Impact of recurrent pregnancy loss on depression, anxiety and fertility related stress in Omani women: A cross sectional survey.

Pregnancy is a state of happiness and hope not only for a woman but for her family as well as near and dear ones. However, this phase of happiness comes shattering down for some couple who are not able to successfully complete pregnancy and end up losing a baby in the early stages of pregnancy. Recurrent pregnancy loss (RPL) is prevalent among Omani women and the psychosocial impact of RPL is heavy upon these young women devastating their overall quality of life. Researchers conducted a cross sectional survey among 184 Omani women who had a history of recurrent pregnancy loss in a pioneering teaching tertiary care hospital. Data collection done from using a self-reported questionnaire to assess the depression, anxiety and RPL associated stress of women with history of RPL The mean age of women with RPL was 34.05 and 81% reported 2-3 pregnancy loss. Participants reported higher mean scores of depression (9.94), Anxiety (10.32) and fertility related stress (30.28). Women with multiple pregnancy losses (above 3) reported higher level of anxiety which was significant at (p<0.05%) The findings from current study also indicated that women with RPL experience higher levels of depression, anxiety, and fertility related stress.

La grossesse est un état de bonheur et d'espoir non seulement pour une femme mais aussi pour sa famille ainsi que pour ses proches. Cependant, cette phase de bonheur s'effondre pour certains couples qui ne parviennent pas à mener à bien leur grossesse et finissent par perdre un bébé au début de la grossesse. Les fausses couches récurrentes (RPL) sont répandues chez les femmes omanaises et l'impact psychosocial de la RPL est lourd sur ces jeunes femmes, dévastant leur qualité de vie globale. Les chercheurs ont mené une enquête transversale auprès de 184 femmes omanaises ayant des antécédents de fausses couches récurrentes dans un hôpital universitaire de soins tertiaires pionnier. Collecte de données effectuée à l'aide d'un questionnaire autodéclaré pour évaluer la dépression, l'anxiété et le stress associé au RPL des femmes ayant des antécédents de RPL. L'âge moyen des femmes atteintes de RPL était de 34,05 ans et 81 % ont signalé 2 à 3 fausses couches. Les participants ont signalé des scores moyens plus élevés de dépression (9,94), d'anxiété (10,32) et de stress lié à la fertilité (30,28). Les femmes ayant subi plusieurs fausses couches (plus de 3) ont signalé un niveau d'anxiété plus élevé qui était significatif à (p<0.05%). Les résultats de l'étude actuelle ont également indiqué que les femmes atteintes de RPL connaissent des niveaux plus élevés de dépression, d'anxiété et de stress lié à la fertilité.

Challenges and Strategies of Providing Effective Antenatal Education Services in Oman's Public Healthcare System: Perspectives of service providers and pregnant women.

Objectives: This study aimed to explore the challenges of providing quality antenatal education from the perspectives of the healthcare service providers and pregnant women. Globally, maternal mortality is considered a critical healthcare issue because statistics consistently show that many deaths and injuries that occur during pregnancy and childbirth are avoidable. Methods: This qualitative study was conducted from January 2021 to March 2021 at 9 outpatient antenatal clinics located in the public health centres of Muscat governorate, Oman. A purposive sampling technique was used, and data were collected through in-depth interviews and field notes and analysed manually using thematic analysis. Results: A total of 30 participants were included in this study. The challenges identified by the healthcare service providers included the lack of a consultation room and designated space for health education, work overload, time constraints, under-staffing, lack of educational materials, language barriers, lack of authority and negative attitude. The pregnant women identified lack of focus on women's needs, superficial antenatal education, overcrowding, lack of educational facilities, use of medical jargon and unprofessional staff attitude towards women as key barriers to receiving quality antenatal service. Suggested solutions included improving staffing levels, designating a space for antenatal education, expanding educational activities, continuing education for caregivers, establishing midwife-led units, providing focused antenatal education and improving communication between the providers and users. Conclusion: Both healthcare service providers and pregnant women experience significant barriers that hinder them from providing and accessing quality antenatal education services, respectively. Therefore, policymakers, health planners and hospital administrators should remove these barriers and integrate some of the recommendations in this study to promote better health outcomes.

Effects of Twitter use on academic performance and satisfaction in a pathophysiology course among Omani nursing students: a quasi-experimental study.

BACKGROUND: Nursing students often find bioscience courses, such as pathophysiology, challenging. Utilizing Twitter to provide concise course content and answer students' questions before exams may be beneficial. The objective of this study was to determine if using Twitter can improve nursing students' academic performance and satisfaction with pathophysiology courses. METHODS: A post-test, two-group quasi-experimental research design was employed in this study. It involved second-year Bachelor of Nursing students participating in a pathophysiology course at the College of Nursing, Sultan Qaboos University, in Muscat, Oman. Seventy-three second-year Bachelor of Nursing students participated in the pathophysiology course; 50 students opted to use Twitter, forming the experimental group, while the remaining 23, who chose not to use Twitter, formed the control group. We used Twitter to provide concise course content for the pathophysiology course and conduct one-hour question-and-answer sessions the night before exams. Academic performance was assessed through examination scores, and student satisfaction levels with Twitter was measured using five-point Likert scale questionnaires. Data were analyzed using Mann-Whitney and t-tests. RESULTS: Although there was no significant difference in final exam scores between the experimental and control groups, survey results showed that students were generally satisfied with the incorporation of Twitter in the pathophysiology course, including the question-and-answer sessions. CONCLUSIONS: The findings suggest that Twitter can serve as a valuable tool for enhancing nursing student satisfaction with the pathophysiology course.

Prevalence of Urinary Incontinence and its Relationship With Sociodemographic and Obstetrical Variables Among Omani Women.

Objective: Urinary incontinence (UI) is defined by the International Continence Society as any complaint of involuntary urine leakage. This research study highlights the prevalence, types, and associated factors of UI among women in Oman. Methodology: A descriptive cross-sectional design was used to collect data using purposive sampling technique from 400 women between 20 and 60 years; who were attending outpatient department of a referral hospital in Oman. Women were assessed using the Questionnaire for Urinary Incontinence Diagnosis to determine the type of UI. The severity and the impact of UI in women were assessed using the female urinary tract symptoms module (ICIQ-UI-SF). Descriptive statistics were used to determine the prevalence and type of UI, and the Chi-square test was used to find the association between UI and sociodemographic and obstetrical variables. Results: In our study, 28.25% of the women belonged to the age of 50-59 years. The point prevalence (per 1000) of UI among Omani women who were between 20 and 60 years was 44%. In the women who had UI, the majority were having stress UI (41.6%). In the women who had UI, the severity of UI, according to the ICIQ-UI-SF scoring, 15.2% of the women had slight, 50.3% had moderate, 33.1% had severe, and only 1.3% had very intense. Conclusion: Understanding the prevalence of UI in every community and associated factors is essential for the policy makers and healthcare providers to consider the early diagnosis, prevention, health promotion, and management of UI.

Antenatal Education Services in Oman: A Descriptive Qualitative Inquiry of Healthcare Provider's Perspective.

Introduction: To ensure positive pregnancy and birth outcomes, healthcare providers working in antenatal clinics are expected to provide regular antenatal education to enable early detection and timely treatment of pregnancy-related morbidities to prevent complications during labor, birth, and postnatal period. Although antenatal education and services are provided through standard programs in developed countries, presently there are no well-structured programs in many developing countries. The study compares the current service with the national and international guidelines. Objective: To identify the current practices of healthcare providers in antenatal education service in Oman with the aim of identifying any major implementation gaps. Methods: A qualitative inquiry was implemented through semi-structured in-depth interviews guided by open-ended questions. The study population were healthcare providers who routinely provide antenatal services at healthcare facilities. A purposive non-probability sampling technique was used to select the key informants. Data was analyzed manually using the thematic analysis framework. Results: The antenatal education services provided fall under four themes: In relation to "Education for safe pregnancy," the findings revealed that healthcare providers did not adequately address the needs. In relation to "Education for Safe labor and Birth," the pregnant women are briefed with inadequate information about labor and birth during the antenatal period. In relation to "Education related to Postpartum," healthcare providers generally do not provide information regarding pregnant women's psychological wellbeing, breastfeeding, family planning, hygiene, and nutrition during antenatal visits. In relation to "Education related to Newborn Care," the study findings indicate that contrary to what was stipulated by the WHO (2016) to establish antenatal educational programs to help pregnant women gain the skills and knowledge regarding proper newborn care, our findings demonstrated a lack of education about newborn care by providers. Conclusion: The findings have the capacity to contribute towards the development of remedial strategies to improve maternal and neonatal outcomes in Oman. This can be achieved by addressing the practice gaps identified when comparing the current practices with international standards.

A Qualitative Inquiry of Women's Perspective of Antenatal Education Services in Oman.

Introduction: Antenatal care (ANC) provides an opportunity for systematic assessment and follow-up of pregnant women to ensure positive outcomes for mother and foetus. Pregnant women should be offered evidence-based information with support to enable them to make informed decisions. Objective: To identify the gap between the current practices and the recommended guidelines for antenatal education services in Oman. Methods: A qualitative inquiry was implemented through semistructured in-depth interviews guided by open-ended questions and probes. A purposive non-probability sampling technique was used to select 13 pregnant women who had completed 30 weeks of gestation. The women were selected from 9 antenatal healthcare facilities among them: 7 primary health centers, one polyclinic and one, tertiary hospital. Results: Antenatal education focused on four thematic areas of safe pregnancy; safe labor and birth; postpartum care; and new-born care. Regarding antenatal education for safe pregnancy, the findings indicate that most healthcare workers provided pregnant women adequate information to promote healthy dietary habits; cope with pregnancy symptoms; recognize and manage medical conditions, and to adhere to dietary supplements and medication. In addition, the findings revealed that the healthcare team did not provide the required antenatal education to meet the pregnant women's needs to ensure they had safe labor and birth, postpartum care, and new-born care. Conclusion: This study is the first of its kind in Oman to provide baseline data regarding the current antenatal education services from the perspective of pregnant women. These findings will help in developing strategies to improve maternal and neonatal outcomes in the country.

Maternal and Neonatal Outcomes of Healthy Pregnant Women With COVID-19 Versus High-risk Pregnant Women: A Multi-Center Case-Control Comparison Study.

The purpose of this retrospective, matched case-control study (two controls [healthy control and high- risk control] vs. COVID-19 cases) was to compare the maternal and neonatal outcomes of pregnant women with and without COVID-19. A total of 261 pregnant women from three different countries with and without COVID-19 were included in this study. Several pregnancy complications were more common in high-risk pregnant women compared to COVID-19 cases and healthy pregnant women. These include preeclampsia (p < .01), vaginal bleeding (p < .05), preterm labor (p < .05), premature rupture of membrane (p < .01), requiring induction of labor (p < .05), have lower gestational age on delivery (F (2) = 3.1, p < .05), requiring cesarean section (p < .01), neonatal admission in the NICU (p < .01), and low neonatal Apgar score (p < .01). Nurses are advised to provide equal attention to pregnant women with underlying health issues and to pregnant women infected with COVID-19 in terms of the risk assessment, health care, and follow-up for optimal maternal and neonatal outcomes.

Case Study Analysis as an Effective Teaching Strategy: Perceptions of Undergraduate Nursing Students From a Middle Eastern Country.

Background: Case study analysis is an active, problem-based, student-centered, teacher-facilitated teaching strategy preferred in undergraduate programs as they help the students in developing critical thinking skills. Objective: It determined the effectiveness of case study analysis as an effective teacher-facilitated strategy in an undergraduate nursing program. Methodology: A descriptive qualitative research design using focus group discussion method guided the study. The sample included undergraduate nursing students enrolled in the Maternal Health Nursing Course during the Academic Years 2017 and 2018. The researcher used a purposive sampling technique and a total of 22 students participated in the study, through five (5) focus groups, with each focus group comprising between four to six nursing students. Results: In total, nine subthemes emerged from the three themes. The themes were "Knowledge development", "Critical thinking and Problem solving", and "Communication and Collaboration". Regarding "Knowledge development", the students perceived case study analysis method as contributing toward deeper understanding of the course content thereby helping to reduce the gap between theory and practice especially during clinical placement. The "Enhanced critical thinking ability" on the other hand implies that case study analysis increased student's ability to think critically and aroused problem-solving interest in the learners. The "Communication and Collaboration" theme implies that case study analysis allowed students to share their views, opinions, and experiences with others and this enabled them to communicate better with others and to respect other's ideas which further enhanced their team building capacities. Conclusion: This method is effective for imparting professional knowledge and skills in undergraduate nursing education and it results in deeper level of learning and helps in the application of theoretical knowledge into clinical practice. It also broadened students' perspectives, improved their cooperation capacity and their communication with each other. Finally, it enhanced student's judgment and critical thinking skills which is key for their success.

Knowledge and readiness for inter professional education and collaborative practice among undergraduate nursing students in a Middle Eastern country - A pilot study.

BACKGROUND: Inter Professional Education and Collaboration (IPEC) is grounded on mutual respect, enhances collaborative practice, and increases satisfaction among health care professionals. PURPOSE: The study was conducted to assess the level of knowledge and readiness for IPEC among nursing students. METHODS: The student's level of knowledge was assessed using a 20 item questionnaire while their readiness for IPEC was measured using the Readiness for Interprofessional Learning Scale (RIPLS) comprising 19 items. A total of 125 nursing students participated in the study and data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25 DISCUSSION: The mean level of knowledge was 44.41 with SD of 4.72. The mean readiness score was 79.09 with the SD of 11.77. There is no significant association between the knowledge and readiness of nursing students regarding IPEC and their demographic variables at 0.05 confidence level. CONCLUSIONS: Majority of the students had moderately adequate knowledge about IPEC and high level of readiness towards IPEC. This implies that when appropriately implemented, the students will reap the benefits of IPEC, which has the potential to improve their ability to provide holistic nursing care to their patients.

Non-Medical Strategies to Improve Pregnancy Outcomes of Women with Gestational Diabetes Mellitus: A literature review.

This review aimed to examine the literature related to non-medical strategies used to improve pregnancy outcomes of women with gestational diabetes mellitus (GDM) and to determine the risk of bias of the selected studies. Treatment for GDM is changing due to the increased prevalence of GDM-related maternal and neonatal complications. A growing body of evidence suggests that early detection, aggressive monitoring and management of GDM using non-medical strategies can greatly improve outcomes for pregnant women and their babies. PubMed® (National Library of Medicine, Bethesda, Maryland, USA), Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA), SCOPUS® (Elsevier, Amsterdam, Netherlands) and other electronic databases were searched for relevant literature published between 2005-2015. A total of 15 studies on women with GDM that met the inclusion criteria were included in this review and assessment of risk of bias was performed for each study. The results of the studies were consistent with findings of significant improvement in maternal and neonatal outcomes when diet was combined with moderate exercise, self-monitoring of blood glucose and individualised health education. Future intervention studies in this area should be focussed on identifying and implementing factors that enhance and encourage adherence to the healthy behaviours mentioned above.

Can Gestational Anemia be Alleviated with Increased Awareness of its Causes and Management Strategies? Implications for Health Care Services.

OBJECTIVES: We conducted this study to assess the risk factors of gestational anemia and evaluate the effectiveness of a culturally-tailored nutrition educational intervention on hemoglobin (Hb) status among pregnant Omani women. Newborn birthweight was used as a birth outcome. METHODS: The study was conducted in two phases. The first phase investigated the risk factors associated with gestational anemia in 206 Omani women who were 3 20 years old and had at least completed 12 weeks of gestation. A suitable sample was recruited at a tertiary teaching hospital in Muscat, Oman. Hb status was recorded, and backward linear regression was used to analyze the demographic and obstetric variables associated with Hb levels. In the second phase, a specially designed culturally-tailored nutrition educational intervention was delivered to women in the study group by trained research assistants whereas women in the control group received routine care only. The Hb levels of the pregnant women and birth weight of newborns after the intervention were evaluated in the second phase of the study. RESULTS: The prevalence of gestational anemia among 206 pregnant Omani women was 41.7%. A significant negative relationship was found between Hb and parity whereas a positive relationship was found between Hb and gestational age. The Hb level increased as the gestational age advanced (ß = 0.31, p < 0.050) and decreased as the parity increased (ß = -0.22, p < 0.050). The pre-post mean difference of Hb levels in the study group was 11.0 g/dL and in the control group was 10.7 g/dL. The difference between the pre- and post-test Hb levels for the study group was significant (t = 3.58, p = 0.001), indicating that the culturally-tailored nutrition education intervention was effective in improving the Hb level in pregnant Omani women. No significant difference was found between the study and control group with respect to birth outcomes. CONCLUSION: The prevalence of gestational anemia is high in pregnant Omani women. The use of a specially designed culturally-tailored nutrition education intervention for pregnant women supplemented with follow-up reminders can reduce the occurrence of gestational anemia. Such programs are ultimately necessary in light of the high prevalence of gestational anemia in developing countries.

I Do Not Even Say "It" - a Mixed Methods Study on Breast Cancer Awareness of Omani Women.

BACKGROUND: The incidence of breast cancer is rising in Oman, and the disease is diagnosed at late stages, when treatment success is limited. Omani women might benefit from better awareness, so that breast cancer can be detected early and treated. This study was conducted to assess Omani women's levels of breast cancer awareness and early detection practice, and explore factors which might influence these levels. MATERIALS AND METHODS: A mixed methods study was conducted in 2014, including a quantitative survey of 1,372 and a qualitative assessment of 19 Omani women, aged ≥20 years from five Omani governorates using convenient sampling. Demographic information and scores for awareness levels were used in a multivariate regression model to investigate factors associated with awareness. Thematic analysis and interpretive description were used to analyse the qualitative data. RESULTS: The overall means for early detection and general awareness scores were 0.58 (SD 0.24) and 0.46 (SD 0.21), respectively. General awareness was significantly associated with age, education, income and familiarity with cancer patients (<0.05), while early detection was significantly associated with age, marital status and education. A majority of women (59.5%) agreed with a belief in 'evil eye' or envy as a risk factor for breast cancer. Women discussed various factors which may empower or inhibit awareness, including the cultural-religion-fatalistic system, personal-familial-environmental system, and healthcare-political-social system. CONCLUSIONS: The overall low scores for awareness and early detection, and the survey of local beliefs highlight a severe necessity for a contextually-tailored breast cancer awareness intervention programme in Oman.

Effect of a Video-Assisted Teaching Program for Kegel's Exercises on Women's Knowledge About Urinary Incontinence.

PURPOSE: The aim of this study was to assess community-dwelling women's knowledge about urinary incontinence (UI) and the effectiveness of a Video Assisted Teaching Program for Kegel's Exercises (VATPKE) in increasing their knowledge. METHODS: A cross-sectional design was used to collect data from 598 community-dwelling women. A pre-/posttest design was then used to assess the effectiveness of the VATPKE in improving knowledge about UI in women with self-reported UI (202) and without UI (396). Data were analyzed using independent and paired t tests. RESULTS: Of the 598 participants, 33.8% self-reported having UI. The majority of women with UI (90%) and without UI (90%) had inadequate knowledge. The mean post-VATPKE knowledge levels of women with and without UI were higher than pre-VATPKE mean scores. Differences in knowledge levels in women with and without UI were statistically significant (P < .001). CONCLUSION: Most of the women at risk or already affected with UI have inadequate knowledge about the condition. In a resource-poor setting with limited health care human resources to provide one-on-one health education, interventions such as the VATPKE may help improve knowledge about UI among the large numbers of affected and at-risk women.

Challenges and Strategies for Building and Maintaining Effective Preceptor-Preceptee Relationships among Nurses.

OBJECTIVES: This study aimed to determine the challenges encountered and strategies used by nurse preceptors to build effective professional relationships during the preceptorship of final year nursing students. METHODS: This study was conducted in November 2012 at the College of Nursing in Sultan Qaboos University, Muscat, Oman. A qualitative research design consisting of focus group discussions was used to investigate the challenges that preceptors encounter and the strategies that they use to build effective relationships with preceptees. A total of 21 preceptors from Sultan Qaboos University Hospital participated in the study as part of a training workshop for nurse preceptors. The interviews were audio recorded, transcribed verbatim and thematically analysed. RESULTS: The main challenges faced by preceptors included discrepancies in applying theory to practice; lack of trust; lack of time, and perceived lack of knowledge. The effective strategies identified by the preceptors to be used in building a healthy preceptor-preceptee relationship were proper orientation; effective communication; preparation for complex situations; appreciation and acknowledgment; positive feedback; assurance of support; spending time together; knowing preceptors personally; giving breaks, and encouraging self-commitment. CONCLUSION: Preceptors should be encouraged to identify challenges that hinder the building of effective relationships with preceptees early during their preceptorship. The incorporation of appropriate and evidenced-based strategies, such as those identified in this study, can transform the preceptorship experience into one that is fulfilling for both preceptors and preceptees. This may lead to greater job satisfaction, personal and professional growth as well as higher self-esteem levels for preceptors and the realisation of clinical objectives for preceptees.

What do Omani Women know about Breast Cancer Symptoms?

OBJECTIVES: Breast cancer is one of the most common cancers and a leading cause of cancer-related mortality in women worldwide. Studies to detect the awareness of breast cancer among Arab women are few and point to a lack of breast cancer knowledge among females. Early detection of breast cancer plays a leading role in reducing mortality rates and improving prognosis. This study aims to assess the knowledge and awareness of breast cancer symptoms among Omani women. METHODS: A descriptive, cross-sectional survey design was carried out in Muscat, Oman. The study was conducted at three health centers and three shopping malls using convenience sampling. A total of 369 women consented to be part of the study and completed a questionnaire. Responses to the questionnaire were summed to give an overall knowledge score. Descriptive statistics were used to summarize the data, which was also analyzed statistically. RESULTS: Among the total number of women 68 (19%) were calculated to have poor knowledge, 219 (59%) had average knowledge, 77 (21%) had good knowledge, and five (1%) had excellent knowledge on breast cancer. Among the variables, education status (p=0.002, p<0.050), and family history of breast cancer (p =0.000, p<0.010) was significantly related to a higher knowledge level. CONCLUSION: The study revealed that there was lack of awareness and knowledge on breast cancer symptoms among Omani women. Breast cancer awareness and early detection through regular breast screening is important to reduce the mortality and morbidity of the disease.

Insight into Jordanian thinking about HIV: knowledge of Jordanian men and women about HIV prevention.

Research on HIV prevention programs for countries with large Muslim populations is scarce. HIV knowledge, attitudes, and beliefs were assessed in a convenience sample of 128 women and 88 men at two universities in Jordan with the goal of gaining insight into how to approach HIV risk behaviors. In general terms, 97% of participants had heard of AIDS and the majority understood the common methods of transmission. Misconceptions were common; most participants did not recognize condoms as an HIV prevention method. A sense of fatalism regarding the acquisition of HIV was common. In Jordan, challenges to HIV-prevention interventions includes misconceptions about HIV transmission, gender-related differences in the willingness to discuss sexual issues, and fatalism regarding the acquisition of HIV. Silence about sexual activity, particularly among women, was pervasive. Culturally tailored interventions are needed to decrease stigma and address gender inequalities that may contribute to increased risks of HIV in Jordan.

Improving vaginal examinations performed by midwives.

A vaginal examination (VE) is an essential part of midwifery care, and is routinely performed when assessing the progress of labour. As evidence shows that during labour women may find VEs unpleasant, embarrassing and sometimes painful, the aim of this article is to review literature on the use of VEs during labour and to synthesise information from the available literature on how to provide an effective VE. The studies considered were retrieved from three databases (the Cumulative Index to Nursing and Allied Health Literature [CINAHL], SCOPUS and MEDLINE) using the following search terms: "VEs in labour", "midwives and use of VEs" and "women experiences of VEs in labour". The literature reviewed suggests that midwives are not careful about VEs. Therefore, a concerted effort is needed to pay attention to the frequency of VEs, the management of pain and distress, information-giving and the preferences of the patient, so that the patient can feel in control during a VE.

Predictors of Human Immunodeficiency Virus Knowledge among Jordanian Youths.

OBJECTIVES: Understanding factors associated with the level of human immunodeficiency virus (HIV) knowledge acquisition is crucial to inform preventative programmes for young people. This study examines predictors of HIV knowledge among Jordanian youths. METHODS: A cross-sectional survey was conducted among 8,129 youths aged between 14 and 25 years randomly selected from schools representing each of the 12 governorates of Jordan. A total of 50% of respondents were female and, on average, 17 years old. Participants completed a self-administered questionnaire covering sociodemographic characteristics, HIV knowledge, gender awareness, exposure to and favourable attitudes toward risky behaviours. RESULTS: On a 13-item HIV knowledge test, participants answered an average of 7 questions correctly (mean = 7.21; standard deviation = 2.63). Female respondents from rural areas demonstrated significantly lower levels of HIV knowledge, while college and university students demonstrated higher levels. HIV knowledge differed significantly by sources of information, with peer-acquired information associated with more accuracy, while HIV information from parents or health centres was associated with a lower score. Youths with more egalitarian gender views also demonstrated higher knowledge levels, whereas youths approving of drug use showed lower levels of HIV knowledge. CONCLUSION: HIV education programmes in Jordan should focus on females and youths living in rural areas. Educational institutions have been shown to be effective in providing accurate information to students, while parents and health professionals should also be included in HIV prevention programmes in order to reduce misconceptions and raise the level of HIV knowledge among Jordanian youths.

Self-reported urinary incontinence and factors associated with symptom severity in community dwelling adult women: implications for women's health promotion.

BACKGROUND: Urinary incontinence (UI) continues to affect millions of women worldwide and those living in resource poor settings seem to be more affected. The purpose of this study was to determine the prevalence of UI and factors associated with UI symptom severity (UISS) among women in a selected district in India. METHODS: A cross-sectional design was used to collect data from a sample of 598 community dwelling women in the age range of 20 to 60 years. Data was collected using a questionnaire survey of participants who were found in their homes. RESULTS: The prevalence of UI was 33.8% and the majority of women had negative attitudes about the condition. For instance most women were in agreement with statements such as: UI cannot be prevented or cured (98%); women with UI are cursed (97%); women are not supposed to tell anyone about the problem (90%) and others. Of the 202 women with self-reported UI, the majority reported having moderate UISS (78%) and others rated the symptoms as mild (22%). The woman's age at first birth (p<.01) was negatively associated with UISS, while the number of pregnancies (p<.01) and weight of the largest baby ever delivered (p<.01), were positively associated with UISS. The weight of the largest baby delivered had the strongest impact on predicting UISS. CONCLUSIONS: Many community dwelling women are suffering from UI at proportions which warrant significant public health consideration. Therefore public health programs to prevent UI or worsening of symptoms are required and should emphasize health education, because of the pervasive negative attitudes among affected and unaffected women. The predictors reported here can be used to priotize care for affected women and to encourage early uptake of health actions and behaviors that promote pelvic floor strengthening in at risk women who may be reluctant to disclose UI.