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Objective: The increasing number of COVID-19 cases, as well as the overwhelming workload, constitutes a serious occupational health threat to Emergency Room (ER) nurses working on the frontlines. In Lebanon, where unstable socio-economic conditions reign, the Covid-19 outbreak was added to the plethora of daily challenges faced by healthcare workers. The study’s objective is to explore how Lebanese ER nurses perceived their duty on the frontlines amid the Covid-19 pandemic. Methods: This study employed a descriptive exploratory qualitative design. 15 Lebanese ER nurses working directly with Covid-19 patients were recruited from 3 university hospitals in Beirut. Interviews were held for data collection until data saturation. Subsequent analysis was done via coding of the transcribed verbatim. Results: The findings showed significant gaps related to preparedness, support, and governmental action. Similarly, the frontliners faced serious challenges that increased their stress levels both physically and mentally. Furthermore, some participants were subject to stigma and had to face irresponsible behaviors during triage. Participants emphasized the need to guarantee a safe environment at work, to provide Covid-19 patients with the needed care. Conclusions: ER nurses struggled during this pandemic while working on the frontlines. They described their experience as not satisfying, with high levels of stress, danger, and challenges.

This study is the first attempt to assess exposure to metals and trace elements in subgroups of the Lebanese population using a multi-matrix biomonitoring approach. Concentrations of 11 metals and trace elements (aluminum (Al), arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), lead (Pb), manganese (Mn), selenium (Se), uranium (U), zinc (Zn)) were measured in urine, hair and toenails. Biological levels were compared according to age, sex, smoking status, socioeconomic status, geographical area and drinking water source. While most urinary and toenail concentrations of metals and trace elements were not different between males and females, measured concentrations of several elements in hair were higher in females compared to males. Urinary concentrations of some metals (Al, Cu, Se and Zn) were higher in children compared to teenagers and adults. Hair and toenail concentrations of several elements (As, Cd, Pb, Mn, Se in hair and toenails plus Al, Fe in toenails) were also significantly higher in children compared to teenagers and/or adults. Smoking status had no influence on metal and trace element concentrations. Levels of Cd, Pb and Mn were also higher in samples from subgroups with lower economic status (Cd and Pb in the three matrices and Mn in hair and toenails). Very few correlations were identified between sources of drinking water and urine, hair, and toenail concentrations of metals and trace elements. However, a correlation was observed between hair and toenails levels of As, Cd and Pb. Overall, results highlight that a special attention should be given to metal and trace element exposure in this population (including Pb, As, Cd, Mn, and Se). It could be relevant to scale up this kind of investigation with a large human biomonitoring initiative in the Lebanese population in order to generalize results, and assess trends over time.

The main aim of this national survey was to identify the levels of colorectal cancer screening knowledge and uptake in Lebanon.A total of 1200 participants were enrolled in this cross-sectional household survey targeting the Lebanese population aged 50 years and above. The sample was recruited using a two-stage stratified cluster sampling approach.Of the total sample, 38.3% knew about any screening test for colorectal cancer but only 7.5% had ever used any. Thirty-nine percent of the participants rated their risk of getting colorectal cancer as very low or low, and only 53.5% were confident in their ability to undertake a screening test. Almost all participants agreed that medical advice and test reimbursement would encourage them to do a screening test. At the multivariate analysis level, hearing of an awareness campaign in the last two years showed the strongest association with the knowledge of a colorectal cancer screening test with an estimated ORThis national study highlights an alarming lack of uptake and low levels of knowledge of colorectal cancer screening tests even though it is among the most prevalent cancers in Lebanon and its prevalence has been continuously increasing in the past years. The evidence suggests that people who had an experience with colorectal cancer diagnostic tests, either personally or through a family member, and those who have heard of an awareness campaign about colorectal cancer in the last two years are more likely to know its screening tests.Colorectal cancer screening knowledge and uptake in Lebanon are limited and justify the need for public health interventions. This study gives evidence that awareness campaigns, coupled with the involvement of medical providers and the reimbursement of screening test fees, would alleviate the burden of colorectal cancer in Lebanon.

Highlights • The moderate quantity and quality of evidence indicate benefits from community participation. • There was limited evidence on involvement of communities in framing problems or designing solutions. • There was inadequate engagement with the construct of community participation and power relations. • There was extremely weak evidence on participation by forcibly displaced communities., Background Community participation in health responses in humanitarian crises is increasingly promoted by humanitarian actors to support adoption of measures that are relevant and effective to local needs. Our aim was to understand the role of community participation in humanitarian health responses for conflict-affected populations (including forcibly displaced populations) in low- and middle-income countries and the barriers and facilitators to community participation in healthcare responses. Methods Using a systematic review methodology, following the PRISMA protocol, we searched four bibliographic databases for publications reporting peer-reviewed primary research. Studies were selected if they reported how conflict-affected populations were involved in healthcare responses in low- and middle-income settings, and associated changes in healthcare responses or health outcomes. We applied descriptive thematic synthesis and assessed study quality using study design-specific appraisal tools. Results Of 18,247 records identified through the database searching, 18 studies met our inclusion criteria. Various types of community participation were observed, with participation mostly involved in implementing interventions rather than framing problems or designing solutions. Most studies on community participation focused on changes in health services (access, utilisation, quality), community acceptability and awareness, and ownership and sustainability. Key barriers and facilitators to community participation included political will at national and local level, ongoing armed conflict, financial and economic factors, socio-cultural dynamics of communities, design of humanitarian responses, health system factors, and health knowledge and beliefs. Included studies were of mixed quality and the overall strength of evidence was weak. More generally there was limited critical engagement with concepts of participation. Conclusion This review highlights the need for more research on more meaningful community participation in healthcare responses in conflict-affected communities, particularly in framing problems and creating solutions. More robust research is also required linking community participation with longer-term individual and health system outcomes, and that critically engages in constructs of community participation.

Developers of computer systems and interfaces compete to produce tools that are usable and useful in the sense of assisting potential users to achieve the desired result. This usefulness angle of the discussion is what prompts us to look at existing knowledge on the potential of technology for improving social interaction and inclusion of people with learning disability (LD). We investigate how the extant literature guides conversation around premises of assistive devices and information technologies, in the context of improving interaction with people with LD for an inclusive value co-creation in our digital society of today. Through the lens of the DART framework, the four pillars of interaction of (Dialogue, Access, Risk, and Transparency), our approach seeks to explore how the current literature treats this contemporary topic.

This community-based, cross-sectional survey was conducted to determine the prevalence of anemia and iron deficiency anemia (IDA) and their association with nutritional behavior and other determinants. Arabic-speaking women, aged 15–49 years old, residing in Lebanon’s rural areas were included. Demographic and behavioral characteristics, obstetrical and gynecological history, personal and family medical history, and dietary intake data were collected. Predictors of anemia and IDA were determined using logistic regression. A total of 578 women were included (Lebanese: 55.2%; Syrian: 43.3%) in which 35.5% had anemia and 23.2% had IDA. The mean number of pregnancies was 3.1 ± 3.0 (number of children: 2.5 ± 2.5). In total, 30% had a personal history of anemia or IDA, 29% a family history of anemia, and 20% a family history of IDA. Iron-rich products were consumed by > 90% of the women, whereby > 66.7% mentioned eating liver, tuna, dates and nuts. Syrian nationality (OR = 2.21; CI 95%: 1.38–3.54), age (OR = 1.03, CI 95%: 1.00–1.06), personal history of anemia (OR = 1.97; CI 95%: 1.31–2.95), consumption of dates (OR = 2.07, CI 95%: 1.29–3.31), molasses (OR = 1.61; CI 95%: 1.03–2.51), and soft drinks > 5 times/week (OR = 1.66; CI 95%: 1.09–2.53) were predictors of anemia. Syrian nationality (OR = 1.73, CI 95%: 1.14–2.62), number of pregnancies (OR = 1.08; CI 95%: 1.01–1.15), period > 8 days (OR = 2.01, CI 95%: 1.07–3.80), consumption of eggs (OR = 0.48; CI 95%: 0.25–0.90), dates (OR = 2.58, CI 95%: 1.49–4.46), and coffee or tea (OR = 1.59, CI 95%: 1.03–2.45) were predictors of IDA. Anemia and IDA are prevalent in women of childbearing age in rural Lebanon. Intervention programs for raising the population’s awareness about IDA’s risk factors and proper nutrition must be implemented.

People with learning disabilities are often in isolation from the rest of society. This affects their development, their health and their full participation in society. Technologies are an indispensable answer to the problem of this marginalization and not only allows to promote their inclusion in societies but also to raise awareness of society while connecting them to the services and resources available. This paper aims at exploring guiding principles to cater for the needs for inclusive technology accessibility. We review the state of the literature and identify extant concepts in search for a set of Meta principles of technology accessibility design for users with learning disabilities.

In view of the rapid health transition faced by the country and a highly dominant private sector, the issue of obtaining reliable health statistics is becoming a priority for Lebanon. This paper reviews the process of compiling and disseminating national health statistics from the multitude of public, private and nongovernmental partners in the country. The lessons learned from preparing two editions of the National health statistics report in Lebanon allow identification of some challenges and strengths of the current health information system in Lebanon. The experience emphasizes the need for a close partnership with all stakeholders, an efficient management system, adequate human resources and predefined systems and procedures. The process would benefit from having an interactive website for exchange of data and information among stakeholders and the public. The existence of clear guidelines with consistent definitions and standardized forms would also facilitate the collection and analysis of data.

This paper develops a contextual model of individuals’ intention to accept/reject e-banking in Lebanon. It captures the influence of local cultural variables on banking e-services’ acceptance at the first stages of the adoption process. Based on the MATH, an adapted model was proposed that includes religiosity to identify the factors that would influence the adoption of Internet banking. The proposed model was empirically tested using data collected through a survey designed to capture a cross-sectional snapshot of the underlying phenomena. Data was collected from over 147 Lebanese potential adopters of e-banking. Results revealed that the utilitarian factors, the hedonic factors with social influences and computer self-efficacy are antecedents to the intention of e-banking acceptance. In addition, extrinsic religiosity is an antecedent to intrinsic religiosity and they are both negatively associated with e-banking acceptance. The implications of this research are discussed and suggestions for future research presented.

International audience; Healthcare waste mismanagement constitutes a serious environmental and sanitary problem, especially in developing countries. This article describes the strategy and the methodology of the implementation of a national network for healthcare waste management by a non-profit organisation in Lebanon, taking into consideration environmental, social and economic issues. It presents a holistic description of the main aspects of this crucial sustainable development topic: the elaboration of the strategy and the selection of the optimal treatment technique based on an analysis of the context; the training on waste minimisation and waste management issues inside hospitals; the waste transportation and treatment procedures; the quality management of the process; the evaluation and the monitoring of the produced quantities and the established system; the optimisation of sterilisation parameters and process in order to reduce sterilisation time and fuel consumption.