Recreational use of anabolic-androgenic steroids (AAS) is a growing worldwide public health concern. However, studies assessing the level of awareness and knowledge of its effects on health are fairly limited, especially in developing countries, including Saudi Arabia. This community-based cross-sectional study was conducted to assess knowledge, attitudes and practices among male gym members toward AAS in Riyadh (Saudi Arabia) from March to October 2016. Twenty gyms were randomly selected from four different geographical regions (clusters) within Riyadh. In total, 482 participants responded to the self-administered anonymous questionnaire, which covered socio-demographic data, data assessing knowledge, attitude and behavior related to AAS use. The mean (±standard deviation) age of study participants was 27.2 (±6.9) years. Among these, 29.3% of participants reported having used AAS, while the majority (53.5%) reported hearing of AAS use, mostly through friends. Most study participants reported awareness of the effects of AAS on muscle mass, body weight and muscles strength (53.2%, 51.1% and 45.5%, respectively). In contrast, a higher proportion of study participants were unaware of the side-effects of AAS use. A high proportion of study participants (43.2%) reported that they had been offered AAS and 68.7% believed that AAS are easily accessible. Most of the gym users (90.1%) reported never having used any narcotics or psychoactive drugs. Regression analysis revealed that use of anabolic-androgenic steroids is significantly associated with “weight lifting practice” OR [95%CI] = 1.9[1.02 − 3.61], P = 0.044; “using supplementary vitamins, OR [95%CI] = 7.8[4.05 − 15.03], P < 0.0001, knowing anyone using anabolic-androgenic steroids’ OR [95%CI] = 7.5[3.78 − 14.10], P < 0.0001, and someone advised Gym users to take anabolic-androgenic steroids” OR [95%CI] = 2.26[1.23 − 4.14], P < 0.008. Our findings suggest that the level of awareness regarding the possible side-effects of AAS is fairly limited. Thus, efforts directed toward educating the public and limiting access to AAS as well as health policy reforms are crucial to reduce future negative implications of AAS use.
The pandemic has triggered an unprecedented global demand for home caregiving to manage asymptomatic and mild COVID-19 cases. Older people and others with pre-existing medical conditions (including diabetes) appear to be more vulnerable to severe illness caused by the severe acute respiratory syndrome coronavirus 2. Approximately 25% of Saudis suffer from diabetes; these 4 million patients require 5.5 million consultations and follow-up visits each year to manage their disease. Furthermore, with the increasing number of patients with diabetes and their need for professional care, it is difficult and time consuming to share patient-care information among caregivers in a traditional way; this increases the financial and psychological burden of home caregivers. Although the pandemic has also triggered a global demand for digital health technology adoption worldwide to achieve higher standards of health, recent developments in advanced technologies and mobile health (mHealth) applications have failed to equip the caregivers with the right ecosystem for patient-centered information sharing to allow for informed care decisions. Therefore, there is a gap in the literature as the current solutions fall short of facilitating an effective communication channel among caregivers and between them and their patients, supporting diverse caregiving groups with multiple languages, distributing tasks between caregivers to alleviate the burden on one caregiver, providing a treatment plan by a specialized care team to be viewed and followed by caregivers and patients, and alerting everyone in case of an emergency. Based on the need for empowering home caregivers to cope with the pressure, we propose eHomeCaregiving, an mHealth solution that can build a transparent blockchain-based patient-centered family caregiving ecosystem. eHomeCaregiving facilitates care continuity in patients with type 2 diabetes in Saudi Arabia by integrating care, saving time and efforts of all caregivers, and improving the patient’s quality of life and outcomes, particularly in terms of facing emerging challenges amid the pandemic.
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