Nutritional Knowledge, Attitudes, and Practices among Family Physician Practitioners in Gulf Countries (Bahrain, Kuwait, Saudi Arabia, and UAE).

Family physicians serve as pivotal points of contact within global healthcare systems. Nutrition plays a significant role in lifestyle and preventive medicine. With the rise of chronic and non-communicable diseases in Gulf Cooperation Council (GCC) countries, these physicians advise patients and the public on diet-related conditions. This descriptive cross-sectional study assessed the nutritional knowledge and practices across the GCC. Combining survey data from multiple GCC sites, a sample of family physicians was generated. Registered GCC family physicians received email invitations containing participant information, informed consent forms, and a self-administered online questionnaire. Analysis of data from four GCC countries involving 8751 family physicians and nutrition experts revealed an average nutrition knowledge score of 62%. Nearly all participants recognized the importance of nutrition in preventing and treating chronic diseases. Common nutritional practices included recommending regular exercise (92%), referring patients to dietitians for nutrition-related concerns (70%), and providing nutrition advice (68.6%). GCC family physicians underscore the significance of nutrition in preventing and managing chronic ailments. Therefore, incorporating nutritional counseling into their practices is essential. This study highlights the need to integrate nutrition education into medical curricula and ongoing professional development, given that only 62% of GCC family physicians correctly answered nutrition-related questions.

UAE Women's Knowledge and Attitudes towards Physical Activity during Pregnancy.

The benefits of being physically active during pregnancy are widely acknowledged. It is important for the prevention of chronic diseases and the promotion of good health for mothers and children. However, physical activity by women in the UAE is notoriously low and reduced further during pregnancy. The same can be said regarding research about the knowledge and understanding of the benefits and risks associated with exercise as a predictor of behavior. We aimed to assess knowledge and attitudes towards physical activity during pregnancy amongst Emirati women. A cross-sectional digital survey was designed to assess knowledge and attitudes and distributed to women, aged 18-40 years, using non-randomized, purposeful snowball sampling. A total of 1538 women were recruited. Most participants were aged 20-29 years (53.5%), were Emiratis (88.9%), and had no history of chronic disease (68.6%). The participants self-reported very low levels of PA (75.5%) and had a below-average level of knowledge overall (40.6 ± 20). Younger ages (p < 0.001), lower educational levels (p = 0.004), being employed (p = 0.014), and having a history of chronic disease (p = 0.016) were significantly associated with lower mean knowledge scores, while being married (p = 0.003) was significantly associated with higher scores. The participants also exhibited a positive attitude towards physical activity during pregnancy by selecting answers that they supported it. To encourage physical activity, women living in the UAE could benefit from clear advice about safe physical activity during pregnancy.

The attitudes and practices of United Arab Emirates consumers towards food waste: A nationwide cross-sectional study.

Background: Reducing global food waste is an international environmental, health, and sus-tainability priority. Although significant reductions have been achieved across the food chain, progress by UAE households and consumers remain inadequate. This study seeks to understand the association between consumer attitudes, knowledge, and awareness relating to food waste practice of residents living in the UAE. to help inform policy and action for addressing this national priority. Methods: A cross-sectional study was conducted using a validated semi-structured online questionnaire through stratified sampling (n =1052). The Spearman correlation coefficient was performed to determine the correlations. Two independent regression analysis were used to determine the association between food waste practice with: 1) knowledge and awareness and attitude subdomains, and 2) sociodemographic characteristics. Respondents (n=1072) largely reflect the socio-demographic characteristics and population distribution across the seven Emirates. Results: As expected, a significant and negative correlation was found between food waste practice knowledge and awareness and overall attitude. The regression models showed reduced food waste practice was associated with better knowledge, personal attitude, financial attitude (first model), older age and fewer adults in the household (second model). We found a significant and negative association of personal attitude (a commitment, intention), financial attitude (cost-saving motivation), and (existing) knowledge of Food waste (FW) with practice of food waste, indicating that better knowledge about FW, personal attitude or financial attitude was associated with reduction in undesirable food waste practice. While awareness and emotional attitude (moral concerns) were positively and significantly associated with food waste practice (undesirable behaviour). Conclusions: Food waste poses significant challenges in the UAE, and addressing it requires a comprehensive understanding of the multifaceted factors influencing consumer behavior. By promoting knowledge, fostering positive attitudes, and considering socio-cultural factors, policymakers can develop effective strategies to reduce food waste in households and contribute to sustainable development goals.

Can Weight Watchers (WW) Help Address Maternal Obesity? An Audit of Weight Change in Women of Childbearing Age and Mothers-To-Be, Referred into a Commercial Slimming Programme.

OBJECTIVES: The scale of overweight and obesity amongst women of childbearing age or mothers to be, living in Wales, places a considerable burden on the NHS and public health. High BMI (over 30) during pregnancy increases the health risks for mother and baby. Policy advice recommends weight management services are available to help women lose weight before and whilst planning pregnancy. In parts of Wales, NHS partnerships with commercial companies provide weight management services for women considering or planning pregnancy. This study evaluates whether an established referral Weight Watchers (WW) programme, known to be effective in adults in England, can help mothers-to-be living in North Wales lose weight. METHODS: Analysis used routine data from 82 referrals to WW between June 2013 and January 2015. Participants received a referral letter inviting them to attend face-to-face group workshops combined with a digital experience. The programme encompassed healthy eating, physical activity and positive mind-set. Trained WW staff measured bodyweight before, during and at 12 weeks. On entry to the course, participants had a median age of 31.4 years (interquartile range (IQR) 28-34) with a median BMI of 36.8 kg/m2 (IQR 33.3-43.7). RESULTS: Women completing the course (n = 34) had a median weight loss of 5.65 kg (IQR 0.45-10.85), equating to 5.7% (SD 3.46) of initial body weight. Intention-to-treat analysis (last observation carried forward), which included lapsed courses n = 66, showed a median weight loss of 3.6 kg (IQR - 2.53 to 9.73), equating to 3.7% (SD 3.62) of initial body weight. Overall, there was significant weight loss during the WW programme (Wilcoxon signed rank test Z = - 6.16; p < 0.001). Weight loss was significantly correlated with the number of workshops attended (Spearman correlation coefficient 0.61 p < 0.001). The proportion of all 82 participants (intention to treat, baseline observation carried forward) that achieved a weight loss of ≥ 5% initial weight was 30.5%. CONCLUSIONS FOR PRACTICE: Referral of obese mothers-to-be into WW can successfully achieve short-term weight loss, at or above 5%, in approximately one third of participants. The dose-response effect supports a causal inference. Successful weight loss at this critical life stage may provide women with the necessary motivation to initiate weight loss for healthy pregnancy, however further research is required.

Implementing AORN recommended practices for a safe environment of care, part II.

Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN "Recommended practices for a safe environment of care, part II" provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distractions. Whether the OR suite evolves through construction, reconstruction, or remodeling, a multidisciplinary team of construction experts and health care professionals should create a functional plan and communicate at every stage of the project to maintain a safe environment and achieve a well-designed outcome. Emergency preparedness, a facility-wide security plan, and minimization of noise and distractions in the OR also help enhance the safety of the perioperative environment.

Eating for 1, Healthy and Active for 2; feasibility of delivering novel, compact training for midwives to build knowledge and confidence in giving nutrition, physical activity and weight management advice during pregnancy.

BACKGROUND: Women in Wales are more likely to be obese in pregnancy than in any other United Kingdom (UK) country. Midwives are ideally placed to explore nutrition, physical activity and weight management concerns however qualitative studies indicate they lack confidence in raising the sensitive issue of weight. Acknowledging this and the reality of finite time and resources, this study aimed to deliver compact training on nutrition, physical activity and weight management during pregnancy to increase the knowledge and confidence of midwives in this subject. METHODS: A compact training package for midwives was developed comprising of evidence based nutrition, physical activity and weight management guidance for pregnancy. Training was promoted via midwifery leads and delivered within the Health Board. Questionnaires based on statements from national public health guidance were used to assess changes in self-reported knowledge and confidence pre and post training. Descriptive statistics were applied and 95% confidence intervals were calculated. RESULTS: 43 midwives registered for training, 32 (74%) attended and completed the questionnaires. Although, pre training knowledge and confidence varied between participants, statistically significant improvements in self-reported knowledge and confidence were observed post training. 97% indicated knowledge of pregnancy specific food and nutrition messages as 'better' (95% CI 85 to 100), as opposed to 3% stating 'stayed the same'--60% stated 'much better'. 83% indicated confidence to explain the risks of raised BMI in pregnancy was either 'much' or 'somewhat better' (95% CI 66 to 93), as opposed to 17% stating 'stayed the same'. 89% indicated confidence to discuss eating habits and physical activity was 'much' or 'somewhat better' (95% CI 73 to 97) as opposed to 11% stating 'stayed the same'. Emergent themes highlighted that training was positively received and relevant to midwifery practice. CONCLUSIONS: This study provides early indications that a compact nutrition, physical activity and weight management training package improves midwives self-reported knowledge and confidence. Cascading training across the midwifery service in the Health Board and conducting further studies to elicit longer term impact on midwifery practice and patient outcomes are recommended.

Exploring salutogenic mechanisms of an outdoor experiential learning programme on youth care farms in the Netherlands: untapped potential?

This study explored how (learning) experiences offered through outdoor experiential programmes, particularly the youth care farm approach, may (or may not) enhance young peoples' ability to recognise and then utilise available resources for personal growth, protection and health promotion. A total of 11 youngsters were asked to look back on their half-year stay on a care farm in the Netherlands, by using semi-structured interviews to elicit their experiences from a salutogenic perspective. Analysis revealed that several resources (and the interaction of these resources) on the youth care farm worked well for the youngsters; contributed to their personal development and to their sense of coherence: the feeling that the world is or can be meaningful, comprehensible and manageable, associated with positive outcome in endeavours linked to improving health and well-being. In general, the attitude of the farmer, working with animals, the informal atmosphere and being temporarily cut-off from the former environment were elements most positively highlighted by the youngsters. The farm environment was mentioned as calming, however, as structuring as well. The strength of the programme as an experiential learning opportunity appears to be the diversity and richness of resources (and stressors!) available to the participants. This creates various opportunities for learning: making sense, interpreting and giving meaning to resources and stressors. Further research into the impact of this kind of programmes, compared to more 'traditional' programmes, especially on the ability of youngsters to use resources to finish school, find employment and develop better relationships with their parents is recommended.

Wellbeing for homeless people: a Salutogenic approach.

Homelessness affects considerable numbers in the UK and is caused by poverty and social exclusion. Much of the literature on housing and health is disease centric, where the experience of homelessness is described as traumatic, disempowering and socially isolating. Based on the Salutogenic approach, which calls for a positive orientation on health, the aim of this study was to explore the subjective lived experiences of wellbeing in the situated context of homeless people's lives. Nine in-depth qualitative interviews with temporarily housed adults (>25 years) in a socio-economically deprived region of North-west England were held. Accounts of renewed self-confidence, perceived resourcefulness and continual personal participation are said to be supporting wellbeing. A strong belief, or sense of coherence, in internal and external general resistance resources was a critical enabling factor for those living in temporary accommodation. Wellbeing was consistently linked with both social and formal activities; keeping occupied and having a strong sense of purpose were essential to wellbeing. In utilizing a Salutogenic approach we demonstrate how the 'context and meaning' of health actions can improve the understanding about the kinds of factors influencing wellbeing.

Implementing AORN recommended practices for sterile technique.

Using sterile technique helps prevent the surgical environment from becoming contaminated and thus can help reduce the incidence of surgical site infection. The AORN "Recommended practices for sterile technique" provides guidance for setting up, maintaining, and monitoring a sterile field. Topics include the use of surgical attire and personal protective equipment; appropriate selection and evaluation of surgical gowns, gloves, and drape products for each procedure; use of sterile technique to don sterile gowns and gloves; appropriate methods for establishing and monitoring a sterile field; and techniques to ensure that items such as surgical instruments that may be contaminated are not used. Breaks in sterile technique should be corrected immediately unless the actions necessary would endanger the patient. If remedial actions must be delayed, they should be undertaken as soon as possible. Adhering to best practices for sterile technique requires remaining up to date with new approaches and incorporating these into quality initiatives.

Evaluating the implementation of the WHO Healthy Cities Programme across Germany (1999-2002).

The WHO Healthy Cities Project (1988) is a well-known example of the setting-based approach to health promotion. Developed as a framework for translating the key principles of the Ottawa Charter for Health Promotion (1986) into practice, it is best characterized as a process for successfully encouraging healthy public policy. In 2001, the German Healthy Cities Network (HCN) commissioned a survey of the 52 local Healthy Cities programme Coordinators (HCC) to monitor progress and identify strengths and weaknesses associated with its implementation. Most (90%; 47/52) HCC participated in the survey. Several positive aspects of the Health Cities Programmes (HCP) in Germany were identified: during the first 5 years, it expanded rapidly; project coordinators felt highly engaged, despite limited resources; a combination of traditional and innovative approaches was adopted and applauded; and almost 75% of HCC felt that their efforts had been beneficial. Nonetheless, the following shortcomings were identified: increased resources required; greater clarification of concepts and strategies at the local level; stronger commitment to the Nine-Point Programme of Action; greater integration within the national HCN and the local political administrative system (PAS); better programme documentation and evaluation. In conclusion, the HCN in Germany has expanded and developed since its inception 20 years ago. German HCP will only improve if professionalism and quality of local work are improved, particularly in terms of strengthening their influence on the local PAS and on public policies.