ObjectiveThe aim of this study was to determine the prevalence of anabolic androgenic steroid (AAS) use among athletes and examine the extent of their knowledge on the effects of AAS in Riyadh, Saudi Arabia.MethodsThis cross-sectional study was conducted at gyms in Riyadh, Saudi Arabia, during 2015. In total 600 athletes from three gyms participated in the study. The study included Saudi and non-Saudi athletes chosen by the simple random sampling method. A self-reported questionnaire was used for data collection. The questionnaire was designed to study the prevalence and assess the knowledge of athletes regarding AAS use. Frequency and percentage distributions were used to describe the data. Comparison between the subgroups was made with a chi-square test.ResultsThe percentage of AAS users was 30.5%. The age of AAS users ranged from 15 to 49 years with the majority (52.5%) belonging to age group of 25–29 years. Approximately 20% of the users admitted using AAS due to body dysmorphia as their best motivational factor; in addition, they also believed that there are no side effects of the use. Among the nonusers, 40% had appropriate knowledge, while all the AAS-users had inadequate knowledge about the adverse effects of AAS. Moreover, 77% of the users would recommend AAS to their friends but none from the nonusers. A significant difference in age distribution (df = 5, p<0.001) and knowledge (df = 4, p< 0.001) between users and nonusers was observed.ConclusionMost athletes were ignorant of the harmful side effects of the drug but still continued to use and promote it to other athletes. These athletes should intensify their knowledge and awareness regarding the use of AAS and its effects on the body.

Background: The imapct of Kangaroo Mother Care (KMC) in neonates is positively reported in the literature. However, several challenges hindered the wide-scale application of this practice. Objectives: To assess the levels of knowledge and competency of kangaroo mother care (KMC) among nurses and to identify the potential barriers to practice. Methodology: Structured web-based questionnaires were submitted to nurses working at neonatal intensive care units (NICUs) located in Riyadh, Saudi Arabia. The participants were asked to answer 23 questions distributed in four main domains, namely, demographic data, knowledge about KMC, practice levels, and barriers to KMC practice. For answers to the knowledge and barriers to practice domains, the mean scores (standard deviations) were calculated to present participants' perceptions and beliefs from 1 (strongly disagree) to 5 (strongly agree). Results: Two hundred nine NICU nurses responded (95.2% females, 89.5% working in a government hospital, 69.9% obtained a Bachelor's degree). The majority of respondents perceived KMC as promoting maternal-infant bonding (4.47 ± 1.3) and enhancing successful breastfeeding (4.44 ± 0.9), while there were considerable uncertainties about KMC application in infants weighing < 1000 g (2.21 ± 1.2). Most of the nurses encouraged parents to perform KMC (92.8%) and provided sufficient information to optimize practice (90%). However, several barriers were apparent, including fear of accidental extubation, lack of time due to workload, familial reluctance to initiate KMC, and lack of privacy during KMC practice. Conclusion: There is reasonable knowledge among NICU nurses, and most of them are actively engaged in practice. There is an urgent need to address the reported barriers through the implementation of clear practice guidelines, provision of suitable educational programs, optimization of staff numbers, and financial support for the development of areas conducive to KMC.

Background and objectives: Research provides skills for lifelong learning and promotes patient care. In Saudi Arabia, until recently, research training has not been integrated effectively in postgraduate medical education. The aim of this study was to investigate the factors involved in research training, productivity, challenges and attitude among trainees in paediatric residency programs across Saudi Arabia. Materials and methods: This is a cross-sectional, multicentre study using a questionnaire designed to assess several aspects of research training among trainees of the national paediatric residency program in Saudi Arabia from September to December 2013. Results: Eighty-three residents from seven training centres participated (response rate of 65.5%). Ninety percent of participants agreed that research training must be mandated in each residency program. The majority of participants (85.5e89.2%) agree that research is beneficial because it improves patient care, enhances the pursuit of academic careers, and improves fellowship acceptance rates and success. More than half (51.8%) of participants believe that research training will interfere with their efforts to become a medical expert in their fields. The survey indicated low research involvement by trainees, with 86.7% of participants having never published scientific manuscripts. The majority of participants (73.5%) reported a lack of regular, structured research activity in their training curriculum. The main challenge in research training was the lack of protected time (according to 86.7% of respondents). The majority of participants (85.6%) agreed that training in research methodologies represents their top educational need. Conclusion: This study represents a "needs assessment" phase in the development of a research training curriculum for the Saudi paediatric residency program. The majority of

Background and objectives: Metered-dose inhalers plus spacers (MDI-spacer) are as effective as, or better than, nebulizers in aerosol delivery. The selection of aerosol delivery system for hospitalized children can have a significant impact on the utilization of healthcare resources. Design and setting: A quality improvement project to evaluate the impact of conversion to MDI-spacer to administer bronchodilators (BDs) and inhaled corticosteroids (ICSs) to hospitalized children on the utilization of hospital resources. The project was conducted in a tertiary pediatric ward from April to May 2013. Materials and methods: The project was conducted over a six-week period. In the first two weeks, data were gathered from all hospitalized children receiving BDs and/or ICSs by nebulizers. This data collection was followed by a two-week washout period during which training of healthcare providers and operational changes were implemented to enhance the conversion to MDI-spacer. In the last two weeks, data were gathered from hospitalized children after conversion to MDI-spacer. The primary outcomes included the mean time (in minutes) of medication preparation and delivery. Secondary outcomes included the following: need for respiratory therapy assistance, estimated cost of treatment sessions, and patient/caregiver satisfaction. Results: Five hundred seventy-five treatment sessions were enrolled (288 on nebulizers, 287 on MDI-spacer). The nebulizer group had more male predominance and were slightly older compared to the MDI-spacer group (male: 59% vs. 53% and mean age: 52 vs. 40 months respectively). The duration of treatment preparation and delivery was significantly lower in the MDI-spacer group (2 min reduction in preparation time and 5 min reduction in delivery time; p < 0.01). Caregivers mastered MDI-spacer use after an average of two observed sessions, eliminating the need for respiratory therapy assistance during the hospital stay. Medication cost analysis showed savings in favor of MDI-spacer (cost reduction per 100 doses: 50% for albuterol, 30% for ipratropium bromide, and 87% for ICSs). The patient satisfaction survey showed "very good" to "excellent" levels in both groups. Conclusions: Conversion to MDI-spacer for BDs and ICSs administration in hospitalized children improve hospital resource utilization.

BackgroundProblem-based learning (PBL) is a method by which students solve clinical scenarios in a small group discussion. The aim of this study was to assess the implementation of PBL in Saudi Universities.MethodsThis is a cross-sectional study including 151 participants from 16 universities. A questionnaire was distributed to the faculty members through e-mail messages. The questionnaire consisted of 35 questions with 5-point Likert scale arranged in three subscales.ResultsThe total mean of PBL implementation score was 2.5 (SD =0.39). The scores of the three PBL implementation subscales showed marked variance, with the average score of the subscale “overall PBL experience in my college” being the most highly affected, with an average score of (3.07, SD =0.72), followed by “implementation of PBL model” (2.36, SD=0.47). The least affected subscale was “preparation for PBL implementation” (2.13, SD =0.67).ConclusionRelatively moderate level of PBL implementation was observed in Saudi Arabia. However, we suggest that more courses should be introduced in order to improve the skills of faculty members and provide a strong infrastructure to implement PBL model in Saudi medical colleges.