The Impact of COVID-19 Confinement on Reading Behavior.

Background: The COVID-19 pandemic was detrimental to lifestyle and behavior. In this investigation, changes in reading habits during the pandemic were examined. Methods: The study is cross-sectional and survey-based. 1844 individuals completed an online survey about sociodemographic and reading habits during COVID-19. Multinomial logistic regression was used to examine the relationship between the study variables. Results: Most of the participants were active readers (71.5%-83.2%). Fewer (13.8-18.0%) reported a decrease in reading, while about half reported a no change, and 1/3rd reported an increase. Changes in reading habits were related to age, education, job type, and income. Conclusion: About half of the participants during the pandemic reported a change in reading habits. Interventions to further enhance reading among people during the pandemic might help ameliorate the negative impacts of the pandemic.

The impact of COVID-19 pandemic on tobacco use: A population-based study.

BACKGROUND: Various aspects of lifestyle seem to change during confinement, particularly during the COVID-19 pandemic. The current study examines confinement's effects on tobacco smoking habits (SH). METHODS: A survey was distributed among adults living in Jordan (age >18 years) of both genders during April-May of 2020, of which 1925 responded to the survey. RESULTS: The prevalence of smoking was 33.3%, 46.1%, and 21.1% for cigarettes (Cg), waterpipe (Wp), and E-cigarettes (ECg), respectively. Among the smokers, 38.5-45.8% reported a "no-change," while 32.1-41.7% reported a "decrease" in SH during confinement. On the other hand, 18.0-22.1% reported an "increase" in the SH. However, concerning the factors that might affect SH, the results showed that age, gender, income, and job sector contribute to the observed changes. CONCLUSIONS: Changes in the SH during COVID-19 have been reported in about 50% of participants who smoke tobacco, with a more reported decrease than increase in use. Studies and interventions are needed to confirm further and understand the current results and discourage smoking during the COVID-19 pandemic.

The mitigating role of physical activities on emotions is gender-specific: An experience during "lenient" COVID-19 prevention protocols.

The researchers examined emotional status subsequent to changes in physical (PA) and sedentary (SA) activities during "lenient" COVID-19 prevention protocols that allowed being outdoors. Emotions, PA, and SA were collected from 272 women and 145 men in Qatar. The researchers showed a decrease (p < 0.05) in PA and an increase (p < 0.05) in SA participation during the pandemic. These alterations were different (p < 0.05) between genders and associated (p < 0.05) with emotional status during the COVID-19-induced confinement, but only (p < 0.05) in men. The "mitigating" role of PA for the adverse emotional effects of the pandemic is demonstrated, especially among men. Therefore, "lenient" regulations should be considered around the globe during future pandemics for adequate PA and emotional wellbeing. However, plans should incorporate additional tactics to PA to manage emotional status among women.

Public Perception Toward COVID-19 Disease Nature, Susceptibility to Complication, and Relationship to Influenza: A Cross-Sectional Study from Yemen.

Background: Following the coronavirus disease (COVID-19) declaration as a pandemic, Yemen has started applying preventive measures to prevent its spread. This study aims to identify the perception regarding the nature of the COVID-19 disease, susceptibility to severe forms of the disease, and its relationship to seasonal influenza among the population of Yemen. Methods: This was a cross-sectional study of the public in Yemen. The relationship between participants' sociodemographic factors and their responses was assessed by the chi-square test. Results: A total of 748 participants agreed to participate in the study. Regarding the nature of the diseases, nearly half of the participants (48.8%, n=352) believed that COVID-19 is a naturally occurring human virus that is a serious and fatal disease (61.2%, n=448). The majority (74.9%; n=518) did not agree that bacteria cause COVID-19. More than half of the participants (57.5%, n=423) believed this disease is transmitted to humans through a host animal. Regarding the vulnerable groups to develop severe COVID-19 infection, most of the participants pointed out that the elderly (94.3%, n=705), people with chronic diseases (89.9%, n=669), and pregnant women (53%, n=365) were more susceptible to severe diseases. Regarding symptoms, the majority (61.9%, n=458) of the participants agreed that the symptoms of COVID-19 are similar to those of seasonal influenza. Additionally, the majority (81.9%, n=579) agreed that some individuals develop more severe symptoms than seasonal influenza, particularly those with chronic illness. Gender, age, and education were found to be associated with participants' perceptions regarding the nature of the virus and susceptibility to severe disease. Conclusion: Participants demonstrate a good understanding of the nature and susceptibility to complications associated with COVID-19 disease and its relationship to influenza. However, the respondents with a lower level of education might require additional educational campaigns to improve their awareness of the disease.

The Protective Effects of the Combination of Vitamin E and Swimming Exercise on Memory Impairment Induced by Exposure to Waterpipe Smoke.

BACKGROUND: Waterpipe smoking (WP) exposure involves a negative health impact, including memory deficit, which is attributed to the elevation of oxidative stress. Vitamin E (VitE) in combination with swimming exercise exerts protective effects that prevent memory impairment. In the current study, the modulation of WP-induced memory impairment by the combined effect of VitE and swimming exercise (SE) was investigated. METHODS: Animals were exposed to WP one hour/day, five days per week for four weeks. Simultaneously, VitE (100 mg/kg, six days/week for four weeks) was administered via oral gavage, and the rats were made to swim one hour/day, five days/week for four weeks. Changes in memory were evaluated using radial arm water maze (RAWM), and oxidative stress biomarkers were examined in the hippocampus. RESULTS: WP exposure induced short-term/long-term memory impairment (p<0.05). This impairment was prevented by a combination of VitE with SE (p<0.05). Additionally, this combination normalized the hippocampal catalase, GPx, and GSH/GSSG ratios that were modulated by WP (p<0.05). The combination further reduced TBARs levels below those of the control group (p<0.05). CONCLUSION: WP-induced memory impairments were prevented by the combination of VitE with SE. This could be attributed to preserving the hippocampal oxidative mechanism by combining VitE and SE during WP exposure.

Exercise capacity in people with Parkinson's disease: which clinical characteristics are important?

BACKGROUND: People with Parkinson's (PwP) are suffering from reduced exercise capacity. However, little information is known about clinical correlates of exercise capacity in this population. OBJECTIVE: This study aimed to evaluate correlations between motor and non-motor symptoms with exercise capacity in PwP. METHODS: A total of 50 individuals with Parkinson's disease participated in the study. Exercise capacity was measured by 6 minutes' walk test (6MWT). Besides, the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-Part III used to evaluate disease motor severity, Berg Balance Scale to assess balance, Montréal Cognitive Assessment to evaluate cognitive status, hospital anxiety and depression scale to assess depression and anxiety, Modified Fatigue Impact scale to evaluate fatigue, and the Pittsburgh Sleep Quality Index to evaluate sleep quality. RESULTS: The results showed that exercise capacity, when measured by the 6MWT, can be significantly predicted by balance, disease motor severity, anxiety, and age (R2 = 0.61 P < .0001). CONCLUSION: These results suggest that exercise capacity in PwP is multifactorial and can potentially be predicted by balance, motor severity, anxiety, and age.

Lipid profile in Parkinson's disease: The potential role of brain-derived neurotrophic factor.

BACKGROUND: Parkinson's disease is a neurodegenerative disease manifested as increased tremor, bradykinesia, rigidity, and postural instability. Brain-derived neurotrophic factor (BDNF) is essential for neurocognitive function. However, its cardiometabolic effect has recently been identified in health and disease, but not in PD. Therefore, the current study examined the relationship of BDNF with glucose and lipid profile. METHODS: This was a cross sectional comparative study where PD patients (n = 26) and age-matched healthy controls (n = 27) were recruited. Blood samples were drawn to determine BDNF, glucose, and lipid profile including total cholesterol (TC), HDL, LDL, triglyceride (TriG). RESULT: The linear regression showed that BDNF predicted 11.9 % of TC (p = 0.05), 3.0 % of HDL (p = 0.003), 27.3 % of LDL (p = 0.006), 16.6 % of TriG (p = 0.04), 15.8 % of TC/HDL (p = 0.06), 22.1 % of TC/LDL (p = 0.01), and 35.1 % of TriG/HDL (p = 0.001) but not glucose (B = -0.006; CI = -0.19/0.18; F = 0.005; p = 0.9) and LDL/HDL (B = 0.06; CI = -0.17/0.3; F = 0.3; p = 0.6). Subsequent ANCOVA revealed differences (p < 0.05) in TC, HDL, LDL, TC/LDL, and TriG/HDL but not in glucose, TriG, and TC/HDL among the patients with low-BDNF versus high-BDNF. SIGNIFICANCE: The results demonstrate a relationship of BDNF with lipid profile suggesting the importance of BDNF for lipid metabolism in PD.

Cross-cultural adaptation and reliability of the Arabic version of Children's Hand-use Experience Questionnaire (CHEQ).

Background: Validated outcome measures are essential for assessment and treatment of children with disabilities. The Children's Hand-use Experience Questionnaire (CHEQ) was developed and validated for use in Western countries for children with unilateral hand dysfunction. This study aimed to perform a cross-cultural adaptation and investigate reliability for the Arabic CHEQ. Methods: Translation and cross-cultural adaptation were performed in four phases: (i) forward-translation and reconciliation with feedback from parents and typically developing children from Jordan (n = 14); (ii) backward-translation and review; (iii) cognitive debriefing with parents and/or their children with unilateral hand dysfunction (n = 17); and (iv) review and proofreading. In the psychometric analyses, 161 children from Jordan (mean age [SD] 10y 8 m [5y 8 m]; 88 males) participated. Internal consistency was evaluated with Cronbach's alpha. Test-retest reliability was evaluated in 39 children with intraclass correlation coefficient (ICC) and weighted kappa (κ). Results: Synonyms of four words were added to accommodate for different Arabic dialects. On average, 93% of children with unilateral hand dysfunction and their parents understood the CHEQ items. One response alternative, 'Get help', to the opening question was unclear for 70% of the respondents and need further explanation. Two items about using a knife and fork were difficult to comprehend and culturally irrelevant. High internal consistency was demonstrated (Cronbach's alphas 0.94- 0.97) and moderate to excellent ICC (0.77-0.93). For 18 individual items, κ indicated poor to good agreement (κ between 0.28 and 0.66). Conclusions: After the suggested minor adjustments, the Arabic CHEQ will be comprehensible, culturally relevant and reliable for assessing children with unilateral hand dysfunction in Jordan.

Physical activity to ameliorate the negative mental health effects of COVID-19-induced confinement.

Mental health is strongly affected by physical (PA) and sedentary (SA) activity. In the current study, the relationships of PA and sedentary activity (SA) with mental status amid confinement caused by COVID-19 were examined. The study is self-reporting, survey-based, and cross-sectional in design. The study was conducted in Jordan and included 1744 participants (≥18 years old). The participants' mental status was obtained using the Depression-Anxiety-Stress Scale (DASS). The results showed involvement in both PA and SA during COVID-19-induced confinement. The involvement includes walking (77.2%), running (70.3%), cycling (84.9%), swimming (83.1%), sports (82.9%), weightlifting (86.4%), watching TV (79.4%), using electronics (86.3%), and logging to social media (85.1%). Lower DASS scores were associated (p < 0.05) with lower walking, running, and weightlifting but not (p > 0.05) with cycling and swimming PA. Additionally, DASS scores (p < 0.05) were associated with changes in television viewing but not (p > 0.05) with electronics and social media use during confinement. In conclusion, individuals who experienced higher levels of stress, anxiety, and depression were more likely to turn to more PA and less SA. These findings are important and suggest that individuals during confinement find PA a useful strategy to mitigate the negative mental effects of the pandemic.

Negative emotional symptoms during COVID19 confinement: The relationship with reading habits.

Background: Coronavirus disease (COVID19) is an ongoing pandemic, which forced governments across the globe to implement confinement measures to limit the spread of the disease. These measures have impacted the daily life and psychological status of people. However, no studies have examined the relationship between changes in psychological status with reading habits during the COVID19 pandemic. Objectives: The study aims at examining the relationship between changes in reading habits and negative emotional states. Method: The psychological status was measured using the Depression, Anxiety, Stress Scales (DASS). In addition, the participants reported changes in four types of reading experiences during COVID19 confinement. These reading types are specialized, general knowledge, story/novels, and religious material. An internet-based survey was used to collect the data among adults. Results: A total of 1711 individuals participated in the study. About 60.0%, 55.1%, 60.5% and 61.0% reported participating in scientific, religious, general, and novel reading, respectively. Additionally, the ANOVA revealed differences (p < 0.05) in DASS scores according to the changes in scientific, religious, newspaper, and novel/story reading. Subgroup post hoc comparisons showed that DASS scores were associated with a no-change or increase in all types of reading habits indicating a main effect of emotional state on all types of reading. Conclusions: Current results might suggest that the participants who experienced greater negative emotions, tended to either not change or increase their reading habits. Additionally, individuals with lower negative emotion scores reported a decrease in reading during the COVID19 pandemic.

Depression, stress, anxiety among jordanian people during COVID-19 pandemic: A survey-based study.

COVID-19 pandemic is associated with negative impacts on mental health. The study investigated mental health measures that include depression, stress, and anxiety, and their correlation with gender and age among Jordanians in the COVID-19 era. This investigation adopted a quantitative, cross-sectional, and descriptive design and included 1587 subjects recruited through a convenient sampling approach. Jordanians (≥18 years old) were recruited in the study. The total DASS score of the whole sample was 32.7 ± 0.67. The DASS scale showed significantly high scores for stress, anxiety, and depression in the groups that perceived a moderate-high probability of infection with COVID-19 (P < 0.05). The stress score was greater (P < 0.001) in the men (11.39 ± 0.469) compared to the women (10.74 ± 0.33). On the other hand, anxiety and depression scores were higher in women than men (8.13 ± 0.25, and 12.71 ± 0.30 respectively). Finally, DASS total score significantly decreased with the increasing age of the participants (P < 0.001). Many Jordanians experienced moderate to severe depression, stress, and anxiety during the COVID-19 era. Such experience was associated with the sex and age of subjects. The results of this study will benefit decision-makers in establishing a plan to prevent the consequences of these mental disorders during pandemics.

Changes in dietary habits and eating behaviors during COVID-19 induced confinement: A study from Jordan.

Objective: This study aimed to evaluate dietary habits (DH) and eating behaviors (EB) among adults during confinement induced by COVID-19 in Jordan. Method: In this cross-sectional study, an online survey designed to assess the change in DH and EB during April and May 2020 was distributed using various social media platforms. Results: The survey was completed by a total of 1844 adult (18-72 years) participants from the public in Jordan. The results indicated an increase (42.5-61.8%) in most of the DH and EB examined in the current study in the majority of participants. Among these changes, they have increased (p < 0.05) the prevalence of fruit and vegetable, immune boosters, water, and hot beverage consumption, as well as decreased (p < 0.05) eating in restaurants and fatty food consumption, indicating a positive change. Conversely, a larger (p < 0.05) proportion of participants reported increased consumption of high-calorie food and late-night eating, indicating a risky behavior for obesity and subsequent chronic complications. Additionally, age, sex, obesity, education, income, and type of job appeared to contribute (p < 0.05) to changes in DH and EB. Overall, confinement caused by COVID-19 appears to compel adults to adopt a specific DH and EB. Although most of these changes were positive, some were negative. Conclusion: This study provides essential information for designing subpopulation recommendations and developmental programs for adults under such conditions.

Sleeping habits during COVID-19 induced confinement: A study from Jordan.

Sleep can significantly modulate the immune response to infectious agents. In the current study, changes in sleep quality during COVID-19-induced confinement among adults were investigated. This was a cross-sectional survey study of the public using social media. Participants (n = 1846) were recruited in the study, of which >92% reported a variety of confinement procedures such as self-quarantine, physical distancing, banning of public events, school closure, and lockdown. Majority of the participants (53-59%) reported an increase in most of the sleep parameters except a decrease (49.1%) in daytime sleep. Age was associated with changes in sleeping disturbances during COVID-19 confinement (p < 0.001). Young participants were more likely to experience sleeping disturbance than older ones (p < 0.05). In addition, gender (p < 0.001) is an independent predictor of nighttime sleeping. Being a male is associated with a "decrease" and being a female is associated with an "increase" in nighttime sleeping hours (p < 0.05). Moreover, change in daytime sleeping was related to age, gender, and job type (p < 0.05). In conclusion, changes in sleep quality during COVID-19-induced confinement were reported. Intervention programs and strategies are warranted to further improve sleep during the current and future disease-induced confinement.

Swimming exercise improves short- and long-term memories: Time-course changes.

The beneficial effects of exercise training on memory formation are well documented. However, the memory enhancement profile following the time-course of exercise training remains unknown. In this investigation, changes in the spatial hippocampal memory following a time-course of swimming exercise training were examined. Young adult Wistar rats were tested for both short-term and long-term memories using the radial arm water maize (RAWM) paradigm following 0, 1, 7, 14, and 28 days of swimming exercise training (60 min per day, 5 days/week)s. The mean total errors on RAWM during the learning phase and memory testing remained the same (p > 0.5) after 1 day of swimming exercise. On the other hand, swimming exercise-induced significant enhancement to the learning phase and memory formation after 7 days of training (p < 0.01). Errors decreased (p < 0.0001) after 7 days of training and remained lower (p < 0.0001) than baseline without differences between 7, 14, and 28 days (p > 0.5). Similarly, short- and long-term memories improved after 7 days (p < 0.05) of training as compared to the baseline without differences between 7, 14, and 28 days (p > 0.05). The time course of improvement of learning and both short- and long-term memories after swimming exercise were evident after 7 days and plateaued thereafter. Results of the current study could form the base for future utilization of exercises to enhance cognitive function in healthy individuals.

Public Perception Regarding COVID-19, Nature of the Disease, Susceptibility to Complications, and Relationship to Influenza: A Study from Jordan Using Google Forms.

BACKGROUND: COVID-19 was declared by the World Health Organization (WHO) as a pandemic and had spread to most of the globe. In the current study, perception regarding the nature of the COVID-19 disease, susceptibility to its complications, and its relationship to seasonal influenza was investigated among the Jordanian population. METHODS: This was a survey-based cross-sectional study among public in Jordan. RESULTS: A total of 1863 participants agreed to participate in this questionnaire-based study. The results showed that more than half (55%) of the sample believed that COVID-19 is a naturally occurring virus which causes a serious and possibly fatal disease (50.7%). The majority (62.9%) did not accept that this disease is actually caused by bacteria, or is similar to seasonal influenza. Interestingly, 45.0% of the sampled population felt that the COVID-19 virus was engineered in the lab. Most of the participants (95%) agreed that the elderly or individuals with chronic illnesses such as diabetes and heart disease were more susceptible to severe COVID-19 infections. With respect to symptoms, about two-thirds of the participants (65.2%) felt that the symptoms of COVID-19 are to a large extent similar to those of seasonal influenza. In addition, the majority (82.7%) believed that only some COVID-19 patients develop symptoms that can be described as severe. Factors such as age, gender, and education were found to modulate some of the perceptions of Jordanians regarding different aspects of COVID-19 disease. CONCLUSION: The majority of Jordanians have a good perception about the nature, cause and symptoms of COVID-19 disease.

Changes in Physical Activity and Sedentary Behavior Amid Confinement: The BKSQ-COVID-19 Project.

BACKGROUND: Coronavirus disease 19 (COVID-19) has compelled implementing confinement measure across the globe. These measures can potentially lead to many changes in lifestyle. However, no studies examined the effect of COVID-19-induced confinement on physical activity (PA) and sedentary behavior (SB). METHODS: During April and May of 2020, the current study surveyed changes in PA and SB induced by COVID-19 confinement. RESULTS: The participants of the study were 1844. Among the participants who were regularly involved in PA, the majority (41.8-42.2%) of the participants reported a "decrease" (p<0.05) in walking, jogging, and sports while the majority (46.3-53.1%) reported a "no change" (p<0.05) in swimming, cycling, and weight lifting. With regard to the SB, most of the participants reported an "increase" in watching TV (72.3%), using electronics (82.7%), and logging to social media (81.9%). Additionally, gender, job type, obesity, and being worried to contract the disease were associated (p<0.05) with changes in PA. On the other hand, age, gender, obesity, job type and income were related (p<0.05) to changes in SB. CONCLUSION: Results of the current study might enhance knowledge about the impact of COVID-19 on lifestyle, particularly PA and SB. Subsequently, it can also be used to establish strategies to enhance engagement in activities during the current and future pandemics.

Puffing topography and physiological responses in men and women with low versus high waterpipe dependence during smoking: The WiHi Irbid project.

BACKGROUND: Waterpipe smoking is spreading worldwide, and it is associated with many adverse effects. The aim of this study was to investigate the interaction of waterpipe smoking puffing topography, and related physiological measures, with both gender and level of dependence on waterpipe. METHOD: Exclusive waterpipe smokers were asked to smoke a single waterpipe session in a specialized laboratory while their smoking topography, and in-breath CO level were recorded pre- and post- smoking. Waterpipe dependence was measured using the LWDS-11 scale. RESULTS: In the high dependence group, the total number of puffs, was greater in men than women. In addition, the average flow rate was greater in men with high compared to low dependence. For inter-puffing intervals, greater values were recorded in men and women with low versus high dependence. No other differences were found between the subgroups in total session time, average puff duration, average puff volume, and maximum flow rate. Pre-smoking CO content and CO boost were greater in men versus women in both dependence groups. Post-smoking CO content was greater in women with high versus low dependence, whereas it was lower in women versus men with low dependence. CONCLUSIONS: The current results indicate several effects for waterpipe smoking dependence on smoking topography. Many of these differences were gender dependent with men having higher exposure than women in most aspects.

Metabolic differences between men and women who are long-term users of the water pipe: The Irbid WiHi project.

Smoking tobacco and metabolic disorders are global epidemics associated with cardiovascular, immune, respiratory, and metabolic diseases. Cigarette smoking seems to affect metabolic disorders. However, the effect of water pipe (Wp), also called hookah, smoking duration on obesity and lipid profile is still a sparse. The present study examined the relationship of smoking Wp with body weight (Bw), body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), total cholesterol/HDLc, LDLc/HDLc, and triglycerides. Obesity, lipid profile, and smoking status were obtained from a total of 291 participants of which 147 smoked Wp. Smokers were divided into 3 groups: smoked <10 years (Wp1) (n = 72), smoked 10-20 years (Wp2) (n = 43), and smoked >20 years (Wp3) (n = 30). The ANCOVA revealed greater BMI and Bw and lipid profile measures in individuals smoking Wp vs never (P < .01). Additional analysis revealed that Bw and BMI were greater in the women (n = 11) with longer Wp smoking history (P < .05) but not the men (n = 19). In addition, Tc, LDLc, Tc/HDLc, and LDLc/HDLc levels were greater among the men smoking Wp for longer time (P < .05), but not the women. In conclusion, the study found greater obesity and lipid profile in the adults smoked Wp vs never, especially the ones smoked for longer time.

The importance of physical fitness for the relationship of BDNF with obesity measures in young normal-weight adults.

AIMS: Brain derived neurotrophic factor (BDNF) is essential for cognitive function. It is also found in non-neuronal tissues with various regulatory actions, including metabolic. Physical fitness (PF) is associated with improved synthesis and secretion of BDNF and reduced obesity. However, the importance of PF for the relationship of BDNF with obesity has not been investigated. This study aims at examining the relationship of PF with BDNF and obesity in 174 young (age = 25.30 ± 9.2 years) healthy adults. MAIN METHODS: Serum BDNF was evaluated using ELISA while obesity was determined using body weight (BW), BMI, and waist circumference (WC). Six minute walk distance (6MWD) test was used to estimate PF. KEY FINDINGS: Serum BDNF was greater (p = 0.000) in the participants with high (Hi6MWD) versus low (Lw6MWD) PF group. Additionally, 6MWD explained 6.8% of serum BDNF. Obesity measures were greater (p < 0.05) in the participants with low versus high BDNF. In regression analyses, serum BDNF explained 4.7% of BW (p = 0.004), 3.8% of BMI (p = 0.011), and 6.2% of WC (p = 0.001). However, when the participants were divided into Hi6MWD and Lw6MWD, BDNF explained 8.2% of BW (p = 0.009), 6.0% of BMI (p = 0.03), and 7.0% of WC (p = 0.013), only in the Hi6MWD, but not in the Lw6MWD (p > 0.05) groups. SIGNIFICANCE: The finding confirms the relationship of BDNF with obesity. Additionally, it further suggests the importance of PF level to this relationship among young adults. Future studies are needed to confirm these findings.

Assent and consent in adolescent research: teachers' perspectives from a developing country.

Teachers play a vital role in facilitating research in schools. However, teachers' views of informed consent/assent for children participation in research in the Middle East have not been investigated. In this study, focus group interviews were conducted to understand high-school teachers' perspectives toward adolescent assents and consents. The teachers indicated that parent consent is important and should be coupled with sufficient information about the research study. The teachers added that assent is most important for children above 13 years old. Conversely, the teachers believed that parent approval is only important for invasive (such as research involves blood withdrawal) but not simple procedures. Most importantly, for procedures that are considered simple, part of the teachers do not acknowledge the significance of parental approval, such as body weight, or beneficial, such as new treatment. The results indicate that some of the teachers' views were consistent with proper conduction of pediatric research. However, other views were worrisome and might warrant further studies and actions. Risks related need to be assessed and policies needs to be developed in order to ensure the proper conduction of pediatric research.