronic inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis are known for a combination of food intolerance, decreased oral intake, and malabsorption which all predispose patients to malnutrition and suboptimal dietary intake. The present study was conducted to 1) examine self-reported food intolerances and dietary supplement use 2) assess nutritional intake 3) assess the nutritional status and screen for malnutrition among patients with chronic inflammatory bowel disease (CIBD). Methods: 48 patients with CIBDs (28 Crohn's disease, 15 ulcerative colitis and 7 with atypical forms of IBD) took part in this cross-sectional study. Participants completed a food frequency questionnaire targeting dietary intakes and food trends over time. A questionnaire about food intolerance was also used. The nutritional status of patients with CIBDs was evaluated by a detailed history (medical diagnosis and medications and supplements administered) and by using the subjective global assessment (SGA) tool. Anthropometric data including height, weight, and BMI with body composition assessment using automated scales and stadiometer, while Bio-impedancemetry was used to measure body fat and visceral fat. Statistical analysis was conducted using SPSS 27, employing mean values, standard deviations, absolute and relative frequencies and Pearson's chi-square test, with significance set at p ≤ 0.05. Results: Food intolerance was equally common in all the types of CIBD specifically for dairy products, spicy foods, and high-fiber food items (beans and raw vegetables). Individuals with CIBD were also complaining about meat and chicken products (68%), followed by alcohol and soda (64%) and fish and sea foods (59%). 17% of the patients were malnourished. A significant percentage of malnourished patients with CIBD had to follow a diet outside the flare, had a nutritional follow up, were currently taking corticosteroids and had a severe form of the disease compared to patients who were well nourished. Conclusions: This study has contributed valuable insights into the understanding that some food items could be associated to periods of increased disease activity in CIBD patients and that awareness/intervention regarding nutrition must be provided by healthcare professionals (dietitians, physicians...) to decrease the need for second line therapy. In addition, this self-reported food intolerance paper gives an insight for patients on food items usually avoided by CIBD patients during flares. [ABSTRACT FROM AUTHOR]

Fine particles (PM2.5) have generally been reported as the major contributor to the adverse health effects of air pollution. Lebanon is characterized by a high density of transport, the production of electricity by generators, and a problem of uncontrolled incineration of household waste. For the purpose of this paper, the physico-chemical properties of fine (PM2.5-0.3) and quasi-ultrafine (PM0.3) particulate matter sampled in Southern Lebanon, were studied. Then, an evaluation and comparison of the toxicity of the different extracted fractions from PM (i.e., native PM2.5-0.3 vs. organic extractable matter fraction (OEM2.5-0.3), and non-extractable matter fraction (NEM2.5-0.3)) was performed. Also, an examination of the toxicity of PM0.3 was conducted indirectly through the evaluation of the OEM0.3 harmfulness. The physico-chemical analysis showed that PM0.3 was much more concentrated than PM2.5-0.3 in organic compounds such as polycyclic aromatic hydrocarbons (PAHs) (28-fold) and their nitrated (N-PAHs, 14-fold) and oxygenated (O-PAHs, 10-fold) derivatives. Normal human bronchial epithelial cells (BEAS-2B) were exposed to PM2.5-0.3, its derived fractions (i.e., OEM2.5-0.3 and NEM2.5-0.3), and OEM0.3 before evaluating the global cytotoxicity, metabolic activation of organic compounds, genotoxicity, and inflammatory response. Different responses were observed depending on the considered fraction of particles. The global cytotoxicity showed a pronounced response related to ATP and LDH activities after exposure to the quasi-ultrafine organic extractable matter fraction (OEM0.3). There was no significant induction of the AhR cell-signaling pathway by NEM2.5-0.3. Despite the apparent difference in the kinetics of induction of the toxicological endpoints under study, OEM0.3 provoked a higher overall cytotoxicity and genotoxicity than OEM2.5-0.3 and total PM2.5-0.3. Taken together, these results clearly showed that the finest particles are more damaging to BEAS-2B cells than PM2.5-0.3 because they are richer in organic compounds, thereby inducing more remarkable toxic effects. [ABSTRACT FROM AUTHOR]

Mutated or unmutated immunoglobulin heavy chain (IGHV) gene is an important prognostic factor in chronic lymphocytic leukemia (CLL). However, a small fraction of patients with CLL are classified as borderline (BL)-IGHV. Few data are available on this subgroup of CLL. In this paper, we retrospectively report and analyze data from 21 patients with BL-IGHV CLL, showing the heterogeneity of this subgroup of CLL and paving the way for more research focusing on this entity to optimize the management and treatment of patients with Borderline- IGHV CLL. [ABSTRACT FROM AUTHOR]

Rockfalls are incidents of nature that take place when rocks or boulders break from a steep slope and fall to the ground. They can pose considerable threats to buildings placed in high-risk zones. Despite the fact that the impact of a rockfall on a building can cause structural and non-structural damage, few studies have been undertaken to investigate the danger associated with this event. Most of these studies indicated that the risk resulting from rockfall hazards is hard to forecast and assess. A comprehensive quantitative risk assessment approach for rockfalls on buildings is developed and described in this paper and applied for the Mtein village in Mount Lebanon. This method employs a 3D model to simulate the rockfall trajectories using a combination of digital elevation data, field surveys, and orthorectified aerial photographs. The spatial and temporal probability of rockfalls were evaluated using the analysis of historical data in two triggering-factor scenarios: earthquake and precipitation. The findings show that, during the period of 1472 years between the years 551 (the first observed large earthquake in Lebanon) and the current year of the study (2023), the temporal probability will potentially be equal to 0.002 and 0.105 in the cases of earthquake- and rainfall-triggered rockfalls, respectively, while the maximal damage values are expected to be 232 USD and 10,511 USD per year, respectively. The end result is a final map presenting the risk values assigned to each building that could be damaged by rockfalls. [ABSTRACT FROM AUTHOR]

The importance of international collaboration in the research field is well-documented, but its impact on the number of citations received by research publications is not fully understood. This paper aims to fill this gap by examining the relationship between international collaboration and other factors and the number of citations for research publications. Using data from the Lebanese American University, the authors employ ordinary least squares estimation to analyze the impact of international collaboration on the number of citations while controlling for various publications, authorship, university, and socioeconomic factors. The results show that international collaboration has a statistically significant positive effect on the number of citations. Based on these findings, we recommend that institutions and researchers seeking to increase the number of citations for their publications should focus on building and maintaining strong international collaborations and publishing in high-quality journals. This paper provides evidence of the importance of international collaboration for researchers seeking to increase the reach and impact of their publications. It also provides insights into the relevance of other factors, such as the number of publications, age, and journal rank. [ABSTRACT FROM AUTHOR]

Introduction: The Lebanese government estimates the number of Syrian refugees to be 1.5 million, representing 25% of the population. Refugee healthcare services have been integrated into the existing Lebanese health system. This study aims to describe the integration of Syrian refugee health services into the Lebanese national health system from 2011 to 2022, amid an ongoing economic crisis since 2019 and the COVID-19 pandemic. Methods: This paper employs a mixed-methods approach drawing upon different data sources including: 1- document review (policies, legislation, laws, etc.); 2- semi-structured interviews with policymakers, stakeholders, and health workers; 3- focus group discussions with patients from both host and refugee populations; and 4- health systems and care seeking indicators. Results: Although the demand for primary health care increased due to the Syrian refugee crisis, the provision of primary health care services was maintained. The infusion of international funding over time allowed primary health care centers to expand their resources to accommodate increased demand. The oversupply of physicians in Lebanon allowed the system to maintain a relatively high density of physicians even after the massive influx of refugees. The highly privatized, fragmented and expensive healthcare system has impeded Syrian refugees' access to secondary and tertiary healthcare services. The economic crisis further exacerbated limits on access for both the host and refugee populations and caused tension between the two populations. Our findings showed that the funds are not channeled through the government, fragmentation across multiple financing sources and reliance on international funding. Common medications and vaccines were available in the public system for both refugee and host communities and were reported to be affordable. The economic crisis hindered both communities' access to medications due to shortages and dramatic price increases. Conclusion: Integrating refugees in national health systems is essential to achieve sustainable development goals, in particular universal health coverage. Although it can strengthen the capacity of national health systems, the integration of refugees in low-resource settings can be challenging due to existing health system arrangements (e.g., heavily privatized care, curative-oriented, high out-of-pocket, fragmentation across multiple financing sources, and system vulnerability to economic shocks). [ABSTRACT FROM AUTHOR]

The management of solid waste in Lebanon has evolved into a complex issue, marked by its deleterious environmental, economic, and public health ramifications for both civilians and the state exchequer. Despite the longstanding nature of Lebanon's municipal waste predicament, it escalated to catastrophic proportions in 2015 following the closure of Naameh, the nation's largest landfill. The persisting crisis from 2015 endures due to the government's inadequate and poorly conceived solutions, with the potential to rekindle at any juncture. This paper addresses two fundamental concerns. Initially, a comprehensive portrayal of the municipal solid waste scenario in Lebanon is provided, encompassing its diverse facets. Subsequently, the researchers advocate an integrative approach amalgamating centralized and decentralized systems. Pioneering a strategic proposal to address Lebanon's solid waste predicament, the researchers employ a Journey-Making (JM) methodology to discern direct and indirect actors. Subsequently, a game theory approach, facilitated by the Graph Model for Conflict Resolution (GMCR+) software, is utilized to derive solutions that cater to the satisfaction of all involved parties. The selection of the optimal scenario is contingent upon the available options for the primary stakeholders, factoring in the political, sectarian, economic, and environmental landscape of Lebanon. [ABSTRACT FROM AUTHOR]

Within multi-national research collaborations, power dynamics often shape who is involved in which parts of the research process. The analysis phase of research has historically been framed as requiring expert perspective, excluding national or local researchers whose role is often limited to collecting data and transferring it to others to analyze. In this paper, we describe and reflect on the process of collaborative coding across a multi-national team based in Lebanon and the United Kingdom, as part of a broader approach to co-production. We explore the value and benefit of collaborative coding, reflecting on how coding together enabled greater inclusion, teamwork, improved analysis as well as improved future data collection. We also discuss the technical and logistical challenges we faced in coding within a team and using internet-based software, including the complications involved in navigating power dynamics between researchers and coming to final decisions about codes. Over time, we found collaborative coding became a smoother process, however working in this way is not straight-forward. Our paper contributes a reflexive analysis on the power dynamics and decision-making complexities involved in collaborative coding. It emphasizes the importance of investing in interpersonal relationships over time and prioritizing less-centralized decision-making within research collaborations. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the links between knowledge risks, organizational performance and knowledge-intensive firms (KIFs)' sustainability. Design/methodology/approach: A questionnaire was administered with a sample of 427 respondents from Lebanon. The gathered data were analyzed using SEM approach. Findings: The empirical evidence confirms the potential role of knowledge risks in reducing the sustainability of firms. Furthermore, organizational performance was revealed to partially mediate the relationship between knowledge risks and sustainability. Practical implications: The study's findings inspire managers of KIFs to use effective knowledge management practices to mitigate potential knowledge risks. Originality/value: Knowledge risks and knowledge risk management are still unexplored in the literature. This paper is a pioneering study that advances the knowledge management field by emphasizing the significance of knowledge risks and their influence on the performance and sustainability of KIFs in Lebanon, a country with a culture distinct from that of Western contexts. [ABSTRACT FROM AUTHOR]

Introduction: Lebanon has battled the COVID-19 pandemic in the midst of an economic crisis. The evolution of the pandemic and a fragile health system have meant that public health policy has had to rely heavily on non-pharmaceutical interventions for disease control. However, changes in disease dynamics, an unraveling economy, and pandemic fatigue have meant that disease control policies need to be updated. Methods: Using recent and timely data on older (50 years and above) Syrian refugees in Lebanon, this paper uses multivariate linear probability models to explore the determinants of adherence to two non-pharmaceutical COVID-19 prevention measures (wearing a mask and avoiding social gatherings) among this high-risk subgroup in a vulnerable population. Among respondents who report adhering to these measures, the paper also investigates the determinants of sustained adherence over a period of 6 months. Results: The findings suggest that no individual-level characteristics were robustly associated with mask wearing. For avoiding social gatherings, education was inversely associated with adherence to this preventive measure. Avoiding social gatherings was also significantly lower for residents of informal tented settlements (ITSs). Among initial adherents, and for both preventive practices, ITS dwellers were also significantly less likely to maintain adherence. Conclusion: Identifying variables associated with adherence to non-pharmaceutical preventive practices, particularly for vulnerable groups, can help inform and refine interventions in the face of changing conditions. The material, physical, administrative and socio-economic constraints of life in an ITS suggest that avoiding social gatherings is hardly feasible. Yet despite the challenging conditions of ITSs, the indication to wear a mask is initially complied with, suggesting that tailoring policies to the limits and constrains of context can lead to successful outcomes even in very adverse settings. [ABSTRACT FROM AUTHOR]

Solar power is an effective way to reduce the dependency on conventional fuels and mitigate the water and energy shortage issue. The main aim of the current paper is to assess and compare the techno-economic feasibility of rooftop grid-connected photovoltaic energy systems for generating electricity and generating drinkable water in Nahr El Bared, Lebanon. To this aim, the present paper first reviews previous scientific studies associated with the water resources and energy situation to summarize the current status in Lebanon. According to this review, Lebanon's water resources are highly polluted, domestic and industrial sewage is largely untreated, and intolerable agricultural practices further exacerbate the situation. Furthermore, population and economic growth and the continuous utilization of old power plants have led to an increase in the number of hours of power outages in the country. Accordingly, the proposed project aims to evaluate the viability of using solar energy as an alternative solution to the shortage of water and energy in the country. Secondly, the techno-economic performance of the proposed system in the selected region was evaluated based on the variations in financial parameters using RETScreen Experts software. The results demonstrate that 11770-13451kWh/yr could be generated from the solar system, which can help reduce the energy shortage and generate drinkable water. Furthermore, the investment was found to be economically viable and attractive for investors. This paper concludes that solar energy can be able to solve the energy shortage of electricity, reduce the country's electricity costs, and produce freshwater for drinking and domestic use in the country. [ABSTRACT FROM AUTHOR]

Purpose: The current study examined employment rates and predictors of employment among Syrian refugees currently living in Lebanon and Jordan. This paper argues that men and women refugees have different experiences seeking out employment after resettlement due to patriarchal structures and attitudes toward women that are present in the Arab Middle East. The goals of this paper were a) to examine employment rates among Syrian refugees, b) to examine predictors of employment among male and female refugees, and c) to examine refugee status as a moderator of the relationship between attitudes toward women and employment status. Design/methodology/approach: Nationally representative data from the Arab Barometer on 600 refugees and 1400 native-born individuals living in Lebanon and Jordan from 2016–2017 were used. Findings: Native-born individuals living in Lebanon and Jordan were 2.16 times more likely to be employed than refugees. Men living in Lebanon and Jordan were 7.83 times more likely to be employed than women. Finally, refugee status moderated the relationship between attitudes toward women's rights and roles and employment. Among native-born women, a positive attitude toward women's rights and roles predicted employment status, whereas this positive relationship was not found for women refugees. Among refugee men, a positive attitude toward women's rights and roles was linked to a lower likelihood of holding a job. Practical implications: These findings suggest that agencies supporting refugees should communicate realistic expectations about employment during resettlement and should address the challenges that women refugees face when seeking employment. Originality/value: This study is the first study to identify attitudes toward women's rights and roles as a predictor of employment among refugee populations and highlights the unique struggles that refugee women face. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic significantly increased the usage of various types of face masks. In addition, it triggered the rapid manufacture of new production lines of masks to cope with the unprecedented demand to overcome worldwide shortages. Such masks, which were previously used mostly by the health care personnel, became a daily necessity to the greater mainstream population. This rapid and sudden increase in their usage and the fact that new masks' innovations are progressively emerging to meet the growing global shortage requires an ongoing analysis on the factors associated with the fit and comfort while using these masks. Methods: This paper presents the first translation and validation of the R-COMFI questionnaire to evaluate the comfort of a newly developed filtering face-piece respirator by the research team at the University of Antwerp. The questionnaire, which consists of 3 sections: Discomfort, General wearing experience, and Function, was translated from English to Arabic and involved 43 participants in the Lebanese Red Cross healthcare field based in Lebanon. Results: The results showed discomfort factors that are mostly related to breathability and sweating caused by mask usage. Additionally, the results revealed that female respondents found the mask significantly less comfortable than male respondents (p-value with the two-tailed test is 0.0319), which confirmed that future validations should consider the concerns of both genders, and validated the R-COMFI translation exercise detailed in this paper. Discussion: The contribution of this paper can be pinned down into three findings. The first finding is related to the discomfort issues. The second finding highlighted a significant difference in comfort experience between females and males. The last finding is the translation validation of the R-COMFI instrument, which confirmed that the questionnaire can be applied among wider geographical locations. [ABSTRACT FROM AUTHOR]

Many studies have been conducted worldwide to study travel behavior, specifically commuting times. Nevertheless, few or none have been conducted in the Middle East and North Africa region. The main objective of this paper is to understand the relationship between the actual, ideal and maximum willingness to commute times, and satisfaction with commuting in the city of Jounieh, Lebanon. Socio-economic and land use factors were included to investigate whether they influence commuting times. The average commuting time of the sample is 48.2 minutes, longer than their ideal commute time by about 20 minutes, while their maximum willingness to commute time is 53.46 minutes. The sample was neither satisfied nor dissatisfied with their commutes. After performing multivariate Ordinary Least Squares model, and fixing the socio-economic and land use variables, the model proved that the actual and ideal commuting times as well as the actual and maximum commuting times are positively correlated, but the actual commuting time and satisfaction are negatively correlated. A univariate Ordinary Least Square model was performed to determine the correlation between ideal and maximum commuting times; they are highly positively correlated. Finally, the average commuting times and satisfaction were compared for some categories. Women spend almost 13% less time commuting than men, yet they have lower level of satisfaction. Lebanese commuters are also shown to commute more than non-Lebanese ones by approximately 22%. University level commuters commute about 36% more than non-university level people, while unemployed and employed respondents commute for the same time. [ABSTRACT FROM AUTHOR]

Because intercultural communication has become one of the most demanded skills in the current digitalized world, many educational institutions aspire to graduate students who possess intercultural skills and are able to successfully communicate with people from diverse cultures. However, intercultural communication has not received much attention in the Lebanese context, especially in schools. To this end, this paper examined the Lebanese high school directors' perceptions of intercultural communication. As pragmatists, the researchers employed quantitative and qualitative methods to better understand the problem under investigation. Using a snowball sampling, they surveyed the perceptions of 55 Lebanese director.s in private and public high schools and interviewed two informants in the Center for Educational Research and Development. The collected data were analyzed quantitatively and qualitatively. Then, the derived conclusions were compared to ensure trust worthiness of the findings. Major findings showed that though intercultural communication is a learning outcome in most schools, it is mostly taught at the knowledge level in the foreign language classrooms. Assessment of this outcome was neither systematic nor consistent. It was also shown that directors in private schools tended to be more informed than those in the public sector. Recommendations are made for enhancing intercultural communication skills in Lebanese educat.ional institutions. [ABSTRACT FROM AUTHOR]

Purpose: The paper explores the inflationary consequences of the Lebanese economic and financial crises on Lebanese society. The study investigates the distribution of inflationary harm across various demographic characteristics, including age, marital status, educational level, employment type, region of residence, income range and type. It also identifies the different coping mechanisms adopted by the Lebanese people to survive during the inflationary period. Design/methodology/approach: The study surveys 168 Lebanese citizens to determine which groups of people are most affected by inflation, its impact on their quality of life and the different coping mechanisms the citizens employ to endure the period of growing prices. Findings: The results show that some groups of Lebanese citizens are more influenced than others by rising prices. The categories of people who suffer the most from inflation are the elderly, the widowed, those characterized by low educational and low-income levels, the unemployed, the retired and public sector employees, as well as homemakers. Originality/value: This study provides policymakers with substantial information regarding the economic and social well-being of Lebanese citizens by highlighting the categories of people in need for special financial and social support. The findings can guide targeted policy interventions to support vulnerable populations. The study can also inform future research on the impact of the crisis and the effectiveness of policies. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-11-2022-0736 [ABSTRACT FROM AUTHOR]

Introduction: Lebanon is a middle-income country facing substantial fragility features. Its health profile shows a high burden of NCD morbidity and mortality. This paper intends to analyse the political economy of NCD prevention and control in Lebanon. Methods: This study adopted a literature-based case study research design using a problem-driven political economy analysis framework. A total of 94 peer-reviewed articles and documents from the grey literature published before June 2019 were retrieved and analysed. Results: Lebanon's political instability and fragile governance negatively affect its capacity to adapt a Health-in-All-Policies approach to NCD prevention and enable the blocking of NCD prevention policies by opposed stakeholders. Recent economic crises limit the fiscal capacity to address health financing issues and resulting health inequities. NCD care provision is twisted by powerful stakeholders towards a hospital-centred model with a powerful private sector. Stakeholders like the MOPH, UN agencies, and NGOs have been pushing towards changing the existing care model towards a primary care model. An incremental reform has been adopted to strengthen a network of primary care centres, support them with health technologies and improve the quality of primary care services. Nevertheless, outpatient services that are covered by other public funds remain specialist-led without much institutional regulation. Conclusion: Our study revealed a locked equilibrium in NCD prevention policymaking in Lebanon, but with an incremental progress in service delivery reforms towards a primary care model. Advocacy and close monitoring by policy entrepreneurs (such as civil society) could initiate and sustain the implementation of policy change and care model reforms. [ABSTRACT FROM AUTHOR]

Agroclimatic classification identifies zones for efficient use of natural resources leading to optimal and non-optimal crop production. The aim of this paper is the development of a methodology to determine sustainable agricultural zones in three Mediterranean study areas, namely, "La Mancha Oriental" in Spain, "Sidi Bouzid" in Tunisia, and "Bekaa" valley in Lebanon. To achieve this, time series analysis with advanced geoinformatic techniques is applied. The agroclimatic classification methodology is based on three-stages: first, the microclimate features of the region are considered using aridity and vegetation health indices leading to water-limited growth environment (WLGE) zones based on water availability; second, landform features and soil types are associated with WLGE zones to identify non-crop-specific agroclimatic zones (NCSAZ); finally, specific restricted crop parameters are combined with NCSAZ to create the suitability zones. The results are promising as compared with the current crop production systems of the three areas under investigation. Due to climate change, the results indicate that these arid or semi-arid regions are also faced with insufficient amounts of precipitation for supporting rainfed annual crops. Finally, the proposed methodology reveals that the employment and use of remote sensing data and methods could be a significant tool for quickly creating detailed, and up to date agroclimatic zones. [ABSTRACT FROM AUTHOR]

The Pine Processionary Moth (PPM) Thaumetopoea wilkinsoni has long been attacking Mediterranean forests. In its management strategy, Lebanon has focused mainly on pesticides, leaving natural predators as an understudied control option. This study aims to understand the distribution of the Eurasian Hoopoe Upupa epops, by assessing the damage caused by the PPM. We attempted to explain the distribution of the two species, their relation to other factors and, with a Citizen Science (CS) approach, we developed their distribution maps. We found that the varying PPM damage between cadastral units was linked to Important Bird Areas (IBAs), highlighting the importance of multiple birds, including the Eurasian Hoopoe, as natural predators of this pest and calling for their conservation. As understudied species in Lebanon, this paper sets the path and offers guidelines for future researchers willing to work on similar crucial research in a climate change context and reveal the underlying relation between the two species. [ABSTRACT FROM AUTHOR]

The degree and nature of participation of disabled persons in the labor market have many direct and indirect effects on their living standards and quality of life. Therefore, this is a critical area for investigation and policy concern. This paper seeks to quantify the relationship between disability and labor force participation in Lebanon, a topic that has not received much attention in the literature. The empirical analysis is performed using an individual-level data set obtained from the Lebanese Labor Force and Household Conditions Survey (2019). A firthlogit model was estimated in order to capture the relationship between disability and employment status. The empirical findings reveal that people who report a disability condition have a much lower likelihood of participating in the labor force. This finding is robust even after controlling for other characteristics such as age, marital status and education. We propose several policy recommendations based on our findings that might be helpful to the inclusion of disabled people in the labor market. [ABSTRACT FROM AUTHOR]

The objective of the current paper is to evaluate Lebanon's wind energy generation potential as an alternative solution to the electricity supply to households and to enhance sustainable technological development. Firstly, the paper aims to investigate the appropriateness of 44 distribution function models for the evaluation of wind speed characteristics and compared them with popular models at 12 locations in Lebanon for the first time. The results showed that Wakeby and Beta distribution functions gave the best fit to the actual data for most locations. Secondly, the techno-economic and environmental feasibility assessment for 10MW grid-connected wind farms was developed based on variations in financial parameters using RETScreen Experts software. The findings demonstrate that the proposed power plant is both technically and financially feasible. It was found that Ain ed Dabaa is the most viable location for the installation of a wind farm. [ABSTRACT FROM AUTHOR]

In recent years, increasing attention has been paid to the ways refugees in displacement manage to organize themselves and act upon their needs. The growing recognition in the UN system of the importance of localization of aid and the potential role played by local actors has given refugee-led organizations (RLO) a space to grow. In this paper, we analyze refugee agency and solidarity through the organization of the refugee communities in Turkey, Jordan, and Lebanon. In doing so, we examine: (1) the reasons behind the creation of these organizations and their dynamics; (2) the role of host states toward this drive to organize refugee communities; and (3) the patterns, forms, and structures that these organizations take in providing humanitarian services, as well as community support and empowerment. [ABSTRACT FROM AUTHOR]

Background: Health information records in many countries, especially developing countries, are still paper based. Compared to electronic systems, paper-based systems are disadvantageous in terms of data storage and data extraction. Given the importance of health records for epidemiological studies, guidelines for effective data cleaning and sorting are essential. They are, however, largely absent from the literature. The following paper discusses the process by which an algorithm was developed for the cleaning and sorting of a database generated from emergency department records in Lebanon. Design and methods: Demographic and health related information were extracted from the emergency department records of three hospitals in Beirut. Appropriate categories were selected for data categorization. For health information, disease categories and codes were selected according to the International Classification of Disease 10th Edition. Results: A total of 16,537 entries were collected. Demographic information was categorized into groups for future epidemiological studies. Analysis of the health information led to the creation of a sorting algorithm which was then used to categorize and code the health data. Several counts were then performed to represent and visualize the data numerically and graphically. Conclusions: The article describes the current state of health information records in Lebanon and the associated disadvantages of a paper-based system in terms of storage and data extraction. Furthermore, the article describes the algorithm by which health information was sorted and categorized to allow for future data analysis using paper records. [ABSTRACT FROM AUTHOR]

Nowadays, Social media is heading toward personalization more and more. People express themselves and reveal their beliefs, interests, habits, and activities, simply giving a glimpse of their personality traits. The thing that pushed us toward further investigating the mutual relation between personality and social media, taking into consideration the shortage in covering such important topic, especially in rich morphological languages. In this paper, we work on the connection between usage of Arabic language on social outlets (mainly Facebook and Twitter) and personality traits. We indicate the personality traits of users based on the information extracted from their activities and the content of their posts/tweets in Social Networks. We use linguistic features, beside some other features like emoticons. We gathered personality data using Arabic personality test based on Myers-Briggs Type Indicator (MBTI), which contains Thinking, Feeling, Intuition, Introversion, Sensation, Extroversion, Perceiving and Judgement traits. We collected our dataset from 522 volunteers, who permitted us to crawl their tweets and posts in Twitter and Facebook. Analysis of this dataset proved that some linguistic features could be used to differentiate between different personality traits. We used and implemented Deep Learning, and BERT to reveal personality and create a model for this purpose. Up to our knowledge, this is the first work on detection of personality traits from social network's data in Arabic language. [ABSTRACT FROM AUTHOR]

This paper investigates the determinants of refugee students' social integration in Lebanon, Turkey, and Australia. This paper seeks to understand how legal status and the corresponding length of refugee asylum shape refugee children's social integration. The three host countries offer refugees different legal statuses ranging from short-term in Lebanon, medium-term in Turkey, and long-term in Australia. Therefore, our data collection covers a sample of 1298 middle school refugee students from all three countries. Our probit regression analysis sheds light on the importance of micro-level factors related to individual and household characteristics and meso-level factors related to school factors shaping refugee students' social integration. The statistical dominance of meso-level factors indicates that the within-country differences are stronger than the between-country differences, yet it does not rule out the importance of macro policies that indirectly influence refugee students' social integration by shaping provisions at the micro and meso levels. [ABSTRACT FROM AUTHOR]

Background: Since 2019 Lebanon has faced multiple compounded crises. Political and social instability, the COVID-19 pandemic, and the Beirut Port explosion, alongside the influx of refugees related to the ongoing Syrian conflict, have resulted in a nationwide economic emergency. In the context of the humanitarian response to the Syrian conflict, the UN and government-led gender-based violence (GBV) task force has coordinated the sub-sector since 2012. The compounded crisis, however, created new challenges for GBV coordination and service delivery, which we explore in this paper. We highlight lessons for strengthening GBV coordination in Lebanon and other complex emergencies. Methods: We conducted 29 remote in-depth interviews, reviewed key policy documents and observed seven GBV task force meetings. We analysed and presented our findings across three key themes: context-relevant and adaptable coordination mechanisms; coordination to support GBV service delivery; and stakeholders' roles, legitimacy and power. Results: Parallel response frameworks developed to address the multiple crises, created a complex humanitarian architecture within an increasingly challenging operating context, with some perceived inefficiencies. Positively, coordination was integrated under the established government-UN interagency system and the GBV task force maintained GBV sub-sector coordination. The task force was commended for effectively adapting to the evolving context, including working remotely, maintaining essential GBV services, assessing the compounded crises' impact on programming and adjusting accordingly, and harmonising guidance, tools and approaches. The importance of ensuring a government co-led response was highlighted by both UN and government informants, who pointed to examples where marginalising government leadership compromised coordination effectiveness and sustainability. The participation of local actors had become increasingly important but more difficult, with the impact of the various crises, and remote modalities, challenging service delivery and staff wellbeing. Conclusion: Experiences from Lebanon highlight the essential role of government leadership in coordination; the value of investing in local GBV capacity; the significance of effective national, subnational and intersectoral coordination to support service delivery and address cross-cutting GBV issues; the importance of targeted interventions to support marginalised populations; and the need to prioritize the well-being of front-line staff during crisis response. In Lebanon, and other complex crises, donors are encouraged to increase flexible, multiyear funding for GBV coordination and services, while women-led organizations should be at the forefront of recovery efforts, contributing to a more equitable society. [ABSTRACT FROM AUTHOR]

Background: Dysfunctional metacognitive processes and emotional dysregulation have been widely documented in the eating disorder literature. Despite numerous research and recent consensus suggesting the categorization of orthorexia nervosa as a form of eating disorder, no previous study has examined whether aberrant metacognitive processes also correlate with orthorexia nervosa tendencies. This paper investigates potential associations between symptoms of orthorexia nervosa and dysfunctional metacognitive processes while also exploring whether such relationships may be influenced by adaptive/maladaptive emotion regulation strategies. Methods: We conducted a cross-sectional study in all Lebanese governorates. In total, 423 Lebanese adults completed an online questionnaire including the Teruel Orthorexia Scale, the Emotion Regulation Questionnaire, the Difficulties in Emotion Regulation Scale – 16 Item Version, and the Metacognitions Questionnaire – Short Form. Results: Higher physical activity, expressive suppression, emotion regulation difficulties, positive metacognitive beliefs about worry, and need to control thoughts were significantly associated with higher orthorexia nervosa. Additionally, the emotion regulation strategies moderated the relationships between two dysfunctional metacognitive processes and orthorexia nervosa. Specifically, cognitive self-consciousness was negatively related to orthorexia nervosa only in individuals with low (versus higher) emotion suppression (maladaptive emotion regulation strategy). In contrast, negative beliefs about worry uncontrollability and danger positively predicted orthorexia nervosa only in individuals with lower (versus high) cognitive reappraisal (adaptive emotion regulation strategy). Lower socio-economic status and having a university level of education compared to secondary level were significantly associated with lower orthorexia nervosa. Conclusion: Our study provides the first empirical evidence for the existence of significant associations between dysfunctional metacognitive processes and orthorexia nervosa. It also highlights that these pathways are considerably modulated by individuals' ability to regulate their emotions adaptively versus maladaptively. Our findings thus suggest that therapies aimed at improving thought monitoring and emotional regulation may be beneficial for individuals with symptoms of orthorexia nervosa. [ABSTRACT FROM AUTHOR]

This paper uses unique data from Lebanon to explore the factors affecting promotion in academia. We use the Ordered Probit model to answer the research question empirically. The results indicate that the number of publications is an essential factor affecting promotion decisions. Moreover, our findings indicate a quadratic relationship between age and promotion, reaching a peak at 62 years. After this turning point, age and promotion become negatively correlated. When dividing our sample by academic generations, we find that the number of publications is an important determinant for promotion only for the cohort who graduated after the year 2000. Finally, after dividing by gender, the results suggest that males and females who publish more have equal chances of earning a promotion. [ABSTRACT FROM AUTHOR]

INTRODUCTION Since the beginning of the COVID-19 pandemic, a growing number of studies have documented more severe COVID-19 symptoms and worse outcomes among smokers compared to non-smokers. The aim of this research is to understand the views, risk perceptions, and behaviors of Lebanese adult smokers during the pandemic. METHODS We conducted 18 qualitative online structured interviews with adults who smoke cigarettes and waterpipe tobacco residing in Lebanon from November 2020 through April 2021. Participants were recruited predominantly via paid social media ads. Interviews were audio-recorded using Zoom software then transcribed verbatim. Data were analyzed thematically. RESULTS The findings showed three main themes: changes to smoking behaviors, concerns over the susceptibility and severity of COVID-19, and using coping methods to protect smokers from COVID-19. Although there was an increased risk perception of COVID-19 in relation to smoking, most participants reported an increase in smoking. Instead of being encouraged to quit, participants developed coping strategies against COVID-19 while smoking. CONCLUSIONS Smoking behavior did not seem to decrease during the COVID-19 pandemic. To support cessation initiatives and raise awareness, effective health messaging aimed at smokers is pivotal. Smoking cessation programs need to be better equipped at supporting people who smoke in finding healthier coping mechanisms during a pandemic. Moreover, policies to regulate the propagation of misinformation are required to prevent the development of a false sense of safety and protection from COVID-19. [ABSTRACT FROM AUTHOR]

This paper analyzed the tools and techniques used by the leaders of five NGOs, used for online volunteer work. Due to the prominent role that NGOs play in the development sector we consider that it was necessary to talk about this issue that face volunteers' leaders. The descriptive research used a cross-sectional design, and the data was collected using qualitative research method. There were conducted 5 online interviews with 5 top managers in different NGOs that located in Lebanon, Spain, Qatar, Turkey. The results approved the research hypothesis of the efficacy of democratic leadership style with volunteers' teams online. Furthermore, social media impact, communication, engagement, and skills development with volunteers and lead to plenty of achievement in terms of work through efficient virtual management. [ABSTRACT FROM AUTHOR]

The post-pandemic age has heightened the importance of digitalizing organizational practices and fostering innovation for SMEs to ensure resilient business operations in a volatile work environment. This research paper examines the impact of digital transformation leadership on the digitalization of business practices and the development of innovative business models while considering the roles of organizational agility and knowledge transfer. A survey of 270 employees from SMEs in Lebanon was conducted using the convenience sampling technique. Data analysis was performed quantitatively through Partial Least Squares—Structural Equation Modeling (PLS-SEM). The results reveal that adopting digital transformation leadership fosters organizational agility, enabling effective digital transformation and business model innovation with a robust knowledge transfer system. This study contributes to the fields of digital transformation and innovation, and offers practical insights for SME managers navigating uncertainties and market volatility in the post-pandemic period. [ABSTRACT FROM AUTHOR]

Background: Excessive use of mobile phones leading to development of symptoms suggestive of dependence syndrome with teenagers are far more likely to become dependent on mobile phones as compared to adults. COVID-19 pandemic has had an impact on the mental health of several groups in society, especially university students. This study aimed to explore the prevalence of mobile phone dependence among university students and its associated factors. Methods: Between September 2021 and January 2022, a cross-sectional study was conducted at universities in Jordan, Lebanon, Egypt, Bahrain, and Saudi Arabia utilizing an online and paper-based self-administered questionnaire. We employed a previously developed questionnaire by Aggarwal et al. Results: A total of 5,720 university students were involved in this study (Egypt = 2813, Saudi Arabia = 1509, Jordan = 766, Lebanon = 432, and Bahrain = 200). The mean estimated daily time spent on using mobile phone was 186.4 (94.4) minutes. The highest mobile dependence score was observed for the university students from Egypt and the lowest mobile dependence score was observed for the university students from Lebanon. The most common dependence criteria across the study sample was impaired control (55.6%) and the least common one was harmful use (25.1%). Females and those reported having anxiety problem or using a treatment for anxiety were at higher risk of developing mobile phone dependence by 15% and 75%, respectively. Conclusion: Mobile phone dependence is common among university students in Arab countries in the Middle East region. Future studies exploring useful interventions to decrease mobile phone dependence are warranted. [ABSTRACT FROM AUTHOR]

Introduction: The Syrian crisis, followed by a financial crisis, port explosion, and COVID-19, have put enormous strain on Lebanon's health system. Syrian refugees and the vulnerable host population have a high burden of Non-communicable Diseases (NCD) morbidity and unmet mental health, psychosocial and rehabilitation needs. The International Committee of the Red Cross (ICRC) recently introduced integrated NCD services within its package of primary care in Lebanon, which includes NCD primary health care, rehabilitation, and mental health and psychosocial support services. We aimed to identify relevant outcomes for people living with NCDs from refugee and host communities in northern Lebanon, as well as to define the processes needed to achieve them through an integrated model of care. Given the complexity of the health system in which the interventions are delivered, and the limited practical guidance on integration, we considered systems thinking to be the most appropriate methodological approach. Methods: A Theory of Change (ToC) workshop and follow-up meetings were held online by the ICRC, the London School of Hygiene and Tropical Medicine and the American University of Beirut in 2021. ToC is a participatory and iterative planning process involving key stakeholders, and seeks to understand a process of change by mapping out intermediate and long-term outcomes along hypothesised causal pathways. Participants included academics, and ICRC regional, coordination, and headquarters staff. Results: We identified two distinct pathways to integrated NCD primary care: a multidisciplinary service pathway and a patient and family support pathway. These were interdependent and linked via an essential social worker role and a robust information system. We also defined a list of key assumptions and interventions to achieve integration, and developed a list of monitoring indicators. Discussion: ToC is a useful tool to deconstruct the complexity of integrating NCD services. We highlight that integrated care rests on multidisciplinary and patient-centred approaches, which depend on a well-trained and resourced team, strong leadership, and adequate information systems. This paper provides the first theory-driven road map of implementation pathways, to help support the integration of NCD care for crises-affected populations in Lebanon and globally. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis (CL), caused by an obligate intracellular protozoan parasite from the genus Leishmania, imposing a significant burden on underdeveloped countries especially those located in the Middle East. Four electronic databases were searched to evaluate the prevalence of CL in the Middle East. The random effects model (95% confidence intervals (CI)) were applied to determine the overall and subgroup pooled prevalence. Heterogeneity was assessed by Cochran's Q test and I2 statistics. Among 2424 peer-reviewed papers, 37 datasets from 34 studies were included in the current meta-analysis. 285560 individuals were assessed across 9 Middle Eastern countries. The pooled prevalence of CL was estimated at 12% (95% CI 9-15 %; 10718/285560). The highest prevalence rate was observed in Syria (39%, 37-42%), and the lowest one was found in Iraq and Lebanon (0%, 0-1%). The prevalence of CL in studies that applied LST assays had the highest rate (48%, 17-80%). The infection rate in males was similar to females (7%, 4-10%). The prevalence of infection in individuals living in urban areas was higher than in rural areas (14%, 10-19%). The prevalence of CL in the age group 0-15 years was higher than in individuals 16-40 and >40 years (9%, 6-13%). Most of the lesions were found on the face, and single lesions were more prevalent than two and three ones. In conclusion, the occurrence of CL was considerable in Middle Eastern countries. Therefore, more efforts should be made to precisely report the CL in this region for developing appropriate preventive and controlling strategies. [ABSTRACT FROM AUTHOR]