An epidemiological investigation of health-related behaviours among male high school adolescents in Riyadh, Saudi Arabia

PhD ThesisObjective: Little is known about health-related behaviours and their co-occurrence among male adolescents in Saudi Arabia. The main purpose of this study was to determine the prevalence of health related behaviours, and to investigate the associations between socio-demographic variables and health related behaviours and the clustering of health risk behaviours. Research Methods: A cross-sectional study using a self-completion anonymous questionnaire was undertaken between February and April, 2008. A stratified random sample of 1501 male adolescents was recruited from one private and public high school in each of the five districts in the city of Riyadh, Saudi Arabia. Main Outcome Measures: Prevalence and associations between health, social and demographic factors and health-related behaviours, including dietary behaviours, oral health, physical activity, smoking, violence, injuries and safety, and mental health factors. Results: The results of this study showed that only 24.2% and 39.9% of the students consumed fruit and vegetables on a daily basis (at least once every day), and only 7% and 13.7% ate fruit and vegetables 3 times or more every day. Also, only 52.4% consumed dairy products at least once every day and only 18.3% of the students consumed dairy products 3 times or more every day. 48.1% reported to not consume any fish products on any day of the week. About 48.7%, 60.2% and 25.2% of the students consumed sweets, soft drinks, and energy drinks at least once every day. The results of this study also showed that only 36.7% of students eat breakfast regularly (≥ 5 days per week). Eating breakfast regularly was positively associated with lower age, liking school, good academic performance, not eating high fat food every day, drinking soft drinks ≤ 1 time/day, drinking milk every day, low BMI, brushing teeth every day, physical activity ≥ 3 days/week, and not engaging in physical fights. Around half (51.3%) participants reported good teeth health status, 22.6% brushed their teeth two times daily, 29.7% brushed their teeth once daily, whereas 47.7% of the subjects do not brush their teeth daily and 54.3% never visited the dentist during the past year. About 29.5% of participants suffered teeth pain sometimes or most of the time and 16.4% missed some school days for this reason. Brushing teeth every day was positively associated with higher standards of parental education, attending private school, living district, good academic performance, liking school, visiting dentist during the last year, good teeth status, and not suffering from teeth pain. Only 18.4% of the students were physically active and only 65.2% participated in physical activity classes in schools. Regular physical activity was positively associated with younger age, liking school, good health status, lower BMI, father’s, mother’s, siblings’ and peers’ physical activity, not smoking, not fighting, not wanting to use drugs or alcohol, and not feeling lonely. Over a third (36.3%) of the participants were overweight or obese. A fifth (20.8%) of the adolescents were current smokers. 20.8% of the students were current smokers. Smoking among students was positively associated with higher age, studying in private school, poor health status, poor school performance, not liking school, father smoking, mother smoking, sibling smoking, peers smoking, low physical activity, wanting to use drugs and alcohol, carrying weapons, fighting, performing car drifting, and being abused by teachers. ii Over half the sample (55.5%) reported an injury, 21.8% had been threatened or injured by weapons. Just under half (49%) of the adolescents reported they were involved in a physical fight. Moreover, fighting among students was positively associated with the interaction of low parental education, not liking school, poor academic performance, skipping breakfast, low physical activity, current smoking, being threatened or injured by weapons, carrying weapons, joining people performing car drifting, bullying others, being abused by teachers. Carrying weapons during the last 30 days was reported by 36.6% of the sample. Carrying weapons was positively associated with higher age, not liking school, poor academic performance, current smoking, fighting, being threatened or injured by weapons, performing car drifting, joining people performing car drifting, taking part in bullying others, and being abused by family. Some (26.1%) of participants reported having been bullied and 24.6% of the students reported bullying others. Many of the adolescents reported being abused by a family member (34.4%) or one of their school teachers (39.5%) during the past 12 months preceding the survey. During this time period, many of the students reported feeling lonely (22.8%), feeling very worried about something that they could not sleep at night sometimes or more (27.0%), and feeling very sad or hopeless almost every day for two weeks or more (40%). About 14% of the participants in this study reported that they had wanted to use alcohol or drugs. A small but notable proportion (13.9%) of the participants reported that they had thought of attempting suicide and 6.9% had actually attempted suicide. Over a third (36.1%) of adolescents had performed car drifting 12 months preceding the survey. However, car drifting was positively associated with higher age, attending a private school, not liking school, poor academic performance, not brushing teeth every day, current smoking, wanting to use drugs and alcohol, carrying weapons, joining people who performing car drifting, bullying others, and attempting suicide. The majority (78.7%) of participants drove vehicles and 96% and 97.7% reported that they did not use a seat belt when doing so and did not use a seat belt when riding in a car as a passenger, respectively. Only 2.1% and 1.4% of participants wore a helmet when used motorized vehicle or nonmotorized. Conclusions and implications: The results of this study reveal that the adolescents engage in multiple health-risk behaviours, and these risk behaviours are relatively common among adolescents and cluster together. Health related behaviours are associated with several socio-demographic variables (age, father’s and mother’s education, school factors, health status and living districts), although not necessarily in the same order. However, the data emphasized the need for further quantitative and indepth qualitative research throughout Saudi Arabia, including other cities, rural communities, female adolescents, and other Middle Eastern countries. Cross-sectional research to gather evidence on youth health to collect population-based data on a range of health-related behaviours along with physical and social environments amongst school-age students and out-of-school youth facilities are important and highly needed to investigate health-related behaviours and associated risk factors and to measure change over time

School safety and emergency preparedness in Saudi Arabia: a call for effective action

Accidents and injuries are a growing global public health problem. Both accidents and injuries can happen anytime and anywhere. Children and school personnel might experience medical emergency situations because of injuries, complications of chronic health conditions, or unexpected major accidents that occur in schools. A safe learning environment is essential for students, and without it they are unable to focus on learning the skills needed for a successful education and future development. There are about 6 million children younger than 18 years living in the kingdom of Saudi Arabia. Regrettably, many accidental tragedies occurred during the few last years in schools in Saudi Arabia which caused many forms of injuries and death among children and school teachers. Unfortunately, most schools lack a health care professional to respond to school medical emergencies. It is essential to believe that there is a fundamental link between emergency preparedness and disaster response. Therefore, schools that are prepared for an emergency are more likely to be prepared for complex events such as major fire, injury related accidents and natural disaster. The quality of schools about safety management and emergency preparedness is far worrying in Saudi Arabia. Thus, there is a need in creating a ‘‘culture of safety’’ and realize that injuries prevention and safety promotion are everybody’s business. The time has come to develop effective injury prevention strategies and promote safety that can help reduce the impact of injuries on the health of the Saudi population, economy and health care system. The issue of school safety must be a major concern at all levels of government. Efforts should be made to increase the education of school personnel in the assessment and management of safety and life-threatening emergencies, particularly head injury, cardiac arrest, suffocation and fire events

Performance Evaluation of UK Acquiring Companies in the Pre and Post-Acquisitions Periods

This paper has two objectives: first, it examines the financial performance of twenty UK based acquiring companies over the period of five years (2009-2013) using financial ratios of Liquidity, Profitability and Solvency in order to empirically determine whether there is any significant financial performance changes in the operation of the underlying companies as a result of acquisitions. Both average ratio and paired t-test analysis have been conducted. The analysis concludes that none of the ratios proved statistical significance which shows that the underlying acquisitions did not influence changes in the financial performance of the acquiring companies. The paper also examines whether shareholders make short-term gain while opting for acquisitions by analyzing stocks return over 58 days window period i.e. 29 days prior to acquisition announcement and 29 days after acquisition announcement by applying CAPM model and AAR and CAAR analysis. The analysis concludes that none of the results show statistical significance which further asserts that UK shareholders do not make gain in the short-term as a result of the acquisition activities they have undertaken

Cyber Security against Intrusion Detection Using Ensemble-Based Approaches

The attacks of cyber are rapidly increasing due to advanced techniques applied by hackers. Furthermore, cyber security is demanding day by day, as cybercriminals are performing cyberattacks in this digital world. So, designing privacy and security measurements for IoT-based systems is necessary for secure network. Although various techniques of machine learning are applied to achieve the goal of cyber security, but still a lot of work is needed against intrusion detection. Recently, the concept of hybrid learning gives more attention to information security specialists for further improvement against cyber threats. In the proposed framework, a hybrid method of swarm intelligence and evolutionary for feature selection, namely, PSO-GA (PSO-based GA) is applied on dataset named CICIDS-2017 before training the model. The model is evaluated using ELM-BA based on bootstrap resampling to increase the reliability of ELM. This work achieved highest accuracy of 100% on PortScan, Sql injection, and brute force attack, which shows that the proposed model can be employed effectively in cybersecurity applications

Effect of Ajwa date pits powder (Phoenix dactylifera L.) on body composition, lipid profile and blood pressure in patients with hyperlipidemia: A randomized clinical trial

Objective: To evaluate the effect of Ajwa dates pit powder (ADP) on lipid profile, body composition and blood pressure in patients with hyperlipidemia.Materials and Methods: This randomized controlled clinical study was carried out on 40 patients with total cholesterol >200 mg/dl, triglycerides >150 mg/dl and BMI >25, of either sex, aged 30-50 years, who were recruited through written consent. The patients were divided into two groups (n=20 each): the ADP and the control group (CG). All patients received the doctor’s prescribed class A statin (Rosuvastatin/ Atorvastatin) 10 mg/day, while 2.7 g ADP was given on daily basis before breakfast with lukewarm water for 40 days and the control group received the same amount of wheat flour. Body composition, blood pressure and lipid profile were determined at baseline, and after 20 and 40 days. Data were analyzed by using SPSS and GraphPad Prism.Results: ADP significantly reduced body weight (p<0.001), BMI (p<0.001), fat mass, body fat percentage, visceral fat area and waist circumference compared to the control group. Similarly, ADP significantly (p=0.000) decreased the serum level of total cholesterol and low-density lipoprotein. Conclusion: ADP may have the potential to improve dyslipidemia and obesity

What is the right sequencing approach? Solo VS extended family analysis in consanguineous populations.

Testing strategies is crucial for genetics clinics and testing laboratories. In this study, we tried to compare the hit rate between solo and trio and trio plus testing and between trio and sibship testing. Finally, we studied the impact of extended family analysis, mainly in complex and unsolved cases. Three cohorts were used for this analysis: one cohort to assess the hit rate between solo, trio and trio plus testing, another cohort to examine the impact of the testing strategy of sibship genome vs trio-based analysis, and a third cohort to test the impact of an extended family analysis of up to eight family members to lower the number of candidate variants. The hit rates in solo, trio and trio plus testing were 39, 40, and 41%, respectively. The total number of candidate variants in the sibship testing strategy was 117 variants compared to 59 variants in the trio-based analysis. We noticed that the average number of coding candidate variants in trio-based analysis was 1192 variants and 26,454 noncoding variants, and this number was lowered by 50-75% after adding additional family members, with up to two coding and 66 noncoding homozygous variants only, in families with eight family members. There was no difference in the hit rate between solo and extended family members. Trio-based analysis was a better approach than sibship testing, even in a consanguineous population. Finally, each additional family member helped to narrow down the number of variants by 50-75%. Our findings could help clinicians, researchers and testing laboratories select the most cost-effective and appropriate sequencing approach for their patients. Furthermore, using extended family analysis is a very useful tool for complex cases with novel genes

Adenovirus and RNA-based COVID-19 vaccines’ perceptions and acceptance among healthcare workers in Saudi Arabia: a national survey

Objectives The aim of this study was to compare the perception, confidence, hesitancy and acceptance rate of various COVID-19 vaccine types among healthcare workers (HCWs) in Saudi Arabia, a nation with Middle East respiratory syndrome coronavirus experience. Design National cross-sectional, pilot-validated questionnaire. Setting Online, self-administered questionnaire among HCWs. Participants A total of 2007 HCWs working in the Kingdom of Saudi Arabia participated; 1512 (75.3%) participants completed the survey and were included in the analysis. Intervention Data were collected through an online survey sent to HCWs during 1–15 November 2020. The main outcome measure was HCW acceptance of COVID-19 candidate vaccines. The associated factors of vaccination acceptance were identified through a logistic regression analysis and via measurement of the level of anxiety, using the Generalised Anxiety Disorder 7 scale. Results Among the 1512 HCWs who were included, 62.4% were women, 70.3% were between 21 and 40 years of age, and the majority (62.2%) were from tertiary hospitals. In addition, 59.5% reported knowing about at least one vaccine; 24.4% of the participants were sure about their willingness to receive the ChAdOx1 nCoV-19 vaccine, and 20.9% were willing to receive the RNA BNT162b2 vaccine. However, 18.3% reported that they would refuse to receive the Ad5-vectored vaccine, and 17.9% would refuse the Gam-COVID-Vac vaccine. Factors that influenced the differential readiness of HCWs included their perceptions of the vaccine’s efficiency in preventing the infection (33%), their personal preferences (29%) and the vaccine’s manufacturing country (28.6%). Conclusions Awareness by HCWs of the several COVID-19 candidate vaccines could improve their perceptions and acceptance of vaccination. Reliable sources on vaccine efficiency could improve vaccine uptake, so healthcare authorities should use reliable information to decrease vaccine hesitancy among frontline healthcare providers

Transmission and evolution of the Middle East respiratory syndrome coronavirus in Saudi Arabia:a descriptive genomic study

BACKGROUND: Since June, 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) has, worldwide, caused 104 infections in people including 49 deaths, with 82 cases and 41 deaths reported from Saudi Arabia. In addition to confirming diagnosis, we generated the MERS-CoV genomic sequences obtained directly from patient samples to provide important information on MERS-CoV transmission, evolution, and origin. METHODS: Full genome deep sequencing was done on nucleic acid extracted directly from PCR-confirmed clinical samples. Viral genomes were obtained from 21 MERS cases of which 13 had 100%, four 85-95%, and four 30-50% genome coverage. Phylogenetic analysis of the 21 sequences, combined with nine published MERS-CoV genomes, was done. FINDINGS: Three distinct MERS-CoV genotypes were identified in Riyadh. Phylogeographic analyses suggest the MERS-CoV zoonotic reservoir is geographically disperse. Selection analysis of the MERS-CoV genomes reveals the expected accumulation of genetic diversity including changes in the S protein. The genetic diversity in the Al-Hasa cluster suggests that the hospital outbreak might have had more than one virus introduction. INTERPRETATION: We present the largest number of MERS-CoV genomes (21) described so far. MERS-CoV full genome sequences provide greater detail in tracking transmission. Multiple introductions of MERS-CoV are identified and suggest lower R0 values. Transmission within Saudi Arabia is consistent with either movement of an animal reservoir, animal products, or movement of infected people. Further definition of the exposures responsible for the sporadic introductions of MERS-CoV into human populations is urgently needed. FUNDING: Saudi Arabian Ministry of Health, Wellcome Trust, European Community, and National Institute of Health Research University College London Hospitals Biomedical Research Centre

Optimality and iterative learning control: duality and input prediction

This thesis considers the use of optimal techniques within iterative learning control (ILC) applied to linear systems. Two different aspects are addressed: the first is the duality relationship existing between iterative learning control and repetitive control which allows the synthesis of controllers developed in one domain to be applied in the other. Significant extensions to existing duality framework are made by eliminating an explicit current-error feedback loop and providing the facility of both current error feedback, and previous error feedforward within the control structure. This, in turn, with the case when either state-feedback or output-feedback is used to solve the ILC control paradigm extends the range of underlying plants to which the framework can be applied. In this context optimal control is used to solve the stabilisation problem which yields solutions for both RC and ILC cases in terms of state-feedback, and for ILC in terms of output-injection. These significantly extend the range of underlying plants to which the framework can be applied. The second aspect addressed is the selection of a suitable first input. Whilst ILC algorithms have been shown to over a high level of performance both theoretically and in practical applications, resulting error convergence is generally highly dependent on the initial choice of input applied. Optimal techniques are therefore applied to generate the most appropriate initial input to speed up the learning process over subsequent trials. Two approaches are developed to tackle the problem, both involving optimal solutions. The first is frequency domain bases, and involves a description of system uncertainty. An input is constructed which maximises convergence in the presence of uncertainty and noise, making use of the Fast Fourier Transform (FFT). The second approach is time domain based and an initial input is constructed using a library of previous references and their associated converged inputs. The assumption of system linearity is used to find the choice of previous inputs which maximises robust convergence. It is then shown how the frequency and time domain schemes may be combined. Both the duality and initial input techniques developed in this thesis have been evaluated experimentally on a gantry robot testbed, and the results obtained confirm the success of these additions to the ILC/RC framewor