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Developing a Peritoneal Dialysis (Pd) Clinic At AUBMC: A Focus on Clinical Functions
No full textProject. M.S.N. American University of Beirut. Rafic Hariri School of Nursing, 2025.Introduction and Background: This project outlines the development of a
Peritoneal Dialysis (PD) clinic at the American University of Beirut Medical
Center (AUBMC), with a focused emphasis on clinical functions. As the global
burden of chronic kidney disease (CKD) and end-stage renal disease (ESRD)
continues to rise, expanding renal replacement therapy (RRT) options is
essential. PD presents a patient-centered, home-based alternative to conventional
hemodialysis, offering greater flexibility and quality of life when supported by a
structured clinical framework.
Goals: The primary goal of this project was to develop the framework of a
comprehensive PD clinic within AUBMC, define its core clinical functions, and
propose the integration of multidisciplinary care, education, and follow-up
processes to optimize patient outcomes. This project aims will serve as a
foundational model for a PD clinic to ensure that patients opting for PD at
AUBMC receive safe, and effective care through a dedicated and collaborative
clinical structure.
Methods: A proposal of a PD clinic was developed based on literature, with a
focus on clinical functions, and considering needs-based assessment,
stakeholders’ engagement, workflow mapping, and alignment with international
best practices and standards of care in PD.
Program Implementation and Evaluation Plan: The implementation plan entails
aspect of building clinical infrastructure, operationalization of PD clinic and
achieving the provision of quality care. The evaluation plan incorporated both
patient-level and program-level metrics. From a patient perspective, outcomes
such as adherence to therapy, complication rates (peritonitis), dialysis
adequacy, patient education, and quality of life were prioritized. From a
programmatic standpoint, indicators such as protocol implementation,
interdisciplinary coordination, staff training, and continuous quality
improvement initiatives will be assesse
Exploring the Association of Perceived Interpersonal Competence in Nurses and Competency-Based Nursing Programs: A Mixed Methods Study
No full textCompetency development of nurses starts at the pre-service level where students are instructed and supported to develop their clinical skills. In 2021, the American Association of Colleges of Nursing (AACN) called for the renovation of nursing education as an attempt to reduce the competency gap of new graduates and suggested Competency-Based Education (CBE) as a strategy educators can use to help bridge the gap between theory and practice. AACN identified ten domains for nursing practice with specific areas of competence, which provide a robust framework for CBE. One of the essential pillars identified by AACN for nursing practice is communication skills, which is an integral aspect for developing Interpersonal Competence (IC) in nurses. However, there is no research addressing the association of CBE and IC in new nursing graduates. Therefore, it is critical to assess the level of IC in nurses and the association between this level of competence and the type of education the nurses receive.
This study explored the association between CBE versus traditional programs and IC of newly graduated nurses in Lebanon. An observational cross-sectional mixed methods study was conducted to explore the difference in IC between new registered nurses working in medical-surgical units, maternity units, adult critical care areas including intensive care units, respiratory care units, neurologic care units, coronary care units, and post-anesthesia units and graduated within the last 6-12 months from CBE programs and those who graduated from traditional ones. An exploratory sequential method design was used in which qualitative data were collected and analyzed first; then quantitative data was collected and used to test the study hypotheses regarding the association between the IC of novice nurses and the type of educational program they studied in, followed by individual nurses’ interviews to verify the survey results. Two phases of data collection were used.
In the first phase, a desk review of four selected university programs in Lebanon was carried out using a checklist that was created based on the eight elements of the quality framework for CBE programs and the Hallmark practices in CBE Assessment that the CBE Network identified in 2021. Then, four focused group discussions (one from each university under study) were conducted with faculty members using an interview guide based also on the Hallmark practices in CBE Assessment to clarify and validate the results of the desk review. The results of Phase I were used to identify which of the four universities use the CBE approach. According to the results of Phase I, two nursing programs were considered emerging to developing CBE programs while the other two were considered traditional programs.
In the second phase, nurses with BSN who studied in the selected programs, were surveyed using the Interpersonal Competence Questionnaires (ICQ) to assess their IC levels. Then, based on the results of the analysis of the Lime survey, semi-structured interviews with willing nurses were conducted to clarify the results of the survey that were not amenable to interpretation and required further explanation. The results of the ICQ lime survey of nurses revealed that in general new nurses had average to low IC scores. The comparison of IC scores between university groups indicated that there is no significant difference between the IC scores of the nurses who graduated from CBE programs and those from traditional ones. In addition, the tested sociodemographic and work-related variables did not significantly affect the total IC scores. The results of the six semi-structured interviews for nurses helped to foster a better understanding of the nurses’ opinions of why the IC scores were low. According to the interviewed nurses, the work environment, the crisis affecting the country, and university preparation of students for the transition from theory to practice are important factors that affect IC scores.
This study provided baseline knowledge about the types of nursing education approaches used in Lebanon and the level of IC in new graduate registered nurses. This study has significant implications for future research, educational practice, and policy and regulations. It highlighted the gaps in curricula implementation, the need to train and develop the faculty members and preceptors involved in teaching nursing students, and the need to create and regulate a policy to assess and evaluate the effectiveness of the educational approaches used in teaching nursing students in Lebanon
"Embracing Multiple Perspectives": Dynamics of Harmony and Dissonance in English Classroom Discussions
No full textIncludes bibliographical references (pages 28-30)MENA Writing Studies Journal, vol. 1.1, Spring 2025, pp. 10-30In this study, we examine the discourse patterns unfolding in first-year writing
classroom discussions, with attention to the ways those dynamics are informed by
broader sociocultural contexts. In examining students’ discourse moves through
sociocultural lenses, including Hofstede et al.’s (2010) conception of collectivism,
we trace patterns of harmony—expressions of agreement or unity—and
dissonance—moments of discord or tension—in student discussions. We situate
our inquiry in the Socratic Seminar, a student-centered discussion model that
invites spaces for the dialogic unfolding of multiple voices and perspectives. We
employ a discourse analytic approach to investigate the ways students signal
harmonic or dissonant perspectives. In complicating the notions of harmony as
unproductive agreement and dissonance as a disruptive force, we elucidate the
ways students co-construct knowledge by negotiating a delicate interplay between
harmony and dissonance. We illustrate the ways students seek deeper meanings
through tonal counterpoint and the dialogic expansion of alternative interpretive
possibilities. We also examine how a culturally responsive pedagogy might inform
the ways we view and attempt to “move” the discussion. Ultimately, we illuminate
insights into the multivocal, multiperspectival nature of student discourse as
inflected by sociocultural dimensions
The Use of Marjoram Essential Oil as a Preservative against Escherichia coli and Staphylococcus aureus in Baladi Cheese
No full textThe increasing consumer preference for natural food preservatives necessitates innovative approaches to enhance food safety and extend shelf life. This study aimed to evaluate the antibacterial activity of Origanum majorana (marjoram) essential oil (EO) against Escherichia coli and Staphylococcus aureus, including antimicrobial-resistant (AMR) and heat-resistant (HR) strains, in Baladi cheese and investigate its effect on extending the shelf life. Various EO concentrations (250, 300, 500, 1000, and 25000 ppm) were tested to determine their impact on non-resistant E. coli growth for 7 days and determine the optimal concentration. The optimal concentration was then tested to check its efficacy on E. coli and S. aureus isolates survival in cheese. EO-supplemented cheese was inoculated with E. coli and S. aureus and stored at 4°C for testing over 21 days. Cheese samples were cultured on agar media and incubated at 37°C for 24h for E. coli and 48h for S. aureus for counting. Finally, the cheese supplemented with the optimal concentration of EO was tested to check its capacity to extend the product's shelf life and determine the consumer's overall acceptability using the triangle and a 9-point hedonic scale.
The results revealed that at 2500 ppm, EO significantly reduced bacterial counts, leading to complete elimination of HR E. coli and all S. aureus strains by days 21 and 7, respectively. In contrast, lower EO concentrations showed no significant antimicrobial effect. Additionally, EO extended the cheese’s shelf life by approximately 7 days by delaying coliform development compared to the control. However, the sensory evaluation revealed that all panelists unanimously rejected the EO-treated cheese, identifying intense flavor alterations as a limiting factor for acceptability. These findings underscore the potential of marjoram EO as a natural, effective preservative for dairy products, addressing microbial safety challenges and aligning with consumer demand for clean-label solutions. However, future research should focus on improving sensory acceptability, possibly through microencapsulation, and evaluating its economic feasibility in commercial food applications
Perception of Project Management Among Construction Workers: The Case of Lebanon
No full textThe construction industry is undergoing significant transformation driven by technological advancements, evolving materials, and innovative methodologies. These changes require continuous improvements in operational practices and workforce engagement. While the integration of technology is essential to transitioning the industry into the digital era, the role of on-site workers remains critical. Although previous research has explored various factors affecting workers’ satisfaction, few studies have focused on workers’ perceptions of site dynamics and project management.
A key element in enhancing efficiency and productivity is understanding how construction workers perceive different aspects of project’s execution. This study investigates project dynamics, such as management practices, inter-team relationships, and overall project performance, and how these factors influence workers’ satisfaction, productivity, and well-being. The research employs a survey adapted from an international study and tailored to the Lebanese construction environment, ensuring alignment with the original research framework. Through 86 questions, it examines factors shaping daily work experiences, including communication, management efficiency, working conditions, and health and safety protocols. The survey targets a diverse sample of workers from different projects’ types, different age groups, different regions, and different trades and experiences.
Findings indicate that workers’ perceptions of certain project elements vary based on their experience, trade, and role. Their views on project management are particularly influenced by their level of integration within the team and whether they feel heard. Occupational factors also significantly shape how workers perceive the work environment, especially in relation to on-site workflow, coordination issues, and interactions with other site crews. This study underscores the importance of understanding workers’ perspectives on construction dynamics and highlights several critical factors that should be addressed to improve both the worker’s experience and the project’s daily operational performance
PhageQuest: Harnessing Gut Phages to Combat Antimicrobial Resistance and Pathogenic Threats in the Gut Microbiota
No full textBackground: Antimicrobial resistance [AMR] is a growing global health crisis, with the
gut microbiome emerging as a critical reservoir for multidrug-resistant [MDR] bacteria.
Central to this issue is the gut resistome, the complete set of antimicrobial resistance
genes [ARGs] present in both pathogenic and commensal gut bacteria. These genes can
be horizontally transferred, facilitating the spread of resistance across species and
environments. Conventional antibiotics are increasingly ineffective, especially in the gut
where biofilms and complex resistance mechanisms prevail. In this context,
bacteriophages offer a promising alternative, capable of targeting bacteria with high
specificity and minimal impact on beneficial microbiota. Environmental sources like
sewage and fecal filtrates may provide phages already adapted to the gut ecosystem.
Methods: This study used a combination of culturomics, 16S rRNA gene sequencing via
Oxford Nanopore Technology, and phage activity screening to evaluate the potential of
phages sourced from sewage and fecal filtrates. Stool samples from healthy donors were
processed to isolate bacterial strains under anaerobic conditions. Sequencing was
performed to assess microbial diversity, and phage activity was screened by monitoring
bacterial growth inhibition in the presence of filtrates using a 96-well microplate reader.
Results: Of the 247 bacterial isolates screened, 83 [33.6%] exhibited a significant
decrease in optical density, indicating potential bacteriophage-induced lysis. This
included 23 isolates responsive to both filtrates, 36 to sewage only, and 24 to fecal
filtrate only. Sequencing revealed that nearly 60% of microbial sequences were
unclassified, highlighting the presence of unexplored taxa. Culturomics enabled the
growth of both common and hard-to-culture organisms, including opportunistic
pathogens relevant for phage targeting.
Conclusion: The study demonstrates that sewage and fecal filtrates contain
bacteriophages capable of lysing MDR gut bacteria under anaerobic conditions. These
findings support the potential of phage therapy as a targeted, microbiome-sparing
approach to combat AMR. The integration of culturomics and sequencing proved
essential for both bacterial host identification and phage discovery. Future research
should focus on isolating individual phages, confirming their lytic activity, and
evaluating their efficacy in clinical or in vivo settings
Investigating Academic Misconduct and Its Impact on Skill Development in Civil Engineering Education
No full textThis thesis investigates the relationship between academic misconduct and skills development among civil and environmental engineering students at the American University of Beirut. A total of 35 semi-structured interviews were conducted, including 28 undergraduate and graduate students and 7 experienced civil engineers. The study was conducted in two phases: first, a content analysis was applied to explore patterns of academic misconduct and their impact on students’ skill acquisition. Second, a t-test based comparative analysis was performed using the NEOM “The Line” project as a real-world case study to evaluate how participants across different academic and professional stages engaged with ethical and technical challenges.
Participants were segmented into five groups by educational and professional standing, revealing a clear developmental gap. Group 5, engineers with over two years of experience, consistently demonstrated higher ethical awareness and practical reasoning, indicating the positive influence of real-world exposure. The findings suggest that academic misconduct negatively affects the foundation of key engineering skills and that traditional education may not sufficiently prepare students for ethical decision-making. Based on these insights, the study advocates for the integration of project-based learning (PBL) strategies within engineering curricula to foster practical competence, ethical reasoning, and skill resilience from an early stage
Artificial Intelligence and Employment in the OECD: A Panel Data Analysis
No full textThis thesis examines the relationship between artificial intelligence (AI) and employment across 35 OECD countries from 2013 to 2022 using panel data analysis. By employing ordinary least squares (OLS) and fixed effects regression models, the study explores how AI, proxied through AI patent activity and private investment, affects total employment, with a focus on demographic (gender and age) and sectoral heterogeneity. The results illustrate a positive association between AI and employment, consistent with the labor augmentation theory. Employment growth was observed across all demographic groups and economic sectors. However, the employment gains were mostly concentrated among the middle-aged workers and in the service sector. While evidence indicates that AI can act as a complement to human labor and create new jobs, the analysis is constrained by data limitations and potential endogeneity concerns. The findings emphasize the importance of inclusive, forward-looking policies that promote skill development and equitable AI adoption across sectors and groups
SHIFT WORK AND OCCUPATIONAL INJURIES AMONG HEALTHCARE WORKERS IN A TERTIARY HEALTHCARE CENTER IN LEBANON: A RETROSPECTIVE STUDY
No full textBackground: Occupational injuries are a significant concern among healthcare workers (HCWs), particularly in low- and middle-income countries like Lebanon, where health systems face resource limitations and workforce shortages. Although shift work has been associated with elevated injury risk globally, little is known about its effects in low-resource settings. In 2020, a policy shift at a major tertiary hospital in Lebanon transitioned registered nurses from 8-hour to 12-hour shifts, providing a unique opportunity to examine the impact of extended shift work on injury incidence.
Methods: This retrospective cross-sectional study analyzed 2,218 occupational injury reports filed by HCWs at the American University of Beirut Medical Center (AUBMC) between 2019 and 2023. Data on injuries, costs, and absenteeism were drawn from administrative records. Negative binomial regression and a difference-in-differences (DiD) approach were used to examine the associations between shift type, policy change, and injury risk. Logistic and linear regressions assessed injury severity and economic outcomes.
Results: Shift work accounted for 53% of all injuries, with a 12% higher incidence compared to standard shifts (IRR=1.12, p=0.07). Following the 2020 policy change, injury risk during shift work increased significantly (IRR=1.34, p<0.001), with registered nurses experiencing a 69% higher injury rate relative to other HCWs (DiD IRR=1.69, p<0.001). Needle stick injuries and workplace violence were significantly more common during shift work. Each day of absenteeism was associated with a $67.12 monthly increase in injury-related costs (p<0.001).
Conclusion: In our study, shift work and extended 12-hour shifts were associated with increased occupational injury risk among HCWs, especially registered nurses. These findings underscore the importance of re-evaluating work scheduling policies and suggest the need for more elaborate studies
Effectiveness of Outdoor Windcatcher and Mist Cooling in Mitigating Urban Heat and Improving Pedestrian Thermal Comfort
No full textUrban heat and the resulting pedestrian thermal discomfort are critical issues in arid cities. This study examines the effectiveness of combining outdoor windcatchers with mist cooling to mitigate urban heat and improve outdoor thermal comfort (OTC). To
simulate the effect of the windcatcher and mist cooling on urban canyon, the ENVI-met
urban microclimate model was utilized and validated using published experimental and
modeling datasets. The validated model was applied to a realistic urban morphology for
a case study in Souq Waqif, Doha, Qatar, on a hot summer day ( = 37.7 °C). Three
intervention scenarios—windcatcher alone, mist cooling alone, and an integrated
windcatcher–mist cooling system—were assessed against a baseline scenario without
interventions.
Results showed that the windcatcher alone improved pedestrian-level airflow velocity,
increasing it by 5 times compared to the baseline at 0.1 m/s, but decreased temperature
by 0.63 °C. The mist cooling alone reduced pedestrian-level temperature by 1.9 °C with
negligible airflow change. The integrated windcatcher–mist cooling system lowered air
temperature by 3.06 °C and enhanced air velocities by 0.43 m/s at a mist-water flow rate
of 45 g/s using three nozzles. Upon using 12 nozzles, the local cooling was amplified,
reducing air temperature to 6.4°C. This resulted in a substantial reduction in the
Physiological Equivalent Temperature of up to 8.3 °C, hence shifting the thermal
sensation by 1 to 2 categories and improving OTC over extended hours of the day. Hence,
the windcatcher mist cooling strategy presented an effective sustainable solution for
enhanced OTC