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When self-reported data are used in statistical analysis to estimate the mean and variance, as well as the regression parameters, the estimates tend, in many cases, to be biased. This is because interviewees have a tendency to heap their answers to certain values. The aim of the paper is to examine the bias-inducing effect of the heaping error in self-reported data, and study the effect on the heaping error on the mean and variance of a distribution as well as the regression parameters. As a result a new method is introduced to correct the effects of bias due to the heaping error using validation data. Using publicly available data and simulation studies, it can be shown that the newly developed method is practical and can easily be applied to correct the bias in the estimated mean and variance, as well as in the estimated regression parameters computed from self-reported data. Hence, using the method of correction presented in this paper allows researchers to draw accurate conclusions leading to the right decisions, e.g. regarding health care planning and delivery.

Background: Digital health significantly affects healthcare delivery. Moreover, empirical studies on the utilization of telehealth in Dubai are limited. Accordingly, this study examines the utilization of telehealth services in Dubai Health Authority (DHA) facilities and the factors associated with telehealth appointment completion and turnaround time. Methods: This cross-sectional study examines patients who used telehealth services in DHA from 2020 through 2021 using 241,822 records. A binary logistic regression model was constructed to investigate the association between appointment turnaround time as a dependent variable and patient and visit characteristics as independent variables. Results: Of the total scheduled telehealth visits, more than three-quarter (78.55%) were completed. Older patients, non-Emiratis, patients who had their visits in 2020, patients who had video visits, and those who sought family medicine as a specialty had a shorter turnaround time to receive their appointment. Conclusions: This study identifies several characteristics associated with the turnaround time. Moreover, technological improvements focusing on specialties that can readily be addressed through telehealth and further research in this domain will improve service provision and support building an evidence-base in the government sector of the emirate of Dubai.

Background: Digital health significantly affects healthcare delivery. Moreover, empirical studies on the utilization of telehealth in Dubai are limited. Accordingly, this study examines the utilization of telehealth services in Dubai Health Authority (DHA) facilities and the factors associated with telehealth appointment completion and turnaround time. Methods: This cross-sectional study examines patients who used telehealth services in DHA from 2020 through 2021 using 241,822 records. A binary logistic regression model was constructed to investigate the association between appointment turnaround time as a dependent variable and patient and visit characteristics as independent variables. Results: Of the total scheduled telehealth visits, more than three-quarter (78.55%) were completed. Older patients, non-Emiratis, patients who had their visits in 2020, patients who had video visits, and those who sought family medicine as a specialty had a shorter turn-around time to receive their appointment. Conclusions: This study identifies several characteristics associated with the turn-around time. Moreover, technological improvements focusing on specialties that can readily be addressed through telehealth and further research in this domain will improve service provision and support building an evidence base.

Background: The COVID-19 pandemic had a significant impact on the mental well-being of students worldwide. There is a scarcity of information on the mental health impact of the COVID-19 pandemic on university students in the United Arab Emirates (UAE). This study aimed to investigate the mental health impact of the COVID-19, including depression, anxiety and resilience among a sample of university students in the UAE. Methods: A cross-sectional study using an online survey was conducted from September to November 2021. The patient health questionnaire (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Connor–Davidson Resilience Scale (CD-RISC-10) were used to assess depression, anxiety, and resilience. The COVID-19 impact was assessed using a list of questions. Results: Only, 798 students completed the survey and were analyzed for this study. Overall, 74.8% of the students were females, 91.2% were never married, and 66.3% were UAE-nationals. Based on PHQ-9 and GAD-7 cut-off scores (≥ 10), four out of ten of the students self-reported moderate and severe depression (40.9%) and anxiety (39.1%). Significantly higher mean PHQ-9 and GAD-7 scores were found among students who were impacted by COVID-19 than those non-impacted (mean PHQ-9 of 9.51± 6.39 and 6.80 ±6.34; p= 0.001, respectively) and (mean GAD-7 of 9.03 ±6.00 and 8.54 ±6.02; respectively, p < 0.001). Female students who were impacted by COVID-19 had statistically significant higher depression and anxiety scores than the non-impacted females (mean PHQ-9 of 9.14 ±5.86 versus 6.83 ±6.25, respectively; pConclusions: The results of this study demonstrate that the COVID-19 pandemic has negatively impacted the mental health of this sample of university students in terms of depression and anxiety. The results highlight the need to adopt culturally appropriate interventions for university students and focus on vulnerable groups.

BACKGROUND The world as we know it changed during the COVID-19 pandemic. Hope has emerged with the development of new vaccines against the disease. However, many factors hinder vaccine uptake and lead to vaccine hesitancy. Understanding the factors affecting vaccine hesitancy and how to assess its prevalence have become imperative amid the COVID-19 pandemic. The vaccine hesitancy scale (VHS), developed by the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunization, has been modified to the adult VHS (aVHS) and validated in English and Chinese. To our knowledge, no available aVHS has been designed or validated in Arabic or French. OBJECTIVE The aim of this research is to translate the aVHS from its original English language to Arabic and French and validate the translations in the WHO Eastern Mediterranean region. METHODS The study will follow a cross-sectional design divided into 5 phases. In phase 1, the original aVHS will be forward-translated to Arabic and French, followed by backward translation to English. An expert committee will review and rate all versions of the translations. Expert agreement will then be measured using the Cohen kappa coefficient (k). In phase 2, the translated aVHS will be pilot-tested with 2 samples of participants (n=100): a group that speaks both Arabic and English and another that speaks French and English. Participants’ responses to the English version will also be collected. In phase 3, responses will then be compared. Descriptive statistics and paired t tests or one-way analyses of variance (ANOVA) and Pearson correlation coefficient will be used in the preliminary validation. In phase 4, prefinal versions (Arabic and French) will be tested with larger sample sizes of Arabic speakers (n=1000) and French speakers (n=1000). Sociodemographic information and vaccination status will be collected and used for further analysis. In phase 5, the scale's statistical reliability and internal consistency will be measured using Cronbach alpha. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) will be used to examine the model fit resulting from the EFA. ANOVA and regression models will be constructed to control for confounders. All data will be electronically collected. RESULTS As of January 2022, the scale had been translated to Arabic and French and was undergoing the process of back translation. All data collection tools have been prepared (ie, sociodemographics, vaccination status, and open-ended questions) and are ready to go into their electronic formats. We expect to reach the desired sample size in this phase by June 2022. CONCLUSIONS This study will provide researchers with a validated tool to assess adult vaccine hesitancy within populations that speak Arabic and/or French and provide a road map to scale translation and ensure cross-cultural adaptation. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/36928

ObjectiveTo study the prevalence of overweight and obesity and determine the associated risk factors among adults in Dubai.Design and settingA cross-sectional survey with a multistage, stratified random sampling design was conducted in the Emirate of Dubai in 2019.ParticipantsThe study included 2142 adults aged 18+ years in the Emirate of Dubai.ResultsThe overall prevalence of obesity, which was defined as body mass index (BMI) ≥30 kg/m2, was 17.8%. The highest obesity rates were reported among women (21.6%) and the United Arab Emirates (UAE)-nationals (39.6%). Moreover, 39.8% of the population was overweight (BMI ≥25–29.9 kg/m2). Multivariate logistic regression showed associations between obesity and age, sex, nationality, hypertension and occupation. Obesity increases with age, with the highest risk at age group 50–59 years (OR 4.30; 95% CI 1.57 to 11.78) compared with the reference group (18–24 years). Females had a higher risk of obesity than males (OR 1.62; 95% CI 1.10 to 2.38). Compared with those in the reference group (Western and others), UAE nationals, other Arabs and Asians were more likely to be obese ((OR 2.08; 95% CI 1.18 to 3.67), (OR 3.61; 95% CI 2.41 to 5.44) and (OR 1.98; 95% CI 1.12 to 3.50), respectively). Clerical and service workers (OR 4.50; 95% CI 2.54 to 8.00) and elementary and unskilled occupation categories (OR 2.57; 95% CI 1.56 to 4.25) had higher risks of obesity than the reference group (professionals), pConclusionsObesity and overweight are highly prevalent among adults in Dubai and are remarkably associated with sociodemographic and behavioural risk factors. Comprehensive strategic initiatives are urgently needed to control obesity in the high-risk populations in the Emirate of Dubai.

Background: WHO estimates that seasonal influenza may result in 290 000-650 000 deaths each year due to respiratory diseases alone. In addition, affected more than 10% of total population annually worldwide, Seasonal influenza is highly contagious disease; spreads easily, with rapid transmission in crowded areas including schools and nursing homes. Objectives: To study incidence rates, trends and patterns of seasonal influenza among Dubai population for the period of 2017-2019 and some of its associated factors. Materials and Subjects: A retrospective records review study was carried out using a convenience sample of 29,158 confirmed seasonal influenza cases reported in Emirate of Dubai for the period 2017-2019. All age groups, genders, nationalities, occupations, education and seasons were considered as associated factors. Findings: In terms of the socio-demographic aggregates, the results showed that males were more to report 53.42% seasonal influenza cases and 50% of the cases were reported among children 15 years and under. As for the nationalities, 54.37% of the seasonal influenza reported by Asian groups, while 14.59% of the seasonal flu cases were among The Emirati population. As per occupation status, 30.74% of total seasonal influenza cases were among students in Dubai and 5.22% among housewives. On the other hand, the study revealed that 84.53% of the total seasonal influenza cases during 2017- 2019 were handled at outpatient level, yet the remaining percent required hospital admission. Incidence rate per 100,000 population were increased from 2017 through out 2019 (168 and 466 per 100,000 population, respectively). The study revealed that 30.74% of total seasonal influenza were students in Dubai, 84.53% of the total seasonal influenza cases during 2017-2019 were managed at outpatient. yet 15.47% were sever enough cases to be admitted and treated at inpatient level of different health care facilities in Dubai. Incidence among Egyptian was 557/100,000, while among Emirates, 325 /100,000. The present study revealed a seasonality pattern of seasonal influenza cases in Dubai in 2017-2019 as noted from the monthly distributions of cases, where the highest (21.4%) reported in November, followed by 18.2% in December, and the least was in July (2%). The study showed that 30.74% of total seasonal influenza were students in Dubai, 84.53% of the total seasonal influenza cases during 2017-2019 were managed at outpatient. yet 15.47% were sever enough cases to be admitted and treated at inpatient level of different health care facilities in Dubai. Incidence among Egyptian was 557/100000, while among Emirates, 325 /100000, Incidence rate of seasonal influenza 2017-2019 according to age distributions showed that 30.7% among students, and 7.8% among children preschool age, and 5.22% among housewives. The present study showed that the incidence rate of seasonal influenza in Dubai in 2017-2019 as per moth distributions was the highest, 21.4% in November followed by 18.2% in December, and the least was 2% in July. Conclusions: Incidence rates of seasonal influenza in the Emirates of Dubai keep increasing during the last three years, the highest rates was among children under 15 years old, followed by the elderly group as well. The incidence rate of seasonal influenza shows a seasonality pattern with the highest rates reported from October to end of February annually.

Ethical challenges facing research and reporting from conflict-affected zones are well known; among them is the difficulty of finding reliable information; the tendency to take sides and define actors as either good or evil; the precarious security situation of residents and the ever-changing scenarios on the ground. We observed, however, that these challenges go unacknowledged in research and reporting on health state and on the health system from the conflict in Iraq and Syria, with the lines between science and journalistic reporting routinely blurred in the literature. What should be the restraining factor of academic research against prejudiced reporting on injury, death and the healthcare system has mostly failed in the Syrian conflict. Even social media, with its promise of 'independent' and 'citizens' voice', can be skewed, with much of the output in the Syria crisis coming from one side only, largely due to access issues. While researchers in conflict-affected zones, such as Syria, may need to take a position on one side or another when reporting, death, destruction and disease, it is important that they admit to the challenges of accessing unbiased data, the near impossibility of obtaining representative samples and the risk of the contamination of evidence, clinical or otherwise. The example of the Syrian and Iraqi conflicts (as context) indicates a need to reassess research ethics in conflict zones and their implications for policy.

Background: Middle East Respiratory Syndrome (MERS) virus causing acute severe respiratory Diseases has been reported in 2012 in Saudi Arabia. Causative agent is corona virus which is called MERS-CoV. Confirmed cases of virus positive came to have MERS-CoV were presented with severe acute respiratory illness. Typically developed fever, cough, and shortness of breath. And almost half of the confirmed diagnosis was died so far, which revealed high mortality rate. Objectives: To study the incidence and mortality rate of MERS-CoV, to identify main threatens and opportunities. Methodology: MEDLINE and CINAHL electronic databases were searched using a pre-defined search strategy. Additional references from the bibliographies of retrieved articles were also reviewed and experts in the area were contacted. Selection Criteria: Only original research articles on MERS-CoV incidence. Search Result and Quality Assessment: The initial literature search identified 47 papers. Of these, 9 original articles met the selection criteria, and directly related. All were type II evidence-population-based clinical MERS-CoV Studies. The methodological qualities of included studies were assessed using the Downs and Black checklist. systematic review of the relevant literature, using specific search engine strategies and specific key words, out 0f 47 research only 9 original articles were only included. Results: Since 2012 the cases has been reported in 21 countries, yet most of the reporting still come from Arab Peninsula region, almost 842 cases has been reported, about 322 case were died, main countries affected by the disease is Saudi Arabia 714 cases reported among which 292 (40 %) were died and UAE as 71 cases were diagnosed among which 9 were died (21.6%%), So far, all the cases have been linked to six countries in or near the Arabian Peninsula. And 2 cases have been identified in the U.S. This virus has spread from ill people to others through close contact. However, the virus has not shown to spread in a sustained way in communities. The situation is still evolving. Conclusion: The disease is taking propagating epidemic curve and trending towards more spreading and adding more and more cases at the beginning of the epidemic, by time increasing number of index cases led to change to new epidemiological curve pattern into explosive curve, Recommendations, Breaking transmition chain at its main weak point is highly recommended, health care professionals with direct concern needs to do deep Gap analysis studies to address why the virus still circulating and propagating in spite of all advanced preventive and control measures applied so far, and the main question needs to be addressed here is how to reach sources of infections and to breaking down the transmission chain, CDC is working with partners to better understand the risks of this virus, including the source, how it spreads, and how infections might be prevented.