Background:Adequate sleep is essential for children and adolescents, supporting mental, physical, and academic development. Increasingly, widespread use of digital devices, including smartphones, tablets, and video games, has been linked to poor sleep quality, delayed bedtimes, and behavioral issues. Excessive screen time, particularly before bedtime, can disrupt sleep patterns and increase the risk of emotional and cognitive problems. Understanding parental awareness, beliefs, and practices regarding children's use of smart devices is crucial to mitigate these negative effects. Methods:A cross-sectional study was conducted from November 2023 to May 2024 among 400 parents of healthy children and adolescents in Majmaah. Data were collected through online-based questionnaires assessing on the basis of educational level, complete structured questionnaire covering demographics, beliefs, and practices. Analysis was performed using SPSS Version 27, applying chi-square and t-tests with a significance level of p < 0.05. Results:The study included 400 parents, predominantly females (79.75%) and married (66.5%), with most holding a bachelor's degree (49%) and having more than four children (41.5%). Most parents (86.75%) were aware of the negative effects of smart devices, particularly on sleep (93%) and vision (92.75%). Although 77.5% enforced device limits and 86% sought medical care for related symptoms, many children still exceeded recommending screen time, affecting sleep and behavior. Parental education was significantly associated with awareness (p < 0.05). Findings highlight that despite high awareness, consistent regulation of device use remains challenging, especially in younger children. Conclusion:This study assessed parents' awareness and practices regarding children's smart device use in Majmaah. Educated parents recognized risks to sleep and vision, yet many struggled to limit usage, especially in children aged 0-5 years. Parental education correlated with awareness, and device use affected sleep. Findings highlight the need for parental guidance and structured screen time limits to protect children's health.

Introduction The integration of medical informatics (MI) in medical education is crucial for preparing future healthcare professionals to effectively utilize technology in their practice. This study aimed to investigate the impact of MI training on Saudi medical students’ knowledge and attitude towards using technology in future medical practice. Method A cross-sectional descriptive study was conducted among medical students at Saudi medical universities, employing a non-probability convenience sampling method. A standard pre-structured, self-reported questionnaire was used to collect data from 1508 students, with 1192 having undertaken an MI course and 316 not having undertaken the course. The validated questionnaire included two dimensions of knowledge and attitude and each dimension had 12 items. Results The mean scores of knowledge and attitude towards MI were significantly higher among students who had undertaken the MI course compared to those who had not (p < 0.001). The results highlighted the effectiveness of MI training in enhancing students’ understanding of various MI concepts and applications, including electronic medical records, patient confidentiality, clinical decision support systems, telemedicine, e-prescriptions, evidence-based practice, and legal/ethical considerations in clinical informatics. Conclusion This result of this study highlights the significance of MI course in shaping students’ perceptions and understanding of various aspects of healthcare, particularly in the context of EMRs, patient confidentiality, and the role of technology in healthcare. The findings provide valuable insights into the transformative impact of MI training on students’ knowledge and attitude towards utilizing informatics in their future medical careers. BJMS, Volume: 24. Supplementary Issue 2025, Page : 170-177

Background: Hypertension and diabetes are leading contributors to global morbidity and mortality, with the burden disproportionately affecting low-resource communities. Primary health care (PHC) facilities serve as the first point of contact and are pivotal in early detection and long-term management of chronic diseases. However, the effectiveness of PHC systems in resource-limited settings remains underexplored. Methods: This cross-sectional analytical study was conducted enrolling 295 adult patients attending PHC facilities. Data were collected through structured interviews, clinical assessments, and review of medical records, focusing on sociodemographic characteristics, disease prevalence, detection methods, treatment initiation, follow-up adherence, and patient satisfaction. Results: Out of 295 patients, 48.1% had hypertension, 33.2% diabetes, and 13.9% both conditions. The mean age was 52.4 +/- 11.8 years, with older age associated with dual disease (p = 0.018). PHC screening detected 66.9% of hypertension and 65.3% of diabetes cases, though the average diagnostic delay was 7.6 +/- 4.2 months for hypertension and 8.3 +/- 5.1 months for diabetes. Pharmacological therapy was initiated in 89.3% of patients, and 75.8% received lifestyle counseling, yet only 60.9% reported consistent medication availability. Regular follow-up adherence was 59.9% for hypertension, 59.2% for diabetes, and 46.3% for dual conditions. Control rates were modest: 53.5% for hypertension, 52.0% for diabetes, and 31.7% for both diseases. Regression analysis identified higher education, income >$200, consistent follow-up, and reliable drug supply as significant predictors of disease control (p < 0.05). Patient satisfaction was moderate, with 66.8% satisfied overall, though barriers such as drug shortages, financial difficulties, and transport issues were frequently reported. Conclusion: It is concluded that PHC services are effective in detecting hypertension and diabetes and initiating treatment in low-resource settings, but systemic barriers limit long-term disease control, particularly in patients with dual conditions. Strengthening PHC through reliable supply chains, standardized care protocols, and community engagement is essential to improve outcomes and reduce the burden of noncommunicable diseases.

Introduction:This study aims to assess the level of mental health literacy (MHL) among healthcare providers working in different healthcare settings in Saudi Arabia and to examine how socio-demographic factors such as gender, education, age, and personal exposure to mental health conditions associate with MHL. Methods:This is a cross-sectional study that used a computer-assisted telephone interview. The study followed a previously validated methodology, ensuring consistency and comparability for future studies. Interviewers were trained to adhere to the interview guidelines and data collection that were streamlined using the ZDataCloud system. Participants aged 18 years and above and from 13 administrative different regions in Saudi Arabia were included and informed consent was obtained verbally from all participants. Data collection included healthcare worker demographics, mental health history, and familiarity with mental health issues. The Arabic MHL scale was used to assess participants' knowledge and understanding of mental health disorders. MHL scale has been validated in the population in Saudi Arabia, demonstrating strong reliability and validity. Results:The study revealed that female healthcare providers had significantly higher MHL scores in mental health recognition (females = 8.7 ± 1.2, males = 7.2 ± 1.5; p < 0.001) and attitudes (females = 9.3 ± 1.1, males = 7.8 ± 1.4; p < 0.001) compared to males. Healthcare providers with a Bachelor's degree or higher exhibited higher score in mental health recognition (8.9 ± 1.3 vs. 7.1 ± 1.6; p < 0.001) and information-seeking (8.4 ± 1.4 vs. 7.2 ± 1.5; p = 0.003) compared to lower level of education. Younger participants (20-29 years old) showed more positive attitudes (p = 0.011), while those exposed to mental illness (p = 0.001) and higher-income earners (p = 0.040) demonstrated higher overall MHL. Conclusion:Significant association between MHL domains and sociodemographic factors among healthcare providers in Saudi Arabia, highlighting the need for targeted interventions to improve MHL across among different healthcare groups.

The Chikungunya virus (CHIKV) presents substantial public health challenges in the Eastern Mediterranean Region (EMR), with its prevalence and interaction with other arboviruses (ABVs) remaining poorly understood. This systematic review and meta-analysis aimed to assess the prevalence of CHIKV and its association with other ABVs, such as dengue virus (DENV), Rift Valley fever virus (RVFV), malaria, and yellow fever virus (YFV), in the EMR. We systematically searched databases including PubMed, Embase, Web of Science, Scopus, Cochrane Library, CINAHL, PsycINFO, and ScienceDirect to identify epidemiological studies that report CHIKV prevalence and provide odds ratios (ORs) for CHIKV compared to other ABVs. Data analysis was performed using a random-effects model. Heterogeneity was evaluated using the chi 2 test and I2 statistic. The GRADE approach was used to evaluate the quality of the studies while the AXIS tool, NOS tool, and AHRQ checklist assessed the risk of bias. The meta-analysis revealed a significant prevalence of CHIKV in the EMR. However, the studies exhibited heterogeneity, indicating variability in the results. A comparison of CHIKV with other ABVs did not show any statistically significant differences in prevalence. The meta-analysis found a notable prevalence of CHIKV in the EMR. The results also indicated that the prevalence of CHIKV is comparable to that of other ABVs in the region. These findings provide an overview of the burden of CHIKV in the EMR.

Background:Given the limited understanding of individuals' positive gains, this study aimed to identify these gains that could be leveraged by policymakers to enhance future health and societal resilience. Methods:We used a global qualitative approach to survey adults over 18 from 30 countries across six World Health Organization (WHO) regions, who detailed up to three personal positive gains from COVID-19 pandemic via an open-ended question. Inductive thematic analysis was employed to identify main themes, and quantitative methods were used for demographic and regional comparisons based on the percentage of responses for each theme. Results:From 35 911 valid responses provided by 13 853 participants, six main themes (one negative theme), 39 subthemes, and 673 codes were identified. Five positive gain themes emerged, ordered by response frequency: 1) improved health awareness and practices; 2) strengthened social bonds and trust; 3) multi-dimensional personal growth; 4) resilience and preparedness building; 5) accelerated digital transformation. The percentage of responses under these themes consistently appeared in the same order across various demographic groups and economic development levels. However, there were variations in the predominant theme across WHO regions and countries, with either Theme 1, Theme 2, or Theme 3 having the highest percentage of responses. Although our study primarily focused on positive gains, unexpectedly, 12% of responses (4304) revealed 'negative gains', leading to an unforeseen theme: 'Distrust and emerging vulnerabilities.' While this deviates from our main topic, we retained it as it provides valuable insights. Notably, these 'negative gains' had a higher percentage of responses in areas like Burundi (94.1%), Rwanda (31.8%), Canada (26.9%), and in the African Region (37.7%) and low-income (43.9%) countries, as well as among non-binary individuals, those with lower education, and those facing employment challenges. Conclusions:Globally, the identified diverse positive gains guide the domains in which health policies and practices can transform these transient benefits into enduring improvements for a healthier, more resilient society. However, variations in thematic responses across demographics, countries, and regions highlights need for tailored health strategies.

Background: Congestive heart failure (CHF) represents an important health issue characterised by considerable morbidity and mortality. This study sought to identify risk factors for CHF and to evaluate clinical outcomes between CHF patients and control subjects. Methods: Data were obtained through interviews, physical examinations, and medical records. Risk variables encompassed hypertension, diabetes, dyslipidaemia, tobacco use, alcohol use, sedentary lifestyle, dietary practices, age, gender, and familial history of cardiovascular disease. The outcomes were all-cause mortality, cardiovascular mortality, hospitalisation, major adverse cardiovascular events (MACE), quality of life as measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and functional level according to the New York Heart Association (NYHA) classification. Statistical analyses including t-tests, Chi-square tests, logistic regression and Cox regression. Results: The findings indicated that hypertension (71.8% vs. 38.5%, p < 0.001), diabetes (47.9% vs. 28.2%, p = 0.002), dyslipidaemia (54.7% vs. 41.0%, p = 0.04), smoking (42.7% vs. 29.1%, p = 0.03), and physical inactivity (65.8% vs. 41.9%, p < 0.001) were more prevalent in cases. Cases exhibited increased hospitalisations (1.8 ± 1.2 vs. 0.7 ± 0.9, p < 0.001), prolonged stays (10.5 ± 5.4 vs. 6.2 ± 3.8 days, p < 0.001), elevated 30-day rehospitalisation rates (21.4% vs. 8.5%, p = 0.007), and a greater incidence of intensive care units (ICU) admissions (17.1% vs. 6.0%, p = 0.01). All-cause mortality (35.9% vs. 17.1%, p = 0.001), cardiovascular mortality (25.6% vs. 10.3%, p = 0.003), and MACE (51.3% vs. 25.6%, p < 0.001) were greater in cases. Quality of life (45.8 ± 12.4 vs. 25.6 ± 10.3, p < 0.001) and functional status (55.6% vs. 23.9%, p < 0.001) were inferior in cases. Conclusion: CHF patients had greater rates of modifiable risk variables and worse clinical outcomes than controls, underscoring the necessity for comprehensive risk management.

Purpose: The aim of this study was to assess the frequency and intensity of food cravings among adults in Central and Western Saudi Arabia. Patients and Methods: This retrospective, cross-sectional study was conducted using online questionnaires. The collected data were analyzed using SPSS version 24.0. Results: A sample of 432 individuals was investigated, which was almost evenly split between men (50.5%) and women (49.5%). Body mass index (BMI) of most participants fell within the normal (31.9%) and overweight (32.6%) categories, highlighting a fairly balanced distribution of these BMI ranges. The obesity category included 24.5% of participants, raising concerns about potential obesity-related health issues. A significant proportion of participants had irregular meal-taking patterns. Overall, snacks and fruits were most frequently consumed daily, whereas eating with family was the least frequent activity. Finally, p-values from an assessment of food cravings and their effects on BMI indicated various levels of significance. Cravings for salty foods (p=0.008), the influence of emotional factors on food cravings (p=0.03), eating due to sadness even when not hungry (p=0.01), challenges in resisting or controlling food cravings (p=0.04), and feelings of guilt or regret after indulging in cravings (p=0.000) were all significant factors, suggesting potential links with BMI. Conclusion: Food craving involves a complex interplay of different factors, including emotional states and social cues, with varying levels of self-control and associated guilt or regret.

Background We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements. Methods From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network. Results Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P< 0.05). Conclusions In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study's cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research.

This study investigates the potential impact of gestational diabetes mellitus (GDM) on the concentration of heavy metals in breast milk (BrM), a critical concern due to its possible health implications for infants. It compares HM levels in BrM from mothers with and without a history of GDM, assessing infant health risks. 100 BrM samples from 50 mothers in each group were analyzed for ten heavy metals using inductively coupled plasma mass spectrometry (ICP-MS). Also, Monte Carlo simulation was used to estimate the likelihood of various outcomes in a complex process. The results revealed that both groups' average concentrations of As, Pb, Cr, Ni, and Mn exceeded the maximum tolerable limit. The potential risks posed by all ten heavy metals in BrM for infants aged 1-12 months were higher than the acceptable level, indicating the need for health risk mitigation measures. No significant difference was found in the average concentration of each HM in BrM between the two groups, suggesting that a history of GDM may not significantly influence the heavy metals levels in BrM postpartum (P > 0.05). This indicates that a history of GDM during pregnancy may not considerably influence the heavy metals levels in BrM during the postpartum period.

Introduction: This research examines the effects of depression and anxiety on patients' recovery and quality of life following cardiac intervention, highlighting the frequent occurrence of these psychological conditions after ICU stays and intensive rehab, emphasizing the need for addressing pain perception and providing patient education and counseling. Methodology: A descriptive cross-sectional research design was used, and the research was conducted in Saudi Arabia from April 2023 to September 2023. All participants were from Saudi Arabia and had cardiac intervention. Questionnaires collected data: The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) questionnaire. Results: Among the 543 patients included who underwent cardiac intervention, 61.3% (n=333) were males, and 38.7% (n=210) were females. The most common types of intervention were percutaneous coronary intervention (30.8%, n=167) and coronary artery bypass grafting (26.7%, n=145). Notable comorbidities included arrhythmia (22.1%, n=120), diabetes (42.7%, n=232), high cholesterol (41.8%, n=227), hypertension (52.3%, n=284), a sedentary lifestyle (37.8%, n=205), and smoking (33.1%, n=180). Patients with depressive and anxiety symptoms were further categorized into different levels of severity based on their PHQ and GAD-7 scores, respectively. Conclusion: Our study indicated a high prevalence of depressive and anxiety symptoms in this population. Factors such as comorbidities, demographics, and intervention characteristics were associated with the presence and severity of these symptoms. The findings highlight the importance of addressing psychological well-being and implementing targeted interventions to improve the mental health outcomes of cardiac intervention patients in Saudi Arabia

Sexually transmitted infections (STIs) are a major global health, occurring in different worldwide nations. Discussing STIs in Saudi society is considered taboo, due to social and ethical constraints. Sexual health is a serious issue in Saudi Arabia due to conservative religious values make sexual health among youth a significant concern, as young people face heightened vulnerability to STIs due to increased sexual experimentation, limited awareness, and difficulty accessing treatment. The study purpose is to evaluate the knowledge of STIs among adults in Saudi Arabia. This cross-sectional study involves adult men and women from various regions of Saudi Arabia. Sexually transmitted diseases (STD) knowledge scores were calculated using a validated 27-item Arabic questionnaire adapted from existing tools. Survey data were analyzed using IBM SPSS version 20.0. Results are presented as frequencies and percentages. Chi-squared or Fisher's exact tests were used for comparisons, with statistical significance set at p < 0.05. In a study with 1706 participants (94.7% response rate), the gender distribution was 825 males (48%) and 881 females (52%). Most respondents were aged 18-23 (43%), followed by 24-31 (27%) and 32-39 (14%) years. Geographically, 71% were from the central region, with significant gender differences in regional distribution (p < 0.0001). The estimated overall mean of knowledge scores (STDs-KS) was 6.65 +/- 3.1. The STD-KS showed no significant association with age. However, gender had a significant association (p < 0.0001), with males having slightly lower scores (6.5 +/- 3.0) than females (6.8 +/- 3.2). Marital status showed marginal significance (p = 0.042), and educational status had a significant association (p <0.0001) with STD-KS. In conclusion, this study highlights the significance of demographic factors in STD knowledge. It emphasizes the need for targeted interventions considering age, gender, marital status, education and geography to enhance STI awareness and prevention.

Background Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements. Methods We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test. Findings Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). Conclusion To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies.

Human breast milk is the optimal source of nutrition for newborns, but the potential transfer of contaminants like mycotoxins, particularly ochratoxin A (OTA), from maternal blood to milk remains a concern. This systematic review aims to provide a comprehensive analysis of global OTA levels in human breast milk and assess the associated health risks. We conducted a thorough search of scientific databases, including Web of Science, ScienceDirect, Scopus, Google Scholar and PubMed, using keywords related to OTA in human breast milk. A total of 39 studies met the inclusion criteria for this review. OTA levels compared to limits, estimated infant intake at various ages and health risks assessed using Margin of Exposures (MOEs) and Hazard quotient (HQ). Our findings reveal the widespread presence of OTA in breast milk across different regions, with notably higher levels detected in Africa compared to Asia, South America and Europe. The higher concentrations observed in warmer, humid climates suggest that environmental factors significantly influence OTA contamination. Mature breast milk samples generally exhibited greater OTA exposure. The neoplastic and non-neoplastic effects demonstrate generally low risks globally. The regional differences in OTA levels and associated health risk assessments underscore the need for continued research into the health impacts of OTA exposure in infants. This includes further investigation into multiple sources of exposure, such as infant formula, within the broader context of the exposome framework.

Objective:This study aimed to evaluate the effect of child-friendly dentist attire and camouflage syringes on reducing dental anxiety in children. Methods:A cross-sectional study was conducted with 120 pediatric patients aged 6 to 12 years. Participants were assigned to one of three groups: group A (child-friendly dentist attire), group B (camouflage syringe), or group C (control group). Child preference for dentist attire was assessed using a visual analog scale, while dental anxiety was measured using the Modified Child Dental Anxiety Scale and the Facial Image Scale. Results:The results showed a significant decrease in dental anxiety scores in both group 2 and group 3 compared to group 1 (P < 0.001). Children in group A exhibited a higher preference for child-friendly dentist attire [mean score: 8.7, standard deviation (SD): 1.2] compared to group 1 (mean score: 3.2, SD: 1.5) (P < 0.001). Similarly, children in group 2 showed a higher preference for a camouflage syringe (mean score: 8.5, SD: 1.3) compared to group 1 (mean score: 3.4, SD: 1.6) (P < 0.001). Conclusion:Child-friendly dentist attire and camouflage syringes were found to be effective in reducing dental anxiety among pediatric patients. These interventions were well received by children and their parents, highlighting the importance of considering child preferences in dental settings.

Background In this study, we assessed the general population's fears towards various diseases and events, aiming to inform public health strategies that balance health-seeking behaviours. Methods We surveyed adults from 30 countries across all World Health Organization (WHO) regions between July 2020 and August 2021. Participants rated their fear of 11 factors on an 11-point Likert scale. We stratified the data by age and gender and examined variations across countries and regions through multidimensional preference analysis. Results Of the 16 512 adult participants, 62.7% (n = 10 351) were women. The most feared factor was the loss of family members, reported by 4232 participants (25.9%), followed by cancer (n = 2248, 13.7%) and stroke (n = 1416, 8.7%). The highest weighted fear scores were for loss of family members (mean ((x) over bar) = 7.46, standard deviation (SD) = 3.04), cancer (= 7.00, SD = 3.09), and stroke ((x) over bar = 6.61, SD = 3.24). The least feared factors included animals/ insects ((x) over bar = 3.72, SD = 2.96), loss of a mobile phone ((x) over bar = 4.27, SD = 2.98), and social isolation ((x) over bar = 4.83, SD = 3.13). Coronavirus disease 2019 (COVID-19) was the sixth most feared factor ((x) over bar = 6.23, SD = 2.92). Multidimensional preference analyses showed distinct fears of COVID-19 and job loss in Australia and Burundi. The other countries primarily feared loss of family members, cancer, stroke, and heart attacks; this ranking was consistent across WHO regions, economic levels, and COVID-19 severity levels. Conclusions Fear of family loss can improve public health messaging, highlighting the need for bereavement support and the prevention of early death-causing diseases. Addressing cancer fears is crucial to encouraging the use of preventive services. Fear of non-communicable diseases remains high during health emergencies. Top fears require more resources and countries with similar concerns should collaborate internationally for effective fear management.

This study reviews global levels of ochratoxin A (OTA) in infant formula and cereal-based foods, using Monte Carlo simulation to assess risks. The review found 24 studies on global OTA levels in infant food and cereal-based products, using databases including PubMed, Scopus, Web of Science and Embase until March 2024. We estimated OTA exposure in infant food based on concentration, intake and body weight. The exposure and hazard quotient margin were calculated using BMDL10 and TDI values. Monte Carlo simulation evaluated human health risks from OTA in infant formula and cereal-based foods. A global study from 14 countries shows varying levels, surpassing EU limits in Tunisia, Ecuador, the USA, and generally in Africa, notably in infant cereals, which had higher levels than formula. Globally, OTA was present in 29.3% of the 3348 samples analyzed, with Lebanon at 95.2% and Brazil at 0%. Analysis indicates only non-carcinogenic risk for infants. While health risks for infants are mostly low, ongoing research and monitoring are vital to minimize OTA exposure in infant food.

Background:The interconnected nature of lifestyles and interim health outcomes implies the presence of the central lifestyle, central interim health outcome and bridge lifestyle, which are yet to be determined. Modifying these factors holds immense potential for substantial positive changes across all aspects of health and lifestyles. We aimed to identify these factors from a pool of 18 lifestyle factors and 13 interim health outcomes while investigating potential gender and occupation differences.Methods:An international cross-sectional study was conducted in 30 countries across six World Health Organization regions from July 2020 to August 2021, with 16 512 adults self-reporting changes in 18 lifestyle factors and 13 interim health outcomes since the pandemic.Results:Three networks were computed and tested. The central variables decided by the expected influence centrality were consumption of fruits and vegetables (centrality = 0.98) jointly with less sugary drinks (centrality = 0.93) in the lifestyles network; and quality of life (centrality = 1.00) co-dominant (centrality = 1.00) with less emotional distress in the interim health outcomes network. The overall amount of exercise had the highest bridge expected influence centrality in the bridge network (centrality = 0.51). No significant differences were found in the network global strength or the centrality of the aforementioned key variables within each network between males and females or health workers and non-health workers (all P-values >0.05 after Holm-Bonferroni correction).Conclusions:Consumption of fruits and vegetables, sugary drinks, quality of life, emotional distress, and the overall amount of exercise are key intervention components for improving overall lifestyle, overall health and overall health via lifestyle in the general population, respectively. Although modifications are needed for all aspects of lifestyle and interim health outcomes, a larger allocation of resources and more intensive interventions were recommended for these key variables to produce the most cost-effective improvements in lifestyles and health, regardless of gender or occupation.

OBJECTIVE:In the hospital setting, long waiting times and the lengthy formal process have increased the inefficiency and mismanagement resulting in the missing chance of saving the patients' life. Our aim was to assess the time wastage of every patient coming from reception to the actual emergency unit, to analyze the factor associated with the time lapse that occurs during every visit, and to see the effect of training on the services provided in the Pediatric emergency room.SUBJECTS AND METHODS:An intervention study was carried out in the following secondary care hospital in the Al Jouf region, Saudi Arabia: Esawiyah Hospital, Haditha Hospital, King Faisal Hospital, and Gurayat General Hospital among 400 study participants for 12 months. The study was carried out in 2 phases: pre-training, a period of training for hospital staff, and post-training data collection. Templates were generated on an MS Excel sheet and analysis of data was done using SPSS software. Percentages and proportions were calculated for descriptive statistics.RESULTS:Male and female patients were in the ratio of nearly 1:1. Training has significantly reduced the time to doctor consultation (U = 188, p < 0.001), and the time difference pre- and post-training from triage to consultation in a pediatric emergency is not significant (U = 16,769, p = 0.01). There is a strongly significant association (p < 0.001) between Canadian Triage and Acuity Scale (CTAS) implementation in triage. The practice of giving intravenous (IV) antibiotics in the emergency room has reduced significantly (p < 0.001) post-training.CONCLUSIONS:Training has a significant impact on the services provided in the pediatric emergency room.