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Background: Tracheostomy care is a standard procedure that nurses perform in Critical Care Units (CCUs) to reduce complications from tracheostomy. The literature indicates a clear variety of care and practice in managing tracheostomy patients within the healthcare system. This study was conducted to assess the knowledge level of tracheostomy care among nurses in CCUs in Jordanian hospitals. Materials and Methods: A cross sectional descriptive design was used for this study. A convenience sample of 260 nurses working in the CCUs of four government hospitals completed a self reported structured questionnaire. Data were collected from January 2021 to March 2021. A t test and one way Analysis of Variance (ANOVA) were used to assess the differences among socio demographic variables in terms of knowledge score. Results: The result revealed that the level of knowledge was suboptimal. There was a statistically significant difference in the mean level of knowledge regarding tracheostomy care (in all dimensions) by age (F = 22.595, p < 0.001), educational level (F = 355.30, p < 0.001), and work experience (F = 13.63, p < 0.001). For gender, there was a statistically significant difference in knowledge of the tracheostomy suctioning dimension (p = 0.001). Conclusions: The level of knowledge among nurses regarding tracheostomy care was moderate, indicating an urgent need for education. [ABSTRACT FROM AUTHOR]

Background: Cancer patients frequently experience unrelieved pain as a significant symptom. However, several studies have found that cancer‐related pain is frequently undertreated. Purpose: This study aimed to understand the pain experiences of cancer patients who were newly engaged in a multidisciplinary pain management program (PMP) at King Hussein Cancer Centre and still receiving cancer treatments and cancer pain management. Methods: A qualitative study design and semi‐structured interviews were used to obtain data from 21 cancer patients who were purposefully selected. All patients had advanced cancer, including skeleton metastases. All female participants had breast cancer, and all male participants had prostate cancer. Results: It was found that the patient−healthcare professional relationship and satisfaction with services emerged as two themes in healthcare professionals' pain management. Conclusion: The results from this study can offer a new understanding of the knowledge related to satisfaction of patients with cancer in terms of the quality of pain management. Additional qualitative studies are required to replicate the findings in populations from different backgrounds, ethnicities, and cultures experiencing cancer pain. [ABSTRACT FROM AUTHOR]

Background: Self-medication is a global concern among professionals and non-professionals, with a rapid increase in prevalence. The study aims to assess the prevalence of self-medication and its associated factors among university students. Materials and Methods: A cross-sectional, descriptive study was conducted in three universities, and a total of 817 college students participated in this study. Results: About 75.40% of the participants reported using medications without a professional prescription. The category of analgesics was the most commonly used in self-medication (82.80%), while the most common symptom was a headache (81.50%). Almost 74.10% percent of participants who have practiced self-medication stated that the reason was the "lack of time to consult a physician." Most participants who have used self-medication (90.30%) stated that the source of knowledge was "previous prescription." Conclusions: Health education programs concerning self-mediation should be held in university settings to improve attitudes and practices toward self-mediation. [ABSTRACT FROM AUTHOR]

Objectives: The global refugee crisis, exacerbated by the Syrian war, has placed tremendous strain on Jordan's healthcare system and infrastructure, notably impacting nurses working in refugee camps. The aim to identify factors influencing nurses' Quality of life at work (QWL) and understand their significance in crisis healthcare environments. Methodology: A cross-sectional study was conducted in multiple healthcare facilities within Syrian refugee camps. A convenient sample of 166 nurses participated, and data were collected using the Brook's Quality of Nursing Work Life Survey. Data analysis included descriptive and inferential (one-way ANOVA) statistics. Significance level was set at 0.05. Results: Nurses in this study generally reported a moderate QWL, with an average score of 152.85, indicating that their overall work experience falls into the moderate range. The study found that nurses perceived their work-life/home-life balance (mean score 25.79), work design (mean score 35.71), work context (mean score 71.37), and work world (mean score 19.96) at levels indicative of moderate satisfaction. There were no statistically significant differences in QWL among participating nurses, suggesting that factors other than demographic characteristics may play a more influential role in determining nurses' QWL in the unique context of refugee caregiving. Conclusion: This study underscores that working within refugee healthcare missions and recommends targeted interventions to enhance their well-being. [ABSTRACT FROM AUTHOR]

Background: With an increase in elderly people, it is essential to address the issue of cognitive impairment and support healthy aging. This study aimed to assess cognitive impairment and factors associated with it among older adults. Materials and Methods: A cross-sectional study was carried out in different catchment areas within the Jerash governorate in the north of Jordan. The Elderly Cognitive Assessment Questionnaire (ECAQ) and a household face-to-face interview were used to collect data from 220 older adult participants aged 60 years and more. Descriptive statistics were conducted to describe the study variables. Correlation tests were applied to find associations between them. Logistic regression analysis was applied, with a minimum significance level (p < 0.05). Results: About 9.10% of the older adults had cognitive impairment. Cognitive impairment was correlated with age, self-perceived health, hypertension, stroke, and mental illness. The primary predictors of cognitive impairment were age [odds ratio (OR) =1.07 (1.01-1.14), p = 0.001] and stroke [OR = 10.92 (1.44-82.85), p = 0.001]. Conclusions: While many factors were correlated with cognitive impairment, the strongest predictors of cognitive impairment were age and stroke. [ABSTRACT FROM AUTHOR]

Background: Although breakfast skipping among university students is a significant concern, its prevalence and the contributing factors among university students have received little attention in the literature. This study aims to determine the prevalence of skipping breakfast among Jordanian university students and examine the associated factors and variations in rates of skipping breakfast by day of the week. Materials and Methods: A cross-sectional study was conducted among undergraduate students between March and May 2022 through a self-questionnaire. A convenience sample of 891 students was chosen at four Jordanian public universities. The data were analyzed using descriptive and inferential statistics. Results: The prevalence of skipping breakfast among university students was 66%. The reasons for skipping breakfast were having no time due to oversleeping and having no feeling of hunger (59% for both), followed by having no energy to prepare the breakfast and making no difference (49% and 48%), and not being able to afford to eat or buy breakfast (19%). There is a strong correlation between eating fast food and skipping breakfast. With whom the student eats breakfast is significantly associated with breakfast skipping, revealing that the highest percentages of skipping occur with friends. About 63% of students skipped breakfast through university days compared with 37% on the weekend, while 37% of them had breakfast through university days compared with 67% on the weekend. Conclusions: A high percentage of university students in Jordan skip breakfast. More attention should be paid to correlating factors and developing interventions to help students adhere to the breakfast. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your knowledge of the McCloskey/Mueller Satisfaction Scale, used to measure job satisfaction • To find out about the job satisfaction of migrant nurses working in critical care in Saudi Arabia • To consider strategies for enhancing nurses' job satisfaction and increasing nurse retention Background: Nurses' job satisfaction is a crucial component of a safe and efficient healthcare environment. Aim: To understand the level of job satisfaction among migrant nurses working in intensive and critical care in Saudi Arabia. Method: This study used a quantitative descriptive design. A total of 421 migrant nurses working in intensive and critical care units in two teaching hospitals in Saudi Arabia completed a questionnaire based on the McCloskey/Mueller Satisfaction Scale. Findings: Participating migrant nurses had moderate levels of job satisfaction overall, except for salary, holiday allowance and maternity leave, which attracted low satisfaction scores, and nursing peers, which attracted a high satisfaction score. There were no statistically significant differences in job satisfaction scores according to demographic variables except marital status, with a significantly higher job satisfaction among married respondents. Conclusion: Promoting job satisfaction among nurses could improve the efficiency and quality of nursing care. There is a range of strategies that can be used to enhance nurses' job satisfaction, including improving working conditions and promoting career development. [ABSTRACT FROM AUTHOR]

Background Asthma is a chronic illness of the airways that can cause a persistent cough. The illness affects a significant population of young people worldwide and can affect their ongoing quality of life. Aim To explore Jordanian adolescents' knowledge and attitudes to asthma. Method A cross-sectional research design was used with a convenience sample of 302 adolescents from six schools in northern Jordan, who completed a self-reported knowledge and attitude survey. Results Although the adolescents had an adequate knowledge level about asthma, several areas of knowledge deficit were identified and some negative attitudes were demonstrated. No significant association was found between adolescents' level of knowledge and their attitudes to adolescents with asthma. Conclusion Jordanian adolescents need more educational programmes about living with life-changing chronic illnesses such as asthma, and about how the knowledge and positive attitudes of peer groups can normalise the illness for the affected person, enhancing their quality of life. [ABSTRACT FROM AUTHOR]

Aim To determine what secondary schoolchildren in Jordan want from overweight and obesity intervention strategies and prevention programmes. Method A school-based, cross-sectional study using a quantitative design was carried out during October 2014. The participants were secondary schoolchildren in grades 11 and 12. Data were analysed using SPSS program version 17. Percentages, standard deviations and means were computed. Findings The main suggestions were for programmes at school, during school hours (n=962, 85.4%), followed by one that involved family and friends (n = 951, 84.5%), and a programme at a convenient time free of charge (n=919, 81.6%). The students also suggested many strategies to tackle overweight and obesity, such as: taking more physical exercise (n = 925, 82.1%), increasing consumption of more fruit and vegetables (n = 712, 63.2%) eating less fast food (n = 689, 61.2%). Conclusion Schools, families, health providers and community organisations should encourage students to adopt healthy lifestyles, and facilitate their selection and participation in health programmes. [ABSTRACT FROM AUTHOR]

Background Breakfast is considered to be the most important meal of the day. It provides the essential nutrients needed for the day's activities. Aims To determine the prevalence of breakfast consumption and to assess the nutritional status of students aged 12-18 years. Methods A school-based study carried out between September and October 2014 involved 1,303 school students from grades 7 to 12, aged 12 to 18 years, who completed a questionnaire on breakfast consumption. The chi-square test was used. An odds ratio and 95% confidence interval determined the predictive factors for skipping breakfast. Results The prevalence of breakfast consumption was 52.3%, statistically decreasing with age. Adjusted logistic regression analysis reflected a statistically high consumption among 12-15 year olds, those with highly educated mothers and those with low family income. Conclusion For the target groups at risk, a community and school-based health education programme, conducted by school nurses and other healthcare providers, would be beneficial. [ABSTRACT FROM AUTHOR]

The article presents a cross-sectional study to investigate the workplace violence against emergency department staff (EDS) working at hospitals in Jordan. Workplace violence against EDS is the most common and widespread phenomena of violence, and patients and their relatives are identified as the main perpetrators of this violence. EDS should be trained to deal with violent incidents and legislation related to workplace violence should be instituted and developed.

Background: Lecturing has been traditionally used as the core teaching strategy in university education in all disciplines. However, new research in education suggests that other formats such as game teaching could be more effective. Aim: To compare students’ performance, satisfaction and retention of knowledge between a Jeopardy!-style game format and a didactic lecture format in teaching the subject of models for organising patient care to fourth-year nursing students. Methods: A parallel-group randomised controlled trial was conducted. Participants were fourth-year nursing students who registered in the second semester of 2012–2013 and enrolled in the Nursing Management and Ethics in Nursing Course in the Community Health Department. Results: 66 students completed the study (34 in the quiz game group and 32 in the lecture group). Pre-test results showed no significant difference between the two groups in their achievement scores. However, in the immediate achievement post-test and the retention test the students in the quiz group scored significantly better than those in the lecture group. A satisfaction questionnaire showed that the game format was well liked and accepted by students as a more satisfying teaching method. Conclusion: This study is the first of its kind in Jordan to explore the effectiveness of this particular game format versus the lecture format. Results suggest that the game format was well liked and accepted by students as a more satisfying teaching method. Additionally, it appeared to be a better method of education as it promoted greater information retention. [ABSTRACT FROM AUTHOR]

Background: Oral anticoagulation is the most common method to decrease the risk of stroke in people with atrial fibrillation. Purpose: To assess the knowledge of Jordanian nurses about anticoagulation therapy, the effectiveness of educational courses in increasing their knowledge, and the factors that affect nurses' changing knowledge following completion of an educational course. Method: A pre/posttest quasi‐experimental design was used. A total of 123 nurses participated in the study, identified by convenience sampling and recruited from five governmental hospitals in Jordan. To assess changes in knowledge between pre‐and posttest, a questionnaire based on European cardiovascular nurses' knowledge of anticoagulation therapy was used. An educational course was given to improve participants' knowledge of anticoagulation therapy. The participants' knowledge was assessed before and after the educational course. For data analysis, Statistical Package for the Social Sciences version 23 was used. Results: Nurses' knowledge of anticoagulants was poor; however, a significant improvement was achieved following the educational course (M = 25.5, SD = 3.41), as compared to before conducting it (M = 12.2, SD = 5.3, t = 42.54, p < 0.001). Having an academic degree was found to affect the change in knowledge scores among participants (t = −3.52, p = 0.001). Conclusion: The educational course was effective in improving the nurses' knowledge. Baccalaureate degree holders achieved more improvement in their knowledge scores. Post‐graduate education for nurses would help to improve their knowledge of anticoagulants. Revision of nursing curricula may be deemed necessary to improve the quality of education for nurses during their degree work, especially regarding anticoagulants. [ABSTRACT FROM AUTHOR]

Background: Despite the advantages of vaccination in preventing maternal and fetal problems, there were many concerns in the medical community regarding vaccine safety for pregnant women, and this has put obstetricians in a challenging situation when it comes to advising their pregnant patients on whether to obtain the vaccine Aim: This study was performed to define the level of acceptance of COVID-19 vaccination and assess the impact of COVID-19 attitudes and knowledge on vaccine acceptance between pregnant and lactating Syrian women who are seeking prenatal care services at the clinics in Azraq refugee camp in Jordan. Method: A quantitative, cross-sectional study utilizing a non-probability convenience sample. A validated and reliable self-administered questionnaire consisting of four sections was used. Results: A total of 412 pregnant/lactating women was recruited The acceptance rate of the COVID-19 vaccine among participants was 86.5%. There was a significant positive moderate association between respondents' attitudes and knowledge around the COVID-19 vaccine and their acceptance of the vaccine (r =.468, p <.001, r =.357, p <.001), respectively. Conclusion: To effectively mitigate the COVID-19 pandemic and achieve collective protection, decision-makers must intensify the efforts in promoting the importance of maternal vaccination, especially in vulnerable communities that suffer the most from pandemic outcomes. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of the relationships between workplace stressors and job performance • To familiarise yourself with validated scales that can be used to measure stress, resilience and job performance • To consider measures that could be implemented to mitigate stressors, increase resilience and foster effective coping mechanisms among nurses. Background: Nurses are a crucial part of healthcare organisations, constituting around half of the global healthcare workforce. Therefore, it is important to examine the factors that may affect their job performance, which is central to the delivery of effective healthcare services. Aim: To examine the relationships between stress, resilience and job performance within the nursing context in Jordan. Method: A cross-sectional descriptive correlational design was used. A self-administered questionnaire comprising stress, resilience and job performance scales was completed by a convenience sample of 207 nurses working in five hospitals in the northern and middle regions of Jordan. Results: Overall, respondents self-reported moderate stress levels, normal resilience levels and moderate job performance. The study identified: a moderate positive correlation between stress and resilience; a weak negative correlation between stress and job performance; and a weak positive correlation between resilience and job performance. Conclusion: It is essential that nurse managers, leaders and policymakers implement measures to mitigate the stressors encountered by nurses, increase resilience and foster effective coping mechanisms. Such measures could enhance nurses’ resilience and job performance, ultimately improving patient care. [ABSTRACT FROM AUTHOR]

Background Aim Design Methods Results Conclusion Intermittent catheterization (IC) has been identified as one of the critical techniques used by spinal cord injury (SCI) patients to cope with emptying the bladder, despite several problems impeding this procedure.The study aimed accordingly to explore the lived experience of Arab male patients on IC after their SCI.This study was carried out by using a descriptive qualitative approach with a phenomenological analysis of data.A qualitative study was carried out on 10 Arab male patients from the Rehabilitation Hospital at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia who were utilizing intermittent catheters following SCI. The interviews were analysed using Husserl's phenomenology and the Colaizzi method of data analysis.Two major themes and six sub‐themes were identified from exploring the patients experience. These themes are as follows: Theme 1: The Way to IC; with two sub‐themes: (i) ‘service provided and acceptance’ and (ii) ‘educational experience’; Theme 2: Lifestyle and self‐adaptation; with four sub‐themes: (i) ‘Flexibility and freedom’, (ii) ‘Physical access to the community’, (iii) ‘Traveling’ and (iv) ‘Work and Social life balance’.It is evident that using an intermittent catheter among patients with SCI influenced almost all aspects of the participant's life, including their social lives and body image appearance. [ABSTRACT FROM AUTHOR]

The number of individuals with dementia is on the rise, highlighting the need to create effective educational methods that can improve nursing students' understanding and attitude toward this group of people who require special care. Explore the effectiveness of introducing a new curricular course in improving nursing students' knowledge of and attitudes toward people living with dementia and the provision of care for them. A pretest – posttest quasi-experimental design was used. After the introduction of dementia lectures, both study groups had a significant improvement in knowledge and attitude toward people living with dementia (P ≤.05). Adding clinical experience did not significantly enhance knowledge. It improved attitudes, but the result was not statistically significant (P >.05). The introduction of a new curricular course had a positive impact on the knowledge of and attitudes of nursing students toward people living with dementia. These findings emphasize the importance of incorporating dementia-focused education to enhance the quality of care provided by future nursing professionals. [ABSTRACT FROM AUTHOR]

Background/Aims: Neonatal jaundice is a common cause of hospitalisation. This study aimed to identify maternal and neonatal factors associated with neonatal jaundice among hospitalised neonates in north Jordan. Methods: This was a case control study involving 312 mothers and their neonates (106 cases, 206 controls), recruited from two governmental hospitals in north Jordan. A structured interview was used to collect data. Neonatal medical records were accessed for clinical data. Results: Maternal factors associated with higher risk of jaundice included having higher education, being employed and having had a caesarean section. Neonatal factors associated with higher risk of jaundice included being preterm, receiving <5 feeds per day and having ABO incompatibility. Conclusions: Using evidence-based guidelines for the assessment and management of risk factors helps to reduce the prevalence of jaundice requiring hospitalisation among neonates. Raising mothers' awareness of neonatal jaundice through interventions and education sessions during antenatal care, in particular for high-risk mothers, is also likely to help reduce its prevalence. [ABSTRACT FROM AUTHOR]

Background: The magnitude of postpartum depression in Jordan during the COVID-19 pandemic is under-documented, and little is known about its potential social, demographic, and clinical correlates. This study aimed to explore the prevalence and related factors of postpartum depression among Jordanian mothers with a history of COVID-19 during pregnancy or after childbirth. Materials and Methods: This cross-sectional descriptive study was carried out in March-June 2021 among a convenient sample of 109 women with a history of COVID-19 during pregnancy or after childbirth, who were at a leading hospital equipped to care for COVID-19 cases in North Jordan. An online survey using the Edinburgh Postnatal Depression Scale (EPDS) was used to collect information from mothers with a history of COVID-19-positive tests. Results: Among the total number of women who participated in the study (n = 109), 73 women had postpartum depression. The prevalence of postpartum depression in the present study was 67%. In addition, the study found a positive statistically significant correlation between EPDS scores and being a smoker, delivery method, experiencing severe COVID-19 symptoms, and being hospitalized. Conclusions: During the COVID-19 pandemic, women had a high level of postpartum depression. It would be necessary to follow further the confirmed cases of COVID-19, and mothers should be screened for depressive symptoms during pregnancy and followed up for antenatal and postnatal care. [ABSTRACT FROM AUTHOR]

Reports have highlighted the role of supportive work environments in several nurse outcome measures, indicating a need for effective leadership styles that improve the nurse working environment. Authentic leadership is a relatively new concept in Arab work culture. The purpose of this study was to examine the relationship between authentic leadership demonstrated by nurse managers and work engagement among Jordanian registered nurses. A cross-sectional correlational design was employed. A sample of 238 registered nurses working in a public hospital in Jordan was collected. Data collection was performed by using the staff demographics questionnaire, the authentic leadership questionnaire (ALQ), and the Utrecht Work Engagement Scale (UWES)-17 items. Descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson correlation, and hierarchical multiple regression analysis were employed to analyze the data. The results showed a statistically significant positive correlation between authentic leadership and work engagement in the hierarchical regression analysis (B = 0.34, t = 5.54, p < 0.001). After controlling demographic variables, authentic leadership accounted for 11% of the additional variance above and beyond the 5% accounted for age, educational level, and work experience (change of R 2 = 0.11, p < 0.01). Nurses whose managers demonstrate higher levels of authentic leadership report more work engagement (r = 0.37, p < 0.001). Considering the role of authentic leadership in promoting nurses' work engagement, it would be beneficial to develop authentic leadership behaviors for nurse managers. [ABSTRACT FROM AUTHOR]

This study aimed to explore self and public stigma towards mental illness and associated factors among university students from 11 Arabic‐speaking countries. This cross‐sectional study included 4241 university students recruited from Oman, Saudi Arabia, the United Arab Emirates (UAE), Syria, Sudan, Bahrain, Iraq, Jordan, Lebanon, Palestine and Egypt. The participants completed three self‐administrative online questionnaires—Demographic Proforma (age, gender, family income, etc.), Peer Mental Health Stigmatization Scale and Mental Health Knowledge Questionnaire. There was a significant difference in the average mean between the 11 countries (p < 0.01) based on stigma agreement (self) and stigma awareness (public). The mean stigma agreement towards mental illnesses among university students was 19.7 (SD = 6.0), with the lowest in Lebanon, 15.9 (SD = 5.1) and the highest in UAE, 24.1 (SD = 5.6). The factors associated with stigma agreement included poor knowledge, being male, high family income, age, weak cumulative grade point average (cGPA), mothers with primary education, an unemployed parent, students in scientific colleges and fathers who completed secondary or university degrees. Furthermore, the factors associated with stigma awareness included good knowledge, acceptable cGPA and having a father who has a low income and is illiterate. Stigma towards mental illness varies among university students across Arabic‐speaking countries. There is a need to sensitize youngsters to the need for a humanitarian approach in society to individuals affected by mental health concerns. Major governmental reforms must be initiated for the provision of mental health services for individuals with mental illnesses. [ABSTRACT FROM AUTHOR]

There is currently limited knowledge about the firsthand experiences of adolescents and young adults with mental health problems and the meanings they ascribe to these experiences, particularly within Arab countries. This study, therefore, aimed to explore the lived experience of Omani adolescents and young adults with a mental health problem. A sample of 15 participants aged 13–22 diagnosed with a range of mental health problems took part in the study. A qualitative interview guide consisting of open-ended questions was used to allow participants to speak in-depth about their experiences. Using the thematic analysis approach to uncover patterns in the data, three major themes emerged: "living in darkness", "perilous journey" and "uncertain future". Results show that the progress of adolescents and young adults with mental health problems is characterized by several challenges; the most significant of which is having insufficient knowledge about their illness, leading to unnecessary delays in their treatment. These findings shed light on the breadth and depth of the experience of adolescents and young adults with mental health problems and lay the groundwork for further examinations. Implications lie in the development of approaches for preventing or mitigating difficulties faced by adolescents and young adults with mental health problems. [ABSTRACT FROM AUTHOR]

Background: Post-laparoscopic shoulder pain is very common after laparoscopy. One method to reduce postoperative shoulder pain is the pulmonary recruitment maneuver. It is used to reduce post-laparoscopic shoulder pain. This study utilizes a truly experimental, double-blinded, prospective randomized design to assess the effect of pulmonary recruitment maneuvers on post-laparoscopic shoulder pain after laparoscopic cholecystectomy. Methods: Sixty patients were allocated randomly into two groups. The intervention group received five manual pulmonary inflations for 5 s at a maximum pressure of 25 cm H2O. The control group included patients whose residual CO2 gas was evacuated from the abdominal cavity using passive exsufflation as the routine method at the end of surgery by abdominal massage. Gentle abdominal pressure was applied to facilitate CO2 gas removal. Results: When Ramsay's Sedation Score's results were compared between the two groups after the operation, there was no statistically significant difference between the two groups during the first and (p value = 0.20) second (p value = 0.61) hours. A repeated measures ANOVA revealed that the pulmonary recruitment maneuver is significant (p-value 0.001) and had a high effect size (0.527) in reducing shoulder pain among laparoscopic cholecystectomy patients after controlling the effect of other covariate patient characteristics. Conclusion: Utilizing a pulmonary recruitment maneuver at the end of laparoscopic surgery reduces shoulder pain. [ABSTRACT FROM AUTHOR]

Assessing self-care is important aspects among patients with heart failure. However, few studies were conducted to assess self-care among patients with heart failure in Jordan. Therefore, this study aimed to assess the most and the least performed maintenance self-care behaviors and to examine the relationship between maintenance self-care behaviors and selected sociodemographics. A cross-sectional design utilizing a convenience sample of 226 patients with heart failure was used. The maintenance self-care mean was 53.89 and considered below the clinical target level (≥70). Asking for low salt item and performing physical exercises were the most performed self-care behaviors, while "trying to avoid getting sick" and "checking ankles for swelling" were the least performed self-care behaviors. Limited self-care behaviors indicated the need to implement cardiac education that may improve self-care behaviors. Cardiac education should target mainly patients with low income, low educational level, elderly, living alone, unemployed, and who are using traditional treatment. [ABSTRACT FROM AUTHOR]

This study aims to explore the association between fruit and vegetable intake, high fat, body mass index (BMI) score, physical activity, and the occurrence of prostate cancer among Jordanian men. A case-control study was conducted in three large referral hospitals. The sample included 165 prostate cancer patients in the case group and 177 healthy participants in the control group. The results showed that smoking (odds ratio [OR] = 0.32; 95% confidence interval [CI] = [0.18, 0.57]), a history of prostate infection (OR = 0.21; 95% CI = [0.11, 0.38]), high-fat intake (OR = 0.44; 95% CI = [0.23, 0.85]), and increased mean of BMI (OR = 1.08; 95% CI = [1.02, 1.13]) increased the likelihood of developing prostate cancer. Healthy diet and giving up smoking are recommended, as they may contribute to a reduction in the incidence of prostate cancer. More randomized clinical trials in this area are needed to strengthen the available evidence and reduce the effects of confounding variables. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To consider the effect of caring for patients with COVID-19 on front-line nurses' professional quality of life • To learn about sociodemographic and work-related factors that influence front-line nurses' professional quality of life when caring for patients with COVID-19 • To recognise the importance of providing appropriate training and health and well-being interventions for front-line nurses during a pandemic Background: Front-line nurses caring for patients with coronavirus disease 2019 (COVID-19) experience stressful and traumatic working conditions, which may affect their professional quality of life. Aim: To identify the effect of COVID-19 on front-line nurses' professional quality of life, specifically on their levels of compassion satisfaction, burnout and secondary traumatic stress. Method: A descriptive, cross-sectional comparative design was adopted. Data collection tools included self-reported sociodemographic and work-related characteristics and the self-report Professional Quality of Life Scale (ProQOL). Questionnaires (n=200) were distributed by email to two groups of nurses working in a government hospital in Saudi Arabia: front-line nurses who cared for patients with COVID-19 in isolation units; and front-line nurses who cared for patients without COVID-19 in inpatient units. Results: Completed questionnaires were received from 167 respondents, a response rate of 84%. Moderate levels of compassion satisfaction, burnout and secondary traumatic stress were found regardless of respondents' involvement in caring for patients with COVID-19. There was no statistically significant difference between the two groups in terms of compassion satisfaction, burnout and secondary traumatic stress. Conclusion: The COVID-19 pandemic presents a new challenge for front-line nurses, necessitating appropriate interventions to avoid burnout and secondary traumatic stress. [ABSTRACT FROM AUTHOR]

Background: Few longitudinal studies have focused on patients' cancer pain experience when receiving care in a multidisciplinary pain management clinic (MPMC). This study aimed to evaluate the experiences of a cohort of cancer patients newly engaged in a MPMC. Methods: This study was based on a longitudinal approach in which data were collected over a 6 months period at the King Hussein Cancer Centre in Jordan. The study adopted the Arabic version of the Brief Pain Inventory to identify the level and prevalence of cancer pain, and to identify the impact of receiving care at the MPMC on patients' pain experience. Data were collected over four time points, and the period between these points ranged from 2 to 3 weeks. Results: The majority of patients demonstrated improvement in their pain after receiving treatment at the MPMC, while a third still experienced severe pain. Significant improvement was reported at T1, and no further decline in pain was noted after this point. This indicates that exposure to the intervention provided by the MPMC generated, on average, an improvement in patients' pain experience. Conclusion: The MPMC may be an effective pain management strategy in the treatment of cancer pain. [ABSTRACT FROM AUTHOR]

AIMThe study aimed to identify nursing students' professional competencies and examine which factors of the clinical learning environment affect these competencies. BACKGROUND Professional competencies are vital for the quality and safety of nursing practice. The learning environment is important for the development of professional competencies. METHOD Data were collected from 178 nursing students using the Clinical Learning Environment and Supervision Scale and the Nursing Professional Competencies Scale-Short Form. RESULTS The highest competency was achieved in value-based nursing care; the lowest competency was achieved in development, leadership, and organization of nursing. Factors such as positive pedagogical atmosphere, nursing care on the ward, and good supervisory relationship affected learning and, in turn, improved professional competencies. CONCLUSION The results establish a link between the clinical environment and reported professional competencies, leading to a call for more focused coverage of these factors in the academic curricula. [ABSTRACT FROM AUTHOR]

Background: The recent coronavirus disease 2019 (COVID‐19) pandemic has imposed severe psychological pressure on nurses. Mindfulness has been shown to be effective in improving professional quality of life (ProQOL) and reducing psychological distress in a wide range of populations and contexts. However, its role in supporting critical care nurses during the outbreak of COVID‐19 has yet to be established. Purpose: This study explores the relationship of mindfulness with negative emotional states and ProQOL among nurses working in critical care units during COVID‐19 pandemic. Methods: A cross‐sectional descriptive correlational design was used. A sample of 156 critical care nurses completed self‐reported measures of mindfulness, ProQOL, and negative emotional states. Multiple regressions were used to address the study purpose. Results: Overall, the participants had severe anxiety, moderate depression, moderate stress, moderate burnout, moderate secondary traumatic stress, and moderate compassion satisfaction. Mindfulness was significantly and negatively associated with stress (r = − 0.230, p =.004), depression (r = − 0.190, p =.018), burnout (r = − 0.218, p =.007), and secondary traumatic stress (r = − 0.168, p =.037). Mindfulness explained 3% of the variance in depression (B = −0.19, p =.018), 3.9% of variance in stress, (B = −0.201, p =.012), 4.2% of variance in BO (B = −0.206, p =.009), and 2.2% of the variance in secondary traumatic stress (B = −0.168, t = −2.104, p =.037), controlling for demographics. Conclusions: The current study provides preliminary evidence that mindfulness can be helpful in reducing critical care nurses' psychological distress and promoting their ProQOL, and is worthy of further investigation in this population. [ABSTRACT FROM AUTHOR]

Older adults are at a higher risk of being diagnosed with long-term conditions than those in other age groups. The aim of this study was to examine long-term conditions associated with, and predictive of, primary health care (PHC) service use among older adults living in the Irbid Governorate of Jordan over the previous one, six and 12 months. Cross-sectional data were collected from 190 adults aged 60 years and above. Face-to-face interviews were conducted within the catchment areas associated with three comprehensive healthcare centres. Results show that rates of PHC service use among older adults with long-term conditions are high, with heart conditions, diabetes and hypertension the most consistent predictors of service use. [ABSTRACT FROM AUTHOR]

Being overweight and obese in adolescence are significant global public health issues which threaten the viability of basic healthcare delivery in many countries. The number of affected adolescents is growing at an alarming rate. Behavioural treatment, which refers to a set of principles and techniques designed to help people reverse maladaptive eating and activity habits, has become a crucial part of most programmes designed to address overweight and obesity. This article outlines three steps involved in the behavioural treatment of overweight and obesity in adolescents: antecedents, eating behaviour and the consequences of eating behaviour. Regular and consistent daily recording of food intake and the individual's activities are foundations of behavioural management, and should form part of the nursing care plan. [ABSTRACT FROM AUTHOR]

• Schoolchildren demonstrated inadequate knowledge about the causes of epilepsy. • The most common source of students' knowledge about epilepsy was from the media. • The students' feeling of responsibility or thinking they were doing their best for the patient by contacting the parents. • Most of students said that a person with epilepsy should be able to marry and have children. • Schoolchildren who already had first aid training presented more positive attitudes than those who had not. The purpose of this study was to assess knowledge, attitudes, and practice toward epilepsy among Jordanian schoolchildren. A cross-sectional design was used, utilizing a self-administered questionnaire to assess students' knowledge, attitudes, and practices in eight schools in a single province in Jordan. The results showed students' age ranged from 12 to 18 years (mean = 15.19, SD = 1.8). Students demonstrated inadequate knowledge and negative attitudes toward people with epilepsy. None of the participating students had received first aid or seizure management training in or out of school. The conclusion state that students demonstrated poor knowledge and negative attitudes toward people with epilepsy. They had no form of education or training regarding epilepsy management or first aid, indicating a need to launch education sessions as part of the school curriculum and to introduce straightforward activities in the school health education program. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to examine the relationships between structural empowerment, psychological empowerment, and organizational commitment in Jordanian staff nurses. Background: Empowering nurses is one of the most effective strategies for increasing efficiency. Therefore, studying the contribution of structural and psychological empowerment to organizational commitment will provide a base for future interventions to improve nurses' working environment. Materials and Methods: This cross‐sectional study used snowball sampling to recruit staff nurses working in Jordanian public and private hospitals. The sample consisted of 180 nurses. Data were collected using three valid and reliable self‐reporting questionnaires that were distributed in electronic format. Results: Nurses reported a moderate level of both structural and psychological empowerment, and a high level of organizational commitment. Significant positive relationships were found between structural empowerment and psychological empowerment and organizational commitment (r =.62, p <.001) and (r =.57, p <.001) respectively. Conclusion: Staff nurses reported moderate levels of both structural and psychological empowerment, and have a high level of organizational commitment. Positive relationships between structural empowerment, psychological empowerment, and organizational commitment were found among Jordanian staff nurses. [ABSTRACT FROM AUTHOR]

The purpose of this study was to ascertain elementary schoolteachers' perceptions of attention deficit hyperactivity disorder (ADHD) in northern Jordan. This study utilized a descriptive cross-sectional research design using a self-reporting questionnaire to gather data from elementary schoolteachers in northern Jordan from February to June 2019. The results indicate that elementary schoolteachers in northern Jordan have negative perceptions regarding ADHD and its causes, treatment, and diagnosis. The lack of professional pre-service training and education about children's behavioral problems overall, but especially regarding ADHD knowledge and management of children with ADHD was found to be deficient among our sample of elementary schoolteachers. The pronounced lack of research on teacher management of ADHD in children in Jordan may have contributed to these findings. Structured educational and training programs addressing children with ADHD should be implemented to enhance teachers' knowledge about ADHD and to improve their role in helping the affected children and their families. [ABSTRACT FROM AUTHOR]

Background: Public awareness and attitudes toward cancer and cancer patients are highly important in enhancing the effectiveness of cancer screening and early diagnosis programmes. This study aimed to explore the public attitudes toward cancer and cancer patients in Jordan. Method: A cross-sectional design was used to conduct this online survey study in Jordan between March 20th and April 20th 2020.The sample was conveniently selected, and 1157 participants were included from the public. The Public Attitudes toward Cancer Questionnaire was employed. Results: Descriptive statistics, unpaired t-test, ANOVA, and multiple linear regression were utilized. The mean age was 44.2 years (SD = 20.1), and 53% were female. The total mean attitude score was 38.2 (SD = 4.3). Based on the results, having a family member or a friend with cancer (P = 0.003), willingness to be informed about cancer diagnosis (P = 0.001), informing a friend about cancer diagnosis (P = 0.021), and willingness to participate in screening and early detection programmes (P < 0.001) were significant predictive positive attitudes towards cancer and cancer patients. In addition, being married predicted more negative attitudes compared with being single (P = 0.001). Conclusion: This study demonstrated that Jordanians had positive attitudes toward cancer and cancer patients and most were willing to be informed about cancer diagnosis. This calls for healthcare providers to adopt shared decision models when devising health care plans for cancer patients, with more involvement on the parts of both patients and family members rather than adopting a paternal approach. Policy makers and managers should consider positive attitudes when developing healthcare programmes to enhance public participation in early cancer detection and screening programmes so as to reduce cancer mortality and morbidity rates. [ABSTRACT FROM AUTHOR]

Aim and Objective: This study investigated the effects of social support, parenting stress and maternal self‐efficacy on postpartum depression among adolescent mothers in Jordan. Background: Adolescent pregnancy may have serious health, social and economic consequences for young women, families and communities. In Jordan, the incidence of adolescent pregnancy has increased from 5% in 2012 to 15% in 2018. Little attention has been given to postpartum depression among adolescent mothers in Arab and Middle Eastern countries. Method: In a cross‐sectional design using convenience sampling, 200 women aged less than 20 years, six to eight weeks postpartum and who could speak and read Arabic were interviewed in a participating health clinic. The interview occurred before or after a woman's scheduled clinic appointment and included socio‐demographic data, Edinburgh Postnatal Depression Scale (EPDS), Maternity Social Support Scale (MSSS), Parenting Stress Scale (PSS) and Perceived Self‐efficacy Scale (PSES). Data collection took place between December of 2018 and April of 2019. Reporting followed the STROBE guidelines. Results: Results revealed that 28.5% of adolescent mothers had probable postpartum depression. Mothers who reported high social support, high parenting stress, low self‐efficacy, financial stress and marital conflict had significantly higher EPDS scores than those who did not report these stressors. Conclusion: Prevalence of postpartum depression reported in this study warrants immediate action on early assessment, detection and intervention. High levels of social support may feel overwhelming for young mothers and contribute to high parenting stress, low maternal self‐efficacy and marital conflict. Relevance to clinical practice: Adolescent mothers are at increased risk of PPD compared to mothers over 20 years of age. Perceived quality rather than availability of social support needs to be considered. Young mothers require education and early intervention prevention strategies to better prepared them for motherhood and manage stressors associated with their changing social role. [ABSTRACT FROM AUTHOR]

-Why you should read this article: • To refresh your knowledge about routes of infection and risk factors in toxoplasmosis • To learn about toxoplasmosis knowledge and practices among pregnant women in Jordan • To understand the preventive practices required from pregnant women to avoid toxoplasmosis Background: Toxoplasmosis is a common zoonotic infection which, in pregnant women, can result in miscarriage, stillbirth or child disability. Prevention and education play a crucial role in reducing the risks of infection and complications. Aim: To assess the knowledge and practices of pregnant women in Jordan in relation to toxoplasmosis and its prevention. Method: A cross-sectional descriptive study was conducted in a convenience sample of 583 pregnant women visiting a health centre, hospital or private gynaecology clinic in the Jordanian governorate of Mafraq. The governorate has the second-largest population of Syrian refugees in Jordan. A structured questionnaire was used to collect data on participants' knowledge and practices. Results: Of the 583 participants, 75% had never heard of toxoplasmosis. Participants demonstrated, to varying degrees, some adequate knowledge of toxoplasmosis prevention and some adequate use of preventive practices. None of the sociodemographic characteristics of participants was predictive of their level of knowledge of toxoplasmosis, except nationality: Syrian women had a statistically significant lower level of knowledge than Jordanian women. Conclusion: There are gaps in knowledge and practices among pregnant women in Jordan in relation to toxoplasmosis and its prevention. Improved health education, particularly for female Syrian refugees living in Jordan, could enhance knowledge and practices, thereby reducing the risks of infection and complications. [ABSTRACT FROM AUTHOR]

Background: Predicting nurse turnover is important to prevent expensive and avoidable staff loss. One factor that may influence nurse turnover is nurse managers' leadership styles. Three main leadership styles have been identified: transactional, in which leaders give contingent rewards; transformational, in which leaders inspire and motivate; and passive-avoidant, in which leaders are absent. Aim: To assess the effect of nurse managers' leadership styles on predicted nurse turnover in Jordanian hospitals. Method: A descriptive, cross-sectional, and correlational study design was used. The Multifactor Leadership Questionnaire (MLQ-5X) was used to assess nurses' perceptions of their nurse managers' leadership styles, while the Anticipated Turnover Scale was used to assess nurses' intention to leave the job. The questionnaires were distributed to 280 nurses in three public sector hospitals and one university-affiliated (teaching) hospital in the north of Jordan. Results: Responses were received from 250 nurses working in a variety of clinical areas, yielding a response rate of 89%. The respondents perceived that the transactional leadership style was the most common among their nurse managers, followed by the transformational style and passive-avoidant style. It was also identified that, on average, respondents had a slight intention to leave their jobs. The transformational leadership style was found to reduce predicted nurse turnover, while the passive-avoidant and transactional leadership styles had no significant effect on this. Conclusion: Understanding the effect of nurse managers' leadership styles on predicted nurse turnover may improve retention. Therefore, nurse managers should undertake training programmes on effective leadership to improve nurses' job satisfaction and reduce turnover. [ABSTRACT FROM AUTHOR]

The aim: To investigate the relationship between marital violence and Jordanian nurses' physical and mental health. Background: Despite the negative impact of marital violence on female nurses' health, few studies have investigated its physical and mental aspects. Method: A descriptive correlational design was used to investigate the relationship between marital violence and the physical and mental health of female Jordanian nurses. One hundred ninety‐eight female Jordanian nurses from five governmental hospitals were recruited. The Women Abuse Screening Test was used to measure forms of violence, and the SF‐36 V2 instrument was used to examine physical and mental health. The prevalence of violence was calculated, and the linear relationship between violence and physical and mental health was measured using Pearson correlation. Results: Female nurses reported a high percentage of different forms of violence. The study results revealed a negative relationship between violence and mental health and physical health. Conclusion: Jordanian female nurses suffered hazardous physical and mental health consequences of violence that adversely affect their entire life. Implications for nursing policy and education: Nursing educators should establish clear guidelines and training policies on marital violence for nurses through creation of an effective and cooperative networking and resources. Also, nursing/health policymakers should create responsive healthcare environment through raising the awareness on marital violence against nurses and providing counselling services for emergency and concurrent cases. [ABSTRACT FROM AUTHOR]

Security personnel are the first ones who attend the scene in the case of out-of-hospital cardiac arrest (OHCA) at malls. Cardiopulmonary resuscitation (CPR) is not enough for those patients; they need an automated external defibrillator (AED) to bring the heart to function normally. This study aimed to assess the current status of CPR and AED knowledge and availability in Saudi malls by security personnel. Using a descriptive design, a study was conducted at seven malls located in the Eastern Province of Saudi Arabia. Two hundred and fifty participants were surveyed using the American Heart Association (AHA) 2015 guidelines to assess CPR and AED knowledge and availability in Saudi malls. The sample mean age was 32.60 years (SD = 10.02), and 87% of participants were working as security personnel. The majority of the participants had not received training about CPR and AED (75.8% and 95.2%, respectively). Common misconceptions are fallen into all categories of CPR and AED knowledge. Correctly answered statements ranged from 7.2% in the compression rate to 24.2% in hand placement. The study results indicated a poor training knowledge of CPR and AED in public settings. Integrating high-quality CPR and AED knowledge within the school and college curricula is a vital need. However, in order to maximize the survival rate, it is important to set laws and legislation adopted by stakeholders and decision makers to advocate the people who try to help, mandate AED installation in crowded places, and mandate teaching hands-only CPR and AED together as a package. [ABSTRACT FROM AUTHOR]

Background: Disordered eating attitudes and behaviours are linked to poor physical and psychological outcomes. Aim: To examine the individual, psychological, and socio‐cultural factors associated with disordered eating attitudes among Jordanian adolescents. Methods: A stratified sampling method was used to select school students aged 15 to 18 years from three governates in Jordan in 2013/2014. Participants filled out questionnaires on socio‐demographic variables, the Eating Attitudes Test (EAT‐26; to discriminate adolescents with disordered eating); the Body Shape Questionnaire (BSQ; used to measure psychological factors associated with disordered eating); Body Mass Index was calculated and obesity evaluated according to international cut off points (to categorize normal weight, overweight, and obese adolescents, and these categories were used as individual factors associated with disordered eating). Results: A total of 963 (460 boys and 503 girls) participated in the study. Disordered eating (EAT score ≥ 20) was present in 389 (40.4%); body shape dissatisfaction (BSQ scores ≥110) was present in 161 (16.8%). Overweight and obesity were found in 332 (34.5%) participants. Unhealthy weight loss behaviours (such as self‐induced vomiting, substance abuse, and smoking) were very common. Multivariate logistic regression analysis demonstrated that female sex, urban residence, distorted perceptions of weight, BMI (excess weight), body dissatisfaction, and socio‐cultural variables (parents, peers and mass media) were significantly associated with disordered eating. Conclusion: Jordanian urban adolescents seem to embrace Western norms to fit in with the demands of Western culture. Socio‐cultural factors, particularly mass media, play a significant role in changing adolescents' norms. Prevention and intervention programs are needed to control these disorders. SUMMARY STATEMENT: What is already known about this topic? Worldwide, disordered eating among adolescents is a significant health issue with serious physical, psychological, and social consequences.Studies on the factors that lead to the development of disordered eating in Jordanian adolescents are limited What this paper adds? The rate of disordered eating in this study indicated that adolescents are being exposed to greater pressures to fit in with "Western" norms more than previously.Sociocultural factors appear to play a significant role in changing adolescents' norms.Adolescents who engage in dieting or weight loss behaviours might not necessarily be overweight and may in fact even be normal weight. The implications of this paper: School nurses have multiple opportunities to facilitate early detection, initiate prevention programmes, and develop culturally sensitive interventions.Offering school nurses an effective assessment tool like EAT‐26 will allow them to accurately assess students, identify those at risk, and develop appropriate prevention strategies. [ABSTRACT FROM AUTHOR]

Ovarian cancer accounts for 3% of all female cancers and has a high mortality rate among gynecological malignancies. Early diagnosis carries a high survival rate of 93%. So, this study was carried out to assess the knowledge and awareness of Jordanian women about ovarian cancer symptoms and risk factors. A cross-sectional survey design was used; 896 women completed the survey. The mean of total symptoms recognized was low at level of 3.2 (SD = 2.7) out of 10. The three highest known symptoms among women were as follows: extreme fatigue (43.2%), back pain (42.4%), and persistent pain in pelvic area (40.7%). The most commonly known risk factor was smoking (68.4%), followed by having ovarian cyst(s) (59.7%). Hence, with the absence of an effective screening program, a national awareness campaign is urgently needed to improve the public’s understanding of symptoms and risk factors and increasing women’s confidence in symptom recognition. [ABSTRACT FROM AUTHOR]

The article cites a study that focuses on anxiety and depression among parents of children with cancer. The study included 215 participants in Jordan who were mostly mothers. It is said that the number of Jordanians diagnosed with cancer increased by 46% from 2000 to 2012. Cancer diagnoses also affect patients' families, forcing them to face up to several life challenges.

Background: The documentation of patient data on health records is a vital component of the care process. Accurate and complete recording of this data is a necessary practice. The adoption of electronic health records to improve the quality of nursing documentation is on the rise. Objectives: This study compares the accuracy and completeness of pressure ulcer data documentation between electronic and paper records. Design: A descriptive, comparative design with a retrospective review of patient records. Settings and sample: Two hospitals were chosen purposefully, one using electronic recording of patient data and the other using paper records. Methods: In the first phase, all hospitalised patients aged 18 years and over were inspected for pressure ulcers. In the second phase, the files of patients with pressure ulcers were audited. Results: Of the 52 patients with ulcers found in the hospital that used an electronic system, 43 of their records documented the pressure ulcers (83%). Of the 55 patients with pressure ulcers in the hospital using paper records, 39 files had corresponding documentation of the presence of a pressure ulcer (71%). Conclusion: In terms of accuracy and completeness, more comprehensive documentation practice was found on the electronic health records compared with paper records. However, both types of systems have shortcomings in the practice of pressure ulcer data documentation. [ABSTRACT FROM AUTHOR]

Background: The documentation of patient data on health records is a vital component of the care process. Accurate and complete recording of this data is a necessary practice. The adoption of electronic health records to improve the quality of nursing documentation is on the rise. Objectives: This study compares the accuracy and completeness of pressure ulcer data documentation between electronic and paper records. Design: A descriptive, comparative design with a retrospective review of patient records. Settings and sample: Two hospitals were chosen purposefully, one using electronic recording of patient data and the other using paper records. Methods: In the first phase, all hospitalised patients aged 18 years and over were inspected for pressure ulcers. In the second phase, the files of patients with pressure ulcers were audited. Results: Of the 52 patients with ulcers found in the hospital that used an electronic system, 43 of their records documented the pressure ulcers (83%). Of the 55 patients with pressure ulcers in the hospital using paper records, 39 files had corresponding documentation of the presence of a pressure ulcer (71%). Conclusion: In terms of accuracy and completeness, more comprehensive documentation practice was found on the electronic health records compared with paper records. However, both types of systems have shortcomings in the practice of pressure ulcer data documentation. [ABSTRACT FROM AUTHOR]