Background: Self-medication with leftover antibiotics (LA) is a global health crisis, particularly in contexts of economic and political instability. This study examines the social determinants of health (SDOH) influencing LA use among Lebanese households, focusing on how individuals are born, grow, live, and work. Methods: A cross-sectional study was conducted among 368 Lebanese adults to collect data on socio-demographic characteristics, self-medication practices related to LA, and key SDOH such as socioeconomic status (SES), perceived discrimination in medical settings (DMS), political and economic instability, drug shortages, and trusted sources of health information. Data were analyzed using bivariate tests and multivariable logistic regression. Results: Bivariate analysis showed that LA use was significantly associated with male gender (45.0% vs. 33.3%, p = 0.024), lower educational levels (58.7% vs. 35.1%, p = 0.002), presence of chronic disease (54.7% vs. 32.2%, p < 0.001), older age (p = 0.028), and a higher household crowding index (p = 0.018). LA use was also more prevalent among participants impacted by political instability, economic crisis, and drug shortages (all p < 0.001). In multivariable logistic regression, chronic disease (OR = 2.711, p = 0.002), economic crisis (OR = 2.013, p < 0.001), and prior experience with the same illness (OR = 4.085, p < 0.001) were identified as significant predictors for LA use. Conclusion: These findings show the critical role of socio-economic instability, healthcare access challenges, and experiential factors as key SDOH driving LA practices. The study highlights the urgent need for multi-sectoral interventions addressing economic hardship, improving healthcare access, and enhancing public awareness to mitigate LA misuse and its contribution to antimicrobial resistance in Lebanon.

Background: Self-medication with leftover antibiotics (SMLA) drives antimicrobial resistance (AMR), particularly in developing countries. This study examined knowledge–practice gaps regarding antibiotic use and handling among individuals with prior SMLA across seven developing countries. Methods: A cross-sectional study (February 2023–February 2024) included 3191 adults from Bangladesh, Brazil, Egypt, India, Jordan, Lebanon, and Serbia who reported previous leftover antibiotic use. The questionnaires assessed knowledge of antibiotic use (15 items), resistance (12 items), and SMLA risks (15 items). Storage and disposal practices were evaluated using dichotomized correct/incorrect measures. Results: Participants demonstrated above-average knowledge scores as follows: antibiotic use (54.4 ± 8.4), resistance (43.3 ± 6.1), and SMLA risks (58.4 ± 10.3). However, substantial practice gaps emerged. Only 21.9% properly disposed of leftover antibiotics, while 47.0% used household garbage. For storage, 55.1% used appropriate methods, but 32.6% stored antibiotics inappropriately, and 12.8% lacked protocols. Serbian participants showed the highest SMLA risk knowledge (64.3 ± 10.6), Bangladeshi participants the lowest (52.0 ± 8.5, p < 0.001). Women had superior knowledge (59.6 ± 10.4 versus 56.5 ± 9.8, p < 0.001) and storage practices (56.6% versus 52.7%, p = 0.031). Paradoxically, higher AMR knowledge was associated with poorer disposal practices (OR = 0.97, p < 0.001). Conclusions: Despite extensive theoretical knowledge, unsafe medication practices persist, revealing a critical knowledge–practice gap. Our findings challenge education-focused AMR approaches, suggesting cognitive awareness alone cannot drive behavioral change. Effective interventions must address structural barriers, cultural factors, and individual health beliefs beyond traditional knowledge-deficit models.

Background and aim: The Mediterranean Diet (MD) is valued for its health benefits, yet adherence is declining, especially in its regions of origin. In Middle Eastern Mediterranean countries like Lebanon, this decline is exacerbated by ongoing economic challenges, which have disrupted dietary habits and access to MD components. Revitalizing adherence to the MD requires a clear understanding of its determinants, which remain poorly understood in these contexts. This study aims to address this gap by examining the socio-cognitive and environmental factors influencing MD adherence among Lebanese adults, using the Socio-Ecological Model (SEM). Methods: A cross-sectional study was conducted in Lebanon between November 2023 and January 2024 using an online questionnaire, available in Arabic and English. Adults aged 18 and above were recruited via convenience and snowball sampling. The questionnaire assessed socio-demographics, socio-cognitive and environmental factors, and adherence to the MD using the validated MEDAS questionnaire. Data were analyzed using univariate tests and multiple regression to examine associations between MD adherence and socio-demographic, socio-cognitive, and environmental factors. Results: A total of 304 participants completed the survey. The majority were women (74.7%). The research population had a mean age of 33.3 years and a relatively high education (92.7% bachelor's degree and above). Adherence to the MD was generally low to moderate (mean score: 5.97 ± 2.0 on a scale from 0 to 14), with only 4.3% showing high adherence. While several socio-cognitive and environmental factors were correlated with MD adherence in bivariate analysis, only perceived ease of following the MD, a component of perceived behavioral control, was significantly associated with MD adherence in the multiple regression analysis (β = 0.23; p = 0.002). Conclusions : These findings highlight the importance of addressing perceived behavioral control by implementing practical, context-specific interventions that make adherence to the MD easier, especially in times of crisis.

Noise in intensive care units (ICUs) is a recognized environmental hazard, yet most evidence documents its prevalence and sources rather than how nurses ex