Influence of Organisational-Level Factors on Delayed Door-to-Balloon Time among Patients with ST-Elevation Myocardial Infarction

Objective: To estimate the door-to-balloon (DTB) time and determine the organisational-level factors that influence delayed DTB times among patients with ST-elevation myocardial infarction in the Sultanate of Oman. Methods: A cross-sectional retrospective study was conducted. All patients who presented to the emergency department at two public hospitals and underwent primary percutaneous interventions during the period of two years were included. Results: The sample included 426 patients. The median door-to-balloon time was 142 minutes. The result of bivariate logistic regression showed that patients who presented to the emergency department with atypical symptoms were three times more likely to have a delayed DTB time compared with patients presenting with typical symptoms (OR = 3.003, 95% CI: 1.409–6.400, p = .004). In addition, patients who presented during off-hours were two times more likely to have a delayed DTB time compared with patients who presented during regular working hours (OR = 2.291, 95% CI: 1.284–4.087, p = .005). Conclusion: To meet the door-to-balloon time recommendation, it is important to ensure that there is adequate staffing during both regular and irregular working hours. Results from this study can be used as a baseline for future studies and inform strategies for improving the quality of care. Keywords: Acute Myocardial Infarction; Clinical Management; Door-to-balloon Time; Emergency Care Systems; Staffing and Scheduling; Oman

Health-Related Quality of Life of Children and Adolescents with Sickle Cell Disease in the Middle East and North Africa Region: A systematic review

Sickle cell disease (SCD) can significantly impair the health-related quality of life (HRQOL) of children and adolescents. This review aimed to assess current evidence regarding the HRQOL of children and adolescents with SCD in the Middle East and North Africa region. A systematic search of various databases was conducted to identify relevant articles, including MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), Scopus® (Elsevier, Amsterdam, the Netherlands), Cumulative Index to Nursing and Allied Health Literature®, Masader (Oman Virtual Science Library, Muscat, Oman) and EBSCOhost (EBSCO Information Services, Ipswich, Massachusetts, USA). A total of 533 articles were identified; however, only 10 were eligible for inclusion in the final analysis. Results from these studies showed that children and adolescents with SCD had compromised HRQOL compared to their healthy peers, particularly in terms of physical, psychosocial, familial, financial and academic functioning. Therefore, interventions are necessary to improve overall HRQOL outcomes for this population. Keywords: Sickle Cell Disease; Health-Related Quality Of Life; Infants; Children; Adolescents; Middle East; North Africa

Direct and Moderating Effects of Work Environment and Structural Empowerment on Job Stress and Job Satisfaction Among Nurses in the Sultanate of Oman

Objective: This paper seeks to explore the relationships between nurses’ work environment, job stress, and job satisfaction, as well as the moderating effects of work environment and empowerment on the job stress–job satisfaction relationship. Methods: A descriptive correlational design was utilized. The study encompassed a convenience sample of 1,796 hospital nurses from the 11 governorates in Oman. A self-report questionnaire that included a set of instruments was used to collect data. Results: The results showed that nurses who perceived higher levels of job stress reported lower levels of satisfaction and empowerment, and perceived their work environment as less favorable and supportive. The findings only confirmed the direct effects of work environment and empowerment on satisfaction; there was no support for indirect or moderating effects. The hierarchical regression model showed that 46.5% of the variation in the level of job satisfaction was explained by the study variables. Conclusion: The results of this study demonstrate the importance of implementing strategies that empower staff, provide a supportive and positive work environment, and tackle job stress to enhance levels of job satisfaction. Keywords: Work Environment; Empowerment; Job Stress; Job Satisfaction; Nurses; Oman

Determinants of Physicians’ Job Satisfaction: A national multi-centre study from the Sultanate of Oman

Objectives: Physician satisfaction with their job can lead to a better quality of care, fewer chances of making errors, and better patient outcomes. The purpose of the study was to examine physician satisfaction; and to assess job satisfaction across several factors, such as quality of care, ease of practice, relationship with leadership, and inter-professional collaboration. Method: A descriptive cross-sectional design was used. Data were collected between July 2019 and January 2020. Participants provided demographic information and completed surveys related to physician satisfaction (13-item Likert type items on a scale from 1 to 5), and inter-professional collaboration (15-item, 4-point Likert scale, ranging from 1 for “strongly disagree” to 4 for “strongly agree”). Multiple linear regressions were used to determine the relationship between overall job satisfaction and demographic features and inter-professional collaboration. Results: Out of 396 physicians who were contacted, 354 responded (response rate = 89.4%). The median age was 40 years, and there were 208 male and 124 female physicians. The vast majority (238/354 = 62%) were expatriates. Seventy percent had a post-graduate degree. The vast majority (308 = 87%) worked in government hospitals. Results showed that 15 (5%) of the physicians were not satisfied with their job (<3.00), 179 (40%) expressed a moderate level of satisfaction (3.00 – 3.75), and 129 (55%) were highly satisfied (>3.76). There was no difference in mean job satisfaction score among different groups of study participants, except for gender, and the working grade (p < 0.05). The overall job satisfaction rates were higher for the quality of care (M = 3.93, SD = 0.61), and for ease of practice (M = 3.89, SD = 0.55) and lower for the relationship with leadership (M = 3.67, SD = 0.86). Having a clinical postgraduate degree together with a PhD, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates (p = 0.003 and 0.007, respectively). Conclusion: Overall, the job satisfaction rate was high. There was no difference among different groups of study participants, except for the working grade. Having a clinical postgraduate degree, a senior level of responsibility, and good inter-professional relationship were associated with higher job satisfaction rates. The overall job satisfaction rates were higher for the quality of care, and for ease of practice, and lower for relationship with the leadership. Relationship with the leadership is a modifiable factor and efforts at enhancing the physician-leadership relationship may lead to even higher satisfaction rates. Keywords: Interprofessional relations; Job Satisfaction; Leadership; Oman; Physician; Quality of health car

Associations between the LEP -2548G/A Promoter and Baseline Weight and between LEPR Gln223Arg and Lys656Asn Variants and Change in BMI z Scores in Arab Children and Adolescents Treated with Risperidone

Data on baseline (antipsychotic-naïve) age, weight, and height and change in these over three subsequent follow up time points up to 313.6 days (CI 303.5-323.7), were collected from 181 risperidone-treated children and adolescents (mean age 12.58 years, SD 4.99, range 2.17-17.7) attending a pediatric neurology clinic in Saudi Arabia. Owing to differences in genotypic distributions in subsamples, results are reported from the white Arabs (N=144). Age and gender-normed BMI-standardised z scores (BMI z) were calculated (lmsgrowth program). Linear regression was performed for baseline weight and BMI z, while change in BMI z was assessed using random effects ordered logistic regression. The following SNPs were analyzed: rs7799039 in the LEP promoter, rs1805094 (previously rs8179183), rs1137100 and rs1137101 in the LEPR, and rs1414334 in HTR2C. We found a nominally significant association between rs7799309 and baseline weight, adjusting for height, age, gender and diagnosis (A/G, P=0.035, β=-3.62, compared to G/G). rs1137101 (G/G, P=0.018, OR=4.13 compared to A/A) and rs1805094 C-allele carriers (P=0.019, OR=0.51) showed nominally significant associations with change in BMI z categories. Our data support and replicate previous relevant associations for these variants including with weight gain on risperidone, whilst being the first to report such associations in those of Arab ethnicity

Hydrogel-coated microneedle arrays for minimally invasive sampling and sensing of specific circulating nucleic acids from skin interstitial fluid

Minimally invasive technologies that can sample and detect cell-free nucleic acid biomarkers from liquid biopsies have recently emerged as clinically useful for early diagnosis of a broad range of pathologies, including cancer. Although blood has so far been the most commonly interrogated bodily fluid, skin interstitial fluid has been mostly overlooked despite containing the same broad variety of molecular biomarkers originating from cells and surrounding blood capillaries. Emerging technologies to sample this fluid in a pain-free and minimally-invasive manner often take the form of microneedle patches. Herein, we developed microneedles that are coated with an alginate–peptide nucleic acid hybrid material for sequence-specific sampling, isolation, and detection of nucleic acid biomarkers from skin interstitial fluid. Characterized by fast sampling kinetics and large sampling capacity (∼6.5 μL in 2 min), this platform technology also enables the detection of specific nucleic acid biomarkers either on the patch itself or in solution after light-triggered release from the hydrogel. Considering the emergence of cell-free nucleic acids in bodily fluids as clinically informative biomarkers, platform technologies that can detect them in an automated and minimally invasive fashion have great potential for personalized diagnosis and longitudinal monitoring of patient-specific disease progression

Knowledge and perceptions of diabetes in a semi-urban Omani population

<p>Abstract</p> <p>Background</p> <p>Diabetes mellitus is a major public health problem in the Sultanate of Oman. This study aimed to evaluate the knowledge and perception of diabetes in a sample of the Omani general population, and the associations between the elements of knowledge and perception, and socio-demographic factors.</p> <p>Methods</p> <p>The study was carried out in two semi-urban localities. A total of 563 adult residents were interviewed, using a questionnaire specifically designed for the present study. In addition to demographic information, the questionnaire contained questions on knowledge related to diabetes definition, symptoms, risk factors, complications and preventative measures, as well as risk perception for diabetes.</p> <p>Results</p> <p>Knowledge of diabetes was suboptimal. The percentages of correct responses to questions on diabetes definition, classical symptoms, and complications were 46.5%, 57.0%, and 55.1%, respectively. Only 29.5%, 20.8% and 16.9% identified obesity, physical inactivity and a positive family history, respectively, as risk factors for diabetes. A higher level of education, a higher household income, and the presence of a family history of diabetes were found to be positively associated with more knowledge.</p> <p>Conclusion</p> <p>This study demonstrated that there is lack of awareness of major risk factors for diabetes mellitus. Level of education is the most significant predictor of knowledge regarding risk factors, complications and the prevention of diabetes. Given that the prevalence of diabetes has increased drastically in Oman over the last decade, health promotion seems essential, along with other means to prevent and control this emerging health problem.</p

Groundwater resources assessment using integrated geophysical techniques in the southwestern region of Peninsular Malaysia.

Combined geophysical techniques such as multi-electrode resistivity, induced polarization, and borehole geophysical techniques were carried out on volcano-sedimentary rocks in the north of Gemas as part of the groundwater resource’s investigations. The result identifies four resistivity units: the tuffaceous mudstone, tuffaceous sandstone, the tuff bed, and the shale layer. Two types of aquifer systems in terms of storage were identified within the area: one within a fracture system (tuff), which is the leaky area through which vertical flow of groundwater occurs, and an intergranular property of the sandy material of the aquifer which includes sandstone and tuffaceous sandstone. The result also reveals that the aquifer occupies a surface area of about 3,250,555 m2 with a mean depth of 43.71 m and a net volume of 9.798 × 107 m3. From the approximate volume of the porous zone (28 %) and the total aquifer volume, a usable capacity of (274.339 ± 30.177) × 107 m3 of water in the study area can be deduced. This study provides useful information that can be used to develop a much broader understanding of the nature of groundwater potential in the area and their relationship with the local geology

The antibacterial properties of Malaysian tualang honey against wound and enteric microorganisms in comparison to manuka honey

<p>Abstract</p> <p>Background</p> <p>Antibiotic resistance of bacteria is on the rise, thus the discovery of alternative therapeutic agents is urgently needed. Honey possesses therapeutic potential, including wound healing properties and antimicrobial activity. Although the antimicrobial activity of honey has been effectively established against an extensive spectrum of microorganisms, it differs depending on the type of honey. To date, no extensive studies of the antibacterial properties of tualang (<it>Koompassia excelsa</it>) honey on wound and enteric microorganisms have been conducted. The objectives of this study were to conduct such studies and to compare the antibacterial activity of tualang honey with that of manuka honey.</p> <p>Methods</p> <p>Using a broth dilution method, the antibacterial activity of tualang honey against 13 wound and enteric microorganisms was determined; manuka honey was used as the control. Different concentrations of honey [6.25-25% (w/v)] were tested against each type of microorganism. Briefly, two-fold dilutions of honey solutions were tested to determine the minimum inhibitory concentration (MIC) against each type of microorganism, followed by more assays within a narrower dilution range to obtain more precise MIC values. MICs were determined by both visual inspection and spectrophotometric assay at 620 nm. Minimum bactericidal concentration (MBC) also was determined by culturing on blood agar plates.</p> <p>Results</p> <p>By visual inspection, the MICs of tualang honey ranged from 8.75% to 25% compared to manuka honey (8.75-20%). Spectrophotometric readings of at least 95% inhibition yielded MIC values ranging between 10% and 25% for both types of honey. The lowest MBC for tualang honey was 20%, whereas that for manuka honey was 11.25% for the microorganisms tested. The lowest MIC value (8.75%) for both types of honey was against <it>Stenotrophomonas maltophilia</it>. Tualang honey had a lower MIC (11.25%) against <it>Acinetobacter baumannii </it>compared to manuka honey (12.5%).</p> <p>Conclusion</p> <p>Tualang honey exhibited variable activities against different microorganisms, but they were within the same range as those for manuka honey. This result suggests that tualang honey could potentially be used as an alternative therapeutic agent against certain microorganisms, particularly <it>A. baumannii </it>and <it>S. maltophilia</it>.</p

Non-Isothermal Model for Nematic Spherulite Growth

A computational study of the growth of two-dimensional nematic spherulites in an isotropic phase was performed using a Landau-de Gennes type quadrupolar ensor order parameter model for the first-order isotropic/nematic transition of 5CB (pentyl-cyanobiphenyl). An energy balance, taking anisotropy into account, was derived and incorporated into the time-dependent model. Growth laws were determined for two different spherulite morphologies of the form tn, with and without the inclusion of thermal effects. Results show that incorporation of the thermal energy balance correctly predicts the transition of the growth law exponent from the volume driven regime (n=1) to the thermally limited regime (approaching n=0.5), agreeing well with experimental observations. An interfacial nemato-dynamic model is used to gain insight into the interactions that result in the progression of different spherulite growth regimes