Appropriateness of Emergency Referrals Made by Primary Care Clinicians: A cross-sectional review of referral notes

Objectives: To evaluate the appropriateness of emergency referrals made by primary care clinicians and determine factors contributing to inappropriate referrals. Methods: A cross sectional study, based on referral notes review. Patients referred to Khawla Hospital emergency department by a primary care clinician in Muscat governorate were randomly selected. Referral notes were reviewed by five family physicians. Appropriateness of referrals were evaluated according to primary care referral protocol. Any referral document that deviated from the protocol was classified as inappropriate. The prevalence and characteristics of inappropriate referrals were identified. Factors contributing to inappropriate referral were determined using multivariable logistic regression. Results: A total of 591 referrals were reviewed. 354 (59.9%) were classified as inappropriate. The reason for inappropriate classification was due to inadequate medical notes 291 (82.2%), lack of provisional diagnosis 176 (49.7%), misdirected to a non-concerned emergency 30 (8.4%), misclassification of urgency in which 107 (30.2%) were urgent and 45 (12.7%) were routine. After adjusting for multiple variables, insufficient clinical notes, unavailability of referral guidelines, and lack of expertise were strong determinants of inappropriate referral with odds ratio 62.52 (95% CI: 32.04 - 121.96), 2.88 (95% CI: 1.40 – 5.92), and 9.37 (95% CI: 4.09 – 21.43), respectively. Conclusion: While most referrals made by primary care clinicians required emergency management, the majority were identified as inappropriate and that was mainly due to insufficient clinical documentation. Inadequate clinical notes, lack of national guidelines and expertise were found to be strong predictors for inappropriate emergency referrals. Keywords: Referral and consultation, hospital referral; emergency; primary care; physicians; documentation; records; guidelines

Psychological Hardiness and its Relationship to some Demographic Variables among Post-Basic Education Teachers in the Governorate of South Al-Batinah in the Sultanate of Oman

This study aimed to identify the level of psychological hardiness and its relationship to some demographic variables among post-basic education teachers in the Governorate of South Al-Batinah in the Sultanate of Oman. The sample of the study, which was chosen based on the stratification random method, consisted of 306 teachers; 178 males and 128 females. In order to achieve the aims of the study, a descriptive correlational approach was used, and the psychological hardiness scale was developed by the researchers and administered to the study sample after assessing its psychometric properties. The results of this study showed that the level of psychological hardiness among post-basic education teachers in the Governorate of South Al-Batinah was high as the mean score of psychological hardiness was 2.44/3. Additionally, there were no statistically significant differences at the 0.05 level in psychological hardiness due to gender, major and teaching experience

Relationship between alexithymia and career decision -making self-efficacy among Tenth and Eleventh grade students in Muscat governorate

 The purpose of this study was to examine the relationship between alexithymia and career decision -making self-efficacy among Tenth and Eleventh grade students in Muscat governorate. To achieve this purpose,  Alexithymia Scale (AS),and CDMSE Short Form were administered to a total sample of 556 students of Tenth and Eleventh grades ( (n = 278) males and (n = 278) females . Findings revealed that the level of alexithymia was less than the mean of items, while the level of CDMSE was more than the mean of items, as well as there was no significant correlational relationship between alexithymia and CDMSE. The findings also indicated that there were significant gender differences in alexithymia, while there were no significant gender differences in CDMSE. With regard to GPA, the findings revealed that there were no significant differences in alexithymia, while there were significant differences in CDMSE. Conclusion: It concludes that although there was no significant correlational relationship between alexithymia and career decision-making self-efficacy, alexithymia negatively affects individual’s decisions in life

Psychological Hardiness and its Relationship to some Demographic Variables among Post-Basic Education Teachers in the Governorate of South Al-Batinah in the Sultanate of Oman

This study aimed to identify the level of psychological hardiness and its relationship to some demographic variables among post-basic education teachers in the Governorate of South Al-Batinah in the Sultanate of Oman. The sample of the study, which was chosen based on the stratification random method, consisted of 306 teachers; 178 males and 128 females. In order to achieve the aims of the study, a descriptive correlational approach was used, and the psychological hardiness scale was developed by the researchers and administered to the study sample after assessing its psychometric properties. The results of this study showed that the level of psychological hardiness among post-basic education teachers in the Governorate of South Al-Batinah was high as the mean score of psychological hardiness was 2.44/3. Additionally, there were no statistically significant differences at the 0.05 level in psychological hardiness due to gender, major and teaching experience.This study aimed to identify the level of psychological hardiness and its relationship to some demographic variables among post-basic education teachers in the Governorate of South Al-Batinah in the Sultanate of Oman. The sample of the study, which was chosen based on the stratification random method, consisted of 306 teachers; 178 males and 128 females. In order to achieve the aims of the study, a descriptive correlational approach was used, and the psychological hardiness scale was developed by the researchers and administered to the study sample after assessing its psychometric properties. The results of this study showed that the level of psychological hardiness among post-basic education teachers in the Governorate of South Al-Batinah was high as the mean score of psychological hardiness was 2.44/3. Additionally, there were no statistically significant differences at the 0.05 level in psychological hardiness due to gender, major and teaching experience

Knowledge and Attitude of University Students Towards Premarital Screening Program

Objectives: The aim of this study was to explore the knowledge and attitude of Sultan Qaboos University students towards premarital screening program.Methods: A cross-sectional study conducted at the students’ clinic from January to April 2011. A self-administered questionnaire was distributed to 590 unmarried Omani students of both genders. The questionnaire consisted of 3 main parts; the first part was based on socio-demographic data, the second part dealt with the students’ knowledge about the premarital screening program while the third part explored their attitudes towards the screening program.Results: Most of the participants (n=469; 79%) were aware about the availability of premarital screening program in Oman. The main sources of information were: school/college (n=212; 36%), media (n=209; 35%), family and friends (n=197; 33%), and/or health services (n=181, 31%). The vast majority of the participants (n=540; 92%) thought it is important to carry out premarital screening and agreed to do it. Around half of the participants (n=313; 53%) favored having premarital screening as an obligatory procedure before marriage and about one third (n=212; 36%) favored making laws and regulation to prevent marriage in case of positive results.Conclusion: Even though the majority of the participants thought it is important to carry out premarital screening; only half favored making it obligatory before marriage and one third favored making laws and regulations to prevent marriage in case of positive results. This reflects the importance of health education as a keystone in improving knowledge and attitude towards premarital screening program