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Since the early 1990s, countries in the Middle East and North Africa (MENA) Region have made admirable progress in reducing the gap between girls and boys in areas such as access to education and health care. Indeed, almost all young girls in the Region attend school, and more women than men are enrolled in university. Over the past two decades, maternal mortality declined 60 percent, the largest decrease in the world. Women in MENA are more educated than ever before. It is not only in the protest squares that have seen women whose aspirations are changing rapidly but increasingly unmet. The worldwide average for the participation of women in the workforce is approximately 50 percent. In MENA, their participation is half that at 25 percent. Facing popular pressure to be more open and inclusive, some governments in the region are considering and implementing electoral and constitutional reforms to deepen democracy. These reforms present an opportunity to enhance economic, social, and political inclusion for all, including women, who make up half the population. However, the outlook remains uncertain. Finally, there are limited private sector and entrepreneurial prospects not only for jobs but also for those women who aspire to create and run a business. These constraints present multiple challenges for reform. Each country in MENA will, of course, confront these constraints in different contexts. However, inherent in many of these challenges are rich opportunities as reforms unleash new economic actors. For the private sector, the challenge is to create more jobs for young women and men. The World Bank has been pursuing an exciting pilot program in Jordan to assist young women graduates in preparing to face the work environment.

Climate change is a major source of concern in the Middle East and North Africa (MENA) region, and migration is often understood as one of several strategies used by households to respond to changes in climate and environmental conditions, including extreme weather events. This study focuses on the link between climate change and migration. Most micro-level studies measure climate change either by the incidences of extreme weather events or by variation in temperature or rainfall. A few studies have found that formal and informal institutions as well as policies also affect migration. Institutions that make government more responsive to households (for example through public spending) discourage both international and domestic migration in the aftermath of extreme weather events. Migration is often an option of last resort after vulnerable rural populations attempting to cope with new and challenging circumstances have exhausted other options such as eating less, selling assets, or removing children from school. This study is based in large part on new data collected in 2011 in Algeria, Egypt, Morocco, Syria, and the Republic of Yemen. The surveys were administered by in-country partners to a randomly selected set of 800 households per country. It is also important to emphasize that neither the household survey results nor the findings from the qualitative focus groups are meant to be representative of the five countries in which the work was carried, since only a few areas were surveyed in each country. This report is organized as follows: section one gives synthesis. Section two discusses household perceptions about climate change and extreme weather events. Section three focuses on migration as a coping mechanisms and income diversification strategy. Section four examines other coping and adaptation strategies. Section five discusses perceptions about government and community programs.

No detailed description available for \"Daily Life, Materiality, and Complexity in Early Urban Communities of the Southern Levant\".

The world's attention to the countries of the Middle East and North Africa (MENA) region has often been dominated by headline issues: conflict, sanctions, political turmoil, and rising oil prices.Little of this international attention has considered the broad range of development challenges facing this diverse group of countries.

Objectives The study aims to understand the return to work (RTW) needs of young and middle‐aged people who have experienced a stroke and to contribute to the development of supportive RTW services. Design A qualitative study employing the phenomenological method. Participants Eleven young and middle‐aged people who have experienced a stroke participated in the study. Methods Semi‐structured in‐depth interviews were conducted and analysed using Colaizzi's 7‐step method to identify and categorize the RTW needs of participants. Results The analysis delineated four overarching thematic categories of RTW needs among the participants: self‐management needs, emphasizing the regulation of symptoms, health maintenance and recovery planning; social support needs, highlighting the significance of workplace accommodations, professional medical guidance, and emotional encouragement from companions and family; the need for information related to returning to work, which includes accessing resources on rehabilitation opportunities, labour rights and professional consultation services; and personal development needs, focusing on fostering self‐worth, identifying growth opportunities and acquiring new skills to adapt to changing professional demands. Conclusion The diverse and comprehensive needs of young and middle‐aged people who have experienced a stroke underscore the importance of multifaceted support from healthcare professionals. This support should encompass medical, psychological, informational and skill‐development aspects and should involve enhanced communication and collaboration with relevant stakeholders to facilitate a successful RTW. Patient or Public Contribution This study was designed without direct involvement from patients or the public in the development of the research question, the design of the study, or the conduct of the research. This decision was informed by the specific focus on qualitative experiences and perceptions of stroke survivors regarding their RTW journey, which relied heavily on personal narratives and subjective accounts collected through individual interviews. However, the insights gained from these narratives have been crucial in shaping the research outcomes, emphasizing the patient‐centred approach to understanding RTW barriers and facilitators. Reporting Method This study followed the SRQR checklist for qualitative studies as its reporting method.

This article studies the causes of China's Great Famine, during which 16.5 to 45 million individuals perished in rural areas. We document that average rural food retention during the famine was too high to generate a severe famine without rural inequality in food availability; that there was significant variance in famine mortality rates across rural regions; and that rural mortality rates were positively correlated with per capita food production, a surprising pattern that is unique to the famine years. We provide evidence that an inflexible and progressive government procurement policy (where procurement could not adjust to contemporaneous production and larger shares of expected production were procured from more productive regions) was necessary for generating this pattern and that this policy was a quantitatively important contributor to overall famine mortality.

Respiratory tract infections, caused by various bacteria and viruses, pose a significant global health burden. In Lebanon, post-COVID-19 epidemiological data on respiratory infections remain scarce. To address this gap, this multicenter study investigates the epidemiology of community-acquired acute respiratory infections among children and adults in Tripoli, North Lebanon. From May 2023 to February 2024, nasopharyngeal samples were collected from outpatients with acute respiratory infections visiting hospitals and pediatric clinics in Tripoli. Samples were analyzed using BioFire ® Respiratory Panel 2.1 Plus (bioMérieux, France), which targets 23 pathogens, including 19 viruses and four bacteria. We used multivariable logistic regression models to identify the determinants of respiratory infections and examine associations between respiratory pathogens. Among 324 enrolled patients, 69.1% were co-infected with at least one pathogen. Human rhinovirus/enterovirus was the most prevalent (27.2%), followed by influenza A (19.8%), particularly influenza A/H1-2009 (16.4%), and RSV (11.4%). SARS-CoV-2 was still circulating with a prevalence of 6.8%. Classical human coronaviruses accounted for 6.1% of infections, with HCoV-NL63 (2.8%) being the most common. Parainfluenza viruses were identified in 5.2% of patients, with type 4 (2.5%) being the most prevalent, followed by type 3 (1.5%), type 1 (1.2%), and type 2 (0.3%). Logistic regression analysis revealed that human rhinovirus/enterovirus infection decreased the likelihood of influenza A (OR=0.25; 95%CI = 0.10–0.54; P = 0.001) or SARS-CoV-2 (OR=0.21; 95%CI = 0.03–0.75; P = 0.039) co-infection. Additionally, our logistic regression models identified significant associations between various determinants, symptoms, and common viruses, including a lower likelihood of influenza A (OR=0.23; 95%CI = 0.06–0.76; P = 0.019) and RSV (OR=0.29; 95%CI = 0.10–0.76; P = 0.017) infection among patients with higher educational levels. Notably, parainfluenza virus infections occurred significantly more in refugee patients (OR=7.22; 95%CI = 1.19–37.0; P = 0.020) compared to the host community. In conclusion, this study provides critical insights into the post-pandemic epidemiology of respiratory infections in Lebanon, informing clinicians, health authorities, and policymakers to optimize diagnostics, preventive measures, and antimicrobial stewardship strategies.

The authors effectively define and map out urban social history in the Middle East from the eighteenth to twentieth centuries, affording us a foundational volume that enriches our understanding of society in the late Ottoman and colonial periods.

Background Sepsis represents a high-risk mortality cohort among patients with severe community-acquired pneumonia (SCAP). Rapid and precise identification along with prompt decision-making, serves as a practical approach to improve patient prognosis. Methods This retrospective observational study enrolled adult patients with severe community-acquired pneumonia (SCAP) who were continuously hospitalized in the intensive care unit (ICU) of West China Hospital, Sichuan University, from September 2011 to September 2019. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for co-sepsis, followed by the utilization of LASSO regression to filter features to establish a nomogram. Model robustness was evaluated via the C index, receiver operating characteristic (ROC) analysis, and calculation of the area under the curve (AUC). Furthermore, its predictive accuracy was assessed via decision curve analysis (DCA). Results In total, 5855 SCAP patients were included in the present study, of whom 654 developed sepsis. Patients with sepsis exhibited a prolonged length of stay in the ICU and higher mortality rates, indicating a worse prognosis than those without sepsis. We identified 15 independent risk factors associated with the development of sepsis in SCAP patients. Further analysis incorporating 9 of these features to construct a nomogram demonstrated a C index of 0.722 (95%CI 0.702–0.742), including lactate, D-dimer, respiratory rate, heart rate, albumin, hemoglobin, activated partial thromboplastin time (APTT), glucose, and C-reactive protein (CRP) levels. The AUC values and DCA curves demonstrated that the model exhibited superior accuracy and overall net benefit in predicting co-sepsis development compared with the qSOFA, CURB-65, SOFA, and APACHE II scores. Additionally, the calibration curve confirmed good concordance between the predicted probabilities of the model. Conclusions This study investigated the risk factors for co-sepsis in SCAP patients and constructed an expedited, cost-effective and personalized model for predicting the probability of co-sepsis.