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This study aims to assess existing sleep apps for mobile phones to determine the perceived effect of these applications on user's attitudes, knowledge, willingness to change, and its likelihood to change behavior from a user's perspective.A systematic search was conducted through Google play store and iTunes Apple store using terms related to sleep tracking. Apps were evaluated using Mobile Application Rating Scale (MARS) tool for assessing and classifying mobile health applications quality. Additionally, a convenience sample of subjects were asked to evaluate the included apps for perceived sleep behavior changes.The average MARS app quality score on a 5-point scale was 3.3. Between 30-50% of participants believed that sleep tracker apps are likely to increase awareness about sleep patterns and sleep hygiene, infuence sleep hygiene habits, and are likely to encourage help seeking for sleep hygiene when required.Apps available for sleep self-management and tracking may be valuable tools for self-management of sleep disorder and/or improving sleep quality, yet they require improvement in terms of quality and content, highlighting the need for further validity studies.

Objective:Internet Gaming Disorder (IGD) is a rapidly growing public health problem that may have detrimental effects. The purpose of this study is to identify factors associated with IGD status.Methods:In this cross-sectional observational study, a convenient sample of gamers in Jordan was recruited and asked to participate in an online survey based on the nine criteria of the 20-item Internet Gaming Disorder (IGD-20) used to assess gaming disorder. Sociodemographic and psychosocial data were also obtained.Results:A total of 504 gamers participated in this study. The mean age of respondents was 21.6 ± 3.90 years. Using the standard IGD-20 scale, 96 participants (19%) were classified as potential IGD cases, compared to 408 (80.9%) non-disordered gamers. Males were dominant among the population, constituting 348 (69%) of gamers. Males also played significantly more hours per week [17.8 ±16.75] compared to females [13 ± 17.65]. The majority of gamers (411 (81.5%)) were students, although unemployed adults played for the highest total time [23.9 ± 30.84 hours/week]. Device type used for gaming also significantly (p Conclusion:Establishing gamer profiles and recognizing predictors of IGD is therefore vital for guiding clinical classification and diagnosis of the disease.

Background The novel coronavirus outbreak is now shifting the way educational institutions operate around the world. This study aims to assess the online learning experience during the pandemic and recognize its perceived barriers according to university professors in Jordan. Methods This is a questionnaire-based, cross-sectional, and descriptive study. A web-based survey was distributed to all university professors and lecturers in public universities across Jordan. Results A total of 508 educators responded to this study. Males (67.5%, n=343) dominated the study population compared to females (32.5%, n=165). Educators spent an average of 20.2 ± 15.9 hours/week using the internet for educational purposes during the pandemic. Positive attitudes towards online teaching were seen, as 65.7% reported being prepared for online teaching, while 40.8% were comfortable communicating with students via online platforms. Institutional support for online learning also appears to have increased following the coronavirus outbreak. An overwhelming majority (81.9%, n=416) stated that their universities supported online education during the pandemic, compared to 56.5% (n=287) before. The main recognized barriers for online teaching were poor internet connection (78.3%, n=398), disadvantages in old learning tools (e.g., uploading capacity) (70.9%, n=360), and family atmosphere (69.3%, n=352). Participants also recognized technical (74.0%, n=376) and computer skills (49.2%, n=250) as areas requiring development. Conclusion Despite the positive attitudes of educators towards online teaching, many barriers need to be overcome before the shift from traditional learning is implemented. Faculty training and inter-departmental communication are warranted for the success of online teaching during the COVID-19 pandemic.

INTRODUCTIONSmall Intestinal Bacterial Overgrowth (SIBO) is a common yet underdiagnosed condition. Lactulose hydrogen breath tests (LHBT) are typically used to detect SIBO; however, current breath testing methods require specialised, expensive equipment and technical support and are either done at a point-of-care facility and/or have to be mailed to a central laboratory. To address these issues a novel hand-held breath analyzer (AIRE®, FoodMarble) was tested. The aims of this study were first, to perform a technical assessment of the AIRE device, second to compare the performance of the AIRE device against a commercially available mail-in LHBT kit using a zero-inflated negative binomial mixed effect model.METHODSThree AIRE devices were tested with certified test gases covering a diagnostically meaningful range (hydrogen mixed with air at 3 ppm, 10 ppm and 50 ppm). For the clinical study, 36 patients suspected to have SIBO presenting to a tertiary level clinic were provided with an AIRE device and performed concurrent LHBTs at home with a mail-in LHBT kit.RESULTSThe overall average readings (mean ± SD) for the AIRE devices tested at 3 ppm, 10 ppm and 50 ppm H2 were: 3.5 ± 0.7 ppm; 10.7 ± 1.1 ppm and 49.5 ± 2.6 ppm respectively. The overall mean absolute error across the tested devices was 1.2 ppm. A significant positive correlation (r = 0.78, p < 0.001) was demonstrated between AIRE and mail-in kit H2 values.DISCUSSIONThe AIRE device is a compelling alternative to mail-in LHBT kits for the diagnosis of SIBO. The AIRE device may also offer advantages over other traditional breath testing methods.

Reema Karasneh,1 Abdel-Hameed Al-Mistarehi,2 Sayer Al-Azzam,3 Sawsan Abuhammad,4 Suhaib M Muflih,3 Sahar Hawamdeh,3 Karem H Alzoubi3,5 1Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan; 2Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Maternal and Child Health, Jordan University of Science and Technology, Irbid, 22110, Jordan; 5Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab EmiratesCorrespondence: Reema KarasnehDepartment of Basic Medical Science, Faculty of Medicine, Yarmouk University, P.O. Box 566, Irbid, 21163, JordanTel +962 2 7211111 Ext 7141Fax +962 2 7211162Email reema.karasneh@yu.edu.joBackground: The protection of patient confidentiality is an essential practice for the successful provision of healthcare. This study examines physicians’ knowledge and attitudes related to data sharing and patient confidentiality.Methods: This is a descriptive, questionnaire-based study. Physicians were invited via e-mail to complete the study survey. The survey comprised three sections related to knowledge, attitudes, and demographic characteristics.Results: A total of 221 physicians, with varying levels of experience and from a range of specialty areas, completed the study survey. Ethical dilemmas were encountered annually by physicians specialized in family medicine and daily by physicians in internal medicine wards more often than those in other departments. The mean score for knowledge was 7.34 (out of 14; SD=2.92) and had a positive correlation with attitudes towards the protection of data confidentiality (r2=0.282, p< 0.001). Undergraduate courses were the main source of knowledge related to ethical issues (167; 74.9%). Sex (B=-1.47, p=0.001), marriage (B=-1.198, p=0.021), and source of consultation (B=-.248, p=0.02) were all found to predict knowledge scores. Likewise, attitudes were predicted by experience (B= 0.279, p< 0.001), sex (B= -2.797, p=0.002), marriage (B=1.91, p=0.02), and number of ethical dilemmas faced (B=1.695, p < 0.001).Conclusion: Physicians from different departments were found to lack sufficient knowledge about many aspects of patient confidentiality. While some of the physicians’ practices complied with the law, other practices were identified as patient confidentiality breaches.Keywords: confidentiality, physician, knowledge, attitudes, data sharing, ethical dilemma

Introduction Piperine, the bioactive compound of black pepper, and warfarin are metabolized by cytochrome P450 enzymes and are both highly plasma protein-bound compounds. In this study, we evaluated the effect of co-administered piperine on the pharmacokinetics and anticoagulation of warfarin in rats. Methods We studied four Sprague-Dawley rat groups: a negative control group receiving only oral warfarin, a test group receiving warfarin plus piperine, a positive control group receiving warfarin plus sulfaphenazole (CYP2C inhibitor), and another positive control group receiving warfarin plus ketoconazole (CYP3A inhibitor). We also analyzed plasma concentrations of warfarin and its major metabolite, 7-hydoxywarfarin. Blood clotting time, calculated as international normalized ratio (INR), was also measured. Results Our results showed that although co-administration of piperine produced a non-significant decrease in warfarin concentrations, it resulted in significantly lower 7-hydroxywarfarin metabolite concentrations. Piperine significantly decreased, by sixfold, AUC0-∞, by eightfold, Cmax, but significantly increased, by fivefold, CL/F and, by sixfold, Vd/F of 7-hydroxywarfarin. The INR values were consistent with the decrease in warfarin concentration in the presence of piperine and showed a significant decrease at 24 h after warfarin dose. Conclusion We conclude that piperine could be a potent inhibitor of cytochrome P450 metabolism of warfarin in vivo and, contrary to the expectation, may reduce the plasma concentration and anticoagulation of warfarin. This interaction could have a clinical significance and should be investigated in patients.

This study investigated the clinical characteristics and symptomatology of ESRD patients in Jordan taking a multidimensional approach. This was a cross-sectional study that included a cohort of 620 patients undergoing maintenance hemodialysis (HD). Data were retrieved via patient survey administration and electronic health records. A modified version of the Charlson Comorbidity index (CCI) was utilized to assess comorbidity. Symptoms were assessed using the validated Arabic version of the CKD Symptom Burden Index (CKD-SBI). The mean (± SD) age of participants was 50.9 ± 16.1 years, with the 59.8% being males. Diabetes was the leading cause of kidney disease among patients (29.2%), followed by hypertension (20.7%) and medication use (8.6%). Common comorbidities included hypertension (72.4%), diabetes (38.4%), and cardiovascular disease (18.7%). Patients experienced 13 CKD-related symptoms on average, with a total symptom burden score of 29.6. Muscle strain was the most common symptom (62.6%), followed by itchiness (59.7%), nervousness (57.7%), and anxiety (57.7%). Charlson comorbidity index (CCI) [β = 0.88, 95% CI (0.34–1.41)], male gender [β = − 5.59; 95% CI (− 8.34 to − 2.85)], higher educational level [β = − 3.38; 95% CI (− 6.39 to − 0.37)], and number of dialysis sessions/week (β = 6.22, 95% CI 3.37–9.07) were independent predictors of total symptom burden. Similarly, these factors predicted symptom troublesomeness, intensity, and recurrence. A holistic clinical picture of ESRD that includes multidimensional symptom assessment is warranted for better disease management and resource allocation. Our paper identifies key characteristic of this population and factors contributing to total symptom burden.

Purpose The main focus of this study is to assess the knowledge and practices of healthcare practitioners regarding data sharing, security, and confidentiality, with a focus on the use of health data retrieved from electronic health records (EHRs) for research purposes. Methods A descriptive, cross-sectional, questionnaire-based survey study was conducted across all academic institutions including all researchers in the medical field in Jordan. Personal and administrative practices in data sharing were assessed through collecting data from respondents. Results The response rate was 22% with an average of 10.25 years of experience in publications. Almost 60% had published at least 1 to 3 studies using EHRs. The prevalence of researchers who "Always" used antivirus software and preserved patient's information was 75.5% and 92.2%, respectively. However, other personal security and confidentiality measures were not satisfactory. Less than half of health data used in the research was "Always" anonymised or encrypted and only around 44.0% had "Always" used sensitive data with more specificity than normal data. Conclusion Confidentiality and data sharing practices of healthcare practitioners and researchers were generally less than optimal. Efforts from healthcare providers, health institutions, and lawmakers should be put in place to protect the security and confidentiality of electronic patient data.

Background Coronavirus disease (COVID-19), an infection of the zoonotic coronavirus, is presenting a healthcare challenge around the globe. This study aims to assess the levels of disease knowledge and risk perception among pharmacists. We also recognize predictors of risk perception and perceived media roles. Methods This is a questionnaire-base cross-sectional study. The questionnaire was developed on a web-based platform and invitations were sent to pharmacists nationwide to participate in the study using social media applications. Results A total of 486 pharmacists participated in this study, where females were dominant (78.6%, n = 382). Most (40.4%, n = 198) pharmacists scored 4 out of 5 in basic disease knowledge, and more than half were able to recognize common methods of spread. Risk was highly perceived among participants, and was predicted by gender, living area, and having children (p

Background E-cigarette (EC) use is increasing worldwide. Understanding the practices and perceptions of e-cigarette users and profiling the symptoms they experience is essential for regulating the use of such products. This study aims to investigate the practices and perceptions of e-cigarette users in Jordan and examine the symptoms (e.g. respiratory) they associate with e-cigarette use. Methods A cross-sectional online survey was conducted to assess EC use and tobacco smoking behaviors and the corresponding health symptoms among EC users in Jordan. EC use expectancies were also assessed using the Short Form Vaping Consequences Questionnaire, which was first translated into Arabic and tested for validity and reliability. Results Out of the 400 EC users surveyed, 95.5% were male, 76.2% used nicotine-containing juice, and 56.8% were concurrent tobacco smokers. Further, the participants had a mean age of 28.9 years (±10.2). Among dual EC/cigarette users, 88.6% reported that they tried to quit cigarette smoking, with e-cigarette use being the most commonly tried method of smoking cessation. The smoking-related symptoms reported by regular cigarette smokers mainly included sputum production (77.5%). The participants reported that using e-cigarettes instead of tobacco cigarettes had led to improvements in their sputum production (60.8%), breathing (59%), and general wellbeing (52%). Pleasant taste, enjoyable taste sensation, and flavor were significantly stronger (P-value < 0.05) among e-cigarette users compared to dual users. Dual EC/cigarette users reported stronger perceptions in the negative consequences scale, particularly with regards to the hazardous effects of smoking on health (P-value < 0.05). Conclusion Dual daily use of e-cigarettes and regular cigarettes is a common practice among EC users. We recommend that further research is conducted on dual EC/cigarette use and the potential health risks this may have (e.g. higher nicotine intake as compared to the single use of either products).

Background. The use of mobile apps for health and well-being has grown exponentially in the last decade, as such apps were reported to be ideal platforms for behavioral change and symptoms monitoring and management. Objective. This study aimed to systematically review period tracking applications available at Google Play and Apple App Stores and determine the presence, features, and quality of these smartphone apps. In addition, behavioral changes associated with the top 5 rated apps were assessed. Methods. This study used the Systematic Search Criteria through Google Play Store and iTunes Apple Store, using terms related to period tracking. Apps were scanned for matching the inclusion criteria and the included apps were assessed by two reviewers using the Mobile Application Rating Scale (MARS), a tool that was developed for classifying and assessing the quality of mHealth apps. Results. Forty-nine apps met the inclusion criteria. Most of the apps enabled setting user goals, motivations, and interactivity, tracking multiple symptoms or mood changes, allowed notifications, and used graphs to illustrate the tracking result over a specific period of time. The majority of features and functions within these apps were offered for free, while some apps included limited in-app purchases or needed Internet connection to function. Certain apps were reported by participants to promote behavioral change and increase knowledge and awareness regarding monthly periods. Conclusions. Period tracking apps were easy to use and navigate and can hence be readily adopted into routine tracking and management of periods. However, most apps were not based on significant evidence and may need further development to support period-related symptom management.