ABSTRACT
BACKGROUND: Developmental dysplasia of the hip (DDH) is a condition where there is an abnormal relationship between the femoral head and acetabulum. DDH is prevalent in Jordan, where late presentations of complicated cases are common due to the absence of a national screening program and cultural behaviors that can exacerbate DDH progression. The study aims to prove that the absence of a nationwide screening program and low awareness of the population about DDH are the primary reasons for the high incidence of late-presenting DDH in Jordan. The study highlights the need for addressing modifiable risk factors like swaddling and correcting common misconceptions such as using multiple diapers as a treatment option. METHODS: The cross-sectional study evaluated the awareness level of DDH among Jordan residents above the age of 18. An online questionnaire was used, containing two sections. The Chi-square test was used to analyze the level of awareness scores according to demographic variables and cultural norms such as tight swaddling and using multiple diapers. The sample was categorized into three groups based on their scores: low awareness (0-4), moderate awareness (5-8), and high awareness (9-12). RESULTS: The study included 1013 participants. The results indicated that 48.9% had moderate awareness, 37.8% had low awareness, and 13.3% had high awareness of DDH. Gender and place of residence had no significant relationship with the level of awareness. However, the majority of participants with high and moderate levels of awareness were in the 25-40 years age group, and healthcare workers had the highest levels of awareness. The study showed that 33.9% of participants gained their knowledge from either relatives or self-experience, while awareness campaigns were the least assessed source of information with only 2.9% of participants getting their information from them. The study also revealed misconceptions regarding DDH, such as the belief that tight swaddling and wearing many diapers reduced the risk of developing DDH. Additionally, about half of the participants were unaware of the presence of screening guidelines for DDH. CONCLUSION: The study underscores the urgent need to establish a national screening program and awareness campaigns to increase knowledge about DDH and prevent late presentations of complicated cases in Jordan. The study findings provide essential information for the development of future DDH campaigns and screening protocols.
ABSTRACT
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted public health systems worldwide and created anxiety and stress among communities, resulting in the stigmatization of patients infected with the virus. Stigmatization of individuals who are sick or thought to be infected has a long history and can lead to discrimination and prejudice. This study aims to evaluate the prevalence of COVID-19-related stigma in Jordan, assess the relationship between stigma and the quality of life (QoL) in healthcare workers, and identify possible measures to decrease stressful events. Understanding the psychological effects of healthcare workers' jobs and reducing their burden is essential to improving medical outcomes and the QoL of patients. METHODOLOGY: This cross-sectional study was conducted in three primary hospitals in Amman, Jordan, from July to December 2021. Healthcare workers were recruited through convenience sampling and completed a self-administered questionnaire, which included demographic information, a validated COVID-19 stigma questionnaire, work conditions during the pandemic, the Depression, Anxiety and Stress Scale - 21 Items (DASS-21) questionnaire to measure depression, anxiety, and stress, and the EUROHIS-QOL questionnaire to assess the QoL. Data were analyzed using descriptive and inferential statistics, including chi-square tests and post hoc analysis. The study was approved by the institutional review board, and participation was voluntary and confidential. RESULTS: The study was conducted among 683 healthcare workers in Jordan, with 77.7% based in the capital city, Amman. Most of the participants were between 18 and 30 years of age, and slightly more than half were female. The study found that 38.1% of healthcare workers would not take the COVID-19 vaccine once it became available. More than half (56%) reported experiencing stress, 61% reported anxiety, and 65% reported depression during the pandemic. Internal medicine specialties and frontline nurses reported the highest levels of stress, and healthcare workers with greater exposure to COVID-19 patients reported higher levels of anxiety and stress. Only 3% of participants reported experiencing stigmatization (p=0.043), with low-income participants reporting it more frequently. Stigmatization was significantly correlated with feelings of depression, anxiety, and stress (p<0.001). CONCLUSION: Healthcare workers' mental well-being has been affected negatively by the COVID-19 pandemic, resulting in depression, anxiety, and stress. Widespread mental surveillance for healthcare workers is crucial to protect healthcare workers from psychological issues and to improve the healthcare service provided to patients. Stigma among healthcare workers can be a major factor that may increase depression, anxiety, and stress.
ABSTRACT
INTRODUCTION: Neck-shaft angle (NSA) is of paramount importance to orthopedic surgeons due to its implications for various pathologies of the hip and femur. The primary aim of the study was to establish if NSA measurement may be affected by imaging position (standing and supine) and provide evidence regarding whether the contralateral NSA can be used as a template. The secondary aim was to determine a reference value and precisely understand the effects of sex on NSA measurement. MATERIALS AND METHODS: We measured bilateral NSA in a retrospective study of 200 standing and 200 supine anteroposterior pelvis radiographs that met the inclusion criteria, while paying special attention to bilateral hip symmetry. The overall inter-rater reliability was 0.688 (CI 0.128-0.851). Matching was performed according to sex (exact matching) and age. Paired t-test, Pearson correlation coefficient, and independent sample t-test were used (p < 0.01). RESULTS: A total of 400 pairs of femoral necks were reviewed, comprising of 200 males and 200 females. In the upright radiograph, the overall mean NSA was 131.21° ± 4.72°. There was no significant difference between right and left femur NSA among the patients (p = 0.95). On both sides, male NSA was higher than female NSA (p < 0.001). In supine radiograph, the overall mean NSA for the supine position was 133.06° ± 5.71°. There was a significant difference between NSA of the right and left femur among the patients in the supine position (p < 0.001). On supine radiographs there was no statistically significant difference between male and female NSA (p = 0.85). CONCLUSION: Our findings indicated no significant variability in upright radiographs between the right and left NSA. In contrast, significant asymmetry between the right and left NSA was found in the supine radiographs. However, this study does not provide definitive clinical evidence, and further clinical-oriented research is required. LEVEL OF EVIDENCE: Level III; retrospective comparative study.
