Identifying the Challenges of Child Abuse Detection Among Emergency, Pediatrics, and Family Medicine Practitioners in Saudi Arabia.

BACKGROUND: Child abuse is a significant issue across many countries. Despite the situation's innate understanding, many children are not reported to authorities and continue to experience abuse, sometimes even death. Healthcare professionals must be alert for abuse in any child who appears with injuries that are out of the ordinary because it is easy for indicators of child abuse to go unnoticed in a busy emergency department. The current study aims to evaluate and detect the challenges in diagnosing and reporting cases of child abuse among healthcare practitioners in emergency, pediatrics, and family medicine. METHODS: A self-administered online disseminated questionnaire was used for data collection during the period from October 1 to December 30, 2022. A cross-sectional study was conducted on emergency, pediatrics, and family medicine healthcare practitioners working in hospitals in healthcare centers in Riyadh, Saudi Arabia. All data were collected, tabulated, and statistically analyzed using SPSS 23.0 for (IBM Corp., Armonk, NY) Windows. RESULTS: The study sample constituted 200 physicians working in the front lines of healthcare like emergency, pediatrics, and family medicine primary care services, 50.5% were males and 49.5% were females. 36.5% of participants were 31-39 years old. 42% were family medicine physicians, 36.5% were pediatricians, and 21.5% were emergency medicine. About 43% of participants attended an educational workshop on child abuse. Nineteen percent of participants are very familiar with the diagnosis of child abuse and 36% of participants reported one to three cases of child abuse in the emergency department in the last year, 5% reported four to six cases and 56.5% reported none. Forty-seven percent of participants reported diagnosing one to five cases of child abuse throughout their whole career, 13% reported 11-15 cases, 6.5% reported six to 10 cases and 28.5% reported none. Causes of underdiagnosis of child abuse by healthcare providers were reported as 63% inexperience, 59% inadequate time for physical examination, 59% lack of diagnosis protocol, 51% lack of confidence in communicating with parents, 36% physicians' cultural background, and 38% lack of confidence in the diagnosis. 93.5% of participants think that healthcare practices need further education for child abuse. CONCLUSION: In conclusion, physicians in Saudi Arabia who participated in the study had good knowledge to diagnose a case of child abuse. Inexperience, inadequate time for physical examination, lack of diagnosis protocol, lack of confidence in communicating with parents, and physicians' cultural background were the main identified challenges for diagnosing child abuse. Familiarity with cases of child abuse was significantly associated with physicians' age, specialty, and level of training.

Factors Influencing the Choice of Radiology Subspecialty Among Radiology Trainees in Saudi Arabia.

Background Differential choices of radiology subspecialties by radiology trainees can cause shortages in some subspecialties. The objective of the current study was to evaluate the relative preference of different radiology subspecialties and the influencing factors among radiology trainees in Saudi Arabia.  Methods An online questionnaire was developed based on previous publications and was used to collect the data from radiology trainees in Saudi Arabia during August 2018. The relative importance of potential personal and work-related factors was assessed using Likert-scaled responses. Results A total of 105 radiology trainees were included in the current analysis. Approximately 64.8% of the trainees were males. A total of eight subspecialties were reported, with the most frequent being interventional radiology (20%), neuroradiology (19%), abdominal/gastrointestinal (15.2%), and musculoskeletal (14.3%). Personal factors that were reported as extremely or very important included strong personal interest (84.8%), successful/enjoyable rotation during training (84.8%), and intellectual challenge (76.2%). Work-related factors that were reported as extremely or very important included direct impact on patient care (84.8%), advanced or a variety of imaging modalities (81%), direct professional contact (77.1%), and favorable/flexibility of working hours and on-call commitments (77.1%). The subspecialty of interventional radiology was more frequently chosen by male trainees (p = 0.006), while the gynecological/breast subspecialty was exclusively chosen by female trainees (p < 0.001). Conclusion In addition to gender-specific differences, we are reporting several important personal and professional factors that influence the choice of radiology subspecialty. These findings can potentially help the directors of radiology training in making evidence-based modifications to their residency programs to ensure the maintenance of a sufficient radiology workforce.

Epidemiology of hand fractures at a tertiary care setting in Saudi Arabia.

OBJECTIVES: To examine the epidemiology of hand fractures including common bones affected, causes, interventions, outcomes, and complications. Methods: This retrospective records-based study included patients who were admitted to King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, with traumatic metacarpal or phalangeal fractures between January 2016 and September 2017. Carpal fractures, wrist fractures, and all pathological fractures were excluded. Results: A total of 82 patients (90.2% of them men with an average age of 27.6±13.4 years) with 101 fractures were included. The fifth (25.5%) and first (24.5%) rays were the most commonly affected ones. The fifth finger (27.8%) and first metacarpal (28.9%) were the most commonly affected finger and metacarpal bone. Approximately 32.7% of the fractures were open fractures. The most frequent causes of hand fractures included falls (40.5%), road traffic accidents (20.3%), crushing injuries (9.5%), and machinery injuries (9.5%). Approximately 90.1% of the patients underwent operative interventions including open reduction (50.5%) and closed reduction (34.3%). The majority of fractures (79.2%) healed, and only 14.7% of fractures developed complications. Conclusion: In this study of hand fractures, patients were predominantly males and the main causes of fractures were falls and road traffic accidents.

Association between Race and Cancer-Related Mortality among Patients with Colorectal Cancer in the United States: A Retrospective Cohort Study.

Colorectal cancer (CRC) is the third most common cause of mortality in the United States (US). Differences in CRC mortality according to race have been extensively studied; however, much more understanding with regard to tumor characteristics' effect on mortality is needed. The objective was to investigate the association between race and mortality among CRC patients in the US during 2007⁻2014. A retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) Program, which collects cancer statistics through selected population-based cancer registries during in the US, was conducted. The outcome variable was CRC-related mortality in adult patients (≥18 years old) during 2007⁻2014. The independent variable was race of white, black, Asian/Pacific Islander (API), and American Indian/Alaska Native (others). The covariates were, age, sex, marital status, health insurance, tumor stage at diagnosis, and tumor size and grade. Bivariate analysis was performed to identify possible confounders (chi-square tests). Unadjusted and adjusted logistic regression models were used to study the association between race and CRC-specific mortality. The final number of participants consisted of 70,392 patients. Blacks had a 32% higher risk of death compared to whites (adjusted odds ratio (OR) 1.32; 95% confidence interval (CI) 1.22⁻1.43). Corresponding OR for others were 1.41 (95% CI 1.10⁻1.84). API had nonsignificant adjusted odds of mortality compared to whites (0.95; 95% CI 0.87⁻1.03). In conclusion, we observed a significant increased risk of mortality in black and American Indian/Alaska Native patients with CRC compared to white patients.