BACKGROUND: Research on incidence and characteristics of Out-of-Hospital Cardiac Arrest (OHCA) in the Middle East is limited. We assessed the incidence, prehospital characteristics, and outcomes of OHCA in Qatar, a Middle Eastern country. Subsequently, we performed gender-specific analysis.
METHODS: This was a retrospective examination of data obtained from the OHCA registry at Hamad Medical Corporation (HMC) in Qatar from 2017 to 2022. We included adults, non-traumatic, EMS-treatment OHCA. We calculated the incidence of adult OHCA and conducted descriptive analyses for prehospital characteristics, and prehospital outcomes presented by return of spontaneous circulation (ROSC). We evaluated gender differences in prehospital characteristics and ROSC using Student\'s t-test and the Chi-Square test as appropriate. Furthermore, we conducted a multivariable logistic regression analysis to investigate the correlation between gender and achieving ROSC.
RESULTS: We included 4,306 adult OHCA patients, with 869 (20.2%) being females. The mean annual incidence of adult OHCA was 27.4 per 100,000 population-year. Males had a higher annual incidence of OHCA than females. Among all cases, 36.3% occurred in a public location, 25.8% had an initial shockable rhythm, and 28.8% achieved ROSC. Males had a higher proportion of bystander CPR, arrests in public locations, and initial shockable rhythms. While unadjusted analysis showed no significant gender differences in achieving ROSC, adjusted analysis revealed that male gender was associated with higher odds of achieving ROSC (adjusted OR male vs. female 1.38, 95% CI 1.15-1.66, p < 0.001).
CONCLUSIONS: Approximately 720 adults undergo non-traumatic OHCA in Qatar every year, with a higher incidence observed in males. Male gender was associated with higher odds of achieving ROSC. Further gender-specific research in OHCA intervention and outcome in the Middle East is required.

OBJECTIVE: This study aimed to investigate the prevalence and predictors of soft drink consumption among adolescents in the Gulf Cooperation Council (GCC) countries using nationally representative data from the Global School-based Student Health Survey (GSHS).
METHODS: Cross-sectional data were collected using a self-administered questionnaire in a school survey and included 22,116 adolescents aged 12-18 years from Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates. Data were collected and analyzed using complex survey methods. The GSHS was not available for Saudi Arabia. Soft drink consumption was the main outcome variable. Multivariable logistic regression was used to examine its associations with sociodemographic characteristics, dietary behaviors, parental factors, and health-related behaviors.
RESULTS: The prevalence of soft drink consumption three or more times per day ranged from 10.6% to 26.8% across the countries, with the highest being in Qatar. Adjusted analyses showed that girls had lower odds of SD consumption compared to boys (OR = 0.66; 95% CI: 0.57-0.77). Food insecurity, a proxy for low socioeconomic status, was associated with twice the odds of frequent consumption (OR = 2.06; 95% CI: 1.75-2.43). Parental smoking and low physical activity levels were also associated with higher soft drink intake (OR = 1.46, 95% CI: 1.13-1.88 and OR = 1.18, 95% CI: 1.08-1.28, respectively), while obesity showed a weak positive association.
CONCLUSIONS: Daily soft drink consumption was highly prevalent among adolescents in the GCC countries. Sociodemographic, behavioral, and health-related factors were significantly associated with frequent intake. These findings highlight the need for comprehensive, multi-sectoral interventions to reduce soft drink consumption in the region.

The kinase suppressor of Ras 2 (KSR2) gene is associated with monogenic obesity, and loss-of-function variants in KSR2 have been identified in individuals with severe early-onset obesity. This study investigated KSR2 variants in 9 pediatric patients with severe early-onset obesity in Qatar using whole genome sequencing among a cohort of 240 individuals. We focused on KSR2 variants with a minor allele frequency (MAF) below 1% and a Combined Annotation Dependent Depletion (CADD) score above 13 to identify potential causative variants. Our analysis identified four KSR2 variants: one intronic (c.1765-8G>A) and three missense variants (c.1057G>A, c.1673G>A, and c.923T>C) in nine patients. The intronic variant c.1765-8G>A was the most frequent (seen in six individuals) and had a CADD score of 21.10, suggesting possible pathogenicity. This variant showed a significantly higher allele frequency in the Qatari population compared to the Genome Aggregation Database (gnomAD), indicating a possible founder effect. Molecular modeling of the missense variants revealed structural changes in the protein structure. The study concludes that these four KSR2 variants are associated with monogenic obesity, with an autosomal dominant inheritance pattern. The c.1765-8G>A variant\'s prevalence in Qatar underscores its importance in genetic screening for severe obesity. This research advances the understanding of genetic factors in severe early-onset obesity and may inform better management strategies.

BACKGROUND: The number of patients seeking medical care is increasing, necessitating more access to primary healthcare services. As several of these patients usually present with complex medical conditions, the need for interprofessional collaboration (IPC) among health professionals in primary care is necessary. IPC is essential for facing the increasing and challenging healthcare demands. Therefore, the facilitators of and the barriers to IPC should be studied in the hope that the results will be used to promote such endeavors.
OBJECTIVE: This study aimed to explore the perspectives of different health professionals regarding the facilitators of and the barriers to IPC in the primary healthcare settings in Qatar.
METHODS: A qualitative study using focus groups was conducted within the Primary Health Care Corporation (PHCC) in Qatar. Several health professionals were invited to participate in the focus groups. The focus groups were uniprofessional for general practitioners (GPs), nurses, and dentists, while they were interprofessional for the other health professionals. Focus groups were audio-recorded and transcribed verbatim and validated by the research team. The data were analyzed by deductive thematic analysis using the \"Gears\" Conceptual Model as a coding framework.
RESULTS: Fourteen focus groups were conducted involving 58 participants (including 17 GPs, 12 nurses, 15 pharmacists, 3 dentists, and 11 allied health professionals) working in PHCC in Qatar. The findings revealed a spectrum of factors influencing IPC, categorized into four main domains: Macro, Meso, Micro, and individual levels, with each accompanied by relevant barriers and facilitators. Key challenges identified included a lack of communication skills, insufficient professional competencies, and power imbalances, among others. To address these challenges, recommendations were made to implement dedicated training sessions on IPC, reduce hierarchical barriers among different health professionals, and enhance the effectiveness of existing systems. Conversely, it was emphasized that projects and campaigns focused on IPC, alongside the development of enhanced communication skills and the presence of supportive leadership, as essential for facilitating effective IPC in PHCCs.
CONCLUSIONS: The interplay between the meso, macro, micro, and individual levels highlight the significance of a multifaceted approach to interventions, aiming to enhance the successes of IPC. While initiatives like interprofessional education training are underway, numerous challenges persist before achieving improved collaboration and more efficient integration of IPC in the PHCC setting.

BACKGROUND: Pain is a complex and challenging phenomenon. People have different pain experiences, but everyone has the right to effective pain management. Pain assessment and management are integral components of a nurse\'s role.
OBJECTIVE: To assess the knowledge and attitudes of nurses in Qatar about adult post-operative patients\' pain assessment and management, and the factors that may be associated with such knowledge and attitudes.
METHODS: Post-operative registered nurses from all peri-operative areas at Hamad Medical Corporation participated in a cross-sectional online survey using a self-administered questionnaire. A knowledge and attitudes (K&A) score was calculated. Associations between K&A and potential explanatory variables were assessed using t-tests and one-way ANOVA.
RESULTS: A total of 151 post-operative nurses participated in the study. The mean knowledge and attitudes (K&A) score was 19.6 ± 4.5 out of 41 (48%), indicating a large deficit in nurses\' knowledge and attitudes about adult post-operative pain. There were no statistically significant differences in the mean K&A scores of participants based on gender, nationality, education level, marital status, workplace facility, current job designation, or hours of pain education.
CONCLUSIONS: There is a significant deficit in post-operative nurses\' knowledge and attitudes about pain across the nursing workforce in post-operative care. Implications for nursing education and policy: Evidence-based, innovative nursing education courses are needed to improve nurses\' knowledge and attitudes about pain assessment and management. Health service policy is required to ensure that evidence-based in-service education on pain management is compulsory for all nurses. This study was not registered.

BACKGROUND: Human Papilloma Virus (HPV) infection is a significant public health concern in the Gulf Cooperation Council countries, being widely prevalent and the main risk factor for cervical cancer. We aimed to assess knowledge and perception towards HPV, acceptability of the HPV vaccine, and HPV vaccination rates among university students in Education City, Doha, Qatar.
METHODS: This cross-sectional survey utilized proportional quota-sampling, with quotas based on university, sex, and nationality, to recruit students from seven universities between February and September 2022. The English language questionnaire requested socio-demographic information, knowledge, and attitudes about HPV infection and the vaccine. The chi-square test, Student t-test, Mann-Whitney-Wilcoxon tests and multivariable ordinal logistic regression were used to assess differences in proportion, mean, and median according to broad HPV knowledge categories.
RESULTS: Three hundred and ninety-eight students were recruited (response rate = 82.3%), of whom 251 (63.1%) were female. Mean age was 21.7 years. Eighty-nine (22.4%, 95% CI 18.4-26.8%) students had poor knowledge about HPV, 220 (55.3%, 95% CI 50.2-60.2%) students had some awareness, and 89 (22.4%, 95% CI 18.4-26.8%) students were knowledgeable. Age, nationality, and field of study influenced the students\' knowledge about HPV. Only 25 (6.3%) students had previously been vaccinated against HPV. However, 71% of the unvaccinated students reported being willing to get vaccinated if recommended by their healthcare provider.
CONCLUSIONS: Overall, 77.7% of the student population had some-to-good levels of knowledge about HPV-related infection, cancer, and vaccination. There are gaps in the student population\'s understanding and knowledge about HPV. Increasing knowledge can be key toward shared decision-making for HPV vaccination among eligible populations. Targeted public health campaigns and integration into childhood vaccination programs should be critical first steps, especially as most of the surveyed students had a positive outlook on getting vaccinated. Healthcare professionals should be incentivized to increase their HPV knowledge and communication skills, while policymakers can work toward easing barriers in integrating HPV vaccinations in the immunization schedule and encouraging overall HPV vaccination uptake.

BACKGROUND: Diabetes is a major public health problem in Qatar and is associated with an increased risk of depression. However, no study has been conducted in Qatar on the relationship between dietary patterns and depression symptoms in adults. The aim of this study was to assess the association between dietary patterns and depression symptoms among adults with or without diabetes in Qatar.
METHODS: A total of 1000 participants from the Qatar Biobank (QBB) were included in this cross-sectional study. Food intake was assessed using a computer-administered food frequency questionnaire (FFQ), and dietary patterns were identified using factor analysis. Depression symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9).
RESULTS: Depression symptoms were present in 13.5% of the sample. Two dietary patterns were identified: \"unhealthy\" (high consumption of fast food, biryani, mixed dish (chicken/meat/fish), croissant) and \"prudent\" (high consumption of fresh fruit, salads/raw vegetables, canned/dried fruit, and dates). After adjusting for sociodemographic, lifestyle factors (smoking and physical activity), diabetes and medication use for diabetes and hypertension, a high intake of \"unhealthy\" pattern was associated with an increased prevalence of depressive symptoms in individuals with diabetes (prevalence ratio, PR = 1.41; 95% CI = 1.28, 1.56; p-value < 0.001), while there was no statistically significant association between depressive symptoms and the \"prudent\" dietary pattern. The \"prudent\" pattern was inversely and significantly associated with depressive symptoms in individuals with a normal body weight (PR = 0.21; 95% CI = 0.06, 0.76; p-value = 0.018).
CONCLUSIONS: The \"unhealthy\" dietary pattern was positively associated with depression symptoms in those with diabetes, whereas the \"prudent\" dietary pattern was inversely associated with depression symptoms in those with a normal body weight. Promoting healthy eating habits should be considered in the prevention and management of depression.

In-depth multiomic phenotyping provides molecular insights into complex physiological processes and their pathologies. Here, we report on integrating 18 diverse deep molecular phenotyping (omics-) technologies applied to urine, blood, and saliva samples from 391 participants of the multiethnic diabetes Qatar Metabolomics Study of Diabetes (QMDiab). Using 6,304 quantitative molecular traits with 1,221,345 genetic variants, methylation at 470,837 DNA CpG sites, and gene expression of 57,000 transcripts, we determine (1) within-platform partial correlations, (2) between-platform mutual best correlations, and (3) genome-, epigenome-, transcriptome-, and phenome-wide associations. Combined into a molecular network of > 34,000 statistically significant trait-trait links in biofluids, our study portrays \"The Molecular Human\". We describe the variances explained by each omics in the phenotypes (age, sex, BMI, and diabetes state), platform complementarity, and the inherent correlation structures of multiomics data. Further, we construct multi-molecular network of diabetes subtypes. Finally, we generated an open-access web interface to \"The Molecular Human\" ( http://comics.metabolomix.com ), providing interactive data exploration and hypotheses generation possibilities.

BACKGROUND: The quality of the learning environment significantly impacts student engagement and professional identity formation in health professions education. Despite global recognition of its importance, research on student perceptions of learning environments across different health education programs is scarce. This study aimed to explore how health professional students perceive their learning environment and its influence on their professional identity development.
METHODS: An explanatory mixed-methods approach was employed. In the quantitative phase, the Dundee Ready Education Environment Measure [Minimum-Maximum possible scores = 0-200] and Macleod Clark Professional Identity Scale [Minimum-Maximum possible scores = 1-45] were administered to Qatar University-Health students (N = 908), with a minimum required sample size of 271 students. Data were analyzed using SPSS, including descriptive statistics and inferential analysis. In the qualitative phase, seven focus groups (FGs) were conducted online via Microsoft Teams. FGs were guided by a topic guide developed from the quantitative results and the framework proposed by Gruppen et al. (Acad Med 94:969-74, 2019), transcribed verbatim, and thematically analyzed using NVIVO®.
RESULTS: The questionnaire response rate was 57.8% (525 responses out of 908), with a usability rate of 74.3% (390 responses out of 525) after excluding students who only completed the demographic section. The study indicated a \"more positive than negative\" perception of the learning environment (Median [IQR] = 132 [116-174], Minimum-Maximum obtained scores = 43-185), and a \"good\" perception of their professional identity (Median [IQR] = 24 [22-27], Minimum-Maximum obtained scores = 3-36). Qualitative data confirmed that the learning environment was supportive in developing competence, interpersonal skills, and professional identity, though opinions on emotional support adequacy were mixed. Key attributes of an ideal learning environment included mentorship programs, a reward system, and measures to address fatigue and boredom.
CONCLUSIONS: The learning environment at QU-Health was effective in developing competence and interpersonal skills. Students\' perceptions of their learning environment positively correlated with their professional identity. Ideal environments should include mentorship programs, a reward system, and strategies to address fatigue and boredom, emphasizing the need for ongoing improvements in learning environments to enhance student satisfaction, professional identity development, and high-quality patient care.

Non-democratic regimes have increasingly been hosting major sports events to boost their visibility and image abroad, which sparked debates about the potential for \"sportswashing\". Using the case of the 2022 FIFA World Cup in Qatar we examine how the framing of the tournament influenced opinions about Qatar abroad. Our pre-registered survey experiment with more than 14,000 respondents in eight European countries conducted before the tournament shows that framing it in light of human rights issues in Qatar leads to more negative attitudes towards the host of the World Cup. In contrast, frames emphasizing Qatar\'s organizational capacity improve respondents\' attitudes. The heterogeneity of effects across countries highlights the relevance of the national information environment for the effects of major sports events on public opinion. These findings suggest that critical media coverage could potentially mitigate sportswashing efforts while uncritical coverage can increase the legitimacy of autocracies.