Path analysis of the role of coping strategies between emotional intelligence and lifestyle habits during COVID-19 lockdown.

The relationship between Emotional Intelligence (EI) and lifestyle choices during the COVID-19 pandemic is obscure and not very well understood. To clarify the mechanisms underlying this relationship, we proposed to test the hypothesis that different coping styles (avoidant and approach) have an indirect effect on the association between EI and many types of lifestyle habits. A cross-sectional study was conducted between December 2020 and January 2021. Our target sample consisted of Lebanese adults from the general population. In path analysis, approach coping mediated the association between EI and different lifestyle habits (rest, nutrition, general physical conditions), but not exercise. Furthermore, avoidant coping did mediate the association between EI and general physical conditions, but not between EI and other lifestyle choices (namely rest, exercise, and nutrition). To conclude, individuals with high EI, and that are users of approach coping strategies to deal with stressors, have increased rest time, healthy nutrition and general physical conditions. This cautiously implies that fostering approach coping may help improve the positive effects of EI on healthy lifestyles during crises such as this pandemic.

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.

The association between mental health and Bulimia Nervosa among a sample of Lebanese young adults: the indirect effect of difficulties in emotion regulation.

BACKGROUND: Bulimia nervosa (BN) is defined as repeated episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting. BN has been shown to be associated with many co-morbidities including depression and anxiety. BN has also been associated with stress, which was shown to trigger binge eating episodes in BN. Furthermore, difficulties in emotion regulation have been seen to play an important role in the psychopathology of eating disorders, including BN. Seeing that BN is the most prevalent eating disorder in Lebanon, which is linked to the stressful events the country has been through, the study aims to examine the indirect effect of emotional dysregulation on this relationship between mental health issues (stress, anxiety and depression) and bulimia nervosa among young adults. We hypothesize that difficulties in emotion regulation would have an indirect effect in the relationship between mental health and BN. METHODS: This was a cross-sectional observational study, based on an online anonymous survey, which was carried out between September and December of 2020. Participants were all 18 years and above, recruited from all Lebanese governorates (n = 1175). RESULTS: Difficulties in emotion regulation mediated the association between anxiety/stress/depression and bulimia. Higher mental health issues were significantly associated with more difficulties in emotion regulation; higher difficulties in emotion regulation were significantly associated with more bulimia. Finally, higher anxiety and higher stress, but not depression, were significantly and directly associated with higher bulimia. CONCLUSION: Results of this study could be used by mental health professional to shed light on the difficulties in emotion regulation in patients with BN and try to use therapeutic strategies to help them better regulate their emotions.

Development and validation of the Socioeconomic Status Composite Scale (SES-C).

BACKGROUND: Socioeconomic status (SES) is a critical multifactorial determinant of health and plays a significant role in shaping an individual's health outcomes. While a composite scale has been proposed to measure SES in children, to our knowledge, limited composite scales were developed for adults in different contexts, highlighting the need for a comprehensive and valid SES measure to elucidate the relationship between SES and health in this population. OBJECTIVE: This study aimed to develop and validate a composite scale that measures the socioeconomic status in Lebanon and assess its correlates in a socioeconomic crisis context. METHODS: An online study was carried out between October and November 2022 across all Lebanese regions. Snowball sampling was used to enroll 448 adults living in Lebanon through a questionnaire created on Google Forms and shared by WhatsApp to a first sample from all geographic areas. RESULTS: The developed composite scale (SES-C) was found to be reliable and valid. It was based on several aspects of socioeconomic status, i.e., participant education level, family head education level, perceived social class, not being in debt, not receiving financial help, crowding index, participant work status, family head work status, monthly household income, and financial well-being. Furthermore, high SES was significantly associated with married status, older age, alcohol consumption, the absence of chronic disease, easy access to healthcare, private insurance coverage, and the number of rooms in the house in the bivariate analysis. In the multivariable analysis, high SES was significantly associated with age (ORa-1.13; p = 0.011) and easy access to healthcare (ORa = 7.81; p = 0.001) and inversely associated with chronic disease (ORa = 0.17; p = 0.002). Similar results with lower magnitude were found for moderate SES. CONCLUSION: The study successfully developed and validated a composite scale (SES-C) for measuring the socioeconomic status in Lebanon, taking into account the complexities of the Lebanese context. The scale was found to be reliable and valid, and its results showed significant correlations with various factors such as older age, lower risk of chronic disease, and easy access to healthcare.

Comprehension of prescription orders with and without pictograms: tool validation and comparative assessment among a sample of participants from a developing country.

BACKGROUND: Medication errors can often occur due to the patient's inability to comprehend written or verbal medication orders. This study aimed to develop pictograms of selected medication orders and to validate the comprehension of prescription orders index and compare the comprehension scores with and without pictograms. In addition to determine the predictors that could be associated with a better or worse comprehension of prescription orders with pictograms versus that of their written counterparts. METHODS: A cross-sectional study was conducted using a snowball sampling technique. Six pictograms were developed to depict specific medication orders. The comprehension of prescription orders index was constructed and validated. The study then compared the comprehension scores of prescription orders with and without pictograms, and identified the predicting factors score difference. RESULTS: A total of 1848 participants were included in the study. The structure of the comprehension of prescription orders index was validated over a solution of four factors, with an adequate Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy of 0.711 and a significant Bartlett's test of sphericity (P < 0.001). The construct validity of the index was further confirmed by highly significant correlations between each item and the full index (P < 0.001). The study also found a significant association between the difference in comprehension scores for prescription orders with and without pictograms and several factors, including age, level of education, area of residence, number of children, and smoking status with the difference of comprehension scores (P < 0.001). CONCLUSION: Pictogram-based instructions of medication orders were better understood by the Lebanese population than written instructions, making the incorporation of pictograms in pharmacy practice paramount to optimize medication use by the patient and thus yielding better health outcomes.

The effect of research on the perceived quality of teaching: a cross-sectional study among university students in Lebanon.

INTRODUCTION: The complementarity between research and teaching is still debated, although several higher education institutions require instructors to do research. In the absence of a consensus on this matter and given the lack of related studies in Lebanon, this study aimed to describe students' perception of research integration into teaching, and to link research and professional skills to quality teaching, using validated scales related to these concepts. METHODS: A standardized questionnaire was diffused to university students; it included validated scales: the Student Perception of Research Integration Questionnaire (SPRIQ), the Adapted-Teachers' quality assessment questionnaire (A-TQAQ), the Student Evaluation of Teaching short form (SET37-QS), and Knowledge and Attitudes Towards Health Research Questionnaire. RESULTS: Research integration was well perceived, and teaching was well evaluated by 445 participants from various disciplines, particularly those of a higher socioeconomic level, majoring in health, and females, as indicated by their mean scores. Research-active instructors had a significantly better-perceived teaching quality (17%; p < 0.001) than their non-active counterparts. This finding was particularly true among postgraduate and higher GPA students. The multivariable analysis showed that the knowledge and attitude towards research were related to students' better perception of research integration and higher evaluation of teaching. CONCLUSION: This study showed an overall good perception of research and teaching evaluation among participants from various disciplines, with research-active instructors having a better-perceived teaching quality. These findings could guide decisions on research integration into curricula using multidisciplinary methodologies to strengthen research integration and involve students in research activities.

Instructional educational games in pharmacy experiential education: a quasi-experimental assessment of learning outcomes, students' engagement and motivation.

BACKGROUND: This study aimed to determine the impact of implementing instructional educational games on attaining the intended learning outcomes mapped with the competencies of a pharmacy practice experience course, and to assess students' attitudes towards motivation and engagement in this active learning activity. METHODS: This was a quasi-experimental study that utilized a pretest-posttest for the research groups. Students were divided into teams and challenged to answer different questions related to the case scenarios. Different gaming platforms as Gamilab, Wisc-Online, and Quizizz were accordingly used to create different questions that help students memorize medications' brand names, and acquire the advanced community knowledge and skills. The attainment of the intended learning outcomes was assessed and compared between the experimental and control groups through the course total average of grades, and the subsequent averages of domains relating to the course competencies. Attitudes towards motivation and engagement in educational games activities were also assessed among the experimental group. RESULTS: A total of 233 students were enrolled in the study. The experimental group had significantly higher total posttest average compared to the control group (Beta = 7.695, 95% CI = 4.964-10.425, P < 0.001). The experimental group had also significantly higher averages of competency domains related to foundational knowledge (Beta = 1.471, 95% CI = 0.723-2.219, P < 0.001), pharmaceutical care (Beta = 1.650, 95% CI = 0.673-2.627, P < 0.001), essentials to practice and care (Beta = 1.838, 95% CI = 0.626-3.050, P < 0.003), and approach to practice and care (Beta = 2.736, 95% CI = 1.384-4.088, P < 0.001) averages. The experimental group reflected positive attitudes toward gamification engagement and motivation, with greater than 60% of the students recommend engage educational games to be part of the course. CONCLUSION: Incorporation of educational games into pharmacy practice experiences resulted in better learning outcomes. This kind of active learning appears to be acceptable and motivational for students, and is recommended for further research in didactic courses in the pharmacy curriculum.

Academic pharmacist competencies in ordinary and emergency situations: content validation and pilot description in Lebanese academia.

BACKGROUND: In the absence of a similar study in the Lebanese context, this study aimed to validate the content of the specialized competencies frameworks of academic pharmacists (educators, researchers, and clinical preceptors) and pilot their use for practice assessment in the context of multiple severe crises. METHODS: A web-based cross-sectional study was conducted between March and September 2022 among academic pharmacists enrolled by snowball sampling using a questionnaire created on Google Forms. RESULTS: The suggested frameworks had appropriate content to assess the competencies of academic pharmacists. Educators and clinical preceptors were confident in all their competencies except for emergency preparedness. Researchers had varying levels of confidence, ranging from moderate to high confidence for many competencies, but gaps were reported in fundamental research, conducting clinical trials, and pharmacy practice research (mean < 80). Educators and researchers relied primarily on experience and postgraduate studies, while clinical preceptors emphasized undergraduate studies to acquire their respective competencies. Continuing education sessions/programs were the least cited as a competency-acquiring venue across all roles. CONCLUSION: This study could develop and validate the content of frameworks for specialized competencies of academic pharmacists, including educators, researchers, and clinical preceptors, in a challenging setting. The frameworks were also piloted for practice assessment, which could contribute to supporting effective performance and sustained development of practitioners and help link the skills and competencies pharmacists learn during their studies with those required for a career in academia.

Smartphone addiction and personality traits among Lebanese adults: the mediating role of self-esteem.

Smartphone usage in Lebanon is increasing constantly. Lebanese population especially university students were described to be at a higher risk of smartphone addiction compared to the general population. To our knowledge there has been no study in the literature that investigated the mediating effect of self-esteem when assessing personality traits and smartphone addiction in young adults. The aim of our study was to assess factors associated with smartphone addiction and investigate the mediating role of self-esteem in the association between smartphone addiction and personality traits. A cross-sectional study was carried out between August and September 2020, during the lockdown period imposed by the government for the COVID-19 pandemic and that coincides with the summer season vacation for most Lebanese, using a sample of community-dwelling participants aged 18 to 29 years. The snowball technique was followed for participants' recruitment. The results showed that the mean age of the participants was 22.25 ± 2.87 years, with 70.9% females. The results showed that 216 (46.9%) of the participants had smartphone addiction. Higher negative emotionality (Beta = 0.17) was significantly associated with more smartphone addiction, whereas higher self-esteem (Beta = -0.37) and household crowding index (Beta = -1.58) were significantly associated with less smartphone addiction. Self-esteem mediated the association between negative emotionality and smartphone addiction. Lebanese young adults were found to be at a high risk of smartphone addiction. These results might serve as a first step towards implementing preventive measures to reduce smartphone addiction. Improving face to face communication, as well as setting specific time for cell phone usage might help reduce the development of addictive behaviors.

Should samples be weighted to decrease selection bias in online surveys during the COVID-19 pandemic? Data from seven datasets.

BACKGROUND: Online surveys have triggered a heated debate regarding their scientific validity. Many authors have adopted weighting methods to enhance the quality of online survey findings, while others did not find an advantage for this method. This work aims to compare weighted and unweighted association measures after adjustment over potential confounding, taking into account dataset properties such as the initial gap between the population and the selected sample, the sample size, and the variable types. METHODS: This study assessed seven datasets collected between 2019 and 2021 during the COVID-19 pandemic through online cross-sectional surveys using the snowball sampling technique. Weighting methods were applied to adjust the online sample over sociodemographic features of the target population. RESULTS: Despite varying age and gender gaps between weighted and unweighted samples, strong similarities were found for dependent and independent variables. When applied on the same datasets, the regression analysis results showed a high relative difference between methods for some variables, while a low difference was found for others. In terms of absolute impact, the highest impact on the association measure was related to the sample size, followed by the age gap, the gender gap, and finally, the significance of the association between weighted age and the dependent variable. CONCLUSION: The results of this analysis of online surveys indicate that weighting methods should be used cautiously, as weighting did not affect the results in some databases, while it did in others. Further research is necessary to define situations in which weighting would be beneficial.

Emotion regulation and drunkorexia behaviors among Lebanese adults: the indirect effects of positive and negative metacognition.

BACKGROUND: Although metacognition processes are a core feature of restrictive eating and alcohol cravings and entail an individual to control both of his/her emotions and thoughts, yet, to our knowledge, a scarcity of research has examined their potential role in drunkorexia as cognitive and emotional predictors. The following study investigates the different associations between two emotion regulation strategies (i.e. emotional suppression and cognitive reappraisal) and drunkorexia behaviors in a sample of Lebanese adults, exploring the possible indirect effects of positive and negative alcohol-related metacognitions. METHODS: This was a cross-sectional study that enrolled 335 participants (March-July 2021). RESULTS: Higher problematic alcohol use (beta = 5.56), higher physical activity index (beta = 0.08), higher expressive suppression (beta = 0.23), higher negative metacognitive beliefs about cognitive harm due to drinking (beta = 0.75) and higher cognitive reappraisal (beta = 0.20) were significantly associated with more drunkorexic behaviors. The positive metacognitive beliefs about cognitive self-regulation significantly mediated the association between cognitive reappraisal and drunkorexia behaviors. Both the positive metacognitive beliefs about cognitive self-regulation and the negative metacognitive beliefs about the uncontrollability of drinking significantly mediated the association between expressive suppression and drunkorexia behaviors. CONCLUSION: This study demonstrated that emotional and metacognitive processes are associated with drunkorexia, addressing as well the mediating effect between deficient emotional regulation and risky behavioral patterns. Overall, our results would speculate that the lack of emotional and cognitive assets might enhance internal distress perceived out of control, leading individuals to indulge in maladaptive behavioral patterns for managing the underlying impairment.

Eating disorders and their relationship with menopausal phases among a sample of middle-aged Lebanese women.

OBJECTIVES: The objective of our study was to evaluate the association between the transition to menopause, body dissatisfaction, and abnormal eating habits (restrained eating, binge eating, and orthorexia nervosa) in a sample of middle-aged Lebanese women. METHODS: A cross-sectional study conducted between July 2019 and January 2020 enrolled 1001 women aged 40 years and above from all Lebanese governorates. Data were collected by face-to-face interviews with all participants. The Body dissatisfaction subscale of the Eating Disorder Inventory­second version was used to assess body dissatisfaction, whereas the Binge Eating Scale, Dutch Restrained Eating Scale, ORTO-15, Dusseldorf Orthorexia Scale (DOS), and Teruel Orthorexia Scale (TOS) were used to assess eating disorders (binge eating, restrained eating and orthorexia nervosa respectively. Multivariable analysis of covariance (MANCOVA) was used to compare multiple measures among the three menopausal phases, after adjustment over potential confounding variables (age, monthly income, body mass index, marital status, education level, and body dissatisfaction). RESULTS: Postmenopause was significantly associated with more orthorexia nervosa tendencies (lower ORTO-15 scores) than premenopause (ß = - 1.87; p = 0.022). Perimenopause was associated with more binge eating (ß = 1.56; p = 0.031), and less orthorexia nervosa (as measured by the DOS) than premenopause, with this association tending to significance (ß = - 1.10; p = 0.051). Furthermore, higher body dissatisfaction was significantly associated with higher restrained eating (ß = 0.02; p < 0.001), binge eating (ß = 0.48; p < 0.001), and orthorexia nervosa as measured by ORTO-15 (ß = - 0.17; p < 0.001) and TOS (ß = 0.08; p = 0.002), but not DOS. CONCLUSION: Our study showed that menopausal stages are associated with some disordered eating behaviors (binge eating and orthorexia nervosa) among middle-aged women. Those results may serve as a first step towards spreading awareness among women within this age group regarding eating attitudes. Moreover, healthcare professionals should screen for the presence of disordered eating during those women's routine visits to the clinics.

Knowledge, attitude and practice of Lebanese parents towards childhood overweight/obesity: the role of parent-physician communication.

BACKGROUND: Childhood overweight and obesity is one of the most challenging public health problems facing both developed and developing countries. Several studies carried worldwide assessed predisposing risk factors for childhood obesity, however, few addressed the Middle East region and particularly Lebanon. We aimed in our study to assess factors associated with knowledge, attitude and practice of Lebanese parents regarding childhood overweight, particularly the parent-physician communication. METHODS: This cross-sectional study conducted between September and December 2019. The questionnaire used was the standardized questionnaire of "Parent Questionnaire Curriculum" from the "We Can program" (Ways to Enhance Children's Activity and Nutrition). RESULTS: A higher parent-physician communication score (Beta = 0.05) was significantly associated with higher knowledge, whereas having a higher intermediate vs low income (Beta = -0.65) was significantly associated with lower knowledge. A higher knowledge global score (Beta = 1.25), a higher parent-physician communication score (Beta = 0.18), and having a university education level compared to illiterate/primary/complementary (Beta = 2.59) were significantly associated with better attitude. A better attitude (Beta = 0.92) and a higher global knowledge score (Beta = 0.6) were significantly associated with a better practice. CONCLUSION: This study found that a better parent-physician communication and higher knowledge were associated with better attitude and practice towards obesity. Given the rise in childhood obesity worldwide, identifying factors that help reduce childhood obesity, is becoming mandatory. Our results can open up to future studies addressing strategies to prevent childhood obesity in Lebanon.

Assessing self-reported core competencies of public health practitioners in Lebanon using the WHO-ASPHER validated scale: a pilot study.

BACKGROUND: The World Health Organization and the Association of Schools of Public Health in the European Region recommend the self-assessment of public health core competencies to strengthen the proficiency of the public health workforce and prepare them for future challenges. A framework for these competencies is lacking and highly needed in Lebanon. This study aims to validate the WHO-ASPHER self-declared scale and evaluate the perceived competency level of the different categories of Lebanese public health practitioners. METHODS: This population-based cross-sectional study conducted online between July and September 2021 involved 66 public health practitioners who graduated from different universities in Lebanon. Data were collected using the snowball technique via a self-report questionnaire that assessed public health proficiency, categorized into 1) content and context, 2) relationship and interactions, and 3) performance and achievements. The rotated component matrix technique was used to test the construct validity of the scales. Bivariate and multivariate analyses were performed after ensuring the adequacy of the models. Significance was set at a p-value < 0.05. RESULTS: The factor analysis for scale domains showed that the Barlett test sphericity was significant (p < 0.001), high loadings of items on factors, and Cronbach's alpha values of more than 0.9 in all three categories, showing an appropriate scale validity and reliability. The perceived level of competencies was significantly different between public health professionals and other health professionals with public health activities. All respondents scored low in most public health categories, mainly science and practice. CONCLUSION: Data findings showed variability of self-declared gaps in knowledge and proficiency, suggesting the need to review the national public health education programs. Our study offers a valuable tool for academia and public health professionals to self-assess the level of public health proficiency and guide continuous education needs for professional development.

Drunkorexia behaviors and motives, eating attitudes and mental health in Lebanese alcohol drinkers: a path analysis model.

BACKGROUND: Drunkorexia refers to limited intake of high-calorie food to avert gaining weight and the need to increase in alcohol excessive consumption. The present study aimed to check for an association between depression, anxiety, and stress with drunkorexia behaviors/motives among Lebanese adults, while evaluating the mediating role of inappropriate eating attitude in those associations. METHODS: Two hundred and fifty-eight participants enrolled in this cross-sectional study, who filled an online survey (September-December 2020). RESULTS: Drunkorexia behaviors were considered as the dependent variable; the path coefficients from stress to anxiety, from anxiety to eating attitudes, from eating attitudes to drunkorexia behaviors and from anxiety to drunkorexia behaviors were all significant. The indirect relationships showed that eating attitudes mediated the association between anxiety and drunkorexia behaviors. When taking the drunkorexia motives as the dependent variable, the path coefficients from stress to anxiety, from anxiety to eating attitudes, from eating attitudes to drunkorexia motives, and from anxiety to drunkorexia motives were all significant. The indirect relationships showed that eating attitudes mediated the association between anxiety and drunkorexia motives. CONCLUSION: This study highlighted that individuals with more psychological problems (depression, anxiety, and stress) and inappropriate eating habits exhibit more drunkorexic motivations and behaviors. LEVEL OF EVIDENCE: Level V, Cross-sectional study.

Adherence to Post-Stroke Pharmacotherapy: Scale Validation and Correlates among a Sample of Stroke Survivors.

Background and Objectives: Adherence to post-stroke pharmacotherapy has been less studied compared with other cardiovascular diseases, and previous research in this context utilized generic tools without cross-validating for stroke specific factors and patient characteristics. This study aimed to validate the Lebanese Medication Adherence Scale (LMAS-14) among stroke survivors to assess adherence to post-stroke pharmacotherapy. It also aimed to determine the socioeconomic, clinical characteristics, and health related quality of life correlates of medication adherence among stroke survivors. Materials and Methods: This was a cross-sectional study that included stroke survivors from districts throughout Lebanon. A well-structured questionnaire consisting of three parts was developed and utilized to collect data. The first part included questions about the sociodemographic and socioeconomic characteristics. The second part included questions about medical history, current clinical characteristics of the patients, and use of medications. The third part included validated scales to assess stroke outcomes, daily performance and activities, and quality of life. Results: A total of 172 stroke survivors were included. The LMAS-14 structure was validated over a solution of three factors, with a Kaiser−Meyer−Olkin (KMO) measure of sampling adequacy = 0.836 and a significant Bartlett's test of sphericity (p < 0.001). Severe difficulty in obtaining medications within the current Lebanese economic crisis was significantly associated with lower medication adherence (Beta = −8.473, p = 0.001). Lower medication adherence was also associated with poor stroke prognosis (Beta = −3.264, p = 0.027), higher number of used medications (Beta = −0.610, p = 0.034), and longer duration of stroke diagnosis (Beta = −4.292, p = 0.002). Conclusions: The LMAS−14 is a valid and reliable tool to assess medication adherence in stroke practice and research. Severe difficulty in obtaining medications due to unpredictable availability and shortage of supplies is associated with lower medication adherence, and thus places stroke survivors at higher risk of complications and morality. Additional measures and urgent action by stroke care providers and public health stakeholders are necessary to ensure adequate post-stroke management and outcomes.

Factors associated with general well-being among Lebanese adults: The role of emotional intelligence, fear of COVID, healthy lifestyle, coping strategies (avoidance and approach).

General well-being is best described as the state of mind that gives people happiness and satisfaction in life. This concept is influenced by behaviors and attitudes that individuals do on a daily basis. The purpose of this study was to understand how general well-being is correlated with other factors such as emotional intelligence, Covid-19-induced fear, healthy lifestyle, and coping strategies. This cross-sectional study was carried out between December 2020 and January 2021 during the COVID-19 pandemic when lockdown restrictions were implemented at different instances. A total of 470 individuals participated. The results of a linear regression, taking the general well-being schedule score as the dependent variable, showed that more avoidance coping (B = 1.05, t(459) =8.44, p < 0.001), higher healthy lifestyle scores (B = 0.45, t(459) = 5.45, p < 0.001), and more approach coping (B = 0.42, t(459) = 4.03, p < 0.001) were significantly associated with higher GWB schedule scores. Moreover, having more fear of COVID-19 (B = -0.62, t(459) = -5.09, p < 0.001) and female gender (B = -6.80, t(459) = -4.34, p < 0.001) were significantly associated with lower GWB schedule scores. To our knowledge, this is the first study in Lebanon to evaluate GWB and factors that predict it among the general population. Nevertheless, more comprehensive future studies with longitudinal designs, more diverse socio-demographic backgrounds of sampled population recruited via probability sampling, and more reliable and valid instruments utilized are warranted to confirm our findings and draw a more certain conclusion.

Phubbing among Lebanese young adults: Scale validation and association with mental health (depression, anxiety, and stress).

Mobile phones use has not been without several social and psychological problems, specifically during the fast spread of the COVID-19 infection, which imposed strict restrictions and isolation. This research principal aims were to (1) confirm the validity of the Generic Scale of Phubbing in Arabic (GSP), and (2) evaluate the association between phubbing and mental health (depression, anxiety and stress). A first cross-sectional study enrolled 203 participants to confirm the factor structure of the phubbing scale among Lebanese young adults. A confirmatory factor analysis (CFA) was carried out on the whole sample using SPSS AMOS v.24 to confirm the four-factor structure of the GSP. The root mean square error of approximation (RMSEA) statistic, the comparative fit index (CFI) and the Tucker Lewis Index (TLI) were used to evaluate the goodness-of-fit of the model. RMSEA values ≤0.08 and ≤ 0.10 indicate a good and acceptable fit respectively. CFI and TLI values ≥0.90 indicate good model fit. A second cross-sectional study enrolled 461 respondents (18-29 years old) to conduct the multivariable analysis. The fit indices values were as follows: χ2/df = 181.74/84 = 2.16, TLI = .92, CFI = .94 and RMSEA = .076 [95% CI .061-.091] respectively, indicating an excellent fit of the model. The results of the multiple linear regression using the ENTER model, when taking the phubbing score as the dependent variable, showed that female gender (ß = 0.11; t(454) = 2.50; p = .013), more stress (ß = 0.27; t(454) = 3.94; p < .001), more anxiety (ß = 0.30; t(454) = 4.24; p < .001), and older age (ß = 0.28; t(454) = 6.12; p < .001) were positively correlated with higher phubbing, or higher household crowding index (ß = -0.15; t(454) = -3.62; p < .001) was significantly correlated with less phubbing. The results of this study were able to confirm the validity of the Arabic version of the GSP scale. This will allow Lebanese clinicians to use this validated tool to screen for the presence of the phubbing phenomenon within this age group. We propose finding possible correlation between phubbing and others factors (such as obsession and loneliness) and validating this scale in other Arabic-speaking countries.

Suicidal ideation among Lebanese adults: scale validation and correlates.

BACKGROUND: According to the World Health Organization (WHO) figures in 2015, the number of people attempting suicide worldwide per year exceeds 800,000 individuals. The majority of completed suicides (78%) occur in low- and middle-income countries. Therefore, this study aimed to validate the suicidal ideation subscale of the Columbia-Suicide Severity Rating Scale and evaluate risk factors (emotional intelligence, alexithymia, anxiety, depression, and stress) related to suicidal ideation among the Lebanese adult population. METHODS: A structured cross-sectional survey was carried out between November 2017 and March 2018, enrolling a proportionate random sample of 789 community-dwelling participants from all the Lebanese regions. A correlation analysis between the C-SSRS and anxiety and depression assessed the convergent validity of the scale. An exploratory and a confirmatory factor analysis validated its construct. Cronbach's alpha was used to assess internal consistency reliability. Multiple linear regression was performed using the suicidal ideation score as the dependent variable. All variables were included in the multivariable model. RESULTS: The C-SSRS scale converged over a solution of one factor; the proportion of explained variance was 0.797. The Cronbach's alpha value was good (0.797). The convergent validity was tested with depression and anxiety scales. The results showed a moderate positive correlation between the suicide ideation score and depression (rho = 0.507, p < 0.001) and anxiety (rho = 0.402, p < 0.001). The multivariable analysis showed that higher depression (Unstandardized Beta, B = 0.035, p < 0.001), higher anxiety (B = 0.015, p = 0.008), and higher alcohol dependence (B = 0.024, p < 0.001) were significantly linked to higher suicidal ideation score. However, higher self-esteem (B = -0.041, p = 0.006) was significantly associated with lower suicidal ideation scores. CONCLUSION: Our findings suggest that the Arabic version of the C-SSRS subscale could serve as an appropriate assessment tool for suicidal ideation. This paper also gave insights into factors correlated with higher suicidal ideation scores, such as depression, anxiety, and alcohol dependence. Further studies are necessary to confirm our findings and implement suicide prevention programs.

Food neophobia in Lebanese children: scale validation and correlates.

OBJECTIVE: To validate the Food Neophobia Scale (FNS) and determine factors associated with the presence of food neophobia (FN) in a sample of Lebanese children. DESIGN: Cross-sectional study conducted between July and December 2019. SETTING: All Lebanese governorates. PARTICIPANTS: Parents of Lebanese children aged 2 to 10 years. RESULTS: Out of 850 questionnaires, 194 were excluded. The mean age of children was 5·34 ± 2·20 years (50·8 % females); 238 (36·4 %) had low neophobia scores (≤37), whereas 219 (33·5 %) and 197 (30·1 %) had, respectively, moderate (between 38 and 41) and severe neophobia scores (≥42). All items of the FNS were extracted except item 8 and yielded a two-factor solution with Eigenvalues > 1 (variance explained = 51·64 %; Kaiser-Meyer-Olkin (KMO) test = 0·746; Bartlett's sphericity test P < 0·001; αCronbach = 0·739). Children who refused initially to eat vegetables (ß = 5·51), fish (ß = 4·57), fruits (ß = 4·75) or eggs (ß = 2·99) and higher parents' instrumental feeding scores (ß = 0·3) were significantly associated with higher neophobia scores, whereas higher parents' encouragement scores (ß = -0·21) were significantly associated with lower neophobia scores in children. CONCLUSION: FN is common in children. Neophobic children tend to have lower variety in their diets. One of the ways to lower the levels of neophobia is the use of encouragement by the parents. In contrast, offering a reward to children for them to eat a certain food was associated with more signs of avoidance. More studies should be conducted to evaluate awareness levels concerning FN.