The detection and analysis of land use changes in the urban environment is an important issue in planning. Remote sensing and geographic information systems are considered as the most efficient techniques for this type of studies. These techniques had been applied to investigate the effects of urbanization on fertile lands and to quantify urban growth of Amman area. Five land covers were identified in space and time using aerial photographs, LANDSAT and IKONOS images acquired at different dates. The study showed that the urban area was increased by 162 km 2 over the period 1918-2002, which represents 509 times the original urban area. The fertile lands decreased by 86 km 2 , which represents 23% of loss. Moreover, the urban expansion over 1918-2002 was analyzed and its impacts on the Amman area environment were assessed. The results of our study were compared to other similar studies for Istanbul and Bangkok. The comparison showed that Amman has the largest percent annual rate of urban expansion.
Background
Yemen's health system has severely deteriorated due to the ongoing civil war accompanied by the COVID-19 pandemic which coincided with other outbreaks of endemic infections. Many health institutions closed due to insufficient equipment and supplies. Consequently, pharmacists became the available healthcare provider on the frontlines. This study aimed to evaluate the pattern of demand for prescription and nonprescription drugs during the pandemic based on the pharmacist's perspective in Yemen, a conflict zone country.
Methods
An online survey was developed, validated, and distributed among pharmacists. The questionnaire was composed of two sections: (1) demographic characteristics of the participants and (2) changes in the demand for different drug categories. Chi-square test and Fisher's exact test were used to find statistical associations.
Results
Responses (330) were received from pharmacists working in 12 out of 22 governorates in Yemen. During the pandemic, there was an increase in the demand for prescription drugs such as antibiotics, antimalarials, and sedatives (95%, 90%, and 71%, respectively) and an increase in the demand for nonprescription drugs such as vitamins (93%) and paracetamol (> 90%). Some of these drugs could have serious side effects if taken without medical advice, and others could result in severe effects if taken concomitantly. In addition, there was an increase in the demand for prescription drugs without a prescription, which was reported by 50% of the participants. No statistical difference was seen between the frontline districts and major cities in terms of requesting these drugs without a prescription. On the other hand, most participants (75.2%) did not attend any training or workshop during the last 6 months of conducting this survey.
Conclusion
COVID-19 has increased the demand for many prescription and nonprescription drugs, where the irrational use of these drugs may lead to devastating health effects. In war zone areas hit by a pandemic, policymakers and public health organizations should focus on training and educating pharmacists as important health care and medicine providers for the public.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.