King Saud Medical City (KSMC) is a quaternary care center based in the center of the capital city, Riyadh, Kingdom of Saudi Arabia (KSA) and is one of the key Ministry of Health (MoH) facilities dedicated to the care of COVID-19 patients in the central region.

A comprehensive surge plan was promptly launched in mid-March 2020 to address the pandemic and then expanded in a phase-wise approach. Supporting the capacity of the infection prevention and control department (IPCD) was one of the main pillars of KSMC surge plan. Task force Infection Control teams have been formulated to tackle the different aspects of pandemic containment processes. The challenges and measures undertaken by the IPC team have been described.

Realizing the more prominent role of infection prevention and control staff as frontline responders to public health emergencies like COVID-19, a solid infection prevention and control system at the healthcare setting supported by qualified and sufficient manpower, a well-developed multidisciplinary team approach, electronic infrastructure and efficient supply utilization is required for effective crisis management.

The Radiation Injury Treatment Network (RITN) is prepared to respond to a national disaster resulting in mass casualties with marrow toxic injuries. How effective existing RITN workforce education and training is, or whether health-care providers (HCPs) at these centers possess the knowledge and skills to care for patients following a radiation emergency is unclear. HCP knowledge regarding the medical effects and medical management of radiation-exposed patients, along with clinical competence and willingness to care for patients following a radiation emergency was assessed.

An online survey was conducted to assess level of knowledge regarding the medical effects of radiation, medical/nursing management of patients, self-perception of clinical competence, and willingness to respond to radiation emergencies and nuclear events.

Attendance at previous radiation emergency management courses and overall knowledge scores were low for all respondents. The majority indicated they were willing to respond to a radiation event, but few believed they were clinically competent to do so.

Despite willingness to respond, HCPs at RITN centers may not possess adequate knowledge of medical management of radiation patients, and appropriate response actions during a radiation emergency. RITN should increase the awareness of the importance of radiation education and training.

Their average age at admission was 65.7. Thirty-six patients had a diagnosis of chronic psychosis, two with bipolar disorders, one with frontotemportal dementia, two with Korsakoff syndrome.

At admission, 21 (51%) patientsshowed mild cognitive deterioration (score = 18–26), 12 (29%) moderate deterioration (12–17), 6 severe deterioration (0–11), 2 had normal scores (27–30). Over the following years, 28 patients were reassessed:

– 12 (42%) were stable, 7 (25%) had a fluctuating score, 5 (18%) improved;

– 4 (14%) deteriorated over their successive MMS evaluations;

– age, socio-cultural level and psychiatric diagnosis were not associated with change in MMS scores;

– average change between initial and final assessment was +6.0 points for patients with improved score, –7.75 for those showing deterioration;

– 1.28 for those with fluctuating scores, –1.0 for stable patients.

Unstable psychiatric disorders associated with somatic pathologies influenced MMS scores for all patients, particularly for those with MMS deterioration or fluctuation even if this phenomenon could also be observed to a lesser extent in stable patients. By contrast, patients whose MMS scores improved over time were more mentally stable and had no current somatic problems. Multidisciplinary teamwork is important for patients with deteriorating MMS scores.

By illustrating the impact of somatic and psychiatric factors on dementia, the present study underlines the value of multidisciplinary professional care, the role of the family and the importance of long-stay wards.

The authors have not supplied their declaration of competing interest.

Large scale radiologic and nuclear disasters are rare; however, recent events such as the Fukushima Daiichi nuclear reactor emergency in Japan and current global political tensions have highlighted the need for health-care providers with expertise in managing radiation injuries. Medical Toxicologists have the ability to collaborate with other specialists in filling this critical role.

We conducted a cross-sectional survey to assess the attitudes, experiences, and knowledge of medical toxicologists through the assistance of the American College of Medical Toxicology.

The survey was completed by 114 medical toxicologists during the enrollment period. Medical toxicologists who had a willingness to participate in radiologic or nuclear emergencies or who had taken care of patients contaminated with radioactive material were more likely to perform well on the knowledge assessment.

We identified that there is a group of medical toxicologists who have the willingness, experience, and knowledge to help manage patients in the event of a radiologic or nuclear emergency.

The device standardized infection ratio (SIR) is used to compare unit and hospital performance for different publicly reported infections. Interventions to reduce unnecessary device use may select a higher-risk population, leading to a paradoxical increase in SIR for some high-performing facilities. The standardized utilization ratio (SUR) adjusts for device use for different units and facilities.

We calculated the device SIR (calculated based on actual device days) and population SIR (defined as Σ observed events divided by Σ predicted events based on predicted device days), adjusting for the facility SUR for both central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) in 84 hospitals from a single system for calendar years 2016 and 2017.

The central-line SUR was 1.02 for 801,172 central-line days, with a device SIR of 0.76 and a population SIR of 0.78, a 1.6% relative increase. On the other hand, the urinary catheter SUR was 0.90 for 757,504 urinary catheter days, with a device SIR of 0.84 and a population SIR of 0.76, a 10.0% relative decrease. The cumulative attributable difference for CAUTI to a target SIR of 1 was −135.4 for the device SIR compared to −203.66 for the population SIR, a 50.8% increase in prevented events.

Population SIR accounts for predicted device utilization; thus, it is an attractive metric with which to address overall risk of infection or harm to a patient population. It also reduces the risk of selection bias that may impact the device SIR with interventions to reduce device use.

Public health (PH) and nursing students are an underutilized demographic in disaster response. Knowledge of the disaster response phase may enhance student understanding of preparedness, and provide response capabilities.

A single four-hour simulation-based training session, with toxicologists as instructors, can effectively improve PH and nursing student knowledge and skills in chemical and radiation response, despite minimal prior experience.

A convenience sample was used to test PH and nursing students in a response training program. An introductory lecture and simulation training reviewed: mass casualty care, triage, personal protective equipment, decontamination, and chemical and radiation exposure toxidromes. An examination was administered pre-training, and then post-training, to evaluate relevant training, knowledge, risk perception, and comfort in response capabilities to chemical and radiation incidents.

Forty-two students attended the course; 39 were included in the study. Seventy-two percent (n=28) of participants had no prior disaster training. Overall, there were significant differences between the pre-test and post-test scores for all students [95% CI: 5.4 (4.7-6.1); p<0.0001, paired t-test]; maximum score 15/15. Comparing scores of nursing and PH students, despite statistical difference in pre-test scores (median, IQR: 9.0 (7.5-10±2.0); 7.0 (5.7-9.0) respectively; p=0.048, Mann Whitney U-test), there were no statistical differences in post-test scores (median, IQR: 14.0 (13.0-14.0); 13.0 (12.0-14.0), respectively, Mann Whitney U-test). All students recognized nerve agent toxidrome and performed SALT triage after the training (p <0.0001, McNemar test). Subjectively, participant comfort level in responding to a chemical or radiological incident improved (p <0.0001, McNemar test). Individual risk perception for chemical or radiological disasters did not improve after training.

Improvement of knowledge and comfort was demonstrated, irrespective of previous experience. Simulation-based training of chemical and radiation disaster preparedness, led by medical toxicologists, is an effective means of educating PH and nursing students, with minimal prior fluency.

Despite children’s unique vulnerability, clinical guidance and resources are lacking around the use of radiation medical countermeasures (MCMs) available commercially and in the Strategic National Stockpile to support immediate dispensing to pediatric populations. To better understand the current capabilities and shortfalls, a literature review and gap analysis were performed.

A comprehensive review of the medical literature, Food and Drug Administration (FDA)-approved labeling, FDA summary reviews, medical references, and educational resources related to pediatric radiation MCMs was performed from May 2016 to February 2017.

Fifteen gaps related to the use of radiation MCMs in children were identified. The need to address these gaps was prioritized based upon the potential to decrease morbidity and mortality, improve clinical management, strengthen caregiver education, and increase the relevant evidence base.

Key gaps exist in information to support the safe and successful use of MCMs in children during radiation emergencies; failure to address these gaps could have negative consequences for families and communities. There is a clear need for pediatric-specific guidance to ensure clinicians can appropriately identify, triage, and treat children who have been exposed to radiation, and for resources to ensure accurate communication about the safety and utility of radiation MCMs for children. (Disaster Med Public Health Preparedness. 2019;13:639-646)

No recent original studies on the pattern of diet are available for Saudi Arabia at the national level. The present study was performed to describe the consumption of foods and beverages by Saudi adults.

The Saudi Health Interview Survey (SHIS) was conducted in 2013. Data were collected through interviews and anthropometric measurements were done. A diet history questionnaire was used to determine the amount of consumption for eighteen food or beverage items in a typical week.

The study was a household survey in all thirteen administrative regions of Saudi Arabia.

Participants were 10 735 individuals aged 15 years or older.

Mean daily consumption was 70·9 (se 1·3) g for fruits, 111·1 (se 2·0) g for vegetables, 11·6 (se 0·3) g for dark fish, 13·8 (se 0·3) g for other fish, 44·2 (se 0·7) g for red meat, 4·8 (se 0·2) g for processed meat, 10·9 (se 0·3) g for nuts, 219·4 (se 5·1) ml for milk and 115·5 (se 2·6) ml for sugar-sweetened beverages. Dietary guideline recommendations were met by only 5·2 % of individuals for fruits, 7·5 % for vegetables, 31·4 % for nuts and 44·7 % for fish. The consumption of processed foods and sugar-sweetened beverages was high in young adults.

Only a small percentage of the Saudi population met the dietary recommendations. Programmes to improve dietary behaviours are urgently needed to reduce the current and future burden of disease. The promotion of healthy diets should target both the general population and specific high-risk groups. Regular assessments of dietary status are needed to monitor trends and inform interventions.