Anxiety and fear of COVID-19 as potential mechanisms to explain vaccine hesitancy among adults.

Background: Vaccine hesitancy is a significant global problem resulting from the interaction of multiple factors, including mental health factors. However, the association of COVID-19 vaccine hesitancy with mental health has not been well-examined, especially in Arab culture. This study aims to identify the correlation between anxiety/fear of COVID-19 and vaccine hesitancy among Saudi adults. Methods: An online-based survey was administered to 558 participants from all regions of Saudi Arabia using the snowball technique. However, this sample may not be representative of the Saudi adult population. Participants responded to the Questionnaire of Vaccine Hesitancy, the COVID-19-Anxiety Questionnaire (C-19-A), and the Fear of COVID-19 Scale (FCV-19S). Data were analyzed on vaccine uptake, vaccine hesitancy, coronavirus infection, and demographic variables. The predictive factors of vaccine hesitancy were examined in one model using multiple regression analysis by the Enter method (P= 0.05). Results: COVID-19 anxiety and fear have significant correlations with vaccine hesitancy (Phi=0.33, P=0.017; Phi=0.29, P=0.013, respectively). Anxiety and fear were higher among unhesitating participants (t =2.469, P=0.014; t=2.025, P=0.043, respectively). Participants who had previously been infected with coronavirus were more likely to be hesitant (X2 = 23.126, P=0.000). Participants who scored high in anxiety were more likely to be vaccinated (F=3.979, P=0.019) and have a secondary school or college education (F=4.903 P=0.002). COVID-19 anxiety, gender, and coronavirus infection significantly predicted vaccine hesitancy. Conclusion: Anxiety and fear of COVID-19 are among the most important factors correlated with vaccine hesitancy; unhesitant people are more likely to have anxiety and fear. COVID-19 anxiety significantly predicted vaccine hesitancy. We recommend integrating psychological care into vaccination plans to help increase the uptake rate during potential subsequent pandemics. Relevant intervention programs can be designed to help increase vaccine acceptance, deal with vaccine hesitancy, and relieve psychological symptoms during major pandemics. Psychologists can provide awareness messages, counselling seminars, online mentoring, or telemental health outreach.

Exploring Mental Health Literacy and Its Associated Factors: A National Cross-Sectional Study in Saudi Arabia, 2023.

Objective: The aim of this study is to examine, for the first time, the mental health literacy of the Saudi general population. Additionally, we aim to identify demographic factors associated with elevated mental health literacy scores. Methods: A cross-sectional study using a phone interview survey with quota sampling was conducted for equal distribution of sexes, age and administrative regions. Mental health literacy was assessed by the previously validated mental health literacy scale (MHLS). The MHLS ranges from 35 to 160, and a higher score indicates greater level of mental health literacy. Results: In this study, 4,547 (70.2%) agreed to complete the interview. The sample was equally distributed across Saudi Arabia's 13 administrative regions with 50.1% female and mean age 35.9 (SD: ±12.8). In terms of education, 55.1% have a bachelor's degree or above. The nationally weighted score on the original MHLS was 110.75. the MHLS Saudi validation score was influenced by various variables including: marital status, healthcare-related job, sex, education level, and proximity to individuals with mental health issues. Conclusion: The study offers data for the first time on Saudi Arabian mental health literacy status. The high MHLS score reflects good societal awareness and understanding of mental health related concepts and issues in the Saudi population. The results of this study set the baseline for mental health literacy in Saudi Arabia. Future research may focus on utilizing the validated MHLS and the method used in this study to explore the effect of other social and individual factors on mental health literacy.

Validation and psychometric testing of the Arabic version of the mental health literacy scale among the Saudi Arabian general population.

OBJECTIVE: This study aimed to validate the Arabic Version of the Mental Health Literacy Scale (Arabic-MHLS) among the Saudi Arabian general population, assessing its internal consistency, test-retest reliability, and structural validity. METHODS: A total of 700 Arabic-speaking Saudi adults were randomly selected to complete the electronic questionnaire in May 2023, which generated 544 participants. Data were coded and stored in the ZdataCloud research data collection system database. Test-retest reliability was assessed using a subsample of 48 participants who completed the questionnaire twice, with a one-week interval. Structural validity was examined using confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA). RESULTS: The Arabic-MHLS demonstrated good internal consistency (Cronbach's alpha = 0.87) and test-retest reliability (intraclass correlation coefficient = 0.89). EFA revealed a four-factor model closely resembling the model identified in the Slovenian validation of MHLS, with factor loadings ranging from 0.40 to 0.85. The four factors included knowledge of mental health disorders, knowledge of help-seeking, knowledge of self-help strategies, and knowledge of professional help also showed good internal consistency. CONCLUSION: The Arabic-MHLS is a valid and reliable tool for assessing mental health literacy in the Saudi Arabian general population. However, further research is needed to refine the measurement tool and understand the complex relationships between mental health literacy and other mental health-related concepts. This will contribute to the development of targeted interventions and policies aimed at improving mental health literacy and promoting mental well-being in the Saudi Arabian population and beyond.

Working with patients and the mental health of health care workers during the COVID-19 pandemic.

BACKGROUND: Anxiety and concern are among the most common problems facing healthcare workers (HCWs) during epidemic diseases. OBJECTIVE: To identify the predictive factors of anxiety, fears, and psychological distress among healthcare workers during the COVID-19 pandemic. METHODS: An online survey method was used on a sample of 153 of HCWs; (110) frontline and (43) non-frontline HCWs. They answered on the Hamilton anxiety rating scale, the Kessler psychological distress scale (K10), and the COVID-19 Concerns Questionnaire. RESULTS: The results demonstrated that 47.05% of HCWs have a severe level of fear related to COVID-19, 43.13% have very severe anxiety, and 30.71% experience severe psychological distress. The differences between frontline and non-frontline HCWs, female and male HCWs, and HCWs working in medical clinics, on quarantine, or in another place were significant in the three scales. Predictive factors of anxiety, fear, and psychological distress include working on the front lines, being female, and being over 50 years old. Meanwhile, working in a workplace with COVID-19 patients predicted anxiety and psychological distress, but not fears associated with COVID-19. CONCLUSION: HCWs have a high prevalence of symptoms of mental disorders that may interfere with their work. These results may have therapeutic applications during pandemics.

It is spatial neglect syndrome, not only attention deficit! A child with spinal ependymoma post-resection misdiagnosed as having ADHD: Case report.

The neurobehavioral syndrome known as spatial neglect, which could be a result of a brain tumor, is common but difficult to diagnose and manage. This case study describes the evaluation of spatial neglect syndrome psychologically in detail and also builds an initial discussion of the role of the Arabic language, which requires a right-to-left-oriented spatial frame, to understand the severity of the symptoms. We report a case of spatial neglect syndrome after a brain tumor. A 7-year-old boy presented to the CDC clinics with a significant limitation of attention and very poor school achievement. The patient underwent several neuropsychological assessments, including an intellectual IQ test, social and adaptive behavior testing, attention deficit hyperactivity disorder testing, and a battery of neuropsychological tests to detect the presence of spatial neglect, as well as a psychological interview and observation. We present a 7-year-old boy with spatial neglect syndrome who visited the primary children's mental health department. The additional role of the Arabic language could have more of an impact on the symptoms and the proper rehabilitation intervention. After the proper diagnosis and rehabilitation intervention, the child showed a good outcome with regard to his attention and focusing skills as well as his school performance.

Risk perceptions of COVID-19 and its impact on precautionary behavior: A qualitative study.

OBJECTIVE: The controlling of the COVID-19 pandemic is influenced by the precautionary behavior of the community, and such behavior is frequently related to individuals' risk perception. The current study aimed to explore risk perceptions and precautionary behavior in response to COVID-19. METHOD: Qualitative in-depth interviews by telephone were undertaken with 26 participants from three affected cities in an initial stage of the disease outbreak, from May 3 to June 5, 2020. The method of analyzing data was inductive. The results were analyzed using interpretation, categorizing, and thematic analysis. RESULTS: The perception of risk is influenced by numerous individual, community, and cultural factors; these perceptions act as triggers for precautionary behavior, with a tendency to deny risks or react with exaggeration in terms of the precautionary reactions related to COVID-19. The thematic analysis produced two major categories: 1) risk perception and 2) precautionary behavior. The analysis provides essential insight into risk perception and precautionary behavior. CONCLUSION: The risk perceptions and patterns of precautionary behavior could be unreliable, unhealthy, and culturally affected, which would influence the effectiveness of pandemic control measures. Further investigations with more data and including risk perception and precautionary behavior in the national response plan for emergency and crisis are highly recommended. PRACTICE IMPLICATIONS: A greater understanding and ongoing assessment of COVID-19 risk perception could inform policymakers and health professionals who seek to promote precautionary behavior. This could also facilitate early interventions during pandemics.

The mediating role of religiosity and hope for the effect of self-stigma on psychological well-being among COVID-19 patients.

BACKGROUND: Over the past few months, there has been a significant increase in mortality and morbidity due to Coronavirus disease (COVID-19). Less attention has been paid to stigmatism, psychological well-being, hope, and religiosity, and how these may impact a patient's recovery. OBJECTIVES: This study aimed to detect the difference in religiosity, hope, self-stigma, and psychological well-being (PWB) due to demographic variables (age, education level, social status, and level of income). Additionally, the research sought to test the mediation role of religiosity and hope in the relationship between self-stigma and psychological well-being among COVID-19 patients. METHOD: A random sample of 426 COVID-19 patients answered an online questionnaire that contained four scales (Religiosity, Hope, stigma, and PWB). The data collected from the study participants were analyzed quantitatively by using One-way ANOVA, Exploratory Factor Analysis EFA, Confirmatory Factor Analysis CFA, and Structural Equation Model (IBM SPSS statistics 21, and Amos v.25). RESULTS: The current results showed statistically significant differences due to age in hope and well-being, in favor of the sample members belonging to the age group from 30 years old and over old, while there were no differences in religiosity and stigma due to age. There were no differences due to education level in religiosity, hope, stigma, and well-being. Results showed statistically significant differences in well-being in favor of the married group, while there were no differences in religiosity, hope, and stigma due to social status. Regarding the effect of income level in the study variables, the results showed no differences due to religiosity, hope, stigma, and well-being. Moreover, the findings found that both religiosity and hope play a mediating role. CONCLUSION: Religiosity and hope play a mediating role in the relationship between stigma associated with COVID-19 and psychological well-being. These results indicate several strategies to reduce the adverse effects of the stigma associated with COVID-19 and increase well-being among COVID-19 patients.

The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder.

BACKGROUND: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. METHODS: We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. RESULTS: We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. CONCLUSIONS: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.

Attention-deficit hyperactive disorder in school-aged children in Saudi Arabia.

The current study was designed to explore the prevalence of attention-deficit hyperactive disorder (ADHD) in primary schools in Saudi Arabia. The study collected data from both teachers and parents for 708 primary school pupils attending grades 1-3 (7-9 years old), using DSM-IV criteria of ADHD. The result showed that the overall rate of ADHD was 2.7%, and in particular, the rate of attention types, 2.0%; hyperactive/impulsivity type, 1.4% and combined type, 0.7%. Teachers reported ADHD in a higher frequency than parents. However, applying a combination of reports from teachers and parents, screening of ADHD is likely to be more accurate. These findings highlight the importance of detecting ADHD in pupils at an early age and to develop a specific set of psychological clinical interventions for helping them.

Ability of laboratories to detect emerging antimicrobial resistance: proficiency testing and quality control results from the World Health Organization's external quality assurance system for antimicrobial susceptibility testing.

The accuracy of antimicrobial susceptibility data submitted by microbiology laboratories to national and international surveillance systems has been debated for a number of years. To assess the accuracy of data submitted to the World Health Organization by users of the WHONET software, the Centers for Disease Control and Prevention distributed six bacterial isolates representing key antimicrobial-resistance phenotypes to approximately 130 laboratories, all but one of which were outside of the United States, for antimicrobial susceptibility testing as part of the World Health Organization's External Quality Assurance System for Antimicrobial Susceptibility Testing. Each laboratory also was asked to submit 10 consecutive quality control values for several key organism-drug combinations. Most laboratories were able to detect methicillin (oxacillin) resistance in Staphylococcus aureus, high-level vancomycin resistance in Enterococcus faecium, and resistance to extended-spectrum cephalosporins in Klebsiella pneumoniae. Many laboratories, particularly those using disk diffusion tests, had difficulty in recognizing reduced susceptibility to penicillin in an isolate of Streptococcus pneumoniae. The most difficult phenotype for laboratories to detect was reduced susceptibility to vancomycin in an isolate of Staphylococcus epidermidis. The proficiency testing challenge also included a request for biochemical identification of a gram-negative bacillus, which most laboratories recognized as Enterobacter cloacae. Although only a small subset of laboratories have submitted their quality control data, it is clear that many of these laboratories generate disk diffusion results for oxacillin when testing S. aureus ATCC 25923 and S. pneumoniae ATCC 49619 that are outside of the acceptable quality control range. The narrow quality control range for vancomycin also proved to be a challenge for many of the laboratories submitting data; approximately 27% of results were out of range. Thus, it is important to establish the proficiency of laboratories submitting data to surveillance systems in which the organisms are tested locally, particularly for penicillin resistance in pneumococci and glycopeptide resistance in staphylococci.

Evaluation of the PASCO strep plus broth microdilution antimicrobial susceptibility panels for testing Streptococcus pneumoniae and other Streptococcal species.

Antimicrobial resistance continues to increase worldwide among isolates of Streptococcus pneumoniae and other species of streptococci. Increasing rates of penicillin resistance, particularly in viridans group streptococci, and resistance to multiple classes of antimicrobial agents, including beta-lactams, macrolides, and fluoroquinolones, in pneumococci have increased the importance of having accurate antimicrobial susceptibility testing results for guiding therapy. One commercial method of assessing resistance in streptococci is the PASCO Strep Plus panel. This broth microdilution-based method has recently been expanded to include a variety of newer antimicrobial agents. Therefore, we compared the results of the new PASCO Strep Plus panels for 26 antimicrobial agents against the results generated using the National Committee for Clinical Laboratory Standards (NCCLS) broth microdilution reference method for 75 pneumococci and 68 other streptococcal isolates. Only 4 (0.2%) very major errors (all with pneumococci and each with a different antimicrobial agent) were observed. There were 5 (0.3%) major errors observed with pneumococci (each with a different antimicrobial agent), but only 1 major error with nonpneumococcal streptococci. All of the very major and major errors resolved on retesting. Of the 65 (3.9%) and 17 (1.6%) minor errors observed with pneumococci and other streptococci, respectively, all were within 1 dilution of the broth microdilution reference MIC result. Thus, the PASCO Strep Plus panel has comparable accuracy to the NCCLS broth microdilution reference method.

Detection and reporting of organisms producing extended-spectrum beta-lactamases: survey of laboratories in Connecticut.

Extended-spectrum beta-lactamases (ESBLs) are enzymes produced in some gram-negative bacilli that mediate resistance to extended-spectrum cephalosporins and aztreonam. They are most common in Klebsiella spp. and Escherichia coli but are present in a variety of Enterobacteriaceae. Resistance mediated by these enzymes can be difficult to detect depending on the antimicrobial agents tested. AmpC beta-lactamases are related to the chromosomal enzymes of Enterobacter and Citrobacter spp. and also mediate resistance to extended-spectrum cephalosporins and aztreonam in addition to cephamycins, such as cefoxitin. Unlike ESBLs, however, AmpC beta-lactamases are not inhibited by clavulanic acid or other similar compounds. To assess the abilities of various antimicrobial susceptibility testing methods to detect ESBLs, we sent three ESBL-producing organisms, one AmpC-producing organism, and a control strain that was susceptible to extended-spectrum cephalosporins to 38 laboratories in Connecticut for testing. Eight (21.0%) of 38 labs failed to detect extended-spectrum cephalosporin or aztreonam resistance in any of the ESBL- or AmpC-producing isolates. Errors were encountered with both automated and disk diffusion methods. Conversely, seven (18.4%) labs categorized at least some of the four resistant isolates as potential ESBL producers and reported the results with the extended-spectrum cephalosporins and aztreonam as resistant as suggested by current National Committee for Clinical Laboratory Standards (NCCLS) guidelines. The percentage of laboratories that failed to detect resistance in the ESBL or AmpC isolates ranged from 23.7 to 31.6% depending on the type of enzyme present in the test organism. This survey suggests that many laboratories have difficulty detecting resistance in ESBL and AmpC-producing organisms and may be unaware of the NCCLS guidelines on modifying susceptibility testing reports for ESBL-producing strains.

Antibacterial evaluation of some xanthate derivatives and their diorganotin (IV) complexes.

The antibacterial activity of some xanthate derivatives K(SSCOR), where R = C6H5-(CyX), CH3NHCH2CH2-(MAEX), (CH3)2NCH2CH2-(DMAX), (CH3)2NCH2CH(CH3)-(DMAIX) and (C2H5)2NCH2CH2-(DEAEX) together with their diorganotin (IV) complexes R2Sn(SSCOR)2, where R' = Me, Bu(n), Ph, has been studied against eight species of bacteria in vitro. A significant activity against S. typhimurium was displayed by the xanthate derivative CyX and its complex Ph2Sn(CyX)2 at concentrations ranging from 1-10 micrograms/ml, and a remarkable activity was exhibited by the complexes Ph2Sn(CyX)2, Ph2Sn(MAEX)2 and Ph2Sn(DMAX)2 against P. aeruginosa at concentrations ranging from 0.1-10 micrograms/ml. By contrast, no such activity was demonstrated by the antibiotics used in this study (amoxicillin and chloramphenicol) against the same bacterial species.