Emirati women’s knowledge about the menopause and menopausal hormone therapy

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. The aim of this study was to investigate the knowledge of Emirati women aged 30–64 about menopause, menopausal hormone therapy (MHT), and their associated health risks, and additionally, to determine the relationships between Emirati women’s knowledge about menopause and their sociodemographic and reproductive characteristics. A community-based cross-sectional study was conducted of 497 Emirati women visiting five primary healthcare centers in Dubai. Data were collected using a questionnaire composed of sociodemographic and reproductive characteristics, menopause knowledge scale (MKS), and menopause symptoms knowledge and MHT practice. The mean menopause symptoms knowledge percentage was 41%, with a standard deviation of 21%. There were significant differences in the mean knowledge percentage among categories of education level (p \u3c 0.001) and employment (p = 0.003). No significant differences in the knowledge percentages were found among categories of menopausal status. “Pregnancy cannot occur after menopause” was the statement with the highest knowledge percentage (83.3%), while the lowest knowledge percentages were “risk of cardiovascular diseases increases with menopause” (23.1%), “MHT increases risk of breast cancer” (22.1%), and “MHT decreases risk of colon cancer” (13.9%). The knowledge of Emirati women about menopause, MHT, and related heart diseases was very low; therefore, an education campaign about menopause and MHT risks is needed to improve their knowledge for better coping with the symptoms

Psychological interventions for women with non-metastatic breast cancer (Review)

Background: Breast cancer is the most common cancer affecting women worldwide. It is a distressing diagnosis and, as a result, considerable research has examined the psychological sequelae of being diagnosed and treated for breast cancer. Breast cancer is associated with increased rates of depression and anxiety and reduced quality of life. As a consequence, multiple studies have explored the impact of psychological interventions on the psychological distress experienced after a diagnosis of breast cancer. Objectives: To assess the effects of psychological interventions on psychological morbidities, quality of life and survival among women with nonmetastatic breast cancer. Search methods: We searched the following databases up to 16 May 2013: the Cochrane Breast Cancer Group Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL and PsycINFO; and reference lists of articles. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) search portal and ClinicalTrials.gov for ongoing trials in addition to handsearching. Selection criteria: Randomised controlled trials that assessed the effectiveness of psychological interventions for non-metastatic breast cancer in women. Data collection and analysis: Two review authors independently appraised and extracted data from eligible trials. Any disagreement was resolved by discussion. Extracted data included information about participants, methods, the intervention and outcome. Main results: Twenty-eight randomised controlled trials comprising 3940 participants were included. The most frequent reasons for exclusion were non-randomised trials and the inclusion of women with metastatic disease. A wide range of interventions were evaluated, with 24 trials investigating a cognitive behavioural therapy and four trials investigating psychotherapy compared to control. Pooled standardised mean differences (SMD) from baseline indicated less depression (SMD -1.01, 95% confidence interval (CI) -1.83 to -0.18; P = 0.02; 7 studies, 637 participants, I2 = 95%, low quality evidence), anxiety (SMD -0.48, 95% CI -0.76 to -0.21; P = 0.0006; 8 studies, 776 participants, I2 = 64%, low quality evidence) and mood disturbance (SMD -0.28, 95% CI -0.43 to -0.13; P = 0.0003; 8 studies, 1536 participants, I2 = 47%, moderate quality evidence) for the cognitive behavioural therapy group than the control group. For quality of life, only an individually-delivered cognitive behavioural intervention showed significantly better quality of life than the control with an SMD of 0.65 (95% CI 0.07 to 1.23; P = 0.03; 3 studies, 141 participants, I2 = 41%, very low quality evidence). Pooled data from two group-delivered studies showed a non-significant overall survival benefit favouring cognitive behavioural therapy compared to control (pooled hazard ratio (HR) 0.76, 95% CI 0.25 to 2.32; P = 0.63; 530 participants, I2 = 84%, low quality evidence). Four studies compared psychotherapy to control with one to two studies reporting on each outcome. The four studies were assessed as high risk of bias and provided limited evidence of the efficacy of psychotherapy. Adverse events were not reported in any of the included studies. Authors’ conclusions: A psychological intervention, namely cognitive behavioural therapy, produced favourable effects on some psychological outcomes, in particular anxiety, depression and mood disturbance. However, the evidence for survival improvement is still lacking. These findings are open to criticism because of the notable heterogeneity across the included studies and the shortcomings of the included studies

The lifestyle habits and wellbeing of physicians in Bahrain: a cross-sectional study.

BACKGROUND: Lifestyle habits of physicians are of paramount importance both because they influence the physician\u27s own health and because these habits have been shown to affect patients\u27 care. There is limited information on physician health and lifestyle habits in Bahrain. METHODS: In a cross-sectional study design, an anonymous self-administered questionnaire that assesses wellbeing and lifestyle habits was distributed to a random sample of 175 out of 320 primary health care physicians in Bahrain. Descriptive analyses were performed, and the variables were cross-tabulated using SPSS version 20.0. RESULTS: 152 physicians agreed to participate in the study. Respondents were 67.1 % female with a mean age of 45 (SD = 10). The majority were of Bahraini nationality. The most prevalent reported health conditions were hyperlipidaemia (25.5 %), hypertension (20.3 %), and diabetes (11.0 %). Only 29.6 % of physicians reported performing ≥ 30 min of exercise in a usual week. Of physicians exercising ≥ 30 min weekly, only 13 % exercised ≥ 5 days weekly. 98.0 % report never drinking, 1.3 % report previously drinking, and 0.7 % report drinking less than once weekly. The average body mass index (BMI) was 27.8 (SD = 5), with 39 % of physicians being overweight and 33 % obese. BMI was directly associated with sleep time (P0.027, r(2) = 0.034), age (P CONCLUSIONS: There is a clear pattern of unfavourable lifestyle habits and obesity among primary health care physicians in Bahrain. We encourage institutions and public health sectors to be more proactive in assisting physicians to attain healthier lifestyles

Emirati women’s attitudes towards menopause: Implications for health care policy

© The Author(s) 2019. Objectives: To investigate the attitudes of Emirati women aged 30–64 years towards menopause and determine the relationships between these attitudes and their sociodemographic and reproductive characteristics. Study design: A community-based cross-sectional study was conducted with 497 Emirati women attending five primary health care centres in Dubai using a multistage stratified and clustered random sampling technique. Emirati women were interviewed face-to-face via a structured questionnaire with two parts: sociodemographic and reproductive characteristics and the attitudes towards menopause scale. Results: The mean ± S.D. of age was 42.06 years ± 8.716 (median 40 years). Mean age at menopause for the study sample (N = 436) was 49.94 years ± 4.593 (median 50 years). Of the respondents, 36.6% had completed high school, and 41.4% had graduated from university. Approximately, 70.8% of the women were premenopausal, 13.1% were perimenopausal and 16.1% were postmenopausal. Sixty-four percent of the respondents had never used oral contraceptive pills, while 32.9% were past users; 44.6% were employed outside the home. Mean average attitudes score ± S.D. was 2.42 ± 0.26 (minimum score of 1 indicates very negative attitudes, maximum score of 4 indicates very positive attitudes). Statistically significant differences in mean average attitudes score were noted for employment and menopausal status, and mean average attitudes score was positively correlated with age. Premenopausal women held more positive attitudes towards menopause than peri- and postmenopausal women. Conclusions: Emirati women displayed neutral to positive attitudes towards menopause and premenopausal women exhibited more negative attitudes towards menopause than postmenopausal women

Prevalence of tobacco smoking among health-care physicians in Bahrain.

BACKGROUND: There is a clear shift in smoking habits among the Middle Eastern population with a recent and alarming increase in the prevalence of waterpipe (shisha) smoking. This phenomenon has not yet been studied sufficiently across the physician population. Therefore, we set out to establish the smoking status of primary healthcare physicians in the kingdom of Bahrain. METHODS: A self-administered questionnaire was distributed to a random sample of 175 out of the total 320 primary care physicians. Descriptive analysis was performed on all data and associations between variables were tested using Fishers Exact t test with statistical significance set as P-value \u3c 0.05. RESULTS: One hundred and fifty two physicians agreed to participate in the study. Sixty seven percent of physicians were females and the mean (SD) age was 45 (10) years. The majority of the physicians were married (93%) and of Bahraini nationality (76%). Ever-smokers were 11% of the population while current smokers corresponded to 8.6%. Waterpipe was the most common method of tobacco smoking followed by cigarettes. Among male physicians, the prevalence of current \u27waterpipe only\u27 smokers was 12%, followed by 4% and 2% corresponding to \u27cigarette only\u27 smokers and both, respectively. There were only three female smokers in the population, two \u27waterpipe only\u27 smokers and one cigar smoker. Of those who smoked waterpipe (n = 9; 6%), 33% smoked daily, 44% smoked weekly and 22% smoked at least once a month. Current smoking status was associated with male gender (P CONCLUSION: Waterpipe smoking rates exceeded cigarette smoking among the population of physicians in Bahrain. Prevalence of smoking remains unacceptably high among male physicians. Assessment of physicians\u27 knowledge of the harmful effects of waterpipe tobacco smoking is warranted to plan future interventions

Knowledge, attitudes, and practices regarding cervical cancer and screening among women visiting primary health care Centres in Bahrain

Abstract Background Cervical cancer is one of the most common cancers among women, with 80% of the cases occurring in developing countries. Cervical cancer is largely preventable by effective screening programs. This has not been possible with opportunistic screening and its low use in the Kingdom of Bahrain. The objective of this study was to explore the knowledge, attitudes, and practices of women attending primary care health centres for cervical cancer screening. Methods This was a cross-sectional study of 300 women attending primary health care centres in Bahrain. We used a validated tool comprised of 45 items to collect data through face-to-face interviews between December 2015 and February 2016. Descriptive data are presented for demographic data, and frequency distributions with percentages are presented for each item of the knowledge and attitude questionnaire. Results The mean age ± SD of the participants was 37.24 ± 11.89 years, they were mostly married (221; 73.7%), and had a high school or higher education (261; 87%). Over 64% (194 participants) had never heard of a Pap smear procedure and only 3.7% (11 participants) had heard about the human papillomavirus (HPV) vaccine. Nearly 64% (192 participants) believed that a Pap smear was helpful in detecting pre-cancer and cancer of the cervix, and 44.3% (133 participants) believed that they should have a Pap smear at least every 3 years. Regarding the practice, only 40.7% (122 participants) had a Pap smear in their lifetime. The majority of participants felt embarrassed when examined by a male doctor (250, 83.3%) and few underwent a Pap smear screening if they were never married (69, 23.0%). Conclusions The participants demonstrated a wide range of knowledge and attitudes towards cervical cancer screening. However, the majority demonstrated positive attitudes towards the HPV vaccine

Attitudes and barriers towards conducting research amongst primary care physicians in Bahrain: a cross-sectional study

Abstract Background Research in primary care is essential for disease diagnosis, management and prevention in relation to the individuals, families and the community. This research aims to study the attitude of primary care physicians towards conducting research in Bahrain and to identify the main barriers encountered during research. Methods A cross-sectional study was conducted amongst 200 randomly selected primary care physicians registered in Ministry of Health affiliated primary healthcare centers in Bahrain. A self-administered validated questionnaire was adopted and used for data collection. Research data was analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Results Primary care physicians had a positive attitude towards conducting research with a total mean score (SD) of 4.47(0.65) (on a scale from 1 to 5 with higher scores indicating more positive attitudes). The total mean score (SD) for barriers encountered by physicians during research was 3.34 (0.80). Insufficient research allotted time (76.5%), insufficient financial support (63%), lack of financial incentives (51%) and lack of statistical support (50%) were major barriers. Physicians designation and board certificate were significantly associated with attitudes and barriers towards research (P-value < 0.05). Conclusion The majority or primary care physicians had positive attitudes towards conducting research. The major difficulties faced by physicians in conducting research are: Insufficient research allotted time, lack of financial incentives and inadequate statistical support. The study addressed a gap in building research capacity which should be embraced by many institutions through partnership and collaboration

Characteristics of patients with SARS-CoV-2 positive cerebrospinal fluid: a systematic review

Background: The coronavirus disease 2019 (COVID-19) has been shown to affect several systems, notably the respiratory system. However, there has been considerable evidence implicating the nervous system in COVID-19 infection. This study aims to investigate the clinical characteristics of patients whose cerebrospinal fluid (CSF) tested positive for SARS-CoV-2.Methods: A comprehensive search of PubMed, EMBASE, Scopus, WHO Coronavirus database, bioRxiv, medRxiv, and Web of Science databases was carried out in August 2020. Original studies involving patients who tested positive for SARS-COV-2 in their CSF were included. Key search terms encompassed all variations of "COVID-19" AND "Cerebrospinal Fluid".Results: A total of 525 studies were identified. Fifty-six full-text articles were assessed, of which 14 were included. In total, 14 patients tested positive for SARS-CoV-2 in their CSF. 21.4% (3/14) of patients had negative nasopharyngeal (NP) swabs despite a positive CSF sample. About 14.2% (2/14) of patients who initially had positive NP swabs developed neurological deterioration after a supposed recovery as indicated by their negative NP swabs, but their CSF still tested positive for SARS-CoV-2. Common symptoms were headache (42.8%; 6/14), fever (35.6%; 5/14), vomiting (28.6%; 4/14), cough (28.6; 4/14), visual disturbances (28.6%; 4/14), diarrhea (21.4%; 3/14), and seizures (21.4%; 3/14). Four patients (28.6%) were admitted to ICU, one (7.14%) was admitted to a rehabilitation facility, and two (14.3%) died.Conclusion: Physicians should be familiar with the presenting neurological features of COVID-19, and be aware that they can occur despite a negative NP swab. The results of this study are intended to aid in the development of informed guidelines to diagnose and treat COVID-19 patients with neurological manifestations.</div