Search

Academic life in the present era is subject to several occupational stressors, including increased workloads, reduced research funding, tenuous career paths, and family-work conflicts. Such stressors affect academics’ quality of life, wellbeing, and job satisfaction, and women are particularly vulnerable. There is, however, a dearth of information on such issues in the Arab World. We conducted a scoping review to map the current body of knowledge related to the institutional and socio-cultural factors that influence the wellbeing status of women working in academia in Arab countries. Fourteen articles were included. Several challenges threatening women’s wellbeing in academia were identified including institutional factors (i.e., human resource policies and laws, workplace empowerment, and academic mentoring) and socio-cultural factors (i.e., work-life balance, culture and religion). Current human resources, policies, and labor laws do not adequately support maternal or complex family roles contributing to work-life imbalances and contribute to poor mental health outcomes for academic women working in academia in Arab countries. Although some of these challenges may stem from lingering cultural stereotypes about gender roles, this review highlights the need for professional development and mentoring programs for academic women in Arab countries, in addition to supportive institutional laws, policies, and resources for empowerment of women in academia.

Yasmine Mahgoub,1 Suhad Daher-Nashif,2 Rafal Al-Shebly,1 Hamza Said Wali,1 Aisha Khan,1 Ameera Almarkhi,1 Maryam Al-Motawa,1 Ghalya AlObaidan,1 Zamzam Al-Muhannadi1 1College of Medicine, QU Health, Qatar University, Doha, Qatar; 2Population Medicine Department, College of Medicine, QU Health, Qatar University, Doha, QatarCorrespondence: Suhad Daher-Nashif, Population Medicine Department, College of Medicine, QU Health, Qatar University, Doha, Qatar, Email snashif@qu.edu.qa; suhadh@hotmail.comIntroduction: Past studies have shown high prevalence of mental illness among medical students. This is often linked to the demands of the medical curriculum, and to mental health stigma that prevents students from seeking help. This study aimed to examine experiences of mental health problems among medical students of different nationalities in Qatar and to uncover sociodemographic factors related to their prevalence and associated stigma.Methods: A cross-sectional online survey was conducted with medical students in their second through fifth years at the College of Medicine at Qatar University. The survey began with a consent form, and those agreed to take the survey were directed to the questionnaire. The survey comprised 64 items across three sections. The first section collected sociodemographic data. The second section screened depressive symptoms using the PHQ-9; anxiety symptoms using GAD-7; and psychological distress symptoms using Kessler-6. The third section included 27 questions adopted from Schwenk et al, which evaluate students’ perceptions of stigma and their attitudes toward seeking help with their mental health.Results: One hundred and eighty-two students participated in the study. The prevalence of self-reported symptoms of severe depression, anxiety, and psychological distress was 4.4% (95% CI 2– 9), 10.4% (95% CI 7– 16), and 39.6% (95% CI 33– 47), respectively; the prevalence of high stigma was 31.9% (95% CI 25– 39). Parental education, repetition of an academic year, progress in medical studies, gender, and nationality had statistically significant correlations with mental health problems and stigma.Conclusion: In addition to the impact of the requirements of medical study, the high prevalence of reported mental illness among medical students is impacted by sociodemographic factors and the mental health stigma that constitutes a barrier to seeking help. Preventive wellbeing programs should be an essential component of medical curricula.Keywords: mental health problems, mental health stigma, medical students, problem based learning curriculum, sociodemographic factors, Middle East

Suhad Daher-Nashif Population Medicine Department, College of Medicine, QU-Health, Qatar University, Doha, 2713, QatarCorrespondence: Suhad Daher-NashifPopulation Medicine Department, College of Medicine, QU-Health Qatar University, Doha, 2713, QatarEmail snashif@qu.edu.qaBackground: Movies have a strong influence on public perceptions due to their popularity and accessibility. Hence, movies on healthcare providers in general and medical doctors in particular can affect public opinions, expectations, and attitudes toward these professions.Aim: This paper aims to present how realistic fiction movies reflect doctors’ roles and challenges during infectious disease outbreaks and describe how some of this content can be used in medical education settings.Methods: Two sources were used to select the movies for inclusion in the study. First, the IMDB.com movie database was searched using the words “virus,” “pandemic,” “endemic,” “epidemic,” “outbreak,” and “infectious disease.” Second, Google was used to search the terms “movies on pandemics,” “movies on epidemics,” “movies on outbreaks,” “movies on endemics,” “movies on virus,” and “movies on infectious diseases.” Inclusion criteria were English language movies, realistic fiction movies, doctors as main actors, and a movie focus on community experiences. Exclusion criteria were non-English movies, zombie and apocalypse movies, doctors in secondary roles, and movies about individual experiences.Results: Eight movies met the inclusion criteria. Content analysis was conducted on all movies, and the main categories identified were doctors’ roles, doctors’ vulnerability, potential biases, potential conflicts, female doctors’ power, and doctors bringing salvation.Conclusion: Realistic movies on infectious disease outbreaks can be excellent tools for teaching medical students about doctors’ roles and challenges when fighting an outbreak.Keywords: realistic movies, infectious disease outbreak, doctors’ experiences, medical humanities, medical students

Salah Eldin Kassab,1 Mubarak Bidmos,1 Michail Nomikos,1 Suhad Daher-Nashif,2 Tanya Kane,2 Srikant Sarangi,3 Marwan Abu-Hijleh1 1Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar; 2Department of Population Medicine, College of Medicine, Qatar University, QU Health, Doha, Qatar; 3Danish Institute of Humanities and Medicine (DIHM), Aalborg University, Aalborg, DenmarkCorrespondence: Salah Eldin KassabPhysiology & Medical Education, College of Medicine, QU Health, Qatar University, PO Box 2713, Doha, QatarTel +974 – 4403 7843Email skassab@qu.edu.qaPurpose: Assessment of reflective writing for medical students is challenging, and there is lack of an available instrument with good psychometric properties. The authors developed a new instrument for assessment of reflective writing-based portfolios and examined the construct validity of this instrument.Methods: After an extensive literature review and pilot testing of the instrument, two raters assessed the reflective writing-based portfolios from years 2 and 3 medical students (n=135) on three occasions. The instrument consists of three criteria: organization, description of an experience and reflection on the experience. We calculated the reliability of scores using generalizability theory with a fully crossed design and two facets (raters and occasions). In addition, we measured criterion validity by testing correlations with students’ scores using other assessment methods.Results: The dependability (Φ) coefficient of the portfolio scores was 0.75 using two raters on three occasions. Students’ portfolio scores represented 46.6% of the total variance across all score comparisons. The variance due to occasions was negligible, while the student–occasion interaction was small. The variance due to student–rater interaction represented 17.7%, and the remaining 27.7% of the variance was due to unexplained sources of error. The decision (D) study suggested that an acceptable dependability (Φ = 0.70 and 0.72) can be achieved by using two raters for one and two occasions, respectively. Finally, we found moderate to large effect-size correlations between students’ scores in reflective writing-based portfolios and communication skills (r = 0.47) and PBL tutorials (r = 0.50).Conclusion: We demonstrated the presence of different sources of evidence that support construct validity of the study instrument. Further studies are warranted before utilizing this instrument for summative assessment of students’ reflective writing-based portfolios in other medical schools.Keywords: G-theory, validity, reflective writing, portfolio, reliability, student assessment

Suhad Daher-Nashif Population Medicine Department, College of Medicine, QU-Health, Qatar University, Doha, 2713, QatarCorrespondence: Suhad Daher-NashifPopulation Medicine Department, College of Medicine, QU-Health Qatar University, Doha, 2713, QatarEmail snashif@qu.edu.qa View the original paper by Dr Daher-Nashif and colleagues This is in response to the Letter to the Editor

Salah Eldin Kassab,1 Mubarak Bidmos,1 Michail Nomikos,1 Suhad Daher-Nashif,2 Tanya Kane,2 Srikant Sarangi,3 Marwan Abu-Hijleh1 1Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar; 2Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar; 3Danish Institute of Humanities and Medicine (DIHM), Aalborg University, Aalborg, DenmarkCorrespondence: Salah Eldin KassabPhysiology and Medical Education, College of Medicine, QU Health, Qatar University, PO Box 2713, Doha, QatarTel +974 4403 7843Email skassab@qu.edu.qa We thank Forenc et al1 for their interest in our study titled Construct Validity of an Instrument for Assessment of Reflective Writing-Based Portfolios of Medical Students.2 In their Letter to Editor, their main critique concerned the extent to which the nonanonymity of reflective portfolios and the lack of reflection prompts to students may have affected the G-theory analysis. In their view, these two aspects will have reduced the percentage variance of the object of measurement (students) and thus influenced the variance attributed to the study facets. In addition, they draw attention that the study instrument might not be replicable for clinical students, due to increased complexity of the learning environment. We address their concerns in turn. View the original paper by Kassab and colleagues This is in response to the Letter to the Editor

Introduction: Insomnia is common, adversely impacts physical and mental health, functional ability and hence impacts global public health. The prevalence of insomnia and its impact on mental health in Qatar's non-clinical population is relatively unknown. Objectives: We aimed to estimate the prevalence of Insomnia Disorder in the household population of Qatar and explore its link to depressive and anxiety symptoms. Methods: We hypothesized that insomnia would be prevalent and strongly associated with depressive and anxiety symptoms in the Qatari population. We used probability-based sampling to select a Qatar household population sample (N= 1,611). Face-to-face household interviews were conducted with consenting adults living in Qatar. We used the Espie (2014) Sleep Condition Indicator and DSM-5 criteria to estimate the prevalence of insomnia. Depressive and anxiety symptoms were ascertained using the PHQ-9 and GAD-2 and markers of autoimmune disease resorded. Univariate, bivariate, and multivariate statistics were used in analysis. Results: The prevalence of insomnia was 5.5% (95%CI: 4.3-6.7) and was higher in females (6.3%) than males (4.6%), (P = 0.216). Insomnia was strongly associated with depressive (OR=5.4, P<0.01) and anxiety symptoms (OR=3.0, P<0.05). Having one or more autoimmune diseases were strongly associated with insomnia (OR=3.9, P<0.001). Insomnia was positively associated with younger age (P<0.01) and negatively associated with higher (post-secondary) education (OR=0.4, P<0.05). Evidence of strong association between religious affiliation and insomnia was found (OR=25.0, P<0.01), which requires further exploration in future studies. Conclusions: These findings highlight the potential impact of insomnia on mental health in the otherwise healthy population of Qatar. [ABSTRACT FROM AUTHOR]

Background: Student-led clinic is an educational-professional training environment where students are leading the care of patients under the supervision of licensed health care professionals. This study aims to explore medical students' experiences in leading family medicine clinics in Qatar., Methods: The study used a qualitative descriptive method. To collect the data, the researchers have used semi-structured interviews. To recruit students, a convenience sampling strategy was used by sending a call to participate to all students who completed the rotation and met the inclusion criteria. An inductive thematic analysis was employed to data analysis., Results: Ten students participated in the study. Data analysis revealed six themes. These are: Student led clinic as transitional and transformative stage, Challenges faced by students, coping strategies, protective factors, implications of the experience and students' reflections for future rotations. The study revealed that students experienced a mixture of anxiety and excitement during the transition to leading clinics. Challenges included patient-related challenges such as language barriers, challenges related to personal skills such as time and knowledge, and institutional challenges that included limited supervisor availability and balancing academic responsibilities with clinic duties. Coping strategies included continuous knowledge revision, seeking advice from colleagues, and employing creative tools to overcome language barriers., Conclusion: Leading family medicine clinics has an impact on students such as enhancing their time management, diagnostic abilities, communication skills, and confidence. Support from supervisors, team members, patients, and colleagues play a crucial role in students' experiences. This transitional experience supports the shift from self-perception as students perceiving themselves as physicians., (© 2024. The Author(s).)

Objectives: Early introduction to research prepares medical students for the practice of evidence-based medicine. Few studies have examined the experiences of research among medical students in the Arab region. This study assesses medical students' experiences in pursuing research at the national College of Medicine (CMED) in the state of Qatar., Methods: This cross-sectional study was conducted using an online questionnaire distributed through Google Forms. The inclusion criteria called for students over 18 years old enrolled in the college in Years 2 to 6 (pre-clinical and clinical phases) during the spring semester of 2022. The questionnaire included 5 sections with multiple-choice questions and 5-point Likert-scale questions. The questionnaire was validated using esperts review and by piloting it on 10% of the eligible students. STATA 17.0 was used to perform the statistical analysis, which involved a logistic regression and Mann-Whitney U test., Results: The study had 179 student participants (over half of the eligible group). Half were in the preclinical phase, and half were in the clinical phase. Approximately half had published at least 1 paper. For voluntary research, the main motivators were passion and positive past experiences, while the main demoralizer was inadequate time. For mandatory medical-student research, supervisor help was the main facilitator, and an academic load leaving insufficient time for research was the main barrier. The factors positively influencing voluntary research participation were being older, being male, studying in a more advanced program phase, and having a lower score for negative attitudes toward research. The main limitation of the study was the inclusion of only 1 medical school with 1 type of curriculum., Conclusions: Our findings suggest that better research experience can be ensured by providing space, time, and proper academic and moral support to students. The authors believe that doing so will indirectly positively affect the future translation of skills in evidence-based medicine into clinical practice., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: The majority of research attention has been devoted to the link between religiosity and suicide risk, and a considerable amount of studies has been carried out on how stigma impacts individuals with mental health problems of different kinds. However, the interplay between religiosity, suicide literacy and suicide stigma has seldom been empirically researched, especially quantitatively. We sought through this study to redress the imbalance of research attention by examining the relationship between religiosity and suicide stigma; and the indirect and moderating effects of suicide literacy on this relationship., Method: A cross-sectional web-based survey was conducted among Arab-Muslim adults originating from four Arab countries (Egypt: N  = 1029, Kuwait: N  = 2182, Lebanon N  = 781, Tunisia N  = 2343; Total sample: N  = 6335). The outcome measures included the Arabic Religiosity Scale which taps into variation in the degree of religiosity, the Stigma of Suicide Scale-short form to the solicit degree of stigma related to suicide, and the Literacy of Suicide Scale explores knowledge and understanding of suicide., Results: Our Mediation analyses findings showed that literacy of suicide partially mediated the association between religiosity and stigmatizing attitude toward suicide. Higher religiosity was significantly associated with less literacy of suicide; higher literacy of suicide was significantly associated with less stigma of suicide. Finally, higher religiosity was directly and significantly associated with more stigmatization attitude toward suicide., Conclusion: We contribute the literature by showing, for the first time, that suicide literacy plays a mediating role in the association between religiosity and suicide stigma in a sample of Arab-Muslim community adults. This preliminarily suggests that the effects of religiosity on suicide stigma can be modifiable through improving suicide literacy. This implies that interventions targeting highly religious individuals should pay dual attention to increasing suicide literacy and lowering suicide stigma., Competing Interests: Conflict of interestNone.

Background: Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries., Method: The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females)., Results: Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes., Conclusion: Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Covid-19 related studies report psychological impacts during home isolation and social distancing. Despite that, children and adolescents were able to adopt coping strategies that assisted in lowering severe levels of psychological disorders. This study aims to report on the psychosocial implications of social distancing and isolation on children of different nationalities who reside in Qatar, and to reveal their coping ways., Methods: This is a cross sectional study with qualitative component at its end. The study is a part of a larger study that reported the results of a national screening for psychological disorders experienced by children and adolescents in Qatar. A bilingual online questionnaire included close-ended and one open-ended question to screen for psychological changes and identify coping strategies practiced by children and adolescents (7-18 years) during home-isolation and social distancing. The quantitative questionnaire had five main sections as follows: the sociodemographic characteristics, Spence Children's Anxiety Scale, Kutcher Adolescent Depression Scale, and Clinical Anger Scale). The last section screened for eight different coping strategies. The summative content analysis was used to analyze the open-ended question "What practices do you do at home that make you happy?". First, open coding was used (for identification), followed by the axial coding (for comparison), and lasted by sorting of coping strategies inductively., Results: Six thousand six hundred and eight (6608) subjects participated between June 23 and July 18, 2020. The clinical outcomes of the study had varying prevalence and levels of severity, which ranged from mild to severe. Higher prevalence was noted for adjustment disorder 66.5% (n = 4396), and generalized anxiety 60% (n = 3858), in comparison to depression 40% (n = 2588). Additionally, participants reported using cognitive, spiritual, social, and physical coping strategies. Eight higher order themes were identified to reflect the coping strategies: playing with siblings or pets, gardening, cooking, practicing arts and crafts, and doing chores. Furthermore, Sociodemographic factors such as ethnicity, religion and family status played a considerable role in choosing the type of coping strategy., Conclusion: The uniqueness of the study is bringing the psychosocial implications of social distancing through the voices of children and adolescents, and coping strategies from their perspective. These results are of importance for educational and healthcare systems that are recommended to collaborate even in "normal" times to prepare these age categories for any future crises. The importance of daily lifestyle and family is highlighted as protectors, and crucial factors in emotional management., (© 2023. The Author(s).)

Background: There is evidence that culture deeply affects beliefs about mental illnesses' causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking., Methods: We carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public., Results: More than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p < .001), knowledge (F = 88.7, p < .001), and help-seeking attitudes (F = 32.4, p < .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants., Conclusion: Interventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Reports on the risk and prognosis of breast cancer in relation to the sex of a child have been conflicting. Since medical sciences play an important role in informing sociocultural understandings of health and illness, evidence-based studies have the potential to foster or counter stigma and shape social attitudes toward a newborn’s sex., Aims: To pool all available evidence to provide the highest level of evidence on the association between the sex of the first child and breast cancer risk or prognosis., Study Design: Systematic review and meta-analyses., Methods: A comprehensive search using three databases was conducted from inception until May 2020. Titles and abstracts of all papers identified were independently screened by two authors. Data extraction and quality assessment were also performed independently by two researchers. The breast cancer risk was quantified using the odds ratio, and the prognosis (i.e., mortality) was measured using the risk ratio., Results: In the meta-analysis, 11 studies with more than 1 million participants were included. The pooled estimate from the five studies on risk and the six studies on prognosis were odds ratio 0.99 (95% confidence interval, 0.95-1.03) and risk ratio 1.00 (95% confidence interval, 0.80-1.26), respectively., Conclusion: When we pooled all available evidence, the sex of the firstborn child was neither associated with risk nor prognosis in breast cancer. Clinically, our findings are reassuring and important, especially in light of previous studies that recommended differential treatment and counseling based on the sex of the first child. Socially, our findings challenge conventional social stereotypes that regard male children as biologically superior to female children.

Background and Aims: Psychotic-like experiences (PLEs) are hallucinatory or delusional experiences that fall below the threshold of a diagnosable psychotic disorder. Although PLEs are common across the spectrum of psychiatric disorders, they also have been commonly reported in the general population. In this study, we aimed to describe the types of PLEs experienced by university students in Qatar. Furthermore, we aimed to examine how students frame, explain, and deal with these experiences as well as understand how culture and religion may shape the way students attribute and respond to these experiences., Method: This study used a qualitative phenomenological approach. For collecting the data, we conducted semi-structured interviews using the Questionnaire for Psychotic Experiences (QPE). The QPE is a valid and reliable tool to assess the phenomenology of psychotic-like experiences. The questionnaire was translated into Arabic and tested and validated in Qatar (a fast-developing Muslim country in the Arabian Peninsula). We conducted interviews in Arabic with 12 undergraduate female students at Qatar University (the only national university in Qatar). The interviewees were of different Arab nationalities. Interviews were transcribed verbatim and two authors conducted the content-thematic analysis separately, as a strategy to validate the findings. The study was part of a larger nationally funded project that was approved by the Qatar University Institutional Review Board. The approvals were granted before any interview was conducted., Results: The PLEs were prevalent in our non-clinical sample. The content-thematic analysis revealed the following main themes about these experiences: type, impact on daily function, frequency, immediate reaction, attribution style, assumptions about the root cause of these experiences, other associations, and religious links to experiences. The results also highlighted that religion and culture play a role in shaping the types of hallucinations and some delusions., Conclusion: Our findings support the importance of culture and religion in relation to the types and explanations that students provided when describing PLEs. Notably, it was common among those who reported having these experiences to normalize and link PLEs to real-life events. This may be a defense mechanism to protect the self against the stigma of mental illness and from being labeled as "abnormal"., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Yehya, Khaled, Sommer, Woodruff and Daher-Nashif.)

Currently, health authorities around the world are struggling to limit the spread of COVID-19. Since the beginning of the pandemic, social distancing has been the most important strategy used by most countries to control disease spread by flattening and elongating the epidemic curve. Another strategy, herd immunity, was also applied by some countries through relaxed control measures that allow the free spread of natural infection to build up solid immunity within the population. In 2021, COVID-19 vaccination was introduced with tremendous effort as a promising strategy for limiting the spread of disease. Therefore, in this review, we present the current knowledge about social distancing, herd immunity strategies, and aspects of their implementation to control the COVID-19 pandemic in the presence of the newly developed vaccines. Finally, we suggest a short-term option for controlling the pandemic during vaccine application., (© 2022. The Author(s).)

Purpose: Medical students have a higher risk of developing psychological issues, such as feeding and eating disorders (FEDs). In the past few years, a major increase was observed in the number of studies on the topic. The goal of this review was to estimate the prevalence risk of FEDs and its associated risk factors in medical students., Methods: Nine electronic databases were used to conduct an electronic search from the inception of the databases until 15 th September 2021. The DerSimonian-Laird technique was used to pool the estimates using random-effects meta-analysis. The prevalence of FEDs risk in medical students was the major outcome of interest. Data were analyzed globally, by country, by research measure and by culture. Sex, age, and body mass index were examined as potential confounders using meta-regression analysis., Results: A random-effects meta-analysis evaluating the prevalence of FEDs in medical students (K = 35, N = 21,383) generated a pooled prevalence rate of 17.35% (95% CI 14.15-21.10%), heterogeneity [Q = 1528 (34), P = 0.001], τ 2  = 0.51 (95% CI 0.36-1.05), τ = 0.71 (95% CI 0.59-1.02), I 2  = 97.8%; H = 6.70 (95% CI 6.19-7.26). Age and sex were not significant predictors. Body mass index, culture and used research tool were significant confounders., Conclusion: The prevalence of FEDs symptoms in medical students was estimated to be 17.35%. Future prospective studies are urgently needed to construct prevention and treatment programs to provide better outcomes for students at risk of or suffering from FEDs., Level of Evidence: Level I, systematic review and meta-analysis., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background . The global increase in type 2 diabetes (T2D) poses a significant public health challenge worldwide. Due to the chronic and complex nature of the disease, management does not depend on pharmacotherapy alone; rather, a comprehensive medical and self-management plan is required. Diabetes Self-Management Education programs should address diabetes-specific behaviors and be grounded in patients' perceptions of their disease and its consequences. Aim . The study aims to understand perceptions of diabetes self-management (DSM) among persons of different nationalities with T2D living in Qatar. Method . A phenomenological qualitative study was implemented using four focus group interviews using Triandis Interpersonal Behavior Model to understand factors influencing DSM perceptions and behaviors. Therefore, deductive content analysis was used, also inductive content analysis used to find new emerging themes. Twenty-nine participants with T2D of 12 different nationalities were recruited. Results . Content analyses revealed that participants were mainly motivated to manage their diabetes by fear of future health complications-and the resulting impact on their families-triggered by witnessing these complications on other family members and friends. Factors that influenced DSM included cultural factors such as food content and holidays' customs, weather conditions, psychological distress, and social factors such as lack of family support. Furthermore, access to healthy food, number of working hours and time, and cost of DSM supplies were found to be among the barriers to DSM. Conclusion . Understanding and considering patients' perspectives is a core component of culturally competent and evidence-based DSM programs, and it should be considered in any DSM program.

Background : This paper describes the development of a culturally competent medical humanities course for second and third-year medical students at the ethnically diverse College of Medicine at Qatar University. First taught in 2016, the elective seminar "Medicine and the Arts" was restructured in 2017 to cultivate an appreciation of the symbiotic relationship between medicine, art, and humanities, and to foster cultural competence among the students. Methods : Results and tips are based on our experiences and past reports. Results : In designing a course for students immersed in an Arab-Muslim context, we encountered two challenges: the discipline's privileging of a predominantly Western canon of arts and humanities, and the largely Euro-American-centric and unilateral framing of concepts e.g., the doctor-patient relationship, patient-centered approach, patient experiences, and meanings of health and illness. To circumvent these challenges, we followed the Purnell Model for Cultural Competence, adopted the interdisciplinary approach, and employed an intersectionality framework to build and deliver a culturally competent course exploring the nexus of arts, humanities, and medicine. In addition to these tips on which frameworks to adopt and how to structure the course, we recommend a visual literacy workshop to help them develop the ability to recognize and understand ideas conveyed through art. Furthermore, we recommend deep conversations about artistic portrayals of medicine from different cultural contexts as tools for developing cultural awareness. Lastly, we recommend that these discussions adopt a student-centered approach, where students inform about their experiences and their own health and illness determinants, in order to develop their knowledge and practice of holism and patient centered approach, and other issues related to humanities and social sciences.      Conclusions: Adopting and implementing a culturally competent approach to medical education, alongside interdisciplinary and intersectionality concepts, are potential conceptual frameworks to structure a course that uses art to inform about medical humanities., Competing Interests: No competing interests were disclosed., (Copyright: © 2022 Daher-Nashif S and Kane T.)

The present study explored nursing and medical students' perceptions of food security, their access to healthy food and the circumstances that affect their access to healthy food in Qatar. The photovoice method was adopted in the present study. Students submitted their photos pertaining to food security and their access to healthy food in Qatar. Afterwards, the students completed an online synchronous semi-structured interview. The interviews were transcribed verbatim and thematically analysed. After the data analysis, a focus group discussion was conducted for member checking. The present study is a collaborative project between two universities in Qatar: The University of Calgary in Qatar (UCQ) and Qatar University (QU). Undergraduate students (seven nursing students and nine medical students) were recruited, asked to collect photos and interviewed. Four themes emerged from the data. First, food retail environments promoted unhealthy eating. Second, fast food under stressful circumstances: a sense of comfort. Third, food as a symbol of culture and socialisation. Finally, the paradox of access to affordable and healthy food in Qatar. Undergraduate students highlighted various circumstances that affect their perceptions of food security and their access to healthy food in Qatar. Future research that aims at understanding the facilitators and barriers to access healthy food at the university campus may help to improve nutrition interventions targeting those students. Future initiatives should focus on leveraging various resources to assist universities in tailoring their food initiatives to suit their students' local needs., (© The Author(s) 2022.)

This article examines how the intersectionality between political, socio-cultural, and demographic factors influences femicide events and women's experiences in Gaza. Based on the testimonies of 13 female first-degree relatives of murdered women and 7 professionals, the article suggests the "politicological" logic of femicide to highlight the interrelationship between Israel's political and Palestinians' patriarchal control of the killed, the bereaved, and women's lives in Gaza. The article reveals that while all murderers are free and some have even fled Gaza, all women remain trapped in an immense political and patriarchal prison, lacking basic feelings of safety and the right to live.

This cross-sectional study examines knowledge, attitudes, and practices surrounding breast cancer awareness and screening among women residents in Qatar. Females, >18 years old, registered with the Primary Health Care Corporation were invited to complete an Arabic or English online survey using a modified version of the Breast Cancer Awareness Module. Of the 9008 participants, 69% report awareness of breast cancer warning signs, but the results did not substantiate these claims. There remains a disconnect between participants’ perceived awareness of their ability to detect breast cancer and their actual recognition of individual signs and symptoms. Nearly half (45.4%) report rarely or never checking their breasts for abnormalities (44.6%). Breast self-examination (BSE) and Breast Cancer Screening (BCS) uptake is low and many are unaware of the starting age for invitation to Qatar’s BCS program. While only 18% of women report receiving an invitation, 94% attended, indicating that the BCS invitation is a remarkably effective means of improving screening uptake. Policymakers should capitalize on early recognition, which is possible in the youthful population. Broadening awareness campaigns and interventions targeting a broader audience including males, community and religious leaders and healthcare professionals may prove more effective in Arab communities.

Care for persons with dementia in the Middle East and North Africa (MENA) is undertaken predominantly by family members, domestic workers, and private nurses within the home. Domestic caregivers possess different understandings and varying degrees of knowledge of dementia that are influenced by complex socio-cultural and religious factors. With much of the burden falling on the shoulders of "invisible" caregivers, the role and needs of these individuals require deeper scrutiny. The purpose of this scoping review was to examine the empirical studies published on caring for persons with dementia in Arab countries of the MENA region. Using a systematic review technique, searches were conducted on PubMed, Embase, Web of Science, Scopus, and Google Scholar using database-specific terms associated with caregiving, dementia, aging, and the MENA region. To ensure local and regional research was captured, hand searches of regional journals, reference lists of included articles, and Arabic databases Al-Manhal and e-Marefa were also searched. No date restrictions were imposed. Twenty studies met inclusion criteria and the following themes were identified: caregiving experiences and the burden of care; barriers to caregiving; and caregiver recommendations to improve care. Results demonstrate that studies about informal caregivers and dementia within Arab-Muslim populations are underrepresented in the research. This review highlights the paucity of literature on service users' experiences and underscores the need for future research specific to dementia care within the Arab-Islamic sociocultural context. These trajectories are especially pertinent given the unprecedented aging demographics of the MENA populations.

A population's desire to take the COVID-19 vaccine is an important predictor of a country's future pandemic management. This cross-sectional study examines the impact of psychological and sociodemographic factors on attitudes toward and intentions to take the COVID-19 vaccine among students and faculty at four colleges of health professions and sciences at Qatar University. The data were collected through an online survey using Google Forms. The survey was distributed through various online platforms. Data analysis was conducted using Stata 16. Of the 364 participants, 9.89% expressed a high mistrust of vaccine safety, and 21.7% were uncertain about their levels of trust; 28% expressed strong worries about unforeseen side effects, whereas 54.95% expressed moderate worries. Furthermore, 7.69% expressed strong concerns and 39.84% showed moderate concerns about commercial profiteering. Approximately 13% of the participants expressed a strong preference towards natural immunity, whilst 45.33% appeared to believe that natural immunity might be better than a vaccine. Importantly, 68.13% of the participants intended to receive the COVID-19 vaccine once it became available, compared to 17.03% who were uncertain and 14.83% who were unwilling to be vaccinated. Our findings differ from the data on vaccine hesitancy among the general population of Qatar. We argue that this gap is due to scientific knowledge and domain of education. Furthermore, although knowledge and awareness may affect vaccine attitudes, mental health and sociodemographic factors play a role in shaping attitudes towards vaccines.

This paper illustrates the impact of Islamic religious texts on dementia care in the Middle East. It examines how old age and older adults mental disorders are framed in the Quran and Hadith, and how these texts are transformed to belief ideologies and caregiving practices. The study uses a qualitative research methods, which include a review of all Islamic holy texts that address mental and cognitive changes associated with ageing, along with interviews with eight Sharia scholars and 37-Arab-Muslim families living in Qatar. Islamic texts command compassion and honouring of elderly parents and give care instructions. These texts are transformed into social practices and used as diagnostic and treatment tools.

Background: Though common practice in Europe, few studies have described the efficacy of early clinical exposure (ECE) in the Middle East. The barriers to clinical learning experienced by these novice medical students have not been reported. This evaluation reports on introducing ECE in primary care, supported by Experiential Review (ER) debriefing sessions. The evaluation explores students' experiences of their acquisition of clinical and non-technical skills, sociocultural issues commonly encountered but underreported and barriers to clinical learning experienced., Methods: We conducted a cross-sectional study of three student cohorts in 2017-19: All second and third-year students at the new College of Medicine were invited to participate. The primary outcome was students' perceptions of the aims of the Primary Health Centre Placement (PHCP) programme and how it facilitated learning. Secondary outcome measures were students' perceptions of their learning in ER sessions and perceived barriers to learning during PHCPs. Student perceptions of the PHCPs were measured using a Likert scale-based questionnaire., Results: One hundred and fifty-one students participated: 107 in year 2 and 44 in year 3; 72.3% were female. Overall, most students (> 70%) strongly agreed or agreed with the purposes of the PCHPs. Most students (71%) strongly agreed or agreed that the PCHPs allowed them to learn about patient care; 58% to observe doctors as role models and 55% to discuss managing common clinical problems with family physicians. Most students (year 2 = 62.5% and year 3 = 67%) strongly agreed/agreed that they were now confident taking histories and examining patients. Student barriers to clinical learning included: Unclear learning outcomes (48.3%); faculty too busy to teach (41.7%); lacking understanding of clinical medicine (29.1%); shyness (26.5%); and finding talking to patients difficult and embarrassing (25.8%). Over 70% reported that ER enabled them to discuss ethical and professional issues., Conclusions: Overall, our Middle Eastern students regard ECE as beneficial to their clinical learning. PHCPs and ER sessions together provide useful educational experiences for novice learners. We recommend further exploration of the barriers to learning to explore whether these novice students' perceptions are manifesting underlying cultural sensitivities or acculturation to their new environment.

Background: Diabetes is a highly prevalent chronic disease that is associated with major complications. Findings regarding risk of depression among patients with diabetes are controversial. This study aimed to determine the prevalence and determinants of depressive symptoms among Qatari patients with type 2 diabetes. Methods: This cross-sectional study was based on Qatar Biobank (QBB) data of 2448 Qatari adults with diabetes aged 21-60 years old. Data regarding age, gender, education, income, body mass index (BMI), medication use, glycated hemoglobin (HbA1c) were retrieved. Patients' responses to the Patient Health Questionnaire-9 (PHQ-9) were also obtained. Data analyses was performed using STATA 16, and statistical significance was considered at a p -value of <0.05. Results: Of the 2448 participants, 15.4% ( n = 378) had self-reported depressive symptoms. Depressive symptoms were frequent among females (69.6%), smokers (15.9%), and participants with a higher level of education (47.1%). Average age of participants who reported depressive symptoms was significantly less that among participants without depressive symptoms (44.8 vs. 52.9 years). Qatari women with diabetes seem to be at higher risk of depression when compared to men (OR = 1.819, 95% CI: 1.42-2.33); The odds of reporting depressive symptoms were 35% higher among patients with more advanced educational qualifications (OR = 1.351, 95% CI: 1.00, 1.82). Smokers were twice as likely to report depressive symptoms as their non-smoking counterparts. There was no significant relationship between depression and poor glycemic control, physical activity, BMI, or insulin use. Conclusions: In summary, the study results suggest that several sociodemographic factors, such as age, gender, and level of education were associated with the risk of depressive symptoms among Qataris with diabetes.

Background: Epidemiological studies of insomnia in the Middle East remain scarce. The present study aimed to estimate the prevalence of insomnia and explore its associations in the general population of Qatar. With almost 100 nationalities, Qatar is one of the most culturally diverse, richest, and fastest developing countries in the Arabian Peninsula., Methods: A probability sample of community-dwelling adults were surveyed in February of 2019. A total of 1611 respondents completed face-to-face interviews in Arabic or English. Logistic regression modeled associations with insomnia, our dependent variable, as defined by a score of ≤16 on the eight-item Sleep Condition Indicator or according to criteria for insomnia in the Diagnostic & Statistical Manual of Mental Disorders, fifth edition or DSM-5., Results: Approximately, 5.5% of the sample screened positive for insomnia and the 30-day prevalence of those who met all the DSM-5 criteria for insomnia disorder was 3.0%. In addition, 2.0% of the sample screened positive for depression and 3.4% for anxiety in the past 2 weeks. Multivariable analysis showed the following were significantly associated with insomnia: Arab ethnicity, young age, unemployment, being married, having less than high school education, fair or poor health, anxiety, and depression., Conclusions: Insomnia prevalence was in the lower range of previously reported DSM-defined estimates from developed Western countries. Our findings highlight the need for raising awareness and improving sleep hygiene in potential risk groups such as younger adults and those of Arab ethnicity, in addition to incorporating insomnia screening in the provision of mental health services.

Breast cancer, the most common cancer among women in the Middle East and North Africa (MENA) region, is associated with social and psychological implications deriving from women's socio-cultural contexts. Examining 74 articles published between 2007 and 2019, this literature/narrative review explores the psychosocial aspects of female breast cancer in the MENA region. It highlights socio-cultural barriers to seeking help and socio-political factors influencing women's experience with the disease. In 17 of 22 Arab countries, common findings emerge which derive from shared cultural values. Findings indicate that women lack knowledge of breast cancer screening (BCS) and breast cancer self-examination (BSE) benefits/techniques due to a lack of physicians' recommendations, fear, embarrassment, cultural beliefs, and a lack of formal and informal support systems. Women in rural areas or with low socioeconomic status further lack access to health services. Women with breast cancer, report low self-esteem due to gender dynamics and a tendency towards fatalism. Collaboration between mass media, health and education systems, and leading social-religious figures plays a major role in overcoming psychological and cultural barriers, including beliefs surrounding pain, fear, embarrassment, and modesty, particularly for women of lower socioeconomic status and women living in crises and conflict zones.

Background: In 2014, United Nations member states proposed a set of sustainable development goals (SDGs) to help further the millennium development goals that they had proposed in New York in 2000. Of these 13 SDGs, Goal 3 (i.e., SDG 3) was titled "Good Health and Well-Being." This goal highlighted women's health and well-being via two key objectives. The first, SDG 3.1, aimed to reduce maternal mortality rates (MMR) and the second, SDG 3.7, aimed to ensure access to sexual and reproductive health care services. Drawing on all the latest reports, which have been released by Gulf Cooperation Council states (GCC), this paper sheds light on GCC states' work on women's wellbeing through SDG 3. Aim: the paper aims to review GCC states' work on women's wellbeing in SDG3, which achievements they obtained, which tools they used and which gaps still exist. The paper aims to explain the socio-cultural background behind these achievements, tools, and gaps. Methodology: For the purpose of this study, we used narrative review approach through which we reviewed reports from 2017 and 2018 on SDGs published online by the Ministry of Development and Planning of each GCC state, and latest reports of the WHO on the same states. Findings: the study found similarities and differences between different GCC states, which in turn reveals gaps and areas that are not meeting women's needs. The findings show that MMR in GCC countries has declined by nearly half. The main strategies they adopted to address SDG 3.1 included awareness campaigns, improving access to healthcare systems and training professionals. The tools used to meet SDG 3.7 included training health professionals and raising awareness of consanguinity. The study reveals several gaps, such as a lack of discussion around challenges and barriers, and a lack of linkage between an SDG and the targets contained within it. Conclusion: The paper concludes that there is a much greater emphasis on reducing MMR, compared to providing access to sexual and reproductive healthcare. This difference is due to different socio-cultural framing of each of these two issues.

This article explores the murder of women and girls, which we name it Femicide, among the Palestinian community living in Israel. Specifically, it analyzes how the dialectic interrelationship between informal and formal legal-social systems constructs the murders of Palestinian women. The data revealed that femicide is a crime empowered by the wider context of colonization and the increasing spatial segregation of Palestinian communities. The study confirms the need to move beyond simplistic "cultural" explanations of femicide, and pay closer attention to the ways in which the structure, politics and economy of death function in colonized spaces and contexts.