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The phenomenon of social withdrawal, known as the hikikomori-like idiom of distress (HLID), has been reported in many countries. This study aimed to explore profiles of Omanis who have HLID.

A cross-sectional online survey of 673 out of 1,529 Omanis identified with HLID using the Hikikomori Questionnaire (HQ-25) score of 42+.

Two profile groups were determined through cluster analysis according to socio-demographic and HQ-25 outcomes. Subjects in cluster 1 (n = 168, 24.9%) are significantly younger (p < 0.001) and more educated (p = 0.019), spend more time online (p < 0.001) and are living alone (p < 0.001) than subjects in cluster 2 (n = 505, 75.1%). More subjects in cluster 1 had a past mental illness (p = 0.037) but less previous childhood physical/emotional abuse (p = 0.029) than subjects in cluster 2. In contrast, subjects in cluster 2 had a low lack of socialization (p < 0.001), less active isolation (p < 0.001) and total HQ-25 scores (p < 0.001) than cluster 1. Subjects in Cluster 1 have more serious social withdrawal issues than those in Cluster 2, especially on a lack of socialization and isolation.

One limitation that might influence the results of this online study was that information was collected via self-report, and a cross-sectional design limits its results because it cannot assess causal inference. This study has contributed valuably to exploring different profile groups of HDLD, especially in the Arabian Gulf. The authors’ findings facilitate the development by creating innovative interventions strategically tackling different hikikomori groups.

While social withdrawal characterized by HLID has been reported proliferating in different parts of the world, little research has been forthcoming from Arabian Gulf countries. These findings suggest that there are two orthogonal clusters of HLID among Omanis. This study provides a foundation for further research on HLID, which has recently been reported in different parts of the world.

Emotional intelligence (EI) can improve patient–doctor relationships, foster empathy, develop teamwork in the workplace, and boost communication skills. This study aims to determine whether a cohort of residents has different profiles to their demographic and EI.

A cross-sectional survey was conducted in 2017–2018 (n = 440). The Trait Emotional Intelligence Questionnaire was used to measure EI. Cluster analysis was used to identify different profile groups.

Cluster analysis identified three clusters with different profiles. The residents in cluster A (n = 146, 33.2%) were older, more males, studying in their final year, and perceived lower EI. Cluster B (n = 184, 41.8%) were predominantly young females, more single, studying in year one, and perceived moderate EI. Cluster C (n = 110, 25.0%) were predominantly married females studying their year 1 in surgical and perceived higher EI.

Study limitations include respondent honesty, cross-sectional design, and lack of a comparison site. Including EI education can improve emotional regulation, well-being, and sociability and should be assessed as part of residents' development.

Medical residents differ in emotional profiles, with higher EI improving coping and problem-solving skills. EI training should be integrated into the medical curriculum, particularly given the high-stress levels and unique stressors of hospital practicums.

The study suggested that three groups of residents exist, and they differ in demographic, EI, and subscale levels. This study recommended that residents be taught EI-related concepts to help them develop their EI through training on emotionality, self-control, well-being, and sociability.

Much work about health reform and systems improvement in healthcare looks at shortcomings and universal problems facing health systems, but rarely are accomplishments dissected and analyzed internationally. The purpose of this paper is to address this knowledge gap by examining the lessons learned from health system reform and improvement efforts in 60 countries.

In total, 60 low-, middle- and high-income countries provided a case study of successful health reform, which was gathered into a compendium as a recently published book. Here, the extensive source material was re-examined through inductive content analysis to derive broad themes of systems change internationally.

Nine themes were identified: improving policy, coverage and governance; enhancing the quality of care; keeping patients safe; regulating standards and accreditation; organizing care at the macro-level; organizing care at the meso- and micro-level; developing workforces and resources; harnessing technology and IT; and making collaboratives and partnerships work.

These themes provide a model of what constitutes successful systems change across a wide sample of health systems, offering a store of knowledge about how reformers and improvement initiators achieve their goals.

Few comparative international studies of health systems include a sufficiently wide selection of low-, middle- and high-income countries in their analysis. This paper provides a more balanced approach to consider where achievements are being made across healthcare, and what we can do to replicate and spread successful examples of systems change internationally.

This study aims to present comprehensive nonlinear material modelling techniques and simulations of reinforced concrete (RC) beams subjected to short-term monotonic static load using the robust and reliable general-purpose finite element (FE) software ANSYS. A parametric study is carried out to analyse the flexural and ductility behaviour of RC beams under various influencing parameters.

To develop and validate the numerical FE models, a total of four experimentally tested simply supported RC beams are taken from the available literature and two beams are selected from each author. The concrete, steel reinforcements, bond-slip mechanism, loading and supporting plates are modelled using SOLID65, LINK180, COMBIN39 and SOLID185 elements, respectively. The validated models are then used to conduct parametric FE analysis to investigate the effect of concrete compressive strength, percentage of tensile reinforcement, compression reinforcement ratio, transverse shear reinforcement, bond-slip mechanism, concrete compressive stress-strain constitutive models, beam symmetry and varying overall depth of beam on the ultimate load-carrying capacity and ductility behaviour of RC beams.

The developed three-dimensional FE models can able to capture the load and midspan deflections at critical points, the accurate yield point of steel reinforcements, the formation of initial and progressive concrete crack patterns and the complete load-deflection curves of RC beams up to ultimate failure. From the numerical results, it can be concluded that the FE model considering the bond-slip effect with Thorenfeldt’s concrete compressive stress-strain model exhibits a better correlation with the experimental data.

The ultimate load and deflection results of validated FE models show a maximum deviation of less than 10% and 15%, respectively, as compared to the experimental results. The developed model is also capable of capturing concrete failure modes accurately. Overall, the FE analysis results were found quite acceptable and compared well with the experimental data at all loading stages. It is suggested that the proposed FE model is a practical and reliable tool for analyzing the flexural behaviour of RC members and can be used for performing parametric studies.