Prevalence of anxiety, depression, and post-traumatic stress disorder among Omani children and adolescents diagnosed with cancer: a prospective cross-sectional study.

BACKGROUND: Children and adolescents diagnosed with cancer often experience psychological distress, encompassing anxiety, depression, and post-traumatic stress disorder (PTSD). This study aimed to evaluate the prevalence of these conditions among Omani children and adolescents diagnosed with cancer, alongside identifying contributing factors. METHODS: A prospective cross-sectional study was conducted from October 2021 to June 2023 among a cohort of Omani children and adolescents (6-18 years old) diagnosed with cancer at three primary cancer referral centres in Oman. Validated Arabic-language versions of the Screen for Child Anxiety Related Disorders, the Center for Epidemiologic Studies Depression Scale for Children, and the Impact of Event Scale-Revised instruments were used to assess symptoms of anxiety, depression, and PTSD, respectively. An initial assessment (T1) was undertaken within the first 3 months of diagnosis, followed by a second assessment (T2) 3-6 months later. RESULTS: Of 113 eligible participants, 101 agreed to participate in the study (response rate: 95.6%), with 92 (91.0%) completing both assessments and included in the final analysis. Prevalence rates of anxiety, depression, and PTSD decreased from 43.5%, 56.5%, and 32.6%, respectively, at T1, to 38.0%, 35.9%, and 23.9% at T2. All average scores were below diagnostic cut-off points, except for the depression score at T1. Anxiety and depression scores decreased significantly (p = 0.043 and 0.001, respectively) between T1 and T2, as did the overall prevalence of depression (p = 0.004). At T1, linear regression analysis showed significant correlations between anxiety scores and the child's age and PTSD score (p < 0.05); these variables were also correlated with depression scores (p ≤ 0.001). At T2, significant correlations were observed between anxiety scores and the child's age and PTSD scores (p < 0.001). At both T1 and T2, anxiety, depression, and PTSD scores remained significantly correlated (p < 0.001). CONCLUSIONS: Omani children and adolescents recently diagnosed with cancer exhibit a high prevalence of anxiety, depression, and PTSD over time. Age-appropriate communication, ongoing support, and mental health services are recommended to help this patient group cope with their diagnosis and manage their emotional wellbeing. There is a need for future research to determine the effectiveness of specific psychological interventions in reducing the frequency of these disorders.

Knowledge of cervical cancer screening among Omani women attending a university teaching hospital: a cross-sectional study.

OBJECTIVES: To assess knowledge, attitudes, and practices regarding cervical cancer and Pap smear screening among Omani women attending a tertiary clinic in Muscat, Oman, and to establish correlations with selected sociodemographic factors. METHODS: An observational, cross-sectional study was carried out among Omani women aged 18-50 years old attending the outpatient clinic of the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, from October 2019 to February 2020. A validated Arabic-language questionnaire was utilized to collect data regarding the participants' sociodemographic characteristics, their knowledge of cervical cancer and related risk factors, and their knowledge, attitudes, and practices related to cervical cancer screening and Pap smear testing. RESULTS: Of the 380 respondents, 86 and 55% had previously heard of cervical cancer and Pap smear testing, respectively; however, only 26% were knowledgeable concerning these topics. Knowledge scores were significantly associated with various sociodemographic factors, including marital status and a previous awareness of cervical cancer (odds ratio: > 1, p < 0.05). Only 21% had themselves previously undergone Pap smear testing; however, 75% reported being willing to undergo such screening in future. CONCLUSIONS: Knowledge regarding cervical cancer-related risk factors and Pap smear screening was poor among a cohort of Omani women attending a tertiary clinic in Muscat, Oman. This may play a role in the increased frequency of cervical cancer cases observed in Oman over recent years. As such, a well-structured public education program is recommended to raise awareness of this issue.

Prevalence of psychological distress and associated factors among Omani women diagnosed with breast cancer: a single-centre, cross-sectional study.

OBJECTIVES: To determine the prevalence of psychological distress (ie, anxiety and depressive symptoms) among Omani women diagnosed with breast cancer (BC) and to investigate associations with socio-demographic factors. DESIGN: A cross-sectional, self-administered survey was conducted between September 2021 and June 2022. SETTING: Sultan Qaboos Comprehensive Cancer Care and Research Centre (Muscat, Oman). PARTICIPANTS: Adult Omani women diagnosed with BC during the study period. OUTCOME MEASURES: Data regarding anxiety and depressive symptoms were collected using an Arabic version of the Hospital Anxiety and Depression Scale (HADS). Socio-demographic and clinical information was obtained from the participants and their hospital medical records. RESULTS: 190 Omani women diagnosed with BC were invited to participate in the study, of whom 171 participated (response rate: 90.0%). The mean age was 50.3±10.9 years. 52.3% of participants had been diagnosed with BC at stages III or IV and 28.9% had metastasis. 29 women (17.0%) exhibited depressive symptoms (HADS-D score: ≥8), while 37 (21.6%) exhibited anxiety symptoms (HADS-A score: ≥8). Women with anxiety symptoms were almost 15-times more likely to have depressive symptoms than those without anxiety symptoms (OR: 14.87, p<0.001). Younger women were less likely to exhibit depressive symptoms than older women (≤39 vs ≥60 years, p=0.050; 40-59 vs ≥60 years, p=0.005). Women at the school/diploma education level were less likely to have depressive symptoms than those at college/university level (OR: 0.19, p=0.017). CONCLUSIONS: More than half of the women surveyed had been diagnosed at an advanced stage, with up to 21.6% presenting with symptoms of anxiety and depression. Healthcare professionals in Oman should consider additional screening for anxiety and depressive symptoms in this group and encourage patients with BC to disclose emotional information during consultations, particularly for those aged ≥60 years.

The Impact of Sociodemographic, Macroeconomic, and Health Status and Resources on Infant Mortality Rates in Oman: Evidence from 1980 to 2022.

BACKGROUND: The infant mortality rate (IMR) is an important reflection of the well-being of infants and the overall health of the population. This study aims to examine the macroeconomic (ME), sociodemographic (SD), and health status and resources (HSR) effects on IMR, as well as how they may interact with each other. METHODS: A retrospective time-series study using yearly data for Oman from 1980 to 2022. Partial Least Squares-Structural Equation Modelling (PLS-SEM) was utilized to develop the exploratory model of the determinants of IMR. RESULTS: The model indicates that HSR determinants directly, but negatively, affect IMR (ß = -0.617, p < 0.001). SD directly and positively affects IMR (ß = 0.447, p < 0.001). ME only indirectly affects IMR (ß = -0.854, p < 0.001). ME determinants also exert some direct influences on both HSR (ß = 0.722, p < 0.001) and SD (ß = -0.916, p < 0.001) determinants. CONCLUSIONS: This study has indicated that IMR is a multi-faceted issue. It also highlighted the interplay of numerous variables and their influence on IMR, particularly the role that social status, the health sector, and the wealth of the country and its population play in reducing IMR. These findings indicate that an integrated policy that addresses socioeconomic and health-related factors and the overall ME environment is necessary for the health and well-being of the children and the population overall in Oman.

Effectiveness of an Educational Program on Awareness of Breast Cancer Risk Factors, Symptoms, and Barriers to Seeking Medical Help among Adolescent Omani School Students-An Interventional Study.

BACKGROUND AND AIM: Women in Oman and low- and middle-income countries (LMICs) are usually diagnosed with BC at a younger age and more advanced stage, with poor five-year survival. This study aims to evaluate the effectiveness of breast cancer (BC) related educational programs among female Omani adolescents. MATERIALS AND METHODS: Six female-only public schools were randomly selected from three governorates of Oman and assigned to the control or interventional group. An Arabic version of the Breast Cancer Awareness Measure questionnaire was used to evaluate students attending grades 10 and 11 at baseline (T0) and after 4 weeks (T1). After T0, the intervention group participated in a one-hour BC education program involving group discussions, a slideshow presentation, leaflets, and online access to program materials and videos. Non-parametric tests were used to compare scores between intervention and control groups and within each group across time (T0 vs. T1). RESULTS: A total of 1106 students participated, of which 547 (49.5%) and 559 (50.5%) were allocated to the control and intervention groups, respectively. Recognition of BC risk factors (Z = 18.67; p < 0.001) and symptoms (Z = 20.01; p < 0.001) increased significantly in the intervention group between T0 and T1 and compared to the control group at T1 (U = 27.27; p < 0.001, and U = 25.75; p < 0.001, respectively). Anticipated time to seeking medical help (Z = 18.67; p < 0.001) and barriers to help-seeking (Z = 7.91; p < 0.001) decreased significantly between T0 and T1 in the intervention group and compared to the control group at T1 (U = 15.78; p < 0.001, and U = 3.44; p = 0.001, respectively). CONCLUSION: The program increased knowledge of BC risk factors and symptoms and promoted early medical help-seeking among Omani female adolescents. Healthcare strategic planners and policy-makers in Oman and low- and middle-income countries should consider incorporating cancer education programs in the national school curriculum to minimize delays in BC diagnosis and improve the survival rate.

A Comparative Study of the Properties of Gelatin (Porcine and Bovine)-Based Edible Films Loaded with Spearmint Essential Oil.

Gelatin (bovine/porcine)-based edible films are considered as an excellent carrier for essential oils (EOs) to preserve food quality and extend their shelf life. Spearmint essential oil (SEO) is known for its potential antioxidant and antimicrobial effects; nevertheless, its food applications are limited due to the volatile nature of its active components. Thus, edible films loaded with essential oil can be an alternative to synthetic preservatives to improve their food applications. In the present study, the effect of SEO addition was investigated on the physicochemical properties of bovine and porcine gelatin films, and antioxidant activity was assessed. GCMS (Gas chromatography mass spectrometry) analysis revealed the presence of carvone (55%) and limonene (25.3%) as major components. The incorporation of SEO into the films decreased the opacity, moisture content, water solubility, and elongation at break of bovine and porcine gelatin films. However, with the addition of EO, the thickness and water vapor permeability of bovine and porcine-based gelatin films increased. Moreover, the addition of SEO increased the tensile strength (TS) of the porcine-based film, whereas bovine samples demonstrated a decrease in tensile strength. XRD (X-ray diffraction) findings revealed a decrease in the percentage crystallinity of both types of gelatin films. SEM (scanning electron microscope) results showed the changes in the morphology of films after the addition of SEO. Antioxidant properties significantly increased with the incorporation of EO (p < 0.05) when compared with control films. Therefore, the addition of SEO to gelatin-based edible films could be an effective approach to prepare an active food packaging material to prevent food oxidation.

Physicochemical Characterization and Antioxidant Properties of Chitosan and Sodium Alginate Based Films Incorporated with Ficus Extract.

Aqueous extract of fruit obtained from Ficus racemosa enriched with phenolic components was used for the first time to fabricate chitosan (CS) and sodium alginate (SA)-based edible films. The edible films supplemented with Ficus fruit aqueous extract (FFE) were characterized physiochemically (using Fourier transform infrared spectroscopy (FT-IR), Texture analyser (TA), Thermogravimetric analysis (TGA), scanning electron microscopy (SEM), X-ray diffraction (XRD), and colourimeter) and biologically (using antioxidant assays). CS-SA-FFA films showed high thermal stability and high antioxidant properties. The addition of FFA into CS-SA film decreased transparency, crystallinity, tensile strength (TS), and water vapour permeability (WVP) but ameliorate moisture content (MC), elongation at break (EAB) and film thickness. The overall increase in thermal stability and antioxidant property of CS-SA-FFA films demonstrated that FFA could be alternatively used as a potent natural plant-based extract for the development of food packaging material with improved physicochemical and antioxidant properties.

The Effect of Sage (Salvia sclarea) Essential Oil on the Physiochemical and Antioxidant Properties of Sodium Alginate and Casein-Based Composite Edible Films.

The aim of this study was to examine the effect of Sage (Salvia sclarea) essential oil (SEO) on the physiochemical and antioxidant properties of sodium alginate (SA) and casein (CA) based films. Thermal, mechanical, optical, structural, chemical, crystalline, and barrier properties were examined using TGA, texture analyzer, colorimeter, SEM, FTIR, and XRD. Chemical compounds of the SEO were identified via GC-MS, the most important of which were linalyl acetate (43.32%) and linalool (28.51%). The results showed that incorporating SEO caused a significant decrease in tensile strength (1.022-0.140 Mpa), elongation at break (28.2-14.6%), moisture content (25.04-14.7%) and transparency (86.1-56.2%); however, WVP (0.427-0.667 × 10-12 g·cm/cm2·s·Pa) increased. SEM analysis showed that the incorporation of SEO increased the homogeneousness of films. TGA analysis showed that SEO-loaded films showed better thermal stability than others. FTIR analysis revealed the compatibility between the components of the films. Furthermore, increasing the concentration of SEO increased the antioxidant activity of the films. Thus, the present film shows a potential application in the food packaging industry.

Combined Effect of Drying Temperature and Varied Gelatin Concentration on Physicochemical and Antioxidant Properties of Ginger Oil Incorporated Chitosan Based Edible Films.

In the present work, ginger essential oil (GEO) loaded chitosan (CS) based films incorporated with varying concentrations of gelatin (GE) were fabricated and dried at different conditions (25 °C and 45 °C). The physio-chemical, mechanical and antioxidant potential of the films were determined. Films dried at 45 °C showed better physical attributes and less thickness, swelling degree (SD), moisture content, water vapor permeability (WVP), more transparency, and better mechanical characteristics. Fourier transform infrared spectroscopy (FTIR) revealed the chemical composition and interaction between the functional groups of the film components. X-ray diffraction (XRD), thermogravimetric analysis (TGA), and scanning electron microscopy (SEM) findings revealed that samples dried at 45 °C had more crystalline structure, were thermally stable, and smoother. Antioxidant results showed that films dried at low temperature showed comparatively more (p < 0.0001) antioxidant activity. Additionally, an increase in gelatin concentration improved the tensile strength and swelling factor (p < 0.05), however, had no significant impact on other parameters. The overall results suggested better characteristics of GEO-loaded CS-GE based edible films when dried at 45 °C.

Effectiveness of an Educational Program on Awareness of Cancer Risk Factors, Symptoms, and Barriers to Medical Help-Seeking Among Adolescent Omani Students: an Interventional Study.

Cancer is the second leading cause of death worldwide, with attributable mortality expected to continue increasing over time. High school students are often targeted to enhance awareness of cancer risk factors and symptoms and promote early medical help-seeking behaviors. This study aimed to evaluate the effectiveness of a cancer education program among Omani adolescents. A total of 12 public schools were randomly selected from three governorates and assigned to either the intervention or control group. Students attending grades 10 and 11 at the selected schools were targeted. The Cancer Awareness Measure tool was used to evaluate knowledge of cancer risk factors and symptoms, perceived barriers to seeking medical help, and anticipated time to consult a doctor for cancer warning symptoms at baseline (T0) and after 4 weeks (T1). After T0, the intervention group participated in a 1-h cancer education program involving a slideshow presentation and group discussion; they also received a leaflet and online access to program materials and videos. A total of 1716 students were enrolled in the study, including 886 (51.6%) assigned to the control group and 830 (48.4%) to the intervention group. Recognition of cancer risk factors (Z = 24.86; p ˂ 0.001) and cancer symptoms (Z = 24.91; p ˂ 0.001) significantly improved in the intervention group between T0 and T1, and compared to the control group at T1 (U = 33.28; p ˂ 0.001, and U = 34.55; p ˂ 0.001, respectively). In addition, anticipated time to help-seeking (Z = 20.15; p ˂ 0.001) and barriers to help-seeking (Z = 10.33; p < 0.001) decreased significantly between T0 and T1, and compared to the control group at T1 (U = 19.00; p ˂ 0.001, and U = 3.58; p < 0.001, respectively). The intervention effectively increased knowledge of cancer risk factors and symptoms and promoted early medical help-seeking behaviors among school-aged Omani adolescents. Integration of cancer education within high school curricula can aid cancer prevention and early intervention efforts. However, additional follow-up is required to confirm the long-term effectiveness of such programs.

The Unmet Supportive Care Needs of Omani Women Diagnosed with Breast Cancer.

Objectives: This study aimed to assess the unmet supportive care needs of Omani women with breast cancer (BC). Methods: This cross-sectional study was conducted from November 2020 to February 2021 among 250 adult Omani women diagnosed with BC at Sultan Qaboos University Hospital, Muscat, Oman. An Arabic version of the 34-item Supportive Care Needs Survey-Short Form tool was used to determine perceived unmet supportive care needs across five domains. Results: A total of 181 women participated in the study (response rate: 72.4%). The domain with the highest mean score per item was health system and information (mean score: 3.33), with the greatest unmet need in this domain being information about what the patient could do to help themselves get well (40.9%). The domain with the second highest mean score per item was patient care and support (mean score: 3.04), with the greatest unmet need being for clinicians to be more sincere with the patient (36.5%). Higher total mean scores were reported by women who had visited the hospital four times or more over the two months preceding the study (P = 0.045), those with stage 3 or 4 cancer (P = 0.047) and those who had recently undergone radiotherapy or chemotherapy (P = 0.014). Conclusion: Most unmet supportive care needs fell under the health system and information domain. Healthcare providers in Oman should explore patient concerns and provide sufficient information at various stages of the care process to decrease the anxiety associated with living with cancer.

Exploring causes of delays in help-seeking behaviours among symptomatic Omani women diagnosed with late-stage breast cancer - A qualitative study.

PURPOSE: Breast cancer (BC) is the most commonly diagnosed cancer in Oman; however, the majority of women are diagnosed at a relatively young age and late stage. Delays in BC diagnosis may be attributable to patient-related barriers to medical help-seeking, such as embarrassment arising from breast examinations or negative perceptions of cancer or a cancer diagnosis. Identifying and addressing patients-related barriers to medical help-seeking may help early BC detection, increase the survival rate, and improve prognosis. This study aimed to explore causes of delays in medical help-seeking behaviours among symptomatic Omani women diagnosed with late-stage BC. METHODS: Purposeful sampling was used to identify Omani women diagnosed with late-stage BC (i.e., stages III or IV) at the two main referral oncology centres in Oman. Semi-structured individual interviews were utilised to collect data regarding the participants' reasons for delaying seeking medical help. The qualitative framework analysis approach was used for data analysis. RESULTS: A total of 17 women participated in the study. The mean age was 41.94 ± 7.87 years (range: 27-56 years). Six reasons for delays in seeking medical help were identified, including: (1) Being in denial of BC symptoms; (2) normalisation of BC symptoms attributed to hormonal changes, dietary changes, or work-induced stress; (3) misinterpretation of BC symptoms attributed to other diseases or expectation of more alarming/obvious BC symptoms; (4) pursuit of alternative medicine remedies; (5) false reassurance or incorrect advice from family members or friends; and (6) practical barriers, such as childcare responsibilities and lack of access to transport. CONCLUSION: Several reasons were identified for delays in seeking medical help for BC symptoms, including cultural and emotional factors and a lack of knowledge of BC symptoms. Increased awareness of BC symptoms and a better understanding of Omani women's beliefs, cultures, and behaviours may help to reduce delays in BC presentation and diagnosis.

Gallic Acid Crosslinked Gelatin and Casein Based Composite Films for Food Packaging Applications.

In the current work, we fabricated gelatin-casein-based edible films (GC-EFs) crosslinked with gallic acid (GA). We analyzed the physiochemical characteristics, crystallinity, thermal stability, and surface properties of the EFs using Fourier-transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), thermogravimetric analysis (TGA), and scanning electron microscopy (SEM). It was found that the edible films possessed a semi-crystalline structure. Addition of GA enhanced the thermal stability of the edible films as well as the surface properties of the films. It was found that a higher concentration of GA (4-5% w/v) significantly improved the surface properties, observed in the surface and cross-sectional examination of SEM micrographs. EFs containing higher amounts of GA showed more compact and denser structures with smoother and more homogeneous surfaces than the control samples. In addition, swelling degree (SD), thickness, water solubility (WS), moisture content (MC), and water vapor permeability (WVP) were found to be low in EFs containing more GA concentration. Mechanical parameters revealed that the Young modulus (Ym) and tensile strength (TS) increased with a rise in GA concentration, and elongation at break (EB) reduced with a rise in GA concentration. In transparency and color analysis, it was observed that GA positively affected the transparency of the edible films.

Effect of Drying Temperature on Physical, Chemical, and Antioxidant Properties of Ginger Oil Loaded Gelatin-Sodium Alginate Edible Films.

The drying temperature is one of the crucial parameters that impacts the physical, chemical, and biological properties of edible films (EFs). This parameter determines the degree of crystallinity, which can further impact the film's mechanical, barrier, and optical properties. The present work is designed to investigate the effect of different drying temperature conditions (25 °C and 45 °C) on ginger essential oil (GEO) loaded Gelatin-sodium alginate composite films over their physical, chemical, and antioxidant properties. Results indicated that drying of films at 25 °C had a positive effect on certain properties of the EFs, such as the moisture content (MC), water solubility (S), swelling degree (SD), water vapor permeability (WVP), and mechanical and optical properties. SEM analysis showed that films dried at 25 °C presented more uniform surface properties with fewer cracks and pores compared to films dried at 45 °C. TGA analysis demonstrated the higher thermal stability of the films when dried at 25 °C. Findings obtained from X-ray diffraction (XRD) and fourier-transform infrared spectroscopy (FTIR) showed film crystallinity and electrostatic interactions between GE, SA, and GEO. Results obtained from antioxidant assays revealed that films dried at 25 °C showed comparable antioxidant capacity to that of butylated hydroxytoluene (BHT). Furthermore, it was found that the addition of SA and GEO to the blank GE films improved their physical, chemical, and antioxidant properties. The present work suggests that GEO loaded GE-SA based films showed better physical, chemical, and antioxidant potential when dried at a lower temperature. These novel materials can be utilized as potential packaging materials in the food industry.

Preparation and Physiochemical Characterization of Bitter Orange Oil Loaded Sodium Alginate and Casein Based Edible Films.

Biopolymers-based composite edible films are gaining interest in the food packaging industry due to their sustainable nature and diverse biological activities. In the current study, we used sodium alginate (SA) and casein (CA) for the fabrication of composite film using the casting method. We also added orange oil to the edible film and assessed its impact on the biological, chemical, physical, and barrier properties of the films. The fabricated films were analyzed using X-ray diffraction (XRD), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR). It was observed that CA-SA films loaded with 1.5% OEO had better visual attributes, and a further increase in oil concentration was not found to be as favorable. Mechanical assessment of the films revealed that CA-SA-OEO (1.5%) film showed lower puncture deformation and higher puncture force values. XRD data showed that all samples exhibited peaks at similar positions (21° of 2θ) with different intensities. In FTIR analysis, characteristic peaks of the film components (sodium alginate, casein, and orange oil) were reported at corresponding positions. The thermal stability of films was enhanced after the addition of the OEO (1.5%), however, a greater increase in OEO caused a decrease in the thermal stability, observed during TGA analysis. Moreover, the surface of the blank CA-SA film (FL1) was found to be rough (with cracks) compared to CA-SA films (FL2) containing 1.5% OEO. Additionally, FL2 was found to be relatively better than the other samples in terms of swelling degree (SD), thickness, water solubility (WS), oxygen permeability (OP), water vapor permeability (WVP), moisture content (MC), and transparency (T).

Health-Related Quality of Life, Functioning, and Physical Symptoms of Adult Omani Colorectal Cancer Survivors.

BACKGROUND: Colorectal (CRC) survivors often experience physical and psychological symptoms affecting their health-related quality of life (HRQoL). This study aimed to identify factors impacting HRQoL-related functioning and physical symptoms among adult Omani CRC survivors. METHODS: A cross-sectional study of 124 adult CRC survivors was conducted at the two main oncology referral hospitals in Oman. A validated Arabic version of the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire 30 was used to collect data. RESULTS: A total of 118 CRC survivors participated in the study (response rate: 95.2%). The mean age was 52 years and there were an equal number of male and female participants (n = 59 each; 50.0%). A total of 62 survivors (52.5%) had been diagnosed with CRC at stages III or IV. The overall score for global health was high (81.7). With regards to functioning, high mean scores were observed for domains of role (91.0) and social (90.7) functioning. In terms of symptoms, high mean scores were reported for constipation (25.4), insomnia (25.1), pain (20.1), and fatigue (18.9). Survivors under 60 years old (ß=15.5, p=.004) and those with no comorbidities (ß=16.0, p=.001) demonstrated better functional HRQoL. Being male was predictive of better functional HRQoL in the emotional (ß=13.9, p<0.008), cognitive functioning (ß=12.5, p=.013), role functioning (ß=14.0, p=0.006) and physical functioning (ß=17.8, p<0.001) domains. CONCLUSIONS: Healthcare professionals in Oman should implement measures to enhance the HRQoL of CRC survivors, particularly women and those with coexisting morbidities.

Correction: Al-Harrasi et al. Development and Characterization of Chitosan and Porphyran Based Composite Edible Films Containing Ginger Essential Oil. Polymers 2022, 14, 1782.

In the original publication [...].

Effect of Psycho-Educational Intervention to Reduce Anxiety and Depression at Postintervention and Follow-Up in Women with Breast Cancer: A Systematic Review and Meta-Analysis.

OBJECTIVES: To examine the effectiveness of the psycho-educational intervention in reducing anxiety and depressive symptoms for women with breast cancer in post- and follow-up status. DATA SOURCES: A systematic search of 16 electronic databases to identify all randomized controlled trial studies that examine the effects of psycho-education on anxiety and depression among women with breast cancer. The standardized mean differences (SMDs) between groups in depression and anxiety levels for postintervention and follow-up were computed for each study. CONCLUSION: Evidence suggests that psycho-educational intervention effectively relieves anxiety and depressive symptoms among women with breast cancer postintervention and follow-up. IMPLICATIONS FOR PRACTICE: A significant effect of the psycho-education intervention was found to reduce anxiety and depressive symptoms in women with breast cancer. Such service was recommended in nursing practice.

Prevalence of Anxiety, Depression, and Post-Traumatic Stress Disorder among Children and Adolescents with Cancer: A Systematic Review and Meta-Analysis.

Assessment of psychological and emotional disorders is an important indicator of well-being among children and adolescents with cancer. This review aimed to determine the prevalence rates of three major psychological disorders in this population, including anxiety, depression, and post-traumatic stress disorder (PTSD). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Various databases were searched to identify cross-sectional studies assessing anxiety, depression, and PTSD among children and adolescents with cancer. The Joanna Briggs Institute checklist was used to assess research quality. Of the 40 studies included in the literature review, 33 measured anxiety, 28 focused on depression, and nine assessed PTSD. A total of 18 studies were incorporated into the meta-analysis, with pooled prevalence rates of anxiety, depression and PTSD found to be 13.92% (n = 1,971; 95% confidence interval [CI] = 10.23-18.07%), 20.43% (n = 1,990, 95% CI = 13.85-27.93%), and 20.90% (n = 755, 95% CI = 13.28-29.73%), respectively. Mental health and psychological interventions are essential for children and adolescents diagnosed with cancer. Future work should be undertaken in different regions, such as the Middle East or Africa, or South America when assessing the prevalence of psychological disorders in children and adolescents diagnosed with cancer.

A cluster analysis to explore the burden of primary caregivers of children with cancer in Oman.

PURPOSE: Few studies have sought to evaluate the risk burden of primary caregivers, particularly in Oman. This study aimed to explore whether different risk patterns of caregiver burden exist among the primary caregivers of Omani children with leukemia. DESIGN AND METHODS: A cross-sectional study was conducted between May and November 2020. A total of 101 primary caregivers of children with leukemia were recruited from a public hospital in Oman. The Caregiver Burden Inventory (CBI) was used to assess caregiver burden. RESULTS: A two-step cluster analysis indicated that the cohort was not homogeneous (silhouette value: 1.41). Caregivers in Cluster 1 (n = 42; 41.6%) were relatively older, less educated, and had a higher caregiving burden (mean CBI score: 37.7 ± 19.9). In contrast, caregivers in Cluster 2 (n = 59; 58.4%) were younger, more highly educated, and had a moderate caregiving burden (mean CBI score: 26.3 ± 13.6). As such, Clusters 1 and 2 were characterized as the "high-risk" and "moderate-risk" burden groups, respectively. PRACTICE IMPLICATIONS: This study highlights the need for a policy draft to target and reduce the caregiver burden in Oman, Nursing professionals should seek to develop and implement customized care depending on the caregiver risk burden, including additional financial, psychological, and physical support. They should seek to stratify caregivers by risk burden as some groups may require additional support. However, in light of recent precautionary measures due to the current pandemic situation, such services will have to be provided online or via telephone instead of in person for the foreseeable future.