Background The demand for mental health care, particularly for depression and anxiety, is 3-fold greater among patients receiving oncologic and palliative care than for the general population. This population faces unique barriers, making them more susceptible to mental health challenges. Various forms of psychotherapy have been deemed effective in addressing mental health challenges in this population, including supportive psychotherapy, cognitive behavioral therapy, problem-based therapy, and mindfulness; however, their access to traditional face-to-face psychotherapy resources is limited owing to their immunocompromised status, making frequent hospital visits dangerous. Additionally, patients can face hospital fatigue from numerous appointments and investigations or may live in remote areas, which makes commutes both physically and financially challenging. Web-based psychotherapy is a promising solution to address these accessibility barriers. Moreover, web-based psychotherapy has been proven effective in addressing depression and anxiety in other populations and may be implementable among patients receiving oncologic and palliative care. Objective The study will investigate the feasibility and effectiveness of web-based psychotherapy among patients receiving oncologic and palliative care, who have comorbid depression or anxiety. We hypothesized that this program will be a viable and efficacious treatment modality compared to current treatment modalities in addressing depression and anxiety symptoms in this population. Methods Participants (n=60) with depression or anxiety will be recruited from oncology and palliative care settings in Kingston (Ontario, Canada). Participants will be randomly allocated to receive either 8 weeks of web-based psychotherapy plus treatment as usual (treatment arm) or treatment as usual exclusively (control arm). The web-based psychotherapy program will incorporate cognitive behavioral therapy, mindfulness, and problem-solving skills, and homework assignments with personalized feedback from a therapist. All web-based programs will be delivered through a secure platform specifically designed for web-based psychotherapy delivery. To evaluate treatment efficacy, all participants will complete standardized symptomology questionnaires at baseline, midpoint (week 4), and posttreatment. Results The study received ethics approval in February 2021 and began recruiting participants in April 2021. Participant recruitment has been conducted through social media advertisements, physical advertisements, and physician referrals. To date, 11 participants (treatment, n=5; control, n=4; dropout, n=2) have been recruited. Data collection and analysis are expected to conclude by December 2021 and January 2022, respectively. Linear regression (for continuous outcomes) will be conducted with interpretive qualitative methods. Conclusions Our findings can be incorporated into clinical policy and help develop more accessible mental health treatment options for patients receiving oncologic and palliative care. Asynchronous and web-based psychotherapy delivery is a more accessible, scalable, and financially feasible treatment that could have major implications on the health care system. Trial Registration ClinicalTrials.gov NCT04664270; https://clinicaltrials.gov/ct2/show/NCT04664270 International Registered Report Identifier (IRRID) DERR1-10.2196/30735

Vitamin D deficiency is common in pregnant women. It plays an important role in calcium metabolism as well.There are inconsistent findings as to whether vitamin D and calcium levels affect the mode of delivery, whether vaginal, instrumental or operative. We designed a retrospective cohort study reviewing women who delivered in King Hamad University Hospital (KHUH) in the Kingdom of Bahrain from January 2021 until July 2021 to establish whether there is a relationship. 103 women were included in this study. We found no statistically significant relationship between vitamin D and calcium levels and the mode of delivery. Further studies with a larger sample size are warranted to determine the relationship between vitamin D and calcium levels and the mode of delivery. The role of vitamin D and calcium supplementation at improving pregnancy outcomes also needs to be determined.

(1) Background: During 2019, the COVID-19 pandemic was threatening healthcare services and workers, and acquiring immunity was an option to stop or limit the burden of this pandemic. Herd immunity was a top priority worldwide as the virus was spreading rapidly. It was estimated that 67% of the total global population should be immunized against COVID-19 to achieve herd immunity. The aim of the current study is to investigate different perceptions of healthcare workers in the Kingdom of Bahrain and Egypt using an online survey in an attempt to evaluate their awareness and concerns regarding new variants and booster doses. (2) Methods: This study conducted a survey on healthcare workers in the Kingdom of Bahrain and Egypt about their perception and concerns on the COVID-19 vaccines. (3) Results: The study found that out of 389 healthcare workers 46.1% of the physicians were not willing to take the booster doses (p = 0.004). Physicians also did not support taking the COVID-19 vaccine as an annual vaccine (p = 0.04). Furthermore, to assess the association between the type of vaccine taken with the willingness of taking a booster vaccine, healthcare workers beliefs on vaccine effectiveness (p = 0.001), suspension or contact with patients (p = 0.000), and infection after COVID-19 vaccination (p = 0.016) were significant. (4) Conclusion: Knowledge about vaccine accreditation and regulation should be dispersed more widely to ensure that the population has a positive perception on vaccine safety and effectiveness.

BACKGROUND The demand for mental health care, particularly for depression and anxiety, is three times greater in oncology and palliative care patients compared to the general population. This population faces unique barriers making them more susceptible to mental health challenges. Various forms of psychotherapy have been deemed effective in addressing mental health challenges in this population including supportive psychotherapy, cognitive behavioural therapy, problem-based therapy, and mindfulness. However, oncology and palliative care patient's access to traditional face-to-face psychotherapy resources is limited due to compromised immune systems making frequent visits to hospitals dangerous. Additionally, patients can face hospital fatigue from numerous appointments and investigations or may live in remote areas making commutes both physically and financially taxing. The online delivery of psychotherapy is a promising solution to address these accessibility barriers. Moreover, the online delivery of psychotherapy has been proven effective in addressing depression and anxiety in other populations and may be able to be transferred to oncology and palliative care patients. OBJECTIVE The study will investigate the feasibility and effectiveness of online delivery of psychotherapy for oncology and palliative care patients with comorbid depression or anxiety. It is hypothesized that this program will be a viable and efficacious treatment modality compared to treatment as usual in addressing depression and anxiety symptoms in this population. METHODS Participants (n = 60) with depression or anxiety will be recruited from oncology and palliative care settings in Kingston, Ontario, Canada. Participants will be randomly allocated to either receive 8 weeks of online psychotherapy plus treatment as usual (treatment arm), or treatment as usual exclusively (control arm). The online psychotherapy program will incorporate cognitive behavioural therapy, mindfulness, and problem-solving skills as well as homework assignments with personalized feedback from a therapist. All online programs will be delivered through a secure online platform specifically designed for the online delivery of psychotherapy. To evaluate treatment efficacy, all participants will complete standardized symptomology questionnaires at baseline, mid-point (week 4), and post-treatment. RESULTS The study received ethics approval in February 2021 and began recruitment in April 2021. Participant recruitment has been conducted through social media advertisements, physical advertisements, and physician referrals. To date, there have been 11 (treatment n = 5; control n = 4; drop-out n = 2) participants recruited. Data collection is expected to conclude by December 2021, and data analysis is expected to be completed by January 2022. Linear regression (for continuous outcomes) will be conducted with interpretive qualitative methods. CONCLUSIONS Findings from this study can be incorporated into clinical policy and help develop more accessible mental health treatment options for oncology and palliative care patients. The asynchronous and online delivery of psychotherapy is a more accessible, scalable, and financially feasible treatment that could have major implications on the health care system. CLINICALTRIAL ClinicalTrials.gov NCT04664270; clinicaltrials.gov/ct2/show/NCT04664270