The ADAPTE methodology for guideline adaptation can be customized or 'adapted' to the local health care setting and resources. This proposal facilitates supports and improves the utilization and update of the ADAPTE process by CPG programmes or activities in health care organizations. This is of particular importance in health care systems in developing countries with limited resources in the Eastern Mediterranean region like Egypt.

Background: Patient safety culture (PSC) is a vital feature to assess the ability of any healthcare setting in addressing and reducing patients harm. This study attempted to assess the PSC in Intensive Care Units (ICUs) at Alexandria Main University Hospital (AMUH) from the point of view of physicians and nurses. Methods: A cross-sectional study was implemented in two ICUs at AMUH over period of six months. Seventy-two participants were interviewed using the Hospital Patient Safety Scale, customized by the Agency for Healthcare Research and Quality (AHRQ). Results: The average positive response to individual items in the patient safety scale ranged from 2.7% to 79.2%. The "Teamwork within Units" dimension had the utmost average percentage positive score (63.5%) amongst all participants, on the other hand, the "Non-Punitive Response to Errors" dimension had the lowest one (12.0%). Less than half (45.8%) of the interviewed participants rated patient's safety at the hospital as accepted. Conclusions: PSC is friable in targeted ICUs, much of work is needed to raise the responsiveness of health care givers regarding this issue. Executives and supervisors need to encourage the practices of PS through a blame free culture.

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Background Understanding children’s feeding practices and eating behaviors is important to determine etiology of childhood obesity. This study aimed to explore the relationship between early feeding practices, eating behavior and body composition among primary school children. Methods The data were collected from 403 primary school children. They were administered structured questionnaire, including sociodemographic characteristics, early feeding practices and Child’s Eating Behavior Questionnaire. Anthropometric and blood pressure (BP) measurements were performed. Results Children with obesity and overweight showed higher food approach subscales and lower food avoidance subscales compared to a healthy and underweight child. Children who were exclusively or predominantly breast fed during the first 6 months had the lowest scores for the food approach subscales, food responsiveness (FR) and emotional overeating (EOE) and had the highest scores for the food avoidance subscales, satiety responsiveness (SR) and emotional under eating (EUE). Children who were introduced solid food after 6 months showed lower scores for FR, enjoyment of food and EOE but scored highest for SR, slowness in eating (SE) and EUE. All anthropometric measurements were positively correlated with all food approach subscales and negatively with SE, SR and food fussiness. All food approach subscales were positively correlated with BP percentiles. All food avoidance subscales were negatively correlated with both BP percentiles, except for EUE, which was negatively correlated with diastolic BP percentile only. Age, SR, SE and FR were predictors for child body mass index. Conclusion Early feeding practices and eating behavior are considered as prevention approaches for obesity.

Background: To our knowledge, there is no national screening program for prostate cancer in Egypt. The Uro-surgery department in Alexandria University established a screening program for prostate cancer among men aged 55 years or more in January 2012. Objective: To determine a valid Prostatic Specific Antigen (PSA) cutoff point for performing Transrectal Ultrasonography (TRUS) guided biopsy among asymptomatic elderly men. Methods: A screening cross sectional study was conducted on a convenient sample of 1207 men aged ≥55 years who were attending urology department, Alexandria University for non-prostatic symptoms during years 2013 and 2014. Digital Rectal Examination (DRE) and PSA level measurement were performed for all included subjects. TRUS guided biopsy was done for those who found to have PSA ˃ 4ng/ ml and or suspicious DRE. Results: Among subjects who had PSA level of 4.1-10, the Positive Predictive Value (PPV) for cancer prostate was 54% among those with suspicious DRE findings as compared to 0 among those with nonsuspicious DRE. For PSA level of 10.1-20 and >20 with suspicious DRE, PPV was (77% and100% respectively). The mean serum total PSA was 77 and 0.6 ng/ ml for patients with and without prostatic cancer respectively (p= 0.0001). The yield of cancer prostate among all screened men was 103/1207= 8% and 103/157= 66% among those with PSA˃ 4 ng/ ml and or having suspicious DRE and were biopsied. Considering all men who had biopsy, ROC curve could derive a cutoff value of 10.05 ng/ml with a sensitivity of 92% and a specificity of 92.6%. Inability to perform biopsy for men with PSA ≤4 ng/ml was the main limitation. Conclusion: In a country of relatively low prevalence of prostate cancer like Egypt, a cutoff point of PSA in combination with DRE for doing TRUS biopsy could be 10.05 ng/ ml among asymptomatic men ≥55 years of age with a likelihood ratio of 12.43.