Salmonella-related foodborne illness is a significant public health concern, with the primary source of human infection being animal-based food products, particularly chicken meat. Lebanon is currently experiencing a dual crisis: the COVID-19 pandemic and an unprecedented economic crisis, which has resulted in substantial challenges to the public health system and food safety. This study aims to assess the prevalence and antibiotic resistance profile of Salmonella in raw poultry meat sold in North Lebanon during this dual crisis. A cross-sectional study was carried out between May 2021 and April 2022 across six different districts in North Lebanon. A total of 288 whole, unprocessed chickens were examined. The isolation and identification of Salmonella isolates were done based on cultural and biochemical properties. All isolates were subjected to antimicrobial susceptibility testing and phenotypic assays for Extended-Spectrum Beta-lactamase (ESBL) detection. The prevalence of Salmonella in raw poultry meat purchased in North Lebanon reached 18.05 % (52/288). The dry season and chilled chicken were significantly associated with an increased risk of Salmonella contamination (P < 0.05). Additionally, 34.61 % of the isolates were potential ESBL producers, and 57.69 % exhibited multidrug resistance (MDR). This study highlights the existence of MDR in chicken meat in North Lebanon, posing a potential health risk if undercooked chicken meat is consumed. This emphasizes the importance of the implementation of preventive strategies and hygienic procedures throughout the food chain to reduce the risk of Salmonella spp. contamination in chicken meats and its potential transmission to humans.

After the 2008 World Crisis, there is a view that the economic recovery has not been adequate. In this context, the debate on hysteresis and especially investment hysteresis has increased in the last decade. The aim of this study is to analyze the investment hysteresis and the basic dynamics of hysteresis in the Turkish economy. Structural break tests are used to identify hysteresis. Traditional and asymmetric causality tests are used to identify the fundamental dynamics of hysteresis. Investment, GDP, interest rate, and productivity variables are used to analyze investment hysteresis. Structural break tests were applied to the variables, while conventional and asymmetric causality tests were applied between investments and their determinants. Structural break tests prove the existence of hysteresis. According to the Granger causality test, there is no causality from interest rates, GDP and productivity to investments. The fact that interest rates have no effect on investments proves hysteresis. According to the asymmetric causality test, there is no relationship between interest rates and investments. There is an inverse relationship between GDP and investments. There is an asymmetric relationship between productivity and investments. The fact that productivity shocks cause asymmetric effects on investments makes productivity shocks the main dynamic of hysteresis. In addition, there is considerable evidence that the strong hysteresis and high uncertainty of TFP exacerbate investment hysteresis. Therefore, productivity shocks should be taken into account in policymaking for hysteresis.

Information on how economic fluctuations affect educational inequalities in homicides in Latin America is scarce. This study aimed to: (a) analyze the temporal variations of educational inequalities related to homicide mortality and (b) compare these inequalities between years of economic growth and recession in southern South America cities from 2000 to 2019. Data from seven urban areas in three countries in the Southern Cone of South America were used: Mendoza and Rosario (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro, and São Paulo (Brazil); and Santiago (Chile). Poisson models were estimated by using age, sex, city of residence, year of economic growth or recession, and schooling level as explanatory variables. Results showed significant differences in the temporal evolution of homicide rates in the seven cities, although populations with a low schooling level always showed the most vulnerability. The four Brazilian cities, analyzed together, showed greater educational inequalities related to homicides in years of economic recession when compared to those of economic growth. On the one hand, the indiscriminate use of force by the State against criminal groups seems to increase social inequality in homicide mortality. On the other hand, criminal fragmentation and economic crisis can exacerbate these inequalities by increasing territorial disputes between criminal groups.
Se sabe poco sobre cómo las fluctuaciones económicas afectan las desigualdades educativas en homicidios en países latinoamericanos. Los objetivos de este estudio fueron (a) analizar las variaciones temporales de las desigualdades relativas educacionales de la mortalidad por homicidio, y (b) comparar estas desigualdades entre años de crecimiento económico y años de recesión en ciudades del sur sudamericano durante el período 2000-2019. Se utilizaron datos de siete áreas urbanas, en tres países del Cono Sur Sudamericano: Mendoza y Rosario (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro y São Paulo (Brasil); y Santiago (Chile). Se estimaron modelos de Poisson, utilizando como variables explicativas la edad, sexo, año, ciudad de residencia, año de expansión o recesión económica y nivel educativo. Encontramos diferencias marcadas en la evolución temporal de las tasas de homicidio entre las siete ciudades, aunque siempre las poblaciones de nivel educativo bajo fueron las más vulnerables. Las cuatro ciudades de Brasil, analizadas en conjunto, tuvieron desigualdades educativas relativas de homicidios mayores en años de recesión económica, con respecto a años de crecimiento económico. Por un lado, el uso de la fuerza indiscriminado por parte del Estado enfocado hacia grupos criminales parece haber llevado a una creciente desigualdad social de la mortalidad por homicidio. Por el otro, en un contexto de fragmentación criminal y crisis económica se podrían agravar estas desigualdades a través de mayores disputas territoriales entre grupos criminales.
São escassas as informações sobre como as flutuações econômicas afetam as desigualdades educacionais em homicídios na América Latina. Os objetivos deste estudo foram: (a) analisar as variações temporais das desigualdades educacionais relacionadas à mortalidade por homicídio, e (b) comparar essas desigualdades entre os anos de crescimento econômico e os anos de recessão nas cidades do sul da América do Sul no período de 2000 a 2019. Foram utilizados dados de sete áreas urbanas, em três países do Cone Sul da América do Sul: Mendoza e Rosário (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro e São Paulo (Brasil); e Santiago (Chile). Os modelos de Poisson foram estimados utilizando como variáveis explicativas a idade, sexo, ano, cidade de residência, ano de expansão ou recessão econômica e nível de escolaridade. Os resultados mostraram diferenças significativas na evolução temporal das taxas de homicídio entre as sete cidades, apesar de que as populações com baixo nível de escolaridade sempre foram as mais vulneráveis. As quatro cidades brasileiras, analisadas em conjunto, apresentaram maiores desigualdades educacionais relacionadas a homicídios em anos de recessão econômica em relação aos anos de crescimento econômico. Por um lado, o uso indiscriminado da força pelo Estado contra grupos criminosos parece ter levado ao aumento da desigualdade social na mortalidade por homicídio. Por outro lado, em um contexto de fragmentação criminal e crise econômica, essas desigualdades podem ser exacerbadas pelo aumento das disputas territoriais entre grupos criminosos.

OBJECTIVE: This study examined the evidence of the prevalence of psychological distress and poor sleep among medical students and its associations during an economic crisis.
METHODS: This was a cross-sectional study using an online questionnaire. It included the Depression Anxiety Stress Scales and Pittsburgh Sleep Quality Index (PSQI).
METHODS: This study included medical undergraduates from a large metropolitan university in Sri Lanka.
METHODS: We assessed the prevalence of psychological distress, sleep quality, and factors associated with psychological distress. To evaluate the associations, we used logistic regression.
RESULTS: The majority (69.2%) had some form of distress (depression, anxiety or stress), while 23% had distress in all three. Anxiety was the most prevalent (50.7%). Poor sleep quality was reported in 41%. The highest contribution to global PSQI was from sleep latency, duration, and daytime dysfunction subscales. In bivariate analysis, sleep quality was directly related to depression (t245.65 = -6.75, p<0.001)., anxiety (t313.45 = -6.45, p <0.001), and stress (t94.22 = -5.14, p <0.001). In multinomial logistic regression models, sleep quality was independently associated with depression, anxiety and stress. In addition, frequent contact with friends was inversely associated with depression and anxiety. Also, social media use was inversely linked to depression, anxiety and stress. Clinical-year students had lower depression and anxiety than non-clinical students. Engaging in mindfulness activities was inversely associated with depression. However, models explained only a moderate amount of variance (Nagelkerke R-squared values were 0.21, 0.18, and 0.13 for depression, anxiety and stress, respectively).
CONCLUSIONS: Poor sleep quality and psychological distress are high among the undergraduates. The findings emphasize the importance of addressing sleep quality and psychological wellbeing in medical undergraduates. Further research with larger and more diverse samples is needed for a more comprehensive understanding of the factors associated with psychological distress among undergraduates.

This study aimed to identify the perceived advantages and drawbacks of teleworking and their correlates, including health problems, among Lebanese workers holding a university degree. A web-based cross-sectional self-report questionnaire created on Google Forms was used to survey 230 participants through snowball sampling between October 2022 and March 2023. The majority of respondents recognized both the advantages (67.03%) and drawbacks (66.34%) associated with teleworking, suggesting mixed feelings toward this format. Despite the limited satisfaction with teleworking, respondents acknowledged the advantages associated with remote working; in particular, younger, less physically active, and more educated participants valued teleworking more than their counterparts. The mean perception of advantages and drawbacks of telework did not significantly change with participants\' work status (hybrid, online, and in-person). The study revealed a high prevalence of consistent sleeping difficulty (35.7%), limited regular physical activity (60.4%), work-related musculoskeletal disorders (48.7%), back pain (5.7%), and visual disorders (48%) among Lebanese workers. Despite the limited satisfaction with teleworking, respondents acknowledged advantages such as cost and time savings. Older workers showed a preference against teleworking, potentially due to its impact on well-being. Factors such as education, career satisfaction, and prior teleworking experience influenced individuals\' perceptions of telework benefits.

BACKGROUND: The economic crisis that began in 2008 has severely affected Southern (Greece, Italy, Portugal, Spain) Western European (SWE) countries of Western Europe (WE) and may have affected ongoing efforts to eliminate viral hepatitis. This study was conducted to investigate the impact of the economic crisis on the burden of HBV and HCV disease.
METHODS: Global Burden of Diseases 2019 data were used to analyse the rates of epidemiological metrics of HBV and HCV acute and chronic infections in SWE and WE. Time series modelling was performed to quantify the impact of healthcare expenditure on the time trend of HBV and HCV disease burden in 2000-2019.
RESULTS: Declining trends in incidence and prevalence rates of acute HBV (aHBV) and chronic HBV were observed in SWE and WE, with the pace of decline being slower in the post-austerity period (2010-2019) and mortality due to HBV stabilised in SWE. Acute HCV (aHCV) metrics and chronic HCV incidence and mortality showed a stable trend in SWE and WE, whereas the prevalence of chronic HCV showed an oscillating trend, decreasing in WE in 2010-2019 (p < 0.001). Liver cancer due to both hepatitis infections showed a stagnant burden over time. An inverse association was observed between health expenditure and metrics of both acute and chronic HBV and HCV.
CONCLUSIONS: Epidemiological metrics for HBV and HCV showed a slower pace of decline in the post-austerity period with better improvement for HBV, a stabilisation of mortality and a stagnant burden for liver cancer due to both hepatitis infections. The economic crisis of 2008 had a negative impact on the burden of hepatitis B and C. Elimination of HBV and HCV by 2030 will be a major challenge in the SWE countries.

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Is healthcare employment recession-proof? We examine the long-standing hypothesis that healthcare employment is stable across the business cycle. We explicitly distinguish between negative aggregate demand and supply shocks in studying how healthcare employment responds to recessions, and show that this response depends largely on the type of the exogenous shock triggering the recession. First, aggregate healthcare employment responds procyclically during demand-induced recessions but remains stable during supply-induced recessions. Second, healthcare utilization drops significantly during demand-induced recessions, explaining the decline in healthcare employment during these periods. Finally, there is significant heterogeneity in the employment responses of the healthcare sub-sectors. While healthcare employment in most sub-sectors responds procyclically during recessions caused by both negative demand and supply shocks, it responds countercyclically in nursing-dominant sectors. Importantly, by isolating the recessionary impact of negative aggregate demand shocks from supply shocks on healthcare employment, we provide new empirical evidence that healthcare employment, in general, is not recession-proof.

This study examines the impact of austerity measures on mortality rates across Italian regions from 2003 to 2018. Since 2007, regions experiencing substantial healthcare financial deficits have been required to implement recovery plans (RPs). We use a recent difference-in-differences staggered matching estimator to assess the effects of this austerity policy on municipal-level monthly mortality rates. This allows us to evaluate the policy\'s spatial heterogeneity across treated municipalities, accounting for their distance from the nearest hospital. The analysis reveals a significant negative impact of austerity measures on health, particularly in peripheral areas and among vulnerable populations. Mortality rates are higher in regions under RPs, with this effect escalating with increasing distance from hospitals. The policy\'s impact is also more pronounced among vulnerable populations, with differences observed between genders and across seasons.

OBJECTIVE: The reduction of government expenditure in the healthcare system, the difficulty of finding new sources of funding and the reduction in disposable income per capita are the most important problems of the healthcare system in Greece over the last decade. Therefore, studying the profitability of health structures is a crucial factor in making decisions about their solvency and corporate sustainability. The aim of this study is to investigate the effect of economic liquidity, debt and business size on profitability for the Greek general hospitals (GHs) during the period 2016-2018.
METHODS: Financial statements (balance sheets and income statements) of 84 general hospitals (GHs), 52 public and 32 private, over a three-year period (2016-2018), were analyzed. Spearman\'s Rs correlation was carried out on two samples.
RESULTS: The results revealed that there is a positive relationship between the investigated determinants (liquidity, size) and profitability for both public and private GHs. It was also shown that debt has a negative effect on profitability only for private GHs.
CONCLUSIONS: Increasing the turnover of private hospitals through interventions such as expanding private health insurance and adopting modern financial management techniques in public hospitals would have a positive effect both on profitability and the efficient use of limited resources.
CONCLUSIONS: These results, in conjunction with the findings of the low profitability of private hospitals and the excess liquidity of public hospitals, can shape the appropriate framework to guide hospital administrators and government policymakers.