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Using a mobile phone is increasingly becoming recognized as very dangerous while driving. With a smartphone, users feel connected and have access to information. The inability to access smartphone has become a phobia, causing anxiety and fear. The present study’s aims are as follows: first, quantify the association between nomophobia and road safety among motorists; second, determine a cut-off value for nomophobia that would identify poor road safety so that interventions can be designed accordingly.

Participants were surveyed online for nomophobia symptoms and a recent history of traffic contraventions. Nomophobia was measured using the nomophobia questionnaire (NMP-Q).

A total of 1731 participants responded to the survey; the mean age was 33 ± 12, and 43% were male. Overall, 483 (28%) [26–30%] participants received a recent traffic contravention. Participants with severe nomophobia showed a statistically significant increased risk for poor road safety odds ratios and a corresponding 95% CI of 4.64 [3.35-6.38] and 4.54 [3.28-6.29] in crude and adjusted models, respectively. Receiver operator characteristic (ROC)-based analyses revealed that NMP-Q scores of = 90 would be effective for identifying at risk drivers with sensitivity, specificity and accuracy of 61%, 75% and 72%, respectively.

Nomophobia symptoms are quite common among adults. Severe nomophobia is associated with poor road safety among motorists. Developing screening and intervention programs aimed at reducing nomophobia may improve road safety among motorists.

Bullying negatively affects victims’ mental health and has been shown to be associated with anxiety and depression. Moreover, many studies have reported the prevalence of mistreatment among medical students (MS), interns and junior physicians. However, there are limited studies on bullying in the Middle East, and no studies on higher education in Bahrain. The authors’ aim was to investigate and compare the prevalence of bullying between MS at a major public university and non-medical students (NMS) at a private university in Bahrain. The authors also sought to explore the associations between bullying, depression and anxiety.

The authors conducted a survey-based cross-sectional study from October 1 to December 31, 2018, using convenient sampling method. A total of 300 students (150 MS and 150 NMS) participated in the study by answering a questionnaire that explored exposure to different types of bullying. In addition, standard anxiety and depression instruments were distributed to students.

The results showed that MS were more exposed to bullying than NMS, with a significant number (41%) reporting mistreatment from multiple sources, including teachers, consultants and peers. Furthermore, the authors found that bullying was significantly correlated with psychological health, anxiety and depression.

There are limited studies on bullying in the Middle East and no studies on the topic of higher education in Bahrain. Furthermore, the learning environment of tertiary education institutions can be improved by addressing the concerns associated with bullying identified in this study.

This paper aims to translate and validate an Arabic version of the Barriers to Access to Care Evaluation (BACE) BACE scale to make it appropriate for the targeted socio-cultural and linguistic context.

This psychometric study has two main compounds: translating the BACE into Arabic and validating it. Using the back-translation method, the authors involved seven professional individuals to maximize the efficacy of the translated version. The authors began with the process of translating the scale from English into Arabic and vice versa followed by evaluation, compression and matching. Later, a pilot study with a sample size of 35 participants was conducted to receive feedback on the Arabic version of the scale. Finally, an online survey was generated and distributed among Arabic-speaking countries; a total of 630 participants were voluntarily involved in this study.

A total of 630 participants completed the survey with a mean age of 31.4 ± 12.9, and 402 (63.8%) were females. Cronbach’s alpha coefficient and McDonald's Omega coefficient were both greater than 0.9. The confirmatory factor analysis was found to fit highly satisfactory with the stigma-related barriers.

The BACE was validated in Arabic and its psychometric properties were examined in-depth and found to be strong.

This paper fulfils an identified need to translate tools to make mental health more accessible to patients in need.

This study aims to investigate the association between vitamin D measured in serum 25 hydroxyvitamin D [25(OH)D] and outcomes of COVID-19 patients in Bahrain. This paper hypothesized that lower serum 25(OH)D concentration in COVID 19 patients is associated with longer viral clearance time (VCT) and higher risk of admission to the intensive care unit (ICU).

This study used a retrospective cohort design of patients admitted to Salmaniya Medical Complex, Manama, Kingdom of Bahrain, from February to June 2020. This study included patients with positive, confirmed COVID-19 diagnosis made using reverse transcription-polymerase chain reaction (RT-PCR), World Health Organization diagnosis manual and local diagnostic guidelines. Primary outcome measures were: VCT measured as the time in days between the first positive RT-PCR test result and the first of two consecutive negative RT-PCR results on recovery and admission need to ICU.

A total of 450 patients were analyzed; mean age was 46.4 ± 12.4 years and 349 (78%) were men. Mean 25(OH)D concentration was 41.7 ± 23.7 nmol/L for the entire sample. Severe vitamin D deficiency (<25 nmol/L) was present in 20%, mild-to-moderate deficiency (25–50 nmol/L) in 55%, insufficiency (50 to <75 nmol/L) in 18% and sufficiency (=75 nmol/L) in 7%. The mean VCT was 12.9 ± 8.2 days. Multivariate linear regression analysis showed that severe vitamin D deficiency was associated with longer VCT, with an average of three extra days after correction for age and sex (β = 3.1; p = 0.001). Multinomial regression analysis showed that vitamin D deficiency was associated with an 83% increased risk of admission to ICU after correction for age and sex (odds ratio = 1.8; p = 0.03).

The results showed that severe vitamin D deficiency was associated with longer recovery time from COVID-19. Low serum 25(OH)D is associated with increased need for critical care in an ICU. Large-scale randomized controlled trials are necessary to further investigate the complex association between vitamin D and COVID-19 infection.

This study aimed to assess the influence of the community-based campaign on weight loss and healthy lifestyle adoption among Bahrain's adult population.

A cross -sectional self-reported online questionnaire completed in February 2021. The survey evaluated the impact of the community-based campaign health program which includes (exercise, diet plan and psychological eating behavior) weight reduction using social media platforms. The authors employed data from young and middle-aged healthy adults (n = 842) between the ages of 18-55 years, of both sexes. The intervention group (n = 842) was made up of the supporters of the voluntary community initiative called Obesity does not Suit Me (n = 194), and the control group (n = 648) was made up of non-followers of the campaign.

The study showed a statistically significant difference among the followers of the community-based campaign health program in the following parameters: 3.90-4.23 kg less, 1.46-1.59 difference in BMI and 0.05-0.06 WHR. All changes were of low effect size.

Diet and exercise had significant impact on weight, BMI and WHR among the followers of the community campaign. However, more research is required for sponsorship to increase the motivation and rewards for the community campaign.

The COVID-19 pandemic has had a significant impact on medical education and training, with many medical schools and training programs having to adapt to remote or online learning, social distancing measures and other challenges. This paper aimed to examine the disruption for clinical training, as it has reduced the opportunities for students and trainees to gain hands-on experience and interact with patients in person.

The ethnographic qualitative research design was chosen as the research methodology. Using Gibbs' reflective cycle, the researcher explored the psychiatry clerks' (final-year medical students) reflections on the disruption of their clinical training during the COVID-19 pandemic.

The findings demonstrated that the students had a significant psychological impact on their coping capacities as the crisis progressed from shock and depression to resilience. The students being the key stakeholders provided a concrete foundation for the development of a framework for improving practices during uncertain times.

Students' reflections provided valuable insight into the pandemic’s impact on their psychosocial lives with uncertainty and incapacity to cope up with changing stressful dynamics. The results will assist in planning how to best support medical students' well-being during interruptions of their educational process brought about by similar future crises.

This study aims to investigate the antihypertensive effect of camel milk hydrolysate in rats with fructose-induced hypertension.

The antihypertensive effect of fermented camel milk was determined using 6 groups comprising 36 Wistar male rats. Blood pressure of rats was altered via exposure to a 10% fructose (w/v) diet in drinking water for 3 weeks before conducting 21 days of treatment. The authors conducted the experiment for short and long term using different doses of 800 and 1,200 mg/kg body weight. Serum was used to assay total cholesterol (TC), triglyceride (TG), glucose and insulin levels using standard biochemical kits.

The group that received 1,200 mg hydrolysate camel milk (HM) has significantly (p = 0.003) reduced systolic and diastolic blood pressure after a short exposure time (4–8 h). These effects were significantly (p = 0.005) comparable to the nifedipine (NIF) drug group. Similar long-term (21 days) effects on blood pressure were observed in 1,200 mg HM and NIF groups. Angiotensin-converting enzyme (ACE) activity and levels were also reduced in a correlation with blood pressure reduction only in HM1200 and HM800 treated groups. The authors observed no significant effect on blood pressure in groups receiving the 800 mg HM or 1,200 mg unhydrolyzed camel milk (UM). Rats receiving the 10% fructose diet showed significant differences from control rats regarding their blood biochemistry, including TG, TC, blood glucose and insulin levels. Rats in groups NIF, HM1200 and HM800 showed a significant (p < 0.05) reduction in serum glucose, insulin, TG and TC levels toward the baseline level.

Further mechanistic investigation on the HM antihypertensive activity is highly recommended before suggesting HM as a product to reduce blood pressure. While drug–food interaction between HM and antihypertensive drugs, especially ACE inhibitors, is probable, UM seems not to affect blood pressure or ACE activity and therefore is expected to have no or minimal effects on the activity of other antihypertensive drugs. Investigation of ACE expression from various organs including lungs and leukocytes is highly recommended in future works using sodium dodecyl-sulfate polyacrylamide gel electrophoresis and western blot analysis or reverse transcription polymerase chain reaction.

No previous studies have measured the antihypertensive activity of milk hydrolysate mediated by the reduction of ACE activity and levels in plasma. Mechanisms involved in attenuating the levels of ACE warrant further investigation.

The complex interaction between the gut flora and central nervous systems made probiotics one promising natural candidate for the management and treatment of depression. Hence, the purpose of this paper was to assess the knowledge, patterns of consumption and attitudes of patients with depression toward probiotics.

In this cross-sectional study, and through simple random sampling, 200 adults who were diagnosed with various depressive symptoms were selected. A link to a self-reported survey was sent to them with the aim of collecting sociodemographic data, assessing participants’ attitudes and knowledge toward probiotic consumption, and measuring their depression status via the Patient Health Questionnaire (PHQ-9).

A total of 164 participants (82%) provided usable responses. Approximately 55% of participants had moderate depression (PHQ-9). Participants (22.6%) tend to comply with their psychiatrists’ advice regarding probiotics more than other health specialists’ advice (p = 0.04). Only 59 (36%) had knowledge about probiotics and believed that probiotics should be consumed regularly and not only after an antibiotic course. However, many tended to follow marketing tricks and were willing to buy the most expensive and advertised probiotic products. Participants showed some differences in their attitude and knowledge toward probiotics according to symptoms severity; however, the differences were insignificant (p = 0.88).

To the best of the authors’ knowledge, this study is believed to be the first investigation assessing the probiotics’ knowledge, patterns of consumption and attitude of patients with various depression symptoms in Bahrain. The findings of this study may help improve the well-being of depressive patients by addressing the probiotic knowledge gap among them, expand the market of probiotics and enrich nutritional psychiatry literature.

Vending machines (VMs) provide quick access for snack foods and beverages for students during their study days. These vended foods have been reported to affect the student's nutritional status and contributing to obesity by increasing the caloric intake. This study aimed to evaluate the nutritional value of snacks and beverages provided by VM at the university campuses.

A cross-sectional observational study in one large urban university with four campuses was conducted. In total, 55 VMs were found distributed over 50 buildings of the four university campuses. Of the vending slots surveyed, only 57 snacks and beverage food items were found repeated. These items were vended and analyzed using nutrient databases, and their nutritional quality was assessed using nutrient adequacy ratio and nutritional quality score.

Most vended snacks were salty (77%) and sweet (23%). Neither snacks nor beverages were nutrient-dense, and the majority (65%) of snacks and beverages were calorie-dense, with high contents of sugar, sodium and saturated fat; while they were low in vitamins C and A, calcium, iron, sodium, protein and dietary fibers. None of the vended beverages met the low calorie, low sugars and high-fiber criteria.

One limitation of the current work is represented in the fact that VM snacks and beverages are not fixed throughout the year days, and exposed to continuous changes, depending on the customers' attitudes and economic and financial considerations related to the operating contractor company and the customer students. Thus, a continuous, long-term evaluation is suggested to be conducted for a more representative and reflective evaluation of the nutritional quality of vended snacks and beverages.

Poor nutritional quality has been found for vended foods. Healthier food options should be provided to improve students' dietary intake.

Attention has to be directed toward the nutritional quality of VM foods, and how to provide adolescents and young adults with healthy options.

This is the first study conducted in the United Arab Emirates (UAE) and Gulf Cooperation Council countries (GCC) assessing the nutritional value of vending machine foods in university settings.

Global developmental delay (GDD) is highly prevalent among patients at child psychiatry clinics. However, preschool day treatment centers are currently scarce. As such, this study aimed to evaluate a program that was designed for children with GDD in order to improve their global skills and prepare them to join the school system.

This study utilized an observation retrospective design with a comparative group sample and included all children aged between 3 and 6 years who participated in the program for at least one academic year (experimental group). Their GDD diagnoses were based on the DSM-5 criteria (Diagnostic and Statistical Manual of Mental Disorders). Children with similar diagnoses who were on the waiting list constituted the control group. Pre- and post-scoring of the Children’s Global Assessment Scale (CGAS) were conducted by the children’s teacher and blinded investigator for the experimental group, while the children’s mothers conducted the post-CGAS scoring for the control group.

The pre- and post-CGAS scores for the experimental group were 49.5 ± 12.8 and 58.3 ± 12.7 and 47.3 ± 17.3 and 66.6 ± 17.3 for the control group, respectively (p = 0.001). The children in the experimental group scored significantly better than the control group with respect to securing places in integrated, regular classes in the education system (p = 0.001).

This study had certain limitations. First, the number of children in the control group was relatively small. Second, the baseline skill levels of some of the children in the control group may have been lower than those of the children in the experimental group at the beginning of the evaluation; this may explain why they had been put on the waiting list. Third, the information was gathered retrospectively; this is a method that is known to have its own limitations.

The clinical implications of the study are that the early identification and referral of GDD are key elements in the rehabilitation of these children and that early intervention programs are necessary for cases of moderate and severe GDD. Primary care physicians should follow up with GDD patients to ensure that referrals are being appropriately sought (Choo et al., 2019).

The program was effective in both increasing the general functioning skills of the children in the experimental group and preparing them to attend regular, integrated classes. The program should be expanded and made available to more children with GDD.