Knowledge and practice of parents and guardians about childhood asthma at King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia

Eman AlOtaibi, Mohammed AlAteeq King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Department of Family Medicine and Primary Health Care, Riyadh, Saudi Arabia Background: Family management of asthmatic children is affected by several factors, primarily the parent’s knowledge and attitude toward asthma. Objective: The aim of this study was to explore the knowledge and practice of parents and guardians about asthma in their children. Methods: Two hundred and thirty-one self-administered questionnaires were distributed to parents and guardians attending, with their children, general pediatric and pediatric pulmonology outpatient clinics at King Abdullah Specialist Children’s Hospital, King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia, during the period from August 2016 to March 2017. Results: Most of the participants (79.6%) have moderate knowledge. The mean of total knowledge was found to be higher among mothers compared with other groups (p=0.019). Most participants (88.3%) reported providing asthma treatment regularly and 61.9% visited the clinic regularly. Almost half of the participants have misconceptions about asthma medications. During acute asthma attacks, more than half of the participants (54.5%) massaged their child’s chest or back, and 52.4% provided the child homemade or herbal remedies. Conclusion: This study revealed a moderate level of knowledge about asthma among the parents and guardians of asthmatic children, but poor knowledge about asthma medications. For better control of asthma, more effort is needed to educate caregivers and to enhance their awareness about asthma and highlight the misconceptions about asthma medications at both hospital level and community level. Keywords: parenting, home management, chronic disease, emergenc

Smoking cessation advice: the self-reported attitudes and practice of primary health care physicians in a military community, central Saudi Arabia

Mohammed AlAteeq,1 Abdulaziz M Alrashoud,2 Mohammed Khair,2 Mahmoud Salam3 1Department of Family Medicine, 2College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 3King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia Background: Brief advice on smoking cessation from primary health care (PHC) physicians reduces smoking prevalence. However, few studies have investigated the provision of such advice by PHC physicians providing services to military communities. The aim of this study was to evaluate PHC physicians’ attitudes toward and practice of delivering smoking cessation advice to smokers in a military community in central Saudi Arabia.Methods: A self-reported survey of PHC physicians was conducted in 2015 using a previously validated tool. The age, sex, educational level, job title, experience and previous smoking cessation training of each physician was recorded. Attitude (ten statements) and practice (six statements) were evaluated on a five-point Likert scale. Scoring system was applied and percentage mean scores (PMS) were calculated. Descriptive/statistical analyses were applied to identify factors that were significantly associated with a positive attitude and favorable practice (PMS >65 each). P-values <0.05 were considered to be significant.Results: Response rate was 73/150 (48.6%), of which equal sex distribution (52%:48%) was observed, with a mean age of 35.3±9.6 years. General practitioners constituted 71.4%, followed by consultants (17.9%) and specialists (10.7%). Those with a postgraduate education formed 49.3%, while experience averaged 9.5±9.2 years. Approximately 56% had not attended a smoking cessation educational program in the previous year. Approximately 75% of physicians had a positive attitude (PMS =72.4±11.2), while 64.4% reported favorable practice (PMS =65.3±27.7). Higher education levels were significantly more associated with positive attitude than lower education levels (adj. odds ratio [OR] 95% confidence interval [CI] =17.9 [1.3-242.3]; adj. P=0.03). More experienced physicians (adj. OR [95% CI] =9.5 [1.6–54.6]) and those with positive attitude (adj. OR [95% CI] =6.1 [1.6–23.3]) were more likely to report a favorable practice, compared to the less experienced (adj. P=0.012) and physicians with a negative attitude (adj. P=0.008).Conclusion: Provision of smoking cessation advice by primary health care physicians serving a military community is significantly associated with their attitude and years of experience. Patients who are seeking smoking cessation advice should be referred to physicians with higher levels of education. Routinely scheduled training on proper delivery of smoking cessation advice may increase physicians’ confidence; improve their attitude, and subsequently, their practice. Keywords: smoking cessation advice, primary health care, attitude, practice, Saudi Arabi

Menopausal symptoms and quality of life among Saudi women visiting primary care clinics in Riyadh, Saudi Arabia

Aida AlDughaither,1 Hind AlMutairy,2 Mohammed AlAteeq11College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Objectives: Menopause is associated with somatic, vasomotor, psychological, and sexual complaints that may affect quality of life. We determined the prevalence and severity of menopausal symptoms and their impact on the quality of life among Saudi women visiting primary care centers in Riyadh, Saudi Arabia.Methods: A cross-sectional study was conducted from October to November 2010. In total, 119 women aged 45–60 years were randomly interviewed using a questionnaire. Participants were divided into three categories: premenopausal (n=31), perimenopausal (n=49), and postmenopausal (n=39). The Menopause Rating Scale (MRS) assessed the prevalence and severity of eleven menopausal symptoms. Mean scores of menopausal categories were compared for different symptoms.Results: The mean age at menopause was 48.3±3 years (median, 49 years). The symptoms reported to be most prevalent were joint and muscle pain (80.7%), physical and mental exhaustion (64.7%), and hot flushes and sweating (47.1%). Somatic and psychological symptoms were highly prevalent in perimenopausal women compared to other groups. The mean overall quality-of-life score was higher in perimenopausal women, while the total MRS score indicated that the symptoms were mild in severity (MRS <9).Conclusion: The prevalence of menopausal symptoms was comparable to previous studies in Asian women; however, the prevalence of classic symptoms of hot flushes and night sweats was lower than reported in Western studies. Saudi women reported an MRS score indicating milder severity of symptoms, reflecting better quality of life and ability to cope with climacteric symptoms.Keywords: menopause, Saudi women, Menopause Rating Scale, quality of lif

Violence against health workers in Family Medicine Centers

Nouf Al-Turki,1 Ayman AM Afify,1 Mohammed AlAteeq2 1Family Medicine Department, Prince Sultan Military Medical City, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Background: Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting.Objective: To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia.Methods: A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data.Results: A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence.Conclusion: Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers. Keywords: health care workers, violence, primary health care, Saudi Arabia, workplace violence, assault

The Arab COVID‐19 Anxiety Syndrome Scale (C‐19ASS): COVID‐19 anxiety syndrome and psychological symptoms in the Saudi Arabian population

Introduction: The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a reliable scale assessing dysfunctional coping strategies activated in response to COVID-19 fear and threat. The present study aimed to provide a validation of the Arabic version of the C-19ASS and to explore the association between the C-19ASS and psychological symptoms syndrome. Method: In Study 1, a community sample of 404 participants completed the Arabic version of the C-19ASS and results were subjected to an Exploratory Factor Analysis. In study 2, a community sample of 903 participants completed the Arabic version of the C-19ASS and a series of measures assessing depressed mood and anhedonia, generalized anxiety and health anxiety. Internal consistency, construct validity, and incremental validity were assessed. Associations between C-19ASS and psychological symptoms were assessed. Results: Factor analysis identified a two-factor solution (i.e., C-19ASS Perseveration and C-19ASS Avoidance) and confirmatory factor analysis suggested a two-factor model best fits the data. The Arabic version of the C-19ASS showed good internal consistency, good construct, and incremental validity. COVID-19 anxiety syndrome was associated with more severe anxiety symptoms, depressive symptoms, and health anxiety. Females had higher levels of COVID-19 anxiety syndrome than males. Participants diagnosed with COVID-19, and those who had experienced loss as a consequence of COVID-19, had higher levels of COVID-19 anxiety syndrome (Perseveration). Conclusions: The Arabic version of the C-19ASS appears to be a reliable and valid measure of the COVID-19 anxiety syndrome. The COVID-19 anxiety syndrome could be a suitable therapeutic target to improve psychological recovery during the COVID-19 pandemic among Arabs

The Arab COVID-19 Anxiety Syndrome Scale (C-19ASS): COVID-19 anxiety syndrome and psychological symptoms in the Saudi Arabian population

Introduction: The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a reliable scale assessing dysfunctional coping strategies activated in response to COVID-19 fear and threat. The present study aimed to provide a validation of the Arabic version of the C-19ASS and to explore the association between the C-19ASS and psychological symptoms syndrome. Method: In Study 1, a community sample of 404 participants completed the Arabic version of the C-19ASS and results were subjected to an exploratory factor analysis. In Study 2, a community sample of 903 participants completed the Arabic version of the C-19ASS and a series of measures assessing depressed mood and anhedonia, generalized anxiety and health anxiety. Internal consistency, construct validity and incremental validity were assessed. Associations between C-19ASS and psychological symptoms were assessed. Results: Factor analysis identified a two-factor solution (i.e., C-19ASS-Perseveration and C-19ASS-Avoidance), and confirmatory factor analysis suggested a two-factor model best fits the data. The Arabic version of the C-19ASS showed good internal consistency, good construct and incremental validity. COVID-19 anxiety syndrome was associated with more severe anxiety symptoms, depressive symptoms and health anxiety. Females had higher levels of COVID-19 anxiety syndrome than males. Participants diagnosed with COVID-19, and those who had experienced loss as a consequence of COVID-19, had higher levels of COVID-19 anxiety syndrome (Perseveration). Conclusions: The Arabic version of the C-19ASS appears to be a reliable and valid measure of the COVID-19 anxiety syndrome. The COVID-19 anxiety syndrome could be a suitable therapeutic target to improve psychological recovery during the COVID-19 pandemic among Arabs

A Novel Hybrid Chaotic Jaya and Sequential Quadratic Programming Method for Robust Design of Power System Stabilizers and Static VAR Compensator

This paper proposes a novel hybrid algorithm combining chaotic Jaya (CJaya) and sequential quadratic programming (SQP), namely CJaya-SQP, for solving the coordinated design problem of static var compensator (SVC) and power system stabilizers (PSSs). The CJaya serves as a global optimizer and the SQP as a local optimizer for fine-tuning the solution. In the proposed algorithm, chaotic maps are used to generate the initial solutions and control the search process. In order to prove the performance of the CJaya-SQP, a set of benchmark optimization problems is used where the results are compared with those of the basic Jaya and other recognized algorithms. The proposed optimization method is then applied for the optimal tuning of PSSs and SVC controllers in such a way that damping ratios and damping factors of the electromechanical modes are optimally improved. To illustrate the robustness of the CJaya-SQP-based coordinated PSSs and SVC controllers, the four-machine, two-area system is used. Eigenvalue analysis and nonlinear time-domain simulation vividly show that the CJaya-SQP-based coordinated controllers improve greatly the system’s dynamic stability with a robust damping of local and inter-area power oscillations

Analysis of retinal structure and function in cone dystrophy with supernormal rod response

Purpose: To report the clinical and electrophysiological features of cone dystrophy with supernormal rod response (CDSRR). Methods: Retrospective cohort study of 15 unrelated patients (nine males and six females, median age 16, range 5–47 years) diagnosed with CDSRR by clinical examination, full-field electroretinography (ERG) and genetic testing. Observations: History, ophthalmic examination including near vision, color vision and contrast sensitivity assessment, multimodal retinal imaging and ERG. Genetic testing was done for all patients using next-generation sequencing. Results: The rate of consanguinity was 86.7%. Color vision was defective in 56.3%. Near vision was defective in all patients (mean 20/160). Contrast sensitivity was affected in all patients at low contrast of 2.5%. A parafoveal ring of increased autofluorescence imaging was seen in most patients (75%). Supernormal mixed maximal response b-wave was seen bilaterally in 63% of patients (and high normal in 37%). Rod dysfunction with prolonged rod b-wave latency was detected in all. The 30-Hz flicker response was more reduced and delayed compared to the single-flash cone response. A novel homozygous missense variant c.530G>C (p.Cys177Ser) in KCNV2 was detected in one patient, the nonsense homozygous mutation c.427G>T (p.Glu143*) was found in 13 patients, and the nonsense c.159C>G (p.Tyr53*) was found in one patient. Conclusion: This is the largest cohort of CDSRR from a single ethnic background. Rod dysfunction and reduced 30-Hz flicker response were demonstrated in all patients. In contrast to previous descriptions in the literature, a supernormal combined dark-adapted rod-cone ERG was present in the majority of the patients at standard stimulus intensity. Considering the consistent genotype and the demonstration of likely pathogenic genetic variants in all the patients, we argue that the combination of delayed rod b-wave and subnormal flicker response strongly suggests the diagnosis of CDSRR