The long shadow of accumulating adverse childhood experiences on mental health in the United Arab Emirates: implications for policy and practice.

Introduction: This study investigates the cumulative effects of adverse childhood experiences (ACEs) on adult depression, anxiety, and stress in Abu Dhabi, controlling for demographic factors, lifestyle, and known health and mental health diagnoses. Methods: Utilizing a cross-sectional design and self-report measures, the research aims to fill a critical gap in understanding the specific impacts of ACEs in the UAE. Based on a multi-site, cross-sectional community sample of 697 residents of Abu Dhabi. Results: The findings reveal significant variances in current screening values for depression, anxiety, and stress attributable to ACEs after controlling for demographic factors, lifestyle risk factors, and adult diagnoses of health and mental health conditions. Discussion: The results underline the lifelong impact of ACEs and reinforce the importance of early identification and intervention. In particular, the implications for policy and practice in understanding and mitigating ACEs long-term effects on mental health are considered.

Seroprevalence and molecular detection of Brucella infection in livestock in the United Arab Emirates.

Small ruminants and camels are important livestock species in the United Arab Emirates (UAE), although Brucella infection can limit their productivity. This study aimed to investigate the seroprevalence of Brucella infection and its associated risk factors in small ruminants and camels in the Emirate of Abu Dhabi. Additionally, seropositive animals were tested for the DNA of Brucella. Multispecies competitive enzyme-linked immunosorbent assay (c-ELISA) and multispecies indirect (i-ELISA) were used to test 3,086 animals from 2022 to 2023. Brucella cell surface 31 kDa protein (bcsp31) gene-based real-time polymerase chain reaction (q-PCR) was used to detect Brucella DNA. Multivariate logistic regression was used to assess the association between seroprevalence and potential risk factors. The overall seroprevalences of Brucella infection were 1.7% (95% confidence interval [CI], 1.2%-2.2%) and 5.8% (95% CI, 5.0%-6.7%) based on serial and parallel testing, respectively. The DNA of Brucella was detected in 13 of the 51 seropositive animals. The overall seroprevalence of Brucella infection was associated with the region, type of animal holding, species, and age of the animals. In conclusion, this study documented Brucella infection in small ruminants and camels in the Emirate of Abu Dhabi, warranting necessary intervention strategies to eliminate Brucella infections in livestock populations.

Management of Allergic Rhinitis in the United Arab Emirates: Expert Consensus Recommendations on Allergen Immunotherapy.

Allergic rhinitis (AR) is a chronic inflammatory condition of the upper airways caused by a type I hypersensitivity reaction triggered by environmental allergens. AR is associated with significant morbidity and affects patients' quality of life, emotional well-being, productivity, and cognitive functioning. As AR prevalence and morbidity have increased significantly worldwide, similar observations have been noted in the United Arab Emirates (UAE) with AR becoming a potential public health issue. Management of AR in the UAE is mainly provided by non-allergy specialists relying on first-line treatments such as intranasal steroids and antihistamines, with often suboptimal and short-term efficacy. Allergen Immunotherapy (AIT) is the only currently available disease-modifying treatment option in the form of either subcutaneous or sublingual allergen immunotherapy that has been proven to have long-term benefits. This article aims to provide recommendations regarding the use of AIT for managing AR in the UAE, considering both the current landscape in the Emirati healthcare system and local experience.

Interconnectivity can be as important as habitat type in explaining carbon stocks in the coastal lagoons of arid regions.

Coastal blue carbon ecosystems, typically comprising interconnected habitat mosaics, are globally important pathways of carbon sequestration and play a significant role in climate change regulation and mitigation. Current coastal management strategies often rely on simplified regional carbon stock estimates, that overlook the geographical variability and intricate ecological dynamics within these ecosystems. This study adopts a seascape ecology approach to evaluate the role of multiple seascape characteristics on carbon storage in two arid region coastal lagoons. We show that seascape location is the most influential driver of carbon stocks. Additionally, carbon isotopic variability, a proxy for connectivity, can be as influential as habitat type, particularly in the UAQ lagoon. This challenges the conventional reliance on data from individual habitat types (e.g., seagrass, mangrove, or tidal marsh) and highlights the context-dependency of carbon stocks. Moreover, the specific characteristics driving carbon stocks vary between seascapes: in Khor Faridah, connectivity to seagrass and mangrove habitats is crucial, while in the UAQ lagoon, sheltered and elevated areas are more influential. Our findings suggest that the interconnectivity between different habitat types, such as mangroves and saltmarshes, significantly enhances carbon storage. This is especially pronounced in large, sheltered mangrove habitat types within upper intertidal zones. Notably, small patches of mangroves, up to 10 ha, are associated with an approximate 10 % increase in carbon stocks. These results underscore the need for a more holistic, context-specific approach to designing nature-based solutions for coastal management and ecosystem restoration. By considering the specific characteristics and connectivity of seascape mosaics, we can more effectively enhance carbon stock potential in coastal ecosystems. This study contributes to a deeper spatially explicit understanding of the complex factors influencing carbon stocks in blue carbon ecosystems, highlighting the importance of tailored management strategies that reflect the unique ecological patterns of each seascape.

The impact of sociodemographic, health status and resources, macroeconomic, and environmental factors on infant mortality rates in Qatar, Kingdom of Saudi Arabia, and the United Arab Emirates.

OBJECTIVES: This study aims to study the impact of sociodemographic (SD), health status and resources (HSR), macroeconomic (ME), and Environmental (EV) factors on the infant mortality rate (IMR) in Qatar, Kingdom of Saudi Arabia (KSA), and the United Arab Emirates (UAE) and from 1990 to 2022. DESIGN: A retrospective time-series study employing yearly data was conducted. A generalized least squares model was utilized to construct an exploratory model of IMR determinants for each country. RESULTS: In SD, the risk of IMR may be increased with a higher crude birth rate, adolescent fertility rate, and married women percentage. In HSR, immunization coverage shows a significant effect in preventing neonatal diseases and reducing IMR. In ME, the effect of parents' employment seems contradicted among the three countries. In EV, greenhouse emissions have also had contradictory effects among the three countries, suggesting a complex relationship with IMR. Some were consistent with global findings, whereas others contradicted the prevailing narrative. CONCLUSIONS: This study highlights the need for tailored public health interventions addressing socio-demographic, healthcare, and environmental contexts to effectively reduce IMR and enhance infant health outcomes.

Consensus Recommendations for the Management of Atopic Dermatitis in the United Arab Emirates.

Atopic dermatitis often begins in infancy and follows a chronic course of exacerbations and remissions. The etiology is complex and involves numerous factors that contribute to skin barrier defect and inflammation. In the Middle East, the burden of atopic dermatitis is understudied. Epidemiological data specific to the Gulf region are scarce but reveal a prevalence of up to about 40% in the United Arab Emirates. Region-specific factors, such as the climate and the frequency of consanguineous marriages, may affect atopic dermatitis incidence, prevalence, and evolution over time. A panel of experts predominantly from the United Arab Emirates analyzed the evidence from published guidelines, and considered expert guidance and local treatment practices to develop clear recommendations for the management of atopic dermatitis in the United Arab Emirates. They encourage a systematic approach for the diagnosis and treatment, using disease severity scores and quality-of-life measurement tools. Treatment recommendations take into consideration both established therapies and the approved systemic biologics dupilumab and tralokinumab, and the Janus kinase inhibitors baricitinib, upadacitinib, and abrocitinib.

Human papillomavirus prevalence and genotypes in Gulf Cooperation Council countries: A scoping review 2017-2024.

Background: Cervical cancer remains a global health challenge, claiming the lives of millions annually and having a significant impact on Gulf Cooperation Council (GCC) countries. Human papillomavirus (HPV), the primary causative agent, plays a central role, with regional variations in prevalence.1 The process from HPV infection to neoplastic changes takes 5-25 years to occur, hence, knowing its prevalence in our community is vital.2. Methods: PubMed and SCOPUS were searched to identify articles related to cervical and anogenital HPV prevalence and genotypes in Qatar, Kuwait, Bahrain, Oman, the United Arab Emirates (UAE), and the Kingdom of Saudi Arabia (KSA) published between 2017 and 2024. Results: A total of 19 articles were included in this review. Eight studies were from KSA, four were from Kuwait, three were from the UAE, one was from Qatar, Oman, and Bahrain, and one presented data collectively from the KSA, UAE, Qatar, and Bahrain. The prevalence of HPV ranged between 4.7% and 77% in studies from the KSA, between 15% and 54.3% in studies from Kuwait, between 14.7% and 88% in studies from the UAE, was 8.1% and 31.3% in the two studies from Qatar, and was 17.8% and 20% in the studies from Oman and Bahrain, respectively. HPV 16 was the most prevalent high-risk genotype found in studies conducted in the KSA, UAE, Kuwait, and Qatar. In Oman, HPV 82 predominated. In Bahrain, the majority had other non-HPV 16/18/45 genotypes. In the UAE and Kuwait, HPV 11 was the predominant low-risk type, followed by HPV 6. In Qatar, HPV 81 was the most common low-risk type, followed by HPV 11. In Oman, HPV 54 was the most common low-risk type, followed by HPV 42. Conclusion: There are no studies with data on HPV prevalence and genotypes among women who have been vaccinated against HPV in GCC countries.

Staphylococcus spp. in Salad Vegetables: Biodiversity, Antimicrobial Resistance, and First Identification of Methicillin-Resistant Strains in the United Arab Emirates Food Supply.

Contamination of leafy greens with Staphylococcus spp. can occur at various supply chain stages, from farm to table. This study comprehensively analyzes the species diversity, antimicrobial resistance, and virulence factors of Staphylococci in salad vegetables from markets in the United Arab Emirates (UAE). A total of 343 salad items were sampled from three major cities in the UAE from May 2022 to February 2023 and tested for the presence of Staphylococcus spp. using standard culture-based methods. Species-level identification was achieved using matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antimicrobial susceptibility testing was conducted using the VITEK-2 system with AST-P592 cards. Additionally, whole genome sequencing (WGS) of ten selected isolates was performed to characterize antimicrobial resistance determinants and toxin-related virulence factors. Nine Staphylococcus species were identified in 37.6% (129/343) of the tested salad items, with coagulase-negative staphylococci (CoNS) dominating (87.6% [113/129]) and S. xylosus being the most prevalent (89.4% [101/113]). S. aureus was found in 4.6% (14/343) of the salad samples, averaging 1.7 log10 CFU/g. One isolate was confirmed as methicillin-resistant S. aureus, harboring the mecA gene. It belonged to multi-locus sequence type ST-672 and spa type t384 and was isolated from imported fresh dill. Among the characterized S. xylosus (n = 45), 13.3% tested positive in the cefoxitin screen test, and 6.6% were non-susceptible to oxacillin. WGS analysis revealed that the cytolysin gene (cylR2) was the only toxin-associated factor found in S. xylosus, while a methicillin-sensitive S. aureus isolate harbored the Panton-Valentine Leukocidin (LukSF/PVL) gene. This research is the first to document the presence of methicillin-resistant S. aureus in the UAE food chain. Furthermore, S. xylosus (a coagulase-negative staphylococcus not commonly screened in food) has demonstrated phenotypic resistance to clinically relevant antimicrobials. This underscores the need for vigilant monitoring of antimicrobial resistance in bacterial contaminants, whether pathogenic or commensal, at the human-food interface.

Sleep Quality and its Daytime Effects among University Students in the UAE.

Objectives: To determine the irregularity in the sleep schedule among university students in the UAE and determine its correlation with poor sleep quality, daytime sleepiness, and fatigue. Methods: This observational cross-sectional survey was electronically conducted among undergraduate students of Ajman University during the academic year 2022-2023. The participants were selected using a simple random sampling method. The instruments for data collection comprised of sleep schedule questionnaire, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Fatigue Severity Scale. Data was subjected to chi-square analysis, Mann-Whitney U test, Wilcoxon rank-sum test, and Spearman's correlation. Results: Of the 537 participants, 353 (65.7%) were female. The majority (57.2%) kept highly irregular bedtimes. The cohort's mean global PSQI score was 8.9±3.0 indicating poor sleep quality. There was a positive correlation between the irregular bedtime frequency and the global PSQI score (r = 0.311; p < 0.010). Most (70.8%) participants had a total high Fatigue Severity Scale score of ≥ 36. The scores of women (41.0±10.5) were significantly higher than those of men (38.5±11.0) (p =0.006). Around 53.0% of the participants had high ESS scores indicating excessive daytime sleepiness. There was also a significant correlation between ESS score and irregular bedtime frequency (r = 0.113; p =0.009). Conclusions: The students at Ajman University had a high prevalence of irregular bedtime and inadequate sleeping hours. This was affecting their sleep quality and causing excessive daytime sleepiness. The students, especially women, were suffering from fatigue, potentially affecting their normal functionality. It is crucial to encourage students to establish regular sleep patterns and improve sleep habits to promote their productivity and general well-being.

Leaving Against Medical Advice: Current Problems and Plausible Solutions.

Leave against medical advice (LAMA) is defined as 'a decision to leave the hospital before the treating physician recommends discharge', and is associated with higher rates of readmission, longer subsequent hospitalization, and worse health outcomes. In addition to this, they also contribute to poor healthcare resource utilization. We conducted a single-center audit to establish patient demographics and contributing factors of patients leaving against medical advice from our emergency department (ED). We benchmarked our data against locally available clinical policy guidelines. We interrogated our electronic health record system (known as Salamtak®), which is a Cerner-based platform (Cerner Corporation, Kansas City, MO 64138) for patients who signed LAMA from ED from 2018 to 2023. We selected a convenience pilot sample of 120 subjects. Based on a literature review, we identified patient demographics (age, gender, nationality, socioeconomic status, marital status, religion), possible contributing factors (time of attendance, insurance status, length of ED stay), and patient outcomes (reattendances within 1 week and mortality) to evaluate. Based on locally available guidance, we formulated six criteria to audit with a standard set at 100% for each. A team of emergency medicine residents collected data that was anonymized on an Excel spreadsheet (Microsoft Excel, Microsoft Corporation. (2018). Basic descriptive statistics were used to collate results. About 93 patients (77.5%) were 16 years and above, and 27 patients (22.5%) were below 16 years. There was a slight preponderance of males (64 patients, 53.3%) than females (56 patients, 46.6%). The majority of LAMA cases presented in the evening and night (97 patients, 80.8%). About 57 (47.5%) patients had an ED length of stay of 3 hours or more. The average ED length of stay for these patients was 3.4 hours. About 73 patients (60.3%) were insured. Out of 120 patients, only 12 (10%) had a mental capacity assessment documented. The commonest reason for signing LAMA was a social reason in 45 (37.5%) cases. In the remaining cases, the causes were a combination of family, financial, waiting, or other/undocumented reasons). When faced with a decision to LAMA, the involvement of a Public Relationship Officer (PRO) was only documented to be consulted in seven (5.8%) cases. About 14 cases were re-attended within 1 week (11.6%) and no mortalities were reported in any of the reattendances. LAMA is a not-so-rare phenomenon often occurring in EDs, and often a cause of trepidation for healthcare workers. Treating this as an aberrant behavior on the part of the patient, or laying the responsibility for this action on the healthcare provider is primitive, counter-productive, and not patient-centric. Familiarity with local guidelines around this contentious area is essential. Revised nomenclature like 'premature discharge' may be less stigmatizing for the patient. Where possible, a harm reduction approach should be used and frontline healthcare workers must be prepared with an escalation plan. In the United Arab Emirates, familiarity with Wadeema's Law as a child protection measure is essential.

Usher syndrome in the United Arab Emirates.

PURPOSE: Usher syndrome, a common form of syndromic inherited retinal dystrophy in the Arabian Gulf, has not been molecularly defined in the United Arab Emirates. The current study addresses this gap in knowledge. METHODS: A retrospective case series of Emirati patients referred to the Ocular Genetics Clinic of Cleveland Clinic Abu Dhabi who (1) were clinically diagnosed with Usher syndrome and underwent genetic testing (whole exome sequencing, 2019 to 2023, inclusive) and (2) were identified to have biallelic pathogenic variants in Usher syndrome genes during the same time period. RESULTS: Ten probands (thirteen patients) were identified-seven probands (nine patients) with clinically diagnosed Usher syndrome and three additional probands (four patients) with biallelic homozygous USH2A variants. Among the seven probands initially diagnosed with Usher syndrome, six had different homozygous variants (three in MYO7A, one in ADGRV1, and one in CLRN1), one had dual diagnoses rather than Usher syndrome (i.e. separate cause for retinal dystrophy and deafness), and one had no identifiable genetic cause. Regarding the three additional probands identified with homozygous USH2A variants, all three had retinitis pigmentosa only rather than Usher syndrome and all three had different variants. DISCUSSION: Clinically diagnosed Usher syndrome was genetically heterogenous without evidence for founder effect in this Emirati cohort. MYO7A was the most common associated gene. Dual diagnosis rather than single cause can mimic Usher syndrome. Homozygous USH2A variants were not identified as a cause for Usher syndrome in this cohort but were a recurrent cause for retinitis pigmentosa without hearing impairment and without founder effect.

A retrospective analysis of disease epidemiology, comorbidities, treatment patterns, and healthcare resource utilization of alopecia areata in the United Arab Emirates using claims database.

Alopecia areata (AA) is an autoimmune disorder that manifests as nonscarring hair loss and imposes a substantial disease burden. The current study, using an e-claims database, assesses the disease burden, comorbidities, treatment patterns, specialties involved in the diagnosis of AA, healthcare resource utilization (HCRU), and associated costs in privately insured patients with AA in Dubai, United Arab Emirates. The retrospective longitudinal secondary study was conducted using Dubai Real-World Database e-claims data during 01 January 2014 to 30 June 2022. Patients with at least one diagnosis claim of AA during the index period (01 January 2015-30 June 2021) with continuous enrollment (one or more AA/non-AA claim in the post-index period) were included in the analysis. The patients were stratified into subcohorts based on diagnosis code and treatment patterns, as mild, moderate-to-severe, and others. Demographics, comorbidities, treatment patterns, specialists visited, and HCRU were assessed. The study included 11 851 patients with AA (mean age: mild: 37 years; moderate-to-severe: 36 years), with a male predominance (mild: 77.6%; moderate-to-severe: 60.8%). The most prevalent comorbidities in the moderate-to-severe AA subcohort were autoimmune and T-helper 2-mediated immune disorders, including contact dermatitis and eczema (62.1%), atopic dermatitis (36.1%), and asthma (36.1%). Most patients consulted dermatologists for treatment advice (mild AA: 87.4%; moderate-to-severe AA: 47.7%) and, notably, within 1 day of AA diagnosis. Topical steroids were frequently prescribed across cohorts, regardless of disease severity. Analysis of comorbidities among patients with AA indicated an additional HCRU burden among these subsets of patients. The median disease-specific HCRU cost was higher for psychological comorbidities versus autoimmune and T-helper 2-mediated immune disorders (US $224.99 vs US $103.70). There is a substantial disease and economic burden in patients with AA and associated comorbid conditions; therefore, investing in novel therapies that target the underlying autoimmune pathway may address the gap in effective management of AA.

Association between obstructive sleep apnea risk and type 2 diabetes among Emirati adults: results from the UAE healthy future study.

Introduction: Obstructive sleep apnea (OSA) can have negative impacts on the health outcomes of individuals with type 2 diabetes. However, in the United Arab Emirates (UAE), there is a lack of understanding regarding the relationship between OSA and type 2 diabetes despite the significant implications it has on health. The primary objective of this study is to investigate the association between OSA risk and type 2 diabetes, associated risk factors, and gender differences in OSA symptoms among Emirati adults. Methods: We conducted a cross-sectional analysis of the baseline data from the UAE Healthy Future Study (UAEHFS) collected between February 2016 and March 2023. Our sample consisted of 4578 participants aged 18-71 who completed the STOP-BANG survey, provided body measurements and blood samples. We stratified the patients according to their OSA risk and diabetes. We used univariate and multivariate logistic regression models to analyze the relationship between OSA risk and type 2 diabetes and to identify factors associated with risk for OSA and type 2 diabetes. We estimated odds ratios (ORs) with corresponding 95% confidence intervals (95% CI). Results: The mean age was 27.5 years (± 8.35), and 55.81% (n=2555) were men. The overall prevalence of high risk for OSA was 16.58% and was higher in men compared to women (26.46% vs 4.10%). Women reported feeling tired more often than men (68.02% vs 48.96%). Both genders have similar rates of stop breathing and BMI ≥ 35. There was a significant association between the OSA risk and type 2 diabetes in the unadjusted model (OR=2.44; 95% CI: 1.78-3.35; p-value <0.0001) and (OR=6.44; 95% CI: 4.32-9.59; p-value < 0.0001) among those who reported intermediate and high OSA risk, respectively. After adjusting the model for education attainment, marital status, waist circumference, and smoking, the association remained significant between diabetes and OSA risk, with an OR of 1.65 (95%CI: 1.18-2.32; p-value =0.004) for intermediate OSA risk and 3.44 (95%CI: 2.23-5.33; p-value <0.0001) for high OSA risk. Conclusions: This study conducted in the UAE found a significant correlation between OSA risk and type 2 diabetes. We suggest introducing routine screening of OSA for individuals with diabetes.

A national survey on assessment of knowledge, perceptions, practice, and barriers among hospital pharmacists towards medication reconciliation in United Arab Emirates.

Medication reconciliation (MedRec) helps prevent medication errors. This cross-sectional, nationwide study assessed the knowledge, perceptions, practice, and barriers toward MedRec amongst hospital pharmacy practitioners in the United Arab Emirates. A total of 342 conveniently chosen stratified hospital pharmacists responded to the online survey (88.6% response rate). Mann-Whitney U test and Kruskal-Wallis test were applied at alpha = 0.05 and post hoc analysis was performed using Bonferroni test. The overall median knowledge score was 9/12 with IQR (9-11) with higher levels among clinical pharmacists (p < 0.001) and previously trained pharmacists (p < 0.001). Of the respondents, 35.09% (n = 120) practiced MedRec for fewer than five patients per week despite having a strong perception of their role in this process. The overall median perception score was 32.5/35 IQR (28-35) with higher scores among clinical pharmacists (p < 0.001) and those who attended previous training or workshops (p < 0.001). The median barrier score was 24/30 with an IQR (21-25), where lack of training and knowledge were the most common barriers. Results showed that pharmacists who did not attend previous training or workshops on MedRec had higher barrier levels than those who attended (p = 0.012). This study emphasizes the significance of tackling knowledge gaps, aligning perceptions with practice, and suggesting educational interventions.

Utilizing self-report diaries to explore task time distribution of school nurses in UAE.

OBJECTIVE: This study aims to evaluate the roles and tasks of school nurses in the UAE, quantify the time spent on each, and identify areas for improvement in school health services. This aligns with the UAE government's initiative to enhance primary healthcare, focusing on illness prevention and health promotion for children and adolescents. METHODS: The research adopts an observational study design, utilizing self-observation through diary recordings by school nurses to collect data on their daily tasks and time allocation. A sample of total of 2024 school nurse activities were recorded and analyzed over 126 days and 1084 h of observation by eight school nurses using self-report diaries. This method allowed for the collection of detailed information on how nursing time is allocated between core and noncore tasks. RESULTS: In this study a total of 2024 tasks were observed over 1084 h. The findings reveal that core nursing tasks accounted for 78% of activities but only 53% of the total 1084 h observed, while non-nursing tasks, making up 22% of activities, disproportionately consumed 47% of the hours. This discrepancy highlights the inefficiency of time allocation, with non-nursing tasks such as administrative duties taking significantly longer than core patient care tasks. CONCLUSIONS: The study highlights a significant opportunity to enhance school health services in the UAE by optimizing the allocation of nursing time towards more illness prevention and health promotion interventions. By addressing the identified challenges, including the gaps in nurse competencies and the lack of structured practice frameworks, school health services can be improved.

A Complicated Case of Thrombotic Thrombocytopenic Purpura in Pregnancy with Superimposed Preeclampsia.

A 32-year-old woman at 26 weeks gestation presented with severe unexplained thrombocytopenia with signs and symptoms of severe pregnancy-induced hypertension and what appeared to be hemolysis, elevated liver enzymes, and low platelet count syndrome, leading to a severe diagnostic challenge. The multidisciplinary team identified her condition as thrombotic thrombocytopenic purpura. Timely management decisions and multidisciplinary care ensured a safe delivery.

Cost-Minimization Analysis for Subcutaneous Daratumumab in the Treatment of Newly Diagnosed Multiple Myeloma in Three Gulf Countries.

Background: The second most common hematologic cancer worldwide is multiple myeloma (MM), with incidence and mortality rates that have more than doubled over the past 30 years. The safety and efficacy of daratumumab regimens in the treatment of newly diagnosed MM (NDMM) is demonstrated in clinical trials. Objective: To assess the financial effects of the adoption of subcutaneous daratumumab (dara-SC) rather than intravenous daratumumab (dara-IV) for the treatment of NDMM in three Gulf countries (Qatar, Oman and the United Arab Emirates; UAE), a cost-minimization model was constructed. Methods: We performed static cost minimization analyses from a societal perspective to evaluate the costs and possible reductions in resource utilization associated with a shift from dara-IV infusion to dara-SC injection for NDMM patients over a 5-year time horizon. The model included 2 scenarios: the current scenario in which 100% of patients with NDMM are treated with dara-IV infusion and a future scenario in which dara-SC injection is gradually adopted over the modeled time horizon. The model differentiated precisely between autologous stem cell transplantation (ASCT)-eligible and ASCT-ineligible NDMM patients in terms of their number in each group and the associated therapeutic regimens. One-way sensitivity analyses were also conducted. Results: The model showed that the use of dara-SC in NDMM patients who were eligible or ineligible for ASCT resulted in lower non-drug costs, including premedication drug costs, adverse-effect costs, administration costs, medical staff costs, and indirect costs. The resulting total savings over the 5-year time horizon of the model for Hamad Medical Corporation, Sultan Qaboos University Hospital/Royal Hospital, Sheikh Shakhbout Medical City (SSMC), and Tawam Hospital were QAR -2 522 686, OMR -143 214, AED -30 010 627, and AED -5 003 471, respectively. Conclusion: The introduction of dara-SC as a front-line treatment for NDMM patients in Qatar (Hamad Medical Corporation), Oman (Sultan Qaboos University Hospital, Royal Hospital-MOH), and the UAE (SSMC and Tawam Hospital) can help save resources and minimize constraints on the healthcare system.

Fatherhood in disability rehabilitation in the United Arab Emirates: Exploring fathers' involvement in raising children with disabilities.

BACKGROUND: The first agent of socialisation is the family, who are expected to facilitate the inclusion of children in societal activities. While mothers' voices have been widely captured in the literature regarding their experiences raising children with disabilities, fathers' perceptions of their knowledge of and involvement in the development of children with disabilities have been understudied, particularly in non-Western contexts. AIM: The main aim of this study was to examine fathers' perceptions of their involvement in raising children with disabilities in the United Arab Emirates. METHODS AND PROCEDURES: In total, 469 fathers were recruited to understand their involvement in raising their children with disabilities. The Fathers' Involvement in Development and Rehabilitation Scale was used to collect data, which were analysed using SPSS and AMOS. OUTCOMES AND RESULTS: The results showed that fathers rated themselves highly for their attitudes, support, and participation in training to support their children with disabilities. Demographic variables, such as nationality and educational qualifications, provided additional insight into their involvement in raising their children with disabilities. CONCLUSIONS AND IMPLICATIONS: The study concludes with suggestions for training programmes to change fathers' attitudes towards children with disabilities, as such programmes can enable them to better support their children's development.

Health and Wellness Characteristics of Employees Enrolled in a Workplace Wellness Study in the United Arab Emirates: A Descriptive Analysis of a Pilot Study.

INTRODUCTION: Modifiable health behaviors have the power to increase (or decrease) the risk of chronic diseases, impacting a population's health. Health and wellness programs can potentially play a major role in initiating and supporting positive changes in health behaviors, which may lead to reducing the risk of premature mortality. A better understanding of the health and well-being status of the population is crucial to the design of proper and effective interventions. This pilot study aimed to describe the health and well-being status of a cohort of employees in the United Arab Emirates (UAE). METHODS: This pilot study reports the demographic characteristics, body composition, cardiovascular fitness, functional fitness, biological age, and well-being of employees from a large health sector company enrolled in a workplace wellness study in the UAE. Employees were invited to participate in an intervention that was designed to validate the efficacy of weekly health and wellness challenges. Descriptive statistics were used to describe the employees' distribution. RESULTS: Of the 123 selected, 116 employees participated in the study. The mean age of participants was 39.2 years old, 80% of them were non-Emirati, and the majority were from Middle-Eastern and South Asian ethnicities. The prevalence of overweight, obesity, hypercholesterolemia, hyperlipidemia, prediabetes, and diabetes was 35%, 29%, 34%, 79%, 30%, and 7%, respectively. Almost half of the participants (47%) were prehypertensive for systolic blood pressure (BP), 80% had the fitness category of poor-very poor, and the majority (60%) reported exercising <150 minutes/week. The mean functional fitness score was 12.2 points, which indicated an increased risk of injury with physical activity. CONCLUSION: The findings of this pilot study suggest that despite the advancements in healthcare in the UAE, several key preventable risk factors are still prevalent in its population. The introduction of comprehensive health and wellness programs at a broader scale holds the potential to facilitate the adoption of healthier lifestyle behaviors, thereby contributing to improvements in the overall quality of life across the population.

Understanding the Impact of the COVID-19 Pandemic on Mental Health among a Sample of University Workers in the United Arab Emirates.

Research on the mental health of university staff during the COVID-19 pandemic has uncovered a high prevalence of probable anxiety, depression, and post-traumatic stress disorder among academic and non-academic staff in many parts of the world. This study aimed to assess the prevalence of anxiety, depressive symptoms, and resilience among a sample of faculty and staff members working in the Higher College of Technology campuses in the UAE. From September to November 2021, a cross-sectional study was carried out using an online survey. The Generalized Anxiety Disorder 7-item scale, The Patient Health Questionnaire (9-items), and the Connor-Davidson Resilience Scale were used to assess anxiety, depression, and resilience. The impact of COVID-19 was assessed using a designated list of questions. The results demonstrated that the COVID-19 pandemic had impacted the mental health of the studied sample of university workers, with almost 16% of the participants having moderate-to-severe depression and anxiety symptoms. This study highlighted significant differences in the participants' depressive and anxiety symptoms due to sociodemographic differences. Depression and anxiety symptoms were most prevalent among females, those of UAE nationality, and never-married workers, with females scoring 5.81 on the PHQ-9 compared to only 4.10 in males, p = 0.004 *. UAE-national participants had significantly higher mean PHQ-9 scores than their non-national counterparts (6.37 ± 5.49 SD versus 4.77 ± 5.1 SD, respectively, p = 0.040 *). Overall, the total mean scores of all participants were below the assumed cut-off threshold of having a high resilience level (29.51 ± 7.53 SD). The results showed a significant difference in severe depression symptoms as a result of the impact of COVID-19. These results could imply that the COVID-19 pandemic might have augmented negative mental health impacts on this sample of university workers. This study highlighted some areas where the responsible authorities can intervene to further protect and enhance the mental health of university workers, particularly after the COVID-19 pandemic.