Predictors of sleep quality among university students: the use of advanced machine learning techniques.

PURPOSE: To assess the prevalence of sleep disturbances among university students and investigate potential correlated factors and their relative importance in quantifying sleep quality using advanced machine learning techniques. METHODS: A total of 1600 university students participated in this cross-sectional study. Sociodemographic information was collected, and the Pittsburgh Sleep Quality Index (PSQI) was administered to assess sleep quality among university students. Study variables were evaluated using logistic regression and advanced machine learning techniques. Study variables that were significant in the logistic regression and had high mean decrease in model accuracy in the machine learning technique were considered important predictors of sleep quality. RESULTS: The mean (SD) age of the sample was 26.65 (6.38) and 57% of them were females. The prevalence of poor sleep quality in our sample was 70%. The most accurate and balanced predictive model was the random forest model with a 74% accuracy and a 95% specificity. Age and number of cups of tea per day were identified as protective factors for a better sleep quality, while electronics usage hours, headache, other systematic diseases, and neck pain were found risk factors for poor sleep quality. CONCLUSIONS: Six predictors of poor sleep quality were identified in university students in which 2 of them were protective and 3 were risk factors. The results of this study can be used to promote health and well-being in university students, improve their academic performance, and assist in developing appropriate interventions.

Cognitive functioning in Deaf children using Cochlear implants.

BACKGROUND: Cognitive abilities like language, memory, reasoning, visualization, and perceptual functioning shape human action and are considered critical to the successful interaction with the environment. Alternatively, hearing loss can disrupt a child's ability to communicate, and negatively impact cognitive development. Cochlear implants (CI) restore auditory input thereby supporting communication and may enhance cognitive performance. This study compares general cognitive development after cochlear implantation (2017-2019) in two groups of Jordanian children implanted earlier (age:4-6 years, N = 22) and later (7-9 years, N = 16) to the development of randomly selected normal hearing peers (N = 48). DESIGN: Visualization, reasoning, memory, and attention were assessed using the Leiter-R scale at baseline (before implantation), 8 months and 16 months post implantation for children with hearing loss. Same times of testing (baseline, 8 months and 16 months) were used for normal hearing peers. RESULTS: Over the 16-month period, the cognitive improvement of 4-6-year-old deaf children was greater than that of their normal hearing peers on the scales of visualization (5.62 vs. 4.40), reasoning (2.53 vs. 2.38) and memory (17.19 vs. 11.67). while the improvement of 7-9-year-old was less major than that of their normal hearing peers on all scales. CONCLUSIONS: These results suggest that CI not only enhances communication skills but may improve cognitive functioning in deaf children. However, the extent of this improvement was dependent on age at intervention; current results demonstrated that the children received CI at young ages had better cognitive improvements.

Body mass index and potential correlates among elementary school children in Jordan.

PURPOSE: Childhood obesity and overweight are on the rise worldwide, and Jordanian children are no exception to this rule. Childhood Obesity has major implications on the physical and mental health of individuals, and it can often develop into adult obesity. Obesity/overweight correlates have not been researched extensively in the Middle East region, where Jordan is central. This region is undergoing tremendous changes because of wars, globalization, and the influx of refugees. The cultural and eating habits of the people are changing along with demographical changes. Thus, timely research is required to assess the current health state of this dynamic society. The main goal of this study is to understand the environmental and cultural factors that are associated with Body Mass Index (BMI) z score in elementary school children in Jordan. METHODS: A total of 1260 children enrolled in this descriptive, cross-sectional study. The study used a parental self-reporting questionnaire that contains possible factors associated with BMI, zBMI, demographics, and other pertinent information. RESULTS: Several factors have been associated with higher zBMI among elementary school children: if a child owns a smartphone (p = 0.0037), uses electronics to play ([Formula: see text]), uses electronics for longer hours ([Formula: see text]), eats food while using electronics or watching TV ([Formula: see text] and [Formula: see text], respectively), sleeps less hours in weekends ([Formula: see text]), was breastfed for lower number of months ([Formula: see text]), lives in rural areas ([Formula: see text]), goes to a private school ([Formula: see text]) and is a male ([Formula: see text]). CONCLUSION: Investigating characteristics and environmental determinants of childhood obesity play an essential role in establishing effective intervention program and reduce future risks of morbidity. LEVEL OF EVIDENCE: Level V, descriptive (cross-sectional) study.

Adaptation of the Arabic versions of the Hearing Handicap Inventory for adults and elderly with permanent sensorineural hearing loss.

Objective: To translate the Hearing Handicap Inventory for Adults (HHIA) and Hearing Handicap Inventory for the Elderly (HHIE) into Arabic while ensuring that the reliability and validity are the same as those of the original English versions.Design: Descriptive, cross-sectional study.Study sample: In total, 115 individuals with hearing impairment and 114 controls with normal hearing completed the Arabic versions of HHIA/HHIE. Each subject underwent a complete audiological evaluation before answering the questionnaires. The construct and discriminant validities were determined in addition to the reliability, which was investigated by calculating the internal and test-retest consistencies.Results: Internal consistency between the total and subscale scores were excellent for the Arabic versions of HHIA and HHIE (Cronbach's alpha: ∼0.90). With regard to the test-retest reproducibility, the Spearman's correlation coefficient for consistency between total scores obtained at baseline and those obtained at 6 weeks was acceptable (r = 0.761, p < 0.0001). The total scores were statistically proportional to the degree of hearing loss. Moreover, the questionnaire successfully differentiated between individuals with hearing impairment and those with normal hearing.Conclusions: Our findings clarified that the Arabic versions of HHIA and HHIE are acceptable tools for evaluating the psychological influences of hearing loss in Arabic populations.

Memory and potential correlates among children in Jordan.

BACKGROUND: Cognitive functioning hugely affects the performance of tasks of different complexity. Memory, one of the most important cognitive skills, allows children to practice and acquire necessary skills and knowledge and interact with the surrounding environment. Therefore, it is crucial to study the factors that influence the memory of children. The main purpose of his study was to investigate different variables related to memory in school aged children (5-9 years, N = 434). METHODS: Parents of the participants provided information about child's daily behavior, child's school academic achievement, work and family income data and demographics. Memory skills in children were assessed by using the Leiter International Performance Scale -Revised. RESULTS: The score of memory increased 2.53 points with upsurge in maternal occupation level, 3.08 points when the child ate breakfast and 4.51 points when the child daily slept nine hours and more. By contrast, increased family income and smoking by father resulted in decreased scores in memory. CONCLUSION: Screening for and understanding of memory and relevant factors are vital for broad understanding of children's capabilities and weaknesses as well as for developing appropriate interventions.

Construct validity and internal consistency reliability of the Loewenstein occupational therapy cognitive assessment (LOTCA).

BACKGROUND: Cognitive abilities are essential for children's development and independence. Various cognitive assessments, standardized in Western cultures, have yet to be investigated for their multicultural suitability. AIMS: To explore the suitability of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) for a Jordanian population. METHODS: Observed cases of 442 Jordanian children aged 6-12 were used to perform exploratory factor analyses using principal components with Varimax rotation (construct validity evidence) and to compute Cronbach's α coefficient (internal consistency reliability). RESULTS: High total performance on four subscales and a slightly lower total performance on two subscales were observed. Observed performance increased with age on three subtests, whereas a more modest increase was observed on the other three subscales. The expected one-factorial solution confirming the LOTCA's subscales homogeneity (unidimensionality) structure was found on five of six subscales. Variance explained by the subscales ranged from 39 to 82% and internal consistency reliability measured by Cronbach's alpha ranged from .42 to .78. CONCLUSIONS: Satisfactory construct validity and internal consistency reliability were demonstrated on two subscales applicable to Jordanian children without adaptation. With adequate cross-cultural adaptation, increasing internal consistency reliability in other subscales could make the LOTCA an effective tool for assessing cognitive abilities in this population.

Reasoning Abilities and Potential Correlates Among Jordanian School Children.

Objectives To investigate factors related to reasoning skills in 434 school children aged 5-9 years. Methods The Leiter International Performance Scale-Revised was used to assess reasoning skills. Demographic, work and family income data, information on child's daily behavior and school academic achievement were provided by the participating children's parents. Results Reasoning scores increased by 4.56 points with increasing subject's age, 1.71 points with increasing level of father's occupation, 1.86 points with each increase in the subject's GPA, 1.13 points with consumption of breakfast at home and 1.81 points when child slept more hours. Having a father who smoked and living in a rural area decreased scores in reasoning. Conclusions for Practice Screening of reasoning and associated factors is essential for a comprehensive and accurate understanding of the child's abilities and limitations. Understanding the child's reasoning abilities is critical for establishing intervention goals and planning therapeutic activities.

Oral health status and physical, mental and cognitive disabilities among nursing home residents in Jordan.

OBJECTIVE: The purpose of this study is to describe physical, mental and cognitive disabilities and periodontal status as indicated by periodontal health, edentulism and use of dentures among nursing home residents in Jordan. METHODS: A sample of 221 subjects with a mean age of 62.4 years (121 males and 100 females) from nursing home residents in Jordan were recruited to participate in this study. Oral health status, mini mental state examination (MMSE), Geriatric Depression Scale (GDS), Tinetti Assessment Battery for gait and balance (TAB) and disability of arm, shoulder and hand test (DASH) were assessed for all subjects. RESULTS: The response rate was about 88%. The multivariate analysis showed that the degree of upper limb disabilities, as measured by DASH, and reporting not brushing of teeth were the main risk indicators for severity of periodontal disease. Residents with dentures were found to have significantly higher cognitive abilities scores (MMSE), better upper arm abilities (DASH) and gait and balance score (TAB) in comparison with edentulous adults without dentures. Edentulous residents were found to suffer more from cognitive impairment (MMSE) than dentate residents. There was no predilection of upper limb (DASH) and lower limb (TAB) disabilities or depressive symptoms (GDS) for edentulous over dentate subjects. CONCLUSIONS: Results suggest that nursing home residents with a variety of physical, cognitive and psychological disabilities are at increased risk of deterioration of their oral health. All those associated with the health of residents need to be aware of this issue and take preventive and therapeutic measures as needed.

Health-related quality of life and physical, mental, and cognitive disabilities among nursing home residents in Jordan.

PURPOSE: To describe the physical, cognitive, psychological, and medical status of nursing home residents in Jordan. We also investigated the perceived health-related quality of life of this population. METHODS: A sample of 221 nursing home residents in Jordan was recruited to participate in this study. Demographic variables and medical history were collected. In addition, all participants were assessed using health-related quality of life items (HRQOL), mini-mental state examination (MMSE), Geriatric Depression Scale (GDS), Tinetti assessment battery for gait and balance (TAB), and disability of arm, shoulder, and hand assessment (DASH). RESULTS: TAB and DASH scores were related to the following HRQOL items: self-reported general health status, the need for personal care, the need for help from others in handling routine needs, the number of days of pain, feeling sad, depressed, worried, and not getting enough sleep, and the number of days feeling very healthy and full of energy. MMSE scores were related to self-reported need for personal care, the need for help from others in handling daily routine needs, and the number of days feeling pain, sad, worried, and depressed. GDS scores were related to self-reported general health status, the need for personal care, the need for help from others for handling daily routine needs, the number of pain, sad, worried, and not getting enough sleep days, and the number of days feeling healthy and full of energy. CONCLUSIONS: This study revealed a substantial impact of physical, cognitive, and psychological disabilities on HRQOL of nursing home residents in Jordan.

Urinary incontinence among adult women with diabetes in Jordan: epidemiology, correlates and perceived impact on emotional and social well-being.

AIMS AND OBJECTIVES: To assess the epidemiology and correlates of urinary incontinence and its perceived impact on the emotional and social well-being of Jordanian women. BACKGROUND: Diabetes is a chronic disease with rising prevalence in women worldwide. Although urinary incontinence is a complication of diabetes, it is not commonly assessed with limited nurses' knowledge available on its prevalence, correlates and its perceived impact on lives of women. DESIGN: A cross-sectional survey design using probability sampling approach was used to collect information on incontinence. METHODS: A total of 1011 adult women, 20-65 years old, attending primary healthcare centres in Jordan were interviewed using a standardised incontinence questionnaire. Questionnaire included items to assess the perceived impact of incontinence on social and emotional well-being of women. The study outcome included weekly or more any, stress and urge incontinence. RESULTS: Of 435 (43%) diabetic and 576 (57%) nondiabetic women, a total of 676 (66·8%) women reported incontinence. The prevalence of weekly or more any, urge and stress incontinence was significantly higher in diabetic than in nondiabetic women, 31·5, 13·8 and 20% versus 18·2, 5·9 and 14·2%, respectively. After adjusting for age, body mass index, parity and history of urinary tract infections, in multiple logistic regression analyses, diabetes was significantly associated with any (OR: 1·99; 95% CI: 1·44-2·74) urge (OR: 2·23; 95% CI: 1·38-3·61) and stress incontinence (OR: 1·54; CI: 1·07-2·22). Obesity and age were found to be significant correlates for urge incontinence in diabetics. Women with incontinence perceived incontinence as bothersome condition with negative impact on social well-being. CONCLUSIONS: Incontinence is a common and distressing problem in diabetic women, especially for those who are older and obese. Prospective cohort studies are needed to assess how nurse-led interventions may impact the negative consequences of incontinence on women well-being. RELEVANCE TO CLINICAL PRACTICE: Nurses are in the right position to assess urinary incontinence in diabetic women. Proper communications, culturally sensitive screening and tailored interventions may assist nurses in providing care and support to alleviate the impact of incontinence on women well-being.

Adiponectin and Nitric Oxide Deficiency-Induced Cognitive Impairment in Fatigued Home-Resident in Mature and Older Adults: A Case-Control Study.

Objective: The present study explores the underlying factors of cognitive abilities in relation to the expression of adiponectin and nitric oxide, fatigue, and other cofounder variables such as physical activity, diabetes, and adiposity status in healthy home-resident mature and older adults. Background: Fatigue has been shown to be correlated with many metabolic and psychiatric conditions, such as cognitive, neurological, musculoskeletal, and hormonal disorders, as well as physical and unhealthy lifestyles. Methods: A total of 85 home residents aged 50-85 years participated in this case-control study. Mental, fatigue, and pain status were assessed by the cognitive assessment (LOTCA), fatigue questionnaire (CIS20r), and pain score (0-10). VO2 max and the prevalidated global physical activity questionnaire were used to estimate physical status. The levels of adiponectin, nitric oxide (NO), and variables related to diabetes, such as blood sugar and glycated hemoglobin (HbA1c %), were assessed using ELISA and spectrophotometric immunoassays. Results: The participants were classified according to the CIS-fatigue score into two groups: the healthy group (n = 40) and the fatigue group (n = 45). In fatigued subjects, LOTCA scores as a measure of cognitive performance significantly decreased (65.97 ± 7.17; P = 0.01) as compared with healthy subjects (LOTCA scores, 94.2 ± 7.5). The results of cognitive performance domains (LOTCA seven-subset scores) showed a significant decrease in the scores of orientation, visual perception, spatial perception, motor praxis, vasomotor organization, thinking operations, attention, and concentration in older subjects with fatigue compared with healthy subjects. In addition, pain scores significantly increased, and the expression of both nitric oxide (NO) and adiponectin significantly reduced in older adults with fatigue as compared with healthy controls. The decline in cognitive abilities among older adults with fatigue is significantly associated with the CIS-fatigue score, sedentary lifestyle, obesity, pain status, diabetes, and reduction in the levels of nitric oxide (NO), and adiponectin. Moreover, in fatigued cases, the expression of both NO and adiponectin was significantly correlated with CIS-fatigue score, physical activity, obesity, and diabetes, which indicates its availability as diagnostic markers for cognition in mature and older adults with fatigue. Conclusion: In the present study, the data concluded that cognitive abilities were significantly associated with the lower expression of adiponectin and NO as endothelial vascular markers in association with fatigue among home-resident older adults. In addition, the reduction in cognition was significantly affected by other parameters, such as diabetes, obesity, and unhealthy sedentary life activities. Moreover, the results might recommend the use of cellular adiponectin and NO as diagnostic indicators of cognitive abilities in fatigued mature and older adults. However, more studies on larger sample sizes are required.

Predictors of neck disability among undergraduate students: A cross-sectional study.

BACKGROUND: Many cross-sectional studies have examined the predictors of neck pain among adolescents and working-age populations, but there are limited studies included undergraduate students. OBJECTIVE: To investigate the predictors of neck disability among undergraduate students. METHODS: A cross-sectional study using a self-administered online survey. Students completed the survey that included socio-demographic factors, academic-related factors, health and lifestyle factors, and standardized questionnaires including Neck Disability Index (NDI), 12-Item Short-Form Health Survey (SF-12), Depression Anxiety Stress Scales (DASS-21), and Pittsburgh Sleep Quality Index (PSQI). Students who reported an NDI score higher than 15 were considered as having a neck disability. A multivariable logistic regression model was used to identify the significant predictors of neck disability. RESULTS: Of all students (n = 1292), 20.8% reported neck disability. Among all possible predictors, students' major satisfaction (OR 1.46 [95% CI 1.06-2.01]; p = 0.019), DASS-21 anxiety score (OR 1.06 [95% CI 1.03-1.09]; p < 0.001), SF-12 total score (OR 0.89 [95% CI 0.86-92]; p < 0.001), and PSQI score (OR 1.21 [95% CI 1.15-1.28]; p < 0.001) were the only significant predictors of neck disability. CONCLUSIONS: Increased levels of academic stressors and anxiety, and decreased levels of quality of life and sleep quality are associated with increased neck disability among undergraduate students.

Lifestyle Variations during and after the COVID-19 Pandemic: A Cross-Sectional Study of Diet, Physical Activities, and Weight Gain among the Jordanian Adult Population.

The way that COVID-19 has been handled since its inception in 2019 has had a significant impact on lifestyle-related behaviors, such as physical activities, diet, and sleep patterns. This study measures lifestyle-related behavior during the COVID-19 pandemic lockdown using a 22-item questionnaire. The responses were collected from March 2021 to September 2021. A total of four hundred and sixty-seven Jordanian participants were engaged in assessing the changes caused by the pandemic and their effect on BMI. The validity and reliability of the questionnaire were tested for 71 participants. Cronbach's alpha values for the questionnaire exceeded 0.7, demonstrating good reliability and internal consistency. The effect of each question regarding physical activity and dietary habits over the BMI difference was studied using ANOVA. The study shows that more than half of the participants reported snacking more between meals and increased their sitting and screen time, while 74% felt more stressed and anxious. BMI difference among the individuals throughout the lockdown was significantly associated with these variables. In contrast, 62% of the participants showed more awareness about their health by increasing the intake of immunity-boosting foods, and 56% of the participants showed an increase in the consumption of nutrition supplements. Females and married individuals tended to be healthier. Therefore, their BMI showed stability compared to others based on their gender and marital status. Exercise, sleep, and avoiding 'junk' food, which contributes to weight gain and COVID-19 vulnerability, are strongly recommended.

Mental and physical health-related quality of life and their associated factors among students of a comprehensive allied health institution.

BACKGROUND: Healthcare students are subjected to critical levels of mental and physical stress that might hinder their quality of life. OBJECTIVES: This study comprehensively investigated physical and mental Health-related Quality of Life (HR-QoL) and their associated factors among Allied Health (AH) students of nine academic majors. METHODS: Participants completed anonymous questionnaire included demographics and life style, HR-QoL measured by the 12-item Short-Form Health Survey (SF-12), Depression Anxiety Stress Scale (DASS21), and Nordic Musculoskeletal Questionnaire. SF-12 Physical (PCS) and Mental (MCS) Components Summary scores were compared between gender and between academic majors. Multiple linear regressions were conducted to examine factor associated with PCS and MCS scores. RESULTS: A total of 838 students (77.4% females) participated in the study. The overall PCS was 45.64±7.93 and statistically different between majors (P < 0.001). The Overall MCS score was 39.45±10.86 and statistically greater in males (P < 0.001). PCS scores were significantly associated with anxiety score, GPA, diet self-evaluation, and upper back and hip musculoskeletal pain. MCS scores were significantly associated with weekly clinical training hours, stress score, depression score, gender, university year, GPA, sleep self-evaluation, diet self-evaluation, and neck musculoskeletal pain. CONCLUSIONS: Low levels of mental and physical HR-QoL were observed among AH students and were associated with academic-related, health-related, and lifestyle-related factors. Longitudinal studies are needed to assess effective approaches to improve HR-QoL among AH students.

The Influence of Parents and Schools on Adolescents' Perceived Diet and Exercise Self-Efficacy: A School-Based Sample From the United Arab Emirates.

Introduction: In the United Arab Emirates, an alarming rate of 19% obesity among adolescents, associated with poor lifestyle, is apparent. Diet and exercise self-efficacy could influence adolescents' engagement in healthy behaviors. This study evaluates adolescents' perceptions of diet and exercise self-efficacy and explores the impact of parents and schools on self-efficacy. Method: A cluster sampling approach in cross-sectional design was used to recruit 610 school adolescents (Grades 7-12) over a 6-month period. Information on sociodemographics, lifestyle, parents, and schools was explored. Self-efficacy was assessed using The Eating Habits and Exercise Confidence Survey. Results: Participants reported moderate diet and exercise self-efficacy. Diet self-efficacy was predicted by parental support, eating breakfast and meals regularly at home, and prohibiting soft drinks. School support and frequency of weekly exercise classes predicted exercise self-efficacy; p values ≤.05. Discussion: Cultural knowledge and collaboration are essential to promote self-efficacy in multiethnic adolescents in the United Arab Emirates.

Prevalence of upper limb pain and disability and its correlates with demographic and personal factors.

PURPOSE: The present study aimed to assess the prevalence of upper limb pain and disability and to investigate potentially correlated factors among university students in Jordan. METHODS: This was a cross-sectional questionnaire-based survey study that was conducted among university students. The upper limb pain and disability were assessed by the Disabilities of the Arm, Shoulder, and Hand (DASH) outcome questionnaire. The DASH outcome questionnaire was distributed to 2100 students from the population of 2 public and 2 private universities in the north of Jordan. Demographic and personal information were collected. Data were analyzed using descriptive statistics and linear regression analysis. RESULTS: A total of 1929 DASH outcome questionnaires were returned, with a high response rate of 91.86%. The age of the subjects was between 18-28 years (52% male; 48% female). The majority of subjects (85.2%) used at least one smartphone. The majority of them had been using a smartphone for more than 5 years. The prevalence of upper limb pain and disability among university students was 24%. Several factors were found to be significantly connected with upper limb pain and disability among university students, such as smartphone use, computer use,  the presence of musculoskeletal problems, not living with their families, using public transport (bus), and daily housekeeping. CONCLUSION: The results of this study can be used globally to promote the health and well-being of university students, improve their academic performance and future career. Identifying high-risk groups will assist in early identifications and prevention programs for upper limb pain and disability among university students.

Study-related mental health symptoms and their correlates among allied health professions students.

BACKGROUND: Allied health professions (AHP) students are subject to critical levels of study-related stressors including mental health symptoms (MHS) and musculoskeletal pain. Few studies recruited AHP students of multiple academic majors simultaneously. OBJECTIVES: This study investigated and compared the prevalence of MHS severity and their associated factors among students of nine AHP majors. METHODS: A cross-sectional design was used with a sample of nine AHP academic majors (n = 838). Participants completed a validated self-administered questionnaire that included demographics and life style, the Depression Anxiety Stress Scale (DASS 21), and the Nordic Musculoskeletal Questionnaire. MHS scores were statistically compared between males and females and between majors. A general linear model (GLM) multivariate procedure was used to assess the statistical associations between MHS and their correlates. RESULTS: Mild to extremely severe MHS levels were found in 62.2% of the participants for depression, 65.3% for anxiety, and 54.2% for stress. Compared to males, females showed significantly higher levels of stress (p <  0.01) and depression (p = 0.018). MHS were statistically associated with gender, physical health, diet quality, study difficulty, satisfaction with academic major, academic major and musculoskeletal pain. University GPA demonstrated negative significant correlations with MHS. CONCLUSIONS: MHS in AHP students are prevalent and should be accounted for by AHP educators. More studies are encouraged to assess actual mechanisms causing MHS among AHP students, and effective treatment programs are needed.

The incidence of depression among residents of assisted living: prevalence and related risk factors.

AIM: This study aims to recognize and estimate the prevalence of depression and its risk factors among residents of assisted living facilities (ALs) in Jordan. BACKGROUND: Depression is commonly experienced by residents of ALs. The condition is, however, often misunderstood as a part of normal aging and may be overlooked by health care professionals. Little is known about the extent of depression and its risk factors among AL residents in Jordan. SUBJECTS AND METHODS: A national representative sample of 221 residents selected from all AL units across Jordan was recruited to the study. Data on expected risk factors for depression were collected, including sociodemographics; smoking status; number of roommates; number of family members; assessments for cognitive functioning, for lower limb functioning, for hand, shoulder, and arm impairments; and oral health status. Levels of depression among the sample respondents were also assessed. RESULTS: The study found that around 60% of the participants reported depressive manifestations, with 48.0% of AL residents exhibiting impaired cognitive functions, one-third (33.2%) having >50% upper limb disability, two-thirds (63.2%) being at moderate risk of falls, and 69.7% having fair to poor oral health status. Being female, and having a higher level of education, disability of the upper limbs, and impairment of cognitive functions were found to be independent risk factors for depression in participants. CONCLUSION: Depression is relatively common among residents of AL units in Jordan. Health care professionals, nurses, physiotherapists, and dentists working in these facilities need to work cooperatively to identify the manifestations of depression in residents and collaboratively implement the best practice in the treatment of depression and circumvent its long-term impacts on the health of residents.

Physical, mental and cognitive disabilities in relation to utilization of dental care services by nursing home residents.

OBJECTIVE: The main purpose of this study was to investigate factors affecting dental care utilization among nursing home residents in Jordan. METHODS: A total of 221 subjects with a mean age of 62.4 years (121 males and 100 females) taken from among nursing home residents across Jordan were recruited and composed a convenience sample for this study. The Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Tinetti Assessment Battery for gait and balance (TAB), Disability of Arm, Shoulder, and Hand test (DASH) were administered and oral health status was assessed for all subjects and examined as expected correlates of dental care utilization among nursing home residents. RESULTS: The response rate was about 88%. One-third of residents suffered from total edentulism and most of the remaining dentate residents exhibited periodontal disease (90%). Of the dentate sample, 90% of residents had bleeding upon probing, 85% were diagnosed with tooth mobility, 88% had presence of dental calculus, and 30% were diagnosed with root caries. Of the denture wearers, 59.1 % reported having soreness with their dentures and 32% of denture wearers reported having poor quality dentures. MMSE score, suffering from tooth sensitivity and having diabetes mellitus were identified to be indicators for utilization of dental care services among the study population. CONCLUSION: Regular oral care, assessments, and rehabilitation services are considered to be limited for nursing home residents in Jordan. Based upon these findings, future interventions should address oral health among nursing home residents in Jordan.

The effect of an oral health promotion program for people with psychiatric disabilities.

Oral health programs for people with psychiatric disabilities are rare. This study examined the feasibility efficacy of an oral health intervention for people with psychiatric disabilities. Fifty individuals were recruited and randomly assigned to receive education, reminder system and mechanical toothbrush or just the mechanical toothbrush. 42 completed the study. Plaque index scores recorded at baseline and after 4 weeks indicate a statistically significant improvement for both groups but those in the enhanced intervention improved significantly more. The results suggest the mechanical toothbrush improves the oral hygiene of people with psychiatric disabilities. The combination of mechanical toothbrush, dental instructions and reminders result in additional improvements.