Results from the United Arab Emirates 2022 report card on physical activity for children and adolescents.

Objective: The United Arab Emirates (UAE) 2022 Report Card provides a systematic evaluation of the physical activity (PA) levels of children and adolescents in the UAE. Methods: The 2022 Report Card utilized data from 2017 to 2021 to inform 10 core PA indicators that were common to the Global Matrix 4.0. Results: One in five (19%) UAE school children achieved the recommended amount of moderate-to-vigorous PA (i.e. ≥60 min/d; Total Physical Activity Grade F). Less than 1% of school children used active transport to and from school (Active Transportation Grade F). One in four (26%) secondary school children achieved the recreational screen time recommendations (i.e. ≤2 h/d; Sedentary Behaviours Grade D-). A quarter of adults reported achieving the recommended PA level (i.e. ≥150 min of moderate-intensity PA per week, or equivalent) (Family and Peers Grade D-). All school children are taught physical education (PE) by a specialist with at least a bachelor's degree in PE; however, the duration of weekly PE classes varied between schools (School Grade A-). The UAE Government has invested significant funds and resources into developing and implementing strategies and facilities that will increase PA across the entire population (Government Grade B+). Organised Sport and Physical Activity, Active Play, Physical Fitness, and Community and Environment indicators were graded 'Incomplete' (INC) due to a lack of available data. Conclusions: Overall, PA levels remain low and sedentary behaviours remain high amongst UAE children and adolescents. The UAE Government has sustained investment in further developing PA opportunities for all children and adults which should translate to increased PA and health improvements at a population level.

Metabolic syndrome among children aged 6 to 11 years, Al Ain, United Arab Emirates: Role of obesity.

OBJECTIVES: To evaluate the association of metabolic syndrome with the varying degrees of obesity among children aged 6 to 11 years in Al Ain, United Arab Emirates (UAE). METHODS: As an ancillary to the primary study examining prevalence of MetS in a random sample of 1186 adolescents from 114 schools in Al Ain, parents and siblings aged 6 to 11 years were invited to participate in this study. After informed consent from parents and assent from children, trained nurses administered questionnaires to assess socio-demographic and lifestyle variables and conducted anthropometric measurements. Fasting blood samples were drawn to measure plasma lipids and glucose. We used Centers for Diseases Control and Prevention (CDC)-defined categories of body mass index (BMI = kg/m2 ) for normal weight (<85th percentile), overweight (≥85th to 94th percentile), and obese (≥95th percentiles). MetS was defined according to National Cholesterol Education Program's (NCEP)/Adult Treatment Panel III (ATP III) criteria. RESULTS: Of the total 234 siblings aged 6 to 11 years, 8.9% (95% Confidence Interval [CI]: 5.6-13.4) had MetS. The prevalence of MetS increased with the severity of obesity, 4.5% in normal, 16.7% in overweight, and 30.0% in obese subjects. The age, sex, and ethnicity adjusted odds (1.55, 95% CI: 1.23-1.96) of MetS increased significantly with per unit increase in BMI. CONCLUSIONS: The prevalence of MetS in study subjects increased with an increase in BMI. School-based interventions targeting metabolic risks in this population are urgently needed.

LAPAROSCOPIC CHOLECYSTECTOMY: OUTCOME OF FIRST 202 CASES IN A DISTRICT HOSPITAL IN GILGIT.

BACKGROUND: The incidence of gall stone disease is on the rise in Gilgit Baltistan. The objectives of the study were to assess the outcome of laparoscopic cholecystectomy in terms of conversion rate and postoperative morbidity, in The Aga Khan Medical Centre Gilgit. METHODS: It was descriptive case series. All patients that underwent laparoscopic cholecystectomy between June 2009 to May 2014 were included. The data was collected prospectively. Demographic features, operative time, and hospital stay were studied. Postoperative complications were documented and evaluated according to outcome measures (bile duct injuries, morbidity, mortality, conversion rates, wound infections). RESULTS: A total of 202 consecutive patients were enrolled with a mean age of 49±15 years. There were 164 (81%) female and 38(19%.) male patients. Twenty nine (15%) patients had hypertension, 51 (25%) patients had diabetes mellitus as comorbid conditions. The mean operative time was 54±21 minutes. The operative time was longer in 52 (26%) patients. Three patients (1.5%) required conversion to open cholecystectomy due to obscured anatomy in the area of Calot's triangle, and empyema gallbladder. The mean hospital stay was 2±0.7 days. No common bile duct injury, solid organ or bowel injury occurred in this study. The mean follow up duration was 30±15 months. Postoperative complications include, port site infection in 8 (2%) patient, chest infection in 5 (2.4%) patients, and one (0.5%) patient had myocardial infarction. There was no mortality reported in this group of patients. CONCLUSION: Laparoscopic cholecystectomy is a safe procedure with advantages of decreased wound infection, less pain, decreased hospital stay, and early recovery.

Women's knowledge, attitude and practice towards menopause and hormone replacement therapy: a facility based study in Al-Ain, United Arab Emirates.

BACKGROUND: Hormone replacement therapy (HRT) is an effective treatment for menopausal symptoms like vasomotor symptoms, sleep disturbances, mood alteration, depression, urinary tract infection, vaginal atrophy and increased health risks for osteoporosis, cardiovascular diseases and loss of cognitive function. This study was conducted to determine knowledge, attitude and practice toward menopause among women in UAE. METHODS: A clinic-based cross-sectional study was carried out among women of age 40 and above. Study subjects were recruited from four Primary Health Care centres in Al Ain city. The participants were administered a questionnaire in Arabic and English, which included 33 items; socio-demographic variables, and questions related to knowledge, attitude and practices regarding menopause and HRT. RESULTS: Out of 177 study subjected selected, 150 (85%) completed the survey. Almost half of the participants (51%) had already experienced menopause. A substantial number of women had poor know knowledge about menopause (67%) and HRT (73%). Sixty percent of women had positive attitude towards menopause. Of the fifty three percent of women with symptoms, 35% of them did not use anything to relieve their symptoms. Knowledge about menopause varied significantly (p<0.05) with the level of education and nationality. The association between reported symptoms and attitude towards menopause and HRT was found to be statistically significant. Women with reported symptoms that were bothersome had positive attitude towards HRT uptake. CONCLUSION: The study indicated that there is poor knowledge about menopause and HRT among the participants. Level of knowledge was associated with the level of education. There was a positive attitude towards menopause, with women suffering the most from menopausal symptoms showing positive attitude towards HRT.

Prevalence of antenatal depression: comparison between Pakistani and Canadian women.

OBJECTIVE: To study the prevalence and correlates of depression in pregnant women of different cultures. METHODS: We used a score of 13 or greater on the Edinburgh Postnatal Depression Scale (EPDS) to indicate depression status and logistic regression to determine its correlates in pregnant women from Northern Pakistan (n=128), Caucasian (n=128) and Aboriginal (n=128) women from Saskatchewan, Canada. RESULTS: A higher proportion of Pakistani women (48.4%) had depression compared to their Aboriginal (31.2%) and Caucasian (8.6%) counterparts. Depression was associated with poor physical health in all women; however, there were unique correlates of antenatal depression in each group: physical abuse in Pakistani women (AOR=4.40:95% CI, 1.15-16.85), sexual abuse in Aboriginal women (AOR=3.02:95% CI, 1.09-8.40), and low income in Caucasian women (AOR=5.74:95% CI, 1.04-31.78). CONCLUSION: Depression is a substantial public health problem among pregnant women, with women in Pakistan having a much higher burden of antenatal depression than their Canadian counterparts.

Medication Adherence and Treatment-Resistant Hypertension in Newly Treated Hypertensive Patients in the United Arab Emirates.

(1) Background: The present study aimed to analyze medication adherence and its effect on blood pressure (BP) control and assess the prevalence of treatment-resistant hypertension (TRH) among newly treated hypertensive patients in the United Arab Emirates (UAE); (2) Methods: A retrospective chart review was conducted to evaluate 5308 naïve hypertensive adults registered for the treatment across Abu Dhabi Health Services (SEHA) clinics in Abu Dhabi in 2017. After collecting data regarding basic details and BP measurements, patients were followed up for six months. Patients who did not reach BP targets despite taking three or more antihypertensive medications were defined as TRH; (3) Results: The overall adherence to antihypertensive treatment was 42%. At 6-month, a significant reduction in BP was observed in patients adherent to medications (systolic: -4.5 mm Hg and diastolic: -5.9 mm Hg) than those who were nonadherent to antihypertensive therapy (1.15 mm Hg and 3.59 mm Hg). Among 189 patients using three or more antihypertensive medications for six months, only 34% (n = 64) were adherent to the treatment, and only 13.7% (n = 26) reached the BP target. The prevalence of TRH was 20.1%; (4) Conclusions: Medication adherence and BP control among the participants were suboptimal. The study shows a high prevalence of TRH among newly treated hypertensives in the UAE. More extraordinary efforts toward improving adherence to antihypertensive therapy and more focus toward BP control and TRH are urgently needed.

Prevalence, Awareness, Treatment, and Control of Hypertension in the United Arab Emirates: A Systematic Review and Meta-Analysis.

BACKGROUND: Evidence for the prevalence, awareness, treatment, and control of hypertension in the United Arab Emirates (UAE) is limited. A systematic review and meta-analysis were conducted to summarize the existing knowledge regarding the prevalence, awareness, treatment, and control of hypertension in the UAE. METHODS: We searched PubMed/MEDLINE, Embase, Scopus, and Google Scholar using prespecified medical subject handling (MeSH) terms and text words to identify the relevant published articles from 1 January 1995 to 31 August 2021. Population-based prospective observational studies conducted among healthy adult subjects living in the UAE and that defined hypertension using the guidelines-recommended blood pressure (BP) cut-offs ≥ 130/80 mmHg or ≥ 140/90 mmHg were considered. RESULTS: Of 1038 studies, fifteen cross-sectional studies were included for data extraction involving 139,907 adults with a sample size ranging from 74 to 50,138 and with cases defined as blood pressure ≥ 140/90 mmHg. The pooled prevalence of hypertension was 31% (95% confidence interval (CI): 27-36), and a higher prevalence was observed in Dubai (37%, 95% CI: 28-45) than in the Abu Dhabi region (29%, 95% CI: 24-35) and in multicenter studies (24%, 95% CI: 14-33). The level of awareness was only 29% (95% CI: 17-42), 31% (95% CI: 18-44) for treatment, and 38% (95% CI: 19-57) had controlled BP (< 140/90 mmHg). CONCLUSION: This study revealed a high prevalence of hypertension with low awareness and suboptimal control of hypertension. Multifaceted approaches that include the systematic measurement of BP, raising awareness, and improving hypertension diagnoses and treatments are needed.

Hypertension Control and Guideline-Recommended Target Blood Pressure Goal Achievement at an Early Stage of Hypertension in the UAE.

(1) Background: The present study aimed to assess the changes in blood pressure (BP) within the first 6 months of treatment initiation in a newly treated hypertensive cohort and to identify the factors that are associated with achieving the target BP recommended by the American (ACC/AHA, 2017), European (ESC/ESH, 2018), United Kingdom (NICE, 2019), and International Society of Hypertension (ISH, 2020) guidelines. (2) Methods: We analyzed 5308 incident hypertensive outpatients across Abu Dhabi, United Arab Emirates (UAE), in 2017; each patient was followed up for 6 months. Hypertension was defined as a BP of 130/80 mmHg according to the ACC/AHA guidelines and 140/90 mmHg according to the ESC/ESH, NICE, and ISH guidelines. Multiple logistic regression was used to identify factors associated with achieving the guideline-recommended BP targets. (3) Results: At baseline, the mean BP was 133.9 ± 72.9 mmHg and 132.7 ± 72.5 mmHg at 6 months. The guideline-recommended BP targets were 39.5%, 43%, 65.6%, and 40.8%, according to the ACC/AHA, ESC/ESH, NICE, and ISH guidelines, respectively. A BMI of <25 kg/m2 was associated with better BP control according to the ACC/AHA (odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.07-1.49), ESC/ESH (OR = 1.27; 95% CI = 1.08-1.50), and ISH guidelines (OR = 1.22; 95% CI = 1.03-1.44). Hypertension treated in secondary care settings was more likely to achieve the BP targets recommended by the ACC/AHA (1.31 times), ESC/ESH (1.32 times), NICE (1.41 times), and ISH (1.34 times) guidelines. (4) Conclusions: BP goal achievement was suboptimal. BP control efforts should prioritize improving cardiometabolic goals and lifestyle modifications.

Results From the United Arab Emirates' 2016 Report Card on Physical Activity for Children and Youth.

BACKGROUND: The Active Healthy Kids 2016 United Arab Emirates (UAE) Report Card provides a systematic evaluation of how the UAE is performing in supporting and engaging physical activity (PA) in children and adolescents. METHODS: The Active Healthy Kids Global Alliance framework and standardized set of procedures were used to perform the systematic assessment of PA in UAE youth and children. Indicator grades were based on the proportion of children and youth achieving a defined benchmark: A = 81% to 100%; B = 61% to 80%; C = 41% to 60%; D = 21% to 40%; F = 0% to 20%; INC = incomplete data. RESULTS: Overall Physical Activity Level and Active Transportation both received a grade of D-/F-. Sedentary Behavior and Family and Peers both received a C- minus grade and School was graded D. Minus grades indicate PA disparities related to age, gender, nationality, socioeconomic status, and geographic location. Government Strategies and Investments received a B+ grade. Sport Participation, Active Play, and Community and the Built Environment were graded INC due to a lack of nationally representative data for all 7 emirates. CONCLUSIONS: The majority of UAE children are not achieving the daily recommended level of PA. The UAE leadership has invested significant resources into improving PA through school- and community-based PA interventions; however, inter- and intraemirate population-based strategies remain fragmented.

Injuries and illnesses from wood framing in residential construction, Washington State, 1993-1999.

The construction industry is associated with high rates of work-related injury. We used workers compensation data to describe the injuries and illnesses, claim rates, and claim costs associated with wood framing activities in construction. From 1993 to 1999, there were 33,021 accepted state fund workers compensation claims with direct costs of over $197 million. The average annual claim rate was 45 per 100 full-time equivalent. Statistically significant downward trends were noted in claim rates for all injuries and illnesses, compensable time loss claims, eye and fall injuries. However, these trends were not statistically significantly different from those observed in all other construction risk classes combined. The information in this report can be used to guide prevention efforts and to evaluate the effectiveness of Washington state initiatives to reduce injury and illness rates in wood frame construction.

Carbohydrate intake and overweight and obesity among healthy adults.

BACKGROUND: Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence. OBJECTIVE: To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults. DESIGN: We used a cross-sectional analysis. SUBJECTS/SETTING: The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis. MAIN OUTCOME MEASURES: Outcome variables were body mass index (BMI; calculated as kg/m(2)) and overweight or obesity status (dichotomous) defined as BMI > or =25 compared with BMI <25 based on measured height and weight. Diet was evaluated by 24-hour dietary recall based on the Automated Multi-Pass Method. STATISTICAL ANALYSES PERFORMED: Weighted regression models with bootstrapping and cubic splines were used. Outcome variables were BMI and overweight or obesity, and predictors were daily nutrient intake. Adjustment for total energy intake, age, leisure time energy expenditure, sex, smoking, education, and income adequacy was performed. RESULTS: Risk of overweight and obesity was decreased in all quartiles of carbohydrate intake compared to the lowest intake category (multivariate odds ratio quartile 2=0.63; 95% confidence interval: 0.49 to 0.90; odds ratio quartile 3=0.58; 95% confidence interval: 0.41 to 0.82; odds ratio quartile 4=0.60; 95% confidence interval: 0.42 to 0.85). Spline analyses revealed lowest risk among those consuming 290 to 310 g/day carbohydrates. CONCLUSIONS: Consuming a low-carbohydrate (approximately <47% energy) diet is associated with greater likelihood of being overweight or obese among healthy, free-living adults. Lowest risk may be obtained by consuming 47% to 64% energy from carbohydrates.