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Background/Aims: Anaemia is a multifactorial condition and understanding its prevalence and associated factors is crucial for effective healthcare planning and interventions. The aim of this study was to explore the prevalence of anaemia during pregnancy and its potential risk factors in Oman. Methods: A retrospective approach was used to identify anaemia cases by examining medical records taken from 9321 women who gave birth at the hospital over 3 years. Chi-squared tests were used to establish differences in risk factors using a case-control design, with a 1:2 ratio. Results: The crude prevalence of anaemia was 31.2%, dropping to 4.9% after excluding women with chronic and/or acute diseases. Significant differences were found in nationality (χ2=4.738, P=0.030), body mass index (χ2=6.392, P=0.041) and gestational age (χ2=4.329, P=0.037) for women with anaemia compared to those without. Conclusions: These findings underscore the significance of assessing and managing anaemia in pregnancy, while considering the interaction of demographic and clinical variables in formulating anaemia prevention strategies. [ABSTRACT FROM AUTHOR]

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Purpose: The phenomenon of social withdrawal, known as the hikikomori-like idiom of distress (HLID), has been reported in many countries. This study aimed to explore profiles of Omanis who have HLID. Design/methodology/approach: A cross-sectional online survey of 673 out of 1,529 Omanis identified with HLID using the Hikikomori Questionnaire (HQ-25) score of 42+. Findings: Two profile groups were determined through cluster analysis according to socio-demographic and HQ-25 outcomes. Subjects in cluster 1 (n = 168, 24.9%) are significantly younger (p < 0.001) and more educated (p = 0.019), spend more time online (p < 0.001) and are living alone (p < 0.001) than subjects in cluster 2 (n = 505, 75.1%). More subjects in cluster 1 had a past mental illness (p = 0.037) but less previous childhood physical/emotional abuse (p = 0.029) than subjects in cluster 2. In contrast, subjects in cluster 2 had a low lack of socialization (p < 0.001), less active isolation (p < 0.001) and total HQ-25 scores (p < 0.001) than cluster 1. Subjects in Cluster 1 have more serious social withdrawal issues than those in Cluster 2, especially on a lack of socialization and isolation. Research limitations/implications: One limitation that might influence the results of this online study was that information was collected via self-report, and a cross-sectional design limits its results because it cannot assess causal inference. This study has contributed valuably to exploring different profile groups of HDLD, especially in the Arabian Gulf. The authors' findings facilitate the development by creating innovative interventions strategically tackling different hikikomori groups. Originality/value: While social withdrawal characterized by HLID has been reported proliferating in different parts of the world, little research has been forthcoming from Arabian Gulf countries. These findings suggest that there are two orthogonal clusters of HLID among Omanis. This study provides a foundation for further research on HLID, which has recently been reported in different parts of the world. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis is a significant clinical and public health concern worldwide. Despite the impact of this condition on women's lives, most studies have focused on its clinical manifestations, drug efficacy, and medical treatment. Furthermore, most studies have been conducted in the West. This study aimed to uncover the personal experiences of postmenopausal Omani women living with osteoporosis. Methods: In this interpretive phenomenological study, a purposive sample of 15 postmenopausal Omani women with osteoporosis was recruited from primary and secondary care facilities in Muscat, Oman. Semi‐structured one‐to‐one interviews were conducted via Zoom and telephone because of coronavirus disease 2019 restrictions. The interviews were audio‐recorded, and the Ajjawi and Higgs framework was used to analyse the data thematically. Results: The following key themes were constructed from the interviews: the impact of osteoporosis on religious practices, cultural and social life, and financial status, and the benefits derived from religious and cultural practices and rituals, including Muslim prayer, recitation of Quranic verses, and herbal remedies to cope with osteoporosis‐related pain and suffering. Conclusion: Osteoporosis and fragility fractures have a significant impact on the religious, cultural, and financial lives of postmenopausal Omani women with osteoporosis. Muslim prayers, recitation of Quranic verses, and herbal remedies are coping strategies for pain in this population. Patient or Public Contribution: Postmenopausal Omani women with osteoporosis participated in this study through interviews and contributed their lived experiences. Orthopaedic doctors helped recruit patients with postmenopausal osteoporosis. [ABSTRACT FROM AUTHOR]

Background: Nursing students often find bioscience courses, such as pathophysiology, challenging. Utilizing Twitter to provide concise course content and answer students' questions before exams may be beneficial. The objective of this study was to determine if using Twitter can improve nursing students' academic performance and satisfaction with pathophysiology courses. Methods: A post-test, two-group quasi-experimental research design was employed in this study. It involved second-year Bachelor of Nursing students participating in a pathophysiology course at the College of Nursing, Sultan Qaboos University, in Muscat, Oman. Seventy-three second-year Bachelor of Nursing students participated in the pathophysiology course; 50 students opted to use Twitter, forming the experimental group, while the remaining 23, who chose not to use Twitter, formed the control group. We used Twitter to provide concise course content for the pathophysiology course and conduct one-hour question-and-answer sessions the night before exams. Academic performance was assessed through examination scores, and student satisfaction levels with Twitter was measured using five-point Likert scale questionnaires. Data were analyzed using Mann-Whitney and t-tests. Results: Although there was no significant difference in final exam scores between the experimental and control groups, survey results showed that students were generally satisfied with the incorporation of Twitter in the pathophysiology course, including the question-and-answer sessions. Conclusions: The findings suggest that Twitter can serve as a valuable tool for enhancing nursing student satisfaction with the pathophysiology course. [ABSTRACT FROM AUTHOR]

In this study of more than 1,000 typical and at-risk elementary Arabic-speaking students in Oman, we explore relationships between pragmatic (and other) language skills, literacy, cognition, and behavior and the degree to which demography impacts performance on associated tasks. We found, in most cases, that females performed better than males, students’ performance improved between Grades 2 and 4 but declined in Grade 5, and at-risk students performed as well as their nonreferred peers except on a working memory task. Pragmatic competence was the best predictor of literacy proficiency, and vice versa, for both groups when controlling for other variables. Findings are discussed in the context of Omani education and the limited attention given to pragmatics in research on connections between language and literacy. [ABSTRACT FROM AUTHOR]

Objective: Urinary incontinence (UI) is defined by the International Continence Society as any complaint of involuntary urine leakage. This research study highlights the prevalence, types, and associated factors of UI among women in Oman. Methodology: A descriptive cross-sectional design was used to collect data using purposive sampling technique from 400 women between 20 and 60 years; who were attending outpatient department of a referral hospital in Oman. Women were assessed using the Questionnaire for Urinary Incontinence Diagnosis to determine the type of UI. The severity and the impact of UI in women were assessed using the female urinary tract symptoms module (ICIQ-UI-SF). Descriptive statistics were used to determine the prevalence and type of UI, and the Chi-square test was used to find the association between UI and sociodemographic and obstetrical variables. Results: In our study, 28.25% of the women belonged to the age of 50–59 years. The point prevalence (per 1000) of UI among Omani women who were between 20 and 60 years was 44%. In the women who had UI, the majority were having stress UI (41.6%). In the women who had UI, the severity of UI, according to the ICIQ-UI-SF scoring, 15.2% of the women had slight, 50.3% had moderate, 33.1% had severe, and only 1.3% had very intense. Conclusion: Understanding the prevalence of UI in every community and associated factors is essential for the policy makers and healthcare providers to consider the early diagnosis, prevention, health promotion, and management of UI. [ABSTRACT FROM AUTHOR]

Background: To understand the psychosocial experience of infertility among women with polycystic ovarian syndrome in Oman. Materials and Methods: In this qualitative study, semi-structured interviews were conducted with 20 Omani women diagnosed with polycystic ovarian syndrome (PCOS) and infertility across two fertility clinics, in Muscat-Oman. Interviews were audio-recorded, transcribed analysed verbatim and qualitatively using the framework approach. Results: Four main themes emerged from participants' interviews related to the cultural aspects around infertility, the impact of infertility on participants' emotions, the effects of infertility on couples' relationship and self-management strategies for dealing with infertility. Culturally, women are expected to conceive soon after marriage, and most participants were blamed for the delay rather than their husbands. Participants experienced psychosocial pressure to bear children, mainly from in laws, where some admitted that their husbands' family suggested they remarried for having children. The majority of women mentioned being emotionally supported by their partners; however marital tensions in the form of negative emotions and threats of divorce were apparent in couples that had been experiencing infertility for longer time. Women were emotionally feeling lonely, jealous and inferior to other women with children and concerned that they would not have children to look after them in older age. Although women who had experienced infertility for a greater duration seemed to become more resilient and cope better, other participants described how they were using different strategies to cope with infertility including taking up new activities; whereas others admitted moving out from their in laws' house or avoiding social gatherings where the topic of children was likely to come up. Conclusion: Omani women with PCOS and infertility experience significant psychosocial challenges given the high value placed on fertility within the culture as a result they seem to adapt a variety of coping strategies. Health care providers may consider offering emotional support during consultations. [ABSTRACT FROM AUTHOR]

Nurses experience high levels of stress as they deal with the patients having complex health care problems. Stress in nursing affects the practice of nursing profession worldwide. In response to this, the investigators explored the sources of work-related stress (WRS) among Omani Nurses. Samples were selected through proportionate population sampling from 5 selected tertiary care hospitals. Data were collected through self-administered nursing stress scale (NSS). The study included 383 Omani nurses. Descriptive and inferential statistics were used to analyze the data. The sources of WRS among nurses showed the percentage mean scores ranging from 8.5% to 21%. The overall mean score for the NSS was 42.85 ± 17.705. Out of 7 subscales, the highest level of WRS was on workload with a mean score of 8.99 (21%) followed by emotional issues related to death and dying 8.72 (20.4%). The lowest mean score was seen on the lack of support 3.65 (8.5%) and inadequate preparation to meet the emotional demands of patients and their families 3.86 (9%) of the total mean. WRS was associated with the nursing position as staff nurses, performing night shift and reduced job satisfaction. The study's results may help in developing human resource strategies aimed at minimizing nurses' stress and improving quality of health care and task force performance. [ABSTRACT FROM AUTHOR]

Objectives: Nine strong cyclones have been recorded in Oman in the last 50 years, the last being tropical cyclone Shaheen in October 2021, in the northern Oman area. The aim of our study was to determine the relationship between property loss and the mental health of residents after cyclone Shaheen. Methods: We conducted a cross-sectional study among Omani citizens living in areas affected by cyclone Shaheen three to six months post-cyclone. In an online, self-reported questionnaire, we assessed the loss of participants' properties due to the cyclone and the impact on their perceived mental health. Descriptive statistics, chi-square tests, and associations between demographics, loss of properties, and mental health were performed. Results: Of 440 participants, 79.3% had their houses directly damaged by the cyclone and 90.7% had their outside properties damaged. Most of the respondents reported that they suffered from mental health symptoms in the months following the cyclone. Women, people with a lower socioeconomic status, the unemployed, and those without a university degree were associated with poorer mental health outcomes. Mental health was significantly lower for respondents whose properties were mostly affected by the cyclone. Conclusions: With scant knowledge about how cyclones directly affect Omanis' mental health, the results of this study are paramount for the planning of psychological care services to improve the country's response to extreme weather events. [ABSTRACT FROM AUTHOR]

Aim: This study examined the relationships between patient‐centred care, diabetes self‐management and selected health outcomes for Omani patients with type‐2 diabetes. Methods: Cross‐sectional surveys were administered for 237 patients with type‐2 diabetes. Hierarchical regression analyses examined the relationships between the selected study variables. Results: The sample was middle‐aged (M = 48, SD = 11.0 years) with nearly a decade (M = 9.68, SD = 6.11) since being diagnosed with type‐2 diabetes, with higher than ideal glycaemic control measures (M = 8.8%, SD = 2.4%). In bivariate analyses, patient‐centred care was positively associated with diabetes self‐management but not with glycaemic control or quality of life. However, after controlling demographic and clinical characteristics, patient‐centred care was positively associated with both physical and mental aspects of health‐related quality of life. In the final regression model, controlling for demographic and clinical characteristics and patient‐centred care, diabetes self‐management significantly predicted both glycaemic control and both physical and mental aspects of health‐related quality of life. Conclusions: The findings support that providing individualized care may contribute to the self‐management of chronic conditions. For achieving optimal outcomes, it may be necessary for providers to effectively assess patients' unique challenges and motivations. Increasing diabetes self‐management may improve quality of life and reduce diabetes complications. Summary statement: What is already known about this topic? Patient‐centred care (PCC) enhances diabetes self‐management (DSM).Little is known about the primary care nurse's role in promoting DSM within a PCC model. What this paper adds? PCC contributes to DSM and improves patient health outcomes.Expecting patients with diabetes to comply with provided instructions may not be enough to change self‐management behaviours. The implications of this paper Administrators responsible for employing a PCC approach in their clinics may need to establish clear goals and expectations for each team member to achieve overall success and ensue that nurses and physicians have targeted training on specific strategies to encourage patient‐provider partnerships that support the adoption of effective DSM behaviours.As the patient‐centred model of care is implemented in Oman, medical and nursing education programmes may highlight in their curricula its potential impact upon self‐management behaviours.Observational studies and longitudinal research to monitor Oman's progress towards the transition to a PCC model of care may uncover modifiable barriers and facilitators that primary care providers encounter. [ABSTRACT FROM AUTHOR]

Objectives: To describe the demographic distribution of cystic fibrosis (CF) in Omani children, estimate the national prevalence, and provide updated mutational panels of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Methods: We conducted a retrospective cross-sectional study of all CF patients who had been diagnosed and followed-up at Sultan Qaboos University Hospital and Royal Hospital in Oman between 2006 and 2020. Data were collected from electronic hospital records and telephone interviews. Results: A total of227 patients with CF were included in the study. Geographical clusters of the disease were identified in the governorates of Al-Batinah, A'Dhahirah, and A'Dakhiliyah. Parental consanguinity and family history of CF were present in 68.3% and 69.6% of the patients, respectively. The most common CFTR mutation was p.Ser549Arg (52.0%), followed by p.Phe508del (12.3%), and c.2988+1G>A (4.4%). Three novel CFTR mutations were identified, viz., Leu88TyrFs*, p.Asp192Val, and c.4242+1G>C. Conclusions: The estimated prevalence of CF in Oman is 10.3 per 100 000 individuals. Premarital genetic counseling and preimplantation genetic testing are recommended in CF-prevalent regions. [ABSTRACT FROM AUTHOR]

The aim of this audit study was to establish the utility of follow-up and sleep-deprived electroencephalography testing to improve the detection of interictal abnormalities in a tertiary referral center in Oman. As part of our ongoing auditing process, a total of 3010 EEGs were included in this study. All EEGs were routinely performed for Omanis aged 13 years and above, who were referred for possible diagnosis of seizure disorders. Each EEG was performed over an average period of 20–30 minutes. Of the 3010 EEGs, there were 553 follow-up and sleep-deprived EEGs, including initial baseline EEG studies which were analyzed for this study. The total progressive yield of serial follow-up EEGs to detect overall EEG changes was 53.5%, distributed as 8.8%, 11.4%, 0%, and 33.3% for the second, third, fourth, and fifth serial EEG studies, respectively. For the sleep deprivation EEG group, the yield was 6.5% for detecting overall EEG changes compared to the initial EEG studies. A limitation in this study was the small sample size in the subsequent follow-up and sleep deprivation EEGs. In conclusion, we found a minimal contribution of serial follow-up and sleep deprivation methods in improving the EEG abnormality detection in our study. National guidelines and an increase in awareness among physicians are required to increase the benefit of these well-established, yet not optimally utilized EEG methods. [ABSTRACT FROM AUTHOR]

Objectives: To establish a reference range for acylcarnitines (ACs) and amino acids (AAs) concentrations in dried blood spot (DBS) samples of Omani neonates to detect inborn errors of metabolism (IEM), and to evaluate the effect of age and sex on ACs and AAs. Methods: Electrospray-ionization tandem mass spectrometry (+ESI-MS/MS) was used to determine ACs and AAs concentrations in DBS samples collected from 1302 healthy newborns (0-7 days) delivered at Sultan Qaboos University Hospital between August 2008 and May 2009. Results: More than fifty biomarkers that allow diagnosis of various IEMs were measured, their 1st and 99th percentile values determined, and compared with published international data. Our results were comparable with the corresponding figures from Collaborative Laboratory Integrated Report, despite a much smaller sample size. We found that age had a significant effect on most ACs and AAs except decadienoylcarnitin, decenoylcarnitine, adipylcarnitine, palmitoylcarnitine, steatoylcarnitine, tyrosin, phenylalanine, and valine. Sex of the neonate had insignificant effect on most ACs and AAs except free-carnitine, acetylcarnitine, hexanoylcarnitine, octanoylcarnitine, malonylcarnitine, decanoylcarnitine, dodecenoylcarnitine, dodecanoylcarnitine, and tetradecanoylcarnitine. Conclusions: Tandem mass spectrometer is a highly effective tool for high throughput screening of IEM. This study is the first to publish reference intervals for ACs and AAs from DBS samples of Omani newborns. The results may prove to be of significance when determining cut-off values for newborn screening in the near future. [ABSTRACT FROM AUTHOR]

Objectives: We sought to examine stressors and coping strategies adopted by Omani adults during the COVID-19 pandemic and explore the relationships between coping strategies (avoidant and approach coping) and sociodemographic characteristics. Methods: This national cross-sectional survey was conducted throughout Oman between September and December 2020. An online questionnaire was distributed to collect information concerning sociodemographic characteristics, potential stressors experienced during the pandemic, and coping strategies. Results: A total of 790 Omani adults submitted completed questionnaires (response rate 88.4%). High, moderate, and low stress were reported by 492 (62.3%), 139 (17.6%), and 159 (20.1%) participants, respectively. Approach coping mechanisms received a higher mean score than avoidant mechanisms (22.01±6.55 vs. 8.88±4.80). Regarding specific coping strategies, planning had the highest mean score (5.15±1.31), followed by acceptance (4.95±1.34), religion (4.56±1.52), and positive reframing (4.28±1.89), while substance use (0.01±0.19) was the least reported followed by humor (0.86±1.43), denial (0.97±1.56), and behavioral disengagement (1.02±1.60). Associations were observed between the different coping strategies and participants' gender, age, marital status, exercise level, and stress level (p ≤ 0.05). Conclusions: During a large-scale pandemic, the psychological impact on the general population is significant, even among individuals not infected with the disease. These results underscore the need for a mental health support system in Oman that can address the general population's needs. Public education on coping strategies and stress management may be helpful. [ABSTRACT FROM AUTHOR]

A cancer diagnosis is associated with anxiety and psychological distress. Cultural and societal factors greatly affect the complex process of coping mechanisms and decision making. Omani patients receiving cancer treatment at Sultan Qaboos University Hospital in Oman were interviewed about their perceptions regarding cancer, treatment, outcome, and decision making. Out of a total of 360 approached, 216 patients consented. The median age was 42 years. The results showed that 60.6% of patients considered cancer diagnosis as a test from God, 13.9% considered it as a result of an evil eye, 40% believed prayers treat cancer. Fifty-six percent of participants wanted to make treatment decisions themselves, while 2.3% preferred their family to make decisions. Our findings suggest that perceptions about cancer in Oman are specific and are associated with religion and sociocultural background. [ABSTRACT FROM AUTHOR]

Objectives: Childhood cancers affect 6.7% of those under 14 in Oman, with leukemia being the most common. The psychological distress of having a child with leukemia is often compounded by perceived unmet needs by the child's primary caregiver. We aimed to identify factors contributing to perceived unmet needs among primary caregivers of Omani children with leukemia. Methods: We conducted a cross-sectional study among 119 Omani caregivers accompanying their children to the National Oncology Center, Muscat, Oman. We used an Arabic version of the Needs Assessment of Family Caregivers-Cancer (NAFC-C) questionnaire to assess perceived unmet needs in seven domains. Results: A total of 119 Omani primary caregivers were contacted; 101 agreed to participate in the study (response rate: 84.9%). Linear regression analysis showed significant correlations between total NAFC-C scores and the child's (p = 0.014) and caregiver's age (p < 0.001), and employment status (p = 0.024) and income (p = 0.028). Unmet needs in the obtaining information domain correlated with caregiver's age (p < 0.001), caring time (p = 0.018), and number of family members (p < 0.001), whereas needs in the maintaining own strength domain correlated with the child's gender (p = 0.028), time since diagnosis (p = 0.004), caregiver's age (p < 0.001), and education level (p = 0.019). Unmet needs in the accompanying the sick child domain were correlated with the child's gender (p = 0.049), caregiver's gender (p < 0.001), and income (p < 0.001). Conclusions: Various sociodemographic variables affected the unmet needs of primary caregivers of children with leukemias in Oman. Healthcare professionals in Oman should be aware of such factors to reduce caregiver distress. [ABSTRACT FROM AUTHOR]

Background: The total cost and negative health associated with nosocomial infection are high and early interventions are required. Assessing students' knowledge about nosocomial infection may contribute to solving this issue. Aims: The present study aimed to assess the level of knowledge of nosocomial infection among student nurses and to identify their main sources of information on the topic. Methods: A total of 330 student nurses at Sultan Qaboos University completed the online survey, which included participants' demographics and the Infection Control Standardized Questionnaire (ICSQ). Findings: The results of the study reveal the average total corrected score of the participants was 51.53 (SD=0.89) out of 100, with a minimum score of 16 and a maximum score of 96. Female students had a higher average score (13.9, SD=4.34) than male students (11.6, SD=3.2); t(328)=5.35. Conclusion: The student nurses did not have a sufficient level of knowledge about nosocomial infection. This calls for a review of nursing curricula to pave the way for more pragmatic teaching of infection control. [ABSTRACT FROM AUTHOR]

Objective: The emergence of the COVID‐19 pandemic compelled many academic institutions to resort to distance learning and online education, requiring a higher degree of student self‐direction and motivation to learn. This study explored self‐directed learning (SDL) readiness among nursing students in Oman, their learning styles (LS), and the association of demographic variables and LS with SDL. Methods: The study, which followed a descriptive, cross‐sectional design, surveyed 236 Omani nursing students via an online questionnaire containing two standardized scales: the Self‐Directed Learning Readiness Scale for Nursing Education and the Learning Style Scales. Results: Nursing students were identified as having a low level of SDL (mean = 149.58). Probation status (β = −0.165; p = 0.021) was negatively associated with SDL. In terms of LS, solitary (β = 0.217; p = 0.001), competitive (β = 0.201; p = 0.005), imaginative (β = 0.19; p = 0.012), and perceptive LS (β = 0.437; p = 0.0) were positively associated with SDL. An analytical LS was negatively associated with SDL (β = −0.155; p = 0.022). Conclusion: Academic probation status and an analytical LS both yielded lower SDL scores. Perceptive, solitary, competitive, or imaginative learners tended to have higher SDL scores. Deliberate planning and strategies are necessary to help probation students cope with academic demands, especially with the advent of intensified digital education. Because no single learning environment can fulfill the needs of every LS, nurse educators must implement SDL‐aimed teaching and learning strategies that appeal to a variety of learners. [ABSTRACT FROM AUTHOR]

Objectives: anaphylaxis is an acute and potentially fatal allergic reaction. NO studies have yet been conducted to evaluate the spectrum of anaphylactic reactions among Omani patients. AS such, this study aimed to describe the clinical features, causes, investigation, and management of anaphylaxis among patients presenting to a tertiary care center in Oman. Methods: This retrospective study took place between august 2005 and June 2020 at the allergy and immunology clinic of Sultan Qaboos university Hospital, Muscat, Oman. all patients diagnosed with anaphylaxis during the study period were included. Data were collected from electronic medical records. Results: One hundred patients were diagnosed with anaphylaxis during the study period. Of these, 52.0% were male. The mean age was 15.9± 16.2 years, with 70.0% aged < 18 years old. The eosinophil count ranged from 0.0-16.9 x 109/L, with a mean of 0.8±2.2 x 109/L and a median of 0.3 (0.1-0.6) x 109/L. Total immunoglobulin (Ig) E levels ranged from 25-8706 klU/L, with a mean of 935.1±1369.5 klU/L and a median of 500.4 (186.0-972.5) klU/L. The majority of patients had a family history of allergies (72.0%), and other had concomitant allergic conditions (66.0%). All were prescribed epinephrine (100%). The most common cause of anaphylaxis was food (65.0%). The second most frequent trigger was insect venom (32.0%). Most patients had one category cause (81.0%); two or more causes were present in 12.0% of patients. Clinical symptoms manifested most frequently as cutaneous (92.0%) and respiratory (85.0%). The majority of patients (87.0%) demonstrated the involvement of more than one bodily system. Mean total IgE levels were significantly higher in patients with concomitant presence of other allergic conditions (1193.8 klU/L) than patients without another concomitant allergic disease (503.6 kIU/L; p = 0.030). In addition, concomitant allergic disease is significantly higher in patients < 18 years of age (75.4%) compared to patients > 18 years of age (45.2%; p = 0.010). Conclusions: Due to its life- threatening nature, knowledge of the epidemiology and clinical features of anaphylaxis in different populations is necessary to deliver rapid treatment. This study found that the clinical features of anaphylactic patients in Oman were similar to those reported elsewhere. Further research is needed to determine the true incidence of anaphylaxis in Oman to minimize associated morbidity and mortality. [ABSTRACT FROM AUTHOR]

Objectives: Prostate cancer (PCa) is the third most common cancer worldwide, with its incidence rising in the Middle East. There is a paucity of data about the clinicopathological features and outcomes of metastatic prostate cancer (mPCa) from the Middle East. We report the outcomes of mPCa from Oman. Methods: We recruited consecutive men diagnosed with mPCa and treated at Sultan Qaboos University Hospital in Oman between January 2006 and December 2017. Information about demographics, clinical, laboratory, pathological, and radiological features at presentation, treatment, and survival outcomes was collected. Data were gathered until April 2019 or until the patient's death for progression-free survival (PFS) and overall survival (OS), whichever came first. Survival rates were estimated using the Kaplan-Meier method. Univariate and multivariate analysis and Cox regression analyses were performed to study factors affecting the PFS and the OS. Results: Of the 239 men diagnosed with PCa over the study period, 62 were diagnosed with mPCa. The median age was 71 (range = 57-92) years. The majority of patients (61.3%) had a Gleason score ≥ 8. Median prostate-specific antigen (PSA) level was 100.0. Bone was the most common site of metastatic disease (90.3%). The majority of patients with the hormone-sensitive disease were treated with testosterone suppression only, while abiraterone, enzalutamide, and docetaxel were added for treating metastatic castration-resistant mPCa (mCRPC). After a median follow-up of 34.5 months, the median PFS was 17 months, while the median OS was 43 months. Median survival post mCRPC was 17 months. Conclusions: Omani patients with mPCa present with high PSA and Gleason score and with widespread metastatic disease burden. Treatments offered are according to internationally accepted standards and have comparable PFS and OS as reported elsewhere. [ABSTRACT FROM AUTHOR]

This study examined the oral reading and conversational speech of eight bilinguals who stutter (BWS). The participants spoke Omani Arabic as the dominant and English as the less-dominant language. The samples were examined with particular reference to the production of overall disfluency, stuttering-like disfluencies (SLDs) and other-disfluencies (ODs) occurring at the syllable and word level. The results indicated no difference in the amount of overall disfluency or ODs between the two languages in either reading or conversation. A significantly higher amount of SLDs were found to occur in words during reading in Arabic compared to English, which was attributed to the linguistic complexity of formal Arabic. A higher amount of SLDs in syllables were found in English compared to Arabic during conversation, although no such difference was found at the word level. The results align with a small body of research suggesting equivalent amounts of stuttering between dominant and less-dominant languages during conversation. The finding of a higher amount of stuttering during reading in Arabic is suggestive of motor differences in the production of the two languages that differentially affect speech fluency. [ABSTRACT FROM AUTHOR]

Background. Given the rapid pace of globalization and the fact that the Sultanate of Oman is experiencing a significant impact of social media on specifying appearance norms among youth in the country, research into positive body images and self-esteem among young individuals has become a national priority. Whilst body image has been well studied across cultures, both positive body image and the relationship between positive body image and self-esteem among Omani youth have been neglected. The aim of the study was to investigate the relationship between positive body image and self-esteem and associated sociodemographic factors among Omani university students based on gender. Methods. This cross-sectional study used an online survey consisting of the two questionnaires that are Body Appreciation Scale-2 and Rosenberg's Self-Esteem Scale. A total of 237 students were recruited from Sultan Qaboos University's different colleges. Results. The results indicated that positive body image has a significant relationship with an individual's self-esteem (β = 0.122, t = 2.197, p = 0.038), Cumulative Grade Point Average (cGPA) (β = 0.140, t = 2.306, p = 0.022), body mass index (BMI) (β = −0.414, t = −6.930, p < 0.001), monthly household income (β = −0.129, t = 2.467, p = 0.029), and the number of social media accounts (≥2, β = −0.132, t = −2.232, p = 0.027). In addition, an individual's self-esteem was significantly associated with an individual's cGPA (β = 0.231, t = 3.592, p < 0.001) and mothers' educational level (β = −0.130, t = −2.065, p = 0.040) besides body appreciation (β = 0.160, t = 2.491, p = 0.013). Conclusions. The findings of this study shed light on the current status of positive body image among university students of Oman. In light of the new knowledge, we propose health interventions that include strategies such as involvement of family, to maintain and/or promote positive body image perceptions among young individuals and subsequently promote healthy appreciation of the physical appearance and self-esteem. [ABSTRACT FROM AUTHOR]

This paper strives to present voices of Omani female professionals with the purpose of gaining deeper understanding of their aspirations, fears, and drives through a decomposition and further exploration of the construct of working females. The content obtained from one WhatsApp group discussion (9 participants) and two focus group discussions (13 participants) has been analyzed and categorized into three types of images - self-image of female professionals; image of female professionals through the eyes of males as inferred and interpreted by females themselves; image of female professionals through the eyes of another female. The emerged themes accompanied by communicative strategies confirm an on-going gender struggle in the country's professional context. It also captures the inconsistencies and conflicting narratives embedded in the construct of Omani female professionals. The findings challenge traditional gender hierarchies and add to the discussion on the engagement of traditionally disadvantaged groups. [ABSTRACT FROM AUTHOR]

Background: Nursing students struggle with anatomy and physiology course because of the complicated terminology and the difficulty in handling large amounts of information. New, innovative instructional strategies must be integrated into nursing education to improve nursing students' performance in this challenging bioscience course. The aim of this study was to determine the impact of an innovative teaching strategy, the flipped classroom, on the performance and satisfaction of Omani nursing students in an anatomy and physiology course. Methods: A quasi-experimental design was used with two classes of 112 first-year nursing students at the College of Nursing, Sultan Qaboos University, Oman. Online videos and active-learning activities about the respiratory system were developed and implemented in an anatomy and physiology course with 53 first-semester nursing students. The control group consisted of a previous cohort of 59 students enrolled in the same course but taught with a traditional lecture approach. The impact of the flipped classroom strategy was measured by students' performance on the final examination and students' self-reported satisfaction. Wilcoxon signed-rank and Mann-Whitney U tests were used to compare students' academic performance. Results: Our results showed that the performance of the flipped classroom group was better than that of the traditional lecture group. The mean scores of students instructed with the flipped classroom method on the respiratory system items in the final examination were significantly higher than those of the control group, U = 1089.00, z = − 2.789, p <.005. Moreover, the results of a survey showed that nursing students were satisfied with the flipped classroom method. Overall, 68 to 78% of students agreed or strongly agreed that the flipped classroom method improved their learning and increased their interest in the course. Conclusion: Compared with the didactic lecture format, flipped classroom strategy improved Omani nursing students' performance in and satisfaction with an anatomy and physiology course. These results show that the flipped classroom is an important teaching strategy in nursing education. [ABSTRACT FROM AUTHOR]

Objectives: In 2013, the World Health Organization (WHO) recommended new criteria for diagnosing gestational diabetes mellitus (GDM). Our study aimed to compare the incidence of GDM and its complications among Omani pregnant women using the new diagnostic criteria compared to previous criteria published in 1999. Methods: This retrospective cohort study was conducted between January and December 2016 at the Bawshar Specialized Polyclinic in Muscat, Oman. A total of 613 Omani women were included in the study. Baseline maternal characteristics such as age, body mass index, parity, and socioeconomic status were recorded in addition to maternal and neonatal outcomes. Results: Based on the current diagnostic criteria, the incidence of GDM was 48.5% (n = 297); however, this dropped to 26.4% (n = 162) when applying the old criteria. Moreover, rates of maternal complications including polyhydramnios (5.6% vs. 4.6%), pregnancy-induced hypertension (3.2% vs. 1.5%), and preterm delivery (3.2% vs. 1.5%) were slightly higher among women with GDM diagnosed using the latest criteria. However, these differences were not statistically significant. Neonatal complications were also slightly more frequent among the first group, without any significant differences. Conclusions: The incidence of GDM among Omani women rose dramatically when utilizing the latest WHO diagnostic criteria, owing to a lower fasting blood glucose cut-off value. In addition, a comparison of the frequencies of maternal and neonatal complications supports the validity of the new criteria. These findings should be taken into consideration by decision-makers in Oman when planning antenatal and postnatal services. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine new Omani graduate nurses' role transition from education to practice. We also sought to describe factors that may affect the effective transition of new Omani graduates to their professional nurse role. There is a substantial literature on the process of transition from graduation to being a professional nurse in countries across the globe; however, little is known about new Omani graduate nurses' role transition from education to practice. This study had a descriptive cross-sectional design. Data were collected from nurses who at the time of the study had been working for at least 3 months but not longer than 2 years. Role transition was assessed with the Comfort and Confidence subscale of the Casey–Fink Graduate Nurse Experience Survey (Casey et al., 2004). The survey consists of a 24-items that are rated on a 4-point Likert scale. We conducted a multivariate regression analysis to assess the factors that influence nurses' role transition. These factors included participants' demographic information, employment orientation durations, preceptorship duration and length of time before employment. The total sample consisted of 405 nurses working in 13 hospitals in Oman. Most (68.89%) had worked as a nurse for less than 6 months. The average internship and orientation durations were approximately 6 months (SD = 1.58) and 2 weeks (SD = 1.79), respectively. The number of preceptors assigned to new graduate nurses ranged from none to four. The average score on the Comfort and Confidence subscale was 2.96 (SD = 0.38). Results from the regression analysis demonstrated that age (β = 0.029, SE = 0.012, p =.021), waiting time before employment (β = –0.035, SE = 0.013, p =.007) and employment orientation duration (β = –0.007, SE = 0.003, p =.018) were statistically significant factors influencing role transition experience among newly joined nurses. The results suggest that appropriate intervention strategies at the national level are needed to enhance the transition of nursing school graduates to their professional role. Strategies directed toward shortening the waiting time before employment and improving the internship experience are examples of priority-level tactics that can enhance Omani nursing graduates' transition to their professional role. [ABSTRACT FROM AUTHOR]

Urinary stones are a common problem in Oman and their composition is unknown. The aim of this study is to analyze the components of urinary stones of Omani patients and use the obtained data for future studies of etiology, treatment, and prevention. Urinary stones of 255 consecutive patients were collected at the Sultan Qaboos University Hospital. Stones were analyzed by Fourier transform infrared spectrophotometer. The biochemical, metabolic, and radiological data relating to the patients and stones were collected. The mean age was 41 years, with M: F ratio of 3.7:1. The common comorbidities associated with stone formation were hypertension; diabetes, benign prostate hyperplasia; urinary tract infection; obesity; and atrophic kidney. The common presentation was renal colic and flank pain (96 %). Stones were surgically retrieved in 70 % of patients. Mean stone size was 9 ± 0.5 mm (range 1.3-80). Stone formers had a BMI ≥ 25 in 56 % ( P = 0.006) and positive family history of stones in 3.8 %. The most common stones in Oman were as follows: Calcium Oxalates 45 % (114/255); Mixed calcium phosphates & calcium oxalates 22 % (55/255); Uric Acid 16 % (40/255); and Cystine 4 % (10/255). The most common urinary stones in Oman are Calcium Oxalates. Overweight is an important risk factor associated with stone formation. The hereditary Cystine stones are three times more common in Oman than what is reported in the literature that needs further genetic studies. [ABSTRACT FROM AUTHOR]

The purpose of this study is to document the significance of four practices employed by parents that contribute to such development. Those practices encompassed the availability of materials, activities at home, parent attitude and visits to their child's class. Subjects consisted of 314 male and female parents of kindergarten children in the Sultanate of Oman. The researchers developed a 25-item questionnaire intended to measure the degree of parent involvement in their children's development at acceptable levels of validity and reliability. Results indicated that the role of parents ranged from medium to high on all practice domains of the tool. There were no significant differences for parents reading and writing practices, education levels, income levels, gender of children and siblings order. It is suggested that additional investigation in rural areas and other locales districts with different socially and economical levels should be conducted. In addition, the role of technology at homes and kindergartens such as child's learning style, parent's knowledge of child development and the availability of related outside resources available to families should be considered. [ABSTRACT FROM PUBLISHER]

The article discusses the meaning of being an Ibāḍī. Topics covered include details relating to Omani identity, tribe and geography, the development of the Muscat and Oman concepts, and the core-frontier division of Islam and Ibāḍīsm;. It also discusses intermarriage in the Swahili society, Ibāḍī conversions to Sunnism, and the concept of Nahda.

C- C motif chemokine receptor-5 ( CCR5) is a pro-inflammatory receptor that binds to chemokines and facilitates the entry of the R5 strain of HIV-1. A number of polymorphisms were identified within the promoter and coding regions of the CCR 5 gene, some of which have been found to affect the protein expression and thus receptor function. Although several CCR 5 polymorphisms were shown to vary widely in their distribution among different ethnic populations, there has been no study addressing the potential variants of the CCR 5 gene in the Omani population. The aim of this study was to identify the polymorphic sites that exist within the CCR 5 gene in Omanis. Blood samples were collected from 89 Omani adult individuals, and genomic DNA was amplified by polymerase chain reaction and sequenced to identify the polymorphic sites. The distribution of the detected variants was examined and compared with the previously published data. Four new indels were detected of 32 variable positions, −2973A/-, −2894A/-, −2827 TA/- and −2769T/-, and all were located in the 5′ UTR. Furthermore, two new mutations, −2248G/A and +658A/G, were observed for the first time; the −2248G/A was detected in the intron 1 region in one subject and +658A/G in the coding region of the CCR 5 in another subject. In silico analysis showed that the novel variations in the 5′ UTR may have effects on the transcription factor binding sites. Therefore, this study demonstrates the presence of two new SNPs and four novel indels in the CCR 5 gene in the Omani population. Our findings support the wide spectrum of genetic diversity reported within the CCR 5 gene region among different ethnic groups. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to screen Omani individuals for the familial aggregation of type 2 diabetes mellitus. Methods: A random cohort of 1182 Omani individuals visiting the Family Medicine Clinic at Sultan Qaboos University Hospital (SQUH), Muscat, Oman, for regular medical checkup, aged ?40 years, were sampled. Patients were categorized into three groups: (1) individuals who claim not to have diabetes and had no family history of diabetes; (2) individuals who claim not to have diabetes but had family history of diabetes; (3) individuals with diabetes. Only 16% of these Omani individuals had no diabetes and no family history of diabetes. Another separate random cohort of 234 Omani type 2 diabetes mellitus patients, from the Diabetes Clinic at SQUH, were interviewed and questioned about their family history of type 2 diabetes mellitus. Results: Ninety five percent of the patients had a family history of diabetes. Eighty percent had first degree relatives with diabetes and 46% had second degree relatives with diabetes. At least one parent with diabetes was reported among 55% of these diabetics, while maternal diabetes (55%) was found to be higher than paternal diabetes (47%). However, only 15% had both parents with diabetes. Furthermore, almost half of the 234 diabetics were having at least one of the following relatives with diabetes: brother, sister, aunt or an uncle. Conclusion: The findings of this study confirm familial aggregation of diabetes among the Omani population. Compared to other populations, familial aggregation of type 2 diabetes mellitus among Omanis is relatively very high, and is perhaps due to the very high degree of consanguinity among Omanis. Since almost everyone seems to have a genetic predisposition to diabetes, the dramatic lifestyle changes over the past 25 years, could tip the population into an epidemic of type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the prevalence of pre-hypertension and its association with some selected cardiovascular risk factors among the Omani adult population in the primary healthcare setting. Method: A cross-sectional study involving a sample taken from a National Screening Program of chronic non-communicable diseases in primary healthcare institutions, Sohar city, Sultanate of Oman ( July 2006 - December 2007). Inclusion criteria included Omanis aged 40 years or above residents of Sohar city attending primary healthcare institutions not previously diagnosed with diabetes mellitus, hypertension, or chronic kidney diseases. Descriptive statistics were used to describe the demographic, physical and metabolic characteristics. Univariate analysis was used to identify the significant association between the characteristics and normal blood pressure, pre-hypertension and hypertension. Chi-squared test was used for categorical variables analysis and independent t-test was used for continuous variables analysis. In order to examine the strength of significant associations, the multinomial logistic regression analysis was used. Results: There were 1498 participants, 41% were males and 59% were females. Overall, pre-hypertension was observed in 45% of the total study population (95% CI: 0.422 - 0.473). There were more males affected than females (46% versus 44%). About 34% of the total study population was hypertensive. The multinomial logistic regression analysis revealed that an increase of one unit of age, body mass index, fasting blood glucose and total blood cholesterol, were significantly associated with higher risk in both pre-hypertension and hypertension. High odds ratio of pre-hypertension and hypertension was found with the total blood cholesterol. Conclusion: The prevalence of pre-hypertension was high among the Omani adult population. The determinants of pre-hypertension in this research age, body mass index, fasting blood glucose and total blood cholesterol. A cost-effectiveness study about the management of pre-hypertension within primary healthcare is significant in the future health system service strategies. [ABSTRACT FROM AUTHOR]

Background: Fatalities from road traffic crashes (RTCs) are a public health challenge for low and middle income countries, especially those experiencing epidemiological transition. This paper aims to describe demographics and trend analysis of fatalities of RTCs in Oman from 1995 to 2009. Methods: The RTC data from 1995 to 2009 were obtained from the published reports of the Royal Oman Police (ROP). Data were extracted on the distribution of deaths by age, sex, nationality, mode of travel (driver, passenger, pedestrians), and type of vehicle (four vs. two wheelers). Trend analyses were carried out using the Chi square for the percentages of deaths and linear regression for rates. Results: A total of 9,616 deaths from RTCs were reported from 1995 to 2009. Of 9,616 fatalities, 4,666 (48.5%) were aged 26-50 years, 7,927 (82.4%) were males, 7,215 (75.0%) were Omanis, and 2,278 (23.8%) were pedestrians. Overall, mortality increased by around 50% from 479 deaths during 1995 to 953 deaths during 2009. There was a significant increase in the proportion of deaths (P < 0.05) and death rates (P < 0.05) among individuals aged 26-50 years, males, Omani nationals, and drivers. The number and rate of RTC fatalities due to overspeeding was also increased (P < 0.05). Conclusions: Fatalities due to RTCs in Oman are increasing, especially among those aged 26-50 years, males, drivers, and Omani nationals with overspeeding as a major cause of road traffic fatalities. There is a need for more research in understanding the risk taking behaviors of young drivers, and sociocultural factors, especially among Omani nationals to target interventions. [ABSTRACT FROM AUTHOR]

El artículo discurre sobre el impacto de los cambios climáticos en las sociedades trashumantes. Los autores comentan sobre las poblaciones más vulnerables en Omán y en Mongolia y describen la relación entre el medio ambiente y los trashumantes. También se considera el rol de los gobiernos de cada país en las políticas ambientales.

The Omani-Portuguese relationships had contributed during the period from 1650 to 1730 in changing the balance of power in the Indian Ocean and affected, of course, the Omani relations with the other regional and European forces. After the fall of Muscat in 1650 into Omani hands, the concept of conflict moved from the local context to the overseas conflict required from Oman to have a powerful fleet capable to meet the Portuguese navy. The relationships between Oman and Portuguese have been characterized by competitive form in the willingness of Oman to have a leading role in the Indian Ocean as a maritime nation since old time, and had outstanding contributions in both commercial and civilizational activities in the Medieval Age. There were two historical stages where the luso-omani relations passed through formed as a turning point: 1650 was from the end of the Portuguese political presence in the coast of Oman. While in 1698 was figured in the end of the Portuguese influence in the coast of East Africa. However, despite the intensity rivalry between the two sides, but multiple attempts to have peaceful relations permeated the conflict. The competition has extended into several geographic areas in the western coast of India, the Arabian Gulf, and the Eastern African coasts. While, the competition in India has been illustrated by the Omani yearning to participate in trade with the Indian ports and to make the port of Muscat as a focal point connecting the Indian ports with the Gulf, the clash between the two sides was inevitable because some of these ports were under the Portuguese control. This situation prompted each side to look for means to dwindle the other party, whether by military ways or alliances with other local or European powers. In addition of the Omani aspiration to control the trade route between India and the Gulf, the struggle expanded to the Gulf, where many cooperation efforts were made between Persians and Portuguese in order to devastate the Omani power. In East Africa, the rivalry has taken an expansionist dimension due to historical, cultural and economical factors. Hence, through a half century of contest the "Yaariba" were able to remove the Portuguese from Mombasa, the most important positions in the region in 1698 which paved the way for political, economical and cultural relations with the African nation. [ABSTRACT FROM AUTHOR]