Dental decay in children and the link to weight status: A cross-sectional analysis of national school health data.

Recent national reports have indicated an increasing trend of dental decay among school-aged children. National school-based data are required to guide decision-making to ensure effective public health efforts to manage dental decay. This study aimed to assess the prevalence of dental decay among school-age children in Saudi Arabia and explore the possible link between dental decay and weight status. This was a cross-sectional analysis of a national sample including 1,134,317 Saudi children in the 1st, 4th, 7th, and 10th grades who participated in a national school screening program. Data for weight, height, body mass index (BMI), dental decay prevalence, and decayed, missing, and filled teeth (DMFT) index were analysed. An independent t-test, one-way analysis of variance, and chi-square test were used to compare the means, while Pearson's r correlation and multiple linear regression were used to examine the relationships between the study variables. The prevalence of dental decay was 24.20%, and dental decay was the highest among female students (26.5%), students in primary school (25.9%), students living in the eastern region (35.2%), in the administrative capital (27.6%), and in rural areas (23.4%). Dental decay was the highest among students who were underweight. Female sex and living in rural areas significantly predicted higher DMFT while being overweight/obese significantly predicted lower DMFT. Dental decay is highly prevalent among underweight students, female students, and students living in rural areas and the eastern regions of Saudi Arabia. To reduce the prevalence of dental decay and related health disparities, dental health screening programs should be designed to detect dental decay early among children at high risk due to abnormal BMIs and sociodemographic factors. In addition, dental health screening and management programs should utilize standardized dental decay assessment methods and ethnically representative growth charts.

Assessing the readiness to transition to adult care, perceived medication barriers, and glycemic control among teens with type 1 diabetes.

AIM: This study assessed the readiness to transition (RT) from pediatric to adult care, perceived medication barriers (PMB), and glycemic control in teens with type one diabetes (T1D). BACKGROUND: During the transition from pediatric to adult care, teens with T1D are at risk of long-term complications related to impaired adherence. With the increasing prevalence of T1D in Saudi Arabia, research is required to identify the challenges facing teens with T1D during their transition. METHODS: This was a cross-sectional study with a convenient sample of 83 adolescents (12-17 years old) diagnosed with T1D for ≥6 months, their parents, and their pediatric endocrinologists from the pediatric endocrinology clinic in a tertiary hospital in Riyadh. The RT Questionnaire was used to measure RT, and the Medication Barriers Scale was used to measure PMB. Glycemic control was measured using hemoglobin A1c (HbA1c). RESULTS: About 96 % of teens had HbA1c > 7 %. Male teens had higher HbA1c than female teens. Teens and their parents reported high PMB and low RT. PMB (teens), disease duration, family history of diabetes mellitus, and comorbidity were significant predictors of RT (parents). PMB (teens), teens' age, and having a family history of diabetes mellitus were significant predictors of RT (providers). RT (parents) and RT (providers) were the only significant predictors of HbA1c, with RT (providers) being the strongest predictors of HbA1c. CONCLUSIONS: Health policy reform is required to develop national RT programs to prepare teens with T1D to take full responsibility for managing their medical conditions while ensuring adherence.

Role delineation of advanced practice nursing: A cross-sectional study.

AIMS: To identify the roles and activities of nurses, including advanced practice nursing (APN), and to determine nursing practice patterns across health facilities in Saudi Arabia. METHODS: A descriptive cross-sectional design was used to collect data from 207 nurses working in the Saudi health sector between November 2021 and March 2022 through an online questionnaire. The Advanced Practice Role Delineation tool was used to measure and delineate nursing practice patterns and activities. Data were analysed using descriptive statistics and analysis of variance. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines. RESULTS: Findings showed that participants, regardless of their current role, reported high scores across all domains of practice. The highest average score was obtained for the Clinical Care domain. Except for the leadership domain, findings showed that those reported working as advanced practice nurses had higher average scores across all domains than those working as staff nurses or being in managerial/administrative positions. There were significant differences in the average Clinical Care scores between advanced practice nurses and staff nurses. CONCLUSION: Advanced practice nursing roles and activities are being practised in Saudi Arabia; however, there is no clear delineation of these roles and activities according to a unified and national-level APN scope of practice. IMPACTS: Advanced practice nursing roles are evolving in Saudi Arabia; however, no study has examined the existing patterns of APN activities in Saudi Arabia. This study highlights the practice patterns of advanced practice nurses and adds to the international evidence base on the need for delineating APN activities under a unified scope of practice. The findings of this study are beneficial to practitioners, researchers, and stakeholders as well as the legislative and regulatory bodies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The shifting patterns of childhood obesity: Insights from national school screening data.

Background: Recent reports indicated an increasing prevalence of obesity among children and adolescents in Saudi Arabia, making it an impending national epidemic. However, obesity prevalence data in children and adolescents in Saudi Arabia are largely inconsistent. Objectives: This study analyzed and compared the prevalence of obesity among a national sample of children and adolescents across sexes, school grades, regions, and city types in Saudi Arabia using the Growth Charts for Saudi Children and Adolescents. Methods: Weight, height, and body mass index (BMI) data from 1 134 317 children in first, fourth, seventh, and tenth school grades who participated in the national school screening program were analyzed cross-sectionally. BMI values were classified using the Growth Charts for Saudi Children and Adolescents. Results: Nearly 10.4% of students were overweight, 10.7 % were obese, and 4.50% were severely obese. Male students had a higher prevalence of overweight and obesity than their female counterparts. The prevalence of overweight and obesity was the highest among students in intermediate school, the Central region, and administrative capitals. Conclusion: Managing childhood obesity is challenging due to its multifaceted nature Therefore, utilizing clinical and community-based participatory approaches is essential to develop nationwide obesity prevention and management program that is effective and sustainable. This program must utilize dynamic BMI surveillance systems using ethnically representative growth references, conduct national pediatric obesity research with careful consideration for demographic and regional differences, lead targeted pediatric obesity awareness campaigns, provide obesity management interventions in a pediatric multi-disciplinary clinic, and evaluate the program outcomes periodically.

The link among academic stress, sleep disturbances, depressive symptoms, academic performance, and the moderating role of resourcefulness in health professions students during COVID-19 pandemic.

BACKGROUND: The rapid shift to virtual learning in response to the COVID-19 pandemic contributed to high academic stress among health profession students. High academic stress was associated with impaired psychosocial well-being and decreased academic performance. OBJECTIVES: The purpose of this study was to assess the relationship between academic stress, anxiety, sleep disturbances, depressive symptoms, academic performance, and the moderating effect of resourcefulness among undergraduate health profession students. METHODS: This descriptive and cross-sectional study included undergraduate health profession students. The primary investigator distributed the study link to all students through the university's Central Messaging Centre, Twitter account, and WhatsApp. The study variables were measured using the Student Life Stress Inventory, the Generalized Anxiety Disorder-7 questionnaire, the Centre for Epidemiology Scale of Depression, the Pittsburgh Sleep Quality Index, and the Resourcefulness Skills Scale. Pearson R correlation and linear regression analysis were utilized for statistical analysis. RESULTS: Our sample included 94 undergraduate health profession students, 60 % of which were females with a mean age of 21, and the majority were nursing and medicine students. High academic stress, anxiety, sleep disturbances, depressive symptoms, and resourcefulness were reported among 50.6 %, 43 %, 79.6 %, 60.2 %, and 60 % of the participants, respectively. However, no effect of resourcefulness was found on any of the study variables. Instead, academic stress and sleep disturbances were the strongest predictors of depressive symptoms regardless of the level of resourcefulness. CONCLUSION: Adequate academic support during virtual learning and tools to early detect subtle signs of high academic stress, anxiety, depression, and sleep disturbance should be routinely utilized by educational institutions. In addition, incorporating sleep hygiene and resourcefulness training in health professions education is highly indicated.

Calcium Channel Blocker Toxicity: A Practical Approach.

Calcium channel blockers (CCBs) are widely prescribed medications for various clinical indications in adults and children. They are available in both immediate and long-acting formulations and are generally classified into dihydropyridines and nondihydropyridines, with nondihydropyridines having more cardioselectivity. CCB toxicity is common given the widespread use which leads to serious adverse clinical outcomes, especially in children. Severe CCB toxicities may present with life-threatening bradycardia, hypotension, hyperglycemia, and renal insufficiency. Dihydropyridine toxicity, however, may present with reflex tachycardia instead of bradycardia. Initial patient evaluation and assessment are crucial to identify the severity of CCB toxicity and design the best management strategy. There are different strategies to overcome CCB toxicity that requires precise dosing and close monitoring in various patient populations. These strategies may include large volumes of IV fluids, calcium salts, high insulin euglycemia therapy (HIET), and vasopressors. We hereby summarize the evidence behind the management of CCB toxicity and present a practical guide for clinicians to overcome this common drug toxicity.

The link between executive function, socio-emotional functioning and health-related quality of life in children and adolescents with mild to moderate chronic kidney disease.

BACKGROUND: Children and adolescents with mild to moderate chronic kidney disease (CKD) are at high risk for mild but persistent impairment in executive functions, which have been associated with low health-related quality of life (HRQOL) among children and adolescents with chronic health conditions. However, no similar link has been established among children and adolescents with mild to moderate CKD. Given the essential role executive functions play in the development of adequate cognitive, emotional and social skills, it is essential to gain a clearer understating of the magnitude and attributes of executive functions and its link to HRQOL in order to inform appropriate medical and educational interventions for this patient population. OBJECTIVE: The aim of this study is to examine the relationship between executive functions, socio-emotional functioning and HRQOL in children and adolescents with mild to moderate CKD. METHODS: A cross-sectional design was used for this secondary data analysis of 199 children and adolescents (ages 6-17) with mild to moderate CKD from the United States and Canada who receive care at hospitals associated with the Chronic Kidney Disease in Children Study (CKiD). RESULTS: The presence of impairment in executive functions and socio-emotional functioning (internalizing problems) significantly predicted lower HRQOL after controlling for key covariates (i.e., maternal education, anaemia and hypertension). Further, internalizing problems partially mediated the relationship between executive functions and HRQOL such that impairment in executive functions predicted lower HRQOL directly and indirectly by contributing to higher internalizing problems, which further contributed to low HRQOL. CONCLUSION: This study underscores the importance of executive functions and socio-emotional functioning in the manifestation of HRQOL. Given that HRQOL is potentially compromised for many children and adolescents with mild to moderate CKD, it will be important for both clinicians and researchers to examine a range of factors, including executive functions and socio-emotional functioning, in order to optimize HRQOL.

Saudi nursing students' graduate program experiences from reality shock to reaching desired outcomes: A qualitative study.

BACKGROUND: Graduate students across disciplines encounter countless academic, social, individual, and financial challenges. Research in nursing has shown that nursing students have trouble during their graduate studies. However, this phenomenon has not yet been explored in Saudi Arabia. PURPOSE: To explore the obstacles faced by graduate nursing students; assess the effects of these difficulties on their academic, social, and psychological life; determine how the students overcame these challenges; and recognize their needs throughout the graduate program. METHODS: We used a qualitative descriptive method to interview 14 graduate nursing students from various graduate programs in Saudi Arabia. All interviews were conducted on Zoom platform and were audio recorded. Thematic analysis was used to analyze the data. RESULTS: The findings revealed that graduate nursing students went through three particular stages during the program. These were reality shock, accepting challenges, and reaching desired outcomes. CONCLUSIONS: The findings will help decision makers in supporting and designing programs that facilitate graduate students' experiences. It will also help in improving the quality of graduate programs, by attracting and retaining more Saudis to pursue their graduate studies.

Mothers' Voices Related to Caregiving: The Transition of a Technology-Dependent Infant from the NICU to Home.

PURPOSE: The transition from the NICU to home is a complicated, challenging process for mothers of infants dependent on lifesaving medical technology, such as feeding tubes, supplemental oxygen, tracheostomies, and mechanical ventilation. The study purpose was to explore how these mothers perceive their transition experiences just prior to and during the first three months after initial NICU discharge. DESIGN: A qualitative, descriptive, longitudinal design was employed. SAMPLE: Nineteen mothers of infants dependent on lifesaving technology were recruited from a large Midwest NICU. MAIN OUTCOME VARIABLE: Description of mothers' transition experience. RESULTS: Three themes were identified pretransition: negative emotions, positive cognitive-behavioral efforts, and preparation for life at home. Two posttransition themes were negative and positive transition experiences. Throughout the transition, the mothers expressed heightened anxiety, fear, and stress about life-threatening situations that did not abate over time despite the discharge education received.