Summary Background & aims Malnutrition and frailty are frequent and serious conditions within the geriatric population. Both are of multifactorial origin and linked to adverse outcomes. The purpose ...of this study was to analyze the relationships between these two concepts in a representative sample of rural elderly Lebanese with a high prevalence of malnutrition. Methods A cross-sectional study including a representative sample of 1200 elderly Lebanese aged 65 and over living in the community. The following measurements were recorded: information on socio-demographic status, comorbidities, Activities of Daily Living (ADL), screening for depression (5 item Geriatric Depression Scale GDS) and cognitive status (Mini-Mental-State MMS). Frailty was assessed through the Study of Osteoporotic Fractures (SOF) index whereas nutritional status was measured through the Mini Nutritional Assessment (MNA). Stepwise backwards multinomial logistic regression was used to analyze the association between nutritional status and frailty, independent of these covariates. Results Frailty or prefrailty were present in respectively 36.4% and 30.4% of the participants. The proportion of individuals suffering from poor nutritional status increased with growing level of frailty (p < 0.001). Fourteen out of the 18 MNA items were associated with frailty in age-adjusted analyses. In the final multinominal logistic regression, both malnutrition and risk of malnutrition were related to a significantly increased risk of frailty, respectively (OR: 3.72, 95% IC: 1.40–9.94/OR: 3.66, 95% IC: 2.32–5.76), whereas the relation between poor nutritional status and prefrailty was not significant, independently of reporting less than three comorbidities, being ADL independent, depressive symptoms, illiteracy, and low cognitive status. Conclusion Frailty and malnutrition are two closely related but distinct concepts that share common determinants in this elderly population.
Aim
Social isolation and loneliness are emerging issues among the geriatric population. The relationships between both, and their impact on health and nutritional status in older people are complex. ...The purpose of the present study was to evaluate the association between three components of social isolation: social network, feeling of loneliness, commensality and nutritional status.
Methods
A total of 1200 randomly selected elderly individuals aged ≥65 years and living in rural areas of Lebanon participated in the present study. Data were collected during a face‐to‐face interview including nutritional status (Mini‐Nutritional Assessment), measures of social isolation (Lubben Social Network Scale), subjective loneliness (Jong‐Gierveld Loneliness Scale), sociodemographic conditions, and health and functional status.
Results
Both social isolation and loneliness were independently associated with a higher risk of malnutrition (OR 1.58, P = 0.011; OR 1.15, P = 0.020, respectively). However no association was found between the frequency of sharing meals and the risk of malnutrition.
Conclusions
The present study showed that social isolation and subjective loneliness are two independent risk factors for malnutrition among older people. Geriatr Gerontol Int 2017; 17: 286–294.
The Traffic Locus of Control scale (T-LOC) serves as a measure of drivers' personality attributes, providing insights into their perceptions of potential causes of road traffic crashes (RTCs). This ...study meticulously evaluated the psychometric properties of the Arabic version of T-LOC (T-LOC-A) among Lebanese drivers. Additionally, the study aimed to explore associations between the T-LOC scale and various driving variables, including driver behavior, accident involvement, and traffic offenses. A cross-sectional study was conducted among Lebanese drivers using a face-to-face approach. The validation of the Arabic version of T-LOC (T-LOC-A) occurred through a two-stage process: translating and culturally adapting T-LOC in the first stage, and testing its psychometric properties in the second stage. Data were collected using a comprehensive self-reported questionnaire in Arabic, covering demographic and travel-related variables, risk involvement, and measures such as the Driver Behavior Questionnaire (DBQ) and T-LOC. Exploratory factor analysis and confirmatory factor analysis were performed to scrutinize the factorial structure of T-LOC. Pearson correlation and chi-square tests were used for continuous and categorical variables, respectively. Two logistic regression analyses were executed to probe associations between T-LOC and involvement in road traffic crashes (RTCs) and T-LOC subscales with the occurrence of traffic offenses. The study included 568 drivers, predominantly male (69%) and aged between 30 and 49 years (42.1%). The findings revealed that T-LOC-A exhibited robust psychometric properties, with excellent reliabilities (α = 0.85) and adherence to the original four-factor structure, encompassing self (α = 0.88), other drivers (α = 0.91), vehicle/environment (α = 0.86), and fate (α = 0.66). The multidimensional structure was statistically supported by favorable fit indices. Gender differences revealed men attributing responsibility to other drivers, while women leaned towards fate and luck beliefs. Regarding driver behavior, the "other drivers" and self-dimensions of T-LOC-A correlated positively with aggressive violations. The fate dimension showed positive associations with aggressive violations and lapses. The "other drivers" subscale correlated positively with errors, and the vehicle/environment subscale with lapses. External T-LOC factors were positively associated with accident involvement, while the "LOC self" factor emerged as a protective element. In terms of traffic offenses, "LOC fate" displayed a positive association, while the "LOC self" factor showed a protective effect. In conclusion, the Arabic T-LOC is a reliable and valuable instrument, suggesting potential improvements in driving safety by addressing drivers' locus of control perceptions.
Abstract
Background
Salameh et al. developed the Lebanese Waterpipe Dependence Scale (LWDS-11) that assesses nicotine dependence among adult waterpipe smokers. In view of the high waterpipe use among ...Lebanese youth and other neighboring countries, it was deemed necessary to check the psychometric properties of the LWDS-11, originally adapted to the Lebanese population, to measure nicotine dependence among adolescents.
Methods
Two cross-sectional investigations were conducted; Study 1 (January and May 2019) enrolled a total of 449 students who were exclusive waterpipe smokers; this sample was used to conduct the exploratory factor analysis. Study 2 enrolled another sample composed of 243 waterpipe smoking adolescents. This sample was independent from the first one and was used to conduct the confirmatory analysis.
Results
The results also showed that 312 (69.5%) 95% CI 0.652–0.738 had high waterpipe dependence (scores of ≥10). Results of the factor analysis in sample 1 showed that all LWDS-11 items were extracted following the factor analysis. Items converged over a solution of one factor; total variance explained = 70.45%, α
Cronbach
= 0.96). The results of the confirmatory factor analysis were as follows: the Maximum Likelihood Chi-Square = 129.58 and Degrees of Freedom = 45, which gave a χ
2
/df = 2.88. For non-centrality fit indices, the Steiger-Lind Root Mean Square Error of Approximation (RMSEA) was 0.08 0.071–0.106. Moreover, the Comparative Fit Index (CFI) value was 0.77.
Conclusion
The preliminary results suggest that the LWDS-11 has good psychometric properties to measure waterpipe dependence among adolescents. We hope this tool would serve the benefit of research and epidemiology.
Quarantine/confinement is an effective measure to face the Coronavirus disease 2019 (COVID-19). Consequently, in response to this stressful situation, people confined to their homes may change their ...everyday eating behavior. Therefore, the primary objective of this study is to evaluate the association between quarantine/confinement stressors and eating behavior during the COVID-19 outbreak. The secondary objective is to compare the association of quarantine/confinement stressors and diet behavior between two groups of participants, those attending diet clinics and those not (general population).
A cross-sectional web-based online survey carried out between April 3 and 18, 2020, enrolled 407 participants from the Lebanese population. Eating Disorder Examination - Questionnaire (EDE-Q) were used to measure the behavioral features of eating disorders.
More than half of the sample (53.0%) abide by the home quarantine/confinement, 95.4% were living with someone in the quarantine/confinement, and 39.6% continued to work from home. Higher fear of COVID-19 was found in 182 (44.8%) participants, higher boredom in 200 (49.2%) participants, higher anger in 187 (46.3%), and higher anxiety in 197 (48.5%) participants. Higher fear of COVID-19 (Beta = 0.02), higher BMI (Beta = 0.05), and physical activity (Beta = 1.04) were significantly associated with a higher restraint score. Higher anxiety, higher fear of COVID-19, higher BMI, practicing physical exercise, and a higher number of adults living in the quarantine/confinement were significantly associated with higher shape and weight concerns.
Our results showed that the fear of COVID-19 was correlated with more eating restraint, weight, and shape concerns in the whole sample, but more specifically in the dietitian clients group. Public health control measures are needed to reduce the detrimental effects of psychological distress associated with quarantine/confinement on eating behaviors during the COVID-19 outbreak.
Smoking and COVID-19: A Scoping Review Haddad, Chadia; Bou Malhab, Sandrella; Sacre, Hala ...
Tobacco Use Insights,
02/2021, Letnik:
14
Book Review, Journal Article
Recenzirano
Odprti dostop
Smoking affects a person’s overall health and damages nearly every organ of the body. Since smoking tobacco affects and damages the lungs, it increases the risk of respiratory infections and makes it ...easier for the coronavirus disease (COVID-19) to invade the lung tissue, causing more severe symptoms and increasing the risk of death. However, debates are still ongoing as to the effect of cigarette smoking on vulnerability to COVID-19. Some studies, where active smokers were underrepresented among patients with COVID-19, claimed that a “smoker’s paradox” may exist in COVID-19 and that smokers are protected from infection and severe complications of COVID-19. However, other studies reported the opposite trend. The objective of this study is to review the findings of epidemiological and in vitro studies about the association between smoking and the risk of contracting COVID-19, taking into account disease severity. Several epidemiological studies have found a higher smoking prevalence among COVID-19 infected patients. Also, studies had shown that people with respiratory diseases caused by tobacco use are at higher risk of developing severe COVID-19 symptoms. Studies have shown that in vitro, the acute exposure allows for more severe proximal airway epithelial disease from SARS-CoV-2 by reducing the mucosal innate immune response and the proliferation of airway basal stem cells and has implications for disease spread and severity in people exposed to cigarette smoke, with a more severe viral infection and cell death. Smoker patients with different comorbidities are at higher risk of contracting the COVID-19 virus and have a worse prognosis for the virus as well as for their comorbidities. Further investigations of the interaction between smoking and COVID-19 are warranted to accurately assess the risk of contracting COVID-19 among smokers, and the progression to mechanical ventilation or death in patients who suffer from it.
The International Physical Actvity Questionnaire (IPAQ) is a validated tool for physical activity assessment used in many countries however no Arabic version of the long-form of this questionnaire ...exists to this date. Hence, the aim of this study was to cross-culturally adapt and validate an Arabic version of the long International Physical Activity Questionnaire (AIPAQ) equivalent to the French version (F-IPAQ) in a Lebanese population.
The guidelines for cross-cultural adaptation provided by the World Health Organization and the International Physical Activity Questionnaire committee were followed. One hundred fifty-nine students and staff members from Saint Joseph University of Beirut were randomly recruited to participate in the study. Items of the A-IPAQ were compared to those from the F-IPAQ for concurrent validity using Spearman's correlation coefficient. Content validity of the questionnaire was assessed using factor analysis for the A-IPAQ's items. The physical activity indicators derived from the A-IPAQ were compared with the body mass index (BMI) of the participants for construct validity. The instrument was also evaluated for internal consistency reliability using Cronbach's alpha and Intraclass Correlation Coefficient (ICC). Finally, thirty-one participants were asked to complete the A-IPAQ on two occasions three weeks apart to examine its test-retest reliability. Bland-Altman analyses were performed to evaluate the extent of agreement between the two versions of the questionnaire and its repeated administrations.
A high correlation was observed between answers of the F-IPAQ and those of the A-IPAQ, with Spearman's correlation coefficients ranging from 0.91 to 1.00 (p < 0.05). Bland-Altman analysis showed a high level of agreement between the two versions with all values scattered around the mean for total physical activity (mean difference = 5.3 min/week, 95% limits of agreement = -145.2 to 155.8). Negative correlations were observed between MET values and BMI, independent of age, gender or university campus. The A-IPAQ showed a high internal consistency reliability with Cronbach's alpha ranging from 0.769-1.00 (p < 0.001) and intraclass correlation coefficient (ICC) ranging from 0.625-0.999 (p < 0.001), except for a moderate agreement with the moderate garden/yard activity (alpha = 0.682; ICC = 0.518; p < 0.001). The A-IPAQ had moderate-to-good test-retest reliability for most of its items (ICC ranging from 0.66-0.96; p < 0.001) and the Bland-Altman analysis showed a satisfactory agreement between the two administrations of the A-IPAQ for total physical activity (mean difference = 99.8 min/week, 95% limits of agreement = -1105.3; 1304.9) and total vigorous and moderate physical activity (mean difference = -29.7 min/week, 95% limits of agreement = -777.6; 718.2).
The modified Arabic version of the IPAQ showed acceptable validity and reliability for the assessment of physical activity among Lebanese adults. More studies are necessary in the future to assess its validity compared to a gold-standard criterion measure.
There is a limited number of studies assessing the epidemiology of Adverse Drug Events (ADEs) in the outpatient setting, especially those that do not result in healthcare use. The primary objective ...of this study was to assess the prevalence and determinants of self-reported ADEs among Lebanese outpatients. It was a cross-sectional observational study performed among Lebanese outpatients visiting community pharmacies across Lebanon. A questionnaire was designed to elicit patients' relevant information. The association between categorical variables were evaluated using Pearson χ
test or Fisher's exact test. Binary logistic regression was performed to identify factors that affect the experience of self-reported ADEs. The study comprised 3148 patients. Around 37% of patients reported experiencing an ADE in the previous year. When ADEs occur, 70.5% of the respondents reported informing their physicians. Increasing number of medications per patient, use of injectable medication, and inquiring about potential drug-drug interactions were associated with higher experience of ADEs (p = 0.049; p = 0.003; and p = 0.009 respectively). Patients who received hospital discharge counseling reported experiencing less ADEs (p = 0.002). Our study showed prevalence of ADEs among Lebanese outpatients especially patients with polypharmacy, and highlighted the need to educate patients about the importance of reporting ADEs to their physicians.
Background The Lebanese population has undergone several conflicts and were the most afflicted by shelling and chaos during the civil war from 1975 to 1990, or even by displacement, bereavement, ...emigration, family separations, not to mention the economic crises that have hit the country since 2019 under which young adults are still succumbing. Our study aims to validate the Lebanese Anxiety Scale and assess correlates of anxiety among Lebanese adolescents. Methods A cross-sectional study was carried between January and May 2019, using a proportionate random sampling of schools from all five Lebanese governorates, among which 1810 adolescents aged 14 to 17 years. Results All LAS items remained in the model and formed one factor solution that explained 61.38% of the total variance (KMO = 0.873; p.sub.Bartlett test < 0.001), with an excellent Cronbach's alpha of 0.93. Higher neglect (B = 0.38), insomnia (B = 0.21) and child psychological abuse (B = 0.08) were significantly associated with more anxiety. Those results were considered adjusted overall sociodemographic variables since the latter had no statistically significant association with anxiety. Conclusion The study confirmed the association between anxiety and some variables such as psychological child abuse, neglect, and insomnia and emphasized the correlation between anxiety and these factors. Further, the LAS appears to be a short, valid and efficient tool for assessing anxiety among Lebanese adolescents. Further studies need to be carried to evaluate whether the LAS-10 gives a similar diagnosis to psychiatrists. Keywords: Anxiety, Insomnia, Child abuse, Neglect, Adolescents, Lebanon
Abstract
Background
COVID-19 was first detected in Lebanon on February 21, 2020; it reached its peak in January 2021, with a total number of 418,448 confirmed cases and 5380 deaths (until March 15, ...2021). Gaining insight into factors regarding willingness or refusal for vaccination might guide our goals in raising the awareness and target efforts to increase acceptance of the COVID-19 vaccine and maximize the uptake. Therefore, this study aims to assess the intent to receive the COVID-19 vaccine among Lebanese adults and the factors associated with vaccine refusal.
Methods
We conducted a cross-sectional study during November–December 2020 among Lebanese adults from all Lebanese regions using a survey tool with closed-ended questions that included sociodemographic data and questions about vaccine hesitancy, knowledge, attitude, practice, and fear of COVID-19. We used the snowball technique to collect the data because of the COVID-19 imposed lockdown.
Results
Of the 579 participants, 21.4% were willing to receive the vaccine, 40.9% refused, and the remainder were unsure of their response. More vaccine hesitancy (adjusted odds ratio (aOR) = 1.06; 95% CI 1.03–1.09) was significantly associated with more odds of disagreeing/ strongly disagreeing on receiving the COVID-19 vaccine compared to being neutral. More vaccine hesitancy (aOR = 0.95; 95% CI 0.91–0.99), female gender compared to males (aOR = 0.53; 95% CI 0.32–0.87), and being married compared to single (aOR = 0.53; 95% CI 0.29–0.98) were significantly associated with lower odds of agreeing/strongly agreeing on receiving the COVID-19 vaccine compared to being neutral.
Conclusion
Overall, our findings revealed a high percentage of people (40%) who strongly disagreed with receiving the vaccine, mainly females, married participants, and those who have a general vaccine hesitancy. Moreover, no significant association was found with knowledge, attitude, or prevention practice regarding COVID-19. Targeted efforts are necessary to increase acceptance of a COVID-19 vaccine among the Lebanese population to control the COVID-19 pandemic. Further studies with a larger sample size are warranted to validate our results and provide better insights into the underlying reasons for refusing vaccination.
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