In: International journal of legal information: IJLI ; the official journal of the International Association of Law Libraries, Band 48, Heft 3, S. 122-131
AbstractInternational investment law, particularly the global backlash against investment treaties, has evolved recently. This article aims to clarify how international investment law evolved over history, from the early Arab traders in the 7th century to the Ottoman Empire, to understand its hidden aims. It investigates the practice of signing investment treaties, which appear first during the Fatimid Caliphate2 and Mamluk Sultanate3 periods. It then explains when control over foreign investment started to diminish during the Ottoman Empire period.4 Further, it explains the links between the USA Friendship, Commerce and Navigation treaties (FCNs), and current investment treaties, explaining the impact of colonization and imperialism on drafting treaty provisions. Within this historical context, this article illustrates the need to understand the roots of international investment law in order to urge Arab countries to terminate or renegotiate current bilateral investment treaties (BITs) as a number of developing and developed countries have done.
INTRODUCTION: Social media platforms are used by many people to seek and share health-related information that may influence their decision-making about COVID-19 vaccination. PURPOSE: The objective of this study is to understand the influence of social media on the attitudes and willingness of the general public of the Aseer region of Saudi Arabia to receive COVID-19 vaccination. MATERIALS AND METHODS: A cross-sectional self-administrated online survey was conducted in Saudi Arabia Aseer region, where 613 persons willingly took part in the survey in April and May 2021. Residents of Aseer in Saudi Arabia, who are over the age of 18 (eligible for COVID-19 vaccination) and willing to participate in the survey, were included in the study. RESULTS: Overall, 74.6% agreed that the COVID-19 vaccine was misrepresented via social media. However, 37% of those respondents strongly agreed that social media had increased their willingness to get the COVID-19 vaccine. In addition, employees reported (21.8%) or strongly agreed (28%) that the quantity and quality of information on social media has a detrimental impact on their psychological well-being. Additionally, participants also agreed (21.8%) or strongly agreed (28%) that social media had a negative effect on their psychological condition. CONCLUSION: The study provides that there was a high degree of awareness indicated among Aseer population regarding misleading information about COVID-19 vaccination via social media. Thus, social media that can share up-to-date scientific information about vaccination must be utilized optimally by the government to assist people in making decisions about accepting vaccinations.
Adel Alfatease,1 Ali M Alqahtani,2 Khalid Orayj,3 Sultan M Alshahrani3 1Pharmaceutics Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 2Pharmacology Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 3Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi ArabiaCorrespondence: Sultan M AlshahraniClinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, 61441, Saudi ArabiaTel +966 508747473Email shahrani@kku.edu.saIntroduction: Social media platforms are used by many people to seek and share health-related information that may influence their decision-making about COVID-19 vaccination.Purpose: The objective of this study is to understand the influence of social media on the attitudes and willingness of the general public of the Aseer region of Saudi Arabia to receive COVID-19 vaccination.Materials and Methods: A cross-sectional self-administrated online survey was conducted in Saudi Arabia Aseer region, where 613 persons willingly took part in the survey in April and May 2021. Residents of Aseer in Saudi Arabia, who are over the age of 18 (eligible for COVID-19 vaccination) and willing to participate in the survey, were included in the study.Results: Overall, 74.6% agreed that the COVID-19 vaccine was misrepresented via social media. However, 37% of those respondents strongly agreed that social media had increased their willingness to get the COVID-19 vaccine. In addition, employees reported (21.8%) or strongly agreed (28%) that the quantity and quality of information on social media has a detrimental impact on their psychological well-being. Additionally, participants also agreed (21.8%) or strongly agreed (28%) that social media had a negative effect on their psychological condition.Conclusion: The study provides that there was a high degree of awareness indicated among Aseer population regarding misleading information about COVID-19 vaccination via social media. Thus, social media that can share up-to-date scientific information about vaccination must be utilized optimally by the government to assist people in making decisions about accepting vaccinations.Keywords: social media, COVID-19, vaccination, survey, Saudi Arabia
INTRODUCTION: COVID-19 was declared a pandemic in March 2020 by the World Health Organization. Control of COVID-19 depends on the potential vaccine and its successful delivery to a large portion of the population to develop herd immunity. All the governments have made a robust plan to distribute the vaccine to their people, but many countries could not achieve adequate vaccination coverage. Hence, this study explores people's beliefs and barriers to vaccination and provides valuable inputs to the government to attain adequate vaccination. OBJECTIVE: To know the knowledge level about the COVID-19 vaccine among the residents of KSA. To find out the various concerns (beliefs) about COVID-19 and its vaccine among the residents of KSA. To estimate the vaccine acceptance and understand the barriers to accepting the COVID-19 vaccine among residents of KSA. MATERIALS AND METHODS: A web-based, cross-sectional study was conducted from April to June 2021 in a restricted environment on the adult (>18 years) residents of Saudi Arabia. The minimum calculated sample was 685; 796 study samples were finally studied to minimize the sampling error. Snowball sampling was used to select the study samples, after meeting the inclusion criteria. RESULTS: A total of 796 people responded. Only 782 (98.2%) were finally considered after excluding the incomplete information forms. The selected participant's age ranges from 18 years to 80 years. Almost 723 (92%) of the study group knew COVID vaccines. Most of the participants, 370 (47%), preferred USA-manufactured vaccine followed by Saudi Arabia 217 (28%). A total of 259 (33.1%) participants were hesitant to receive the vaccine. Out of 782, half of the participants, 386 (50%), believed the COVID vaccine will prevent the infection. CONCLUSION: The government must implement appropriate culturally accepted interventional vaccination educational campaigns to remove the beliefs, worries regarding the safety and efficacy of COVID-19 vaccines, to increase vaccine acceptance rates.
Bayapa Reddy Narapureddy,1 Khursheed Muzammil,1 Mohammad Yahya Alshahrani,2 Ali G Alkhathami,2 Abdullah Alsabaani,3 Abdullah M AlShahrani,4 Adam Dawria,1 Nazim Nasir,4 Lingala Kalyan Viswanath Reddy,5 Mohammad Mahtab Alam6 1Department of Public Health, College of Applied Medical Sciences, Khamis Mushayt, King Khalid University, Abha, 62561, Kingdom of Saudi Arabia; 2Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Abha, King Khalid University, Abha, 9088, Kingdom of Saudi Arabia; 3Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia; 4Department of Basic Medical Sciences, College of Applied Medical Sciences, Khamis Mushayt, King Khalid University, Abha, 62561, Kingdom of Saudi Arabia; 5Department of Public Health, College of Health Sciences, Saudi Electronic University, Abha, 62561, Kingdom of Saudi Arabia; 6Department of Basic Medical Sciences, College of Applied Medical Science, Abha, King Khalid University, Abha, 62561, Kingdom of Saudi ArabiaCorrespondence: Bayapa Reddy NarapureddyDepartment of Public Health, College of Applied Medical Sciences, Khamis Mushayt, King Khalid University, Abha, 62561, Kingdom of Saudi ArabiaTel +966-55714527Email bapureddy@kku.edu.saIntroduction: COVID-19 was declared a pandemic in March 2020 by the World Health Organization. Control of COVID-19 depends on the potential vaccine and its successful delivery to a large portion of the population to develop herd immunity. All the governments have made a robust plan to distribute the vaccine to their people, but many countries could not achieve adequate vaccination coverage. Hence, this study explores people's beliefs and barriers to vaccination and provides valuable inputs to the government to attain adequate vaccination.Objective: To know the knowledge level about the COVID-19 vaccine among the residents of KSA. To find out the various concerns (beliefs) about COVID-19 and its vaccine among the residents of KSA. To estimate the vaccine acceptance and understand the barriers to accepting the COVID-19 vaccine among residents of KSA.Materials and Methods: A web-based, cross-sectional study was conducted from April to June 2021 in a restricted environment on the adult (> 18 years) residents of Saudi Arabia. The minimum calculated sample was 685; 796 study samples were finally studied to minimize the sampling error. Snowball sampling was used to select the study samples, after meeting the inclusion criteria.Results: A total of 796 people responded. Only 782 (98.2%) were finally considered after excluding the incomplete information forms. The selected participant's age ranges from 18 years to 80 years. Almost 723 (92%) of the study group knew COVID vaccines. Most of the participants, 370 (47%), preferred USA-manufactured vaccine followed by Saudi Arabia 217 (28%). A total of 259 (33.1%) participants were hesitant to receive the vaccine. Out of 782, half of the participants, 386 (50%), believed the COVID vaccine will prevent the infection.Conclusion: The government must implement appropriate culturally accepted interventional vaccination educational campaigns to remove the beliefs, worries regarding the safety and efficacy of COVID-19 vaccines, to increase vaccine acceptance rates.Keywords: COVID-19, public willingness, vaccine, vaccine hesitancy, vaccine acceptance, Saudi Arabia
Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.
Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.