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Evidence of an association between metabolic syndrome (MetS) and irritable bowel syndrome (IBS) is emerging but is still inconclusive. The current cross-sectional study was conducted to explore the relationship between the two syndromes in a sample of Lebanese adults (n 221; mean age: 43·36 years; 62·9 % females), recruited from a large urban university and its neighbouring community. MetS was diagnosed based on the International Diabetes Federation criteria, and IBS was assessed using the Birmingham IBS scale. Logistic regression analyses were performed taking MetS and its components as dependent variables and IBS and its subscales as independent variables. Covariates included socio-demographic, dietary and lifestyle variables. MetS was positively associated with visual analogue scale (VAS) IBS (total scale (Beta = 4·59, P = 0·029) and VAS–diarrhoea subscale (Beta = 4·96, P = 0·008). Elevated blood pressure (Beta = 5·02, P = 0·007), elevated fasting blood sugar (Beta = 4·19, P = 0·033) and elevated waist circumference (Beta = 5·38, P = 0·010) were positively associated with VAS–Diarrhoea subscale. MetS and IBS were found to be positively associated in a sample of the Lebanese adult population. We suggest that it might be of value to screen for either condition if one of the syndromes exists. Future longitudinal studies are essential to establish a causal relationship between the two syndromes to further understand the commonality related to pathogenesis and explore potential underlying mechanisms.
Dignity is perceived as being valued and respected. Maintaining dignity throughout illness is a fundamental principle of palliative care. Dignity can be influenced through family caregiver’s communication, support, and acts of empathy or indifference among other factors. The perception of dignity and the practices adopted by family caregivers to preserve the dignity of their ill relative with serious illness in Lebanon are explored in this paper.
Methods
This is a part of a larger study that explored the understanding of dignity from patients’ and family caregivers’ perspectives in a palliative care context. Data collection involved in-depth interviews with 15 family caregivers. Interviews were analyzed using reflective thematic analysis.
Results
Four main themes, that explained how family caregivers understand, and uphold their relative’s dignity during illness, were developed:
(a) Familial duty expressed through presence and compassion;
(b) Holistic care and financial stability;
(c) Social connection and family roles;
(d) Compassionate services and communication.
Family caregivers maintained the dignity of their ill relatives through being there, compassionate communication, supporting the personal and medical needs of the patient, and helping them preserve their family role. Family caregiving was often underpinned by religious values and a sense of duty. Compassionate services and effective communication were essential to preserve dignity of the ill relative during hospitalizations.
Significance of results
Family caregivers assume multiple roles in fostering the dignity of relatives with serious illnesses. It is crucial that family caregivers are supported by policies, healthcare systems, and community initiatives as patients cannot thrive nor sustain dignity without their support.
Illegal hunting of migratory birds across the Mediterranean region is a serious international conservation issue with population-level impacts. We analysed photographs posted on social media platforms to assess the bird species illegally targeted in Lebanon. During 2011–2023 we reviewed 1,844 photographs publicly posted by poachers on Facebook and Instagram. In these images we identified 212 bird species, of which 94% are legally protected. Many are species of conservation concern, with 19 listed as threatened or Near Threatened on the IUCN Red List and 33% experiencing population declines in Europe. The five bird species with the most individuals illegally killed were the barn swallow Hirundo rustica, blackcap Sylvia atricapilla, European bee-eater Merops apiaster, Eurasian golden oriole Oriolus oriolus and ortolan bunting Emberiza hortulana. Raptors and other large soaring birds were particularly prevalent, with 35 species of raptor (particularly the European honey-buzzard Pernis apivorus, Eurasian sparrowhawk Accipiter nisus, common kestrel Falco tinnunculus, short-toed snake-eagle Circaetus gallicus and Levant sparrowhawk Accipiter brevipes) as well as storks, pelicans and cranes. Protected mammals were also posted as trophies, including the Near Threatened striped hyaena Hyaena hyaena. Poachers were present in 44% of photographs and were clearly identifiable 89% of the time, showing little concern about posting illegal activities on publicly accessible social media platforms. Our study is the first to use social media as a tool for assessing illegal hunting activities in Lebanon. We discuss both the use and limitations of this approach, as well as the ways in which social media can be utilized by law enforcement, to promote legal hunting or hunting alternatives and improve conservation education.
The framing of the International Center for Agricultural Research in the Dry Areas (ICARDA) in relation to the postwar Middle East and North Africa (MENA) region grafted a political geography onto a broad range of ecological areas. Planners, drawing on climate models, classified the region in agro-ecological terms devised in reference to the tropics. Functionally, their logic shored up a focus on rainfed, or unirrigated, agriculture in semi-arid and arid lands. But their rendering of dry areas masked the geopolitical framing of international agricultural research in the postwar period. Born of the Cold War, ICARDA emerged from exercises of European imperialism, Great Power rivalries, and the improvisation of modern nation-states in Western Asia and North Africa. The chapter charts the imperial origins of international agricultural research in Syria, the Cold War on hunger, and CGIAR’s classification of arid regions, towards an account of (1) the geopolitical logic of international agricultural research and (2) dryland agricultural science as the ground for technological and political intervention in decolonized lands.
The aspirations-ability framework proposed by Carling has begun to place the question of who aspires to migrate at the center of migration research. In this article, building on key determinants assumed to impact individual migration decisions, we investigate their prediction accuracy when observed in the same dataset and in different mixed-migration contexts. In particular, we use a rigorous model selection approach and develop a machine learning algorithm to analyze two original cross-sectional face-to-face surveys conducted in Turkey and Lebanon among Syrian migrants and their respective host populations in early 2021. Studying similar nationalities in two hosting contexts with a distinct history of both immigration and emigration and large shares of assumed-to-be mobile populations, we illustrate that a) (im)mobility aspirations are hard to predict even under ‘ideal’ methodological circumstances, b) commonly referenced “migration drivers” fail to perform well in predicting migration aspirations in our study contexts, while c) aspects relating to social cohesion, political representation and hope play an important role that warrants more emphasis in future research and policymaking. Methodologically, we identify key challenges in quantitative research on predicting migration aspirations and propose a novel modeling approach to address these challenges.
Chapter 3 considers the development of the infamous martyrdom operations, or "suicide bombings," in the late twentieth century. Beginning by considering postcolonial experiences of Shi’i Muslims in 1980s West Asia, I argue for approaching two contexts of conflict—Lebanon and Iran—in tandem, due to their joint recognition of the Guardianship of the Jurisprudent Ayatollah Khomeini. Evaluating the ideological contributions of Shi’a history and Persian art forms, I trace the way the concepts of jihad—struggle in the way of God—and shahid—martyrdom—increasingly take martial shapes during the period, leading to the figure of the istishhadi who gives their life in an attack on the enemy. Both the explosive tactics of Hezbollah and the human wave attacks of Iran’s Basij forces are linked by the conception that willing self-sacrifice paves the way to realizing a divine kingdom on earth and filtered through the lens of Husayn’s battle at Karbala. Finally, I show the connection between the words of these martyrs and contemporary Shi’i authorities to the idea of commanding right and forbidding wrong, and the need to live life according to divine law regardless of the consequences.
Public debates on academic freedom have become increasingly contentious, and understandings of what it is and its purposes are contested within the academy, policymakers and the general public. Drawing on rich empirical interview data, this book critically examines the understudied relationship between academic freedom and its role in knowledge production across four country contexts - Lebanon, the UAE, the UK and the US - through the lived experiences of academics conducting 'controversial' research. It provides an empirically-informed transnational theory of academic freedom, contesting the predominantly national constructions of academic freedom and knowledge production and the methodological nationalism of the field. It is essential reading for academics and students of the sociology of education, as well as anyone interested in this topic of global public concern. This title is part of the Flip it Open Programme and may also be available Open Access. Check our website Cambridge Core for details.
This chapter brings to the fore a key theme across the second part of Mandatory Madness: the considerable agency exercised by families over the management of their mentally ill relatives. This chapter focuses in particular on the petitions that flooded the mandate government from the 1930s onwards, seeking the admission of relatives to the government’s mental institutions. These petitions are read both for what they reveal about the often-complex therapeutic strategies pursued by families, and as carefully crafted arguments about mental illness and the state’s obligations to its subjects. Petitions make clear that Palestinian Arab families in particular were much more actively engaged with questions of psychiatric care than has been often represented, incorporating the mandate’s processes, institutions, and indeed anxieties into their strategies for managing the mentally ill. Petitions reframe our understanding of the interactions between state and society in mandate Palestine, by revealing how these played out in the intimate stretches of people’s lives.
From the end of the 1960s until the outbreak of the Civil War (1975), Lebanon experienced a phase of relatively sustained industrial expansion. Albeit the “boom” did not modify significantly Lebanon's tertiarized economic structure, it was anyway sufficient to create the structural conditions for the emergence of a new militant working-class able to become one of the most relevant contentious actors of its time. This new working class was made primarily of very young and recently urbanized unemployed of rural origin, brutally injected in a crude and hyper-exploitative productive cycle where formal labor unions were, for the most part, absent or scarcely effective. The input for their grassroots, transgressive organization into factory-based Workers’ Committees came from the Organization for Communist Action in Lebanon (OACL), i.e. the most important force of the so-called Lebanese New Left, within the framework of a broader process of militant penetration of the “revolutionary classes” produced by the contradictions of Lebanese capitalism. This created the precondition for the Committees to affirm themselves not only as the radical avant-garde of the Lebanese labor movement but also as an integral part of a broader process of contestation of the existing status quo by the subaltern groups emerged from - or activated by - the structural and cultural changes that the country was experiencing. By retrieving the forgotten history of the Workers’ Committees, the article wants to examine the forms and the trajectories whereby such a new working class became an integral part of this process. In particular, by adopting a Gramscian methodology, the article will first expose the structural changes in the Lebanese industrial sector in the examined period and their labor implications. Then, it will focus on the dynamics which superseded the Committees' birth and affirmation, reserving particular attention to the role played by the OACL. Finally, it will conclude by examining the impact of their agency on the political developments that the country was experiencing. The paper contends that the emergence and the affirmation of counter-hegemonical and transformative working-class activism on the eve of the Civil War, along with representing a direct by-product of structural stresses and constraints, was significantly debtor also of the new ideological and militant infrastructures that the emergence of an Arab New Left had contributed to popularize and deploy. The paper wants also to intervene in the historiographical debate on the Lebanese Civil War, stressing the importance of both subaltern actors and class phenomena in its outbreak, which have generally been widely disregarded by the dominant understandings of the conflict.
The fourth chapter gives a succinct historical description of the secular nationalist ideologies in Syria, Lebanon, and Israel and compares the secular political movements in these countries as they have different regime types and political cultures. The chapter also provides brief biographical accounts of the three top executive leaders from each country: Bashar al-Assad, Saad al-Hariri, and Benjamin Netanyahu. The authors also present and compare the operational code results of the leaders and deliberate on what kind of generic foreign policy behavior and strategies we should expect from secular nationalist leaders. The chapter also sheds light on what these results and strategies mean for MENA politics and for the international relations discipline.
Concerns about the side effects of available coronavirus disease (COVID-19) vaccines have posed a significant barrier to vaccination in several countries. Accordingly, the current study aimed to assess the acceptability of COVID-19 vaccination and its predictors among the Lebanese population.
Methods:
A cross-sectional study was conducted in February 2021 among Lebanese adults from the 5 main Lebanese districts. The questionnaire included demographic data, questions about COVID-19 experience, COVID-19 anxiety syndrome scale, and attitudes regarding the COVID-19 vaccine. Data were analyzed on SPSS, version 23. Statistical significance was considered at a P value ≤ 0.05 with a 95% CI.
Results:
Of 811 participants, 45.4% (95% CI: 41.9-48.9) accepted taking the COVID-19 vaccine. Choices were negatively affected by concerns about the side effects of the vaccine and positively affected by anxiety and seeking COVID-19 news very closely. Moreover, if the COVID-19 vaccination was a requirement for traveling, participants would be more willing to get the vaccine.
Conclusions:
Since 54.7% of the studied Lebanese adults were either unwilling or undecided to get the vaccine and COVID-19 news was retrieved mainly from the Ministry of Public Health online site and the local news, the existing targeted campaign should be enforced toward encouraging vaccination to reach herd immunity against COVID-19 and revealing the safety of the vaccines.
The following interview with Layale Chaker, conducted on 14 September 2023, delves into her unique journey as a Palestinian-Lebanese composer, highlighting the pivotal role of music in shaping her sense of “home” following the Lebanese Civil War. Drawing from her diverse musical upbringing, spanning community choirs to formal conservatory education, Chaker elucidates the disparity between institutional training and the lived musical experiences of the Arab world, informing her quest for authenticity in composition.
Chaker recounts her involvement with the West-Eastern Divan Orchestra, founded by Daniel Barenboim and Edward Said, juxtaposed with her decision to pursue an individual artistic trajectory. Central to the conversation is her composition “En Présence de l'Absence – Homáge à Edward Saïd,” revealing a deeply personal connection to Said's legacy and a nuanced exploration of his ethos through music.
The interview culminates with insights into Chaker's forthcoming opera, “Ruinous Gods,” co-crafted with playwright Lisa Schlesinger. Addressing the profound trauma of refugee children afflicted with uppgivenhetssyndrom (resignation syndrome), the opera promises a poignant musical narrative probing themes of parenthood, displacement, and societal obligation. Set for premiere at the 2024 Spoleto Festival USA, Chaker's work continues to blend artistry with advocacy, offering a resonant reflection on human resilience and responsibility.
The following chapter traces the history of Lebanese politics, reflecting on the structural factors that facilitate the involvement of external powers. It suggests that the structural organization of the state allows for external patronage in support of communal interests and, amid times of crisis, this patronage is seen to be a necessity. Moreover, the geopolitical significance of Lebanon means that external actors also seek local allies as a means of countering rivals who already possess influence across the state while local actors also seek to position themselves within broader regional currents. To understand the competition over Lebanon, we must trace the historical development of the Lebanese state which allows for identification of the structural factors conditioning – or limiting – the deployment of capital and foreign policy activities.
Since 1979, few rivalries have affected Middle Eastern politics as much as the rivalry between Saudi Arabia and Iran. However, too often the rivalry has been framed purely in terms of 'proxy wars', sectarian difference or the associated conflicts that have broken out in Iraq, Lebanon, Syria, Bahrain, and Yemen. In this book, Simon Mabon presents a more nuanced assessment of the rivalry, outlining its history and demonstrating its impact across the Middle East. Highlighting the significance of local groups, Mabon shows how regional politics have shaped and been shaped by the rivalry. The book draws from social theory and the work of Pierre Bourdieu to challenge problematic assumptions about 'proxy wars', the role of religion, and sectarianism. Exploring the changing political landscape of the Middle East as a whole and the implications for regional and international security, Mabon paints a complex picture of this frequently discussed but oft-misunderstood rivalry.
This study aimed to explore the nutritional content and quality of food parcels distributed in Lebanon and assess their adherence to dietary guidelines during the COVID-19 pandemic and an unprecedented economic crisis.
Design:
Cross-sectional study (June–July 2020); phone survey (thirty items).
Setting:
Lebanon.
Participants:
Food parcel providers (FPP; n 72) involved in food parcel distribution (FPD), mainly to Lebanese households.
Results:
FPP included international non-governmental organizations (INGO) (n 3), local non-governmental organizations (n 45) and personal initiatives (n 24). Overall, low adherence to the World Food Programme (WFP) food parcel guidelines were observed among FPP for specific food items, including vegetables, fish, legumes and cereals, whereas salt content significantly surpassed the guidelines (all P-values <0·001). On average, a food parcel provided 608·4 ± 55 kcal/d/person. The greatest contributors to total energy intake (TE) in the food parcel were carbohydrates (46·4 %) and fats (46·8 %), while protein contributed to 7 %TE. In addition, %TE from fats and sugars significantly surpassed the dietary reference intakes (DRI) for a single person per d (134–234 % and 185 % of DRI, respectively, P-values <0·001). Only 10–15 % of daily needs for key micronutrients, including Fe, Zn, thiamin, riboflavin and dietary folate, were met through the food parcels. Adequate food safety and hygiene practices were reported among FPP, yet dramatic changes in food costs due to overlapping crises affected the quality and quantity of food in parcels.
Conclusions:
Findings highlight the need to improve the nutritional content of food parcels and adherence to dietary guidelines to alleviate food and nutrition insecurity while preventing diet-related diseases among vulnerable beneficiaries in Lebanon.
The COVID-19 pandemic remains a public health problem threatening national and global health security. The socio-economic impact of COVID-19 was more severe on developing countries including Lebanon, especially due to the fragile healthcare system, weak surveillance infrastructure and lack of comprehensive emergency preparedness and response plans. Lebanon has been struggling with plethora of challenges at the social, economic, financial, political and healthcare levels prior to the COVID-19 pandemic. The COVID-19 pandemic in Lebanon revealed gaps and challenges across the spectrum of preparedness and response to emergencies. Despite these challenges, the Lebanese response was successful in delaying the steep surge of COVID-19 cases and hospitalisations through imposing strict public health and social measures. The deployment of the national vaccination plan in Lebanon in February 2021 coincided with the reduction in the number of cases and hospitalisation rates. The aim of this manuscript is to advance the epidemiologic evolution of COVID-19 in Lebanon pre- and post-vaccination, the challenges affecting the response and recovery, and the lessons learned.
Tripoli, October 2019: Young people from various religious backgrounds and all walks of life sang and danced together in the city’s central al-Nour Square, shattering the myth of Tripoli as a ‘cradle of terrorism’ or ‘citadel of Muslims’. The Islamists who had often dominated Tripoli’s urban space retreated, and youths, families, and members of the educated middle class filled al-Nour Square during Lebanon’s revolutionary moment.
Why and how did Tripoli become the country’s prime centre of contentious politics in otherwise-peripheral Lebanon?
The introduction presents the main argument of the book, introducing the concepts of the dethronement of secondary cities, politics of autochthony, and erosion of city corporatism in Tripoli. It then discusses the broader lessons of the Tripoli case, which speak to three strands of literature: studies of Lebanon and the Levant; discussions on sectarianization in the Middle East; and debates on the ‘Sunni Crisis’ in the Middle East. Lastly, the research methods used for data collection are presented.
The gender history of the Lebanese Civil War (1975–90) has so far focused on the study of female figures. In an attempt to widen the scope of analysis, this article reconsiders the role of the Lebanese army in war-torn Lebanon through the lens of gender. Based on interviews with retired officers and noncommissioned officers, I argue that the military—the combat personnel in particular—never relinquished its claim to an exclusive militarized masculinity, despite the rise of contending actors. By maintaining this claim, these men strove to confront both the new standards of masculinity imposed by the militias and the anxiety caused by the disruption of gender roles throughout the conflict. To make sense of this confrontation, the article investigates how the veterans have engaged in a social performance, during both past and present, to (re)enact their manliness in front of an audience. This diachronic approach allows me to further untangle the combat officers’ trajectories during the war, using gender to bring them into conversation with their milieu.
In this volume Anthi Andronikou explores the social, cultural, religious and trade encounters between Italy and Cyprus during the late Middle Ages, from ca. 1200 -1400, and situates them within several Mediterranean contexts. Revealing the complex artistic exchange between the two regions for the first time, she probes the rich but neglected cultural interaction through comparison of the intriguing thirteenth-century wall paintings in rock-cut churches of Apulia and Basilicata, the puzzling panels of the Madonna della Madia and the Madonna di Andria, and painted chapels in Cyprus, Lebanon, and Syria. Andronikou also investigates fourteenth-century cross-currents that have not been adequately studied, notably the cult of Saint Aquinas in Cyprus, Crusader propaganda in Santa Maria Novella in Florence, and a unique series of icons crafted by Venetian painters working in Cyprus. Offering new insights into Italian and Byzantine visual cultures, her book contributes to a broader understanding of cultural production and worldviews of the medieval Mediterranean.