Nutrients patterns and attention deficit hyperactivity disorder among Egyptian children: a sibling and community matched case-control study.

BACKGROUND: Attention Deficit Hyperactive Disorder (ADHD) diagnosis has been growing among children, with great public health concern. The relationship between nutrient intake pattern and ADHD remains unclear. AIM: To identify the nutrient intake patterns and its association with ADHD in children. SUBJECTS AND METHODS: The study involved 146 children with ADHD, 141 control sibling, and 146 community controls. ADHD diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) criteria following the assessment by the long-form Conner's Scale. Dietary intakes were assessed using a semi-quantitative food frequency questionnaire. Nutrients patterns were identified using the principal component analysis (PCA). RESULTS: ADHD children have significantly higher mean total energy intake than community controls and siblings (8867.9, 4481.9 and 7308.2 KJ, respectively, p < 0.001). Four nutrient patterns extracted by the PCA explained 75.9% of the total variance. Lower tertiles of "predominantly calcium-phosphorus; pattern 1" and "predominantly-vitamins; pattern 3" were significantly associated with increasing odds of ADHD, compared to community controls (p for trend: 0.002 and 0.005, respectively), while the same associations were noted in "predominantly-vitamins" and "predominantly Zinc-Iron; pattern 2" when compared to siblings (p for trend: <0.001 and <0.001, respectively). However, Higher tertiles of macronutrients; pattern 4" were associated with increased ADHD odds, compared to either community controls or siblings (p for trend: 0.017 and <0.001, respectively). CONCLUSION: Lower intakes of nutrients patterns of minerals and vitamins, and higher intakes of macronutrients were associated with increased likelihood of ADHD in children.

Corrigendum: Psychometric properties of the arabic version of the problem areas in diabetes scale in primary care.

[This corrects the article DOI: 10.3389/fpubh.2022.843164.].

Work-related injuries among 5 - 17 years-old working children in Egypt: findings from a national child labor survey.

BACKGROUND: Egypt has agreed and ratified international regulations that strict child labor. However, the country still struggles with high prevalence of child labor and the associated negative social and health effects. The objective of this study was to identify the prevalence and determinants of work-related injuries among working children in Egypt. METHODS: This study involved a secondary data analysis of the National Child Labor Survey (NCLS) conducted in 2010 by The Central Agency for Public Mobilization and Statistics (CAPMAS) in Egypt with technical and financial support from the ILO's International Program on the Elimination of Child Labor (IPEC) through its Statistical Information and Monitoring Program on Child Labor (SIMPOC). The total number of working children who responded to questions of work-related injuries in the NCLS child questionnaire was 7485 children. RESULTS: The prevalence of work-related injuries among working children in Egypt was estimated as 24.1% (95% CI: 22.0%-26.2%), of whom the majority were superficial wounds (87.3%). Among children who reported work-related injuries, 57.9% did not stop work or schooling because of the most serious injury, while 39.6% had stopped temporarily and 2.6% had stopped completely. The main determinants of work-related injuries among working children in the study sample were gender (boys), age of starting work (5-11 years), type of main economic activity (industry and services), type of main workplace (plantation, farms, or garden), the average work hours per week (28 h or more), and exposure to ergonomic and safety, and chemical hazards at work. CONCLUSIONS: The estimated high prevalence of work-related injuries among working children aged 5-17 years in Egypt raises the health risks concerns associated with child labor. Findings of this study on the determinants of work-related injuries could guide policies and interventions to combat child labor and the associated health risks, including work-related injuries.

Prevalence and Associated Factors of Diabetes Distress, Depression and Anxiety Among Primary Care Patients With Type 2 Diabetes During the COVID-19 Pandemic in Egypt: A Cross-Sectional Study.

The prevalence of type 2 diabetes mellitus (T2DM) is growing worldwide. T2DM is often complicated by a range of psychological disorders that interfere with glycemic control and self-care. Previous studies have reported diabetes distress, depression, and anxiety among patients with T2DM; however; little is known about the burden of these comorbid mental disorders in primary care patients with T2DM treated in Egypt during the COVID-19 era. Participants were selected by convenient sampling from eight rural primary healthcare facilities from Ismailia in Egypt. Symptoms of diabetes distress, depression and anxiety were assessed by using the Arabic version of the 20-item Problem Areas in Diabetes (PAID), Patient Health Questionnaire 9, and Generalized Anxiety Disorder Scales, respectively. Multiple hierarchical logistic regression models were used to estimate the significant factors associated with diabetes distress, depression, and anxiety. A total of 403 individuals with T2DM were interviewed. The prevalence of severe diabetes distress was 13.4% (95% CI: 10.1-16.7), while prevalence of depressive and anxiety symptoms was 9.2% (95% CI: 6.4-12.0%), and 4.0% (95% CI: 2.1-5.9), respectively. In a series of hierarchical logistic regression models, significant predictors for diabetes distress were being married, illiterate, not-working, living with insufficient income, and having multi-comorbidities. Likewise, the significant predictors for depression and anxiety were elevated glycated hemoglobin level and the higher PAID total score, while having multi-comorbidities was a significant predictor for anxiety only. Diabetes distress was more prevalent than depressive and anxiety symptoms in this study population. Several sociodemographic and clinical characteristics were identified to be related with psychological problems among patients with T2DM, which necessitate a multidisciplinary team-based approach for optimal screening and management.

Psychometric evaluation of the Arabic version of the 5-item Problem Areas in Diabetes (AR-PAID-5) scale.

BACKGROUND: Screening for diabetes distress is recommended when caring for patients with type 2 diabetes mellitus (T2DM) in primary healthcare (PHC). The 5-item Problem Areas in Diabetes (PAID-5) scale is widely used to measure diabetes distress, but its Arabic validation studies are scarce, so this study was carried to assess the psychometric properties of the Arabic version of the PAID-5 (AR-PAID-5) in Egyptian PHC patients with T2DM. METHODS: We conducted a cross-sectional study including 260 participants from six rural PHC settings in Ismailia governorate, Egypt. Internal consistency using Cronbach's α and one-month test-retest reliability using intraclass correlation coefficient (ICC) were investigated. Confirmatory factor analysis (CFA) was used to evaluate the one-factor structure of the AR-PAID-5. Correlations of the AR-PAID-5 with the Arabic versions of the 20-item Problem Areas in Diabetes (PAID), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), 5-item World Health Organization Well-Being Index (WHO-5) scales and glycated hemoglobin (HbA1c) were investigated for supporting the convergent validity. Associations of the PAID-5 with sociodemographic, and clinical characteristics were assessed for demonstrating the discriminant validity. Criterion validity was also evaluated. RESULTS: There was a good internal consistency (α = 0.88) and a stable test-retest reliability (ICC = 0.74). The CFA confirmed the one-factor structure of the AR-PAID-5. Significant positive correlations existed between the AR-PAID-5 with diabetes distress evaluated by the Arabic version of the PAID (rho = 0.93, p < 0.001), depressive symptoms (PHQ-9) (rho = 0.56, p < 0.001), anxiety symptoms (GAD-7) (rho = 0.47, p < 0.001), emotional well-being (WHO-5) (rho = - 0.38, p < 0.001), and HbA1c (rho = 0.16, p = 0.003). A satisfactory discriminant validity, and an acceptable criterion validity were demonstrated. CONCLUSIONS: The AR-PAID-5 scale is a reliable and valid tool that can be used for diabetes distress screening and in research in Arabic speaking PHC patients with T2DM.

Occupational Burnout and Productivity Loss: A Cross-Sectional Study Among Academic University Staff.

Background: Burnout has been endorsed with serious negative health- and work-related outcomes. This study is aimed to assess the prevalence of burnout and its association with work productivity among academic staff. Methods: This cross-sectional study involved 240 academic staff working at a public university in Egypt. Participants were invited to complete a web-based questionnaire involving basic personal, health, and work-related characteristics. Besides, Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to assess occupational burnout dimensions (i.e., emotional exhaustion "EE," depersonalization "DP," and personal accomplishment "PA"), while work productivity was assessed with the Health and Work Performance Questionnaire (HPQ). Results: In total, 28% of respondents scored high in EE [95% confidence interval (CI): 22.5-33.8%], 18.3% high in DP (95% CI: 13.8-3.6%), and 88.3% scored low in PA (95% CI: 83.8-91.9%). Seventy percent of respondents scored high in only one burnout dimension, 21.7% scored high in two dimensions, while 7.1% scored high in all three dimensions. Multivariable analysis showed that EE was the only burnout dimension that showed a statistically significant association between absenteeism and presenteeism rates. The absenteeism rates among respondents with moderate and high EE were 2.1 and 3.3 times the rates among those with low EE, respectively. Likewise, the presenteeism rates among respondents with moderate and high EE were 2.4 and 4.7 times the rates among those with low EE, respectively. Conclusions: Academic staff showed a high prevalence of at least one burnout dimension. Moderate and high EE scores were significantly associated with increased productivity loss when compared to low EE.

Psychrometric Properties of the Arabic Version of the Problem Areas in Diabetes Scale in Primary Care.

Background: The Problem Areas in Diabetes (PAID) scale is a reliable and valid tool that is widely used for diabetes-distress screening, but the Arabic version of the scale lacks validity and reliability analysis in primary healthcare (PHC) patients. Our study aimed to evaluate the psychometric properties of the Arabic version of the PAID (AR-PAID) scale among Egyptian patients with type 2 diabetes mellitus (T2DM) in PHC settings. Methods: We conducted a cross-sectional study on a convenience sample of 200 patients from six rural PHC settings in the Ismailia governorate. The confirmatory factor analysis (CFA) was performed to test the goodness-of-fit to the predefined models of the PAID. Convergent construct was evaluated through correlations with the Arabic versions of the Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and 5-item World Health Organization Well-Being Index (WHO-5), additionally glycated hemoglobin (HbA1c) levels. Discriminant validity was evaluated through associations with patients' sociodemographic and clinical characteristics. Reliability was evaluated through internal consistency (Cronbach's α) and test-retest reliability analysis (intraclass correlation coefficient, ICC). Results: The CFA demonstrated the best fit for a four-factor model. The AR-PAID was significantly correlated with the following measures: PHQ-9 (rho = 0.71, p < 0.001), GAD-7 (rho = 0.50, p < 0.001), WHO-5 (rho = -0.69, p < 0.001), and HbA1c (rho = 0.36, p < 0.001), supporting sound convergent validity. Discriminant validity was satisfactory demonstrated. Internal consistency was excellent (α = 0.96) and test-retest reliability was stable (ICC = 0.97). Conclusions: The AR-PAID scale is a valid and reliable instrument for diabetes-distress screening in primary care patients with T2DM that can be used in clinical settings and research. Further research is needed to validate short forms of the AR-PAID scale.

Knowledge, Attitude, and Practice of Cervical Cancer Screening, and HPV Vaccination: A Cross-Sectional Study Among Obstetricians and Gynecologists in Egypt.

BACKGROUND: Although cervical cancer is potentially preventable, lack of knowledge and poor attitude among healthcare professionals toward cervical cancer screening and Human Papilloma Virus (HPV) vaccination can result in underutilization of these preventive strategies. Then, the objective of this study was to assess the knowledge, attitude, and practice of cervical cancer and its prevention through Pap test screening and HPV vaccination among obstetricians and gynecologists (Ob-Gyns). METHODS: A cross-sectional study was conducted on 250 Egyptian attendees of a national Ob-Gyns professional conference. Data collection was performed using a pre-designed self-administered questionnaire, which tested participants' knowledge, attitude, and practices related to cervical cancer, Pap test screening, and HPV vaccination. RESULTS: The study included 41.2% Ob-Gyns specialists and 37.6% of consultants from secondary and tertiary care hospitals or centers. About 45% of participants had poor-to-fair knowledge, 57% had negative-to-fair positive attitudes toward cervical cancer screening and HPV vaccination, and 44% had ever-performed Pap test, while 45% of participants had ever-prescribed the HPV vaccine to their patients. Physicians' knowledge and attitude were significantly associated with their age, professional level, work experience, and place of work. Although performing cervical cancer screening was significantly more common among older, more experienced, and highly professional participants, HPV vaccine prescription was associated with young, less experienced participants at lower educational and professional levels. CONCLUSION: Ob-Gyns had poor-to-fair knowledge, Attitude, and practices related to cervical cancer, Pap test screening, and HPV vaccination.