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- ItemExploring the challenges for medical tourism in the United Arab Emirates during the Covid-19 pandemic era: a stakeholder perspective(2022)Purpose: This paper explores medical tourism development challenges in the United Arab Emirates (UAE) pre- and during Covid-19. Medical tourism is becoming a dynamic, rapid growth area and an engine of economic development. Design/methodology/approach: In-depth interviews were conducted with medical tourism professionals. Fourteen medical tourism stakeholders were interviewed from 1 January to 31 January 2020. Qualitative thematic analysis was applied on medical tourism challenges before and during the pandemic. Findings: The major themes indicated concerns for medical tourism in the UAE and they included higher medical services costs and a shortage of highly qualified medical expertise. The emerging themes related to the challenges of coping with Covid-19 and strategies to attract medical tourists. Originality/value: This study contributes towards (1) the theory of medical tourism, (2) the related limited prior published work on this topic relating to the UAE and (3) the importance of medical tourism in today’s tourism industry. Additionally, there are theoretical and practical implications for medical tourism stakeholders in terms of attracting inbound medical tourists to the UAE from other countries during the Covid-19 crisis and in the post-pandemic situation. © 2022, Emerald Publishing Limited.
- ItemEco-anxiety: A Q method analysis towards eco-anxiety attitudes in the United Arab Emirates(Routledge, 2022)Humans are witnessing extreme events such as droughts, floods, heat waves, wildfires, and emergence of novel diseases causing unprecedented changes to our planet. These rapid changes coupled with a transparent world that enjoys access to information mean that today’s population is more aware and attentive about the progress of climate change. The purpose of this study is to discover attitudes towards new gained consciousness and the term Eco-anxiety. The American Psychological Association (APA) defines eco-anxiety as a ‘chronic fear of environmental doom’. To investigate this phenomenon, we use Q-methodology to analyse discourses on the topic. Thirty-nine people from four different stakeholder groups were surveyed. Five distinct discourses were generated covering the connection between environmental awareness and psychological well-being, coming to terms with emotional response to climate change, importance of climate change, awareness about eco-anxiety leading to a more positive outlook, and disbelief that eco-anxiety and climate change can affect mental well-being. © 2022 GAPS.
- ItemWhat the policy and stewardship landscape of a national health research system looks like in a developing country like Iran: a qualitative study(BioMed Central Ltd, 2022-12)Background: The health research system (HRS) is an important national priority that requires a systematic and functional approach. Evaluating the HRS of Iran as a developing country and identifying its challenges reveals the stewardship-related role in how the whole system is operating well. This study aims to assess the HRS in terms of stewardship functions and highlight the enhancement points. Methods: This study was carried out between March 2020 and April 2021 using a systematic review and meta-synthesis of evidence to examine the Iranian HRS stewardship challenges and interview 32 stakeholders, using a critical case sampling and snowballing approach which included both semi-structured and in-depth interviews. The interviewees were selected based on criteria covering policy-makers, managers, research bodies and nongovernmental organizations (NGOs) in health research-related fields like higher education, research, technology, innovation and science. All data were analysed using content analysis to determine eight main groups of findings under three levels: macro, meso, and micro. Results: Analysis of the findings identified eight main themes. The most critical challenges were the lack of an integrated leadership model and a shared vision among different HRS stakeholders. Their scope and activities were often contradictory, and their role was not clarified in a predetermined big picture. The other challenges were legislation, priority-setting, monitoring and evaluation, networking, and using evidence as a decision support base. Conclusions: Stewardship functions are not appropriately performed and are considered the root causes of many other HRS challenges in Iran. Formulating a clear shared vision and a work scope for HRS actors is critical, along with integrating all efforts towards a unified strategy that assists in addressing many challenges of HRS, including developing strategic plans and future-oriented and systematic research, and evaluating performance. Policy-makers and senior managers need to embrace and use evidence, and effective networking and communication mechanisms among stakeholders need to be enhanced. An effective HRS can be achieved by redesigning the processes, regulations and rules to promote transparency and accountability within a well-organized and systematic framework. © 2022, The Author(s).
- ItemPrevalence and Behavioral-Based Risk Factors (Eye Cosmetic and Tobacco Use) of Symptomatic Dry Eye Disease in Four Middle Eastern Countries: Lebanon, Syria, Jordan, and Palestine(Dove Medical Press Ltd, 2022)Purpose: To estimate the prevalence of symptomatic dry eye disease (DED) in four Middle Eastern Countries and investigate the association between behavioral-based risk factors and severity of DED. Patients and Methods: Population-based cross-sectional study of 1463 participants from 4 Mediterranean countries (Lebanon, Syria, Jordan, and Palestine). The Arabic version of the Ocular Surface Disease Index (ARB-OSDI) questionnaire was used to estimate the prevalence and severity of symptomatic DED using an online format survey. The survey also included demographic questions and possible behavioral risk factors (tobacco and cosmetic use). One-Way ANOVA and multivariate regression analyses were used to investigate the association between OSDI mean scores and behavioral-based risk factors. Results: The prevalence of symptomatic DED (OSDI score ≥ 13) among the overall population (332 males and 1132 females) reached 70.2%. Tobacco and cosmetic users reported a higher significant prevalence and severity of symptomatic DED than non-users (p < 0.0001). Smoking habits (eg, smoking cigarettes or Ajami, smoking in closed areas, and daily smoking) were more likely to report symptomatic DED. Bad hygiene process during the use of any cosmetic product was behind the high prevalence and severity of symptomatic DED among the females of the study population. Conclusion: Symptomatic DED is substantial in Middle Eastern countries. It is statistically associated with cosmetic and tobacco use. © 2022 Ghach et al.
- ItemMulti-matrix biomonitoring approach to assess exposure to metals and trace elements in the Lebanese population and associations with drinking water consumption(Academic Press Inc., 2022-11)This study is the first attempt to assess exposure to metals and trace elements in subgroups of the Lebanese population using a multi-matrix biomonitoring approach. Concentrations of 11 metals and trace elements (aluminum (Al), arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), lead (Pb), manganese (Mn), selenium (Se), uranium (U), zinc (Zn)) were measured in urine, hair and toenails. Biological levels were compared according to age, sex, smoking status, socioeconomic status, geographical area and drinking water source. While most urinary and toenail concentrations of metals and trace elements were not different between males and females, measured concentrations of several elements in hair were higher in females compared to males. Urinary concentrations of some metals (Al, Cu, Se and Zn) were higher in children compared to teenagers and adults. Hair and toenail concentrations of several elements (As, Cd, Pb, Mn, Se in hair and toenails plus Al, Fe in toenails) were also significantly higher in children compared to teenagers and/or adults. Smoking status had no influence on metal and trace element concentrations. Levels of Cd, Pb and Mn were also higher in samples from subgroups with lower economic status (Cd and Pb in the three matrices and Mn in hair and toenails). Very few correlations were identified between sources of drinking water and urine, hair, and toenail concentrations of metals and trace elements. However, a correlation was observed between hair and toenails levels of As, Cd and Pb. Overall, results highlight that a special attention should be given to metal and trace element exposure in this population (including Pb, As, Cd, Mn, and Se). It could be relevant to scale up this kind of investigation with a large human biomonitoring initiative in the Lebanese population in order to generalize results, and assess trends over time. © 2022 Elsevier Inc.