Postpartum Depression and Anxiety among Lebanese Women: Correlates and Scales Psychometric Properties.

Background: We found that it was important to fill a gap in the literature and check the psychometric properties of the Edinburgh Postnatal Depression Scale (EPDS) and Perinatal Anxiety Screening Scale (PASS) in the Arabic language and delineate factors associated with postnatal depression (PPD) and anxiety (PPA) among Lebanese women 4−6 weeks after delivery. Methods: This cross-sectional study carried out between July 2018 and March 2019 enrolled 295 participants who came for a postnatal checkup at four clinics. Results: The EPDS and PASS scales' items converged over two- and four-factor solutions, explaining 62.51% and 53.33% of the variance, respectively (KMO EPDS = 0.816, αCronbach EPDS = 0.826; KMO PASS = 0.878, αCronbach PASS = 0.920; Bartlett's test of sphericity p < 0.001). Higher postpartum anxiety (Beta = 0.256), higher postpartum insomnia (Beta = 0.079), having hypotension during pregnancy (Beta = 2.760), and having a second (Beta = 1.663) or a third baby or more (Beta = 2.470) compared with the first one were significantly associated with higher postpartum depression. Higher postpartum depression (Beta = 1.33) was significantly associated with higher postpartum anxiety, whereas having a baby through a planned pregnancy (Beta = −4.365) and having a baby who ate regularly (Beta = −3.639) were significantly associated with lower postpartum anxiety. Conclusion: Depression and anxiety prevalence rates in the Lebanese population were higher compared with other countries, which may be due in part to the differences in regional, social and environmental culture.

Factors associated with seasonal affective disorders in Lebanese adults.

PURPOSE: Evaluate seasonal affective disorder (SAD) and the possible factors associated with it among Lebanese adults, during winter and summer seasons of 2018 and 2019. DESIGN AND METHODS: Cross-sectional study was conducted in two time intervals. The winter period took place from December 2018 to January 2019, whereas the summer period was from May to June 2019, evaluating the same participants. FINDINGS: Higher winter depression (adjusted odds ratio [ORa] = 1.16), higher winter insomnia (ORa = 1.04) were significantly associated with higher odds of having winter SAD. Higher summer depression (ORa = 1.20) was significantly associated with higher odds of having summer SAD. PRACTICE IMPLICATIONS: A proper recognition of risk factors associated with SAD allows the clinician to effectively differentiate between SAD and nonseasonal depressive symptoms.

Hygiene hypothesis: association between hygiene and asthma among preschool children in Lebanon.

OBJECTIVES: To validate a scale to assess the hygiene hypothesis and the association between hygiene and asthma among Lebanese preschool children aged 3-5 years. METHODS: This cross-sectional study, conducted between November 2018 and March 2019, enrolled 515 preschool children. Asthma and potential risk factors, including hygiene, were assessed using a standardized questionnaire. A specific hygiene hypothesis scale has been generated and validated for this purpose. RESULTS: The hygiene hypothesis scale items converged over a solution of nine factors that had an Eigenvalue over 1, explaining a total of 65.86% of the variance. An acceptable Cronbach's alpha value was recorded for the hygiene hypothesis scale (0.696). Variables correlated with higher odds of asthma were male gender (ORa = 0.41 for females), living near a prairie sprayed with pesticides (ORa = 3.09), having a heating system in the bedroom compared to the sitting room (ORa = 9.97), attending kindergarten (ORa = 2.80), having a mother who smokes waterpipe compared to not smoking (ORa = 3.34), having a mother with a history of asthma (ORa = 5.50), and having respiratory infections (ORa = 14.72). However, the hygiene hypothesis score was not associated with higher odds of asthma (p = 0.881). CONCLUSIONS: The current results suggested that neither home cleaning nor personal cleanliness was correlated with asthma in preschool children. Larger prospective studies that measure the intensity and duration of exposure to each toxicant are suggested to better assess the hygiene hypothesis items and their association with asthma.

Hygiene hypothesis: association between hygiene and asthma among preschool children in Lebanon

OBJECTIVES: To validate a scale to assess the hygiene hypothesis and the association between hygiene and asthma among Lebanese preschool children aged 3-5 years. METHODS: This cross-sectional study, conducted between November 2018 and March 2019, enrolled 515 preschool children. Asthma and potential risk factors, including hygiene, were assessed using a standardized questionnaire. A specific hygiene hypothesis scale has been gen­erated and validated for this purpose. RESULTS: The hygiene hypothesis scale items converged over a solution of nine factors that had an Eigenvalue over 1, explaining a total of 65.86% of the variance. An acceptable Cronbach's alpha value was recorded for the hygiene hypothesis scale (0.696). Variables correlated with higher odds of asthma were male gender (ORa = 0.41 for females), living near a prairie sprayed with pesticides (ORa = 3.09), having a heating system in the bedroom compared to the sitting room (ORa = 9.97), attending kindergarten (ORa = 2.80), having a mother who smokes water­pipe compared to not smoking (ORa = 3.34), having a mother with a history of asthma (ORa = 5.50), and having respiratory infections (ORa = 14.72). However, the hygiene hypothesis score was not associated with higher odds of asthma (p = 0.881). CONCLUSIONS: The current results suggested that neither home cleaning nor personal cleanliness was correlated with asthma in preschool children. Larger prospective studies that measure the intensity and duration of exposure to each toxicant are suggested to better assess the hygiene hypothesis items and their association with asthma

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Factors associated with empathy among community pharmacists in Lebanon.

INTRODUCTION: Empathy is the cornerstone of the relationship between the healthcare provider and the patient. In Lebanon, no studies have investigated the factors associated with empathy among community pharmacists. Hence, the importance of this research to better understand empathy and help community pharmacists with this vital aspect of their practice. OBJECTIVE: This study aimed to evaluate empathy and possible factors associated with it among Lebanese community pharmacists. METHODS: This cross-sectional study was carried out between March and July 2018. It enrolled a proportionate random sample of 435 community pharmacists from all Lebanese districts. The Epi info software calculated the minimum sample size, based on a total number of 3762 community pharmacists, with an expected frequency of 50% of pharmacists with low empathy, and a 95% confidence interval. The minimal sample size required was 350 community pharmacists; our sample size was 435 to account for missing values. RESULTS: Our results revealed that 228 (53.4%) pharmacists had low empathy. Lower empathy was significantly associated with more physical (Beta = - 0.331) and mental (Beta = - 0.126) work fatigue, higher age (Beta = - 0.125) and a practice experience between 3 years and less than 6 years compared to less than 6 months (Beta = - 2.440). CONCLUSION: This study shed the light on some factors associated with empathy among Lebanese community pharmacists. Low empathy levels were significantly associated with factors such as age, practice experience, and mental and physical work fatigue, all of which impact the practice, as the accepted model of pharmacy practice requires that pharmacists establish effective communication and use interpersonal skills. Therefore, developing empathetic communication skills is considered essential. Furthermore, increased mental and physical work fatigue should not hinder community pharmacists' access to self-care, whether for their mental or physical health.

Are antibiotics substandard in Lebanon? Quantification of active pharmaceutical ingredients between brand and generics of selected antibiotics.

BACKGROUND: In developing countries, brand-generic substitution is not based on validated scientific evidence that confirm the therapeutic equivalence of the generic to the originator. Rather, decisions are made based on the availability of generic medications. Substitution by inappropriate preparations applies to antibiotics, which may increase the risk of resistance in case of underdosing. This analytical study aims to dose and assess for the accuracy of labeling three oral antibiotic preparations, namely ciprofloxacin hydrochloride, amoxicillin trihydrate and amoxicillin trihydrate-clavulanate potassium, the active pharmaceutical ingredients (APIs) found in brand and generic tablets available on the Lebanese market. METHODS: One brand and 4 generics of ciprofloxacin tablets, 3 generic amoxicillin tablets, and 1 brand and 4 generics of amoxicillin-clavulanic acid medications, were quantified, taking 2 batches of each. According to the United States Pharmacopeia (USP) guidelines, ultra-high pressure liquid chromatography was used to measure the APIs content within tablets. The USP required assay limit of the API was taken as the main comparison criteria. RESULTS: Out of the 5 ciprofloxacin medications tested, all 5 were out of the 2% required range, thus being substandard. For amoxicillin, all 3 medications were within the 20% range. As for amoxicillin-clavulanic acid medications, 4 out of 5 medications met the 30% required range of clavulanic acid and one exceeded the claimed amount of clavulanic acid, while all 5 met the assay limit for amoxicillin. CONCLUSION: These findings raise safety and efficacy concerns, providing solid grounds for potential correlations of antibiotic resistance/substandard antibiotics.

Factors associated with quality of life among community pharmacists in Lebanon: results of a cross-sectional study

OBJECTIVE: The objective of this study was to assess the quality of life and the factors associated with it among community pharmacists in Lebanon. METHODS: This cross-sectional study was carried out between March and July 2018, enrolling 435 pharmacists, using a proportionate random sample of community pharmacies from all districts of Lebanon. The validated Arabic translation of the Short-Form 12 (SF12v2) was used to derive 2 summary scores: physical and mental component summaries (PCS and MCS). RESULTS: Lebanese community pharmacists scored a mean PCS-12 and MCS-12 of 48.9 (SD 7.1) and 48.8 (SD 8.5), respectively. Higher age (Beta= -0.08), having a PhD degree (Beta= -4.54), higher depression score (Beta= -0.25), higher emotional work fatigue (Beta= -0.13) and higher physical work fatigue (Beta=-0.14) were significantly associated with lower physical QoL (lower PCS-12 scores). Increased stress (Beta= -0.17), higher insomnia (Beta= -0.21), higher depression (Beta= -0.2) and working for over 40 hours per week (Beta= -0.2) were significantly associated with lower mental QoL (lower mental MCS-12 scores). CONCLUSIONS: Our research has found a strong correlation between quality of life and psychological factors, including stress, burnout, insomnia, and depression among community pharmacists

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Factors associated with quality of life among community pharmacists in Lebanon: results of a cross-sectional study.

OBJECTIVE: The objective of this study was to assess the quality of life and the factors associated with it among community pharmacists in Lebanon. METHODS: This cross-sectional study was carried out between March and July 2018, enrolling 435 pharmacists, using a proportionate random sample of community pharmacies from all districts of Lebanon. The validated Arabic translation of the Short-Form 12 (SF12v2) was used to derive 2 summary scores: physical and mental component summaries (PCS and MCS). RESULTS: Lebanese community pharmacists scored a mean PCS-12 and MCS-12 of 48.9 (SD 7.1) and 48.8 (SD 8.5), respectively. Higher age (Beta= -0.08), having a PhD degree (Beta= -4.54), higher depression score (Beta= -0.25), higher emotional work fatigue (Beta= -0.13) and higher physical work fatigue (Beta=-0.14) were significantly associated with lower physical QoL (lower PCS-12 scores). Increased stress (Beta= -0.17), higher insomnia (Beta= -0.21), higher depression (Beta= -0.2) and working for over 40 hours per week (Beta= -0.2) were significantly associated with lower mental QoL (lower mental MCS-12 scores). CONCLUSIONS: Our research has found a strong correlation between quality of life and psychological factors, including stress, burnout, insomnia, and depression among community pharmacists.