Essays on poverty in Saudi Arabia

In Saudi Arabia, it is estimated that around 20% of nationals live in relative poverty. Echoing this estimation, the main research objective of this thesis is to determine the causes of poverty among nationals. For this purpose, a socioeconomic survey was conducted among 496 Saudi households in Dammam, one of the largest metropolitan cities, in 2019. This appears to be one of the first independent household surveys conducted in Saudi Arabia. In addition, a subsample of 166 households took part in a lab-in-the-field experiment to measure the risk and time preferences of household heads. In this study poverty is conceptualised as relative poverty, based on the country’s inflation-adjusted poverty line of $6 per person per day. To measure poverty, the Foster–Greer–Thorbecke (FGT) poverty index is used. Moreover, logit and tobit models are studied to analyse the determinants of the prevalence, intensity and severity of poverty. In addition, a discounted utility model is defined that applies prospect theory and quasi-hyperbolic discounting to jointly estimate the risk and time preferences of household heads. The results show that the key determinants of poverty are unemployment and limited education. Besides, large family sizes, insufficient social capital and being of African descent increase the risk of a household being poor. Moreover, female-headed households are affected by poverty more often and more severely than male-headed households. This is because many women do not seek employment due to cultural barriers. In addition, female household heads have fewer years of education than their male counterparts, which impacts their chances of employment. Nevertheless, it was discovered that females are equally likely to find a job when they have the same educational level as males. Furthermore, the study examined the relationship between poverty and behavioural aspects. A positive correlation between poverty and risk aversion and impatience was found. The study also enquired into Saudi Arabia’s social welfare system. Welfare payments lift one third of poor households out of poverty. However, around 15% of poor households do not receive any support. In particular, households without a national identification card are excluded from social welfare. Those households without access to governmental transfers or social networks were found to be willing to take greater risks. Moreover, female household heads receive higher social welfare payments than male heads. Hence, social welfare payments reduce the gender poverty gap to some extent

TINJAUAN PELAKSANAAN PENDAFTARAN RAWAT JALAN DI PUSKESMAS CIPUTAT TIMUR TANGERANG SELATAN

Puskesmas adalah Fasilitas Kesehatan Tingkat Pertama (FKTP) yang bertanggung jawab atas kesehatan masyarakat di wilayah kerjanya pada satu atau bagian wilayah kecamatan.” (Permenkes.RI 2016). Pendaftaran Rawat Jalan merupakan tempat pertama yang dikunjungi pasien atau keluarga pasien sebelum mendapatkan pelayanan kesehatan. Dalam pelayanan rawat jalan para petugas harus cekatan dalam melayani pasien lama maupun pasien baru. Tujuan penelitian Tinjauan Pelaksanaan Pendaftaran Rawat Jalan di Puskesmas Ciputat timur Tangerang selatan. Desain penelitian cross sectional dengan metode deskriptif melalui analisis kualitatif yaitu dengan cara observasi dan wawancara. Hasil penelitian adanya suatu hambatan dalam melakukan pendaftaran pasien, seperti koneksi internet yang terputus, pasien sering tidak membawa kartu identitas, dan minimnya SDM pada penyiapan berkas Rekam Medis. Saran sebaiknya ada petugas teknisi yang selalu sigap mengontrol koneksi pada saat jam pelayanan berlangsung dan penambahan petugas dengan kelulusan yang tepat pada pelayanan rawat jalan, terutama rekam medi

Association of Self-reported High-Risk Allergy History With Allergy Symptoms After COVID-19 Vaccination

Allergic history in individuals with confirmed anaphylaxis to a messenger RNA (mRNA) COVID-19 vaccine is common. However, the risk factors for allergy symptoms after receiving the vaccine are unknown

“I am not the same as before”: a mixed-methods study on depression in people with spinal injury in Qatar

Incidence of spinal injury is high in the Middle East and North African region (MENA) due to the high incidence of road traffic crashes. A spinal injury may trigger mental health issues. Compared to the general population, people with spinal injury are at higher risk for developing major depression, anxiety, post-traumatic stress disorders, substance abuse, and suicide.ObjectivesThe objectives of the study were to determine depression prevalence; identify relationships between depression and cause and site of spinal injury, sociodemographic factors, and social support; and explore the lived experiences of depression in people with spinal injury in Qatar.MethodsA sequential cross-sectional mixed methods study was conducted. In the quantitative component, the universal sample consisted of 106 consenting individuals presenting with spinal injury at Hamad General Hospital, Doha, Qatar between January and December 2020. The Patient Health Questionnaire-9 was used to assess levels of depression and the Medical Outcomes Study Social Support Survey was used to assess perceived social support. The cause and site of injury were obtained from patient records. In the qualitative component, semi-structured in-depth interviews were conducted with 12 purposively selected participants from the quantitative component.ResultsSpinal injury had a negative impact on participants physical, mental, social, and spiritual wellbeing. In total, 69% of participants had some level of depression: 28% mild, 25.5% minimal, and 15% moderate to severe. Depression was not associated with socio-demographic factors, or the cause or site of spinal injury. Higher levels of emotional/informational support and positive social interaction were associated with milder depression. Social support and religious faith were critical in assisting participants to cope with their new situation.ConclusionsDepression is prevalent among people with spinal injury attending health services. Early detection, referral, and treatment of depression are recommended. Strategies to enhance emotional/informational support and positive social interaction should be developed and tested with people with spinal injury

The Effect of Therapeutic Doses of Culinary Spices in Metabolic Syndrome: A Randomized Controlled Trial

Non-communicable diseases (NCDs) place a significant burden on global health and the healthcare systems which support it. Metabolic syndrome is a major risk factor for a large number of NCDs; however, treatments remain limited. Previous research has shown the protective benefits of edible dietary spices on key components of metabolic syndrome. Therefore we performed a 12-week double-blind, placebo-controlled, randomized, clinical trial to evaluate the effect of ginger (Zingiber officinale), cinnamon (Cinnamomum), and black seed (Nigella sativa) consumption on blood glucose, lipid profiles, and body composition in 120 participants with, or at risk of, metabolic syndrome. Each participant consumed 3 g/day of powder (spice or placebo). Data related to different parameters were collected from participants at the baseline, midpoint, and endpoint of the intervention. Over the 12-week interventions, there was an improvement in a number of biochemical indices of metabolic syndrome, including fasting blood glucose, HbA1c, LCL, and total cholesterol associated with supplementation with the spices when compared to a placebo. This study provides evidence to support the adjunct use of supplementation for those at risk of metabolic syndrome and its sequelae

Lifestyle Interventions for Prevention and Management of Diet-Linked Non-Communicable Diseases among Adults in Arab Countries

The increased incidences of diet-related non-communicable diseases (NCDs) such as diabetes, obesity, and cardiovascular diseases among adults are becoming the chief public health concern in most Arab countries. Economic expansion has contributed to a nutrition shift from a traditional seasonal diet to Westernized eating habits coupled with a sedentary lifestyle. Despite the rising concern for NCD mortality, public health policies are inadequately addressed. This narrative review aims to discuss the effectiveness of nutritional interventions focusing on diet and physical activity in the management of NCDs among Arab adults. A comprehensive literature search was performed using different database platforms such as Cochrane reviews, Scopus, and PubMed for articles published between 1 December 2012 and 31 December 2021. Fifteen recent research articles addressing NCDs, mainly diabetes and obesity, from different Arab countries were included in this review. Structured lifestyle interventions involving behavioral therapy approaches and personalized goals for diet and physical activity were found to improve specific health outcomes in most studies. Significant improvements in health outcomes were reported for longer-duration interventions with follow-ups. A combination of both online and face-to-face sessions was found to be effective. It is important to identify barriers to physical activity for a culturally acceptable lifestyle intervention and conduct further studies to evaluate interventions for the long-term maintenance of health outcomes

Transformation of 'Thielaviopsis basicola' to study host-pathogen interactions

'Thielaviopsis basicola', a filamentous fungus, is a soil-borne plant pathogen belonging to the teleomorphic genus 'Ceratocystis' (perithecial ascomycete). Different strains are capable of attacking a wide range of host plants causing black root rot, a seedling disease. Control strategies based on cultural practices, biocontrol agents, chemical fungicides, and genetically determined host resistance have not yet solved the issue of the loss of yield of agricultural crops. The main aim of this project was to investigate the molecular aspects of host-pathogen interactions, generate new knowledge and make progress towards the development of new control strategies for black root rot. For 'T. basicola' to cause black root rot, it germinates in soil forming a germ tube that elongates to reach the plant roots, attaches to the root surface and penetrates into the root hairs or epidermal cells. It is possible that signalling mechanisms may be required at different stages of the infection process for its progress. 'In vitro' pathogenicity and water agar assays were developed in order to understand and appreciate the ability of 'T. basicola' to perceive signals and respond by germination and/or directed growth towards various plants and in order to analyse the susceptibility of various plants, 'in vitro' pathogenicity and water agar assays were developed. The results provided evidence that exudates released by roots of host and non-host plants were responsible for hyphal directional growth towards plant roots. There was little evidence to suggest that a host-specific stimulus caused hyphal directional growth. There was also little evidence to suggest that a correlation existed between hyphal directional growth towards host plants and disease severity caused by 'T. basicola' isolates. Isolates that showed a strong hyphal directional growth response towards a particular susceptible plant did not necessarily cause disease. Strains of 'T. basicola' isolated from particular hosts may exhibit stronger growth direction and/or pathogenicity towards other hosts

Assessment of Sodium Knowledge and Urinary Sodium Excretion among Regions of the United Arab Emirates: A Cross-Sectional Study

Non-communicable diseases (NCDs) such as cardiovascular disease, cancer and diabetes, are increasing worldwide and cause 65% to 78% of deaths in the Gulf Cooperation Council (GCC). A random sample of 477 healthy adults were recruited in the United Arab Emirates (UAE) in the period March-June 2015. Demographic, lifestyle, medical, anthropometric and sodium excretion data were collected. A questionnaire was used to measure knowledge, attitude and practice regarding salt. Mean sodium and potassium excretion were 2713.4 ± 713 mg/day and 1803 ± 618 mg/day, respectively, significantly higher than the World Health Organization (WHO) recommendations for sodium (2300 mg/day) and lower for potassium (3150 mg/day). Two-thirds (67.4%) exceeded sodium guidelines, with males 2.6 times more likely to consume excessively. The majority of the participants add salt during cooking (82.5%) and whilst eating (66%), and 75% identified processed food as high source of salt. Most (69.1%) were aware that excessive salt could cause disease. Most of the UAE population consumes excess sodium and insufficient potassium, likely increasing the risk of NCDs. Despite most participants being aware that high salt intake is associated with adverse health outcomes, this did not translate into salt reduction action. Low-sodium, high-potassium dietary interventions such as the Mediterranean diet are vital in reducing the impact of NCDs in the UAE

Priority Outcomes in Critically Ill Children: A Patient and Parent Perspective

BACKGROUND: Outcomes in pediatric critical care research are typically selected by the researcher. OBJECTIVES: (1) To identify outcomes prioritized by patients and their families following a critical illness and (2) to determine the overlap between patient-centered and researcher-selected study outcomes. METHODS: An exploratory descriptive qualitative study nested within a longitudinal cohort study conducted in 2 pediatric intensive care units (PICUs). Participants were purposively sampled from the primary cohort to ensure adequate demographic representation. Qualitative descriptive approaches based on naturalistic observation were used to collect data and analyze results. Data were coded by using the International Classification of Functioning, Disability, and Health Children and Youth (ICF-CY) framework. RESULTS: Twenty-one participants were interviewed a mean of 5.1 months after PICU discharge. Outcomes fell into 2 categories: patient-centered and family-centered. In the former, diagnosis, survival, and prognosis were key priorities during the acute critical illness. Once survival appears possible, functioning (physical, cognitive, and emotional), and factors that influence recovery (ie, rehabilitation, environment, and quality of life) are prioritized. Family-centered outcomes consisted of parents\u27 psychosocial functioning and experience of care. Patient-centered outcomes were covered well by the selected study measures of functioning, but not by the clinical outcome measures. CONCLUSION: Functioning and quality of life are key patient-centered outcomes during recovery from critical illness. These are not well captured by end points typically used in PICU studies. These results justify the importance of patient- and family-centered outcomes in PICU research and a need to determine how these outcomes can be comprehensively measured