Background: The ACTION IO study (NCT03584191) aimed to identify perceptions, attitudes, behaviors, and potential barriers to effective obesity care across people with obesity (PwO) and healthcare professionals (HCPs). Results from Saudi Arabia are presented here. Methods: A survey was conducted from June to September 2018. In Saudi Arabia, eligible PwO were ≥18 years with a self reported body mass index of ≥30 kg/m2. Eligible HCPs were in direct patient care. Results: The survey was completed by 1,000 PwO and 200 HCPs in Saudi Arabia. Many PwO (68%) and HCPs (62%) agreed that obesity is a chronic disease. PwO felt responsible for their weight management (67%), but 71% of HCPs acknowledged their responsibility to contribute. Overall, 58% of PwO had discussed weight with their HCP in the past 5 years, 46% had received a diagnosis of obesity, and 44% had a follow up appointment scheduled. Although 50% of PwO said they were motivated to lose weight, only 39% of HCPs thought their patients were motivated to lose weight. Less than half of PwO (39%) and HCPs (49%) regarded genetic factors as a barrier to weight loss. Many PwO had seriously attempted weight loss (92%) and achieved ≥5% weight loss (61%), but few maintained their weight loss for >1 year (5%). Conclusion: Saudi Arabian results have revealed misperceptions among PwO and HCPs about obesity, highlighting opportunities for further education and training about obesity including the biologic basis and clinical management.

IntroductionObesity presents a significant public health problem. Brain plays a central role in etiology and maintenance of obesity. Prior neuroimaging studies have found that individuals with obesity exhibit altered neural responses to images of food within the brain reward system and related brain networks. However, little is known about the dynamics of these neural responses or their relationship to later weight change. In particular, it is unknown if in obesity, the altered reward response to food images emerges early and automatically, or later, in the controlled stage of processing. It also remains unclear if the pretreatment reward system reactivity to food images is predictive of subsequent weight loss intervention outcome.MethodsIn this study, we presented high-calorie and low-calorie food, and nonfood images to individuals with obesity, who were then prescribed lifestyle changes, and matched normal-weight controls, and examined neural reactivity using magnetoencephalography (MEG). We performed whole-brain analysis to explore and characterize large-scale dynamics of brain systems affected in obesity, and tested two specific hypotheses: (1) in obese individuals, the altered reward system reactivity to food images occurs early and automatically, and (2) pretreatment reward system reactivity predicts the outcome of lifestyle weight loss intervention, with reduced activity associated with successful weight loss.ResultsWe identified a distributed set of brain regions and their precise temporal dynamics that showed altered response patterns in obesity. Specifically, we found reduced neural reactivity to food images in brain networks of reward and cognitive control, and elevated reactivity in regions of attentional control and visual processing. The hypoactivity in reward system emerged early, in the automatic stage of processing (< 150 ms post-stimulus). Reduced reward and attention responsivity, and elevated neural cognitive control were predictive of weight loss after six months in treatment.DiscussionIn summary, we have identified, for the first time with high temporal resolution, the large-scale dynamics of brain reactivity to food images in obese versus normal-weight individuals, and have confirmed both our hypotheses. These findings have important implications for our understanding of neurocognition and eating behavior in obesity, and can facilitate development of novel integrated treatment strategies, including tailored cognitive-behavioral and pharmacological therapies.

No abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen of clinical significance within the community and healthcare settings. It has been reported with a variety of infections, including endocarditis, bloodstream infections, pneumonia, joint and bone infections, and soft tissue and skin infections. Although many efforts have been exerted to eradicate the rates of infections and studies have reported a decreasing pattern in the prevalence rates over the years, it has been demonstrated that MRSA represents a significant challenge to the healthcare systems and the affected patients. In this literature review, we have provided a discussion regarding the risk factors, screening, and treatment of MRSA among healthcare workers (HCWs) based on the evidence obtained from the current relevant studies in the literature. HCWs are at increased risk of MRSA colonization, and many risk factors have been identified. These mainly include poor hygiene practices, chronic skin diseases, and having a history of working in an MRSA-endemic country. Decolonization practices are the main line of treatment of MRSA colonization among HCWs because antibiotic therapy is usually of limited use because of the increasing resistance to a wide range of antibiotics. Applying adequate interventions as taking care of hand hygiene and using alcohol-based disinfectants is recommended to achieve better outcomes. Increasing awareness among HCWs is also a potential approach to achieve better management.

No abstract