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The shift to successful online learning requires online assessment strategies that could facilitate the learning and teaching process and determine the achievement of learning outcomes. This study examined how students' achievement was assessed in an online learning environment during the COVID-19 pandemic and how the College of Education (COE) responded to the shift to online assessment strategies. A mixed-method design using questionnaires and interviews was conducted to collect data from academic staff at COE at Sultan Qaboos University. The study sample consisted of (n=60) academic staff who agreed to answer the research questionnaire. Moreover, the researchers interviewed four academic staff who were experts in online assessment and teachers of practical courses. The interview data were analysed and corroborated with evidence from documents issued by the COE and SQU. The study's findings showed that the academic staff applied various online assessment strategies to measure the learners' achievement. The most applied online assessment strategies were individual projects, presentations, online discussions, and written assignments. The study also found that the COE took measures to enhance its online assessment procedures, including developing an online assessment policy, providing professional development programs, workshops and webinars, and encouraging its staff to conduct further studies to improve online learning practices. Based on the findings, the study suggested some educational implications and recommendations.

This study aims to compare how students perceive and use social media networks (SMNs) in both Omani and Russian higher education institutions. An extensive literature survey was conducted through which the content of the questionnaire was compiled in English, validated for its content, clarity and accuracy by Russian and Omani reviewers and then translated. Data was collected from 837 undergraduate Russian and Omani students using online Google Forms. The results indicate a moderate level of SMNs use in both Higher Education Institution (HEIs) contexts with cross-platform mobile applications at the top of list of the SMNs used by both groups for social connections and multimedia sharing. The overall perceptions towards SMNs seem to be neutral among Russian and Omani students followed by positive perceptions. The study recommends that teachers in both countries provide 'attractive' academic content through a social and multimedia design approach.

With the emergence of COVID-19, many educational pillars have been altered from conventional ways to online solutions. The educational assessment has been administered in online environments despite all encountered challenges. This descriptive study aimed to uncover the online assessment challenges that were confronted. Furthermore, it intended to display the impact of these challenges on the assessment principles. A mixed-method approach was adopted for data collection. A survey was used to collect quantitative data from 60 academic staff at Sultan Qaboos University in Oman, and semi-structured interviews were conducted with four of them. The study found some challenges when applying online assessment such as learners' refusal to turn on cameras, heavy teaching loads, cheating, the long time required for developing online assessment instruments, impersonation/dishonesty, assessing practical experiences, plagiarism, grades' inflation, assessing group's work, academic integrity and a large number of students per section. The study concluded that these challenges respectively threatened assessment principles of validity, efficiency, fairness, reliability and variability. [Note: The page range (73-92) shown on the PDF is incorrect. The correct page range is 73-91.]

Objective: Raising a child with autism spectrum disorder (ASD) can have a significant impact on quality of life (QOL). This study was conducted to assess the QOL and coping strategies of parents of children with ASD in Oman. Method: This descriptive cross-sectional study was conducted at Al-Masarra psychiatric hospital. Telephone interviews were conducted with the parents of all children diagnosed with ASD and attending Al-Masarra Hospital between January 2018 and October 2021. Data were collected using the Ways of Coping Checklist-Revised and World Health Organization Quality of Life Assessment-Brief. Results: A total of 304 parents participated in the study (response rate: 100%), of which 59.5% were female. The mean age of the parents and children with ASD was 40.4±6.9 and 8.4 ±2.3 years, respectively. Most children with ASD were male (78.3%) and entirely dependent upon their parents (18.1%). Seeking social support was the most common coping strategy (75.53 ±13.99), while escape avoidance was the least common (51.78 ±8.04). Most parents (48.7%) rated their QOL as good to very good, with acceptable scores in the psychological (70.92 ±11.22) and social (73.27 ±11.46) domains, borderline in the physical health domain (63.51±7.77), and poor in the environmental domain (58.31 ±11.00). Conclusions: Omani parents of children with ASD utilize various coping strategies, with coping skills considered a positive index for mental health in general. No significant differences were observed between Omani fathers and mothers in terms of QOL or coping strategies.

Background: Hypertension is prevalent in the pediatric population, with estimated rates between 2% and 5%, and its incidence is rising globally. This study offers a single-center analysis of hypertension in children. Methods: a retrospective chart review was conducted involving children aged 1 month to 13 years diagnosed with hypertension. Results: The study included a total of 129 children. Secondary hypertension was identified in 103 patients (79.8%), while primary hypertension was noted in 26 patients (20.2%). Primary hypertension was more common among pre-teen children (50.0%), whereas secondary hypertension predominantly affected those aged 1 to 5 years. Renal parenchymal disease emerged as the most frequent etiology of secondary hypertension, followed by endocrine disorders and vascular issues. No significant correlation was found between hypertension and obesity. The primary complications associated with hypertension in these children were cardiovascular, followed by neurological issues. A small proportion (14.7%) managed their hypertension solely through lifestyle modifications, while the majority required additional antihypertensive medications. At the final follow-up, 50% of the children demonstrated improved blood pressure readings. Conclusion: The findings indicate a higher prevalence of secondary hypertension compared to primary hypertension among the studied population. This study underscores the necessity for heightened awareness among pediatricians regarding the early identification and management of hypertension. Larger population-based studies are warranted to further investigate the prevalence, causes, and outcomes of hypertension in this region. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the performance of students of college of Science of Sultan Qaboos University (SQU) in Calculus I course, and examine the predictive validity of student's high school performance and gender for Calculus I success. The data for the study was extracted from students' database maintained by the Deanship of Admission and Registration office of SQU. The study considered a sample of 615 students who took Calculus I course during 2014 spring semester. Both descriptive and inferential statistical techniques were used for data analysis. Predictive validity of selected factors were analyzed using Hierarchical regression analysis. The analysis revealed that female students entered in SQU with a higher average high school scores than male students, and many boys with lesser high school scores than girls were succeeded in getting admission at SQU. The results indicate that female students outperformed male students in both high school and college Calculus course. About 30% of the students obtained grades lower than C in Calculus I, of which 20% failed in the course. The proportion of students with F grade was found to be significantly higher among male students compared to female students (28% vs. 7%). The analysis revealed that gender, high school math score and overall high school score are significant predictors of subsequent performance in Calculus course at college level. Thus differences among gender and high school performance should be taken into consideration during the admission process to allow for more equal opportunities to all applicants and have fairer admission decisions.

Background: Eating disorders are complex illnesses with serious long-term consequences. They are linked to negative outcomes such as miscarriage, low birth weight, and other obstetric and postpartum difficulties. Our study in Muscat, Oman, examines the eating habits of pregnant women who consult primary care physicians. In this study, our aim is to identify key sociodemographic factors linked with eating disorders in Oman. Method: We used the Eating Disorder Examination Questionnaire to assess the potential for the presence of eating disorders. Chi-Square and Fisher's Exact tests were used to analyze relationships between improper eating behavior and independent variables. Results: The study showed that 1.6% of participants had a potential diagnosis of an eating disorder, with the most common inappropriate behavior being binge eating at a prevalence of 18.8%. A pre-gestational low Body Mass Index (BMI) was associated with a higher prevalence of binge eating during pregnancy. Additionally, we found that pregnant women who were working were more prone to self-induced vomiting. High BMI before pregnancy was significantly associated with various inappropriate eating behaviors, such as restraint behavior (p = 0.000), shape concern (p = 0.000), weight concern (p = 0.040), eating (p = 0.045), laxative use (p = 0.020), and excessive exercise (p = 0.043). Conclusion: The study reveals a high prevalence of eating disorders in pregnancy. Less educated women exhibit higher laxative use, while working women show more instances of binge eating and self-induced vomiting. These findings emphasize the critical need to prioritize targeted interventions and support for vulnerable pregnant women. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the health-related quality of life (HRQoL) of adult Omani patients with sickle cell disease (SCD). The quality of life of these patients in Oman is unknown. Methods: This cross-sectional study was conducted at the Sultan Qaboos University Hospital, Muscat, Oman, from June to October 2022 and included patients with SCD. A validated Arabic version of the 36-Item Short-Form Health Survey (SF-36) was used to assess HRQoL in 8 domains. Results: A total of 235 patients with SCD were included in this study, the majority of whom were female (74.9%) and between 18 and 35 years of age (64.6%). The lowest HRQoL was reported for the domain of role limitations due to physical health (median score = 25.0, interquartile range [IQR] = 35.0), while the highest was seen for role limitations due to emotional problems (median score = 66.7, IQR = 100.0). Frequent SCD-related emergency department visits/hospital admissions and the adverse effect of SCD on patients' social lives had a significant negative impact on SF-36 scores for all 8 HRQoL domains (P =0.05). Additionally, SCD's impact on academic performance and a history of having been bullied due to SCD had a significant negative impact on SF-36 scores for 7 domains (P =0.05). Conclusion: Omani adult patients with SCD reported relatively poor HRQoL in several domains, with various factors found to be significantly associated with this. Healthcare providers and policy makers should consider offering additional clinical, educational and financial support to these patients to enhance their HRQoL. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the knowledge, attitude and experiences in sharing unpleasant health information and adherence to the SPIKES protocol among physicians at a tertiary hospital in Muscat, Oman. Methods: This cross-sectional study was conducted at the Sultan Qaboos University Hospital from August to October 2022. An electronic, self-administered questionnaire was used to gather data from physicians across various departments. Results: A total of 89 physicians completed the questionnaire (response rate = 22.3%). Most participants (n = 86, 96.6%) recognised the need for additional training in the delivery of unpleasant health information ('bad news'), with 78.7% (n = 70) expressing their willingness to undertake such training. Additionally, 32.6% (n = 29) reported negative experiences due to improper delivery of bad news, with an equal proportion admitting to disclosing bad news to patients' family without their consent. The majority (n = 77, 86.5%) demonstrated a high level of overall adherence to the SPIKES protocol, with 59.6-85.4%, 12.4-34.8% and 1.1-11.2% reported usually, sometimes and never following specific steps of the protocol, respectively. Marital status (P = 0.015) and qualifications (P = 0.032) were the only variables that were associated with adherence level, with married physicians and those with board and/or fellowship certificates reporting significantly better adherence compared to their counterparts. Conclusion: Physicians in Oman encounter challenges in delivering unpleasant health information, underscoring the interplay of cultural influences, training and adherence to protocols. To address these challenges, targeted and frequent training programmes are recommended, starting from undergraduate medical education and extending to continuous opportunities for physicians at various career levels. [ABSTRACT FROM AUTHOR]

Background. With projected nursing shortages, an aging workforce, and the imminent retirement of nurse leaders, nursing leadership shortages are a concern. While several studies have indicated the interest of nurses in pursuing leadership positions, limited research has focused on examining the influence of the leadership practice environment on nurses' motivation to lead. Aim. The aims of the study were to (1) assess the relationship between the leadership environment and the motivation of nurses to lead and (2) determine whether there are particular aspects of the leadership environment that influence motivation to lead. Methods. A cross‐sectional research design was used to collect data from 435 nurses working in 16 public and private hospitals in Oman. Leadership Environment Scale and Motivation to Lead Scale were used to assess participants' perceived leadership environment and their motivation to engage in formal leadership roles, respectively. Multivariate linear regression was used to assess the relationship between the perceived leadership environment and the motivation of nurses to undertake leadership roles. Findings. Nurses reported a mean scale value of 3.208 out of 5 (SD = 0.467) for their motivation to lead, which exceeds the midpoint, indicating a strong motivation to engage in formal leadership roles. Nurses reported a mean score of 3.194 out of 4 (SD = 0.661), which exceeds the midpoint, suggesting a favorable perception of leadership environment. The findings showed a significant relationship between the leadership environment and nurses' motivation to lead. Specifically, self‐organization (β = 0.185, p = 0.001, CI = 0.086–0.378), agents (β = 0.221, p = 0.002, CI = 0.124–0.474), and transformative exchange (β = 0.100, p = 0.037, CI = 0.101–0.142) were characteristics of the leadership environment that were associated with greater motivation to engage in leadership. Conclusion. This study emphasizes the importance of cultivating a supportive leadership environment as a potential strategy to attract nurses to assume formal nursing leadership roles. Implications for Nursing Management. Strategies to improve nurses' motivation to lead in a complex healthcare environment include improving nurses' active involvement in their organization, creating a collegial supportive and mentoring leadership culture, and improving transformative exchange by supporting career and educational advancement. [ABSTRACT FROM AUTHOR]

Aim. This study aimed to (1) describe the perceived level of role transition from education to practice of new graduate nurses in Oman and (2) explore the barriers to and enablers of a successful transition. Background. The transition from a familiar academic environment to becoming a professional nurse is stressful and challenging. Exploring the transition barriers and enablers is instrumental in designing an effective experience. However, studies exploring the transition experience from academia to practice among new graduate nurses working in Oman are limited. Design. This study used a mixed method research design. Methods. Data were collected from nurses working for no longer than two years. Role transition was assessed using the Casey‐Fink Graduate Nurse Experience Survey. Barriers to and enablers of transition were explored through a focus group interview. Results. The total sample consists of 405 nurses working in 13 public hospitals. The majority (68.89%) of the participants had worked as a nurse for less than 6 months. The average score of the comfort and confidence subscale was 2.96 (SD = 0.38). Findings showed that the amount of workload and unclear role expectations were the most frequent difficulties new graduate nurses were experiencing in their transition from a student to a staff nurse. Findings from focus group interviews revealed a number of barriers and enablers that affected the transition experience of the new graduates. The barriers were fear, insufficient academic preparation, bridging the knowledge‐practice gap, and limited nurse‐physician interactions. The enablers were teamwork, organizational support, and the internship phase. Conclusion. The findings illustrate the need for healthcare organizations to design effective internship programs to ensure a successful transition experience. Providing staff with preceptorship training and enhancing nurse‐physician communication are important strategies for creating a comfortable work environment and ultimately ensuring a successful training experience for new nurses. [ABSTRACT FROM AUTHOR]

Objectives: Cranioplasty is a complex craniofacial and neurosurgical procedure that aims to reinstate the architecture of the cranial vault and elevate both its aesthetic and neurological function. Several reconstructive materials have been thoroughly explored in the search for the optimal solution for cranioplasty. This study aimed to evaluate different material used for cranial reconstruction in Oman. Methods: This retrospective study included all patients who had had cranioplasty procedures performed at Khoula Hospital, Muscat, Oman, from 2012 to 2022. Demographic information, the characteristics of the cranial defect and any complications that occurred post-operatively were analysed. Results: A total of 47 patients were included in this study. The most common cause of cranial defects was craniectomy following traumatic head injury (70.2%) along with excision of fibrous dysplasia (10.6%). The most frequently utilised material for cranial repair was autologous bone grafts (n = 28), followed by polyetheretherketone (PEEK; n = 14). Interestingly, the replacement of bone grafts from previous craniectomy showed a notably high resorption rate (71.4%), in contrast to split calvarial grafts (0%) and other types of bone grafts (14.3%). Additionally, delayed graft infection was observed in 3.6% of the bone graft group and 7.1% of the PEEK group. Conclusion: Patient-specific alloplastic implants such as PEEK have gained popularity for large and complex cranioplasty, as they provide excellent aesthetic outcomes and leave no donor site morbidity. In contrast, bone grafts remain the gold standard for small to medium-sized cranial defects. [ABSTRACT FROM AUTHOR]

Objectives: The impact of beta-thalassemia major (β-TM) on health-related quality of life (HRQoL) in Oman is not yet known. Affected individuals suffer from a wide range of physical, mental, and social consequences due to the need for regular hospital visits for blood transfusions and complications related to iron overload. This study aimed to assess the HRQoL of adult patients with β-TM attending a single tertiary care center in Muscat, Oman, to identify factors influencing Omani patients' QoL for improved management and counseling. Methods: A cross-sectional study was conducted among adult patients (≥ 18 years) with β-TM at Sultan Qaboos University Hospital between September and November 2022. A validated Arabic version of the self-reported 36-item short-form health survey was used to determine HRQoL. Results: A total of 78 patients with β-TM were enrolled in the study; 53.8% were male and the mean age was 26.0±0.8 years, ranging from 21--53 years. Most patients were from Al Batinah North governorate (n = 21; 26.9%) and Muscat (n = 20; 25.6%), unmarried (n = 44; 56.4%), did not have university-level education (n = 45; 57.7%), and were unemployed (n = 44; 56.4%). The HRQoL domain with the highest score was role limitations due to emotional problems (median score = 100), while general health and vitality received the lowest scores (mean scores were 60.2±15.9 and 59.1±20.5, respectively). Several variables were associated with better HRQoL in certain domains, including being married, having a high level of education, being employed, exercising regularly, and receiving family support (p < 0.05). However, iron overload and having ≥ 3 β-TM-related disease complications were associated with poorer general health scores (p = 0.031 and 0.038, respectively), while a history of mental issues was associated with poorer scores in six out of eight HRQoL domains (p < 0.05). Moreover, negative perceptions regarding the social impact of the disease including delayed marriage, workplace difficulties, and reduced academic achievement were associated with poorer HRQoL in various domains (p < 0.05). Conclusions: Although the studied sample reported generally good QoL, several factors were found to affect HRQoL in various domains. Healthcare providers should prioritize maintaining acceptable iron overload levels in Omani patients with β-TM to help avoid the development of disease-related complications, thereby ensuring better control of their clinical conditions and consequently improving their HRQoL. [ABSTRACT FROM AUTHOR]

Background: Sickle cell disease in pregnancy is associated with high maternal and fetal mortality. However, studies reporting pregnancy, fetal, and neonatal outcomes in women with sickle cell disease are extremely limited. Objectives: The objectives of the study are to determine whether women with sickle cell disease have a greater risk of adverse pregnancy, fetal, and neonatal outcomes than women without sickle cell disease and identify the predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. Design: A retrospective pair-matched case-control study was conducted to compare 171 pregnant women with sickle cell disease to 171 pregnant women without sickle cell disease in Muscat, Sultanate of Oman. Methods: All pregnant Omani women with sickle cell disease who delivered between January 2015 and August 2021 at Sultan Qaboos University Hospital and Royal Hospital, who were either primipara or multipara and who had a gestational age of 24–42 weeks, were included as patients, whereas women who had no sickle cell disease or any comorbidity during pregnancy, who delivered within the same timeframe and at the same hospitals, were recruited as controls. The data were retrieved from electronic medical records and delivery registry books between January 2015 and August 2021. Results: Women with sickle cell disease who had severe anemia had increased odds of (χ2 = 58.56, p < 0.001) having adverse pregnancy outcomes. Women with sickle cell disease had 21.97% higher odds of delivering a baby with intrauterine growth retardation (χ2 = 17.80, unadjusted odds ratio = 2.91–166.13, p < 0.001). Newborns born to women with sickle cell disease had 3.93% greater odds of being admitted to the neonatal intensive care unit (χ2 = 16.80, unadjusted odds ratio = 1.97–7.84, p < 0.001). In addition, the children born to women with sickle cell disease had 10.90% higher odds of being born with low birth weight (χ2 = 56.92, unadjusted odds ratio = 5.36–22.16, p < 0.001). Hemoglobin level (odds ratio = 0.17, p < 0.001, 95% confidence interval = 0.10–3.0), past medical history (odds ratio = 7.95, p < 0.001, 95% confidence interval = 2.39–26.43), past surgical history (odds ratio = 17.69, p < 0.001, 95% confidence interval = 3.41–91.76), and preterm delivery (odds ratio = 9.48, p = 0.005, 95% confidence interval = 1.95–46.23) were identified as predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. Conclusion: As pregnant women with sickle cell disease are at increased risk for pregnancy, fetal, and neonatal adverse outcomes; improved antenatal surveillance and management may improve the outcomes. [ABSTRACT FROM AUTHOR]

Background: Considering the increasing prevalence of Polycystic Ovarian Syndrome (PCOS) and its related complications—such as obesity, cardiovascular diseases, and infertility—in the Middle East, it is imperative to create sufficient public awareness about this issue. Accordingly, the potential link between PCOS awareness and health literacy level with the lifestyle choices of Arabic-speaking female university students was examined in this cross-sectional study. Materials and Methods: This research was conducted in the Sultanate of Oman and involved 446 Arabic-speaking female university students, who completed a self-administered online questionnaire, Single Item Literacy Screener, and PCOS Awareness Tool. Results: The findings showed that, while 53.50% of the study participants had inadequate health literacy, 79.80% demonstrated an acceptable level of PCOS awareness. However, this did not seem to influence their lifestyle, given that 59.20% of the respondents were physically inactive and 83.30% regularly consumed fast food. Regression analysis results nonetheless revealed that health literacy and PCOS awareness were significant predictors of lifestyle choices (F2,44 = 5.98, p < 0.05, 95% CI [4.44–5.35]). Conclusions: The Arabic-speaking female university students' health literacy level and PCOS awareness are significant predictors of their lifestyle choices. Thus, the policymakers in the Arab region need to develop effective strategies aimed at PCOS prevention, focusing specifically on raising public awareness about PCOS and its negative consequences on female reproductive health. In addition, university administrators should ensure the availability of healthy food choices at their campuses as well as opportunities for physical activity to promote healthy lifestyle among all students. [ABSTRACT FROM AUTHOR]

Objective: Multiple factors contribute to decision fatigue experienced by emergency physicians (EPs). This study examines the association between decision fatigue and the frequency of computed tomographic (CT) scan requests and inpatient referrals among EPs. Methods: This retrospective database analysis was done for 3 months. Scans and inpatient referral requests were coded and analyzed to assess the impact of physician fatigue on decision-making. Subsequently, the outcomes were evaluated. Results: The majority of patients (n - 481; 51.1%) had a CT brain request. Among these requests, the morning shift (8:00 a.m.-3:00 p.m.) accounted for the highest number (n - 400; 42.5%), followed by the evening shift (3:00-11:00 p.m.) (n -345; 36.7%). Approximately one-third of the patients (n - 301; 31.9%) had positive CT scan findings. Statistical analysis comparing the first and the second halves of each shift did not reveal significant variations in the percentage of negative CT results (p-value: 0.093). Inpatient referral was necessary for over half of the patients (n - 1048; 52.7%), and the majority of these referrals (n - 778; 74.2%) were deemed necessary for treatment under various surgical or medical specialties. There was a statistically significant difference in the proportion of negative inpatient referrals between the first and the second halves of the afternoon shift (p-value < 0.001). Conclusions: Fatigue among EPs was observed, leading to more frequent consultations without inpatient admission during the latter half of the afternoon shift. However, the study found no significant impact of decision fatigue on CT scan decision-making. [ABSTRACT FROM AUTHOR]

Objectives: Preliminary studies suggested that the high rates of stress are increasingly prevalent in students in tertiary education in the Arabian Gulf countries and that their emotional eating is often triggered by stress. Nevertheless, there is a dearth of studies on this topic and Oman is no exception. In this study, we intended to examine the prevalence of emotional eating and perceived stress in Omani college students and to clarify the relationship between their emotional eating and sociodemographic and risk factors among the population in the college students in Oman. Methods: We used Salzburg Emotional Eating Scale and Perceived Stress Scale to assess emotional eating and variations in perceived stress, respectively. We also study their sociodemographic and risk factors. Results: A total of 422 students took part in the study, with the age of 20.6 ± 1.8 (mean ± standard deviation) years. Of all students, 85.8% (n = 362) were reported to have emotional eating and 78.7% of the sample were reported to experience stress. The multivariate logistic analysis showed that body mass index (BMI) and the student's major subjects were the significant risk factors. Students who majored in science/engineering/agriculture (odds ratio [OR] = 0.926, p < 0.001) and arts/business/law were 3.1 times (OR = 3.115, p < 0.05) and 2.3 times (OR = 2.347, p < 0.05) were significantly engaged in emotional eating as compared to those majoring in medicine/nursing. Students who are underweight (BMI < 18) were 3.9 times (OR = 3.984, p < 0.05) were also significantly more to engage in emotional eating than those students who were overweight/obese (BMI 25+). Conclusion: In this study, we found that both rates of emotional eating and stress were high among college students in Oman. Contrary to international trends, underweight students (BMI < 18) were more prone to engaging in emotional eating than overweight/obese students (BMI 25+) in our study sample. This suggests that there is likely to be subcultural diversity or artifacts that are intimately tied to emotional eating. More studies on this discrepant finding are warranted. [ABSTRACT FROM AUTHOR]

Objectives: Postmenopausal osteoporosis is a progressive metabolic bone disease resulting from oestrogen deficiency. Due to the silent nature of the disease, there is an urgent need for a simple, early predictive marker. This study aimed to assess the potential of three factors--neutrophil-to-lymphocyte ratio (NLR), monocyteto- lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR)--as inflammatory markers of bone mineral density (BMD) loss. Methods: A retrospective cross-sectional study was conducted among 450 postmenopausal Omani women undergoing dual-energy X-ray absorptiometry at the Sultan Qaboos University Hospital, Muscat, Oman, from January 2017 to December 2019. The participants were allocated to groups based on lumbar spine BMD t-score values. A receiver operating characteristic curve was used to determine the area under the curve (AUC). Multivariate logistic regression was performed to identify independent predictors of low BMD. Results: A total of 65 (14.4%), 164 (36.4%) and 221 (49.1%) women were allocated to the control, osteopenia and osteoporosis groups, respectively. No significant differences in PLR, MLR and NLR values were observed among the groups. BMD t-score values were reversely correlated with age (P = 0.007) and PLR (P = 0.004) and positively correlated with body mass index (BMI; P <0.001). The AUC was 0.59. The independent predictors of low BMD were age (>65 years) and BMI (<25 kg/m²). Conclusion: None of the three inflammatory biomarkers studied were found to be useful prognostic indicators of bone loss. Further research is recommended to reject or support theories regarding the role of inflammatory status in the pathogenesis. [ABSTRACT FROM AUTHOR]

Background: This article examines differences and similarities in adolescent tobacco use among Member States of the Health Ministers' Council for the Gulf Cooperation Council (HMC/GCC) using Global Youth Tobacco Survey (GYTS) data. Methods: Nationally representative samples of students in grades associated with ages 13-15 in Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen. Schools were selected proportional to enrollment size, classes were randomly selected within participating schools, and all students in selected classes were eligible to participate. Results: GYTS results confirmed that boys are significantly more likely than girls to smoke cigarettes or use shisha (water pipe). Students had higher rates of tobacco use than adults in Bahrain, Oman, and United Arab Emirates. For boys and girls, shisha use was higher than cigarette smoking in almost all countries. Susceptibility to initiate smoking among never smokers was higher than current cigarette smoking in all countries. Exposure to secondhand smoke in public places was greater than 30%, direct protobacco advertising exposure was greater than 70% on billboards and in newspapers, and more than 10% of students were influenced by indirect advertising. Finally, less than half of the students were taught in school about the dangers of tobacco use in the past year. Conclusions: For boys and girls, high prevalence of cigarette smoking, high prevalence of shisha use, and high susceptibility of never smokers to initiate smoking in the next year are troubling indicators for the future of chronic disease and tobacco-related mortality in the Member States of the HMC/GCC. (Contains 5 tables.)

• Mucormycosis is an opportunistic angioinvasive infection with a high mortality rate. • A surge in mucormycosis cases has been observed during the second COVID-19 wave. • Diabetes mellitus, COVID-19, and hot climate increase the risk of mucormycosis. • Glycemic control and ketoacidosis prevention are key in managing mucormycosis. A surge in COVID-19-associated mucormycosis cases has been observed during the second wave of COVID-19 in summer of 2021. Most cases were reported from India. The Delta variant (B.1.617.2) was the most common variant circulating at that time. Mucormycosis is an opportunistic angioinvasive fungal infection with high morbidity and mortality. We present 10 cases of COVID-19-associated rhino-orbital and rhino-orbital-cerebral mucormycosis managed in a secondary hospital in Oman. The median time for developing mucormycosis was two weeks after COVID-19 diagnosis. All patients were newly diagnosed or already known to have poorly controlled diabetes mellitus. Five patients received corticosteroid therapy for COVID-19. Three patients had severe COVID-19 and died of severe acute respiratory distress syndrome and septic shock. Another three patients died of advanced mucormycosis and cerebral involvement. Despite aggressive medical and surgical intervention, the mortality rate was 60% (6/10). Mucormycosis is an aggressive opportunistic infection with high morbidity and mortality that requires prompt recognition and urgent intervention. Uncontrolled blood sugar, the use of corticosteroids, and immune dysfunction due to COVID-19 are all important risk factors for development of mucormycosis. Worse outcomes are associated with poor glycemic control despite aggressive medical and surgical interventions. [ABSTRACT FROM AUTHOR]

The goal of this study was to estimate the prevalence of polypharmacy and medication compliance among patients with T2DM at a primary care clinic in Muscat, Oman, to determine whether various sociodemographic and clinical factors were associated with polypharmacy and to assess relationships between polypharmacy, compliance, and self-related health. It is a cross-sectional study conducted between September and November 2019 and included all adult T2DM patients attending the clinic. Data were collected using a questionnaire, face-to-face interviews, and electronic medical records. A total of 202 T2DM patients were included. The majority were female (56.9%) and ≥60 years old (45.5%). Most had two or more chronic health conditions (66.3%). The prevalence of polypharmacy was 83.1%. Overall, 65% and 92% of patients reported a high level of adherence to treatment and good-to-excellent health, respectively. In conclusion, Polypharmacy was common among T2DM patients and was significantly associated with age, common comorbidities, and T2DM duration. [ABSTRACT FROM AUTHOR]

Objectives: Somatic symptom disorder (SSD) is a diagnostic classification to describe the occurrence of physical symptoms without organic cause. This study aimed to identify prevalence rates and associated characteristics of SSD among adults in primary care settings. Methods: This cross-sectional study took place between July 2020 and March 2021 and included a random selection of 3383 Omani adults attending 12 primary healthcare centres in Muscat Governorate. Screening was conducted using an Arabic version of the Somatic Symptom Scale-8 (SSS-8). Results: A total of 2000 adults participated in the study (response rate: 67.3%), of which most were female (71.7%) and under 50 years old (86.2%). Based on their SSS-8 scores, 602 participants (17.8%) had SSD, resulting in an overall prevalence estimate of 30.1% (95% confidence interval: 28.13–32.15). Significant associations were observed between SSD and age (p = 0.002), gender (p < 0.001), marital status (p = 0.030) and chronic comorbidities (p = 0.001). In addition, adjusted odds ratio estimates revealed SSD to be significantly associated with gender (p < 0.001), education level (p < 0.001) and chronic comorbidities (p = 0.001). Conclusion: The estimated prevalence of SSD in primary care settings is high compared to reports from elsewhere in the Gulf region. There is an urgent need to enhance the diagnosis of SSD at the primary care level in order to reduce healthcare service overutilisation and patient dissatisfaction. Moreover, healthcare practitioners should be aware of the effect of age, gender, educational status and chronic comorbidities on somatic symptoms. [ABSTRACT FROM AUTHOR]

Although placing students in the appropriate proficiency levels of post-secondary English programs is crucial for optimal learning, the evaluation of placement tests (PTs) in terms of establishing their reliability and validity is relatively under-researched. This study assesses the validity, reliability, and effectiveness of an in-house online PT. The content validity was established through the internal and external moderation of the question papers and answer keys while criterion-related concurrent validity was established via IELTS benchmarking. New Student Survey was used to investigate the face validity. The internal consistency and reliability of the reading test items were measured using Cronbach's alpha while descriptive statistics were calculated for the listening test. Paired sample t-test (dependent t-test) was used to assess the inter-rater reliability of the speaking and writing tests which were double-marked. The data analysis revealed that the PT was effective in placing students at different levels of the foundation program (FP) and the statistical analyses conducted to test the reliability and validity showed positive results for most of the test versions. The study offers useful insights to test developers and policymakers regarding the authentication of in-house tests and the creation of guidelines for PT design and evaluation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous research has highlighted potential associations between anemia, diabetes, and worsening kidney disease. The aim of this study, therefore, was to determine the prevalence of anemia in patients with both chronic kidney disease (CKD) and Type 2 diabetes mellitus (T2DM) at a primary care center in Oman. MATERIALS AND METHODS: A cross-sectional study was conducted at the Primary Care Clinic of Sultan Qaboos University Hospital, Muscat, Oman. All patients with established diagnoses of CKD and T2DM who attended appointments at the clinic in 2020 and 2021 were included. Data concerning the patients' sociodemographic characteristics, medical history, clinical findings, and laboratory results during past six months were retrieved from the hospital's information system. Patients were contacted via telephone for clarification in the event of any missing data. SPSS version 23 was used for Statistical analyses of the data. Frequencies and percentages were used to present categorical variables. Chi-squared tests were used to determine association between anemia and demographic and clinical variables. RESULTS: A total of 300 patients with T2DM and CKD were included in the study; 52% were male, 54.3% were 51--65 years of age, and majority (88%) were either overweight or obese. The majority of patients (62.7%) had Stage 1 CKD followed by Stage 2 (34.3%) and Stage 3 (3%). The total prevalence of anemia was 29.3%, with 31.4%, 24.3%, and 44.4% of Stage 1, Stage 2, and Stage 3 CKD patients being anemic, respectively. The frequency of anemia was significantly higher in female than male patients (41.7% vs. 17.9%; P < 0.001). No associations were observed between anemia status and other sociodemographic or clinical characteristics. CONCLUSION: The prevalence of anemia in CKD and T2DM primary care patients in Oman was 29.3%, with gender as the only factor significantly associated with anemia status. Routine screening of anemia in diabetic nephropathy patients is highly recommended. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to estimate the prevalence of cytological abnormalities in Papanicolaou (Pap) smears and related risk factors among Omani women. Methods: A cross-sectional study was conducted from March to September 2019 at the gynaecology and family medicine clinics of Khoula Hospital and Sultan Qaboos University Hospital in Muscat. All asymptomatic Omani women aged between 21 and 65 years were included. Data regarding the participants' sociodemographic characteristics and known risk factors were collected using a selfreported sheet. Pap smears were performed and the results were reported by a cytotechnologist and histopathologist. Results: A total of 442 women participated in the study (response rate: 100%). The mean age was 39.0 ± 9.7 years old. The prevalence of cervical cytological abnormalities was 3.7%. There was a significant association between human papillomavirus (HPV) infection and cervical cell abnormalities (P = 0.017); however, there was no link with hormonal contraception use, pregnancy before the age of 17 years or parity (P >0.050 each). Conclusion: The prevalence of cervical cell abnormalities in Oman was similar to that observed in Arab countries and relatively low in comparison to findings from Western countries. A screening program should be implemented at the primary care level. The findings of this study also highlighted the need for a future vaccination program against HPV infections. [ABSTRACT FROM AUTHOR]

Introduction: For Oman, a country targeting tuberculosis (TB) elimination, TB among expatriates is a major challenge. Thus, screening for active TB using chest X-ray was made mandatory for expatriates' residency renewals. Objective: To estimate the incidence of bacteriologically confirmed TB and assess impact of chest X-ray based TB screening among expatriates in Muscat Governorate. Methods: Applicants for residency and renewals were mandated for chest X-ray-based TB screening in 2018. We collected data of screened subjects with radiological suspicion of TB who were subjected to further bacteriological evaluation. Results: Of 501,290 applicants screened during the study period, 436 (0.09%) had X-ray findings suggestive of TB. Among the 436, TB was confirmed in 53 (12.2%; 95% CI 9.2–15.6), giving an overall prevalence of 10.6 (95% CI 8–13.9) per 100,000 applicants (number needed to be screened 9458). Among renewals, the point prevalence of TB was 10.5 per 100,000 expatriates screened (95% CI 6.9–14.04 per 100,000), with a mean follow-up period of 11.8 years. Conclusion: Our findings are consistent with the recommendation for utilization of chest X-ray as a preferred tool for active case finding in the setting of expatriate screening. Our findings are also suggestive of the need for latent TB screening and ruling out TB prior to latent TB treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Restless legs syndrome (RLS) is a common sensorimotor disorder during pregnancy. The purpose of this study was to assess the prevalence of RLS and explore the associated risk factors and outcomes in Omani women in the first and third trimester and at 2-week postpartum. MATERIALS AND METHODS: This cross-sectional study included 305 pregnant women visiting four health centers in Muscat between May 2018 and October 2020. A structured questionnaire was used and data were collected through review of electronic records and face-to-face interviews. The International RLS Study Group criteria were used to diagnose RLS. Participants were interviewed during their first trimester, their third trimester, and at their 2-week postpartum visit. Results were presented as means and standard deviations or percentages, as appropriate. To assess the association between RLS and various variables, unpaired t-test or McNemar's test were used, as appropriate. RESULTS: The mean age at baseline was 29.8 ± 5.28 years. The prevalence of RLS was significantly higher in the third trimester (41.0%) than in the first trimester (15.7%) and postpartum period (15.1%) (P < 0.001), although there was no significant difference in severity. Family history and personal history of RLS were the only independent correlates of RLS (P < 0.001 and 0.002, respectively). No associations were noted with pregnancy and neonatal outcomes or other comorbidities, including anemia. However, there was a significant relationship between the development of RLS and weight gain during pregnancy (P = 0.023). CONCLUSION: One in six pregnant Omani women may be at risk of RLS during the first trimester, while one in 2–3 may be at risk in the third trimester, particularly those with a personal or family history of RLS and those who gain >12 kg during pregnancy. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to estimate the serological prevalence of coeliac disease in patients with iron deficiency anaemia (IDA) of unknown cause at a primary healthcare facility in Oman. Methods: This prospective case-finding study was conducted at the primary care clinics in Sultan Qaboos University Hospital, Muscat, Oman from September 2018 to June 2020. Patients aged 18 to 55 years, with a haemoglobin (Hb) level <11.5 g/dL for males and <11.0 g/dL for females and a ferritin level <30 ng/mL for males and <13 ng/mL for females, were included in the study. Blood samples were obtained for initial serological screening using serum immunoglobulin (Ig)A level; those samples with normal levels of IgA, IgA anti-tissue transglutaminase antibody (tTG) and IgA anti-deamidated gliadin peptide (DGP) were determined. Positive IgA-tTG test was confirmed using IgA-endomysial antibodies. Patients with low IgA levels were tested using IgG-tTG and IgG-DGP. Results: A total of 104 patients participated in this study. Eight patients (7.7%) were found to have a positive serological screening result for coeliac disease; of these patients, three (37.5%) had a positive IgA-tTG result. Two of those three (66.7%) had a positive IgA-endomysial antibody. The IgA-DGP result was positive in seven (6.7%) of the 104 patients. Out of those seven patients, two also had a positive IgA tTG. Conclusion: Coeliac disease is not a rare disorder. There is a need to increase awareness among healthcare professionals about coeliac disease and its non-classical manifestations such as IDA. [ABSTRACT FROM AUTHOR]

The number of family physicians in Oman is far below that recommended by the World Health Organization. This study aimed to determine factors influencing junior doctors' choice of a career in family medicine. Methods: This cross-sectional study was conducted between March and June 2018 and targeted applicants to Oman Medical Specialty Board residency programmes during the 2018-2019 academic year. Applicants were grouped according to their choice of either family medicine (n = 64) or other specialities (n = 81). A self-administered questionnaire was utilised to compare the applicants' sociodemographic characteristics, factors influencing their choice of career and their Myers-Briggs Type Indicator® (MBTI) personality traits. Results: A total of 52 family medicine and 43 other residency applicants participated in the study (response rates: 81.3% and 53.1%, respectively). Most family medicine applicants were female (86.5%), married (65.4%) and resided in rural areas (73.1%); moreover, 19.2% were ≥30 years of age. Overall, emphasis on continuity of care, opportunity to deal with a variety of medical problems, the ability to use a wide range of skills and knowledge, early exposure to the discipline, opportunity to teach and perform research and the influence of family or friends were important factors in determining choice of a career in family medicine. Moreover, the MBTI analysis revealed that family medicine applicants were commonly extroverted-sensing-thinkingjudging personality types. Conclusion: Knowledge of the factors influencing career choice among junior doctors may be useful in determining future admission policies in order to increase the number of family physicians in Oman. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the value of single photon emission computed tomography/ computed tomography (SPECT/CT) imaging in well-differentiated thyroid cancer (DTC) after radioiodine (I-131) ablation/therapy for clinical staging and risk stratification. It also aimed to determine whether SPECT/CT would change the management plan or predict the clinical outcomes of DTC patients. Methods: A total of 78 DTC patients underwent first post radioiodine therapy "Whole body iodine-131 scintigraphy (WBS) along with SPECT/CT" at the Department of Radiology and Molecular imaging, Sultan Qaboos University Hospital, Muscat, Oman, between January 2014 and August 2017. Differences between WBS and SPECT/CT, change in clinical staging, risk stratification and management were recorded. The clinical outcome at 6-12 months was recorded. A generalised McNemar test was used to assess disagreement between WBS and SPECT/CT. Results: According to the American Thyroid Association (ATA) risk stratification, the sample showed low (35.8%), intermediate (53.8%) and high-risk groups (10.2%) on WBS, which changed to 44.8%, 38.4% and 16.6%, respectively, on SPECT/CT imaging. Overall change in risk stratification was noted in 16.7% and TNM stage in 11.5% of patients after SPECT/CT imaging. SPECT/CT changed the therapeutic plan and clinical outcome in 19.2% of patients. Conclusion: SPECT/CT allows better detection and characterisation of metastatic lymph nodes and distant metastasis in DTC patients compared to WBS imaging alone. It alters TNM staging, ATA risk classification and management in a significant number of patients. It is recommended that SPECT/ CT should be done routinely along with WBS in well-differentiated thyroid carcinoma. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate trauma care capabilities at the primary care level in Muscat, Oman, using World Health Organization guidelines. Methods: This descriptive cross-sectional study was conducted between January and March 2015 at eight primary health centres in Seeb. An English-language questionnaire was distributed to the medical officer or nurse in-charge at each centre to determine the number of staff, total population being served, number of emergency trauma cases and availability of ambulances. Subsequently, 10 doctors from each health centre were randomly selected to assess the availability of physical resources as well as their trauma skills and knowledge. Results: There were limited physical and human resources for the management of trauma and a complete absence of trauma administrative functions, such as local trauma registries or quality improvement activities. Conclusion: This study highlighted the need to introduce national guidelines and improve the delivery of trauma services in Oman. [ABSTRACT FROM AUTHOR]

Objectives: Emergencies can occur at any time and be life-threatening or cause permanent damage. Accordingly, the management of emergency cases is an integral part of primary healthcare (PHC). This study aimed to estimate the proportion and types of emergency cases presented to PHC centres in Muscat, Oman. Methods: This retrospective cross-sectional study was conducted from March to August 2016 at five PHC centres in the Muscat Governorate. A total of 800 emergency cases (i.e. those labelled in the health information system as an accident and emergency) of Omani patients aged =5 years presented during this period. Every second case, based on arrival to the registration desk, was selected for analysis. Electronic medical records were reviewed to collect data regarding demographic features, presenting complaints, time and season of presentation, management provided and method of transportation if referred to tertiary care. Results: The proportion of emergency cases was <2.5% (range: 1-2.5%). The most common type of emergency was musculoskeletal issues/trauma (34.3%) followed by gastroenterological (15.1%) and genitourinary (10.0%) emergencies. Most patients were either 21-39 or 5-12 years old (35.0% and 21.6%, respectively). The majority (59.6%) were treated directly at the health centre, while the remaining patients (40.4%) were referred to tertiary care. At referral, only 12.1% were transported by ambulance and the rest via private transport. Conclusion: Musculoskeletal issues/trauma was the most common type of emergency seen at the selected PHC centres in Muscat. Further research is needed to determine whether PHC centres have the capability and resources necessary to appropriately manage emergency cases. [ABSTRACT FROM AUTHOR]

This study was performed to determine the chemical compositions and heavy metals in the muscle of Scomberomorus commerson from the Oman Sea, during the two seasons, pre-monsoon and postmonsoon in 2018. The protein, fat, moisture, and ash contents were determined by AOAC (Association of Official Analytical Chemists) methods. Heavy metal (Zn, Cu, and Pb) analyses were performed by atomic absorption spectrophotometer after acid digestion. There were significant differences between protein, fat, moisture, and ash values in muscle tissue in two seasons (P< 0.05). The highest content of protein (22.53±2.09%) and fat (4.15±1.25%) was recorded in pre-monsoon. The mean concentrations of heavy metals (μg g-1dw) in muscle tissue were 0.08-0.05 for Zn, 0.04-0.02 for Cu, and 0.02-0.01 for Pb in the pre and post-monsoon, respectively. The accumulation of heavy metals in muscle followed the Zn>Cu>Pb. The amounts of Zn, Cu, and Pb were below maximum permissible limits (MPL) recommended by international standards (FAO, FAO/WHO, and MAFF). Results revealed that estimated daily and weekly intakes of Zn, Cu, and Pb were far below the permissible tolerable daily intake (PTWI) recommended by FAO/WHO. Therefore, consumption of S. commerson in the pre and post-monsoon has no risks for human health in the Oman Sea. [ABSTRACT FROM AUTHOR]

A wide range of gastrointestinal (GI) illnesses is caused by foodborne bacteria that can arise from either a direct bacterial infection or bacterial toxin ingestion. The treatment of these infections has been hampered by the appearance of resistant strains. This current study aims to investigate the prevalence of Gastrointestinal tract (GIT) infections in Omani patients and their resistance pattern against commonly used antibiotics. Seven hundred and ninety fresh stool samples were obtained from Omani patients attending Sultan Qaboos University Hospital with GI manifestation from the 1st of June to the 30th of November 2019. Bacterial identification in stool samples was carried out by inoculation in culture media, microscopical examination and biochemical tests confirmed by MALDI. BD PhoenixTM. The antibiotics sensitivity testing was carried out by the Manual disk diffusion method and by MALDI. BD PhoenixTM. Out of 790 stool samples, 49 samples were positive for GIT bacterial infections. Salmonella spp. was the most prevalent isolate and more associated with children less than ten years old. Out of the 49 bacterial isolates, 3 (6.1%) were Clostridium difficili, 4 (8.2%) were Shigella flexneri, 5 (10.2%) were Campylobacter jejuni, and different Salmonella spp. serotypes were detected such as Salmonella Kentucky (8.2%), Salmonella enteritidis (6.1%), Salmonella infantis (4.1%), Salmonella welteverden (4.1%), Salmonella typhimurium (4.1%), Salmonella anatum (2.0%), Salmonella tesvia (2.0%), Salmonella Uganda (2.0%), Salmonella Arizona (2.0%) and (40.8%) of other Salmonella spp. serotypes. Eighty percent of isolated Campylobacter jejuni were resistant to Ciprofloxacin and Tetracycline. Salmonella spp. and Shigella flexneri were highly resistant to Amikacin, Gentamicin, and Cefuroxime. The low level of bacterial infection detected among screened patients in the present study indicates the excellent hand washing hygiene practice in reducing GIT infections among patients in Oman. This good hand washing hygiene practice is of great help in the efforts of controlling the spread of other severe diseases like COVID-19. However, detecting the emerging of antibiotic-resistant of GIT bacterial pathogens among patients in Oman, such as Salmonella and Shigella to a commonly used antibiotic such as Gentamicin, is alarming. [ABSTRACT FROM AUTHOR]

• Predictors of COVID-19 severity will help prioritize resources and minimize mortality. • Immunological markers can be used as predictors of a poor prognosis. • High IL-6 independently predicts poor outcomes in COVID-19 patients. • A high percentage of large inflammatory monocytes predicts worse COVID-19 outcomes. • Lower circulating naïve CD4+ T cells predicts a poor prognosis in COVID-19 patients. Identifying the immune cells involved in coronavirus disease 2019 (COVID-19) disease progression and the predictors of poor outcomes is important to manage patients adequately. This prospective observational cohort study enrolled 48 patients with COVID-19 hospitalized in a tertiary hospital in Oman and 53 non-hospitalized patients with confirmed mild COVID-19. Hospitalized patients were older (58 years vs 36 years, P < 0.001) and had more comorbid conditions such as diabetes (65% vs 21% P < 0.001). Hospitalized patients had significantly higher inflammatory markers (P < 0.001): C-reactive protein (114 vs 4 mg/l), interleukin 6 (IL-6) (33 vs 3.71 pg/ml), lactate dehydrogenase (417 vs 214 U/l), ferritin (760 vs 196 ng/ml), fibrinogen (6 vs 3 g/l), D-dimer (1.0 vs 0.3 μg/ml), disseminated intravascular coagulopathy score (2 vs 0), and neutrophil/lymphocyte ratio (4 vs 1.1) (P < 0.001). On multivariate regression analysis, statistically significant independent early predictors of intensive care unit admission or death were higher levels of IL-6 (odds ratio 1.03, P = 0.03), frequency of large inflammatory monocytes (CD14+CD16+) (odds ratio 1.117, P = 0.010), and frequency of circulating naïve CD4+ T cells (CD27+CD28+CD45RA+CCR7+) (odds ratio 0.476, P = 0.03). IL-6, the frequency of large inflammatory monocytes, and the frequency of circulating naïve CD4 T cells can be used as independent immunological predictors of poor outcomes in COVID-19 patients to prioritize critical care and resources. [ABSTRACT FROM AUTHOR]

Geographic Information System (GIS) and Remote Sensing (RS) are useful tools in environmental monitoring, evaluation and analysis for various sectors including agriculture. This paper reviews the applications of GIS, RS and the integration of both techniques in the agricultural field, in general, and Controlled Environment Agriculture (CEA), in particular. More emphasis is given to their applications in arid areas and Oman is taken as a case study. GIS techniques have been used in the mapping of soil and water quality, spatial assessment for water quantity stress, land suitability, pest and disease distribution of crops as well as delineating and generating database management systems (DBMS) for protected cultivations. In Oman, GIS was only employed to analyse the spatio-temporal dynamics of land use changes as affected by external factors and greenhouses as an example in northern part. RS was also utilised to map the changes in land cover and their uses, detect and map soil salinity, and monitor agricultural droughts. In CEA, RS was utilised for mapping, detection and classification of greenhouses through aerial images and satellites. In Oman, negligible study was documented on the use of RS techniques in the CEA field. The integration of both techniques has proven its capability in mapping, evaluating and managing natural resources and greenhouse distribution and generating database management system in agriculture and CEA fields. Sophisticated geostatistical analysis models based on Multi-criteria analysis using Fuzzy-logic and Analytic Hierarchy Process could be a good platform for trade-off analysis for land suitability analysis and optimal location of CEA in challenging agriculture like Oman. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess parental knowledge, attitudes and practices regarding antibiotic use for children with upper respiratory tract infections (URTIs). Methods: A multi-centre cross-sectional study was conducted from September 2018 to April 2019 at 15 randomly selected primary health centres in Muscat, Oman. A total of 384 parents with children under 12 years old were recruited. A validated questionnaire was utilised to determine knowledge, attitudes and practices regarding antibiotic use for children with URTIs. Results: All 384 parents participated in the study (response rate: 100%). Almost half of the participants (n = 173; 45.1%) agreed that antibiotics were the first and best treatment for URTIs in children, with 184 parents (47.9%) reporting that influenza symptoms in children improved more rapidly after the administration of antibiotics and 203 (52.9%) believing that antibiotics prevented complications. The majority (n = 219; 57.0%) of parents never gave their children antibiotics without a prescription, and 291 (75.8%) never used leftover antibiotics. Most participants (n = 233; 60.7%) stated that it was the doctor’s decision to prescribe antibiotics, 192 (50.0%) had never asked a physician to prescribe antibiotics for their child and 256 (66.7%) had never changed doctors because they did not prescribe antibiotics. Conclusion: This study found that parents had confidence in their healthcare providers; however, it also showed the extent of their lack of knowledge regarding the use of antibiotics for children with URTIs. There is a need for both public- and healthcare professional-oriented educational initiatives to promote rational antibiotic usage in Oman. [ABSTRACT FROM AUTHOR]

The current research deals with the perceptions of non-native students at a university college in Oman on the use of the lecture and interactive methods in teaching English. The aim is to find out the method which may assist satisfactorily in improving students’ English language competency in terms of skills, developing their cognitive abilities and enhancing their personal growth. This study employs the quantitative approach through conducting and analyzing students’ questionnaires related to the lecture and interactive methods of teaching. The findings of this research indicate that the interactive methods are highly viewed by students while the lecture is lower. However, weak students incline to the lecture method in contrast to average, good and very good students. The implications of the use of both methods could be extended to the social side of education. Students exchange ideas, suggestions and feelings which contribute to strengthening their relationships as colleagues. They would practice expressing their thoughts freely and respecting the viewpoints of others no matter whether they agree or disagree with them. Consequently, this would have positive impacts on their lifestyle when dealing with their surrounding society and in workplaces in later stages. [ABSTRACT FROM AUTHOR]

Despite the numerous benefits presented within Critical Media Literacy (CML) in understanding societies, cultures, and even our values globally, the lack of teacher preparation, including English language teachers, in teaching (CML) skills remains noteworthy. Such education could arm teachers with sufficient media literacy competence to pass on to students' capabilities in democratic self-expression and social progress. The research gap that exists, therefore, leads to this qualitative research study where the aim is to explore how a group of five College EFL teachers in a Middle Eastern institution in Oman relate to critical media awareness. This is by deconstructing a US film entitled'Freedom Writers' (2007) to discuss issues related to social injustice, prejudice, and violence in society. The method used to collect data was semi-structured interviews. The interview questions, guided by a semiotic Inquiry Graphics (IG) approach, aimed to capture those EFL teachers' interpretations, values, and beliefs relevant to CML and their subsequent intentions to teach CML in their future English classrooms. The findings suggest that although the teachers demonstrated positive attitudes and increased awareness of CML, they lacked confidence in applying it and needed to expand their perceptions of CML further. Generally, they viewed CML as being helpful for students in its ability to develop their criticality and citizenship. However, the teachers stressed the harsh realities of a packed curriculum and restrictive program requirements that may obstruct any comprehensive implementation of CML education at a university level, an issue that merits further consideration. [ABSTRACT FROM AUTHOR]

Learning Management System (LMS) has become an integral part of education technology in every institution. Almost all the Higher Education Institutions (HEIs) are using LMS to facilitate their teaching and learning processes. The study aims to evaluate the effectiveness of LMS and the basic perception of students on the usage of LMS and various plugins to support their learning process not only to ensure its quality but also to evaluate different strategies for its future enhancement. Hence, this study adopts a developmental evaluation framework to assess students' satisfaction and perception of using the (LMS) in their experiential Flipped Learning (FL) of English language modules. The methodology follows the pragmatic paradigm based on Dewey's theory to allow for mixed-method instruments to be employed for a better understanding of the LMS, exploring its challenges and opportunities. This small-scale evaluative study involved a survey of 70 respondents and a focus group of ten students in a private HEI in Oman to explore their FL experience in English modules. The depiction of this experience represented positive responses emphasizing how FL technology-enhanced individualized/experiential learning reinforced in life-long learning skills suitable for career practice. Recommendations are offered for LMS to facilitate enhanced flipped teaching implementation, promoting a student-centered environment ideal for a broader approach of active learning in HEI contexts. [ABSTRACT FROM AUTHOR]

Background: Domestic violence against women before and/or during pregnancy is a concerning public health issue. It has a deleterious impact on both the mother and the baby. Aim: The aim of this study is to identify the prevalence and predictors of emotional and physical domestic violence during three periods (lifelong, one year before pregnancy and during pregnancy). Moreover, it evaluates the effects of domestic violence on the outcomes of pregnancy, including miscarriages, birth weight of the baby, gestational age at delivery, and mode of delivery. Methodology: This is a prospective observational study of literate pregnant women, attending four primary health-care centers in Muscat, from 1st April 2019 to 31st March 2020. Subjects with twin pregnancies were excluded from the study. The validated Arabic NorVold Domestic Abuse Questionnaire (NORAQ) was used to determine the prevalence of emotional and physical domestic violence. The recruited subjects were re-evaluated for birth outcomes at 2– 4 weeks postpartum. Results: A total of 960 women participated in the study, with the mean age of 30.3 ± 5.4 years. Overall, experiences of lifelong domestic violence were reported by 161 women (16.8%), and the prevalence rate declined substantially in the one-year period preceding pregnancy and during pregnancy, 2.7% and 1.6%, respectively. Women who reported any type of domestic violence one year before pregnancy were at a higher risk of experiencing it again during pregnancy. A multivariate analysis of the obtained data revealed a strong association between physical domestic violence one year before pregnancy and unplanned pregnancy. Subjects with lifelong domestic violence reported higher rates of depression, insomnia, and somatic symptoms. No significant association was found between domestic violence, across any periods, and birth outcomes. Conclusion: The rates of domestic violence are relatively lower during pregnancy and one year before pregnancy compared to those of the lifelong period among Omani women. A significant association was found between domestic violence and depression, insomnia, somatic symptoms, and unplanned pregnancy. Screening for domestic violence during the perinatal period, using high-quality surveys, is of utmost importance. [ABSTRACT FROM AUTHOR]

Candida auris has emerged in the past decade as a multi-drug resistant public health threat causing health care outbreaks. Here we report epidemiological, clinical, and microbiological investigations of a C. auris outbreak in a regional Omani hospital between April 2018 and April 2019. The outbreak started in the intensive care areas (intensive care unit (ICU), coronary care unit (CCU), and high dependency unit) but cases were subsequently diagnosed in other medical and surgical units. In addition to the patients' clinical and screening samples, environmental swabs from high touch areas and from the hands of 35 staff were collected. All the positive samples from patients and environmental screening were confirmed using MALDI-TOF, and additional ITS-rDNA sequencing was done for ten clinical and two environmental isolates. There were 32 patients positive for C. auris of which 14 (43.8%) had urinary tract infection, 11 (34.4%) had candidemia, and 7 (21.8%) had asymptomatic skin colonization. The median age was 64 years (14-88) with 17 (53.1%) male and 15 (46.9%) female patients. Prior to diagnosis, 21 (65.6%) had been admitted to the intensive care unit, and 11 (34.4%) had been nursed in medical or surgical wards. The crude mortality rate in our patient's cohort was 53.1. Two swabs collected from a ventilator in two different beds in the ICU were positive for C. auris. None of the health care worker samples were positive. Molecular typing showed that clinical and environmental isolates were genetically similar and all belonged to the South Asian C. auris clade I. Most isolates had non-susceptible fluconazole (100%) and amphotericin B (33%) minimal inhibitory concentrations (MICs), but had low echinocandin and voriconazole MICs. Despite multimodal infection prevention and control measures, new cases continued to appear, challenging all the containment efforts. [ABSTRACT FROM AUTHOR]

We tracked 12 adult Egyptian Vultures Neophron percnopterus, captured at a landfill near Muscat, Oman, in January 2018. By 31st May 2018, none had migrated, although one had moved to southern Iran. Assuming that the tracked birds were representative, it seems likely that the majority of Egyptian Vultures found in Oman in winter are resident. Together with findings from oth er studies, including counts at landfill sites and surveys of breeding birds on Masirah Island, tracking suggests that the Omani population must greatly exceed the published estimate of 100 pairs.This, and the apparent low level of current threats in Oman, is welcome news for a species suffering steep declines across most of its range. [ABSTRACT FROM AUTHOR]

Objectives: Breast cancer constitutes the majority of diagnosed cancers in Oman's females, accounting for 19.2%, which prompted the introduction of a breast cancer screening programme into the Omani healthcare system. There are rising international concerns about the effectiveness of mammography as a screening tool and its psychological impact. The current study aimed to determine the social, emotional and physical dysfunction caused by the waiting time from the day of scheduling the appointment until the day of screening and explore associated risk factors. Methods: This cross-sectional study was conducted between March and December 2017 at Khoula Hospital, Muscat, Oman, using a two-part self-administered questionnaire. Part one of the questionnaire collected clinical and demographic data. Part two consisted of the Psychological Consequences Questionnaire (PCQ) and focused on psychological consequences, measuring the effect of mammographic screening on emotional, physical and social functions. Results: A total of 300 women aged ≥40 years old participated in this study (response rate: 100%). Results revealed that there was a minimal negative psychological impact from screening using mammograms. All PCQ domains were significantly impacted for participants who reported a family history of cancer (P = 0.007). The social score was significantly higher among women between 40--50 years old (P = 0.008). Scores of emotional and social functions were significantly affected by participants' employment status; employed women were more affected than those who were not (P = 0.043 and 0.012, respectively). However, women's levels of literacy did not affect any of the domains. Conclusion: The psychosocial impact of the waiting period between scheduling and undergoing mammography screening was minimal in the current sample. Future research should evaluate the psychosocial impact on patients at different recall times. [ABSTRACT FROM AUTHOR]

Problem: Evidence‐based practice (EBP) competence is one of the most desirable outcomes in nursing education. Assessment of knowledge, skills, and attitudes of nursing students regarding EBP is vital in examining the extent to which current approaches to EBP teaching is effective. Purpose: This study examined the predictors of knowledge, skills, and attitudes regarding EBP among Omani nursing students. Methods: This study utilized a descriptive, cross‐sectional approach. Two hundred and forty‐eight nursing students enrolled in one of the universities in Oman participated in the study during the months of May 2016 to August 2017. The evidence‐based practice questionnaire (EBP‐COQ) was used for data collection. Descriptive and inferential statistical tools were used to analyze the data. Findings: The mean values for the three EBP domains (knowledge, skills, and attitudes) were 3.41 (SD = 0.66), 3.62 (SD = 0.51), and 3.41 (SD = 0.68), respectively. Nursing students' sex (being female), classification (being a registered nurse to Bachelors of Science degree in Nursing nursing student), and access to the internet and to nursing journals strongly predicted the knowledge, skills, and attitudes regarding EBP. Overall, 79.0% of Omani nursing students intended to adopt EBP in the future. Conclusions: Omani nursing students possessed moderate knowledge, skills, and attitudes on EBP; however, more efforts are needed to ensure that future Omani nurses are competent and confident to apply EBP in the actual clinical area. Both academe and the hospital administration play a pivotal role in the acquisition and achievement of EBP competence in student nurses. [ABSTRACT FROM AUTHOR]