Longevity of Immunoglobulin-G Antibody Response Against Nucleocapsid Protein Against SARS-CoV-2 Among Healthcare Workers.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the latest pandemic and the most significant challenge in public health worldwide. Studying the longevity of naturally developed antibodies is highly important clinically and epidemiologically. This paper assesses the longevity of antibodies developed against nucleocapsid protein amongst our health-care workers. Methods: This longitudinal cohort study was conducted at a tertiary hospital, Saudi Arabia. Anti-SARSsCoV-2 antibodies were tested among health-care workers at three-point intervals (baseline, eight weeks, and 16 weeks). Results: Of the 648 participants, 112 (17.2%) tested positive for Coronavirus (COVID-19) by PCR before the study. Of all participants, 87 (13.4%) tested positive for anti-SARS-CoV-2 antibodies, including 17 (2.6%) participants who never tested positive for COVID-19 using rt-PCR. Out of the 87 positive IgG participants at baseline, only 12 (13.7%) had remained positive for anti-SARS-CoV-2 antibodies by the end of the study. The IgG titer showed a significant reduction in values over time, where the median time for the confirmed positive rt-PCR subgroup from infection to the last positive antibody test was 70 (95% CI: 33.4-106.5) days. Conclusion: Health-care workers are at high risk of exposure to the SARS-CoV-2 virus, and contracting an asymptomatic infection is not unlikely. Developing and sustaining natural immunity differs from one person to another, while the rate of positive IgG anti-SARS-CoV-2 wanes over time. Clinicaltrialsgov Identifier: NCT04469647, July 14, 2020.

Effect of Hanna Somatic Education on Low Back and Neck Pain Levels.

Background: Neck and low back pain are very common worldwide. Hanna somatic education (HSE) is a method of neuromuscular (mind-body) movement retraining that helps in managing pain, but its efficacy has not yet been studied. Objective: To evaluate the clinical effect of HSE on low back and neck pain and determine differences in pain, use of pain medication, and number of doctor visits before and after 6 months of HSE sessions. Methodology: This retrospective study included patients with neck and/or low back pain of >2-month duration who underwent HSE sessions between January 2016 and January 2018 and completed a minimum one follow-up session. Two to five one-to-one sessions of 40-60 min once every 1-2 weeks for 2-8 weeks were provided for each patient. Pain levels were recorded at each visit using the Wong-Baker FACES Pain Rating Scale. Data regarding medication use and number of doctor visits for pain management were also recorded. Results: A total of 103 patients were included, of which 81 (78.6%) were female. Completing a mean 2.8 HSE sessions resulted in a significant pain level reduction. There were significant reductions in the mean low back, neck, and low back + neck pain values between the first and the last visits (P < 0.001). In the 6 months before and after the HSE intervention, the number of patients using pain medication decreased from 53 (53.5%) to 14 (13.6%), respectively, and the mean number of doctor visits reduced significantly from 2 (±1.6) to 0.5 (±1.16) (P < 0.001), respectively. Conclusion: Clinical sessions of HSE were found to significantly reduce chronic spinal pain. Further investigations are recommended regarding evidence-based treatment of HSE in patients with muscles pain.

A Cohort Study of Seroprevalence of Antibodies Against SARS-CoV-2 Infection Among Healthcare Workers at a Tertiary Hospital in Saudi Arabia.

Background: The nature of the healthcare workers' jobs standing at the frontline against the coronavirus disease 2019 (COVID-19) puts them at a higher risk of unknowingly contracting the disease and potentially contributing to the spread. This study aims to assess the overall positive seroconversion prevalence of SARS-CoV-2. Methods: This is a longitudinal cohort study of healthcare workers at Johns Hopkins Aramco Healthcare (JHAH). JHAH is a tertiary hospital located in Dhahran serving patients in several districts in the Eastern Province of Saudi Arabia. Participants were recruited between June and December 2020. Each participant had a serology blood test and completed the World Health Organization's risk factor assessment questionnaire. Results: This study included 682 participants working in JHAH, representing 15.7% of our population. Out of the 682 participants, 15.2% had a positive SARS-CoV-2 rt-PCR before taking part in the study. However, only 87 tested positive for SARS-CoV-2 antibodies, a prevalence of 12.7% of all participants. Out of the 87 positives for SARS-CoV-2 antibodies, 17 participants never tested positive for COVID-19 rt-PCR, a prevalence of 2.9%. Moreover, not properly using alcohol-based hand rub or soap and water after the risk of body fluid exposure and wearing personal protective equipment when indicated were found to be statistically significant to having a positive SARS-CoV-2 IgG assay. Conclusion: Positive seroconversion rate was considerably low during the first wave of COVID-19 amongst JHAH's healthcare workers and similar to other healthcare organizations in Saudi Arabia. Seropositivity correlated significantly with following infection prevention and control recommendations. Clinicaltrialsgov Identifier: NCT04469647.

Pain coping behaviors of saudi patients suffering from advanced cancer: a revisited experience.

BACKGROUND: Cancer is one of the major health problems throughout the world. The number of cancer patients is increasing, out of the estimated nine million new cancer cases every year, more than half are in developing countries. The majority of these patients are incurable by the time their disease is diagnosed. Therefore, cancer mortality is expected to continue to rise in those regions of the world (WHO, 2002). In Saudi Arabia, the latest report from the Saudi Cancer Registry SCR for 2004 registered 9,381 new cases, of these cases 7,138 were Saudis. The crude incidence rate CIR of all cancers among Saudis was 41.9/100,000. The total number of adult cancer incidence cases reported was 8595, and for children were 713 cases (NCR, 2004). The most common feared symptom encountered in advanced cancer is pain. Through their perpetual encounter with pain, advanced cancer patients usually maintain different coping behaviors. Internationally speaking, there are limited researches and investigations that deal with cancer pain, and the importance of using adaptive coping behaviors to control it. In Saudi Arabia, specifically, pain coping behaviors has never been assessed or discussed before, so is the impact of cancer pain on the quality of life. The presence of any maladaptive coping behaviors with cancer pain will interfere with the patient's life style and their quality of life, and will affect the nurse's role in caring, planning, and implementing effective nursing interventions to reduce and control cancer patient's pain. MATERIALS AND METHODS: A descriptive design was used for this study to assess the pain coping behavior Among Saudi patients suffering from advanced cancer. The study was conducted at the two tumor centers which deal with cancer patients in Jeddah City. A convenient sample of 132 patients with advanced cancer who were returning to the clinics, radiation therapy and medical oncology departments of the aforementioned tumor centers were included in the study. Data were collected by an interview schedule specially designed for this study, and the time ranged between 20-40 minutes. Tool's content validity and reliability were checked and established at 89% and 85%, respectively. Administrative approval from the two tumor centers in Jeddah City was obtained for study conduction. Different statistical methods were used for data analysis and interpretation to specify the value of correlation between study variables using SPSS v 10. RESULTS: Patients age were almost equally distributed among thirties (22%), forties (24.2%), fifties (20.5%), and sixties (22.7%). Females (59.1%) were slightly more than males (40.9%). About one half (47%) of them were diagnosed since one--two years age, and slightly more than half (56.8%) of them were unaware of their diagnosis. The major adaptive and Active pain coping behaviors included: religious practices such as: praying (99.2%); and listening or reciting the Holy Qur'an (98.5%). Cognitive methods such as: thinking that one is more stronger than the pain (99.2%); thinking that one is still in a satisfactory health despite the pain (98.5%); distracting oneself from pain (93.9%); visualization of pleasant scenes (92.4%); thinking about pleasant things (90.9%). The major maladaptive and passive pain coping behaviors included: decreasing activities by: specified positioning (97.7%); protecting the painful area (90.9%); and remaining still and avoiding movement (78%). Expression of feelings by: seeking help from others (90.2%); and crying or moaning (80.3%). Suppression of feelings and tolerating pain as it is (97%). CONCLUSIONS: Most of the adaptive and active pain coping behaviors were coming from patient's belief in god and their faith and trust and holding and obeying Islamic commands. The informational support by the health care professionals was unprovidable in the study sample, which brings the attention to the importance of nursing interventions in this area by providing coordinated and directed programs.

Legal issues in end-of-life care: perspectives from Saudi Arabia and United States.

AIM: This paper provides different perspectives on end-of-life legal issues in Saudi Arabia, and contrasts those perspectives with current legal practice in the United States. BACKGROUND: Islamic law governs end-of-life legal issues in Saudi Arabia which applies to end-of-life legal issues. There is a specific legal terminology, derived from the Qura'an, that is used to settle conflicts in end-of-life care. This contrasts with the United States which has a secular system of law that informs end-of-life issues. DATA SOURCES: extent literature review of Muslim medical ethics; review of Shari'a law and review of US law and legal cases was used to provide both perspectives regarding end-of-life issues. DISCUSSION: Commonalities and differences regarding end-of-life issues were highlighted in depth. CONCLUSIONS: There are many differences, and some commonalities between the laws practiced in both countries which help explain medical and nursing practice at the end of life.

Women in dentistry: A perspective on major universities in Saudi Arabia. Part 2: Analysis and statistical data.

PURPOSE AND SIGNIFICANCE: THE PURPOSES OF THIS STUDY WERE TO: (1) report the number of female graduates from the two oldest dental schools in Saudi Arabia; (2) compare the number of male and female graduates per year from these two major schools; and (3) compare these numbers of female dental graduates to those in the United States for the most recent year available, 2007. METHODS: This study was conducted using a descriptive non-experimental design. The study sample was the number of dental school graduates from the two major dental schools in Saudi Arabia. RESULTS: There were 1621 graduates of the College of Dentistry of King Saud University (KSU) since its inception up to 2007 of which 853 graduates were males and 768 were females, respectively. The total number of graduates from the Faculty of Dentistry of King Abdulaziz University (KAU) since its inception up till 2007 was 628 of which 264 were males and 364 were females. There was no statistically significant difference between the total number of male and female dental school graduates, although there was a significant difference between KSU and KAU dental schools. The proportion of female graduates from the two major Saudi dental schools was just over 50 % in 2007, which is slightly higher than the 45% female graduates from dental schools in the United States and Puerto Rico. CONCLUSIONS: Females currently comprise approximately half of the enrolled dental students at the KSU and KAU, a percentage slightly greater than that in the United States. The substantial enrollments suggested that women in Saudi Arabia consider dentistry to be an excellent career choice.

Women in dentistry: A perspective on major universities in Saudi Arabia. Part 1: Historical background.

As the works of females have been present in many fields of our lives, the history mentions little trace of these facts. The field of dentistry was among these professions. This paper will review the presence of dental practice by women world wide and will present a review of dentistry in Saudi Arabia.

Educational interventions in end-of-life care: part I: an educational intervention responding to the moral distress of NICU nurses provided by an ethics consultation team.

PURPOSE: This study was conducted to assess whether neonatal nurses who care for dying infants could be assisted in their knowledge and comfort via an educational intervention provided by hospital ethics committee members and hospice specialists. PARTICIPANTS: Eighty-two registered nurses working in a level III neonatal intensive care unit (NICU) were included. METHODS AND DESIGN: This was a quantitative pretest, intervention, post-test design with a single group undergoing educational sessions in the 6 areas of pain management, symptom management, ethical/legal issues, communication/culture, spiritual/anxiety, and prevention of compassion fatigue. MAIN OUTCOME MEASUREMENTS: An instrument, "Comfort in Caring for Dying Infants" (CLCDI), was developed to assess pre- and posteducational knowledge and comfort in these areas. RESULTS: There were statistically significant higher levels of comfort and knowledge in care for dying infants in the areas of ethical/legal issues and symptom management after the educational programs. Although not statistically significant, mean scores were higher after the educational sessions on pain management, spirituality/anxiety, and prevention of compassion fatigue. The communication/culture module scores were lower in the post-test administration. CONCLUSIONS: Education by hospice experts in the NICU can assist nurses' comfort with care of the dying infant. In addition, ongoing support is highly desirable for all staff participating in such care. The authors suggest incident debriefings from outside experts, debriefing after each infant's death, multidisciplinary meetings for the whole team, and having sessions of lessons learned on infant death cases.

Educational interventions in end-of-life care: part II: psychometric development of an instrument to measure nursing comfort after an educational intervention in end-of-life care: the "Comfort Level Caring for Dying Infants" (CLCDI).

PURPOSE: This article describes the psychometric development of an instrument that was used to measure nurses' comfort level with care of the dying before and after an educational intervention. PARTICIPANTS: 112 registered nurses working in a level III neonatal intensive care unit (NICU) were included. METHOD: Using a quantitative method, the validity and reliability of the instrument, "Comfort level in Caring for Dying Infants" (CLCDI), was assessed for content validity and internal consistency. RESULTS: The instrument was found to be reliable, but the content validity was questionable, and merits further testing. CONCLUSIONS: Given the results of the current study, the authors plan further refinements to the instrument.