Social anxiety disorder and its associated factors: a cross-sectional study among medical students, Saudi Arabia.

BACKGROUND: Social Anxiety disorder (SAD) is common worldwide. However, data from Saudi Arabia is deficient. This study aims to determine the prevalence of SAD across Saudi medical students and its associations with sociodemographic factors and their academic performance. METHODS: The main outcome was presence/absence of SAD and the secondary outcome was its level of severity. These were assessed from the Social Phobia Inventory. Associated factors included sociodemographic variables, as well as educational characteristics of students. Descriptive statistics were reported as counts and percentages, and unadjusted and adjusted odds ratios (OR) and their 95% confidence intervals (CIs) were computed through bivariate and multivariate logistic regression. RESULTS: Of 5896 Saudi medical students who participated in the study, the prevalence of SAD was almost 51%. While 8.21% and 4.21% had reported severe and very severe SAD, respectively. Older age students were at lower risk of developing SAD (OR = 0.92, 95% CI = 0.89 - 0.96). In contrast, females (OR = 1.13, 95% CI = 1.01 - 1.26), students enrolled in private colleges and colleges implementing non-problem-based learning (OR = 1.29, 95% CI = 1.09 - 1.52 and OR = 1.29. 95% CI = 1.15 - 1.46 respectively) were at higher risk. A significant elevated risk of SAD was found among students who had previously failed, and had a low GPA. CONCLUSION: SAD is prevalent among the sampled population, and different associated factors were identified. Current results could raise the awareness of faculty members and healthcare providers towards early detection and management of these cases.

Screening and management of tobacco, alcohol, and unhealthy drug use in Saudi Arabia: uptake and practices from primary care physicians' perspective.

BACKGROUND: Screening and management of tobacco, alcohol, and unhealthy drug use by primary care physicians are crucial because a minority of individuals seek medical advice. However, data regarding this practice are limited. The study objective was to assess the screening practices of primary care physicians in Saudi Arabia for tobacco, alcohol, and unhealthy drug use, barriers to screening, and management of such cases. METHODS: In this cross-sectional study, an online survey was sent to primary care physicians in Saudi Arabia. RESULTS: A total of 952 physicians participated in the study. Most did not use validated screening tools. A significant proportion of physicians believed that the patient could not answer accurately about using alcohol or drugs and considered it socially unacceptable to ask about these substances. Family physicians screened their patients more frequently for smoking than general practitioners (P < 0.05). More years of experience and practice in the Northern Province of Saudi Arabia were predictors of frequent screening for alcohol and drug use (P < 0.05 and P < 0.01, respectively). Providing information about the risks of these behaviours and brief motivational interviews were the most reported practices. CONCLUSIONS: Most physicians did not utilize validated screening tools. Addressing these barriers is a crucial step in initiating effective screening programmes. Several barriers have been reported from the physicians' perspective; further study to explore these issues from patients' perspectives is suggested. Moreover, raising physicians' awareness about using validated screening tools and locally available services is recommended.

Primary care physicians play an important role in the early detection and management of societal problems. In this study, an online survey was sent to physicians in Saudi Arabia to investigate their screening and management practices regarding smoking, alcohol consumption, and drug use. Most of the sampled physicians did not use validated screening tools. Lack of time was the most reported barrier to screening for smoking. For alcohol and drug use, a significant proportion of physicians thought that patients might not answer accurately and that asking about these issues was socially unacceptable. Regarding the management practices in these cases, providing information about the risks of such behaviour and brief motivational interviews were the most reported practices of primary care physicians.

Cosmetic surgeries and procedures among youth in Saudi Arabia: a cross-sectional study of undergraduate university students in the Eastern Province.

PURPOSE OF THE STUDY: To assess the attitudes and acceptance of cosmetic surgeries and procedures among undergraduate university students in the Eastern Province, Saudi Arabia, as well as the barriers against having cosmetic surgeries and procedures. STUDY DESIGN: A cross-sectional study of undergraduate university students in the Eastern Province, Saudi Arabia, during October 2020. The research instrument included the Attitudes towards Cosmetic Surgery Scale (ACSS), sociodemographic data and perceived barriers towards cosmetic surgeries and procedures. A bivariate analysis was performed followed by a linear regression to account for confounders. RESULTS: A total of 1240 students participated in the study. The mean ACSS for cosmetic surgeries was 3.14 (±1.37 SD), and 3.25 (±1.49 SD) for cosmetic procedures. Older students, students with a history of previous cosmetic surgeries/procedures, and students with engineering specialties had more acceptance scores in both cosmetic surgeries and procedures. On the other hand, men, students belonging to a middle family income and students who perceived themselves to be aware of the risk associated with cosmetic surgeries/procedures had less acceptance scores. The most reported barrier to have cosmetic surgeries and procedures among students was feeling that they do not need it. CONCLUSION: The findings from the current study could help dermatologists, plastic surgeons and adolescent specialists wishing to recognise the rising interest in cosmetic surgeries and procedures in Arabic youth populations, the possible associated factors, as well as the barriers to have these surgeries and procedures. A further qualitative in-depth study to explore the acceptance is suggested.

Predominant learning approaches of medical students in Saudi Arabia.

PURPOSE OF THE STUDY: This study aims at identifying the predominant learning approaches by Saudi medical students across Saudi Arabia and assess its possible associations with sociodemographic and educational characteristics. STUDY DESIGN: A cross-sectional study design using the Approaches and Study Skills Inventory for Students questionnaire. The questionnaire gives rise to three possible learning approaches; deep, strategic and surface approaches. Bivariate analyses were performed through independent samples t-test and χ2 tests where appropriate. A multinominal regression analysis was performed to obtain risk estimates and 95% CIs. RESULTS: A total of 3767 students participated and were included in the analysis. The predominant learning approach was the deep approach, followed by the strategic and surface approaches (40.59%, 37.81% and 21.60%, respectively). Males and students belonging to private medical schools were more likely to adopt a strategic rather than a deep one (relative risk ratio (RRR) 1.22, 95% CI 1.06 to 1.42 and RRR 1.32, 95% CI 1.05 to 1.65, respectively). Students with an A grade point average (GPA) were less likely to adopt a surface approach, whereas those with a C GPA were more likely to adopt it (RRR=0.67, 95% CI 0.54 to 0.83 and RRR=1.29, 95% CI 1.02 to 1.61, respectively). CONCLUSION: The findings from this study show that medical students predominantly favour the deep learning approach. Results from this study encourage the continuous adaptation of clinical teaching in medical schools to optimise students' learning experiences.

Seroprevalence of rubella virus among pregnant women: A 4-year registered-based study from family medicine and obstetric clinics in Saudi Arabia.

OBJECTIVES: This study aimed to determine rubella virus infectivity and immune status in pregnant females who visited the family medicine and obstetrics clinics at a large hospital in Saudi Arabia, and to identify the possible predictors of rubella susceptibility. METHODS: This registered-based, cross-sectional study included pregnant, aged between 18 and 50 years old, who presented for the first antenatal visit between 2017 and 2020. Data on sociodemographic, antenatal characteristics and serological results were collected. Chi-Squared or Fisher's Exact test and t tests were used for bivariate analysis followed by the multivariable logistic regression model. RESULTS: A total of 4328 pregnant were included in the study. Seroprevalence of rubella immunity was 76.41%. Positive rubella IgM antibody was identified in 1.21% of those who performed the test (17/1409). Odds of susceptibility were decreased with an increase in age (OR = 0.96, 95% CI = 0.95-0.97) and in non-Saudis' (OR = 0.44, 95% CI = 0.36-0.54). CONCLUSIONS: Approximately 24% of pregnant were susceptible to rubella virus infections in this study. Screening females of child-bearing age and reimmunisation of susceptible cases before pregnancy are suggested. Further studies to investigate the impact of applying this policy in premarital screening are recommended.

Musculoskeletal symptoms and their associated risk factors among Saudi office workers: a cross-sectional study.

BACKGROUND: Musculoskeletal disorders are common worldwide. Several factors are suggested in their aetiology, one of which is ergonomics alongside other individual factors. This study aims at investigating the prevalence of musculoskeletal disorders among administrative office workers at a large university in Saudi Arabia. METHODS: This cross-sectional study recruited office workers at a Saudi university. A questionnaire was used that involved three sections, the first section consisted of sociodemographic questions, the second included the Rapid Office Strain Assessment (ROSA) checklist to assess ergonomic factors possibly involved, and the third included the Nordic Musculoskeletal Questionnaire to measure the outcome. Bi-variate analyses were performed by Chi-Squared tests and T-tests where appropriate, and a multivariable logistic regression was done to yield odds ratios (OR) and 95% confidence intervals (CIs). RESULTS: The prevalence of musculoskeletal symptoms in any region during the past 12 months preceding the study was 84.5%, and only 30% have sought medical advice. The most common area of complaint was the lower back (54.5%). After adjustment, age and years of experience were positively associated with musculoskeletal symptoms (OR = 1.04, 95% CI = 1.01-1.09 and OR = 1.10, 95% CI = 1.05-1.15). Normal weight was associated with a significant reduction in risk (OR = 0.10, 95% CI = 0.05-0.18). ROSA score was an independent risk factor (OR = 1.77, 95% CI = 1.05-2.96). CONCLUSIONS: Musculoskeletal symptoms were highly prevalent in the current sample. Identified predictors may support the need for interventions to reduce risk.

"Is there a doctor on board?": willingness and confidence of physicians in the Kingdom of Saudi Arabia in assisting with in-flight medical emergencies.

BACKGROUND: In-flight medical emergencies (IMEs) are common, and for a traveling physician, it is very likely to encounter such a condition. Data discussing this issue are limited. Thus, this study aimed to evaluate the willingness and confidence of physicians in the Kingdom of Saudi Arabia (KSA) in responding to IMEs. As well as, to assess the associated sociodemographic, occupational, and travel-related factors, and their previous experience with such events. METHODS: This cross-sectional, online-based, study was conducted among all physicians in KSA during January 2021. The self-administered questionnaire included questions on sociodemographic, occupational, travel profiles, willingness and confidence towards IMEs. Chi-Squared or Fisher's Exact test were used for bivariate analysis followed by the multivariable binary logistic regression analysis. RESULTS: A total of 4558 physicians participated in the study. About one-third of participants reported one or more IME incidents, and the vast majority of them provided assistance. Cardiovascular diseases were the most common IMEs. About half of the participating physicians are concerned about the medico-legal consequences of providing assistance with such a condition. Among all specialties, emergency physicians reported the highest willingness and confidence toward IMEs. Predictors for a physician's willingness to assist in IMEs were being male, having been involved in a previous IME situation, attended life support and IME courses, frequent traveling, and practicing medicine in the Central region of Saudi Arabia. CONCLUSION: Findings from the current study stressed the need for establishing standardized guidelines about the roles of healthcare workers and the legal consequences of providing medical assessment in IMEs. Moreover, training programs on IMEs to all physicians, especially those who deal with a variety of cases during their practice such as internal medicine and family medicine are also suggested.

Characteristics of visits and predictors of admission from a paediatric emergency room in Saudi Arabia.

BACKGROUND: The Emergency Repartment (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia. METHODS: This is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome. RESULTS: The total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4% of the total sample were Saudis. The most common complaint was fever (26.9%) followed by respiratory symptoms (24.9%). Only 7 patients (0.02%) were classified as triage I (Resuscitation), and most were triage IV (Less urgent) (71.0%). Most visits occurred during the winter months. Adjusted ORs showed that neonates had higher odds of admission (OR = 3.85, 95%CI = 2.57-5.76). Moreover, those presenting with haematological conditions showed an OR of 65.49 (95%CI = 47.85-89.64), followed by endocrine conditions showing an OR of 34.89 (95%CI = 23.65-51.47). Triage I had a very high odds of admission (OR = 19.02, 95%CI = 2.70-133.76), whereas triage V was associated with a very low odds of admission (OR = 0.30, 95%CI = 0.23-0.38). CONCLUSIONS: A low rate of hospital admission was found in comparison with other rates worldwide. This was mostly attributed to an alarmingly high number of non-urgent ER visits. This further emphasises the problem with improper use of ER services, as these cases should be more appropriately directed towards primary healthcare centres. Further studies to examine the impact of prioritising patients in the ER based on the identified predictors of hospital admission, in addition to the standard triage system, are suggested.

Prevalence of depression and its associated factors among clinical-year medical students in Eastern Province, Saudi Arabia.

BACKGROUND: To assess the prevalence of depression among medical students in their clinical years (fourth, fifth, and sixth years) in a government university in Eastern Province, Saudi Arabia, and its association with the students' sociodemographic characteristics, academic factors, perceived health problems and their perceived readiness to their future specialties. METHODS: A cross-sectional study was conducted among 527 clinical-year medical students. The Patient Health Questionnaire (PHQ-9) and questionnaire designed by the researchers to collect data on sociodemographic and academic variables were used as research instruments. Statistical analyses were conducted using Stata Statistical Software V.15. Descriptive statistics, the χ test, and both an ordered logistic regression and a binary logistic regression analysis were performed. RESULTS: The prevalence of depression was found to be 39.27%, according to the results of the PHQ-9. Both the ordered logistic regression and the binary logistic regression analyses revealed that the odds of severe depression were high among women, and students who perceived that they were not yet ready for their future specialties. The more senior the medical students were, the less likely it is that they have severe depression. A similar association was found for students who perceived that they did not have psychological problems. However, students' grade point average was not statistically significantly associated with depression. CONCLUSIONS: The prevalence of depression was high among the medical students examined. Policy makers should establish screening programmes, provide counselling for students who need it and deliver early interventions in detected cases.

Community-Based Cross-Sectional Assessment Survey On Herpes Zoster Vaccination Practices.

Background: Herpes Zoster (HZ), also known as Shingles, is a commonly occurring infection especially among the elderly. It is due to the reactivation of the dormant virus in the sensory ends that were present since the primary infection with the virus. Objective: Our study aims at assessing the knowledge, attitudes practices beliefs and current barriers towards the Shingrix vaccine to fully understand where we stand and come up with proper recommendations to services these at-risk individuals and ultimately have a positive impact on the healthcare system. Methods: Questionnaire based cross sectional study using a translated version of a previously developed and tested questionnaire. Results: more than 8000 participants responded to the survey. The vast majority had chicken pox before and did hear about the vaccine from different sources. Most of the participants had minimal knowledge regarding the vaccine and were willing to take it regardless of some safety concerns. Conclusion: more efforts need to be conducted to enhance vaccine uptake in at risk populations in Saudi Arabia.

Pattern of Virtual Consultations in the Kingdom of Saudi Arabia: An Epidemiological Nationwide Study.

BACKGROUND: In the Kingdom of Saudi Arabia (KSA), little is known about the adoption of virtual consultations (VCs), with most studies being survey-based leading to varying results. This study aims to utilise secondary collected data on the use of both kinds of VCs currently available, and to epidemiologically describe the adoption of these consultations. METHODS: This retrospective study analysed data provided by the Ministry of Health between January 1st 2021 and June 30th 2022. For both the home-based and the hospital-based consultations, variables included the age and sex of patients, date of consultation, duration in minutes, closure status for the appointment and the governorate in which the patient is residing. A heat map was drawn to present patterns of utilisation across the country. RESULTS: The total number of VCs for both types were 1,008,228. For both types, females were higher adopters (54.73%). Of the total number of consultations, 751,156 were hospital-based. Of these consultations, family medicine consultations were the most common (20.42%), followed by internal medicine. Maternity follow-up clinics were higher in home-based clinics. The proportion of patient no-shows was high overall (48.30%). Utilisation was high in urban governorates, and low in rural ones. CONCLUSION: Findings have several implications on health policy. It provides further evidence of the importance of family medicine, where it was the most common speciality even in hospital-based settings. The high variability in the adoption of consultations across rural and urban areas as well as the extremely high number of patient-no-shows warrants further investigation.

HPV Vaccine Uptake, Willingness to Receive, and Causes of Vaccine Hesitancy: A National Study Conducted in Saudi Arabia Among Female Healthcare Professionals.

Background: Epidemiological evidence has shown that human papillomavirus (HPV) is the most frequent cause of sexually transmitted infection, and vaccination is an essential measure to prevent associated diseases and complications. This study aimed to assess the HPV vaccine uptake and its associated factors as well as HPV vaccine hesitancy by female healthcare workers (HCWs) in Saudi Arabia. Methods: This online, questionnaire-based, cross-sectional study involved female HCWs in Saudi Arabia between July and October 2022. The study tool included questions about sociodemographic, occupational, and reproductive characteristics, uptake of HPV vaccination, and reasons of hesitancy. Chi-squared and t-tests were used for bivariate analyses, and multivariable logistic regression was used to adjust for confounders. Results: The total number of participants was 1857. Around 20% of HCWs received at least one dose of the HPV vaccine, and around 45% were willing to take it this year. Lower odds of vaccine uptake were reported among older participants and those with a higher level of education. However, nurses, HCWs with a previous HPV infection, those with a family history of cervical cancer, or those with a previous cervical cancer screening test had higher odds of receiving the vaccine. On the other hand, older participants and diploma degree holders were less willing to take the HPV vaccine. Higher odds of willingness were reported in married HCWs, those with a previous HPV infection, those who received a previous HPV vaccine dose, or those who were screened for cervical cancer. Lack of knowledge and some misconceptions were the most reported reasons for hesitancy. Conclusion: Certain factors that affect HCWs personal decisions to take the vaccine were identified. By targeting these issues, epidemiologists, public health officials and women's health care providers can work to increase HPV vaccine uptake and reduce the burden of HPV-related diseases in this population.

Motivators for the public to receive the seasonal influenza vaccination and the effect of coronavirus disease 2019 pandemic on the uptake of the seasonal influenza vaccination.

BACKGROUND: The coverage of the seasonal influenza vaccine has always been sub-par. Understanding the motivators of receiving vaccines, especially during pandemics, could enhance and increase the coverage rates. The Saudi Ministry of Health launched its annual influenza vaccination campaign during the 2021 influenza season and provided vaccinations in primary healthcare settings. This study aims to explore public motivators to receive influenza vaccination, particularly during the coronavirus disease 2019 global pandemic. MATERIALS AND METHODS: This cross-sectional study enrolled 783 participants who attended the influenza vaccination campaign. All persons who received the influenza vaccine in the influenza vaccination campaign held in Dammam, Saudi Arabia, from October to November 2021, were interviewed and completed a self-administered questionnaire. Odds ratio with a 95% confidence interval were estimated using the full model fit. The significance level was set as α = 0.05. RESULTS: The majority of the participants had more than high school education (81%), were males (66.2%), and married (59.6%), and 50.6% were below 35 years of age. Participants with higher education, health-care workers, and those who had been previously counseled on influenza vaccination were less likely to have started taking the influenza vaccination, whereas smokers and persons who do not have routine checkups were more likely to start influenza vaccination. The main motivator to take the influenza vaccine was the establishment of a vaccination campaign near the participant's workplace (62.2%), followed by advice from their physician (30.3%), and fear of having influenza disease (29.6%). CONCLUSION: Accessibility to the vaccination campaigns was the main motivator for receiving the vaccine followed by the advice from physician. Advice from physician and increasing mobile vaccination campaigns and mobile clinics would substantially increase influenza vaccine uptake.

Association between fitness tracker use, physical activity, and general health of adolescents in Eastern Province of Saudi Arabia.

BACKGROUND: Physical inactivity is a major problem of adolescents worldwide. Fitness trackers are widely used technologies that assess physical activity and allow self-monitoring of daily activities. Thirty-five percent of the Saudi population is made up of adolescents, which makes them an important target population. Few studies have evaluated the association of fitness trackers with physical activity levels of adolescents. This study aimed to evaluate physical activity among adolescents and its relationship to their use of fitness trackers and overall health. MATERIALS AND METHODS: A cross-sectional study was carried out among adolescents in middle and high schools in the Eastern Province. Data was collected using a structured questionnaire and physical activity was assessed using International Physical Activity Questionnaire for Adolescents. Chi-square test and ANOVA were performed to test for statistical significance. Unadjusted and adjusted odds ratios (ORs) were obtained through ordered logistic regression models. Model diagnostics were run as post hoc analyses. RESULTS: Majority of participants (82.6%) had low physical activity levels, 12.2% had moderate and 5.2% had vigorous activity level. The model revealed that as participants' ages increased, the odds of having higher levels of physical activity decreased (OR = 0.92; 95% confidence interval [CI]: 0.85-0.99). Moreover, participants who did not go to a gym regularly or own a fitness tracker were less likely to have higher physical activity levels (OR = 0.43; 95% CI:0.30-0.61, and OR = 0.44; 95% CI: 0.33-0.59, respectively). Motivation for using fitness trackers was mostly "no specific reason" for females. However, "luxury and esthetics" were mostly reported by males. CONCLUSION: Physical activity tends to be higher in younger adolescents who use fitness trackers, or go to the gym regularly, with no significant difference between males and females. However, the motivation behind adolescents' use of fitness trackers varied by gender.

A Cross-Sectional Analysis into the Willingness and Hesitancy to Test and Vaccinate Against COVID-19 Among the Elderly Population in the Kingdom of Saudi Arabia.

Introduction: COVID-19 remains a public health concern. Vaccinations, testing and tracing have been proven to provide strong protection against severe illness and death. Older adults are amongst the groups with an increased risk of severe illness. This study aimed to explore the willingness and hesitancy of the elderly population in the Kingdom of Saudi Arabia to test and vaccinate against COVID-19. Methods: This cross-sectional study targeted participants aged 65 years and above. The questionnaire included both sociodemographic variables, and variables related to willingness and hesitancy to vaccinate and test for COVID-19 that were mainly based on existing literature. Bivariate analyses were performed to test for associations. Significance was set at the 0.05 level. Results: The total sample of respondents was 502. The results show that 52.4% were not aware of a previous infection. Participants aged above 70 years and females were found to be more aware of a previous infection (51.6% and 53.1% respectively) (P < 0.05). Also, 54.7% felt it necessary to test against COVID-19, and among those, 70.8% believed that testing would contain and control the spread. The results also show that 3.2% were not vaccinated to date, compared to 95.41% who had the complete dose as well as the recommended booster dose for elderlies. Age, sex and level of education were significantly associated with vaccine uptake, where participants aged between 65 and 70 years, males and high levels of education were associated with a complete vaccine uptake. Discussion: The current findings add to the epidemiological evidence and show that the social network theory within the context of health may have played a role in self-awareness of previous infections. Also, social factors should be incorporated in public health interventions and public health campaigns targeting the elderly are still needed especially with the continued discovery of variants of interests.

Factors Affecting Length of Stay in Pediatric Emergency Department in a Teaching Hospital in Saudi Arabia.

Background: Decreasing the number of Emergency Department patient visits for treatment, especially in non-urgent cases, is an international healthcare goal. The same applies for pediatric emergency rooms where the utilization of ED is much more than adults. Objective: We aim to measure the length of stay for all pediatric patients and examine the factors influencing it. Methods: A retrospective chart review study was conducted at the pediatric ED of King Fahd Hospital in the Eastern Province of Saudi Arabia. The study included all patients presented to the pediatric ED, between January 1, 2018, and December 31, 2018, aged from 1 day to < 14 years old. Data included patient's age, sex, season in which the patient presented in, chief complaint, time of presentation, and whether admission to the hospital ward was collected. Results: The total number of patients was 37,613. The median LOS was 100, interquartile range (IQR) = 53 - 272 minutes. Male pediatric patients were (55.12%). Among all patients, (32.04%) were toddlers, followed by school aged children (25.05%). The ER received more patients during the winter months followed by summer (32.92% and 24.72%, respectively). Fever was the most common complaint for all patients combined. For prolonged LOS patients, the most common complaints were respiratory related (23.44%). Pre-school children and school aged children were found to have a 5.49% and a 7.93% increased LOS when compared to toddlers (95% CI = 2.52 - 8.53, and 95% CI = 5.01 - 10.93, respectively). Summer was associated with a statistically significant increased LOS (% change = 28.92, 95% CI = 25.53 - 32.40). Morning shift was found to have a 7.89% increased LOS when compared to the evening shift. The highest increase in LOS was attributed to haematology related complaints (% change = 108.32, 95% CI = 85.69 - 133.71). Conclusion: Several pediatric LOS predicting factors have been identified; morning arrival, and presentation during summertime. Systemic factors such as staffing, and infrastructure can be modified and may affect the length of stay of patients. The implementation of these strategies and the evaluation of their impact on the length of stay in the pediatric emergency department require further investigation.

Adult ADHD Positive Screening and Sibship, Birth Order and Academic Achievement: Implications for Epidemiologists and Physicians in the Kingdom of Saudi Arabia.

Background: Attention deficit hyperactivity disorder (ADHD) among the youth and university students differs internationally. This study aims to assess the prevalence of ADHD positivity from a validated screening test among medical students across the Kingdom of Saudi Arabia (KSA) and its associated sociodemographic and family-related factors and the impact of ADHD on students' academic performance. Also, to highlight the implications of the current findings on epidemiologists and family physicians in the region. Methods: This cross-sectional study utilised the Adult ADHD Self-Report Scale (ASRS) symptom checklist along with several questions on sociodemographic, siblings and personal academic achievement. Multivariable logistic regression models were performed to obtain the Odds Ratios (ORs) of risk of ADHD screening positivity and their 95% confidence intervals (CIs) against potential predictors. Results: The overall prevalence of positively screened medical students was 38.86%. After adjustment, a statistically significant increased risk of ADHD positivity was observed for students who had one sibling (OR = 1.70, 95% CI = 1.09-2.64). Also, upon examination of birth order, a significant increased risk was observed for students who were firstborn (OR = 1.22, 95% CI = 1.02-1.47). With regard to academic achievement, both before and after adjustment, students who screened positive had a 14% increased risk of obtaining an F GPA (OR = 1.14, 95% CI = 0.99-1.30). Conclusion: A considerable number of medical students are potentially positive for ADHD. Albeit not diagnostically confirmed - this indicates that a substantial number of people have displayed symptoms akin to ADHD, but were not clinically diagnosed. Research into ADHD in the region is still in its infancy, and epidemiologists would benefit from high-quality databases to address this condition. Also, primary care physicians should develop skills in detecting and managing ADHD in children at an earlier age to improve symptoms in adulthood.

Beliefs and Utilization of Cervical Cancer Screening by Female Health Care Workers in Saudi Arabia Using the Health Belief Model: A Nationwide Study.

Purpose: Epidemiologically, cervical cancer is the fourth most commonly diagnosed cancer among females globally and the third most commonly diagnosed gynecological cancer in Saudi Arabia. Screening is an important measure to prevent it. The current study aimed to assess, epidemiologically, female healthcare workers' (HCWs) utilization of cervical cancer screening services and its association with their beliefs about cervical cancer and the screening test, as well as their personal characteristics. Methods: This cross-sectional study included female HCWs in Saudi Arabia. A predesigned, self-administered survey was used to collect data, and it included questions about sociodemographic and reproductive characteristics, self-utilization of cervical cancer screening services, and the Health Belief Model (HBM) scale. Regression analyses were conducted to identify predictors of cervical cancer screening service utilization. Results: A total of 1857 females participated. The cervical cancer screening test uptake was 24.6% of ever-married females. However, 45% of the participants were willing to have the test. The odds of utilizing a screening were significantly higher among older participants, those with a higher level of education, and those with a higher number of pregnancies. Furthermore, HCWs with a history of HPV infection, cervical cancer in the family, hormonal contraception, or immunocompromised diseases were more likely to have the screening. An increase in the mean scores of the perceived benefits and motives subscales of HBM was associated with an increase in the uptake of screening. However, an increase in perceived barrier scores was significantly associated with a lower likelihood of cervical cancer screening uptake. Conclusion: Low cervical screening uptake and slightly higher intentions to have the test exist among HCWs. Certain personal factors and health beliefs significantly affect the utilization of the screening test. Approaches that target perceived benefits, health motivation, and perceived barriers to improve the screening rates of cervical cancer among HCWs are recommended.

Intention and practice on personal preventive measures against COVID-19 among older adults in the Kingdom of Saudi Arabia: an epidemiological study using the Theory of Planned Behaviour.

Introduction: Older adults aged 65 years and above are among the most vulnerable to adverse outcomes and death following a COVID-19 infection. The weekly epidemiological updates by the World Health Organisation show that the continued emergence of concerning subtypes of the virus indicates that the pandemic remains a public health concern and the public should continue to comply with personal preventive measures (PPMs). This study applies the Theory of Planned Behaviour (TPB) which is rooted in the field of Public Health, Epidemiology, and Preventive Medicine to Saudi older adults to predict their health behaviour. Methods: This behavioural epidemiological study recruited older adult participants aged 65 years of age and above. A tool which consisted of sociodemographic and health-related questions, as well as questions regarding the components of the TPB, namely, Attitude, Subjective Norm, Perceived Behavioural Control was used. Bivariate analyses, followed by unadjusted and adjusted multivariable logistic regression analyses were performed to derive odds ratios and 95% confidence intervals. Results: The total number of participants was 502. The mean age was 70.34 years, with similar distributions between males and females. In total, 52.2% intended to practice PPMs, whereas only 48% had a good practice. Also, 56% had a favourable Attitude towards PPMs, 61.4% had a positive Subjective Norm and 39.8% had perceived they had a high control over their behaviour. Females, and high educational status were predictors for high intention to practice PPMs (OR = 1.59, 95% CI = 1.01-2.52 and OR = 2.72, 95% CI = 1.44-5.16 respectively). Further predictors included Attitudes, Subjective Norm and Perceived Behavioural Control. Results also show that intention to practice was significantly associated with a lower odd of practicing PPMs (OR = 0.06, 95% CI = 0.04-0.10). Conclusion: Current findings highlight the need to continue with public health efforts targeting vulnerable older adults. Also, the fact that intention negatively predicted practice highlights the need for further behavioural epidemiological studies addressing the intention-behaviour gap.