Mediating and moderating factors between economic pressure and turnover intention among school teachers in Lebanon during the ongoing crisis era.

Background: The Lebanese ongoing crisis has exposed big challenges for the education system, including low teachers' salaries and their desire to leave their jobs. Identifying key contributing factors to teacher turnover intention may help policymakers develop and implement appropriate and informed retention strategies aiming at preserving the struggling Lebanese educational system and saving costs. The present study aimed to examine the mediating role of three potential factors, i.e. job satisfaction, work-related fatigue, and psychological distress, and the moderating role of employment sector, in the relationship between economic pressure and turnover intention among teachers who work in Lebanon during the economic crisis. Methods: We carried-out a cross-sectional, web-based study targeting a nationally-representative sample of Lebanese teachers (N = 3779, mean age = 38.33 years, 86.7 % females). Results: The results of mediation analyses showed that physical/emotional/mental work fatigue, psychological distress and job satisfaction mediated the relationship between perceived economic pressure and turnover intentions among Lebanese teachers. Economic pressure was significantly associated with higher work fatigue, more distress, less job satisfaction and more turnover intentions. Also, more work fatigue, higher distress levels and less job satisfaction were significantly associated with higher turnover intentions. Finally, more economic pressure was significantly associated with more turnover intentions. On the other hand, the moderating effect of teachers' sector of employment (Private versus Public) was not significant. Conclusion: This is among the first studies to link economic pressure, job satisfaction, work fatigue, psychological distress and turnover intentions in the teachers' psychology literature. This is also the first study on this topic in Lebanon, a country that offers a unique context and opportunity to understand the link between teachers' economic pressure and turnover intentions. The results expand on past research by showing that work-related fatigue, job satisfaction and psychological distress are three factors that underline the cross-sectional relationship between economic pressure and teachers' turnover intention. This implies that further attention of policy makers and school officials should be paid to enhance job satisfaction, decrease work fatigue and prevent psychological distress in order to retain and attract teachers at schools in Lebanon.

Concomitant Listeria monocytogenes and Streptococcus equinus brain abscess in an immunocompetent individual: a case report.

BACKGROUND: Listeria monocytogenes brain abscess is a rare phenomenon that is common in immunocompromised patients. Streptococcus equinus brain abscess has never been reported in the literature to our knowledge. In this case report, we describe a case of brain abscess secondary to Listeria monocytogenes and Streptococcus equinus in an immunocompetent patient with transient low CD4 count. CASE PRESENTATION: A 27-year-old white, male patient, previously healthy, nonalcoholic, and occasional smoker, presented to the emergency department for confusion and headache. The patient was found to have a left parietal abscess, which was drained and the fluid was sent for culture. Culture grew Listeria monocytogenes and Streptococcus equinus. The patient was treated with intravenous ampicillin followed by oral amoxicillin for a total of 6 weeks. The CD4 count was low initially. However, after the resolution of the infection, the CD4 count came back within normal range. Another brain magnetic resonance imaging was done that showed a significantly decreased hyperintensity within the left parietal subcortical white matter at the site of surgery with significantly decreased enhancement and almost total resolution of the previous abscess. CONCLUSION: Transient low CD4 count is a rare phenomenon that exposes patients to unusual and atypical infections. Since low CD4 count is transient, patients treated promptly recover from their illness. Our patient developed a Listeria monocytogenes and Streptococcus equinus brain abscess, which is considered rare and has not been previously described in the literature to our knowledge.

Attitude towards cholera vaccination and its related factors in Jordan amid the 2022 Middle East outbreak.

BACKGROUND: An outbreak of cholera was reported in the Middle East by the second half of 2022. Raising public awareness and vaccination against cholera represent critical factors in the preventive efforts. The current study aimed to assess the knowledge of cholera and attitude towards its vaccination among a sample of the general public residing in Jordan. METHODS: An online self-administered questionnaire was distributed to the residents in Jordan using a snowball convenience-based sampling approach. The questionnaire based on previously published studies included items to evaluate sociodemographic variables, knowledge about cholera symptoms, transmission, and prevention and the willingness to accept cholera vaccination. Additionally, four items based on the validated 5 C scale in Arabic were included to assess the psychological factors influencing attitude to cholera vaccination. RESULTS: The final study sample comprised 1339 respondents, of whom 1216 (90.8%) heard of cholera before the study. Among those who heard of cholera, and on a scale from 0 to 20, the overall mean cholera Knowledge score (K-score) was 12.9 ± 3.8. In multivariate analysis, being over 30 years old and occupation as healthcare workers or students in healthcare-related colleges were significantly associated with a higher K-score compared to younger individuals and students in non-healthcare-related colleges. Overall, the acceptance of cholera vaccination if cases are recorded in Jordan, and if the vaccine is safe, effective, and provided freely was reported among 842 participants (69.2%), while 253 participants were hesitant (20.8%) and 121 participants were resistant (10.0%). In linear regression, the significant predictors of cholera vaccine acceptance were solely the three psychological factors namely high confidence, low constraints, and high collective responsibility. CONCLUSIONS: In this study, the identified gaps in cholera knowledge emphasize the need to enhance educational initiatives. Although cholera vaccine acceptance was relatively high, a significant minority of the respondents exhibited vaccination hesitancy or resistance. The evident correlation between the psychological determinants and attitudes toward cholera vaccination emphasizes the need to consider these factors upon designing public health campaigns aimed at cholera prevention. The insights of the current study highlight the importance of addressing both knowledge gaps and psychological barriers to optimize cholera control strategies.

Correlational Insights into Attention-Deficit/Hyperactivity Disorder in Lebanon.

Attention-Deficit/Hyperactivity Disorder (ADHD), a prevalent childhood neurodevelopmental disorder with complex etiology involving genetic and environmental factors, causes impairments across various life domains and substantial social and economic burden. Identifying correlates to prevent its onset and decrease its incidence is crucial. To our knowledge, our study represents the first case-control investigation of Lebanese ADHD patients to explore potential correlations between familial, maternal, and child health variables and ADHD to enhance understanding of its etiology and aid in prevention efforts. We recruited 61 Lebanese ADHD patients and 58 matched controls aged 6-24 years from all districts of Lebanon. The data to analyze were collected using a questionnaire. We employed statistical tests, including the independent samples t-test and the Chi-square test or Fisher's exact test. We conducted a multivariate logistic regression analysis to identify the statistically significant factors explaining ADHD likelihood. We observed male predominance (68.9%) among patients. Maternal anemia during pregnancy (OR = 3.654; 95% CI [1.158-11.529]), maternal self-reported stress during pregnancy (OR = 3.268; 95% CI [1.263-8.456]), neonatal jaundice (OR = 5.020; 95% CI [1.438-17.532]), and familial history of ADHD (OR = 12.033; 95% CI [2.950-49.072]) were significantly associated with increased odds of the disorder. On the other hand, breastfeeding (OR = 0.263; 95% CI [0.092-0.757]) was identified as a protective factor against ADHD. This pilot study shed light on risk and protective factors associated with ADHD in the Lebanese population. The results are relevant, as some identified correlates could be avoidable. Further rigorous investigation is required to expand upon the observed correlations and to assist in early detection, prevention, and intervention strategies targeting ADHD.

Effects of Hormonal Replacement Therapy and Mindfulness-Based Stress Reduction on Climacteric Symptoms Following Risk-Reducing Salpingo-Oophorectomy.

Breast Cancer Associated Susceptibility Proteins Type 1/2 (BRCA1/2) promote cellular functioning by modulating NRF2-mediated antioxidant signaling. Redox failure in women with BRCA1/2 insufficiency increases the risk for breast/ovarian/uterine cancers. Risk-reducing salpingo-oophorectomy (RRSO) is a prophylactic surgery of the reproductive organs, which is frequently conducted by the age of 40 to lower the occurrence of cancer in women with BRCA1/2 mutations. However, abrupt estrogen decline following RRSO causes ovarian failure, which implicates various cellular physiological processes, resulting in the increased release of free radicals and subsequent severe onset of menopausal symptoms. Comfort measures (e.g., hormonal replacement therapy (HRT) and mindfulness-based stress reduction (MBSR)) may improve chronological menopause-related quality of life, but their specific effects are not clear in women with gene mutations. Aiming to fill the gap, this study used path analysis to examine the effects of HRT and MBSR on menopausal symptoms among RRSO patients (N = 199, mean age = 50.5 ± 6.7 years). HRT directly alleviated the levels of urogenital symptoms (ß = -0.195, p = 0.005), which mediated its indirect significant effects on the somatic-vegetative and psychological symptoms of menopause (ß = -0.046, -0.067; both p values = 0.004, respectively), especially in BRCA2 carriers and in women who were currently physically active, premenopausal at the time of RRSO, had a high BMI, and had no history of breast cancer. It increased the severity of urogenital symptoms in women with a history of cancer. MBSR, on the other hand, was associated with indirect increases in the intensity of the somatic-vegetative and psychological symptoms of menopause (ß = 0.108, 0.029; p = 0.003, 0.033, respectively). It exerted positive direct effects on different menopausal symptoms in multigroup analysis. The results suggest that young women undergoing recent RRSO may benefit from HRT at an individual level, while their need for extensive measures to optimize their psychological wellbeing is ongoing. The adverse effects of MBSR, which are captured in the present study, imply that MBSR may interfere with redox sensitivity associated with estradiol fluctuations in BRCA1/2 carriers. Investigations are needed to test this hypothesis and elaborate on the underlying mechanisms in these women.

The moderating effect of religiosity between climate change anxiety and death anxiety among a sample of Lebanese adults.

BACKGROUND: Acknowledging the increasing worry over climate change and its psychological effects, the aim of this research is to clarify the dynamics between religiosity, climate anxiety and death anxiety, seeking to figure out the way religiosity mitigates the psychological effects of existential anxieties and climate related anxiety. METHODS: Using Google Forms, a questionnaire was developed and disseminated through a variety of messaging platforms, such as WhatsApp, Instagram, and Facebook Messenger. Through a snowball sampling technique, 763 participants were recruited in this cross-sectional during September 2023. RESULTS: The subsequent variables were adjusted in the moderation analysis: age, gender, and place of living. The results suggested that religiosity levels moderated the association between climate anxiety and death anxiety (Beta = 0.02, t = 1.97, p = .05, 95% CI 0.001, 0.035). At low, moderate, and high levels of religiosity, higher climate anxiety was significantly associated with more death anxiety. In addition, at low levels of climate anxiety, individuals with higher levels of religiosity (22.66) had more decreased levels of death anxiety compared to those with lower levels of religiosity (11.99). As climate anxiety levels increase, inverted patterns can be observed, with highly religious individuals showing higher levels of death anxiety than those with lower levels of religiosity. Overall, the relationship between climate anxiety and death anxiety was found to be weakest at low levels of religiosity and strongest at high levels of religiosity. CONCLUSION: Our findings suggest a possible beneficial effect of high religiosity at low levels of climate anxiety. This effect is reversed as climate anxiety starts to increase. Therefore, clinicians and policy-makers should bear in mind these complex interactions when designing strategies to mitigate mental health problems in the context of climate crisis.

The mediating effect of resilience between work fatigue and psychological distress among healthcare workers in Brazil, Lebanon, Nigeria, Pakistan, Poland, Qatar, Serbia, and Tunisia.

OBJECTIVES: To test the hypothesis that resilience has a mediating effect on the association between work fatigue and psychological distress. METHODS: A cross-sectional survey was conducted online in eight countries in 2021: Brazil, Lebanon, Nigeria, Pakistan, Poland, Qatar, Serbia, and Tunisia. A total of 1094 healthcare professionals specialized in medicine, pharmacy, and nurse practitioners that were exposed to/worked with COVID-19 patients were included (age: 33.89 ± 10.79 years; 59.6% females). RESULTS: After adjusting for potential confounders (i.e., country, gender, primary work in emergency department, primary work in infectious disease, primary work in intensive care unit, working in a COVID-19 ward, and working voluntary hours), the results of the mediation analysis showed that resilience fully mediated the association between physical work fatigue and psychological distress and partially mediated the associations between mental and emotional work fatigue and psychological distress. Higher work fatigue was significantly associated with less resilience; higher resilience was significantly associated with less psychological distress. Finally, higher mental and emotional, but not physical, work fatigue, were directly and significantly associated with more psychological distress. CONCLUSION: Identifying resilience as an important mediator in the path from fatigue to distress helps elucidate underlying mechanisms and pathways leading to the mental health-alteration process among healthcare workers during COVID-19. New strategies targeting resilience may be developed to further improve mental health outcomes among healthcare workers.

Impulsivity as a predictor of clinical and psychological outcomes in a naturalistic prospective cohort of subjects at ultra-high risk (UHR) for psychosis from Tunisia.

BACKGROUND: Impulsivity is associated with serious detrimental consequences on physical, mental, behavioral and social aspects of health among patients with psychosis. The present prospective 12-month follow-up study aimed to determine the prevalence of highly impulsive individuals among Ultra High Risk (UHR) patients, how impulsivity evolves over the follow-up period, and whether impulsivity impacts clinical, psychological and functional outcomes in this population. METHOD: UHR patients were invited to complete a battery of measurements at three-time points: at baseline, and at 6 and 12 months of follow-up. Impulsivity was assessed using both behavioral (the Wisconsin Card Sorting Test, WCST) and self-report (the Barratt Impulsiveness Scale, BIS-11) measures. RESULTS: Findings showed that at 6 months of follow-up, higher 6-month BIS-11 attentional and motor impulsivity were significantly associated with lower quality of life and greater general psychological distress. In addition, higher baseline BIS-11 motor impulsivity significantly predicted more severe positive psychotic symptoms at 12 months of follow-up. However, WCST scores did not show any significant associations with study variables at the different times of follow-up. CONCLUSION: Interventions targeting impulsivity in UHR individuals could help decrease psychological distress and positive psychotic symptoms' severity, as well as improve quality of life in UHR individuals.

Psychometric properties of the Arabic version of the Nightmares Distress Questionnaire (NDQ-AV) in a community sample of adolescents.

BACKGROUND: The Nightmare Distress Questionnaire (NDQ), known and commonly used for its adequate psychometric properties, is the most widely used instrument for the measurement of nightmare distress. This study aimed to assess the psychometric properties of a newly translated Arabic version of the Nightmare Distress Questionnaire (NDQ-AV). METHODS: A total of 546 Lebanese adolescents was recruited for this study and completed the NDQ-AV, the Insomnia Severity Index (ISI), and the eight-item Depression, Anxiety and Stress Scale (DASS-8). RESULTS: The results of the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) supported both a one-factor model and a two-factor model of the NDQ-AV, with the latter consisting of seven items within both factors. The first factor was referred to as the "general nightmare distress and coping" while the second was named "nightmare impact and perception". The reliability of the scale was excellent (α = 0.930 and ω = 0.915). Moreover, measurement invariance was shown across gender, demonstrating that this measure performs consistently for both men and women. Additionally, the NDQ-AV scores exhibited excellent reliability alongside factorial and concurrent validity. CONCLUSION: In conclusion, these results support the psychometric validity of the Arabic version of the NDQ. The availability of the NDQ-AV is expected to facilitate the understanding of nightmare distress within the Lebanese context.

Psychometric properties of the ultra-brief self-report Patient Health Questionnaire-4 (PHQ-4) to assess anxiety and depression in Arabic-speaking adults.

BACKGROUND: Anxiety and depression are psychiatric disorders that often coexist and share some features. Developing a simple and cost-effective tool to assess anxiety and depression in the Arabic-speaking population, predominantly residing in low- and middle-income nations where research can be arduous, would be immensely beneficial. The study aimed to translate the four-item composite Patient Health Questionnaire - 4 (PHQ-4) into Arabic and evaluate its psychometric properties, including internal reliability, sex invariance, composite reliability, and correlation with measures of psychological distress. METHODS: 587 Arabic-speaking adults were recruited between February and March 2023. An anonymous self-administered Google Forms link was distributed via social media networks. We utilized the FACTOR software to explore the factor structure of the Arabic PHQ-4. RESULTS: Confirmatory factor analysis (CFA) indicated that fit of the two-factor model of the PHQ-4 scores was modest (χ2/df = .13/1 = .13, RMSEA = .001, SRMR = .002, CFI = 1.005, TLI = 1.000). Internal reliability was excellent (McDonald's omega = .86; Cronbach's alpha = .86). Indices suggested that configural, metric, and scalar invariance were supported across sex. No significant difference was found between males and females in terms of the PHQ-4 total scores, PHQ-4 anxiety scores, and PHQ-4 depression scores. The total score of the PHQ-4 and its depression and anxiety scores were significantly and moderately-to-strongly associated with lower wellbeing and higher Depression Anxiety and Stress Scale (DASS) total and subscales scores. CONCLUSION: The PHQ-4 proves to be a reliable, valid, and cost-effective tool for assessing symptoms related to depression and anxiety. To evaluate the practical effectiveness of the Arabic PHQ-4 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specific populations.

Assessing adherence to treatment guidelines and complications among atrial fibrillation patients in the United Arab Emirates.

Background: Atrial fibrillation (AF), a potential trigger for stroke development, is considered a modifiable condition that can halt complications, decrease mortality, and prevent morbidity. The CHA2DS2-VASc and HAS-BLED scores are categorized as risk assessment tools used to estimate the risk of thrombosis development and assess major bleeding among atrial fibrillation patients. Objectives: Our study aims to assess the adherence to post-discharge treatment recommendations according to CHA2DS2-VASc score risk group and evaluate the impact of CHA2DS2-VASc score and HAS-BLED score risk categories on death, length of hospital stay, complications, and hospital readmission among United Arab Emirates (UAE) patients. Methods: This was a multicenter retrospective study conducted from November 2022 to April 2023 in the United Arab Emirates. Medical charts for AF patients were assessed for possible enrolment in the study. Results: A total number of 400 patients were included with a mean age of 55 (±14.5) years. The majority were females (67.8%), and most had high CHA2DS2-VASc and HAS-BLED scores (60% and 57.3%, respectively). Our study showed that adherence to treatment recommendations upon discharge was 71.8%. The bivariate analysis showed that patients with a high CHA2DS2-VASc score had a significantly higher risk of death (p-value of 0.001), hospital readmission (p-value of 0.007), and complications (p-value of 0.044) vs. the low and moderate risk group with a p-value of <0.05. Furthermore, our findings showed that the risk of death (0.001), complications (0.057), and mean hospital stay (0.003) were significantly higher in the high HAS-BLED risk score compared to both the low- and moderate-risk categories. Hospital stay was significantly higher in CHA2DS2-VASc and HAS-BLED high-risk score categories compared to the low-risk score category with a p-value of <0.001. Conclusion: Our study concluded that the adherence to treatment guidelines in atrial fibrillation patients was high and showed that patients received the most effective and patient-centered treatment. In addition, our study concluded that the risk of complications and mortality was higher in high-risk category patients.

Self-reported food intolerance, dietary supplement use and malnutrition in chronic inflammatory bowel diseases: Findings from a cross-sectional study in Lebanon.

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.

Psychometric properties of the arabic translation of the Physical Appearance Comparison Scale-Revised (PACS-R) in adults.

BACKGROUND: Physical comparison may be a factor in body dissatisfaction and related issues, like eating disorders and depression. The Physical Appearance Comparison Scale-Revised (PACS-R) is a scale developed to assess the frequency of physical comparison. Because there is no validated scale for body comparison in Arabic, this study aims to address this gap by validating the PACS-R in the Arabic language. METHODS: The PACS-R was translated to Arabic following a conventional forward-backward translation procedure, and was administered to a sample of 359 Lebanese adults along with The Depression Anxiety Stress Scale, and the Rosenberg self-esteem scale (RSES) for convergent validity. The factor structure was studied by confirmatory factor analysis (CFA), and composite reliability was assessed using McDonald's omega and Cronbach's alpha. RESULTS: Results suggested a one-factor structure of the Arabic PACS-R, with good internal consistency (McDonald's ω = 0.97 / Cronbach α = 0.97). Measurement invariance was established across sex groups, with no significant difference being reported between males and females in terms of PACS-R scores (15.42 ± 10.64 vs. 13.16 ± 11.88; t(357) = 1.84; p = .066). Finally, adequate convergent validity was tested and found to be adequate, with PACS-R scores found to be correlated negatively with self-esteem and positively with psychological distress. CONCLUSION: The present findings preliminarily establish the Arabic PACS-R as an effective instrument for researchers and practitioners aiming to explore the physical comparison among Arabic-speaking populations, thus contributing to research and clinical work in the Arabic community.

Translation, transcultural adaptation, and convergent validity of the Arabic version of the Mukbang addiction scale.

INTRODUCTION: The present study evaluated the psychometric properties of the Arabic translation of the Mukbang Addiction Scale (MAS) among Arabic-speaking adults from the general population. Specifically, it aimed to assess the factorial structure through a confirmatory factor analysis, determine the composite reliability through Cronbach alpha and McDonald's omega scores, assess gender invariance, and evaluate the convergent validity by examining its correlation to eating addiction and psychological distress. METHODS: A total of 370 individuals with a mean age of 21.94 ± 2.29 years participated in this study, which was conducted using an online platform. The participants were surveyed on demographic information, mukbang addiction, food addiction, and psychological distress. Translation was conducted using the forward and backward technique. RESULTS: The findings demonstrated excellent internal consistency of the Arabic MAS (McDonald's omega coefficient = 0.93). Confirmatory factor analyses validated the one-factor structure of the scale, while establishing measurement invariance across sex at the configural, metric, and scalar levels. No sex differences were observed in the Mukbang addiction levels. Lastly, the MAS scores were significantly and positively correlated with food addiction and psychological distress, supporting their convergent validity. CONCLUSION: The current research provides evidence supporting the reliability and validity of the Arabic version of the MAS as a self-report method for assessing addictive Mukbang watching. While further validations are needed to corroborate the present findings, this measure can be effectively utilized across different fields, including schools, mental health centers, and researchers aiming to understand this global phenomenon. Mukbang refers to individuals or hosts consuming large quantities of food while interacting with their audiences through recorded video or a live stream. The Mukbang phenomenon has gained substantial popularity among young individuals over the past years, rising concerns about its potential impact on their eating habits and health, especially when overconsumed. Overconsumption of mukbang content, or Mukbang addiction, aligns with the core features of addiction, including compulsive engagement, tolerance, and withdrawal symptoms, making it comparable to other addictive behaviors. Mukbang addiction can lead to detrimental effects on mental and physical health, including neglect of balanced nutrition, disordered eating habits, obesity, feelings of guilt, shame, poor self-esteem, distorted self-images, body dissatisfaction, heightened anxiety or depression, and social isolation. Given these significant impacts, valid and reliable tools are crucial to enable an accurate assessment of Mukbang addiction. This study proposes to translate, adapt and examine the psychometric properties of the Mukbang Addiction Scale (MAS) in a sample of Arabic-speaking individuals from the general population. Findings showed that the six MAS items loaded on a single factor with strong internal consistency and good convergent validity, preliminarily indicating its potential validity and reliability for assessing addictive mukbang-watching among Arabic-speaking individuals.

Assessment of knowledge and awareness of stroke among the Syrian population: unveiling the current landscape in Syria through the first nationally representative study.

Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.

Translation and validation to the Arabic language version of the climate change anxiety scale (CCAS).

BACKGROUND: The Arab world is one of the global regions the most directly concerned by, and suffering from climate change's adverse consequences. As such, there appears to be a strong need for an understanding of how Arab people may emotionally respond to climate change. Providing valid and reliable measures of climate change anxiety (CCA) can help gain a clear overview of the situation in Arab countries, and allow to intervene timely and effectively to mitigate any adverse effects on Arab people's mental health. To this end, the present study sought to validate the Arabic language version of the Climate Change Anxiety Scale (CCAS) in a sample of native Arabic-speaking adults from the general population of Lebanon. METHODS: This study adopted a cross-sectional approach and enrolled 763 adults between July and September 2023. RESULTS: A confirmatory analysis of the one-factor model showed poor fit indices as follows: CFI = 0.90, GFI = 0.83, SRMR = 0.048 and RMSEA 0.131 [90% CI 0.123, 0.138). The two-factor model showed a satisfactory fit with a high CFI of and a GFI of 0.91 and a SRMR of 0.04 and RMSEA of 0.05 [90% CI 0.04, 0.06]. Both McDonald's omega and Cronbach alpha values were high for the overall CCAS score (α = 0.96 and ω = 0.96) in the whole sample. Configural, metric and scalar invariance across gender was demonstrated. No significant difference was found between males and females in terms of total CCAS scores (24.53 ± 10.59 vs. 26.03 ± 11.17, t(761) = -1.82, p = .069). Higher CCA, functional impairment and cognitive impairment scores were significantly associated with higher depression, anxiety and stress. CONCLUSION: The reliability and validity of the CCAS in its Arabic version were proven. The availability of this self-report measure could offer a chance to assess CCA among Adults speaking Arabic, and to spread its future use for screening and research purposes.

The moderating effect of resilience in the association between insomnia severity and PTSD symptoms in Lebanese adolescents in the aftermath of the 2023 earthquake.

The interplay between insomnia and PTSD symptoms remains misunderstood, and seems to be influenced by other factors like individual resilience. Our study examined the moderating role of resilience in the relationship between insomnia and PTSD symptoms among a sample of Lebanese adolescents, in the aftermath of the 2023 earthquake. This cross sectional study, conducted in April, 2 months after the earthquake, enrolled 546 Lebanese adolescents. We used the Sleep Self Report, the Resilience Scale for Adolescents and the 13-item Children's Impact of Event Scale. The interaction insomnia severity by resilience was significantly associated with PTSD scores. At low, moderate and high resilience levels, higher insomnia severity was significantly associated with lower PTSD. Resilience moderated the relationship between insomnia and PTSD, mitigating the detrimental impact of disrupted sleep on PTSD symptoms. This data can guide healthcare administrators and psychiatric caregivers in classifying risk factors and implementing interventions to predict PTSD development.

Psychometric properties of the Arabic translation of the Dark Future Scale questionnaire in a non-clinical sample of Arabic-speaking young adults.

BACKGROUND: Through the years, studying negative behaviors of the worldwide population seized the spotlight from many researchers who focused on building scales in order the measure the level of worries, fear and even depression of such stressed individuals. By definition, "Future anxiety" (FA) is fueled by negative thoughts leading to intense fear of unknown future events. The Dark Future scale (DFS) measures the level of anxiety experienced towards the future. Our aim was to examine the psychometric properties of a novel Arabic translation of the DFS. METHODS: A sample of 684 Arabic-speaking young adults (65.6% women) filled the DFS, TEMPS-M (temperaments) and DASS-8 (psychological distress). RESULTS: Confirmatory factor analyses (CFA) supported a unidimensional model of the DFS score, with all 5 items retained. This scale had good reliability. Moreover, concurrent validity demonstrated significant associations between DFS scores and psychological distress, depressive, cyclothymic, irritable and anxious temperament. Scores achieved scalar invariance across gender, with women having greater exposure to anxiety about the future. CONCLUSION: Overall, these findings led to the conclusion that the Arabic DFS is a psychometrically valid tool for the assessment of FA. The DFS is a brief, reliable and easy to apply scale that would help researchers in psychology and psychiatry in assessing anxiety about future.

The Depression Anxiety Stress Scale 8: investigating its cutoff scores in relevance to loneliness and burnout among dementia family caregivers.

The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.

Psychometric properties of an Arabic translation of the resilience scale for older adults.

OBJECTIVES: A significant gap currently exists in the availability of reliable and scientifically rigorous measures for evaluating resilience among older Arabic-speaking populations. The primary objective of this study was to assess the psychometric properties of an Arabic adaptation of the 15-item Resilience Scale of Older Adults (RSOA) in a sample of Arabic-speaking Egyptian older adults. METHOD: Using a cross-sectional design and a convenience sample of 539 Egyptian older adults, with 60.7% aged between 65 and 75 years (50.3% females), participants completed an online Google form-based anonymous questionnaire, including sociodemographic information, the RSOA, and the 10-item CD-RISC. To ensure accurate translation, the forward-backward translation method was employed. Confirmatory factor analysis (CFA) and gender invariance in the RSOA were analyzed. McDonald's ω and Cronbach's α were calculated to assess internal consistency. RESULTS: The results demonstrate that the Arabic RSOA and its subscales exhibit high internal consistency, with McDonald's ω and Cronbach's α values ranging from 0.83 to 0.93. CFA analysis revealed that the four-factor model fit of RSOA was acceptable. Measurement invariance was supported across genders. Furthermore, both genders exhibited no significant differences in all four RSOA dimensions. Convergent validity was supported by demonstrating that the four RSOA sub-scores and total scores correlated positively and significantly with the 10-item CD-RISC. CONCLUSION: While further cross-cultural validation involving other Arab countries and communities is necessary, this study suggests that the Arabic RSOA may be used to measure resilience among broader Arabic-speaking older adults in clinical and research contexts.