Authors: Alnuaimi G1 (Graduated), Adam B1, Grivna M1, Al Maskari F1, Shah SM1. 1Institute of Public Health, College of Medicine & Health Sciences, UAE University, UAE.
Introduction: Migrant workers account for 80% of the total population of the United Arab Emirates (UAE), and most of the migrants work in the construction industry. Few population-based data were available about the burden of time-loss injuries among construction workers.
Aims & Objectives: The present study aimed to determine the prevalence and associated characteristics of time-loss injuries among constructor workers in Al Ain, Abu Dhabi Emirate.
Materials & Methods: We used a cross-sectional study design. We recruited a random sample of 1634 construction workers from a list of construction-related industries in Al Ain. Study participants completed a self-administered multilingual questionnaire with the help of trained research assistants. The primary outcome was an injury resulting in one or more days absence from the work (per 100 construction workers).
Results: A total of 1634 construction workers were surveyed (mean age: 35.9±8.4, range: 19-63). A total of 109 workers reported time-loss injuries (19.9%; 95% CI [16.8-23.5]). Of those with time-loss injuries, 10.7% were hospitalized for the treatment of the injury. The cause of injury included lifting and handling objects (24.0%), falling from height (23.4%), hit by falling objects (4.8%), electrocution injury (3.6%), and (44.2%) had other injuries. The majority of the study participants were of Indian nationality (67.3%), followed by Nepal (11.6%), Pakistan (10.2%), Bangladesh (7.7%), Uganda (1.5%) and other countries (1.7%). Their average work experience was 8.7 (SD±6.3) years. A high proportion (98.1%) reported safety training.
Conclusion: Time-loss injuries are a significant burden among construction workers in UAE. The information in this study can guide the prevention efforts of Abu Dhabi Emirate initiatives to reduce injury and illness rates in the construction sector in the UAE.
Acknowledgments: UAEU Ph.D. student research grant.
Authors: Elsaaran E. (Graduate Student), Paulo M., Institute of Public Health - UAEU
Introduction: The Covid-19 pandemic created a significant load on healthcare systems and economies globally, which may augment the existing worldwide healthcare associated infections (HAI) burden and impacts the prevention and control interventions.
Aims & Objective: The aim of this review is to explore the published data on the impact of Covid -19 on the HAI burden.
Materials & Methods: A literature review of all published data related to the Covid-19 pandemic and HAI from 2020.
Results: Some studies supported the positive correlation of Covid-19 with HAI such as transmission model, overoccupancy of healthcare facilities, personal protective equipment shortage, adverse effect of prescribed medication, inappropriate antibiotic prescription and incompliance to the WHO infection prevention and control strategy, while other studies stress that the followed measures during the pandemic supports preventing and control HAI.
The variations among healthcare support systems and guidelines makes it difficult to assess the impact of the Covid -19 pandemic on HAI burden, this was clear from the discrepancies in the published data from different healthcare system.
Conclusions: HAI remains a major public health concern that may get impacted with emerging and reemerging infections, therefore it is important to conduct multicenter international study to standardize definitions and protocols for prevention and control of HAI during pandemics.
Acknowledgments: I would like to express my special thanks of gratitude to my supervisor Dr. Marilia who had supported me generously in my work and given much of her time and expertise.
Authors: Alderei S (Undergraduate) Alhefeiti S, Bataineh M, Attlee A. Department of Nutrition and Health, Division of Health Sciences, College of Medicine and Health Sciences, United Arab Emirate University, UAE.
Introduction. Self-perceived health-related quality of life (HRQOL) is the sum of wellbeing components and self-perception aspect affected by health status, impacting the quality of life. The relationship between the non-communicable diseases (NCDs) and HRQOL is well documented. Further, nutrition knowledge (NK) is inversely linked with NCDs. However, there is no evidence if NK will impact the self-perceived HRQOL of adults in context to the United Arab Emirates.
Aims & Objectives. To identify the relationship between NK and self-perceived HRQOL, and to determine the impact of a structured course-based nutrition knowledge module on self-perceived HRQOL in university students.
Materials & Methods. A pre-post intervention research design with a control group was adopted. Two groups of 21 students each, registered in Fall 2020 semester in United Arab Emirates University, were selected. The intervention group received an eight-week NK module in the general education course of “Contemporary of Food Science and Nutrition”. The control group comprised of students from colleges other than the College of Food and Agriculture, had no formal background in nutrition at the university. All the students completed the self-administered demographic proforma. In addition, 86-items Arabic General Nutrition Knowledge Questionnaire- Revised (GNKQ-R) for NK, and Arabic translated version of 14-items Centers for Disease Control and Prevention Health Related Quality of Life (CDC HRQOL-14) questionnaires for self-perceived HRQOL were administered twice using Google link. Data were tested for significance at p<0.05 using t-test and Pearson correlation.
Results. CDC-HRQOL-14 questionnaire showed good internal reliability (Cronbach's Alpha=0.848). A significant reduction in body weight observed in the intervention group. (p=0.021). Intervention showed a significant improvement in the post-tests of NK scores (p<0.001), plus “perceived general health” (p=0.03) and “very healthy days” (p=0.034) measures of HRQOL. Moreover, a positive relationship between NK scores and “perceived general health” (r=0.273; p<0.001) and “very healthy days” (r=0.177; p=0.004) measures of HRQOL was established.
Conclusion: The results highlight the importance of integrating the structured NK module within the university curriculum for all students. Also, self-perceived HRQOL should be determined as part of students’ welfare activities of students’ health clinics.
Authors: Alkaabi A1(Undergraduate), Alkous A1, Mahmoud K1, AlAhbabi M1, AlMansoori A1 (Undergraduate Students), Elbarazi I1, Fatheya AlAwadi2, Al-Maskari F1,3.1Institute of Public Health, College of Medicine and Health Sciences, UAE University.2Ambulatory Health Services, SEHA. 3Zayed Centre for Health Sciences, UAE University.
Introduction: chronic diseases are a major public health problem in the United Arab Emirates (UAE) and are the leading cause of mortality and morbidity. Chronic diseases have been associated with an increased prevalence of depression and depressive symptoms. This can seriously affect the prognosis of the disease and quality of life of patients.
Aims & Objectives: to estimate the prevalence and correlates of depression in a sample of chronic disease patients in Al-Ain city, UAE.
Materials & Methods: A cross sectional study was conducted in seven primary care centers of Al-Ain city using the patient Health Questionnaire (PHQ)-9). Medical students with the help of a research assistant were able to collect 417 completed questionnaires. Data was analyzed using SPSS (version 26). The study was approved by AHS Human Ethics Research Committee.
Results: The majority (63%) of the sample were females, 21.5% with university education with a 57.97% above 55 years of age and a mean duration of chronic disease was 10.11 (SD±8.00). The prevalence of Depression was 21.1% (95% CI: 17.5% - 25.3%) based on a cut-off score of 8; Severe depression was present in 1.7% and mild-moderate in 34.7 % of the participants. Depression was statistically significantly associated with increasing age (p:0.006), low level of education (p:0.000), increase duration of chronic disease (p:0.051) presence of asthma (P:0.002) and cardiovascular disease (p:0.005).
Conclusion: The study highlights for health care professionals and policy makers the importance of mental health as part of a comprehensive management plan for patients with chronic diseases. A multidisciplinary comprehensive program will improve the long-term outcomes of these patients. This study raises an alarm that mental health support for patients with conditions such as asthma and cardiovascular diseases may be disregarded. Patients with chronic diseases may need more support and counseling at primary care levels.
Acknowledgment: The study is supported by Sure Plus Grant (2019-2020), UAE University
Authors: Rahma A. (Graduate),1 Elbarazi I.,1Ali B.,1,2 Patrinos G.,2 Ahmed L.1,2 and Al Maskari F. 1,2. 1Institute of Public Health Institute, College of Medicine & Health Science, UAE University, United Arab Emirates. 2Zayed Center for Health Sciences, UAE University, United Arab Emirates.
Introduction: Pharmacogenomics plays a tangible role in improving patients care. Medical and health science students are the future adopter of this evolving field. Understanding their perspectives and attitude is essential to establish a framework for the implementation of pharmacogenomics in UAE along with redesigning the curriculum of the universities.
Aims & Objectives: to assess the attitude toward genomic medicine and pharmacogenomics among undergraduate students and their exposure to pharmacogenomic in class.
Materials & Methods: this cross-sectional survey included undergraduate students of medicine, pharmacy, laboratory and nursing attending different universities in the UAE. Exposure and attitude were assessed using an online questionnaire. Descriptive statistics are presented as frequencies and percentage. Institutional Review Board (IRB (from UAEU social science was granted.
Results: 510 undergraduate students had responded to the survey. Among them, 82% were females, 63.7% from government universities, 52% were medical students, 29% pharmacy students, 6.9% were studying laboratory. 90.5% of the health science students in the study sample indicated that their attitude is influenced by religion while around 50% reported that their attitude is influenced by culture. 62% of the health science students had never studied pharmacogenomics.40% of them ranked workshop and seminar as their most preferred method of learning about pharmacogenomics.
Conclusion: Students are generally exposed to a very limited teaching in genomics and pharmacogenomics this warned to update the curriculum of the universities to prepare future healthcare providers.
Acknowledgments: This study was funded by Zayed Center for Health Sciences, United Arab Emirates University.
Authors: Al Rahma AM (Graduate)1, Habib MA2, Oulhaj A1, Loney T3, Boillat T3, Shah SM1, Ahmed LA1, Nauman J (Supervisor)1. 1Institute of Public Health, United Arab Emirates University, 2Emirates Integrated Telecommunication Company, Dubai. 3College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai.
Introduction: The worldwide rising levels of physical inactivity especially in the United Arab Emirates (UAE) and Eastern Mediterranean region are alarming. The UAE reports one of the highest non-communicable disease mortality and insufficient physical activity is one of major underlying cause. Therefore, action is required to reduce physical inactivity using evidence-based strategies.
Aims & Objectives: The objectives of the study are to evaluate the effect of a 12-week workplace structured exercise intervention on cardiometabolic risk factors and to determine whether the workplace exercise intervention will improve physical activity levels four weeks post-intervention.
Materials & Methods: This is a protocol for a pragmatic parallel, randomised controlled trial with a 1:1 allocation ratio to the intervention group and delayed intervention group. A total of 150 participants will be recruited from a semi-government telecommunication company in Dubai, UAE after meeting the eligibility criteria; 75 will be assigned to the intervention group and 75 to the delayed intervention group. The intervention group will receive two hours of exercise per week from their working hours for 12 weeks (maximum one hour per day). The intervention group will be assigned to attend personal trainer sessions in the workplace gym throughout the intervention period. After the intervention is completed, the delayed intervention group will also receive two hours of exercise time per week from working hours for four weeks.
Results: The main outcome measure is the change in the cardio-metabolic risk components, i.e., systolic or diastolic blood pressure, waist circumference, glycated haemoglobin (Hb1Ac), fasting plasma glucose, low-density lipoprotein cholesterol from baseline to the end of the intervention. The secondary outcome is to examine whether the workplace exercise intervention improves physical activity levels four weeks post-intervention.
Conclusions: The UAE aims to prevent disease through early interventions that lead to behaviour change and therefore improve general health status and quality of life. This randomized clinical study aims to improve health through examining the effects of a workplace exercise intervention on cardio-metabolic health outcomes.
Acknowledgments: This work is funded by United Arab Emirates University, grant number 31M466.
Authors: Dababneh E (Graduate), Dr. Oulhaj A (Supervisor) , Dr. Al-Rifai R, Mrs. Ostlundh L-Institue of Public Health-IPH.
Introduction: Cardiac rehabilitation (CR) is a multidisciplinary,multicomponent program that have shown clinical effectivness in reducing the morbidity and mortality among patients with cardiac diseases; however, the impact of CR on diabetic patients remains underexplored. This is a protocol for a systematic review and meta-analysis methodology to explore if the effect of CR on mortality and morbidity is the same in type 2 diabetic compared to non-diabetic patients.
Aims & Objectives: To explore the clinical effectivness of Cardiac Rehabilitation in terms of reducing mortality and morbidity among Diabeitc and non-Diabetic patients, and trying to identify which group gets more benefit from the rehabilitation programs.
Methods: Interventional and non-interventional studies comparing the effect of CR, for at least one month, on all-cause mortality and cardio-vascular outcomes including fatal and non-fatal myocardial infarction, revascularization, and re-hospitalization in adults with cardiac diseases will be deemed eligible for inclusion. Studies published between 1990-2020, will be searched in PubMed, Embase, Cochrane, CINAHL, Scopus, and in registries for randomized controlled trials. Eligible studies will be selected using the Covidence software, and their salient details regarding the design, population, tested interventions, and outcomes of interest will be gathered. The quality of studies to be deemed-eligible and reviewed will be assessed using the Cochrane collaboration and National Heart, Lung, and Blood Institute's tools. The appraisal process will be based on the study design (interventional and non-interventional). In the meta-analysis step, the pooled effect of CR on the outcomes will be estimated. All meta-analyses will be done using the random-effects model approach (inverse-variance method.
Results: The results shall explore whether there will be any significant pooled effect of CR in reducing cardiovascular (CV) risk factors in terms of mortality and morbidity.
Conculsion: The study will provide an evidence whether there will be significant effects of CR program among DM and non-DM patients,in terms of reducing cardiovascular mortality& morbidity,thus shall highlights the importance of a spread use of CR in UAE in order to reduce the burden from CV Diseases.
Acknowledgement: I am grateful to my supervisor Dr.Oulhaj for his guidance and full support.
Authors: Kittana M (Graduate), Shakoor H, Platat C. Department of Nutrition and Health
Introduction: Intermittent Fasting (IF) is defined as a regular alternance of periods of eating and fasting, over a day or a week. Studies have shown a wide range of health benefits, including the improvement of cardio-metabolic risk factors. Beyond a common religious practice, it became one of the most popular diets worldwide. However, confusion remains due to the variety of IF patterns that were studied over different and short periods of time. Interestingly, a growing body of evidence supports the importance of synchronizing the eating patterns with the circadian clock system. Besides, the role of the caloric restriction (CR) and the impact of food compensation have most probably been underestimated. Therefore, it is now critical to clarify the contributions of these factors to determine IF’s optimum conditions.
Aims & Objectives: To determine the contribution of CR, eating compensation and meal timing pattern to the metabolic effects of IF and to identify the optimum caloric intake-meal timing combination.
Materials & Methods: A specific literature search, Title/Abstract was conducted using PubMed and Cochrane Library. Search terms included: ‘Intermittent Fasting’ OR ‘Ramadan Fasting’ OR ‘Time-restricted Feeding’ OR ‘Chrononutrition’ AND ‘Overweight’ OR ‘Obesity’ AND ‘Diabetes’ AND ‘Cardiovascular disease’ OR ‘Cardio-metabolic health’.
Results: IF has already been shown to induce weight loss and improve several cardio-metabolic factors like blood lipid profile and insulin sensitivity, hence reducing the overall metabolic risk. Nevertheless, due to dietary compensation on feast days, IF without CR may not yield effective results. A moderate CR of 25% seems to improve IF efficacy. Moreover, desynchronization between meal pattern and circadian rhythm may induce negative metabolic adaptations. Eating periods within a window of ≤12 hours, as in time-restricted feeding (TRF), would be optimum. However, if TRF has been associated with a greater adherence, results remain unclear regarding its metabolic benefits compared to IF or CR alone or in combination.
Conclusions: IF in combination with CR and a meal pattern following the circadian rhythm may induce greater metabolic benefits.
Acknowledgments: Authors would like to acknowledge the Department of Nutrition and Health – UAEU for the continuous encouragement and support.
Authors: Abdulla M, Al Nuaimi R, Al Neyadi M (Under-graduate), Riaz A, Shah S (Supervisor). Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University
Introduction: Low self-esteem in in school children and adolescents is a major risk factor for poor academic achievement, mental illness, and suicide. Overweight and obesity is major risk factor for low self-esteem. Few data were available on the relationship of obesity and low-self-esteem among school adolescents in United Arab Emirates (UAE).
Study Objectives. This study aimed to determine the prevalence of overweight and obesity and its relationship with self-esteem scores among school adolescents aged 12 to 18 years in Al Ain, United Arab Emirates (UAE).
Methods: For this cross-sectional study, a random sample of 518 adolescents was selected from four schools. We used the Rosenberg Self-esteem scale to measure self-esteem score. Body mass index (BMI) served to estimate overweight (the 85th to <95th percentiles) and obesity (≥95th percentile) for age and gender, calculated by using the 2000 Centers for Disease Control and Prevention growth charts. We used multivariate linear regression to estimate relationship between overweight and obesity and total self-esteem score.
Results: Of 518 participants, the majority (61%) were girls, with a mean age of 14.3 years (STD±1.3). The overall average self-esteem score was 20.9 (SD ±4.5). A high proportion of adolescents were overweight (20.9%) and obese (15.5%). The average self-esteem score was 21.3 for those with normal body mass index, 20.8 for overweight and 19.7 for obese adolescents.
After adjustment for age, and gender, increase in mean body mass index was significantly associated with decreasing levels of self-esteem score (adjusted ß -0.088; 95% CI, -0.165 to -0.011).
Conclusion: Higher body mass index in Emirati adolescents was significantly associated with lower levels of self-esteem, after controlling for age and gender.
Acknowledgement: This study was completed with CMHS funding support for the project Parents and Children Together (PACT) for obesity prevention to Prof. Syed Shah (supervisor).
Authors: Rahma A. (Graduate),1 Elbarazi I.,1Ali B.,1,2 Patrinos G.,2 Ahmed L.1,2 and Al Maskari F. 1,2. 1Institute of Public Health Institute, College of Medicine & Health Science, UAE University, United Arab Emirates.2Zayed Center for Health Sciences, UAE University, United Arab Emirates.
Introduction: Mapping the power, interest and stance of stakeholders is a cornerstone for genomic medicine implementation. In this study, we aimed at mapping the power/interest of various stakeholders in United Arab Emirates (UAE) and exploring their attitudes toward pressing health genomics aspects.
Aims & Objectives: The overarching aim of this study is to facilitate the construction of a roadmap for the full implementation of genomic medicine and pharmacogenomics in the UAE with potential applicability to many healthcare systems around the world.
Materials & Methods A qualitative approach using in-depth interview was employed. Heterogeneous stakeholders were identified by experts in the field. The analysis of the data was a hybrid of deductive and inductive approach using NVivo software for coding and analysis. Institutional Review Board (IRB (from UAEU social science was granted.
Results: 13 interviews were conducted. Following mapping the Mendelow’s matrix we categorized the stakeholders in UAE to promoter, latent, defender and apathetic. Most of the interviewed stakeholders emphasized the clinical demand for genomic medicine in UAE. However, many of them were less inclined to articulate the need for pharmacogenomics at the moment. The majority of stakeholders in UAE were in favor of building infrastructure for better genetic services in the country. Stakeholder from an insurance sector had contradicting stance about the cost-effectiveness of genomic medicine; the majority were concerns with the legal and ethical aspects of genomic medicine and had an opposing stance on direct-to-consumer kits.
Conclusion: implementing the Mendelow’s model will allow the systematic strategy for implementing genomic medicine in UAE. This can be achieved by engaging the key players (promoters and defenders) as well as engaging and satisfying the latent stakeholder.
Acknowledgments: This study was funded by Zayed Center for Health Sciences, United Arab Emirates University.
Authors: Mutare, S (Graduate), Al Dhaheri, AS. Nutrition and Health Sciences.
Introduction: Evidence suggests strong associations between nutrition in early life and the risk of disease in adult life. This study describes the first United Arab Emirates National Representative Birth Cohort research. The objectives include investigating the nutrition and lifestyle factors in the first 1000 days of life.
Aims & Objectives: The main aims of the study are to 1) to address critical issues related to mother and child nutrition and its effect on growth and development, 2) to profile maternal nutrition, child growth, health and development outcomes development, and 3) to study the associations between these factors in the United Arab Emirates infants.
Material & Methods: The study aims to recruit 250 pregnant Emirati women within their first trimester, which is defined to be between 8 weeks to 12 weeks of pregnancy. The pregnant women will be recruited from obstetrics and gynaecology (OB-GYN) clinics, and they will receive a total of 11 visits divided into 1 visit each trimester of pregnancy and 8 visits after delivery. Maternal data collection includes socio-demographic and lifestyle factors, dietary intake, anthropometric measurements, physical activity, maternal psychological state, and blood samples for biometrical analysis. After delivery, the visits will occur when the child is 0.5, 4, 6, 9, 12, 18, and 24 months old. Infant data collection includes anthropometric measurements, young child feeding practices, dietary intake supplement use and the eating environment at home, and all the maternal data collection stated above, apart from blood samples. Additional data collection for the child includes developmental assessments such as vision, neurodevelopment assessments and sleep, which will occur at three points,1) within 2 weeks of birth, 2) at 10-14 months, and 3) at 22 – 26 months of age.
Conclusion: Birth cohort studies that commence during pregnancy and then follow the offspring significantly contribute to an understanding of optimal and sub-optimal Early Childhood Development (ECD) outcomes in the context of maternal nutrition. Therefore, the cohort study results are of paramount importance to inform future strategies regarding optimal dietary intake and the consequent nutrition-related health of women of child-bearing age and offspring.
Acknowledgements: Zayed Center for Health Sciences, UAEU, Grant 31R186
Authors: Khan M, Menon P, Govender R, Samra A (Undergraduate), Nauman J, Ostlundh L, Mustafa H, Allaham K, Smith J, Alkaabi J. Department of Family Medicine.
Introduction: Pandemics and subsequent lifestyle restrictions, such as ‘lockdowns’, may have unintended consequences, including changes in body weight. Understanding the impact of and the mechanisms affecting body weight is paramount for planning effective public health measures for the present and future ‘lockdown’-type situations.
Aims & Objectives: This systematic review assessed the impact of pandemic confinement on body weight and identified contributory factors.
Materials & Methods: We comprehensively screened the literature in seven electronic databases and in gr. ey sources from their inception until 1st July 2020 with an update in PubMed and Scopus on 1st February 2021. In total, 2,361 unique records were retrieved, of which 41 studies were considered eligible: 1 case control study, 14 cohort and 26 cross-sectional studies (total no. of participants = 469, 362). Participant age was 6–86 years, and 37%–100% participants were women. Pandemic confinements were associated with weight gain and loss in 7.2%–72.4% and 11.1%–32.0% participants, respectively. Participants gained and lost 0.6 (±1.3)–3.0 (±2.4) kg and 2.0 (±1.4)–2.9 (±1.5) kg, respectively.
Results: Overweight or obese participants predominantly gained weight. Associated factors included increased consumption of unhealthy food with decreased intake of healthy fresh fruits and vegetables and changes in physical activity and sleep patterns. Participants who previously had a relatively lower body weight, ate less, and were more physically active before lock down lost weight during the pandemic. Associated factors included increased intake of fruits, vegetables, and water and absence of alcohol consumption. Maintaining a stable weight was more difficult in populations with reduced income, particularly in individuals with lower educational attainment.
Conclusion: The findings of this systematic review highlight the short-term effects of pandemic confinements. Learning from the ‘lockdown’ experience is imperative when preparing for the next wave; a holistic, reactive, tailored response is needed involving multiple providers.
Acknowledgment: We thank Gamila Hassan at the National Medical Library at UAEU for her strategic support in locating and uploading full-text articles to Covidence.