[Health care safety: The discrepancies between experience and degree of satisfaction of hospitalized patients observed in interviews performed by user representatives]. / La sécurité liée aux soins : écarts entre l'expérience et la satisfaction de patients hospitalisés à partir d'entretiens menés par des représentants d'usagers.

INTRODUCTION: The purpose of this article is to present the results of a qualitative survey conducted by user representatives (URs) focusing on the health care safety experience of hospitalized patients. The authors wished to identify factors associated with safety of care and, more specifically, with the possibly ominous medical events reported by patients. METHODS: After being trained with these objectives in mind, eight URs conducted semi-directive interviews with fourteen patients hospitalized in eleven separate hospital units in nine different hospitals. RESULTS: Eight types of factors consisting in 30 contributing factors liable to be reported by patients were identified: 1) factors related to patients' basic needs; 2) personalization of care; 3) professional factors; 4) organizational factors; 5) communication factors; 6) caregiver responsiveness; 7) infectious risks; 8) continuity of care. Patients' overall feelings about their hospitalization remained excellent notwithstanding more tempered, even negative experiences. CONCLUSION: This paradoxical result shows that the patients' actual experience is far more instructive than their degree of satisfaction. In light of this study, the acceptability of this type of research (i.e. research conducted by URs) is excellent and it also appears highly feasible, whatever the limitations imposed by organizational considerations.

Bridging the Gap: Assessing Public Awareness of Psychological Factors Influencing Coronary Heart Disease Outcomes in Makkah, Saudi Arabia.

BACKGROUND: Coronary heart disease (CHD) is a leading cause of death globally, and psychological factors are increasingly recognized as playing a significant role in its prognosis. This study aimed to assess the public's awareness of psychological factors affecting CHD prognosis in Makkah, Saudi Arabia. METHODS: A cross-sectional online survey was conducted with 385 participants recruited randomly. The survey collected data on sociodemographic characteristics and respondents' opinions regarding the effects of negative and positive psychological factors on CHD prognosis, including differences based on age and gender. RESULTS: The majority of participants (96.9%) agreed that negative psychological factors, such as stress (80.5%), anxiety (76.9%), and depression (67.5%), influence CHD prognosis. Positive factors like satisfaction (79.2%) and happiness (75.6%) were also recognized as influential. Participants aged 30-50 and over 50 demonstrated higher awareness of the link between psychological factors and CHD compared to those under 30. No significant gender differences were observed in knowledge levels. CONCLUSION: This study suggests that the Makkah population has a good understanding of the impact of psychological factors on CHD prognosis. Integrating this knowledge into comprehensive health education programs could benefit CHD prevention, management, and prognosis in the region. Future research should explore broader populations and utilize diverse methodologies to refine and generalize these findings.

A Comparative Analysis of Botulinum Toxin Use Versus Other Therapies for Temporomandibular Disorders: A Systematic Review.

Existing literature regarding the efficacy of Botulinum toxin A (BoNT-A) therapy in improving the clinical outcomes of temporomandibular disorders (TMDs) is ambiguous and lacks consistency. Thus, this study aimed to evaluate the efficacy of BoNT-A in reducing pain, occlusal force, electromyographic (EMG) changes, and maximum mouth opening compared with placebo and other interventions. An electronic database search was conducted using MEDLINE, PubMed, Google Scholar, the Cochrane Library, and ClinicalTrials.gov from January 2000 to June 2024 to identify randomized controlled trials (RCTs). A manual search complemented the electronic search. The Risk of Bias 2 (RoB 2) assessment was used to evaluate the internal validity of the included studies. A total of 1719 studies were identified, of which 23 fulfilled the inclusion criteria. Nineteen of these studies evaluated pain levels (primary outcome) after BoTN-A therapy, with six of them observing a decrease. In terms of secondary outcomes, seven of 10 studies noted an increase in maximum mouth opening, while all six reported a drop in EMG activity, and all four found a decrease in occlusal force following BoNT-A therapy. Muscle activity and biting force were significantly reduced in the therapeutic groups. Clinicians must consider these adverse events before treating patients with BoNT-A therapy. Additional regulatory guidelines and standardization of injection protocols are essential in improving therapeutic outcomes and patient safety. These findings suggest that BoNT-A may be a feasible option for TMD management but should be used with caution in clinical settings.

Correction: Bridging the Gap: Assessing Public Awareness of Psychological Factors Influencing Coronary Heart Disease Outcomes in Makkah, Saudi Arabia.

[This corrects the article DOI: 10.7759/cureus.51637.].

Public Awareness and Knowledge of Sepsis: A Cross-Sectional Survey of Adults in the Western Region of Saudi Arabia.

BACKGROUND: Sepsis is a condition in which the body responds improperly to harmful microorganisms and infections, which triggers a chain reaction throughout the body. It is a life-threatening medical emergency. Infections that lead to sepsis, in most cases, start in the lungs, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis rapidly leads to multi-organ failure and death. The risk factors for sepsis include a weakened immune system, being 65 years of age or older, and chronic medical conditions including diabetes, lung disease, and kidney disease. A thorough understanding of the warning signs and symptoms, as well as prompt medical attention, are required for successful sepsis management. Early detection, antimicrobial therapy, and intensive supportive care are the cornerstones of the best sepsis management. AIM: This study aimed to assess the public awareness and knowledge of sepsis in the Western region of Saudi Arabia. METHODS: This was a cross-sectional study conducted from the beginning of June till the end of August 2023, among 425 Saudi adults in the Western region above the age of 18 years. Data collection was carried out by administering a questionnaire through an online platform. The questionnaire included demographic information, risk factors, symptoms, protective factors, and the source of information about sepsis. The data collected were reviewed, coded, and then fed into IBM SPSS Statistics software for Windows, Version 21 (released 2012; IBM Corp., Armonk, NY). RESULTS: The study found that almost half (47.8%) of participants were aware of bacterial septicemia, with the most common sources of awareness being the internet (48.3%) and healthcare professionals (47.8%). Low immunity (75.9%) and infection (39.4%) have been the most frequently reported risk factors. Fever (31.5%) was the most commonly reported symptom. Participants from Yanbu and Jeddah and those in the healthcare sector had significantly higher awareness levels. The majority of participants (93.1%) had poor knowledge about the risk factors and symptoms of septicemia, with only 3.4% having fair or good knowledge. Sociodemographic characteristics did not significantly affect knowledge about septicemia (P>0.05). CONCLUSION: In summary, this study reveals that while awareness of bacterial septicemia is relatively high among the sample population, knowledge about the risk factors and symptoms of the condition is low. The internet, healthcare professionals, and social media play significant roles in raising awareness about bacterial septicemia. Participants from Yanbu and Jeddah, students, and healthcare sector workers had higher awareness levels compared to other groups. However, overall knowledge levels regarding bacterial septicemia were poor across various demographic characteristics. This highlights the need for targeted educational interventions to improve knowledge and understanding of septicemia and its risk factors and symptoms among the general population. Further research is needed to identify the reasons for low knowledge levels and develop effective strategies to improve awareness about bacterial septicemia.

Knowledge, attitude, and practices on exercise among pregnant females attending Al-Wazarat Health Center, Riyadh, Saudi Arabia.

BACKGROUND: The consequences of physical inactivity during pregnancy are one of the major problems among pregnant women in Saudi. To explore the pattern of exercise and to know the beliefs and reasons for not doing physical activity (PA) emphasized the need for conducting this study. This study aimed to improve the level of knowledge and practice of PA among women during pregnancy. METHODS: A cross-sectional study was performed using quota sampling. RESULTS: 41.62% of pregnant women had high level of physical activity (PA) awareness and practice and 58.37% had a low level of awareness and practice. Statistical difference was found between the two groups in terms of parity, education level, work status, and family income. Pregnant women preferred walking as exercise. They are aware about PA benefits during pregnancy, but perceived that tiredness was the greatest barrier for physical activity. CONCLUSION: This study recommends conducting well-designed intervention sessions to promote PA awareness and practice among pregnant women, especially those with low education, low income, and low number of children.

Dietary effect of probiotics and prebiotics on broiler performance, carcass, and immunity.

This experiment was carried out to evaluate the effects of dietary addition of probiotics (Protexin) and prebiotics (active MOS, mannan oligosaccharides) on growth performance, carcasses, and antibody titer in broilers. A total number of 360-day-old Ross broiler chicks were randomly divided into 9 groups in a 3 × 3 factorial arrangement. Nine broiler starter (0-21 d) and finisher (21-35 d) diets were formulated by using 3 levels of probiotics (0, 1, and 2 g/kg of feed) and 3 levels of MOS (0, 1, and 1.5 g/kg of feed) and were randomly allotted to 9 groups. Feed intake was not affected by interaction of treatments during all phases (P > 0.05). Feed intake was improved due to the main effect of probiotic (P = 0.0001) or MOS (P = 0.005). No interaction (P > 0.05) was observed for weight gain in the starter, finisher, and overall phases. While, during the starter and finisher phases, weight gain was increased by probiotics (P = 0.028 or 0.04, respectively). Dietary supplementation of MOS improved weight gain (P = 0.01) and feed conversion ratio (FCR) (P = 0.03) during the overall period, but during starter and finisher periods, weight gain and FCR were not affected by prebiotics. Apart from dressing percentage, no interaction or individual effect of probiotics and prebiotics was observed for carcass, breast, thigh, heart, liver, and gizzard weight. Antibody titer for infectious bursal disease (IBD) was improved (P = 0.026) by the interaction effect between probiotics and prebiotics, when compared with the control group. Antibody titer against Newcastle disease (ND) was not affected by probiotics or prebiotics or their interactions (P > 0.05). It could be concluded that supplementation of prebiotics or probiotics can improve the growth performance of broilers. It may also be helpful in improving the antibody titer against IBD in broilers fed antibiotic-free diets.

Using RT-PCR and glutathione level to study the effect of follicular fluid on in vitro maturation and gene expression of sheep oocytes.

The aim of this study is to evaluate the effect of sheep follicular fluid (SFF) supplementation of the in vitro maturation (IVM) media of sheep oocytes on the resumption of meiosis, glutathione (GSH) level, and expression of apoptosis (Bax, Bcl-2) as well as heat shock protein beta-1 (HSPB1) genes. Sheep ovaries were collected from the central slaughterhouse of Riyadh city, KSA. Oocytes were aspirated from 3 to 8 mm follicles. Sheep oocytes were cultured in maturation medium with different concentrations of sheep follicular fluid: 0% (control), 10%, 20% and 40% for 24 h. The results indicated that the maturation rate of oocytes was significantly (p ≤ .05) decreased in 40% SFF (36.87%) versus the control (61.3%), 10% SFF (63.95%) and 20% SFF (64.08%). The supplementation of the IVM medium with 10% SFF induced an intra-oocyte GSH concentration that was significantly higher than in sheep oocytes cultured with 20% and 40% SFF and similar to the GSH content in oocytes cultured without SFF. Real-time polymerase chain reaction analysis of gene expression revealed no significant differences in the Bax and HSPB1 genes between the control and 10% SFF, whereas they were significantly higher in 40% FF (p ≤ .05) compared to the control. The expression of Bax:Bcl-2 was significantly higher in 20% and 40% SFF compared to the control group. In conclusion, the addition of SFF to the IVM culture of sheep oocytes is recommended to support nuclear maturation and increase oocyte competence.