Factors associated with anxiety-related symptoms in children and adolescents during COVID-19 in Oman: a cross-sectional study.

Reports from different parts of the world suggest that the COVID-19 pandemic and the resultant lockdown and social distancing measures have heralded unprecedented mental health challenges among children and adolescents. To date, there is a dearth of studies emerging from the Arabian Gulf, where the majority of its population are children and adolescents. The study aims to examine the prevalence of anxiety-related symptoms and their covariates among children and adolescents in an Arabian Gulf country, Oman. This is a cross-sectional analytic study carried out over two weeks (1st to 15th of August 2020) during the COVID-19 pandemic across Oman. Parents were asked to complete the online survey, which consisted of the parent version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) instrument and questions regarding basic socio-demographic information. Logistic regression was used to identify the contributing variables associated with anxiety-related symptoms. A total of 790 valid responses were received. Among the 790 children, 33.3% (n = 263) were diagnosed with anxiety-related symptoms by the SCARED instrument. Logistic regression analysis suggested that anxiety-related symptoms in children and adolescents were significantly associated with three demographic variables. The model shows that children with divorced or separated parents were 1.9 times more likely to have anxiety-related symptoms than children of married couples (OR = 1.93, p = 0.035). Children living in families with an income below USD 1000/month, were 1.8 times more likely to have anxiety-related symptoms than a family with an income of USD 4000/month (OR = 1.833, p = 0.018). Children in grades 3-6 were 1.8 times more likely to have anxiety-related symptoms than those in grades 1-2 (OR = 1.79, p = 0.024). Anxiety-related symptoms are common among Omani children and adolescents. They are more likely to be reported in middle scholastic grade levels and children from families with marital discord and low socioeconomic status. It is not clear whether the presently observed rates of anxiety exceed the prevalence that would have been observed prior to the COVID-19 pandemic. More studies are therefore warranted using children and adolescents' self-reported scales.

Perceptions of Undergraduate Medical Students Toward Integrated Management of Childhood Illness (IMCI) Pre-service Education at Sultan Qaboos University, Muscat.

Background Inconsistent evidence concerning the clinical practice implications of the Integrated Management of Childhood Illness (IMCI) pre-service education exists in the literature. The aim of this study is to assess the IMCI pre-service training perceptions of medical students, including their willingness to prospectively utilize the IMCI guidelines in clinical settings. Methods This is an observational cross-sectional study that was conducted between June 1 and August 31, 2022, at the College of Medicine and Health Sciences, Sultan Qaboos University (SQU), Muscat, Sultanate of Oman. The demographic data and IMCI pre-service education perceptions were recorded via the 10 close-ended questions. The questions focused on the student's perception of the usefulness of IMCI pre-service training in improving their knowledge, attitude, and practice (KAP) regarding childhood illnesses and how well it has enhanced their skills in dealing with sick children. SPSS Statistics version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.) was used to analyze the data. Results A total of 196 responses were collected, with 117 of them being from female participants and the remaining 79 from male participants. Participants were subcategorized into phase 2 (n=103), phase 3A (pre-clerkship, n=45), and phase 3B (junior clerkship, n=48). At least 67.8% of 171 medical students complying with one to two training sessions intended to apply their IMCI pre-service education knowledge and skills in clinical practice and parental counseling. The medical knowledge and clinical practice skill enhancement abilities of the IMCI sessions were recognized by ≥49.7% of medical students. The student responses regarding childhood illness management (p=0.03) and holistic assessment confidence (p=0.042) varied significantly between the study phases. The IMCI pre-service skills, knowledge, and confidence levels were observed in 47.1% (phase 2), 13.2% (phase 3A), and 35.5% (phase 3B) of medical students. Similarly, 40.2% (phase 2), 23.7% (phase 3A), and 54.8% (phase 3B) of subjects believed in the IMCI pre-service training's influence on their ability to perform holistic assessments in the pediatric population. Conclusion The overall results of this study advocate the clinical practice implications, based on the positive student perceptions, of the IMCI pre-service training in SQU. Future qualitative studies should evaluate these findings with wider student populations.

Assessment of quality of life in children with epilepsy in Oman.

PURPOSE: The study aims to describe the quality of life (QoL) in Omani children with epilepsy at Sultan Qaboos University Hospital, Oman. METHODS: One hundred and one Omani children, with an age range from 5 to 18 years, diagnosed with epilepsy were enrolled in the study over 3 months. Descriptive epidemiology was used to characterize QoL in these children. QoL was measured using the PedsQL (4.0) questionnaire, a 23-item child and parent report questionnaire. Analysis of variance (ANOVA) was used to compare mean QoL scores, and agreement between the QoL reports of children and parents was evaluated using Spearman's rho; while, Multivariate analysis of variance (MANOVA) was performed to determine differences in subscale ratings. RESULTS: Factors affecting QoL included family status, income level, social security coverage, type of treatment, seizure frequency, age of onset, and seizure-free duration in years. Children between 5 and 7 years and females, in general, were most affected, as reflected by the overall QoL subscale. Consistency between the children's self-reports and parent proxy reports on the PedsQL™ was moderate to low. CONCLUSION: Omani children with epilepsy have poor QoL, and their psychosocial function is severely affected. Therefore, QoL should be an important outcome measure in managing children with epilepsy rather than just seizure control.

The magnitude and effect of work-life imbalance on cognition and affective range among the non-western population: A study from Muscat.

The temporal relationship between work-life balance/imbalance, occupational burnout, and poor mental health outcomes have been widely explored. Little has been forthcoming on cognitive functioning among those with work-life imbalance. This study aimed to explore the rate of work-life imbalance and the variation in neuropsychological functioning. The relationship between affective ranges (anxiety and depressive symptoms) and work-life balance was also explored. The target population in this study are Omani nationals who were referred for psychometric evaluation. The study employs neuropsychology measures tapping into attention and concentration, learning and remembering, processing speed, and executive functioning. Subjective measures of cognitive decline and affective ranges were also explored. A total of 168 subjects (75.3% of the responders) were considered to be at a work-life imbalance. Multivariate analysis showed that demographic and neuropsychological variables were significant risk factors for work-life imbalance including age and the presence of anxiety disorder. Furthermore, participants indicating work-life imbalance were more likely to report cognitive decline on indices of attention, concentration, learning, and remembering. This study reveals that individuals with work-life imbalance might dent the integrity of cognition including attention and concentration, learning and remembering, executive functioning, and endorsed case-ness for anxiety.

Age of Transition Readiness of Adolescents and Young Adults With Chronic Diseases in Oman: Need an Urgent Revisit.

BACKGROUND: The Ministry of Health in Oman and some of Gulf regions set the cut-off age of "transfer" from child health care to adult health care at 13 years of age. Within the existing health system in this part of the world, there is paucity of evidence on the appropriate age for health care "transfer" of adolescents and young adults to adult health care. Similarly, there is lack of a structured health care "transition" program. The objective of the study is to indirectly determine the appropriateness of present cut-off age of transfer by studying readiness for transition among Omani patients suffering from chronic hematological conditions. METHODS: One hundred fifty adolescents and young adults with chronic hematological conditions were recruited from pediatric and adults clinics at Sultan Qaboos University Hospital. Participants were interviewed by a trained research assistant using the Arabic version of UNC TRxANSITION Scale to assess self-management skills and health related knowledge for transition. The score range is 0 to 10; the transition readiness of the patients is assessed as low (0 to 4), moderate (4 to 6), and high (6 to 10) respectively. The continuous variables were analyzed by parametric or nonparametric methods as appropriate. χ2 analysis was done to determine association of age groups within each sexes. RESULTS: The study recruited 150 subjects (52.7% males) with 50 patients in each of the 3 age groups of 10 to 13 years (lower), 14 to 17 years (middle), and 18 to 21years (higher). The mean UNC TRxANSITION Scale scores of 5.14 (SD=1.27) in males in the total sample were significantly lower as compared with that of 5.67 (SD=1.50) in females (P=0.022). There is a steady increase in the overall median score with increase in age group, with median score of 4.42 in the lower, 5.26 in the middle and 6.81 in the higher age group (P<0.001). In section wise analysis, except for Adherence and Nutrition sections of the scale, all sections have statistically significant difference in the median scores across various age categories with lowest scores in the 10 to 13 age group and highest scores in the 18 to 21 years group. In the section related to reproduction, females had significantly higher mean ranks (31.52) and compared with 17.19 in males (P=0.001). The overall median transition score when analyzed separately for males and females across age groups showed that in the higher age group, 67% of males (P=0.008) and 90% females (P<0.001) have high transition scores compared with the other 2 groups. CONCLUSIONS: Higher age was a significant predictor for transition readiness with median score being "moderate" in the lower and middle age groups, while the higher age groups scoring "high" on transition readiness. However, in the higher age group, the females (90%) showed better transition readiness than males (67%). The current age of transfer of 13 years is just at "moderate" levels. We recommend the need for establishing transition preparation program in Oman; increasing health transfer age in Oman to a cut-off age of 18 years and taking sex differences into consideration when providing interventions.

Workplace bullying, occupational burnout, work-life imbalance and perceived medical errors among nurses in Oman: A cluster analysis.

AIM: To explore whether different profiles exist in a cohort of nurses regarding demographic and occupational outcomes. BACKGROUND: Nurses will face many occupational problems, including workplace bullying, work-life imbalance, burnout and medical errors. METHODS: A cross-sectional study included 232 nurses working in a hospital in Oman. Data were collected from December 2018 to April 2019 using convenience sampling. Instruments included work-life balance questions, the Negative Acts questionnaire-revised questionnaire, Oldenburg Burnout Inventory and Stanford Professional Fulfillment Index. Cluster analysis, t test, chi-squared and Fisher's exact tests were used for data analysis. RESULTS: Cluster 1 (n = 108) was characterized as 'low-risk on medical error, burnout and workplace bullying but high-risk in work-life imbalance' group. Cluster 2 (n = 124) was labelled as 'high-risk on medical error, work-life imbalance, burnout and workplace buying' group. CONCLUSIONS: Two groups of nurses in Oman are facing occupational problems differently. Nurses in Cluster 1 need attention to work-life imbalance. However, nurses in Cluster 2 need attention on all occupational problems. IMPLICATIONS FOR NURSING MANAGEMENT: Findings call on the nursing stakeholders in Oman to identify factors related to occupational problems, to provide consultation services to reduce inter-personnel conflicts, and to review nurses' working hours to avoid burnout and resume a balanced work-life.

Cognitive Function in Adults with Beta-Thalassemia Major in Oman: A Pilot Study.

OBJECTIVES: Neurocognitive dysfunction has been established in several studies in children with beta-thalassemia major (TM). However, despite its wide occurrence in populations across the Arabian Peninsula, scant attention has been paid to shedding light on neuropsychological functioning among adults with TM. This study aimed to examine the level of neuropsychological functioning among Omani adults with TM regularly followed-up at a tertiary care hospital in Oman. A related aim was to examine the factors associated with neuropsychological performance. METHODS: Standard neuropsychological tests were used to measure attention and concentration, learning and remembering, verbal fluency, and executive functioning. Participants were also gauged on indices of intellectual ability and affective range. As normative data for neuropsychological functioning in Oman is scarce, healthy age- and sex-matched controls underwent the same testing procedure. The log-linear model was used to identify factors associated with TM patients on demographic and neuropsychological performance. RESULTS: This study recruited 28 adult patients with TM (age 30.0±6.5) and 39 healthy controls (age 29.2±6.1). Findings suggested that having a diagnosis of TM was significantly associated with symptoms of depression (p < 0.001) and anxiety (p < 0.001), indices of executive functioning (verbal fluency) (p =0.003), working memory (digit span) (p < 0.001), and verbal and auditory attention scores (California Verbal Learning, p = 0.002). CONCLUSIONS: The data appears to suggest that short-term memory capacity, verbal fluency, and verbal and auditory attention may be impaired in TM compared to controls. Studies on a larger cohort are therefore warranted.

Child and adolescent mental health disorders in the GCC: A systematic review and meta-analysis.

BACKGROUND: The Gulf Cooperation Council (GCC), with a predominant 'youth bulge' among its 54 million people, has witnessed an exponential increase in research pertinent to child and adolescent mental health (CAMH). Aside from a few narrative reviews, to date, no critical appraisal examining the magnitude of CAMH has emerged from this region. AIMS: This study aimed to report the prevalence rates of CAMH disorders in the GCC through a systematic review of the existing literature followed by a meta-analysis. METHODS: A systematic review of the literature from the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) was conducted. The databases used included Scopus, ProQuest, Pubmed, and a final check was performed on Google Scholar to account for any remaining studies that may have still been under review. Meta analytic techniques were then used to estimate prevalence rates of each specific mental disorder, i.e. ADHD, depression, anxiety, stress, eating disorders, and tobacco use disorder. RESULTS: A total of 33 studies from the six countries were included. The pooled prevalence of ADHD as per the Vanderbilt ADHD Diagnostic Rating Scale (VADHDDRS), clinical judgments, Attention Deficit Disorders Evaluation Scale (ADDES), and the Strengths and Difficulties Questionnaire (SDQ) was found to be 13.125%, 13.38%, 26.135%, and 12.83%, respectively. The pooled prevalence of depressive symptoms solicited by the Patient Health Questionnaire (PHQ-9), Depression, Anxiety, and Stress Scale (DASS), and Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was 44.684%, 45.09%, and 26.12%, respectively. The pooled prevalence of anxiety according to the DASS and the MINI Kid was 57.04% and 17.27%, respectively, while the pooled prevalence of stress as per the DASS was found to be 43.15%. The pooled prevalence of disordered eating solicited by the Eating Attitudes Test (EAT-26) was 31.55%. Lastly, the pooled prevalence of tobacco use disorder per the Global Youth Tobacco Survey was 19.39%. DISCUSSION: To date, this is the first systematic review and meta-analysis of its kind from the GCC. The prevalence rate of CAMH disorders appears to be in the upper range of international trends. The higher rates could be attributed to the existing studies using suboptimal methodological approaches and instruments to solicit the presence of CAMH.

COVID-19 and the Clinical Phase of the Medical Doctorate Curriculum in Oman: Challenges and the way forward.

COVID-19 has gripped the world with lightning speed. Since the onset of the pandemic, activity throughout the world came to a grinding halt. However, business had to continue and people have to learn to live with the virus while the pandemic continues to rage. Medical education is no exception and may even deserve special mention, as it prepares frontline workers against the endemics of tomorrow. We discuss here the journey of medical education at the College of Medicine and Health Sciences at Sultan Qaboos University, Muscat, Oman, as the pandemic struck the world and Oman. This work suggests a roadmap for changes, discusses challenges and proposes measures to mitigate the effects of COVID-19 on medical schools.

Factors associated with self-reported medical errors among healthcare workers: a cross-sectional study from Oman.

BACKGROUND: Despite efforts to improve patient safety, medical errors remain prevalent among healthcare workers. OBJECTIVE: The aim of this study was to investigate the relationships between self-reported medical errors, occupational outcomes and socio-demographic variables. METHODS: The study employed a cross-sectional design to survey healthcare workers at a large tertiary hospital in Muscat, Oman. The survey questionnaire included socio-demographic variables, a self-assessment of medical errors, work-life balance, occupational burnout and work-related bullying. RESULTS: A total of 297 healthcare workers participated in this study. In this sample, the average of self-reported medical errors was 5.4 ± 3.3. The prevalence of work-life imbalance, bullying and moderate/high burnout was 90.2%, 31.3% and 19.5%, respectively. Multivariate analysis showed that gender, nationality, age, profession, occupational burnout and bullying were significantly associated with self-reported medical error. Being male was associated with higher self-reported medical errors compared to female workers (ß = 1.728, P < 0.001). Omani workers reported higher medical errors compared to their non-Omani colleagues (ß = 2.668, P < 0.001). Similarly, healthcare workers in a younger age group reported higher medical errors compared with those in the older age group (ß = ‒1.334, P < 0.001). Physicians reported higher medical error than nurses (ß = 3.126, P < 0.001). Among occupational outcomes, self-reported medical errors increased with higher burnout rates (ß = 1.686, P = 0.003) and frequent exposure to bullying (ß = 1.609, P < 0.001). CONCLUSION: Improving patient safety has become paramount in the modern age of quality improvement. In this study, medical errors reported by healthcare workers were strongly related to their degree of burnout and exposure to work-related bullying practice. This study makes a unique and tangible contribution to the current knowledge of medical errors among healthcare workers in Oman.

Socio-Cultural Constraints in Protecting Child Rights in a Society in Transition: A Review and Synthesis from Oman.

In line with international best practice, the Arabian Gulf countries have ratified the Convention on the Right of the Child (CRC), which has some clauses on child abuse and neglect. The present discourse, made from within an Arabian Gulf society, specifically Oman, reviews the socio-cultural differences of the region and explores the potential regional challenges for effectively implementing the CRC mandated child protection legislation. The international best practices evolved for individualistic, "guilt-based" societies, which may need to be modified to suit the "shame-based" collective societies in the Arabian Gulf where the individual autonomy is overridden by that of the family and society. This may mean that the entire spectrum of child abuse may need to be studied in-depth, starting from what constitutes child abuse and neglect, the methods adopted for identifying cases, setting preventive measures in place, applying penal and corrective action on the perpetrators, and helping the victims recover. It is posited that while modifying the laws may be straightforward, implementation of certain clauses may initially come into conflict with deeply engrained socio-cultural conventions on these societies which have different parenting styles and child-rearing practices. The country in focus is Oman. Pointing out the sparsity of research on the topic in the region, the study suggests additional research to understand how to reconcile these sociocultural constraints with the international best practices of protecting child rights.

Child Maltreatment Prevention Readiness Assessment in Oman.

OBJECTIVES: This study aimed to evaluate Oman's readiness for implementing large-scale child maltreatment prevention (CMP) programmes. METHODS: This cross-sectional study was conducted between May and August 2016 in Oman. Participants, referred to as key informants, were individuals with influence and decision-making powers over CMP. The multidimensional Readiness Assessment for the Prevention of Child Maltreatment tool, developed by the World Health Organization with the help of collaborators from middle- and low-income countries, was used to assess 10 dimensions of readiness, each with a maximum score of 10. RESULTS: A total of 49 participants were included in this study (response rate = 98%). The mean total score for the 10 dimensions was 50.17 out of 100 possible points. The participants showed high mean readiness scores on legislation, mandates and policies (9.08) followed by knowledge of CMP (7.55), institutional resources and links (6.12), willingness to address the problem (5.35), informal social resources (5.15) and current programme implementation and evaluation (5.10). Participants had low scores in readiness in association with human and technical resources (2.44), attitudes towards CMP (2.90), scientific data on CMP (3.06) and material resources (3.46). CONCLUSION: The results of this study indicate that Oman has a moderate level of readiness to implement large-scale evidence-based prevention programmes against child maltreatment; however, several dimensions still need to be strengthened. It is important to develop a national strategy that outlines a framework for organising and prioritising efforts towards CMP.

Child maltreatment prevention readiness in Gulf Cooperation Council (GCC) countries.

BACKGROUND AND OBJECTIVES: Child maltreatment (CM) is a global public health problem that has received growing attention over the past five decades. There have been many recent advances in child maltreatment prevention (CMP). The objective of this study is to assess CMP readiness to implement large-scale evidence-based CMP programs in Gulf Cooperation Council (GCC) countries. METHODS: This cross-sectional study (n = 244) was conducted in the GCC countries. Participants were key decision makers and senior managers in the field of CM. The Readiness Assessment for the Prevention of Child Maltreatment (RAP-CM) was used to assess 10 dimensions of CMP readiness. RESULTS: The key informants gave CMP readiness scores of 47.8 out of 100. Four of the dimensions (knowledge of CMP; legislation, mandates, and policies; institutional resources and links; and informal social resources) had high readiness scores (≥5), while six dimensions (attitudes towards CMP; scientific data on CMP; current program implementation and evaluation; will to address the problem; material resources; and human and technical resources) had low readiness scores (<5). CONCLUSION: GCC countries have moderate-to-fair readiness to implement large-scale evidence-based CMP programs. Strengthening their material, human, and technical resources, and improving the quality of scientific data, collaboration, and attitudes towards CMP are required to improve each country's readiness.

Hemoglobin F as a predictor of health-related quality of life in children with sickle cell anemia.

PURPOSE: As treatment options for children with sickle cell anemia (SCA) continue to expand survival, evaluation of factors associated with health-related quality of life (HRQoL) is becoming an important aspect for further improving clinical management. Although the general features of SCA are similar, factors influencing HRQoL within a country may differ from those of other countries, therefore this study aimed to explore factors affecting HRQoL in children with SCA living in the Sultanate of Oman. METHODS: This was a cross-sectional study in which the PedsQL™ Sickle Cell Disease Module was used to evaluate the overall HRQoL in children with SCA. The socio-demographic data, clinical, and treatment outcomes were collected. Univariate and multivariate linear regression analyses were used to identify predictors of HRQoL. RESULTS: A total of 123 children with SCA, aged from 2 to 16 years were enrolled. The mean total HRQoL score was 52 ± 15% (9-94), where Worry II scale recorded the highest score. The multiple regression analysis revealed that the only predictors of total HRQoL score were hemoglobin F (B = 0.64, 95% confidence interval [CI] 0.149-1.118, P = 0.009) and to a lesser degree white blood cell count (B = - 0.99, 95% CI - 1.761 to - 0.198, P = 0.01), independently of other study parameters such as age, gender, spleen status, and hydroxyurea therapy. CONCLUSIONS: Collectively, these findings indicated that hemoglobin F out-weighted white blood cell count in predicting HRQoL in Omani children with SCA. Recognition of these factors could help health professionals to develop effective strategies to improve the overall HRQoL in these young patients.

The Child Abuse Potential Inventory: Development of an Arabic version.

The Child Abuse Potential Inventory (CAPI) is a well-validated screening tool for assessing potential for child physical abuse, and has been translated into many different languages. To date the CAPI has not been translated into Arabic or used in any studies in Arabic-speaking populations. This study reports on the process of adapting the CAPI into Arabic Language which was undertaken following the International Society of Pharma-economics and Outcomes Research (ISPOR) guidelines. The translation/adaptation process was multi-stage, and involved the use of a Delphi process, cognitive debriefing, back translation, and a pilot testing of the Arabic CAPI at two primary health care centers with a population of pregnant women (n=60). Following "literal translation" 73 out of the 160 items needed re-phrasing to adapt the items to the Oman context. No differences were found when comparing results of the translated or back-translated versions to source; however, eight items needed further amendment following translated to back-translated comparison and feedback from the pilot. Iterations were resolved following in-depth interviews. Discrepancies were due to differences in culture, parenting practices, and religion. Piloting of the tool indicated mean score value of 155.8 (SD=59.4) and eleven women (18%) scored above the cut off value of 215. This Arabic translation of the CAPI was undertaken using rigorous methodology and sets the scene for further research on the Arabic CAPI within Arabic-speaking populations.

Impact of Burden of Thalassemia Major on Health-related Quality of Life in Omani Children.

To improve treatment outcome in young patients with homozygous ß-thalassemia, evaluation of factors associated with health-related quality of life (HRQoL) is essential to develop clinical, counseling, social, and school support programs. This study was performed to evaluate HRQoL in Omani children with thalassemia who have not been previously evaluated. All patients with thalassemia (5 to 18 y) on regular hypertransfusion from August 2013 to February 2014 were included. Demographic-clinical information was obtained from electronic patient records. The 23-item Pediatric Quality of Life Inventory (PedsQL) 4.0 with 4 multidimensional scales and 3 summary scores was used to assess HRQoL by both patients and caregivers. Statistical analysis was performed using SPSS version 19. Delayed age at diagnosis and delayed initiation of chelation were independently associated with a negative impact on total PedsQL scores; children with higher pretransfusion hemoglobin and lower serum ferritin levels scored better overall. Patients self-rated their HRQoL scores lower as compared with caregivers. Although physical health was more affected than psychosocial health function from both patients' (72.26±22.34 vs. 74.55±18.25) and caregivers' (69.91±19.86 vs. 78.83±18.45) perspective, school functioning domain (68.05±21.30 and 69.71±18.96) scored the lowest. Low ratings for physical health and school functioning highlight the importance of adequate transfusion together with the need for a multidisciplinary teamwork by health care providers, social workers, counselors, family members, and school authorities to provide psychosocial support to prevent mental issues and improve academic performance in these young patients.

Factors associated with pediatrician attitudes over the use of complementary and traditional medicine on children in Muscat, Oman.

This study aimed to evaluate the attitude of pediatricians toward the use of complementary and Traditional Medicine (TM) on children in Muscat, Oman. A cross-sectional survey was performed using a self-completed questionnaire during the year 2012. A total of 67 pediatricians, comprising of 30 males (44.8%) and 37 females (55.2%) participated in the study. The majority of the studied group (83.5%) was of the opinion that most types of complementary and TM are not safe for children, except spiritual healing, to which 53.7% considered as safe. About one third (29.9%) of the participants reported that they might recommend complementary and TM for sick children in the future. Almost half the participants (52.2%) acknowledged personal use of complementary and TM in the past and 67.2% reported that their family members used these medicines. Herbal therapy was found to be the most commonly used method (38.9%) followed by spiritual (33.9%), cautery (20.2%) and Curucoma (15.7%). Other methods, which include; acupuncture, bone healing and Chinese healing were also found to be in use but in rare manner. Knowledge level of TM and complementary medicine of most of the doctors was found to be low but one third of them acknowledged that they may recommend these treatments to their patients in future. Therefore, training pediatricians on the types, benefits and side effects of complementary and TM is recommended.

The magnitude and impact of bullying among school pupils in Muscat, Oman: a cross-sectional study.

Research about bullying among school pupils in the Arab/Muslim population is scarce. This study evaluates the characteristics of bullying and its impact among school pupils in Oman via cross-sectional survey among eighth grade school pupils (n = 1,229) during the academic year 2006-2007. The participants were selected using stratified random selection among 6 administrative divisions of one the governorates in the country. Data were collected using self-completed structured questionnaires. This study found similar percentages of males and females (76%) have experienced one form of bullying, and the majority of the incidents (80%) occurred in the vicinity of the school. In almost half of the cases, the bullying was initiated by a student of the same age or older than the victim. The most common type of bullying encountered in this study was verbal (47.7%), followed by misuse (45.9%), physical (43.9%), and, finally, social isolation/exclusion (22.5%). Although the failure of an academic year was uncommon among victims of bullying, the number of pupils who missed 4-6 and ≥ 7 school days was higher among bullied pupils. If this study will withstand further research, educational initiatives are needed to mitigate the rate of bullying in Oman.