Outdoor air pollution is increasingly considered as a serious risk factor for cardiovascular diseases (CVD). High levels of airborne particulate matter (PM) constitute the greatest international air pollution threat. The purpose of this thesis is to broaden our knowledge regarding the relationship between outdoor air pollution and cardiovascular diseases in the Middle Eastern countries, specifically in Lebanon. Moreover, we aimed to develop a scale as CVD screening tool among the Lebanese population. To achieve these goals, we conducted three studies. The first was a systematic review of the literature aiming to assess levels and sources of PM across the Middle East area and to search for an evidence of relationship between PM exposure and CVD (Paper I).The second manuscript was a multicenter case-control study investigating the association between outdoor pollutants and cardiovascular diseases among Lebanese adults (Paper II) while the third study was conducted to develop a score that can be used as a screening tool in clinical and epidemiological settings among the Lebanese adults (Paper III).The annual average values of PM pollutants in the Middle East region are considered to be much higher than the WHO 2006 tolerated levels (PM2.5 = 10 µg/m3, PM10 = 20 µg/m3). We uncovered evidence of an association between PM and CVD in 4 Middle East countries: Iran, Kingdom of Saudi Arabia, Qatar and the United Arab Emirates. Ambient PM pollution is considered a potential risk factor for platelet activation and atherosclerosis. Moreover, it was associated with CVD and found to be linked with an increased risk for mortality and hospital admissions (Paper I). Increased risk of CVD with an odds ratio OR of 5.04, 95% CI (4.44-12.85) for living near busy highway and 4.76, 95% CI (2.07-10.91) for living close to local diesel generator was noticed among population exposed to outdoor air pollution (Paper II). In addition, our results highlight the importance of scale generation, which includes air pollution as predictive factor, as screening tool for patients at risk of CVD. This scale can foresee the cardiovascular disease outcomes better than the established score which use the traditional CVD risk factors (Paper III).In conclusion this study brings new evidence regarding the effects of particulate matter on cardiac diseases, points out the harmful role of diesel exhaust on health and suggest a an important role of traffic exhaust particles in exacerbating heart diseases in the Middle East Region. The developed scale could detect persons at high risk for CVD in the clinical and epidemiological settings. In addition, it serves as an essential public health screening tool for the primary prevention of CVD. / Doctorat en Santé Publique / info:eu-repo/semantics/nonPublished

Outdoor air pollution is increasingly considered as a serious risk factor for cardiovascular diseases (CVD). High levels of airborne particulate matter (PM) constitute the greatest international air pollution threat. The purpose of this thesis is to broaden our knowledge regarding the relationship between outdoor air pollution and cardiovascular diseases in the Middle Eastern countries, specifically in Lebanon. Moreover, we aimed to develop a scale as CVD screening tool among the Lebanese population. To achieve these goals, we conducted three studies. The first was a systematic review of the literature aiming to assess levels and sources of PM across the Middle East area and to search for an evidence of relationship between PM exposure and CVD (Paper I).The second manuscript was a multicenter case-control study investigating the association between outdoor pollutants and cardiovascular diseases among Lebanese adults (Paper II) while the third study was conducted to develop a score that can be used as a screening tool in clinical and epidemiological settings among the Lebanese adults (Paper III).The annual average values of PM pollutants in the Middle East region are considered to be much higher than the WHO 2006 tolerated levels (PM2.5 = 10 µg/m3, PM10 = 20 µg/m3). We uncovered evidence of an association between PM and CVD in 4 Middle East countries: Iran, Kingdom of Saudi Arabia, Qatar and the United Arab Emirates. Ambient PM pollution is considered a potential risk factor for platelet activation and atherosclerosis. Moreover, it was associated with CVD and found to be linked with an increased risk for mortality and hospital admissions (Paper I). Increased risk of CVD with an odds ratio OR of 5.04, 95% CI (4.44-12.85) for living near busy highway and 4.76, 95% CI (2.07-10.91) for living close to local diesel generator was noticed among population exposed to outdoor air pollution (Paper II). In addition, our results highlight the importance of scale generation, which includes air pollution as predictive factor, as screening tool for patients at risk of CVD. This scale can foresee the cardiovascular disease outcomes better than the established score which use the traditional CVD risk factors (Paper III).In conclusion this study brings new evidence regarding the effects of particulate matter on cardiac diseases, points out the harmful role of diesel exhaust on health and suggest a an important role of traffic exhaust particles in exacerbating heart diseases in the Middle East Region. The developed scale could detect persons at high risk for CVD in the clinical and epidemiological settings. In addition, it serves as an essential public health screening tool for the primary prevention of CVD. / Doctorat en Santé Publique / info:eu-repo/semantics/nonPublished

L’objectif de cette thèse est d’étudier, à travers deux quotidiens libanais, An-Naharet As-Safir, les négociations de paix entre le Liban, la Syrie et Israël, de 1991 à 2000, période sensible de l’histoire contemporaine libanaise, phase d’après-guerre marquée par une forte influence politique syrienne sur le pays et intervalle stratégique quant au processus de paix lancé entre Israël et les pays arabes. Il s’agit d’analyser l’évolution de la couverture de ces deux quotidiens, représentatifs de la presse quotidienne nationale libanaise et des divergences politiques que connaît le pays dans le traitement d’un sujet géopolitique sensible qui touche à la souveraineté du Liban, ainsi qu’aux relations entre la Syrie et Israël. Pour ce faire, nous avons choisi un corpus qui couvre l’ensemble de la décennie, en se limitant à la Une de chaque journal. Afin de réaliser cette étude avec le recul scientifique nécessaire, nous avons mis au point un logiciel de tri spécialement conçu à cette fin. Il permet de mettre en place une grille d’organisation et d’analyse des informations textuelles et de la production médiatique.L’étude du corpus a été faite dans un premier temps de manière horizontale, afin de croiser les propos des différents acteurs et d’effectuer les mises en parallèle entre le traitement des deux quotidiens. Elle a ensuite été poursuivie de manière verticale, au sein de chaque journal et pour chaque auteur, dans le but de déterminer l’évolution des discours politiques et journalistiques retenus, tout en croisant les différents propos pour en faire ressortir les divergences et les convergences, ainsi que les constantes et les variantes au fil du temps. / The main purpose of this thesis is to study, peace negotiations between Lebanon,Syria and Israel from 1991 to 2000, via their coverage in two Lebanese news papers An-Naharand As-Safir. This was a tense period in the recent history of Lebanon; it was marked by thepolitical influence of Syria on Lebanon, and a strategic period during which the peace processbetween Israel and Arab countries began. It consists primarily in an analysis of the changingnature of the coverage and discourse of two major Lebanese daily newspapers - An-Nahar andAs-Safir. The “copy” here analyzed related to a sensitive geopolitical issue affecting Lebanese independence and relations between Syria and Israel. The survey spans à decade: it is limited to front-page coverage of each newspaper. In order to examine the subject scientifically, aspecific software was specially designed and developed for this purpose. A matrix fororganizing and analyzing textual information and media production was devised. First thestudy was affected horizontally, in order to compare various actors and their related newspaper coverage. Then the study was elaborated in a vertical manner, i.e. by handlingeach newspaper and each author separately, in order to establish the evolution of different discourse. This was achieved by cross-comparing differences and similarities in the discourse,and constants and variables over time.

This dissertation explores social, cultural and political changes in the region later known as ‘Phoenicia’ during the period of approximately 1300-900 BC. By applying modern approaches to theoretical questions such as the nature of social change, identity, migration and how such phenomena are represented in the archaeological record, this dissertation aims to provide a discussion of Late Bronze/Early Iron Age Phoenicia based on a more solid methodological foundation than has often been the case previously. As well as better illuminating social change occurring within Phoenicia itself, it is hoped that the methodological observations and comparative value of the case-study presented here will prove useful for discussions of the wider social changes occurring in the East Mediterranean at this time. A key observation of this research is that past narratives have placed too much emphasis on the role of external powers such as the Egyptian ‘empire’ or ‘Sea People’ invaders in driving Levantine social change in this period. This dissertation stresses the critical importance of local responses to foreign influence and charts the balance between active choice and constraint by circumstances in shaping the development of the Phoenician polities. It is argued that the most important forms of change which can be identified in the archaeological and written records relate to the construction of identities, especially those of the Phoenician élites. These take the form of a move away from legitimation and identity-negotiation based on foreign contacts, towards greater emphasis on more local, Levantine features. The consequences of this change, it is argued, are felt within social, political, economic, religious and other spheres of life.

The 2015 trash crisis in Lebanon resulted in the emergence of movements centered on rights and the state’s responsibility. The protests and outrage were about an entire political structure that had allowed for such a failure in infrastructure to come into existence. After numbers on the street began to fade, the alternative discourses transitioned from the streets to the May 2016 Beirut municipality elections. My research explores how these actors relate to the state as citizens (a term they themselves use) within a political structure that perpetuates a kind of sectarian citizenship, and asks what being a citizen means in such a failed state, and how alternative fronts can push for a reconceptualization of citizenship, on a backdrop of neoliberalism.

Le Liban est un pays qui constitue un carrefour des civilisations. Depuis le temps des pharaons, ses ressources forestières ont été exploitées, notamment pour le commerce du bois. Le Liban, connu pour son cèdre, possède une autre espèce emblématique, le sapin de Cilicie, dont les forêts sont en majorité non protégées. Historiquement, le bois de sapin a été exploité durant le Nouvel Empire égyptien ancien pour la construction des temples et des navires. Il représentait ainsi un signe de pouvoir du pharaon, en formant notamment la barque d'Amon. De même, le sapin a été coupé pour la construction du temple de Jérusalem, ainsi que des instruments de musique et de guerre. La fragmentation des sapinières au Liban n'est pas ancienne mais cette faible divergence se traduit cependant par un dème Nord-Est englobant 11 populations et un dème Sud-Ouest englobant 4 populations qui semblent être le résultat de deux processus démographiques consécutifs ou simultanés durant l'histoire du sapin au Liban. Le premier est un phénomène de migration en altitude en réponse à des changements dans l'environnement ou le climat. La reconstruction de la dynamique passée du sapin au Liban a montré que le sapin a subi des fluctuations importantes dans sa taille, depuis le Tardiglaciaire, il y a 14,000 ans. Notamment, le sapin a connu des périodes d'absence du registre pollinique qui pourrait être liées à la fragmentation anthropique de l'habitat ou à des extinctions locales ou contraction de l'aire de répartition. De même, il a connu des périodes d'expansion notamment au cours des événements de sécheresse dans le climat, notamment à 4090 cal. BP, à 5010 cal. BP et de 7800 à 8090 cal. BP. La richesse en allèles privés dans le dème Nord-Est indique la présence de plusieurs micro-refuges glaciaires de basses et de hautes altitudes, ainsi que des zones de suture issues de la recolonisation. Dans le dème Sud-Ouest, une recolonisation postglaciaire en altitude à partir du seul micro-refuge glaciaire détecté est probable. Le deuxième phénomène est lié à une migration asymétrique des populations génétiquement diversifiées du centre du dème vers les populations marginales génétiquement peu diversifiées. Ce processus, qui semblait être le résultat de la faible taille des populations cibles, pourrait permettre de retarder l'extinction des populations marginales, localement menacées. La superformance de la migration sur la dérive génétique et la dispersion sur des longues distances de 15 à 20 km constituent les effets médiateurs de ces processus démographiques. L'empreinte de cette dynamique démographique est une réduction historique de la taille effective des populations sur le long terme avec un signal ancien plutôt que récent, et une diversité génétique et richesse allélique basses. Cette diversité génétique semble être façonnée par les effets anthropiques ainsi que par les changements dans l'environnement ou le climat. La conservation in situ et ex situ de ces sapinières est nécessaire pour préserver leur patrimoine historique et génétique. / The Lebanon is a country that constitutes a crossroads of civilizations. Back in the time of pharaohs, fir forests in Lebanon were exploited, particularly for the timber trade. Lebanon, known for its cedar, has another emblematic species, the Cilician fir, whose forests are in majority unprotected. Historically, the fir was used during the ancient Egyptian New Kingdom rule over Phoenicia for the construction of temples and ships. Notably, it represented a sign of power of the pharaoh, forming the sacred barque of Amun. Similarly, this tree was cut from Lebanon to build the temple of Jerusalem, as well as for making instruments of music and war. The fragmentation of the fir populations in Lebanon is not ancient but their low divergence, however, is marked by a Northeastern Ridge including 11 populations and a Southwestern Ridge including 4 populations that seem to be the result of two consecutive or simultaneous demographic processes during the history of fir in Lebanon. The first is a phenomenon of altitudinal migration in response to changes in the environment or climate. The reconstruction of the past dynamics of fir in Lebanon showed that it has undergone significant fluctuations in size, since the Late Glacial, 14,000 years ago. In particular, the tree has experienced periods of absence from the pollen record that could be related to anthropogenic habitat fragmentation or to local extinctions or contraction of the range of distribution. Similarly, there have been periods of expansion especially during periods of drought in the climate, at 4090 cal. BP, at 5010 cal. BP and between 7800 and 8090 cal. BP. The private allelic richness in the Northeastern Ridge indicated the presence of multiple glacial microrefugia of low and high elevations, as well as suture zones issues from recolonization. In the Southwestern Ridge, postglacial altitudinal recolonization from single microrefugial population is moslty probable. The second phenomenon is related to an asymmetric Northeast-Southwest migration from genetically diverse populations towards marginal and less genetically diverse populations. This process, which seems to be the result of the small size of the target populations, could help delay the extinction of marginal populations, locally threatened. The outperformance of migration over genetic drift and the dispersal over long distances of 15 to 20 km constitute the mediating effects of these demographic processes. The footprint of these population dynamics is a historic reduction in the effective population size on the long-term rather than on the short term, and weak genetic diversity and allelic richness. This genetic diversity seems to be shaped by anthropogenic effects as well as by changes in the environment or climate. In situ and ex situ conservation of fir populations in Lebanon is necessary to preserve their historical and genetic heritage.

Le Liban a fait face à 15 ans de guerre civile qui ont détruit non seulement son économie et son infrastructure, mais aussi son image de communication. En effet, dans cette ère de mondialisation où la communication joue un rôle essentiel dans le tissage de liens sociaux et où les médias ont une place importante dans l’expansion des différentes cultures, les libanais perdent cette habilité et classent l’autre selon sa confession et son opinion politique. Les médias, en particulier les chaines télévisées locales (fondées par les différents leaders confessionnels ou politico-confessionnels), n’aident pas l’opinion publique à mieux connaitre l’autre. La cible la plus fragile est les jeunes Libanais nés après la guerre civile mais fortement influencés par ce que leurs parents ont vécu pendant la guerre. Ils sont peu ou pas soutenus dans la réception de l’information télévisée, l’école et le foyer n’étant pas toujours les milieux les plus adaptés pour les aider à interpréter l’actualité sous un angle d’ouverture au monde et d’acceptation d’autrui. Cette crise majeure nous a poussé à signaler un fort besoin d’établir de nouvelles bases aux standards de communication à enseigner aux jeunes en particulier dans les cours d’histoire et d’éducation civique, dans le but de les préparer à un avenir où ils auront à mieux connaitre les autres communautés et à apprendre à les accepter afin de cohabiter ensemble. / Lebanon has faced 15 years of civil war that destroyed severely not only his economy, and his infrastructure, but also his image of communication between different communities constituting it. In fact, after being known, since the era of Phoenicians, as the country that linked the east and the west, the country of people who created the first alphabet, the trilingual society open to other populations, Lebanon is facing nowadays a problem of communication among his communities divided into small fragments. In a century where communication became a must, where media is spreading the culture of different communities and minorities, Lebanon has lost this ability and people are identifying the “Other” by their confession and their political point of view. Moreover, the media, especially the local televisions (founded by the different parties and confessional leaders in Lebanon) are not helping the public opinion to learn about other communities. The most fragile target is the Lebanese youth, born after the civil war but paying the price of what their parents faced or did during the war, and sadly misinterpreting the local TV information. This major crisis pushed us to notice an urgent need of resetting some basic communication standards, to be taught at schools in history or civic education classes, in order to prepare our youth for a better future where they can accept the “Other” and know more about his different background.

Au Liban, le plus petit pays du Proche-Orient, la fragilité environnementale combinée à des mutations sociales et à des crises économiques, a engendré entre autres, une destruction de la cohésion nationale et du sens même de la citoyenneté nationale ; ce qui a exacerbé le processus du non-développement. Face à cette situation, comment œuvrer à l’édification d’un chantier éducatif qui pourrait promouvoir la citoyenneté auprès de la jeunesse? L’objectif de notre recherche est d’exposer la spécificité de l’environnement (physique, sociale et idéologique) et de présenter l’état des lieux en se fondant sur une enquête menée auprès de 2450 lycéens libanais, (étude comparée avec 400 lycéens australiens d’origine libanaise et 200 parents). Cette démarche, additionnée aux résultats relevés, nous mènent à proposer un projet d’établissement « L’Ecole projet de sens », basé sur les valeurs et les procédures qui animeraient tout projet d’Éducation au Développement Durable dans ce pays, afin de travailler à l’édification du citoyen Libanais.L’enseignement de la géographie apporte une contribution déterminante à ce projet. / The environmental fragility (combined to the social change and economic crisis) in Lebanon, smallest country in the Middle East, has led among other things, to the destruction of national cohesion and the very meaning of national citizenship; which exacerbated the process of non-development. Faced to this situation, how can we work to build an educational site that can promote citizenship among youth?The goal of our research is to expose the specificity of the environment (physical, social and ideological) and present the state of play, based on a survey of 2,450 Lebanese students (comparative with 400 Australian-Lebanese students and 200 parents). This approach and the results observed, led us to propose a school project: “School, “Meanings” Project” based on the values and procedures that animate any project on Education for Sustainable Development in this country, to build the Lebanese citizen.The teaching of Geography courses provides a decisive contribution to this project.

L’objectif de l’étude est d’évaluer la durabilité de la filière laitière de petits ruminants au Liban et d’identifier ses faiblesses afin de proposer des solutions garantissant sa pérennité. Les résultats d’une enquête englobant 129 éleveurs (Srour, 2006) ainsi que de trois enquêtes portant sur 15 transformateurs, 83 distributeurs et 250 consommateurs ont été agrégés en 12 paramètres représentant les trois volets de la durabilité (environnementale, sociale et économique). Les résultats ont été utilisés pour concevoir un cahier des charges englobant des solutions aux problèmes de la durabilité ; celui-ci a été validé auprès de 16 producteurs, 15 transformateurs, 17 distributeurs et 20 consommateurs. Les producteurs sont responsables de l’impact environnemental le plus important de la filière et souffrent d’une fragilité économique élevée. Les transformateurs sont caractérisés par un manque d’investissement et de politique de traitement des déchets, mais présentent les meilleures conditions sociales à leurs employés et sont les plus performants au niveau de la valeur ajoutée malgré un taux faible de croissance. Chez les distributeurs, les épiceries sont en régression face à des grandes surfaces en pleine expansion et offrant de meilleures conditions sociales à leurs employés. Les consommateurs ignorent le concept de la durabilité et basent leur confiance sur les vendeurs pour l’achat des produits traditionnels. La mise en place de cahier des charges est soutenue par son originalité, l’absence de produits similaires et la situation géographique, mais elle doit prendre en considération la réceptivité du marché (local et extérieur) et l’absence d’infrastructure spécialisée / The aim of this study is to evaluate the sustainability of dairy small ruminant supply chain in Lebanon and to identify its weaknesses in order to suggest solutions guaranteeing its durability. The results relevant to a survey covering 129 breeders (Srour, 2006) and to three other surveys covering 15 processors, 83 distributors and 250 consumers were combined in 12 parameters representing the three facets of sustainability (environmental, social and economical). The results were used to design a labelling scheme containing solutions to sustainability problems; the latter was then validated with 16 breeders, 15 processors, 17 distributors, and 20 consumers. The breeders are responsible for the most important environmental impact of the supply chain and suffer from a high economical fragility. The processors are characterized with a shortage of investment and waste treatment policy but present the best social conditions to their employees and hold the best added value performance despite a weak growth rate. At the distributors’ level, groceries are in regression, facing large retailers in full expansion and offering better social conditions to their employees. The consumers ignore the sustainability concept and base their trust on the salesmen in buying traditional products. The application of the labelling scheme is supported by its originality, the absence of similar products and the geographical situation, but it has to take into consideration the receptiveness of the market (local and foreign) and the absence of specialized infrastructure

La thèse vise à apprécier les effets de la mise en oeuvre d'un dispositif d'ExAO comparativement à d'autres modalités plus classiques de TP (laboratoire traditionnel et exposé d'expériences). L'apprentissage concerné est celui du concept de réaction chimique par des élèves de 5ème au Liban. Les élèves soumis aux trois modalités pédagogiques ont été confrontés à deux reprises à une épreuve commune de connaissances (prétest et post-test). Les données analysées portent de plus sur les comptes rendus d'expérience réalisés par les élèves des trois groupes. Les résultats attestent d'un effet positif plus important de la modalité de travail par ExAO. Du point de vue quantitatif les élèves de ce groupe ont nettement plus progressé que les autres eu égard à la plupart des dimensions de l'apprentissage concerné. D'un point de vue qualitatif, il s'avère en outre que ces élèves ont fait preuve d'un meilleur niveau de compréhension du contenu du TP réalisé. / The thesis aims at assessing the effects of the implementation of MBL compared with two other classic lab work methods (the presentation of lab work and lab work displaying). The course given to students in grade 7 in Lebanon focuses on the concept of chemical reaction. The students in all three groups sat for both a pre-test and a post-test of knowledge, created specifically for this study. The analyzed data cover also the reports made by students of all three groups.The results are consistent with a positive effect of the modality of MBL work. From a quantitative point of view, the students in this group are significantly more advanced than others in relation to the most relevant dimensions of learning. From a qualitative point of view, it also turns out that these students have demonstrated a greater level of understanding of the content of lab work achieved.