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OBJECTIVES: Post-traumatic stress disorder (PTSD), anxiety, and depression are common mental health disorders among refugees, and all require immediate mental health support to prevent short- and long-term detrimental health outcomes. The purpose of this study was to evaluate the feasibility and preliminary efficacy of narrative exposure therapy (NET) in reducing symptoms of PTSD, depression, and anxiety among Syrian refugees residing in Jordan. METHODS: A two-arm randomized control trial was utilized. A total of 40 Syrian refugees aged 18 to 64 diagnosed with PTSD were randomly allocated to either the NET intervention group (n = 20) or the waitlist control group (n = 20) using a computer-generated allocation list with 1:1 allocation. PTSD symptoms were evaluated using the Arabic rendition of the Harvard Trauma Questionnaire, while depression and anxiety symptoms were appraised using the Arabic adaptation of the Hopkins Symptoms Checklist-25. Descriptive statistics were employed to characterize the sample and survey data. Independent t-tests were conducted to assess mean score differences in PTSD, anxiety, and depression between the intervention and control groups. RESULTS: Post NET intervention, significant reductions in PTSD (t = -10.00, P

BackgroundYoung people in low- and middle-income countries encounter significant barriers to accessing mental health support due to various factors, including a substantial treatment gap and limited health care budgets allocated to mental health. Using innovative strategies, such as scalable digital self-help psychological interventions, offers a potential solution for improving access to mental health support. However, digital mental health interventions come with their own set of challenges, including issues related to low user engagement. Chatbots, with their interactive and engaging nature, may present a promising avenue for the delivery of these interventions. ObjectiveThis study aims to explore the effectiveness of a newly developed World Health Organization (WHO) digital mental health intervention, titled Scalable Technology for Adolescents and Youth to Reduce Stress (STARS). MethodsA single-blind, 2-arm randomized controlled trial will be conducted nationally across Jordan. Participants will include 344 young adults, aged 18-21 years, currently residing in Jordan. Inclusion criteria are heightened levels of psychological distress as determined through the 10-item Kessler Psychological Distress Scale (≥20). Assessment measures will be conducted at baseline, 1-week post intervention, and 3-month follow-up. Following baseline assessments, eligible participants will be randomized to receive STARS or enhanced usual care. The primary outcomes are the reduction of symptoms of depression and anxiety (Hopkins Symptom Checklist, 25 subscales) at 3-month follow-up. Secondary outcomes include general functioning (WHO Disability Assessment Schedule 2.0), well-being (WHO-5 Well-Being Index), personal problems (Psychological Outcomes Profile), and agency (State Hope Scale subscale). ResultsThe study was funded in January 2020 by the Research for Health in Humanitarian Crises Programme (Elhra) and recruitment for the trial started on July 16, 2023. As of November 15, 2023, we randomized 228 participants. ConclusionsThis trial intends to contribute to the growing digital mental health evidence base by exploring technological solutions to address global public health challenges. Given the widespread use of technology globally, even in resource-constrained settings, and the high adoption rates among adolescents and young individuals, digital initiatives such as STARS present promising opportunities for the future of mental health care in low- and middle-income countries. Trial RegistrationISRCTN Registry ISRCTN10152961; https://www.isrctn.com/ISRCTN10152961 International Registered Report Identifier (IRRID)DERR1-10.2196/54585

Artificial intelligence tools are rapidly growing in education, highlighting the imperative need for a thorough and critical evaluation of their performance. To this aim, this study tests the effectiveness of ChatGPT and Google Bard in answering a range of questions within the engineering and health sectors. True/false, multiple choice questions (MCQs), matching, short answer, essay, and calculation questions are among the question types investigated. Findings showed that ChatGPT 4 surpasses both ChatGPT 3.5 and Google Bard in terms of creative problem-solving and accuracy across various question types. The highest accuracy achieved by ChatGPT 4 was in true/false questions, reaching 97.5%, while its least accurate performance was noted in calculation questions with an accuracy of 82.5%. Prompting both ChatGPT and Google Bard to provide short responses apparently prevented them from hallucinating with unrealistic or nonsensical responses. The majority of the problems for which ChatGPT and Google Bard provided incorrect answers demonstrated a correct problem-solving approach; however, both AI models struggled to accurately perform simple calculations. In MCQs related to health sciences, ChatGPT seemed to have a challenge in discerning the correct answer among several plausible options. While all three tools managed the essay questions competently, avoiding any blatantly incorrect responses (unlike with other question types), some nuanced differences were noticed. ChatGPT 3.5 consistently adhered more closely to the essay prompts, providing straightforward and essential responses, while ChatGPT 4 demonstrated superiority over both models in terms of adaptability. ChatGPT4 fabricated references, creating nonexistent authors and research titles in response to prompts for sources. While utilizing AI in education holds a promise, even the latest and most advanced versions of ChatGPT and Google Bard were not able to accurately answer all questions. There remains a significant need for human cognitive skills and further advancements in AI capabilities.

Abstract Background NODAL signaling plays a critical role in embryonic patterning and heart development in vertebrates. Genetic variants resulting in perturbations of the TGF-β/NODAL signaling pathway have reproducibly been shown to cause laterality defects in humans. To further explore this association and improve genetic diagnosis, the study aims to identify and characterize a broader range of NODAL variants in a large number of individuals with laterality defects. Methods We re-analyzed a cohort of 321 proband-only exomes of individuals with clinically diagnosed laterality congenital heart disease (CHD) using family-based, rare variant genomic analyses. To this cohort we added 12 affected subjects with known NODAL variants and CHD from institutional research and clinical cohorts to investigate an allelic series. For those with candidate contributory variants, variant allele confirmation and segregation analysis were studied by Sanger sequencing in available family members. Array comparative genomic hybridization and droplet digital PCR were utilized for copy number variants (CNV) validation and characterization. We performed Human Phenotype Ontology (HPO)-based quantitative phenotypic analyses to dissect allele-specific phenotypic differences. Results Missense, nonsense, splice site, indels, and/or structural variants of NODAL were identified as potential causes of heterotaxy and other laterality defects in 33 CHD cases. We describe a recurrent complex indel variant for which the nucleic acid secondary structure predictions implicate secondary structure mutagenesis as a possible mechanism for formation. We identified two CNV deletion alleles spanning NODAL in two unrelated CHD cases. Furthermore, 17 CHD individuals were found (16/17 with known Hispanic ancestry) to have the c.778G > A:p.G260R NODAL missense variant which we propose reclassification from variant of uncertain significance (VUS) to likely pathogenic. Quantitative HPO-based analyses of the observed clinical phenotype for all cases with p.G260R variation, including heterozygous, homozygous, and compound heterozygous cases, reveal clustering of individuals with biallelic variation. This finding provides evidence for a genotypic-phenotypic correlation and an allele-specific gene dosage model. Conclusion Our data further support a role for rare deleterious variants in NODAL as a cause for sporadic human laterality defects, expand the repertoire of observed anatomical complexity of potential cardiovascular anomalies, and implicate an allele specific gene dosage model.

Key Clinical Message Multiple methods are used to tackle ipsilateral obstructed venous access in patients undergoing a device upgrade by implanting a new left ventricular lead. One feasible solution to tackle this is implantation of the upgrade lead contralaterally with pre‐sternal tunnelization to the opposite side under conscious sedation.

Purpose: Vaccination against HPV plays a crucial role in preventing cervical cancer and related health issues. This study aimed to (1) assess knowledge, awareness, intentions, and attitudes regarding HPV and vaccination among Jordanian parents, and (2) evaluate the efficacy of two intervention strategies in promoting knowledge, awareness, and attitudes towards HPV vaccinations. Methods: In study one, a web-based survey was used to collect data from Jordanian parents. In study two, participants were allocated into three groups: video-based intervention, lecture-based intervention, and a control group. Pre-post tests were conducted to evaluate the efficacy of the intervention strategies in promoting knowledge, awareness, and attitudes toward HPV vaccination among Jordanian parents. Results: A total of 572 participants took part in the survey. Knowledge levels about HPV and its vaccine were generally low. Intentions regarding HPV vaccination were uncertain for the majority of participants, with 92 % reported as not receiving any guidance from medical professionals about administering the HPV vaccine to themselves or their children. Only 22 % agreed that their children might get infected with HPV at any time in their lives. The pilot randomized clinical trial revealed an improvement in knowledge, awareness, and attitudes towards HPV vaccination in both intervention groups compared to the control group with large effect sizes (eta squared between 0.29 and 0.68). Conclusions: Findings highlight the need for increased knowledge and awareness regarding HPV and vaccination. It also supported the potential effectiveness of basic educational efforts in significantly improving knowledge, awareness, and attitudes towards the HPV vaccine.

The results of an experimental investigation of the temperature and wavelength dependence of the Kerr constant (K) of mixtures with an increasing amount of chiral dopant in an isotropic liquid crystal phase are reported. The material was composed of a nematic liquid crystal (5CB) and a chiral dopant (CE2), which formed non-polymer-stabilized liquid crystalline blue phases with an exceptionally large value of K∼2 × 10−9 mV−2. The measurements were performed on liquid and blue phases at several concentrations covering a range of temperatures and using three wavelengths: 532 nm, 589 nm and 633 nm. The work focused on changes caused by concentration and their impact on the increase in the value of K, and it was found that in the case of the 5CB/CE2 mixture these changes were significant and quite systematic with temperature and wavelength. It is shown that the dispersion relation based on the single-band birefringence model described K well in isotropic liquid crystal phases at all of the measured concentrations. In an isotropic fluid, both temperature-dependent parameters in the dispersion relation had a simple linear form and, therefore, the K-surface could be described by only four constants. In the blue phase, the expression reproducing the temperature variation of K depended on concentration, which could vary from being almost linear to quasi-linear and could be represented well by an inverse exponential analytic expression.

Objectives: Post-traumatic stress disorder (PTSD), anxiety, and depression are common mental health disorders among refugees, and all require immediate mental health support to prevent short- and long-term detrimental health outcomes. The purpose of this study was to evaluate the feasibility and preliminary efficacy of narrative exposure therapy (NET) in reducing symptoms of PTSD, depression, and anxiety among Syrian refugees residing in Jordan. Methods: A two-arm randomized control trial was utilized. A total of 40 Syrian refugees aged 18 to 64 diagnosed with PTSD were randomly allocated to either the NET intervention group (n = 20) or the waitlist control group (n = 20) using a computer-generated allocation list with 1:1 allocation. PTSD symptoms were evaluated using the Arabic rendition of the Harvard Trauma Questionnaire, while depression and anxiety symptoms were appraised using the Arabic adaptation of the Hopkins Symptoms Checklist-25. Descriptive statistics were employed to characterize the sample and survey data. Independent t-tests were conducted to assess mean score differences in PTSD, anxiety, and depression between the intervention and control groups. Results: Post NET intervention, significant reductions in PTSD (t = −10.00, P

Viscosity, elasticity, and viscoelastic properties are one of the most fundamental properties of liquid crystalline materials; the main problem in determining these properties is the multitude of physical parameters needed to determine the values of elasticity and viscosity constants. In this paper, a number of different measurement methods for the complete characterization of viscoelastic properties for smectic liquid crystalline materials and their mixtures are analyzed, both theoretically and experimentally. The way in which viscoelastic material constants are determined depends mainly on the application/purpose of the materials under study. The subject of this work was to review the methods used to determine viscoelastic effects in ferroelectric and antiferroelectric chiral liquid crystals, their mixtures, composite materials, and even in dielectric systems, which would bear the hallmark of a universal method allowing the application of sufficiently low electric fields. In the case of chiral liquid crystals with ferroelectric and antiferroelectric phases and their subphases, the following assumption applies: fulfilment of Hooke’s law (in the case of elastic coefficients) and preservation of laminar flow (in the case of viscosity coefficients).

Abstract Studies investigating gender bias against female surgeons yielded conflicting results ranging from neutrality to a clear preference towards male surgeons. Yet, such bias remains understudied within Middle Eastern nations. We aimed to assess preferences of surgeons’ gender among Jordanians and explore reasons for possible gender bias across different surgical specialties. A total of 1708 respondents were examined using a cross-sectional, self-administered questionnaire to evaluate the gender preferences of surgeons, characteristics associated with preferred surgeon’s gender, and surgeon’s preference in certain specialties. Nearly 52.0% of participants had no gender preference for surgeons. Among those with a preference, 75.7% preferred male surgeons while 24.3% preferred female surgeons. Reputation, knowledge, and experience were the most important factors when choosing a surgeon. Male surgeons were viewed as more trustworthy, knowledgeable, experienced, and communicative. Female surgeons were dominantly perceived as more compassionate, cooperative, and prone to listen. Male respondents were 5 times more likely to choose a surgeon of similar gender (OR 5.687; CI 3.791–8.531). Male surgeons were favored for cardiovascular and orthopedic surgeries. Similarly, female surgeons were favored in gynecological and obstetric surgeries, plastic surgeries, and breast surgeries. Female gender (OR 6.193; CI 4.077–9.408), living outside Amman (OR 1.517; CI 1.066–2.160), and being married (OR 2.504; CI 1.601–3.917) were all significant positive predictors of preferring female surgeons. Our findings highlight differences in gender preference and perception of surgeons among Jordanian adults.

Background The burden of common mental disorders in low and middle-income countries (LMICs) is growing with little known about how to allocate limited resources to reach the greatest number of people undergoing instances of significant psychological distress. We present a study protocol for a multicentre, parallel-group, superiority, randomised controlled trial.Methods and analysis Adults with significant psychological distress (K10 score ≥20) will be randomised to receive a stepped care programme involving a self-guided course (Doing What Matters) followed by a more intensive group programme (Problem Management Plus) or the self-guided course alone, both of which will take place in addition to enhanced treatment as usual comprising of a follow-up referral session to available services within the community. We will include 800 participants. An intent-to-treat and completer analysis will explore the impact of the stepped model of care on anxiety and depression symptoms (as measured by the Hopkins Symptom Checklist; HSCL-25) at 24 weeks from baseline. Secondary outcomes include positive psychological well-being, agency, changes in patient-identified problems, quality of life and cost-effectiveness. Linear mixed models will be used to assess the differential impact of the conditions over time. Analyses will focus on the primary outcome (HSCL-25) and secondary outcomes (agency subscale, WHO Well-Being Index, WHO Disability Assessment Schedule V.2.0, EQ-5D, Psychological Outcomes Profiles Scale) for both conditions, with the main outcome time point being the 3-month follow-up, relative to baseline.Ethics and dissemination This will be the first randomised controlled trial to assess the benefits of a stepped model of care to addressing psychological distress in a LMIC setting. Results will provide important insights for managing limited resources to mental healthcare in these settings and will be accordingly disseminated to service providers and organisations via professional training and meetings, and via publication in relevant journals and conference presentations. We will also present these findings to the Jordanian Ministry of Health, where this institute will guide us on the most appropriate format for communication of findings, including written reports, verbal presentations and/or brochures. Ethical approval was obtained from the University of Jordan School of Nursing Research Ethics Committee (number: PF.22.10).Trial registration number ACTRN12621000189820p; Australian New Zealand Clinical Trials Registry.

This research validated an Arabic version of the Psychological General Well-being Index-Short version (PGWB-S) and examined the relationship between perceived psychological well-being, and food insecurity, academic achievement, and other risk factors in a sample of university students in Amman, Jordan, during COVID-19. A cross-sectional study was conducted in two phases. Phase 1 translated and validated the Arabic copy of the PGWB-S in 122 students from the University of Jordan. In Phase 2, 414 students completed the demographic questionnaire, Arabic versions of the PGWB-S, the Ryff Psychological Well-being Scale, and the Individual Food Insecurity Experience Scale. The participants had a mean PGWB-S score of 15.82 ± 0.34, and 41.3% had a mean score below 15. Psychological well-being was better in students younger than 21 and/or who had a GPA ≥3.0, were of normal weight or overweight, physically inactive, and food secure, did not drink coffee or smoke, as well as in those whose neighbourhood contained grocery stores and/or public transportation (P < 0.05). In conclusion, during the pandemic, perceived mental well-being was moderate in a Jordanian sample of university students. Perceived psychological well-being was also positively associated with food security and academic performance. These findings suggest that improving food security and academic achievement may contribute to enhanced psychological well-being among university students. Therefore, higher education institutions with the help of the government are encouraged to facilitate the provision of mental health care services to students, mainly post the coronavirus, which according to our knowledge is limited.

AbstractThis cross-sectional research assessed nutrition knowledge in a sample of college students in Amman, Jordan and its association with food security and other risk factors. An Arabic Nutrition Knowledge Index (ANKI) was developed and validated in 122 college students (pilot study). In the replication study, the demographics scale, validated ANKI, and Arabic Individual Food Insecurity Experience Scale (FIES) were administered to 470 students. The ANKI was reliable (Cα = 0.82) and stable over time (ICC = 0.82, P

This study examined whether family environment and coping strategies mediate the relationship between adolescents' bullying involvement (being a bully or victim) and severity of depression. The study utilized a nationally representative school survey and gathered data from 1083 school adolescents (mean age 15.0 ± 1.4 years; 66% females; 46% from the central urban region; 71% had very good to excellent school GPA). The relationship between bullying involvement and depression was partially mediated by family environment and emotion-focused coping. No mediating effect was revealed for problem-focused coping in this relationship. Findings from this study might help understand how the effect of bullying transmits on adolescents' psychological health, allowing us to supply more in-depth information about the bullying phenomenon than what can be explained by direct effects alone. Family environment and coping strategies used by adolescents seemed to play a critical role in shaping their bullying experience and thus, incorporating these factors into available effective anti-bullying programs can be promising.

Purpose: To identify and understand the multifaceted barriers faced by Syrian refugees when seeking vaccination services for their children. Methods: A survey questionnaire was administered through structured interviews to a sample of Syrian refugees residing inside the Al-Zaatari camp and in various urban areas across Jordanian communities. This process utilized a multi-stage sampling approach, beginning with a random selection from clusters or strata, and then employing convenience sampling within each to select participants. The survey covered demographics, barriers to vaccination, and vaccine hesitancy. Results: A total of 332 participants completed the survey with a mean age of 32.7 ± 10 years ranging from 18 to 67. More than half of the sample (59%) had an education of 11th grade or less. Sociodemographic disparities regarding barrier perception were evident among participants. Middle-aged adults (older than 32), males, and those with a monthly income less than USD 200 had scored significantly higher on barrier perceptions across all categories (p < 0.05). In-camp residents were less likely to face vaccination barriers compared to those living outside the camps (p < 0.001). Psychological antecedents of vaccine assessments showed that younger individuals had significantly higher scores in complacency, calculation, and constraints (p < 0.05). Participants with lower income had lower constraints and calculation scores (p < 0.05). In-camp residents had significantly higher scores in complacency, constraints, and calculation constructs compared outside camps counterparts (p < 0.05). Participants with no formal education had higher scores in complacency and constraints, and those with less than a 12th-grade education and higher education degrees scored significantly higher on the collective responsibility construct (p < 0.05). Conclusions: Efforts to promote vaccination among refugees should consider the specific challenges faced by this population, including financial barriers, healthcare access inequalities, and the impact of living arrangements. Public health strategies should address not only individual and psychological factors but also the physical and logistical challenges in obtaining vaccines.

Novel three-component liquid crystalline mixtures composed of chiral and achiral (racemic) liquid crystalline materials were designed and studied by polarizing optical microscopy, differential scanning calorimetry, and UV–VIS spectroscopy. The compositions of liquid crystalline mixtures were developed based on the composition of a two-component (binary) mixture marked as W-1000 with the following phase sequence: Cr ↔ SmCA* ↔ SmC* ↔ SmA* ↔ Iso. This mixture has an antiferroelectric (SmCA*) phase over a wide temperature range and exhibits a helical pitch inversion in this phase. All newly obtained mixtures occur in a wide temperature range of the SmCA* phase, while the ferroelectric (SmC*) phase and the orthogonal (SmA*) phase occur in a narrow temperature range. The new mixtures also have a very long helical pitch in the antiferroelectric phase and a short helical pitch in the ferroelectric phase.

Adolescents are more likely to engage in risky health practices related to COVID-19. Their compliance with infection control measures is a key factor to mitigate the spread of the disease. The purpose of this study was to explore the knowledge, attitudes, and practices toward COVID-19 and their correlates among Jordanian adolescents. An online cross-sectional survey was utilized. A total of 1,054 Jordanian adolescents aged 12-18 completed and returned the survey. Overall, Jordanian adolescents showed a good base of knowledge regarding COVID-19 (regardless of their demographic characteristics) and tended to hold positive attitudes toward the country's curfew and other protective measures. The majority of adolescents reported that television and social media were their main source of information on COVID-19, while few reported receiving such information from their schools. The majority reported practicing effective health protective behaviors to prevent the spread of COVID-19, which was significantly predicted by their knowledge and attitudes toward these measures. However, there was a relatively small, yet clinically significant, percentage of adolescents who showed poor knowledge on COVID-19, had negative attitudes toward protective measures, and reported being engaged in risky practices related to infection spread. Tailored efforts are needed to improve the levels of knowledge, attitudes, and practices among adolescents. Raising awareness and promoting positive attitudes are vital to change adolescents' health practices. Policy makers should ensure that school nurses are available in all schools and working to their full scope. School nurses are the eyes and ears of public health and primary care. They are essential members on pandemic preparedness, reopening and reentry planning teams, and can lead health care in schools and practice in a holistic culturally competent proactive manner to address the needs of students.

The Seattle Proportional Risk Model (SPRM) estimates the proportion of sudden cardiac death (SCD) in heart failure (HF) patients, identifying those most likely to benefit from implantable cardioverter-defibrillator (ICD) therapy (those with ≥50% estimated proportion of SCD). The GISSI-HF trial tested fish oil and rosuvastatin in HF patients. We used the SPRM to evaluate its accuracy in this cohort in predicting potential ICD benefit in patients with EF ≤50% and an SPRM-predicted proportion of SCD either ≥50% or <50%. The SPRM was estimated in patients with EF ≤50% and in a logistic regression model comparing SCD with non-SCD. We evaluated 6,750 patients with EF ≤50%. There were 1,892 all-cause deaths, including 610 SCDs. Fifty percent of EF ≤35% patients and 43% with EF 36% to 50% had an SPRM of ≥50%. The SPRM (OR: 1.92, P < 0.0001) accurately predicted the risk of SCD vs non-SCD with an estimated proportion of SCD of 44% vs the observed proportion of 41% at 1 year. By traditional criteria for ICD implantation (EF ≤35%, NYHA class II or III), 64.5% of GISSI-HF patients would be eligible, with an estimated ICD benefit of 0.81. By SPRM >50%, 47.8% may be eligible, including 30.2% with EF >35%. GISSI-HF participants with EF ≤35% with SPRM ≥50% had an estimated ICD HR of 0.64, comparable to patients with EF 36% to 50% with SPRM ≥50% (HR: 0.65). The SPRM discriminated SCD vs non-SCD in GISSI-HF, both in patients with EF ≤35% and with EF 36% to 50%. The comparable estimated ICD benefit in patients with EF ≤35% and EF 36% to 50% supports the use of a proportional risk model for shared decision making with patients being considered for primary prevention ICD therapy. [ABSTRACT FROM AUTHOR]

The ideal management of distal radius fractures (DRFs) in patients aged 65 years and older is debated. Acknowledging the evidence that both nonsurgical and surgical treatment yield similar outcomes one year after injury, a patient decision aid (PDA) could facilitate patient engagement in treatment decision-making. The purpose of this study was to develop a PDA to guide patients in the treatment of DRFs in patients ≥65 years of age. The DRF PDA was developed using an established decision sciences framework. The PDA included an overview of DRFs, treatment options (casting vs surgery), risk/benefits, and a values clarification section. During the development phase, hand surgeons and patients reviewed the PDA; then, semistructured interviews were performed with participants to elicit feedback. Eleven patients and 11 hand surgeons participated in the study. All patients found the PDA useful and almost all stated it would make the treatment decision easier. Most patients believed that there was enough information in the PDA, but one desired more information about surgical risks. Almost all surgeons stated the PDA would be easy for patients to use and understand, and approximately half believed that it would help patients make a more informed decision. Most surgeons expressed that the PDA would complement their usual approach to counseling patients, but some noted it would involve changes to their workflow. Most participants believed the information presented was unbiased, but one patient thought it was biased toward surgery, whereas a few surgeons believed that it was biased toward nonsurgical treatment. All patients expressed that the PDA was informative, comprehensive, and easy to understand and would be helpful if they were deciding about DRF treatment. Surgeons believed that patients would find the PDA easy to use and understand, but some had concerns about incorporating it into their clinic workflow. A decision aid for the treatment of DRFs in patients aged ≥65 years can be used to engage patients in the shared decision-making process. [ABSTRACT FROM AUTHOR]

Background and Purpose: Influenza, with its potential for widespread transmission and significant health repercussions for individuals and populations, demands the immediate implementation of effective preventive measures. Vaccination stands as a long-standing evidence-based strategic approach to bolster immunity, especially for healthcare providers at heightened risk due to repeated exposure. Nevertheless, studies indicate a variance in adherence to recommended vaccination protocols and a notable prevalence of hesitancy and negative attitudes toward influenza vaccination among this critical group globally. Recognizing the multifaceted nature of attitudes is essential for the development of targeted interventions and strategies tailored to address the specific concerns and motivations of healthcare providers. To this end, this study synthesized the evidence gathered from an exhaustive systematic review of studies on healthcare providers’ uptake of and perceptions and attitudes toward influenza vaccination. Methods: A systematic literature search was conducted across the databases PubMed, CINAHL, PsycINFO, Scopus, Web of Science, and EMBASE. The review adhered to PRISMA guidelines, using Covidence for screening. The process involved 4970 references, with 2684 screened after duplicate removals and 1891 excluded, leaving 793 full texts evaluated, resulting in a final 368 selected references for analysis. Due to the considerable heterogeneity observed among the studies, a narrative synthesis method was employed. Results: Five themes emerged from the systematic review’s analysis, offering a multifaceted perspective on healthcare providers’ attitudes toward influenza vaccination: (1) fostering positive views: factors promoting attitudes toward influenza vaccines; (2) navigating hesitancy: barriers and challenges to attitudes on influenza vaccines; (3) empowering change: interventions and their impact on healthcare providers’ attitudes; (4) pandemic overlap: intersecting attitudes toward influenza and COVID-19 vaccines; and (5) twin challenges: the impact of mandatory policy on attitudes and influenza vaccination. Conclusions: Healthcare providers’ attitudes toward influenza vaccination are complex and influenced by intrinsic and extrinsic motivations, barriers, demographics, organizational factors, interventions, pandemic contexts, and policy considerations. Effective strategies for promoting influenza vaccination should be multifaceted, adaptable, and tailored to address these interconnected aspects, ultimately contributing to improved vaccination rates and public health outcomes.

Middle Eastern and Arab countries have been experiencing significant advancements in scientific research and development over the past few decades. Understanding the trends, patterns, and impact of research within this region can provide valuable insights into its scientific landscape, identify areas of strength, and uncover potential areas for improvement. This study presents a comprehensive bibliometric analysis of research productivity in the Middle Eastern and Arab region over a 20-year period. The findings revealed a consistent increase in research productivity, yet mapped significant disparities between countries in scholarly output, excellence, and impact. Adjusting for population size and GDP, Iran displayed the highest publication activity, trailed by Egypt and Turkey. Delving into the distribution of research output across different journal quartiles, the results revealed that this region has a lower percentage of scholarly output published in high-impact journals (both the top 10% and the top 25% categories). Compared to North America and the European Union, the Middle Eastern and Arab region consistently exhibited lower performance in terms of top 10% citations, average citations per publication, and field-weighted citation impact. The field of physical sciences took the lead as the most prevalent subject area in the Middle Eastern and Arab region, comprising about 60.5% of the research emphasis. Conversely, social sciences garnered comparatively less research attention, making up approximately 8.9% of the focus. The region showed strong international collaboration levels (40.5%), yet relatively low national (24.4%) and academic–corporate collaborations (1.5%). The outcomes of this study can facilitate international comparisons and benchmarking, allowing Middle Eastern and Arab countries to position themselves within the global scientific community. There remains a need to prioritize quality over quantity by emphasizing rigorous research practices and collaboration. An ongoing evaluation of research performance using a combination of indicators can help track progress and adjust strategies as needed.

School bullying is recognized as a global problem and sparks public concerns for students' safety. While it has recently emerged as a critical concern in the Arab world, particularly in Jordan, no national studies have yet investigated the extent of bullying in Jordanian schools. The purpose of this study was to investigate the prevalence, correlates, and experiences of bullying among a national sample of Jordanian adolescent students. A stratified random sampling procedure was used to select schools that represent the three main regions of Jordan (i.e. north, middle, and south) and a weighted sample of schools was randomly selected using Statistical Analysis System 9.4 based on provinces' density. A nationally representative sample of 1083 adolescents aged 12 to 17 was included in the study. Data were collected using self-administered questionnaires on school bullying and adolescent sociodemographics. The prevalence of bullying among Jordanian adolescents was consistent with international studies; 7% reported their involvement in bullying as a victim, 7.6% as a bully, and 1.7% as both. Verbal bullying was the most common form of bullying among victims and bully-victim, while relational bullying was the most prevalent bullying for bullies. Being a perpetrator was more prevalent among boys than girls. Adolescent students who came from low socioeconomic status or whose fathers were illiterate reported more victimization experience. The majority of students who experienced bullying reported negative attitudes of bystanders, parents, and teachers towards intervening or responding to the bullying experience. Bullying exists among Jordanian students and active steps towards addressing this phenomenon are discussed. This is the first known Jordanian study representing a national sample of adolescent students' experience of bullying. Findings present valuable information for school professionals, parents, and students regarding bullying and its associated factors. These findings also provide an avenue for the adoption and implementation of available anti-bullying programs to ameliorate bullying behaviors among Jordanian school students.

Carer-workers are individuals providing regular unpaid care to an adult dependent while simultaneously employed in the paid labour market, and the group represents a significant portion of the Canadian adult population. Despite the prevalence of unpaid care in Canada, very limited research has explored the spatio-temporal tensions that carer-workers experience. The objective of this study is to explore the space–time constraints experienced by carer-workers. One way of measuring both space and time constraints on an individual is the foundational time geography concept of the Space-Time Prism, and its two-dimensional counterpart, the Potential Path Area (PPA). We collected three to seven day-long trip diaries of 25 carer-workers in the Greater Toronto and Hamilton Area in 2017–18, including all trips made over the diary period and whether the trip involved care work. We developed a customized Python tool and used Open Street Maps to derive PPAs for 12 of the sample carer-workers, which were aggregated to form daily PPAs. Descriptive analyses of the PPAs are presented, and comparisons of PPA size, and therefore, daily accessibility, across carer-workers’ sociodemographic and economic indicators, days of the week, and level of caregiving intensity are examined. Through its ability to represent, quantitatively and visually, the accessibility differences across various population groups, and to fill a gap in our understanding of carer-workers, the PPA represents an important methodological avenue for continuing research into carer-workers in Canada and around the world.

Background: Paravalvular leak (PVL) is a common complication following valve replacement, which leads to heart failure and hemolysis. Transcatheter PVL closure has emerged as a reliable alternative with promising results. We quote the combined three-center experience of PVL patients treated percutaneously. Methods: Consecutive patients treated percutaneously for PVL were retrospectively studied. Procedural characteristics, inhospital, and long-term clinical outcomes were assessed. Technical (successful deployment) and clinical (NYHA and/or hemolysis improvement) success were evaluated. Results: In total, 39 patients treated for PVL in either the aortic (12 patients) or the mitral (27 patients) position were studied. Amplatzer Vascular Plug III was the most commonly used device among the 45 devices totally implanted. Postprocedurally, the rates of at least moderate PVL (87.5% preprocedurally vs 10.5% at discharge) and functional status (mean NYHA class 2.8 ± 0.7 on admission vs 1.5 ± 0.8 at follow-up) were statistically significantly improved.Total population technical success rate was 89.7%, being comparable between patients treated for mitral or aortic valve PVLs (92.6% vs 83.3%, respectively). Clinical success was achieved in 82.1% of patient cohort without statistical difference among those with isolated aortic or mitral PVL or among those with PVL closure an indication of heart failure or hemolysis. During a mean follow-up of 33.5 months, five patients died, including one periprocedural death. Conclusions: This multicenter recorded experience confirms that percutaneous PVL closure can be performed with high technical and clinical success rates and limited complications that lead to significant PVL reduction and functional status improvement.

Background: Rapid population aging in developed countries has resulted in the working-age population increasingly being tasked with the provision of informal care. Methods: An educational intervention was delivered to 21 carer-employees employed at a Canadian University. Work role function, job security, schedule control, work–family conflict, familywork conflict, and supervisor and coworker support were measured as part of an aggregated workplace experience score. This score was used to measure changes pre/post intervention and at a follow-up period approximately 12 months post intervention. Three random intercept models were created via linear mixed modeling to illustrate changes in participants' workplace experience across time. Results: All three models reported statistically significant random and fixed effects intercepts, with a positive coefficient of change. Conclusion: This suggests that the intervention demonstrated an improvement of the workplace experience score for participants over time, with the association particularly strong immediately after intervention.

Background It is unclear how to geographically distribute percutaneous coronary intervention (PCI) programs to optimize patient outcomes. The Washington State Certificate of Need program seeks to balance hospital volume and patient access through regulation of elective PCI. Methods and Results We performed a retrospective cohort study of all non‐Veterans Affairs hospitals with PCI programs in Washington State from 2009 to 2018. Hospitals were classified as having (1) full PCI services and surgical backup (legacy hospitals, n=17); (2) full services without surgical backup (new certificate of need [CON] hospitals, n=9); or (3) only nonelective PCI without surgical backup (myocardial infarction [MI] access hospitals, n=9). Annual median hospital‐level volumes were highest at legacy hospitals (605, interquartile range, 466–780), followed by new CON, (243, interquartile range, 146–287) and MI access, (61, interquartile range, 23–145). Compared with MI access hospitals, risk‐adjusted mortality for nonelective patients was lower for legacy (odds ratio [OR], 0.59 [95% CI, 0.48–0.72]) and new‐CON hospitals (OR, 0.55 [95% CI, 0.45–0.65]). Legacy hospitals provided access within 60 minutes for 90% of the population; addition of new CON and MI access hospitals resulted in only an additional 1.5% of the population having access within 60 minutes. Conclusions Many PCI programs in Washington State do not meet minimum volume standards despite regulation designed to consolidate elective PCI procedures. This CON strategy has resulted in a tiered system that includes low‐volume centers treating high‐risk patients with poor outcomes, without significant increase in geographic access. CON policies should re‐evaluate the number and distribution of PCI programs.

Background As patients derive variable benefit from generator changes (GCs) of implantable cardioverter‐defibrillators (ICDs) with an original primary prevention (PP) indication, better predictors of outcomes are needed. Methods and Results In the National Cardiovascular Data Registry ICD Registry, patients undergoing GCs of initial non‐cardiac resynchronization therapy PP ICDs in 2012 to 2016, predictors of post‐GC survival and survival benefit versus control heart failure patients without ICDs were assessed. These included predicted annual mortality based on the Seattle Heart Failure Model, left ventricular ejection fraction (LVEF) >35%, and the probability that a patient's death would be arrhythmic (proportional risk of arrhythmic death [PRAD]). In 40 933 patients undergoing GCs of initial noncardiac resynchronization therapy PP ICDs (age 67.7±12.0 years, 24.5% women, 34.1% with LVEF >35%), Seattle Heart Failure Model–predicted annual mortality had the greatest effect size for decreased post‐GC survival (P35% had a lower Seattle Heart Failure Model–adjusted survival versus 23 472 control heart failure patients without ICDs (model interaction hazard ratio, 1.21 [95% CI, 1.11–1.31]). In patients undergoing GCs of initial noncardiac resynchonization therapy PP ICDs with LVEF ≤35%, the model indicated worse survival versus controls in the 21% of patients with a PRAD 65%. The association of the PRAD with survival benefit or harm was similar in patients with or without pre‐GC ICD therapies. Conclusions Patients who received replacement of an ICD originally implanted for primary prevention and had at the time of GC either LVEF >35% alone or both LVEF ≤35% and PRAD

Little is known about help-seeking for depression among Jordanian adolescents who are a vulnerable population with high rates of depressive symptoms and few mental health services. The purpose of this study was to (1) explore Jordanian adolescents' helpseeking intentions for depression and (2) examine whether depression stigma, depression severity, or their interaction are associated with Jordanian adolescents' willingness to seek help for depression and the type of treatment they would seek. In collaboration with the Jordanian Ministry of Education, we conducted a nationally representative, school-based survey of adolescents aged 12-17 years (N = 2,349). One fourth of the adolescents reported they would not seek professional help for depression, and those respondents had higher average depression scores. Among those adolescents willing to seek help, the most likely sources included family member (57%), school counselor (46%), psychiatrist (43%), religious leader (39%), and general health practitioner (28%). Lower stigma scores were associated with greater likelihood to seek psychotherapy or visit a psychiatrist, while higher stigma scores were associated with increased likelihood to seek help from a school counselor or a family member. Jordanian adolescents experience significant barriers to seeking professional help for depression. However, even among adolescents with greater depression severity and depression stigma, school counselors were identified as a key resource for help. These findings suggest that school-based interventions may fill a critical service need for adolescents with depression and other mental health problems. School nurses should be leveraged along with counselors to address mental health issues in this vulnerable population.

Eyad Altamimi,1 Mariam Khanfar,2 Omar Rabab’h,3 Zain Dardas,4,5 Luma Srour,4 Lina Mustafa,4 Bilal Azab4,6 1Department of Pediatrics and Neonatology, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Center of Cognition and Neuroethics, University of Michigan-Flint, Flint, MI, USA; 4Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, University of Jordan, Amman, Jordan; 5Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA; 6Human and Molecular Genetics, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USACorrespondence: Eyad AltamimiDepartment of Pediatrics and Neonatology, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, JordanTel +962 797464254Email emaltamimi@just.edu.joBilal AzabDepartment of Pathology, Microbiology and Forensic Medicine, School of Medicine, University of Jordan, Amman, JordanEmail azabbm@mymail.vcu.eduPurpose: Four consanguineous Jordanian families with affected members of unknown gastrointestinal related diseases were recruited to assess the utility and efficiency of whole exome sequencing (WES) in reaching the definitive diagnosis.Patients and Methods: Members from four consanguineous Jordanian families were recruited in this study. Laboratory and imaging tests were used for initial diagnosis, followed by performing WES to test all affected members for the detection of causative variants. Sanger sequencing was used for validation.Results: We had a 100% success rate identifying each case presented in this study.Conclusion: This is the first study applying a WES testing approach in the diagnosis of pediatric diseases in Jordan. Our results strongly suggest the need to implement WES as an evident diagnostic tool in the clinical setting, as it will subsequently allow for proper disease management and genetic counseling.Keywords: pediatric diseases, whole exome sequencing, gastrointestinal diseases, metabolic diseases

Abstract Aims Optimal blood pressure (BP) control is imperative to reduce complications, especially strokes, in continuous flow ventricular assist device (VAD) patients. Doppler BP has been shown to be an accurate and reliable non‐invasive BP measurement method in HeartMate II and HVAD patients. We examined whether Doppler BP is also accurate in patients with the HeartMate 3 VAD. Methods and results In a prospective, longitudinal cohort of HeartMate 3 patients, arterial line BP and simultaneously measured Doppler opening pressure were obtained. Correlation and agreement between Doppler opening pressure and arterial line mean arterial pressure (MAP) versus systolic blood pressure (SBP) were analysed, as well as the effect of pulse pressure on the accuracy of Doppler opening pressure. A total of 589 pairs of simultaneous Doppler opening pressure and arterial line pressure readings were obtained in 43 patients. Doppler opening pressure had good correlation with intra‐arterial MAP (r = 0.754) and more closely approximated MAP than SBP (mean error 2.0 vs. −8.6 mmHg). Pulse pressure did not have a clinically significant impact on the accuracy of the Doppler BP method. These results in HeartMate 3 patients are very similar to previous results in HeartMate II and HVAD patients. Conclusions Doppler BP method should be the default non‐invasive BP measurement method in continuous flow VAD patients including patients implanted with the HeartMate 3.

تشكّل الأحداث العنصر الأساس والعمود الفقري لمجمل العناصر الفنيّة في أيّة رواية، فخيوطها تتشابك وتترابط وفق منطق ثنائية السبب والنتيجة، ولذا فهي المحرّك الرئيس لجسد الحكاية. وتختلف كل رواية عن الأخرى في طريقة بناء الأحداث وتوزيعها وفق نسق معيّن يمنحها نظامها الخاص، كما قد تمزج الرواية الواحدة أكثر من نسق في بنائها. وقد عني النقّاد، وعلى رأسهم الشكلانيون الرّوس، بتصنيف الأنساق التي تبنى عليها أحداث الرواية، وقد خلصوا – بعد تحليل عدد من النصوص الروائية- إلى أنساق عديدة، منها: النسق المتسلسل، والنسق الدائري، والنسق المتضمّن، ونسق التوازي، وغيرها. وقد تأثر عدد من كتّاب الرواية العربيّة الجديدة بالأنساق البنائية الحديثة: كنسق التناوب والنسق الدائري، ومن بينهم الروائي والشاعر العراقي سنان أنطون. وتسعى هذه الدراسة إلى تسليط الضوء على أنساق بنية الحدث في روايته: "فهرس"، مستفيدة من معطيات المنهج البنيوي. فتبدأ بمقدمة نبيّن فيها مفهوم البنية لغة واصطلاحًا، مع توضيح أبرز خصائصها وسماتها. ثم تعرّج إلى دراسة أنساق بنية الحدث في الرواية من خلال ثلاثة محاور. الأول: أنساق بناء الحدث، والثاني: هيكلة بنية الأحداث. والثالث: حبكة الرواية. وقد خلصت الدراسة إلى نتائج منها: أن الأحداث في رواية "فهرس" قد تناوبت وفق ثلاثة أنساق، هي: نسق التناوب، ونسق التتابع، والنسق الدائري، مع تغليب نسق التناوب الذي يحضر منذ البدء في الرواية ويستمرّ حتى منتهاها، مشكّلا القالب المتين الذي تُبنى عليه الحكاية.

ObjectivesTo examine the demographic and health-related factors associated with risk behaviors that have been linked to cancer including smoking, high BMI, and low physical activity.Design and sampleA secondary analysis was conducted using data from Rural Families Speak about Health, a multistate, epidemiologic study of rural American women and their families (N = 444).MeasuresValidated measures for various demographic and health-related items including tobacco use, BMI, physical activity, and depression were used.ResultsOf the total sample with complete data (n = 399), the mean age was 32 years and the majority were White (64%), married (67%), had a high school education or higher (73%), and had an annual household income of less than $40,000 (90%). Regarding cancer risk behaviors, 36% of the sample were smokers, 39% reported low levels of physical activity, and 45% had a calculated BMI over 30. Thirty-five percent of participants reported engaging in two or more risk behaviors. There were significant differences in income, perceived health status, and depression depending on the number of risk behaviors reported.ConclusionsUnderstanding combinations of risk behaviors can assist nurses and other health professionals in tailoring multiple health behavior change interventions to prevent cancer among rural women.

Stigmatization of COVID-19 disease has been speculated due to misinformation about the disease, fearing of contracting the infection, absence of available cure, and holding responsibility for infecting others. We aimed to establish the prevalence of COVID-19 related stigma and its association with empathic responding, in addition to exploring predictors of stigma and testing intention among Jordanian people. A quantitative, descriptive and predictive design was used and data were collected using a web-based survey from 1074 adults. Findings showed that participants had high stigmatization against COVID-19 infection. Higher empathic responding (both cognitive and affective), being a female participant, and older age resulted in higher stigmatization. Only stigmatization of COVID-19 negatively predicted individuals' intention for testing. These findings warrant intensive efforts from the Jordanian government on a local and national level to provide ongoing public education related to several aspects of COVID-19 disease, in order to reduce or prevent the associated stigma and increase people's intention for testing.

BackgroundThe COVID-19 pandemic has infected hundreds of millions of people resulting in millions of deaths worldwide. While N95 respirators remain the gold standard as personal protective equipment, they are resource-intensive to produce and obtain. Surgical masks, easier to produce and obtain, filter ≥95% submicron particles but are less protective due to a lack of seal around a user's face. This study tested the ability of a simple surgical mask modification using rubber bands to create a seal against particle exposure that would pass N95 standards.Methods and findingsForty healthcare workers underwent TSI PortaCount mask fit testing using an ASTM Level 1 surgical mask modified with rubber bands. Fit Factor was determined after testing four standard OSHA N95 fit testing scenarios. Performance of the properly-modified surgical mask was compared to that of a poorly-modified surgical mask, an unmodified standard surgical mask, and an N95 respirator. Thirty-one of forty (78%) healthcare workers passed Fit Factor testing using a properly-modified mask. The Fit Factor success rate significantly improved by subsequent test date (p = 0.043), but was not associated with any other participant characteristics. The average Fit Factor score for the properly-modified mask was 151 (SD 65.2), a significantly better fit than the unmodified mask score of 3.8 (SD 3.1, pConclusionsRubber bands, a low-cost and easily-accessible modification, can improve the seal and protective ability of a standard surgical mask to the level of an N95 respirator. This could mitigate N95 respirator shortages worldwide and provide individuals in under-resourced regions a practical means for increased personal respiratory protection.

Background: The evaluation of scholarly articles’ impact has been heavily based on the citation metrics despite the limitations of this approach. Therefore, the quest for meticulous and refined measures to evaluate publications’ impact is warranted. Semantic Scholar (SS) is an artificial intelligence-based database that allegedly identifies influential citations defined as “Highly Influential Citations” (HICs). Citations are considered highly influential according to SS when the cited publication has a significant impact on the citing publication (i.e., the citer uses or extends the cited work). Altmetrics are measures of online attention to research mined from activity in online tools and environments. Aims: The current study aimed to explore whether SS HICs provide an added value when it comes to measuring research impact compared to total citation counts and Altmetric Attention Score (AAS). Methods: Dimensions was used to generate the dataset for this study, which included COVID-19-related scholarly articles published by researchers affiliated to Jordanian institutions. Altmetric Explorer was selected as an altmetrics harvesting tool, while Semantic Scholar was used to extract details related to HICs. A total of 618 publications comprised the final dataset. Results: Only 4.57% (413/9029) of the total SS citations compiled in this study were classified as SS HICs. Based on SS categories of citations intent, 2626 were background citations (29.08%, providing historical context, justification of importance, and/or additional information related to the cited paper), 358 were result citations (3.97%, that extend on findings from research that was previously conducted), and 263 were method citations (2.91%, that use the previously established procedures or experiments to determine whether the results are consistent with findings in related studies). No correlation was found between HICs and AAS (r = 0.094). Manual inspection of the results revealed substantial contradictions, flaws, and inconsistencies in the SS HICs tool. Conclusions: The use of SS HICs in gauging research impact is significantly limited due to the enigmatic method of its calculation and total dependence on artificial intelligence. Along with the already documented drawbacks of total citation counts and AASs, continuous evaluation of the existing tools and the conception of novel approaches are highly recommended to improve the reliability of publication impact assessment.

Viscoelastic properties are one of the most fundamental properties of chiral liquid crystals. In general, their determination is not a straightforward task. The main problem is the multitude of physical parameters needed to determine the value of the elasticity and viscosity constants. It is also necessary to consider the character of a respective phase. This problem is particularly important in the case of chiral phases such as ferroelectric and antiferroelectric phases or in the blue phases. There are several experimental methods to measure viscosity and elasticity constants in chiral phases. These methods use various phenomena to detect deformation, e.g., light transmission, polarization current, light modulation, dielectric constant and helix deformation or helix unwinding. Commonly, an external electric field is used to induce deformation, the homogeneity of which inside the cell is essential. This study is focused on the analysis of the effect of laser photobleaching on the electro-optic properties of the antiferroelectric liquid crystal and on the homogeneity of the electric field. The results obtained by confocal microscopy as a function of the cell depth are presented. The influence of the stabilization procedure of the isolated region performed by controlled laser photobleaching on the electro-optic properties has been studied. The observation was conducted using a polarizing microscope, and numerical analysis of two-dimensional colored textures was performed. The obtained results suggest that laser photobleaching can produce an anchoring effect, which has a positive effect on the electro-optic properties of antiferroelectric liquid crystal.

Delinquency in adolescence is rooted in a complex multifaceted system that comprises several factors such as personal characteristics, family, school, peers, and community, all of which are embedded in the sociocultural context in which they are present. There is a paucity of research on juvenile delinquency and its risk factors across many regions, especially low- and middle-income countries, including Arab countries. This study aimed to develop an understanding of the personal, familial, and behavioral characteristics of Arab juvenile delinquents in the distinctive sociocultural context of Jordan. All juveniles who were incarcerated at the time of data collection (N = 197) were targeted using a convenience sampling approach from a total of 11 juvenile rehabilitation centers distributed over the northern, middle, and southern regions of the country. Anonymous surveys were used to collect data on juvenile delinquents’ personal, familial, psychosocial, and behavioral characteristics. A total of 186 juvenile delinquents completed the study questionnaire (9.7% females). About 52% were not attending school regularly, 32% had divorced, separated, or deceased parents, 6% reported receiving a diagnosis of mental illness, and 91% reported they never sought psychological support of any kind. Regarding substance consumption, 70% were smokers, 26% were alcohol consumers, and 15% were on drugs. About 12% spent more than 7 h on their cellphones, and 43% reported dedicating no time for physical activity. Theft was the most frequently reported offense (35%), followed by quarreling with peers (25%), and possession of drugs (9%). Approximately 42% reported that their friends encouraged them to cause trouble, while the majority (74%) reported that their school had no positive or negative influence on their behavior. Several behavioral problems were detected, with females showing significantly higher scores in impulsivity, inattention, emotional lability, and social problems compared to their male counterparts. Severity of the conduct problems was negatively associated with the length of engagement in physical activities, while both impulsivity and inattention scores were positively associated with the length of engagement in watching TV and using cellphones (all p < 0.05). Overall, these juvenile delinquents have unsatisfactory academic and schooling experiences, engage in unhealthy lifestyles and exhibit several behavioral problems. Differences in juvenile delinquency risk factors across different sociocultural contexts can influence prevention efforts. Comprehensive prevention strategies that reduce risk and develop protective factors need to target juveniles early in their development and consider factors related to their families, schools, peers, and communities.

Background: Tinnitus is a common complaint that carries a significant impact on life. However, there is paucity of data regarding this condition in Jordan. Our study is the first study to demonstrate the prevalence of tinnitus in Jordan and its characteristics. Methods: A sample of 1060 participant's representative of the Jordanian population was invited to answer a questionnaire. The questionnaire comprised of 15 questions about tinnitus and its characteristics. The data was collected over a year (2016-2017). Results: The prevalence of tinnitus was 28.8% with 72.8% reporting non-pulsatile tinnitus, 95.5% reporting intermittent tinnitus and 57.4% had bilateral tinnitus. There was no significant difference found between males and females (p value: 0.786). There was significant correlation between tinnitus, vertigo, and dizziness (p value < 0.0001). Conclusion: Tinnitus is a common condition with high prevalence in Jordan denoting the significance of diagnosis and offering treatment especially for debilitating cases. [ABSTRACT FROM AUTHOR]

Background and Objective: The recent multi-country outbreak of human monkeypox (HMPX) in non-endemic regions poses an emerging public health concern. University students in health schools/faculties represent a core knowledgeable group that can be helpful to study from a public health point of view. As future healthcare workers, assessment of their knowledge and attitude towards emerging zoonotic viral infections can be helpful to assess their taught material and courses with potential improvement if gaps in knowledge were identified. Therefore, we aimed to evaluate the level of HMPX knowledge, conspiracy beliefs regarding emerging virus infections, as well as their associated determinants among university students studying Medicine, Nursing, Dentistry, Pharmacy, Medical Laboratory Sciences, and Rehabilitation in Jordanian health schools/faculties. In addition, we sought to evaluate the correlation between HMPX knowledge and the extent of holding conspiracy beliefs regarding emerging viral infection. Materials and Methods: A convenient sample of university students was obtained through an electronic survey distributed in late May 2022 using the chain-referral approach. Assessment of HMPX knowledge and general attitude towards emerging virus infections was based on survey items adopted from previously published literature. Results: The study sample comprised 615 students with a mean age of 20 years and a majority of females (432, 70.2%) and medical students (n = 351, 57.1%). Out of eleven monkeypox knowledge items, three were identified correctly by >70% of the respondents. Only 26.2% of the respondents (n = 161) knew that vaccination to prevent monkeypox is available. Age was significantly associated with better HMPX knowledge for a majority of items. Older age, females, and affiliation to non-medical schools/faculties were associated with harboring higher levels of conspiracy beliefs regarding emerging virus infections. Our data also indicate that lower levels of HMPX knowledge were associated with higher levels of conspiracy beliefs. Conclusion: The current study pointed to generally unsatisfactory levels of knowledge regarding the emerging HMPX among university students in Jordanian health schools/faculties. Conspiracy beliefs regarding emerging virus infections were widely prevalent, and its potential detrimental impact on health behavior should be evaluated in future studies.

Modification of the physical properties of the (S)-MHPOBC antiferroelectric liquid crystal (AFLC) by doping with low concentrations of gold nanoparticles is presented for the first time. We used several complementary experimental methods to determine the effect of Au nanoparticles on AFLC in the metal–organic composites. It was found that the dopant inhibits the matrix crystallization process and modifies the phase transitions temperatures and switching time, as well as increases the helical pitch and spontaneous polarization, while the tilt angle slightly changes. We also showed that both the LC matrix and Au nanoparticles show strong fluorescence in the green light range, and the contact angle depends on the temperature and dopant concentration.

Introduction: Carer-employees are defined as individuals who are providing unpaid care usually to a loved one or friend while simultaneously working in the paid labour force. This specific population group is vulnerable to ill-health due to the various challenges faced in managing work-life balance. One of the most demanding and common caregiving tasks in Canada is assisted-transport, which involves running errands for the care-recipient, or driving the care recipient to appointments. Little is known about assisted-transport, except that the frequency of assisted-transport is based on the links between daily constraints and carer-employees’ care tasks; thereby, directly impacting work-life balance. An alternative to mitigate assisted-transport demand is to improve the independent mobility of care-recipients (older adults) using accessibility to services as a demand measurement index. Therefore, this research explores potential accessibility to vital services for the older adult, suggesting areas that may require service intervention within the Hamilton census metropolitan area (CMA) in Ontario, Canada. Methods: The Enhanced Two-Step Floating Catchment Area method was used to analyze potential accessibility from residential addresses of those aged 65+ to vital services; access zones were then outlined. Older adult populations for each access zone were calculated using census data. Suggested areas for service implementation were identified using quadrat analyses of addresses via hexabins. Results: Results inform the location of care-recipients living in potentially underserved areas (high assisted-transport demand) of the Hamilton CMA and, in so doing, provide visual insight for decision-makers and city planners to better mitigate mobility dependence.