Role of Phenolic Compounds in Human Disease: Current Knowledge and Future Prospects.

Inflammation is a natural protective mechanism that occurs when the body's tissue homeostatic mechanisms are disrupted by biotic, physical, or chemical agents. The immune response generates pro-inflammatory mediators, but excessive output, such as chronic inflammation, contributes to many persistent diseases. Some phenolic compounds work in tandem with nonsteroidal anti-inflammatory drugs (NSAIDs) to inhibit pro-inflammatory mediators' activity or gene expression, including cyclooxygenase (COX). Various phenolic compounds can also act on transcription factors, such as nuclear factor-κB (NF-κB) or nuclear factor-erythroid factor 2-related factor 2 (Nrf-2), to up-or downregulate elements within the antioxidant response pathways. Phenolic compounds can inhibit enzymes associated with the development of human diseases and have been used to treat various common human ailments, including hypertension, metabolic problems, incendiary infections, and neurodegenerative diseases. The inhibition of the angiotensin-converting enzyme (ACE) by phenolic compounds has been used to treat hypertension. The inhibition of carbohydrate hydrolyzing enzyme represents a type 2 diabetes mellitus therapy, and cholinesterase inhibition has been applied to treat Alzheimer's disease (AD). Phenolic compounds have also demonstrated anti-inflammatory properties to treat skin diseases, rheumatoid arthritis, and inflammatory bowel disease. Plant extracts and phenolic compounds exert protective effects against oxidative stress and inflammation caused by airborne particulate matter, in addition to a range of anti-inflammatory, anticancer, anti-aging, antibacterial, and antiviral activities. Dietary polyphenols have been used to prevent and treat allergy-related diseases. The chemical and biological contributions of phenolic compounds to cardiovascular disease have also been described. This review summarizes the recent progress delineating the multifunctional roles of phenolic compounds, including their anti-inflammatory properties and the molecular pathways through which they exert anti-inflammatory effects on metabolic disorders. This study also discusses current issues and potential prospects for the therapeutic application of phenolic compounds to various human diseases.

The Effect of Shift Work on Sleep Patterns of Paramedics in Saudi Arabia.

Purpose: Shift work poses significant sleep health challenges for paramedics, affecting their ability to respond effectively in emergencies. This study aimed to evaluate the impact of shift work on sleep parameters among paramedics in Saudi Arabia, identifying key factors influencing insomnia. Patients and Methods: A cross-sectional, online survey was conducted, gathering data on sociodemographic characteristics, work-related factors, sleep duration, and insomnia among paramedics in Saudi Arabia. The Athens Insomnia Scale was used to define insomnia. The association between shift work and sleep parameters was examined. Predictors of insomnia were identified through logistic regression models by inspecting the adjusted odds ratio (aOR). Results: 1076 Saudi paramedics were included, most of whom were 26-35 years old, males, married, had a Bachelor's degree, worked in hospital-based settings for private agencies in rural areas, and had 6-10 years of experience. Occupational stress was reported by 52.96% of paramedics. All shift work characteristics (working hours, number of shifts, work schedule, and off-work days) were significantly associated with insomnia (p=0.0001). The multivariate regression revealed that work setting (aOR=18.71, p=0.02), coffee consumption (aOR=36.83, p=0.01), work schedule (aOR=21.93, p=0.01), and time to bed (aOR=0.01, p=0.01), sleep duration (aOR=0.03, p=0.03), and occupation stress (aOR=9.31, p=0.001) were predictors for insomnia. Conclusion: Our findings underscores the need for targeted interventions to mitigate the adverse effects of shift work on sleep health among paramedics.

The prevalence of depression among paramedical students and workers with highlights from the COVID-19 pandemic: A meta-analysis of prevalence.

OBJECTIVE: To estimate the prevalence and risk factors of depression among paramedical workers/students. METHOD: 6205 paramedics (reported in 25 cross-sectional studies) were meta-analyzed after searching seven electronic databases. The main outcome was the prevalence of depression. Subgroup analyses were conducted based on year and country of investigation, pandemic status and wave, population type, and disease severity. Several risk factors were also examined (gender, marital status, and population type). RESULTS: 34% [95%CI: 26-43%] of paramedics have depression, mostly of the mild form [19%, 95%CI: 13-27%]. Depression was highest in India and Australia. Students [45%, 95%CI: 30-62%] were more vulnerable to depression than workers [29%, 95%CI: 18-40%]. No linear trend was observed for depression over the years. Depression was lower during the pandemic compared to the pre-pandemic period [25% vs. 39%] with similar rates across all pandemic waves. Male [MD = 1.40; 95%CI: 0.57: 2.23] and married paramedics [MD = -1.33, 95%CI: -2.04: -0.62] were significant predictors of depression; however, no significant difference in depression was noted between paramedics and non-paramedics [logOR = 0.08; 95%CI: -0.10: 0.25]. CONCLUSIONS: One in every three paramedics have depression, with higher rates among students and before the COVID-19 pandemic. Gender and marital status are risk factors of depression.

Knowledge and Practices of Public Related to Burns Management in Saudi Arabia: A Cross-Sectional Study.

Burn injuries are a significant global health challenge, with physical and psychological consequences affecting 180 000 people annually. This study aimed to evaluate public knowledge and practices regarding burn management. This cross-sectional survey included 582 participants to assess their knowledge and practices related to burn management between January 2023 and May 2023. Non-healthcare participants in Al Ahsa city in Saudi Arabia were asked questions about demographic data on age, sex, education, and nationality, along with assessing knowledge of burn first aid, sources of information, awareness of burn degree, chemical burn management, personal burn exposure, and traditional treatments. Our study of 582 participants highlighted significant findings related to sex and educational levels in burn management knowledge and practice. Females were more likely to receive information about burn first aid (69.3%), with a preference for social media as their information source, while males favored official courses (31.3%). Males displayed higher self-perceived knowledge were more inclined to consider first-degree burns the most dangerous (44.7%) and were better informed about managing chemical burns (24.2%). Females reported higher burn exposure (72.5%) and were more likely to manage burns themselves (76.5%). Informed participants with prior knowledge exhibited a greater interest in learning more about burn first aid (97%) and were more knowledgeable about burn degree and chemical burn management. These findings underscore the importance of tailoring public health education to burn first aid based on sex and education level. Such targeted approaches can enhance population-level preparedness and reduce burn injuries' affect more effectively.

Implementing Prehospital Ultrasound at the Saudi Red Crescent Authority: Perceived Barriers and Training Needs.

Objective: This study examines the inherent barriers to implementing prehospital ultrasound within the Saudi Red Crescent Authority (SRCA) in Saudi Arabia. Methods: A qualitative study was conducted to explore the perceived barriers, mode of transportation, ultrasound familiarity, and self-efficacy level of relevant stakeholders in implementing the prehospital ultrasound in SRCA. Data was collected via surveys and interviews with 24 SRCA paramedics/EMTs, 4 SRCA station administrators, and two hospital physicians to further examine the inherent barriers of implementing the prehospital ultrasound. Results: Thematic analysis revealed the main barriers were costs of ultrasound equipment, environmental factors affecting image capture, and lack of training in ultrasound skills and interpretation. Administrators and physicians also noted concerns about machine portability and technical maintenance. Stakeholders agreed ultrasound could improve trauma diagnosis if barriers were addressed through extensive training and protocols. In prehospital care setting, the two main modes of transportation are "stay and play", involving on-scene interventions before transport, and "load and go", prioritizing rapid transport to the hospital, with the choice depending on various factors. An overwhelming 96% of paramedics/EMTs preferred a 'stay and play' approach to stabilize patients before transport, while 75% of administrators preferred 'load and go' for rapid transport to hospitals. 62.5% of paramedics were familiar with ultrasound, but only 20.8% had previously used it. Conclusion: This study provides important insights into stakeholder perspectives on the implementation of prehospital ultrasound within the Saudi Red Crescent Authority. The findings can guide efforts to implement appropriate ultrasound use through tailored training programs and enhanced coordination across groups, aimed at improving trauma outcomes.

Family-Centered Care Experiences in Elderly with Chronic Diseases in Communities: Qualitative Study of Patients, Families, Nurses, and Volunteers.

Introduction: The family, at community, must be an important part of elderly care. However, most of the elderly experience a decrease in psychological well-being and quality of life. This is not in accordance with the concept of the family-centered care (FCC) model and can endanger the continuity of the elderly with chronic illnesses. Objective: The aim of this study was to explore experience of FCC among patients with chronic illness, nurses, families, and volunteers. Methods: This study examines the contextual-based FCC model qualitatively. In-depth interviews and focus group discussions were conducted by 12 elderly people, 3 nurses, 10 family members, and 3 volunteers. In total, 36 people, where several were FGD participants, were also interviewed in depth. Data were analyzed using thematic analysis, with codes organized into larger themes. Result: In total, 36 interviews and FGDs were conducted. The concept of information interaction, the phenomenon of emotional interaction, the practical interaction, and various factors that can either facilitate or impede interaction, were considered the four significant themes. Conclusion: FCC acceptance is found in interactions between parents, nurses, family, and volunteers who are not optimistic. Lack of communication and collaboration was noted between community nurses and volunteers. Offer a new perspective on developing and implementing interventions that facilitate positive interactions, reduce family burdens, provide high-quality treatment for parents with chronic diseases, and improve the quality of care for those with advanced chronic conditions. Recommendation: These insights provide a fresh perspective on how to develop and implement effective interventions in this context. It is recommended that future research should employ multiple methodologies to investigate FCC across diverse health practices for the elderly population.

The awareness of public about the Emergency Medical Services in the Eastern region of Saudi Arabia.

Emergency Medical Services (EMS) are crucial for immediate medical assistance during life-threatening situations. However, insufficient public awareness about EMS services can impede their effectiveness. This study aimed to assess EMS knowledge and trust among the population of Eastern Saudi Arabia while identifying factors contributing to low awareness. A cross-sectional study was conducted in Eastern Saudi Arabia from September 2022 to September 2023. The study included participants aged 18 to 60 from diverse backgrounds. Using a convenience sampling approach, data was collected using a validated questionnaire covering demographics, hypothetical scenarios, EMS knowledge, and trust in EMS. We conducted the Chi-square tests and logistic regression using Jamovi software, with significance levels set at p < 0.05. Our study yielded 435 participants; 55% were males. Gender-based analysis showed significant differences in responses regarding first aid provision and EMS services (P < 0.001). Expectations for EMS response times also varied by gender (P = 0.01). Knowledge-based analysis revealed that age and education significantly influenced EMS knowledge (P < 0.001). Respondents with EMS knowledge were more likely to know how to provide first aid, understand the importance of emergency number 112, and trust EMS (P < 0.001). Trust-based analysis showed age and education-related differences in EMS trust (P < 0.001). Respondents with EMS knowledge and awareness of emergency numbers displayed higher trust in EMS (P < 0.001). This study underscores the need for enhanced public awareness of EMS services in Eastern Saudi Arabia. Age, education, and gender emerged as critical factors affecting EMS knowledge and trust. Bridging this awareness gap necessitates tailored educational campaigns and continuous monitoring. Policymakers should prioritise EMS awareness within broader healthcare strategies, contributing to improved public health outcomes and community well-being.

Managing High Frequency of Ambulance Calls in Hospitals: A Systematic Review.

Background: This study addresses the critical issue of high-volume emergency calls in hospitals, focusing on the strain caused by frequent caller patients on ambulance services. The aim was to synthesize various management methods for handling high-frequency hospital calls. Methods: The systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines and guided by the Cochrane Handbook for systematic reviews. Inclusion criteria encompassed studies focusing on the management of emergency departments in hospitals, exploring various medical conditions requiring ambulance attention, and reporting on the impact of a high volume of ambulance calls on hospitals. Databases including PubMed, Web of Science, and Google Scholar were searched from January 1, 2005, to May 1, 2022. The quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) Checklist. Results: Out of 2390 identified citations, 18 studies met the inclusion criteria. These studies, from 12 countries, presented diverse methods categorized into country policy-based management, modeling approaches, and general strategies. Key findings included the effectiveness of risk stratification models and community-based interventions in managing high call frequencies and improving patient care. Our review identified effective strategies such as risk stratification models and community-based interventions, which have shown significant impacts in managing high call frequencies, aligning closely with our objective. These approaches have been pivotal in reducing the burden on emergency services and improving patient care. Conclusion: The study synthesizes effective management methods for high-frequency ambulance calls, including predictive modeling and community interventions. It highlights the need for multi-faceted management strategies in different healthcare settings and underscores the importance of continued research and implementation of these methods to improve emergency service efficiency.

The impact of imposter syndrome on self-esteem and intention to quit among respiratory therapy (RT) students in Saudi Arabia.

Introduction: Imposter syndrome is common among health disciplinary students, leading to serious consequences. However, the impact of imposter syndrome on self-esteem and quitting intention among respiratory therapy students has not been well researched. Objective: To report on the prevalence of imposter syndrome and assess its impacts on self-esteem and quitting intention among respiratory therapy students in Saudi Arabia. Methods: A nonprobability cross-sectional questionnaire using the Clance Impostor Phenomenon Scale and the Rosenberg Self-Esteem Scale was self-administered and distributed among respiratory therapy students between October 2022 and April 2023. Data analysis was performed using Descriptive and inferential statistics. Results: Of the 1500 respiratory therapy students invited to participate in the study, 901 surveys were completed; and thus, included in the final analysis. Of whom, 92% were presented with imposter syndrome: 44% with moderate, 35% with frequent, and 13% with intense feelings. In addition, 60% of respiratory therapy students and interns experienced low self-esteem, while only 0.5% indicated high self-esteem. More than 50% of the study participants thought about quitting the respiratory therapy program, and 30% have been diagnosed with psychological disorders. Furthermore, there was a significant association between imposter syndrome and low self-esteem, p < 0.001. Factors associated with imposter syndrome and low self-esteem were family income (<0.005) and parents' education (<0.005), quitting intention (<0.005), and having been diagnosed with psychological disorders (<0.005). Genders, academic levels, and grade point average were not associated with either imposter syndrome or self-esteem (>0.005). Conclusion: Imposter syndrome and low self-esteem are prevalent among respiratory therapy students, both of which are associated with considering leaving the respiratory therapy program. Effective interventions should be implemented to ameliorate the symptoms imposter syndrome and low self-esteem; thus, improving the academic experience of respiratory therapy students.

The Global Prevalence and Associated Factors of Burnout among Emergency Department Healthcare Workers and the Impact of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

BACKGROUND/AIM: Emergency medicine (EM) settings are very stressful, given the high workload, intense working environment, and prolonged working time. In turn, the rate of burnout and its three domains have been increasingly reported among healthcare workers (HCWs). Therefore, we conducted this meta-analysis to determine the prevalence and risk factors of burnout among EM HCWs. METHODS: Six databases were searched in February 2023, yielding 29 articles (16,619 EM HCWs) reporting burnout or its three domains (emotional exhaustion "EE", depersonalization "DP", and personal accomplishment "PA"). The primary outcome was the prevalence of burnout and its domains, while secondary outcomes included the risk factors of high burnout, EE, DP, or low PA. Burnout rates were pooled across studies using STATA software. The prevalence was measured using the pooled effect size (ES), and the random-effects model was used when heterogeneity was encountered; otherwise, the fixed-effects model was used. RESULTS: The prevalence of overall burnout was high (43%), with 35% of EM HCWs having a high risk of burnout. Meanwhile, 39%, 43%, and 36% of EM workers reported having high levels of EE and DP and low levels of PA, respectively. Country-specific changes in the rate of burnout were observed. The rate of high burnout, high EE, high DP, and low PA was higher during the COVID-19 pandemic as compared to the pre-pandemic period. The type of profession (nurses, physicians, residents, etc.) played a significant role in modifying the rate of burnout and its domains. However, gender was not a significant determinant of high burnout or its domains among EM workers. CONCLUSIONS: Burnout is a prevalent problem in emergency medicine practice, affecting all workers. As residents progress through their training years, their likelihood of experiencing burnout intensifies. Nurses are most affected by this problem, followed by physicians. Country-associated differences in burnout and its domains are evident.

Comparison of the Level of Disaster Preparedness Between Private and Government Hospitals in Saudi Arabia: A Cross-Sectional Study.

OBJECTIVE: The objective of this study was to describe and compare almost all the components of disaster preparedness between private and government hospitals in the Eastern Province of the Kingdom of Saudi Arabia, using the World Health Organization's (WHO) checklist. METHODS: We assessed and compared the disaster preparedness between government and private hospitals in Province, using the 10-key component WHO checklist in a descriptive cross-sectional study. Of 72 hospitals in the region, 63 responded to the survey. RESULTS: All 63 hospitals had an HDP plan and reported having a multidisciplinary HDP committee. In all responding hospitals, HDP was acceptable in most indicators of preparedness; however, some hospitals to some extent fell short of preparedness in surge capacity, equipment and logistic services, and post-disaster recovery. Government and private hospitals were generally comparable in disaster preparedness. However, government hospitals were more likely to have HDP plans that cover WHO's "all-hazard" approach, both internal and external disasters, compared to private hospitals. CONCLUSION: HDP was acceptable, however, preparedness in surge capacity, equipment and logistic services, and post-disaster recovery fell short. Government and private hospitals were comparable in preparedness with regards to all indicators except surge capacity, post-disaster recovery, and availability of some equipment.

Factors Influencing Hospitals' Disaster Preparedness in the Eastern Province of Saudi Arabia.

OBJECTIVE: The study aimed to identify the factors that influence the disaster preparedness of hospitals and validate an evaluation framework to assess hospital disaster preparedness (HDP) capability in the Eastern Province of Saudi Arabia. METHODS: A cross-sectional survey of all hospitals (n = 72) in the Eastern Region of Saudi Arabia was conducted. A factor analysis method was used to identify common factors and validate the evaluation framework to assess HDP capacity. RESULTS: Sixty-three (63) hospitals responded to the survey. A 3-factor structure was identified as key predicators of HDP capacity. The first factor was the most highly weighted factor, which included education and training (0.849), monitoring and assessing HDP (0.723), disaster planning (0.721), and command and control (0.713). The second factor included surge capacity (0.708), triage system (0.844), post-disaster recovery (0.809), and communication (0.678). The third factor represented safety and security (0.638) as well as logistics, equipment, and supplies (0.766). CONCLUSION: The identified 3-factor structure provides an innovative approach to assist the operationalization of the concept of HDP capacity building and service improvement, as well as serve as a groundwork to further develop instrument for assessing HDP in future studies.

Supporting the Frontlines: A Scoping Review Addressing the Health Challenges of Military Personnel and Veterans.

(1) Background: Military personnel and veterans meet unique health challenges that stem from the complex interplay of their service experiences, the nature of warfare, and their interactions with both military and civilian healthcare systems. This study aims to examine the myriad of injuries and medical conditions specific to this population, encompassing physical and psychological traumas. (2) Methods: A scoping review (systematic search and non-systematic review) was performed to evaluate the current landscape of military healthcare. (3) Results: A significant change in the injury profile over time is identified, linked to shifts in combat strategies and the integration of advanced technologies in warfare. Environmental exposures to diverse chemical or natural agents further complicate the health of service members. Additionally, the stressors they face, ranging from routine stress to traumatic experiences, lead to various mental health challenges. A major concern is the gap in healthcare accessibility and quality, worsened by challenges in the civilian healthcare system's capacity to address these unique needs and the military healthcare system's limitations. (4) Conclusions: This review underscores the need for holistic, integrated approaches to care, rigorous research, and targeted interventions to better serve the health needs of military personnel and veterans.

The Use of Prehospital Intensive Care Units in Emergencies-A Scoping Review.

BACKGROUND: Amidst a rising tide of trauma-related emergencies, emergency departments worldwide grapple with the challenges of overcrowding and prolonged patient wait times. Addressing these challenges, the integration of prehospital intensive care units has appeared as a promising solution, streamlining trauma care and enhancing patient safety. Nevertheless, the feasibility of such an initiative becomes murky when considered globally. This review delves into the intricacies of prehospital intensive care units' deployment for trauma care, scrutinizing their configurations, operational practices, and the inherent challenges and research priorities. METHODS: A scoping review was performed for eligible studies. The result was uploaded to the RAYYAN research platform, facilitating simultaneous evaluation of the studies by all researchers. RESULTS: A total of 42 studies were initially selected. Four studies were duplicates, and 25 studies were unanimously removed as irrelevant. The remaining studies (n = 13) were included in the review, and the outcomes were categorized into diverse subgroups. CONCLUSIONS: A country's emergency medical services must achieve specific milestones in education, competency, resource availability, and performance to effectively harness the potential of a prehospital intensive care unit. While certain nations are equipped, others lag, highlighting a global disparity in readiness for such advanced care modalities.

Assessment of medical students' knowledge regarding radiation associated risk and its protection: finding from a cross-sectional study.

OBJECTIVE: The current study assessed the knowledge of the medical students regarding the nature of radiation, associated risks, and protective measures. METHOD: A cross-sectional study was conducted among international students enrolled in different medical colleges/universities in Xian, PR China. A self-developed and self-reported questionnaire was used for the current study. The descriptive statistics was carried out to summarize the finding of the study. Chi-square and Fisher exact tests were conducted to assess the association of the demographics with knowledge level. RESULTS: A total of 796 students responded among 980. Most of the participants fell in the age range of 20-25 years (42.6%), being male (67.1%) and having bachelor's education (56.7%). Participants with previous experience was 58.7%. The age group of 20-25 years (p < 0.001), being male (p < 0.001), having bachelor education (p < 0.001), and previous experience (p = 0.009) was significantly associated with moderate to good knowledge. The overall knowledge about the nature of radiation (96%) and associated risk (82%) was good, but regarding protection, 59% of the participants showed good knowledge. CONCLUSION: Most of the participants showed satisfactory result. However, the knowledge regarding protection measures was poor in almost half of the population.

A Physiologically Based Pharmacokinetic Model to Predict Systemic Ondansetron Concentration in Liver Cirrhosis Patients.

INTRODUCTION: Ondansetron is a drug that is routinely prescribed for the management of nausea and vomiting associated with cancer, radiation therapy, and surgical operations. It is mainly metabolized in the liver, and it might accumulate in patients with hepatic impairment and lead to unwanted adverse events. METHODS: A physiologically based pharmacokinetic (PBPK) model was developed to predict the exposure of ondansetron in healthy and liver cirrhosis populations. The population-based PBPK simulator PK-Sim was utilized for simulating ondansetron exposure in healthy and liver cirrhosis populations. RESULTS: The developed model successfully described the pharmacokinetics of ondansetron in healthy and liver cirrhosis populations. The predicted area under the curve, maximum systemic concentration, and clearance were within the allowed twofold range. The exposure of ondansetron in the population of Child-Pugh class C has doubled in comparison to Child-Pugh class A. The dose has to be adjusted for liver cirrhosis patients to ensure comparable exposure to a healthy population. CONCLUSION: In this study, the developed PBPK model has described the pharmacokinetics of ondansetron successfully. The PBPK model has been successfully evaluated to be used as a tool for dose adjustments in liver cirrhosis patients.

Burnout, Resilience, Supervisory Support, and Quitting Intention among Healthcare Professionals in Saudi Arabia: A National Cross-Sectional Survey.

Although personal resilience and supervisory support are known to reduce the impact of burnout and quitting intention, there is limited data available to explore these relationships among healthcare professionals (HCPs) in Saudi Arabia. This study aimed to assess the prevalence of burnout and explore its association with resilience, supervisory support, and intention to quit among Saudi Arabian HCPs. METHODS: A cross-sectional survey was distributed to a convenience sample of HCPs between April and November 2022. Participants responded to socio-demographic questions, the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS (MP)), the Connor-Davidson resilience scale 10 (CD-RISC 10), and the Perceived of Supervisor Support Scale (PSS). Descriptive, inferential, correlation, and logistic regression tests were performed for data analyses. RESULTS: Of the 1174 HCPs included in the analysis, 77% were presented with high burnout levels: 58% with emotional exhaustion (EE), 72% with depersonalization (DP), and 66% with low personal accomplishment (PA). Females were associated with increased odds of burnout (OR: 1.47; 95% CI: 1.04-2.06) compared to males. Burnout and its subscales were associated with higher intention to leave practice, with 33% of HCPs considering quitting their jobs. Furthermore, HCPs reported a low resilience score overall, and negative correlations were found between EE (r = -0.21; p < 0.001) and DP (r = -0.12; p < 0.01), and positive correlation with low PA (r = 0.38; p < 0.001). In addition, most HCPs perceived supervisory support as low, and it is associated with increased burnout and quitting intention. CONCLUSION: Burnout is common among HCPs across all clinical settings and is associated with higher intention to quit and low resilience and supervisory support. Workplace management should provide a supportive workplace to reduce burnout symptoms and promote resiliency.

Exploring the Relationship Between Stress and Satisfaction During Clinical Training Among Respiratory Therapy Students: A Nationwide Cross-Sectional Survey.

Background: Although clinical training is an important component of healthcare education, it is nevertheless a significant source of stress for students. There is limited information on stress and satisfaction perceived by clinical-level undergraduate students studying respiratory therapy (RT) in Saudi Arabia. Methods: A descriptive, cross-sectional study design with an online questionnaire was employed to conduct this study. Data collection occurred during the academic year 2022-2023 among RT students throughout Saudi Arabia. Patricians responded to demographic questions, the Students Stress Scale and Students Professional Satisfaction questionnaires. Descriptive, inferential, and correlational statistics were used to analyze the collected responses. Results: A total of 1001 undergraduate RT students completed the online survey. RT students and interns had an overall moderate to high stress level (mean (SD); 3.55 (0.49)), while satisfaction was perceived as mild to moderate (mean (SD): 2.56 (0.65)). In addition, 38% of the study participants have considered quitting the RT program. Female students showed higher stress levels in the following domains: inadequate knowledge and training, adverse and embarrassing experiences, clinical supervision, patients' pain, and Education-reality conflict (p<0.005) compared to male students. Additionally, students who considered quitting the RT program revealed higher stress levels in all domains (p<0.005). There were negative correlations between satisfaction and stress domains: inadequate knowledge and training (r = -0.32; p = 0.001), adverse and embarrassing experience (r = -0.31; p = 0.025), close supervision (r = -0.24; p = 0.001), insufficient hospital resources (r = -0.30; p 0.002), patients' pain and suffering (r = 0.28; p = 0.04), and education - reality conflict (r = -0.30; p = 0.001). Conclusion: During clinical training, respiratory therapy students experience moderate to high-stress levels and low satisfaction. There need to be tailored interventions to reduce stress and intention to quit and increase students' clinical experience satisfaction.

Hospitals Disaster Preparedness and Management in the Eastern Province of the Kingdom of Saudi Arabia: A Cross-sectional study.

OBJECTIVE: The current study was conducted to assess disaster preparedness of hospitals in the Eastern region of Saudi Arabia. METHODS: A descriptive cross-sectional study of all hospitals in the Eastern Region of KSA was conducted between July 2017 and July 2018. The included hospitals were selected using convenience sampling. The questionnaire was distributed together with an official letter providing information about the aim and objectives of the study as well as ethical issues guiding their participation in the exercise. RESULTS: All the included hospitals had a disaster plan that was completely accessible by all staff members. About 70% of the included hospitals established an educational program on disaster preparedness once per year. Assessment of hospital disaster preparedness was conducted using disaster drills in 62 (n= 98%) of the hospitals. However, only 9.5% of the hospitals had post-disaster recovery assistance programs like counseling and support services. CONCLUSION: Most hospitals involved in this study had sufficient resources for disaster management; however, the overall effectiveness of hospitals' disaster preparedness was slight to moderate. Some recommendations to improve hospitals' disaster preparedness should be proposed, including improved staff training and testing, better communications and safety procedures, and adoption of a holistic approach for disaster management.

Prehospital Time Interval for Urban and Rural Emergency Medical Services: A Systematic Literature Review.

The aim of this study was to discuss the differences in pre-hospital time intervals between rural and urban communities regarding emergency medical services (EMS). A systematic search was conducted through various relevant databases, together with a manual search to find relevant articles that compared rural and urban communities in terms of response time, on-scene time, and transport time. A total of 37 articles were ultimately included in this review. The sample sizes of the included studies was also remarkably variable, ranging between 137 and 239,464,121. Twenty-nine (78.4%) reported a difference in response time between rural and urban areas. Among these studies, the reported response times for patients were remarkably variable. However, most of them (number (n) = 27, 93.1%) indicate that response times are significantly longer in rural areas than in urban areas. Regarding transport time, 14 studies (37.8%) compared this outcome between rural and urban populations. All of these studies indicate the superiority of EMS in urban over rural communities. In another context, 10 studies (27%) reported on-scene time. Most of these studies (n = 8, 80%) reported that the mean on-scene time for their populations is significantly longer in rural areas than in urban areas. On the other hand, two studies (5.4%) reported that on-scene time is similar in urban and rural communities. Finally, only eight studies (21.6%) reported pre-hospital times for rural and urban populations. All studies reported a significantly shorter pre-hospital time in urban communities compared to rural communities. Conclusions: Even with the recently added data, short pre-hospital time intervals are still superior in urban over rural communities.