Physicians' job satisfaction and its correlates in a tertiary medical care center, Riyadh, Saudi Arabia

Objectives: to measure the degree of job satisfaction among physicians working in a Tertiary Care Hospital and to identify background and work environment characteristics that affect overall and differential job satisfaction

Subjects and Methods: this is a cross-sectional study of 340 physicians selected from a Tertiary Care Center using a stratified random sample with proportional allocation using a self-administered questionnaire with the 5-point Likert scale. From the 340 physicians requested to participate in the study, 217 [63.8%] completed the questionnaire. Descriptive statistics were used appropriately, including mean +/- standard deviation for the quantitative variables, while frequency and percentages were used for the qualitative variables. ANOVA, t-test, and Chi-square were used as necessary to determine if there are any significant relationships between satisfaction scores and the predictor variables

Results: a total of 217 physicians [males 75.6% females 24.4%] completed the questionnaire. Of this total, 52.5% were non-Saudis. The overall perceived satisfaction as measured by one question was 3.42 points out of 5 [68.4%] significantly lower than the overall satisfaction which took in consideration all variables 3.67 points [73.4%]. Mean satisfaction scores were significantly negatively related to the number of children [P < 0.001] the physicians had, but positively correlated to stipend, duration of vacation leave, sick leave policy, health coverage for the employee and family, overall benefits package, involvement in academic work, and involvement in research work [P < 0.001]

Conclusion: the working environment and policies of an organization play important roles in the satisfaction of its physicians. Boosting physician satisfaction is important for both the success of a Tertiary Care Center and for the high quality services offered to patients

demographic and clinical characteristics of leprosy in Saudi Arabia

Leprosy is a chronic disease caused by Mycobacterium leprae. Although the occurrence of leprosy has declined in Saudi Arabia, it has not yet been eradicated. To our knowledge, this descriptive retrospective study is the first to assess the clinical presentation of leprosy at the time of diagnosis in Saudi Arabia. All study subjects were leprosy patients admitted to Ibn Sina hospital, the only referral hospital for leprosy in Saudi Arabia, between January 2000 and May 2012. A total of 164 subjects, the majority of whom [65%] were between 21 and 50 years of age, were included, and the male-to-female ratio was 2.8:1. Of these 164 patients, 63% were Saudis, and 77% of all admitted patients were from the western region. Lepromatous leprosy was observed most frequently [33%], and 31% of cases had a positive history of close contact with leprosy. At the time of diagnosis, 84% of all subjects presented with skin manifestation. The prevalence of neurological deficit at the time of diagnosis was 87%. Erythema nodosum leprosum [E.N.L.] developed in only 10% of all subjects. Further studies are needed to determine the clinical characteristics pertaining to each type of leprosy in the region, and training courses in caring for and diagnosing patients with leprosy should be organized for health workers

major medical ethical challenges facing the public and healthcare providers in Saudi Arabia

Despite the relatively high expenditure on healthcare in Saudi Arabia, its health system remains highly centralized in the main cities with its primary focus on secondary and tertiary care rather than primary care. This had led to numerous ethical challenges for the healthcare providers. This article reports the results of a study conducted with a panel of practitioners, and non-clinicians, in Saudi Arabia, in order to identify the top ten ethical challenges for healthcare providers, patients, and their families. The study design was a cross-sectional, descriptive, and qualitative one. The participants were asked the question: "What top ten ethical challenges are Saudis likely to face in health care?" The participants were asked to rand the top ten ethical challenges throughout a modified Delphi process, using a ranking Scale. A consensus was reached after three rounds of questions and an experts' meeting. The major 10 ethical, issues, as perceived by the participants in order of their importance, were: [1] Patients' Rights, [2] Equity of resources, [3] Confidentiality of the patients, [4] Patient Safety, [5] Conflict of Interests, [6] Ethics of privatization, [7] Informed Consent, [8] Dealing with the opposite sex, [9] Beginning and end of life, and [10] Healthcare team ethics. Although many of the challenges listed by the participants have received significant public and specialized attention worldwide, scant attention has been paid to these top challenges in Saudi Arabia. We propose several possible steps to help address these key challenges

Smoking pattern among female college students in Dammam, Saudi Arabia

Smoking is the most important avoidable cause of premature morbidity and mortality in the world. The estimated annual death rate of 4.9 million people in 1999 is expected to rise to 10 million by the 2020s and 2030s, 7 million of which will occur in developing countries. The aim of the present study was to estimate the prevalence of smoking and assess its pattern among non-medical female college students in Dammam, Saudi Arabia. A cross-sectional study was conducted of 1020 female students selected from the literature and science colleges by multi-stage stratified random sampling technique with proportional allocation. Data were collected using a self-administered modified WHO Global Youth Tobacco Survey questionnaire. Results revealed that occurrence of smoking among female college students was 8.6%. It was significantly higher among literature college students [12.1%] than among Science College students [3.4%]. The mean age at which smoking started was 16 +/- 2.4 years, with a minimum of 11 years. More than half of the students who smoked were cigarette smokers, while 43.2% were shisha smokers. There was a strong relationship between parents who smoked and daughters who smoked. The main motive for smoking was curiosity [44.3%], followed by relief of tension [26.1%]. It may be concluded that smoking is increasing among female college students in Saudi Arabia. Accordingly, it is recommended that a preventive comprehensive health education program on smoking be initiated for females in middle schools, that stricter tobacco control measures be adopted by the government, and that anti-smoking clinics be established in colleges

Comparison of physical activity patterns among diabetic and non diabetic adults in Saudi Arabia

Quantifying the magnitude and risk factors of Diabetes Mellitus in the community is essential for all intervention strategies. The objective of this study is to assess physical activity as a risk factor of diabetes mellitus by comparing physical activity patterns of diabetics and non diabetics. A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample. Data was collected using a questionnaire which included patterns and durations of physical activity, sociodemographics, and history of diabetes, biochemical and anthropometric measurements. Of the total 4657 subjects, 712[15.3%] were diabetic [369[16%] for males and 343[14.6%] for females]. Of all subjects only 12.1, 20.2 and 46.1% were physically active in recreational, work and transport respectively. Diabetes was significantly negatively associated with total level of physical activity .All lower levels of physical activity in leisure, transport and work were significantly associated with increased risk of diabetes .Physical activity at work and walking or cycling for 10 minutes continuously were significant predictors of diabetes. Diabetes mellitus among adults in associated with lower levels of all patterns of physical activity. Specifically tailored and culturally sensitive physical activity interventions, is necessary for preventing, controlling diabetes. Females, elderly and retired persons need special attention

Pilgrims satisfaction with ambulatory health services in Makkah, 2008

The main objective of this study was to assess the level and correlates of patients' satisfaction with ambulatory health services provided for pilgrims during Hajj period in 2008. This was a facility-based, cross-sectional study conducted in the Makkah region during the Hajj season in December 2008. A two-stage technique was used to select 500 patients from those who attended the ambulatory health services. One hundred subjects were selected by systematic random sampling [every fifth] from each of the five hospitals included in the study and asked to fill in a pilot-tested self-administered questionnaire. A total of 487 questionnaires were analyzed. Descriptive statistics and t-test, Mann Whitney test and ANOVA, or Kruskal-Wallis test was used as appropriate after checking for normality. Level of significance level was set to be <0.05 throughout the study. From 478 subjects analyzed, 390 [81.6%] were man, 345 [72.2%] were married, 28.9% had either intermediate or high secondary school education, and 2.4% were skilled laborers. The total satisfaction score for health facilities was 20.45 +/- 4.03 of 25. The satisfaction scores were 20.15 +/- 4.7 of 25 for patient satisfaction with physicians and 21.35 +/- 4.5 for patient satisfaction with paramedical personnel. The overall satisfaction score was 61.5 +/- 4.5 of 75 points. There were significant relations between total satisfaction of health facilities with education level and with occupation [P = 0.012, 0.001, respectively]. The total satisfaction of patients with physicians was significant only with education level. The overall satisfaction score had a significant relation with occupation [P = 0.03], but a borderline relation with the education level [P = 0.056]. Satisfaction with ambulatory Hajj health services is acceptable. Some physicians and waiting area services need special attention to improve satisfaction levels with ambulatory health in the subsequent Hajj seasons

Images in clinical medicine congenital neural malformations related to their embryological background

Congenital neural malformations are complex anomalies, which stem from an abnormality in the embryological development of the nervous system. The development of the nervous system begins by the formation of the neural tube and its subsequent closure. The failure of closure results in neural tube defects [NTD]. Defect in the formation of prosencephalon or rhornbencephalon will result in holoprosencephaly or Dandy walker complex respectively. The formation of neuroblasts and their migration to cerebral cortex may be altered by many neuronal migration disorders, Lissencephaly, schizencephaly, and heterotopic gray matter are the most prominent. The objective of the study is relating congenital neural malformations to their corresponding embryological background, and so helping in better understanding the time and the way of the occurrence of such anomalies

Effect of glutamine on cisplatin-induced nephrotoxicity and antitumor efficacy in mice

Nephrotoxicity is a dose-limiting factor in clinical use of cisplatin.This study aimed at investigating the protective role of two g1utamine[31n] doses against cisplaun-imlucecI nephrotoxictty in normal mice, and investigating their effect on the antitumor efficacy of ciplatin in mice bearing Ehrlich ascites carcinoma[EAC]. Experiment 1: 60 female albino mice were divided into 6 groups, 10 mice each. The first group received a single i.p. injection with normal saline and served as control. The second group received a single i.p.5 mg/kg body weigt cisplatin injection. The third and fourth groups received oral doses of glutamine 150 and 300mg/kg body weight respectively. The fifth and sixth groups received oral glutamine doses as the third and fourth groups one hour prior to Cs injection respectively. Animals were sacrified 7days after cisplatin injection, sera were collected and kidney were surgically removed and 10% homogenates were prepared for detection of creatinine level, malondialdehyde[MDA], reduced glutathione level[GSH], and glutathione peroxidase[GSH-Px].Experiment II for investigating antitumor efficacy, 60 mice bearing i.p. EAC, were treated as mentioned in experiment I The mean survival time was determined. Experiment III, the effect of such treatments on tumor growth delay was also assessed in 60 mice bearing s.c. EAC. Cisplatin injection alone induced a significant increase in serum creatinine, renal MDA, decrease of GSH levels and GSH-Px activity. Histological examination confirmed renal damage. Pretreatment with glutamine significantly attenuated the disturbance induced by cisplatin in creatinine, MDA, GSH levels, GSH-Px activity in a dose dependent manner. Glutamine in low and high dose reserved the improvement of the mean survival time induced by cisplatin. Moreover, pretreatment with glutamine high dose significantly improved the effect of cisplatin on tumor growth delay. These data suggest that glutamine may decrease the toxicity and oxidative stress of cisplatin, besides improving its antitumor efficacy

Health-related quality of life in type 2 diabetic patients

Health-related quality of life [HRQOL] is an important health outcome, representing one of the most important goals of all health interventions. The objectives of this study were to determine HRQOL and the factors affecting it in type 2 diabetic patients. This cross-sectional study was conducted in five primary health care [PHC] centers in the Al-Khobar area. From a random sample of 225 type 2 diabetic patients, 216 patients were included in the study along with 216 age-, sex- and nationality-matched controls. Nine patients refused to participate. Type 2 diabetic patients and controls were interviewed with the translated Arabic SF-12 questionnaire. The mean ages were 50.0 +/- 10.0 years for cases and of 49.3 +/- 10.3 years for controls [P=.526]. Type 2 diabetic patients had lower socioeconomic status and educational level than controls. Obesity was significantly higher in diabetics than controls. HRQOL in type 2 diabetic patients was significantly lower than controls. The mean physical component score was 41.3 +/- 8.9 for cases vs. 47.5 +/- 9.5 for controls [P<.001], and the mean menttal component score 47.8 +/- 9.1 in cases vs. 51.5 +/- 9.4 in controls [P<.001]. HRQOL was significantly lower in females than males [P<.001]. HRQOL was impaired in uncontrolled patients [fasting plasma glucose [FPG]>130 mg/dL] in comparison with controlled patients [FPG?130 mg/dL] [P<.05]. HRQOL was lower in type 2 diabetic patients than controls and was affected by many factors. Females had lower HRQOL than males, possibly because of a higher incidence of obesity. Uncontrolled diabetic patients had a lower HRQOL than controlled diabetics. Improving HRQOL in diabbetic patients is important

Menopausal symptoms and quality of life

This study was to assess the association between menopausal symptoms and the women's quality of life [QOL]. An exploratory descriptive study was conducted at Faculty of Nursing, university of Alexandria. Subjects of the study included all employees of the previously mentioned setting aged between 40 to 55 years old. Assessment sheet, Menopause Rating Scale and Quality of Life scale are the tools for data collection. Findings revealed that those who had no psychological symptoms reported better quality of life [X=94.50 +/- 1 1.475] than those who had severe psychological symptoms [X=62.64 +/- 12.549]. The same results were observed with the somatic symptoms and urogenital symptoms, as the mean score of quality of life of those who had no somatic [X88.00 +/- 11.314] or urogenital symptoms [X=83.14 +/- 12.104] was higher than who had severe somatic [X=7531 +/- 11.026] or sever urogenital symptoms [X=68.50 +/- 12.021]. In relation to the total score of menopause rating scale and the total score of quality of life, it was found that better quality of life was reported among those who had no symptoms [X=88.00 +/- 1 1.314] or mild symptoms [X=88.04 +/- 11.314]. The results also revealed that there were statistically significant differences between the total score of quality of life and the number of living children [P<0.028], medical history of the woman [P<0.041], housing condition [P<0.001], and income [P<0.001]. It can be concluded that severity of menopausal symptoms has a negative association with overall quality of life. Increased number of children, presence of health problems, not suitable housing condition, and not enough income were negatively associated with QOL. Most of the quality of life domains are adversely affected by the presence of menopausal changes. Further researches are required to assess the intervention for pen-and postmenopausal women in context of their needs and expectation

Prevalence and pattern of skin disorders among female school children in Eastern Saudi Arabia

To determine the prevalence and pattern of skin disorders among female schoolchildren in primary and intermediate schools in Al-Khobar city, Eastern Saudi Arabia. This is a cross-sectional study conducted in Al-Khobar city, Kingdom of Saudi Arabia during the period from January-March 2003. It involved 2239 female schoolchildren randomly selected from 30 regular public and private primary and preparatory schools. We used a multi-stage stratified random sampling technique with proportional allocation. We collected data using a pre-designed structured questionnaire and clinical examination. The prevalence of skin diseases among female schoolchildren in Al-Khobar city was 98.6%. The most common skin disease and conditions group was the pigmentary disorders [91.6%], followed by a group of dermatitis/eczema and related conditions [26.7%], and disorders of skin appendages [25.3%]. The common skin diseases and conditions in this study were melanocytic nevi [MN] [68%], post-inflammatory pigmentation [56.6%], scars [26.8%], acne [22.5%], dandruff [18.1%], pediculosis capitis [5.2%] and eczema [3.1%]. Postinflammatory hyper/hypo pigmentation was more common among primary schoolchildren, whereas MN, dandruff, keratosis pilaris, acne and folliculitis were significantly more common among preparatory schoolchildren. The prevalence of skin disorders among female schoolchildren in Al-Khobar city was very high. Therefore, we recommended the introduction of a preventive health education program for schoolchildren at different levels and their families and teachers on skin diseases

p53 Mutation in HCV-genotype-4 associated hepatocellular carcinoma in Egyptian patients

HCV-associated hepatocellular carcinoma [HCC] is a common neoplasm in Egypt where genotype-4 is prevalent. In the present study the incidence and pattern of p53 mutations was assessed in relation to HCV-genotype-4 in Egyptian HCC patients. We investigated 25 HCV positive HCCs for p53 mutations over expression in relation to HCV-N53 by immunohistochemistry, SSCP and sequencing. Genotyping was done using LiPA-Il and TRUGENE 5 NC sequencing kit. Results were correlated to standard clinicopathologic prognostic factors for HCC. Thirteen cases showed p53 overexpression, and 10 showed p53 mutation [13 mutations] by sequencing [72% concordance]. The highest mutation rate was in exons 6 and 7 [30%] followed by exons 5 and 8 [20%]. Mutations included 3 transitions, 5 transversions, 3 deletions, and 2 insertions. All exon 7 mutations were at codon 249 specific for AFB1 [AGG-AGT, Arg-Ser] and codon 248 specific for vinyl chloride contamination [CGG-TGG, Arg-Trp]. Other mutations reported are novel. Immunostaining for HCV N53 was detected in 19 cases independent of p53 mutation. p53 aberrations were significantly associated with poor prognostic factors for HCC. However, no specific pattern for p53 mutations was observed in HCV genotype 4-associated HCC and no significant relation between p53 mutations, HCV-N53 expressions or any HCV sub-genotype-4 sequence

Genetic distance and heterogenecity between quasispecies is a critical predictor to IFN response in Egyptian patients with HCV genotype-4

HCV is one of the major health problem in Egypt, where it is highly prevalent. Genotype 4 is the most common genotype of HCV and its response to treatment is still a controversy. HCV genotype 4 quasispecies diversity within the 5' untranslated region [5'UTR] was studied in a series of 22 native Egyptian patients with chronic hepatitis C virus with no previous treatment who satisfied all NIH criteria for combined treatment of pegylated IFN and ribavirine and was correlated with the outcome of treatment. The study also included 7 control patients with no antiviral treatment. HCV sequencing was done using the TRUGENE HCV 5-NC genotyping kit. At the 48[th] week of treatment, 15 patients [68%] showed virological response. Whereas HCV-RNA was still detected in 7 patients [32%] in this period; of those, 6 experienced a partial virological response followed by viral breakthrough during treatment. Only one patient did not show any virological or chemical response. The four females included in this study were all responders. There was a significant correlation between the response rate and lower fibrosis [p=0.026] as well as the total number of mutation spots [including all the insertions, deletions, transitions and transversions] [p=0.007, p= 0.035]. Patients who responded to interferon treatment had statistically significant less number in both transitions [p=0.007] and the genetic distances between the quasispecies [p= 0.035]. So, viral genetic complexity and variability may play a role in the response to IFN treatment. The consensus alignment of all three groups revealed no characteristic pattern among the three groups. However, the G to A transitions at 160 was observed among non responders who need further study to confirm this observation

Bone turnover markers in infertile women and patients with endometriosis under gonadotropin releasing hormone agonist [GnRH-a] and with add-back therapy

Gonadotropin releasing hormone agonist [GnRH-a] induces an acute reversible inhibition of ovarian function with an increase in bone turnover and significant bone loss. This study was conducted to evaluate the bone turnover in women under single and multiple injections of GnRH-a and also to determine the role of add-back therapy on bone turnover. Patients and The present study was designed to include 80 female patients under single injection [40 cases] and multiple injections [40 cases] of long acting GnRH-a with and without add back therapy [add back therapy was nasal salmon calcitonin 200 I.U daily supplement of 1gm calcium daily]. Biochemical bone turnover markers [serum calcium, phosphorus, alkaline phosphatase, osteocalcin and urinary deoxypyridinoline] were estimated. Determination of serum calcium and phosphorus showed no significant differences after two weeks, three months and six months of GnRH-a therapy. Serum alkaline phosphatase level was of no significant difference after two weeks and also after three and six months in the groups with add-back therapy. But after three and six months in the groups without using add-back therapy, it was significantly elevated. Serum osteocalcin and urinary deoxypyridinoline showed no significant changes after two weeks, three and six months of GnRH-a therapy with add-back therapy. But these markers were significantly increased after three and six months in group under GnRH-a therapy without use add-back therapy. A routine survey for females under GnRH-a therapy is recommended to identify subjects of. accelerated bone loss. Such survey should include serum osteocalcin and urinary deoxypyridinoline as these methods are reliable markers of bone turnover. Add-back therapy proved to be an effective measure against the induced bone loss during GnRH-a therapy

Physicians' knowledge about evidence-based medicine in eastern Saudi Arabia

To explore the knowledge about Evidence-Based Medicine [EBM] among physicians, and to compare the results between hospitals and primary health care centers [PHCCs] physicians. This is a cross-sectional study conducted in May 2002 on all physicians in PHCCs and general hospitals in the Dammam area, Eastern Saudi Arabia. A random sample size of 409 physicians was chosen. The tool of data collection was a self-administered questionnaire. Score was used to assess physicians' knowledge. Out of the respondents, 39.6% had heard about the concept of EBM. Of these, 12% scored more than the cut-of point on the knowledge about EBM. Hospital physicians, scored significantly higher in knowledge than the PHC physicians. There was a low level of awareness of the meaning of critical appraisal and EBM web sites. Even, most of those who were aware did not use them. Physicians rated their knowledge about epidemiological terms higher than their actual knowledge. Results revealed a low level of knowledge in the concept of EBM among physicians, in spite of their awareness of its importance. Hospital physicians were more knowledgeable in EBM than PHC physicians were

Hepatitis c virus and hepatocellular carcinoma

Different etiological factors such as hepatitis viral infection, alcohol, aflatoxin and chemical carcinogens were mentioned in relation to HCC. However, the global distribution of HCC is strongly linked to the prevalence of hepatitis virus infection. The exact pathogenic mechanisms involved in viral-associated HCC are unclear although direct and indirect mechanisms are possible. Direct carcinogenicity is less certain in HCV-Induced HCC since it is a typical RNA virus and therefore the integration of viral genome into host cell chromosomes has not been shown to occur. However, the presence of two conserved potential nuclear localization signals and a DNA binding motif in the HCV core protein suggest a possible functional role as a regulatory element. Moreover, some studies demonstrated that this protein interacts with certain cellular proto-oncogenes at the transcriptional level, resulting in the promotion of cell proliferation and thus affecting normal hepatocyte growth. Therefore the pathogenesis of HCC may be attributed at least in part to the upregulation of hepatocyte growth induced by HCV core protein and other viral proteins like NS3 and NS5. However, the process of malignant transformation represents a dynamic interplay between classes of genes; oncogenes, tumor suppressor genes, mismatch repair genes, genes controlling apoptosis and cell cycle regulatory genes. In conclusion, since the exact mechanism of action of HCV in the context of HCC is still poorly understood, clarification of the molecular basis of viral replication in hepatocytes, the possible genetic and cytogenetic abnormalities that may be induced by the virus were emphasized in this review. Moreover, early detection of hepatocellular changes by molecular biomarkers may help to detect individuals at high risk of development HCC, thus allowing more effective intervention for cure or prevention

Obstructive sleep apnea syndrome among a noring community

To evaluate the relation between snoring and the presence of obstructive sleep apnea [OSA] in terms of relevant health parameters and questionnaire responses. Selective random sampling within a household survey in the cities of Al-Khobar and Dammam, Kingdom of Saudi Arabia over a 3 month period during the year 2000, was carried out. One hundred and fifty-two persons, aged 17-62 years, with a positive history of snoring as determined by the spouse or other members of the family were selected. The presence of OSA was determined using the Epworth sleepiness scale [ESS]. The predictors included age, gender and body mass index. Snoring was found to be more associated with OSA as suggested by ESS in the study sample. The severity of snoring and its pattern are more associated with apneic patients. Snoring is common and may be a serious medical problem. This study revealed that snoring is associated with symptoms suggesting OSA syndrome as detected by ESS. The family doctor and his team should be aware of the condition, using simple screening test such as ESS, improves the patient care, and finding of suspected cases

Treatment-related misconceptions among diabetic patients in western Saudi Arabia

To describe the types and pattern of treatment-related misconceptions among Primary Health Care Centers [PHCCs] registered diabetic patients in Makkah, Kingdom of Saudi Arabia. A sample of 1039 PHCCs registered diabetic patients were interviewed using a structured questionnaire, concerning diabetic treatment-related misconceptions. This cross-sectional study was carried out in Makkah city, Kingdom of Saudi Arabia from May 2000 to September 2000. A scoring system was used to document the frequency of misconceptions. The relationship of misconceptions to socio-demographic and diabetes-related variables were assessed using chi-squared tests. Four hundred and five [39%] patients had a high treatment misconception score. The score was significantly higher among females than males [P< 0.00001], and also among patients older than 35 years [P< 0.05]. There were no statistically significant differences between Saudis and non-Saudis, or in association with different education levels. Also, the score was significantly higher among patients with a shorter disease duration [P<0.04], and among patients who did not enjoy continuity of care [P<0.00001]. Patients' misconceptions were mostly related to reasons for stopping medications. Moreover, patients thought that cure from diabetes was expected following a short course of treatment [16.5%] and that one could eat what he or she liked as long as medications were taken [23%]. The results of this study showed the rate of treatment-related misconceptions to be high. It stresses the need for constant motivation and one on one level education at frequent intervals to encourage better knowledge regarding the disease and subsequent compliance to treatment

Estimating parameters in epidemiological and occupational models in the presence of multicollinearily Amonte-Cario stusy

Multiple linear regression [MLR] is a popular used method of estimate parameters in epidemiological and occupational surveys. Multicollinearity happens when the predictive variables are often highly correlated with each other, so that the influence of one cannot be separated from that of another and may yield unstable and not easily interpreted regression estimates. It results in inflated estimates with a high variance and reverse signs, and makes it difficult to determine the importance of any of the predictors due to the high correlation among them. To handle multicollinearity, there are 2 famous approaches, the first technique is dropping one or more of the offending variables from MLR and the second is using an artificial orthogonalization through any form of factor analysis. Both approaches have been proven to be unsatisfactory. This study demonstrated, through simulation, that using ridge regression [RRM] overcomes the problem of multicollinearity and produces more stable and closer estimates to the true values of the coefficients which the analysts are trying to develop

Teaching Biostatistical concepts to health professionals an evaluation of workshops of basic biostatistics with computer application

Health professionals are considered consumers of biostatistical methods throughout their career. Many of health professionals are not familiar enough with biostatistical techniques, and their appropriate uses in their fields. The widespread use of personal computers in the last 2 decades, made it easy for such professionals to apply some statistical tests in their work without knowing the basic assumptions behind each test, and when, where and how to use each test properly in most of the cases. A workshop of basic biostatistics with computer applications has been developed to suite the basic needs of health professionals to be familiar with biostatistical tests and how to use a statistical package to conduct the simple required analysis. Evaluation of the workshops showed that the participants statistical knowledge, and interpretation of statistical results has significantly increased following such workshops, post-tests, compared to pre-tests [P <0.01]. The mathematics, and computer phobia of the participants were faced, and by the end of the workshops, participants gained confidence necessary for carrying out their data analysis. The study recommended conducting such workshops, and that more statistical applications on the computer is proper for health professionals