Prevalence and Predictors of Leg Cramps in the Third Trimester of Pregnancy: A Cross-Sectional Study.

Objective: This study aimed to estimate the prevalence and determine predictors of leg cramps among pregnant women in their third trimester. Methods: A sample of pregnant women in their third trimester who routinely visited local clinics in Jordan was recruited. Participants completed a socio-demographic and clinical characteristics questionnaire, the numeric pain rating scale (NPRS) for leg cramp pain intensity, the Arabic version of the Pregnant Physical Activity Questionnaire (PPAQ), the Nordic Musculoskeletal Questionnaire (NMQ), Short Form Health Survey (SF-12), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS). In addition, magnesium (Mg) and calcium (Ca) serum levels were examined. Logistic regression analyses were used to identify predictors of leg cramps occurrence. A linear regression model was used to investigate predictors of leg cramps pain intensity among pregnant women who reported leg cramps. Results: Two hundred and five (n=205) pregnant women completed the study. The estimated prevalence of leg cramps was 58%. Logistic regression results showed that not receiving assistance with housework (OR 0.46, p=0.025), progress in the number of gestational weeks (OR 1.10, p=0.021), the number of previous pregnancies (OR 1.21, p=0.049), having leg swelling (OR 2.28, p=0.019), and having gastrointestinal (GIT) problems (OR 2.12, P=0.046) were associated with a higher odds of leg cramps occurrence. In the subsample with pregnant women with leg cramps, linear regression results showed that pregnant women with high school education versus elementary school (ß=0.70, p=0.012), number of working hours (ß=0.11, p=0.010), using vitamins supplements (ß=-1.70, p=0.043), having diabetes after pregnancy (ß=1.05, p=0.036), having sciatica (ß=0.58, p=0.028), having hip pain (ß =-.33, p=0.029), and higher PSQI total score (ß=0.09, p=0.020) were the significant predictors of leg cramp pain intensity. Conclusion: Many health-related conditions, as well as work and home-related work characteristics, may be considered risk factors for the occurrence of leg cramps and increased leg cramps pain intensity in pregnancy.

Prevalence of work-related musculoskeletal disorders and associated factors affecting emergency medical services professionals in Jordan: a cross-sectional study.

OBJECTIVES: Emergency medical services (EMSs) personnel are at high risk for developing work-related musculoskeletal disorders (WMSDs). However, no studies have yet investigated the prevalence and effect of these disorders on the Jordanian EMS personnel. Therefore, this study aimed to determine the prevalence of WMSDs among Jordanian EMS personnel and its associated factors. DESIGN: This study used a cross-sectional design. Participants were asked to complete a self-administrated and validated questionnaire to measure the WMSDs, including a demographic survey and the Nordic Musculoskeletal Questionnaire. Descriptive and multivariable regression analyses were used. SETTING: The Jordanian Civil Defence stations in the main cities of Jordan. PARTICIPANTS: The sample consisted of 435 EMS workers which were obtained across the country of Jordan. A total of 79.0% of the participants were male, with a mean age of 27.9 (±4.3 SD) years. RESULTS: The pain in the lower back (308, 70.8%) and neck (252, 57.9%) were the most reported in the last 12 months. Furthermore, about half of the participants reported having pain in their upper back (234, 53.8%), knee (227, 52.2%) and shoulder (226, 52.0%) pain in the last 12 months. Overall, WMSDs in at least one body part were significantly associated with age, experience, being a male, increased body mass index and lower educational level. CONCLUSIONS: There is a high prevalence of musculoskeletal complaints among EMS personnel. Multiple variables may be incorporated into a national prevention campaign and professional development programme to educate EMS personnel on avoiding WMSDs.

Computational Analysis of Machining Induced Stress Distribution during Dry and Cryogenic Orthogonal Cutting of 7075 Aluminium Closed Cell Syntactic Foams.

The addition of hollow aluminium oxide bubbles to the 7075 aluminium matrix results in a lightweight syntactic foam with a reduced density and an increased peak compression strength. The presence of ceramic bubbles also aids in a reduced coefficient of thermal expansion and thermal conductivity in comparison to aluminium alloys. In spite of their enhanced material properties, the inclusion of hollow aluminium oxide bubbles presents the challenge of poor machinability. In order to elucidate the problem of poor surface machinability, an attempt has been made to develop a thermo-mechanical finite element machining model using AdvantEdgeTM software with which surface quality and machined syntactic foam material can be analyzed. If the novel model developed is combined with virtual reality technology, CNC technicians can observe the machining results to evaluate and optimize the machining program. The main novelty behind this software is that the material foam is assumed as a homogeneous material model for simplifying the material model as a complex heterogeneous material system. The input parameters used in this study are cutting speed, feed, average size and volume fraction of hollow aluminium oxide bubbles, and coolant. For the output parameters, the numerical analysis showed a 6.24% increase in peak tensile machining induced stress as well as a 51.49% increase in peak cutting temperature as cutting speed (25 m/min to 100 m/min) and uncut chip thickness (0.07 mm to 0.2 mm) were increased. The average size and volume fraction of hollow aluminium oxide bubbles showed a significant impact on the magnitude of cutting forces and the depth of tensile induced stress distribution. It was observed on the machined surface that, as the average size of hollow aluminium oxide bubbles became coarser, the peak machining induced tensile stress on the cut surface reduced by 4.47%. It was also noted that an increase in the volume fraction of hollow aluminium oxide bubbles led to an increase in both the peak machining induced tensile stress and the peak cutting temperature by 29.36% and 20.11%, respectively. This study also showed the influence of the ceramic hollow bubbles on plastic deformation behavior in 7075 aluminium matrix; the machining conditions for obtaining a favorable stress distribution in the machined surface and sub-surface of 7075 closed cell syntactic foam are also presented.

Lived experience of Jordanian front-line healthcare workers amid the COVID-19 pandemic: a qualitative study.

OBJECTIVES: This study aimed to explore the lived experience of Jordanian front-line healthcare workers (FHCWs), including their experienced challenges and adaptations amid the COVID-19 pandemic. DESIGN: A phenomenological qualitative design was used to highlight the experiences of a sample Jordanian FHCWs during the COVID-19 pandemic. Qualitative interviews were conducted using a semistructured guide with open-ended questions, audiotaped and then transcribed verbatim. Thematic analysis of the transcribed narratives was conducted using an open coding line by line to develop themes and related subthemes. SETTING: Mobile COVID-19 testing and contact tracing units during an active surge of cases in Jordan between May and September 2020. PARTICIPANTS: Participants were recruited using purposive sampling method and consisted of 15 FHCWs (2 physicians, 10 nurses, 2 paramedics and 1 laboratory technician) who have worked in testing and contact tracing teams in the community and have dealt with suspected or confirmed cases of COVID-19 infection. RESULTS: Participant narratives were classified into two main overarching themes; challenges and adaptation themes. The challenges theme was exhibited as follows: (1) an excruciating encounter with an invisible enemy, (2) distorted knowledge about COVID-19 and (3) organisational and administrative challenges. The adaptation theme was exhibited as follows: (1) seeking relevant knowledge about the disease and (2) seeking more connectedness. CONCLUSIONS: The COVID-19 pandemic exerted many challenges for FHCWs at multiple levels; intrapersonal and interpersonal, organisational and societal levels. Nevertheless, a number of adaptation strategies within these levels have been reported. This study helps to provide the base on which healthcare officials and public health personnel can formulate preparedness plans that tackle challenges faced by front-line workers, which ultimately enhance the resilience of healthcare systems to withstand future pandemics.

Depression, anxiety and insomnia among frontline healthcare workers amid the coronavirus pandemic (COVID-19) in Jordan: a cross-sectional study.

OBJECTIVE: This study aimed to explore the prevalence and factors associated with depression, anxiety and insomnia among frontline healthcare workers (HCWs) in Jordan. METHODS: A cross-sectional design was conducted among 122 frontline HCWs who have dealt with suspected or confirmed cases of COVID-19. The study survey included standardised questionnaires of the 7-item Generalized Anxiety Disorder (GAD-7) Scale, 9-item Patient Health Questionnaire (PHQ-9) and the Insomnia Severity Index (ISI). Data were collected online during the active surge period of cases from 11 May 2020 to 13 June 2020. The statistical analysis included descriptive statistics, analysis of variance, bivariate correlation and multivariate linear regression analyses. RESULTS: A total of 122 HCWs participated in the study (response rate=64.2%). Among the participants, 44.3% were physicians, 32.8% were nurses and 17.2% were paramedics. The mean age of participants was 32.1 (±5.8) years, and the majority were males (80.3%). The mean scores for GAD-7, PHQ-9 and ISI were 8.5 (±5.2), 9.5 (±5.7) and 11.2 (±6.4), respectively. Results showed that the participants reported severe symptoms of anxiety (29.5%), depression (34.5%) and insomnia (31.9%), with no observed differences based on gender, job title, marital status or educational level. Moreover, in the multivariate linear regression, none of the independent factors were associated with GAD-7, PHQ-9 or ISI scores, and the only exception was increased severity of insomnia among paramedics. CONCLUSION: The COVID-19 pandemic has exerted strenuous emotional, psychological and physical pressures on the health of frontline HCWs.

A Comprehensive Technical Review of the Friction Stir Welding of Metal-to-Polymer Hybrid Structures.

Metal-polymer hybrid structures are becoming desirable due to their wide range of applications in the automotive, aerospace, biomedical and construction industries. Properties such as a light weight, high specific strength, and design flexibility along with the low manufacturing costs of metal-polymer hybrid structures make them widely attractive in several applications. One of the main challenges that hinders the widespread utilization of metal-polymer hybrid structures is the challenging dissimilar joining of metals to polymers. Friction stir welding (FSW) shows a promising potential in overcoming most of the issues and limitations faced in the conventional joining methods of such structures. Several works in the literature have explored the FSW of different metal-to-polymer combinations. In some of the works, the joints are examined based on processing parameter optimization, microstructural characteristics, and mechanical performances. It is, therefore, important to summarize the findings of these works as a means of providing a reference to researchers to facilitate further research on the utilization of FSW in joining metals to polymers. Thus, this work aims to present a comprehensive technical review on the FSW technique for joining metals to polymers by reviewing the reported literature findings on the impact of materials, tools, process parameters, and defects on the strength and microstructure of the produced joints. In addition, this work reviews and presents the latest practices aiming to enhance the metal-polymer joint quality that have been reported in the literature.

The role of industry 4.0 technologies in overcoming pandemic challenges for the manufacturing sector.

Industry 4.0 aims to revolutionize the manufacturing sector to achieve sustainable and efficient production. The novel coronavirus pandemic has brought many challenges in different industries globally. Shortage in supply of raw material, changes in product demand, and factories closures due to general lockdown are all examples of such challenges. The adaption of Industry 4.0 technologies can address these challenges and prevent their recurrence in case of another pandemic outbreak in future. A prominent advantage of Industry 4.0 technologies is their capability of building resilient and flexible systems that are responsive to exceptional circumstances such as unpredictable market demand, supply chain interruptions, and manpower shortage which can be crucial at times of pandemics. This work focuses on discussing how different Industry 4.0 technologies such as Cyber Physical Systems, Additive Manufacturing, and Internet of Things can help the manufacturing sector overcome pandemics challenges. The role of Industry 4.0 technologies in raw material provenance identification and counterfeit prevention, collaboration and business continuity, agility and decentralization of manufacturing, crisis simulation, elimination of single point of failure risk, and other factors is discussed. Moreover, a self-assessment readiness model has been developed to help manufacturing firms determine their readiness level for implementing different Industry 4.0 technologies.

Nutritional status and its determinants among community-dwelling older adults in Jordan.

BACKGROUND: The elderly population of Jordan is growing, due to the low mortality rate, high total fertility rate, and the high rate of forced migration from neighboring countries to Jordan in recent years. However, the prevalence of chronic illnesses associated with other comorbidities among the elderly population in Jordan is high. Maintaining a good nutritional status is essential for maintaining general health and well-being among older people. AIM: The aim of this study is to identify the nutritional status of community-dwelling older adults in Jordan and determine its possible associated factors. METHODOLOGY: A cross-sectional, descriptive design was utilized. Proportional multistage nonprobability sampling was employed to obtain a convenient sample of 225 Jordanian community-dwelling older adults. The participants were asked to complete a set of questionnaires related to nutritional status, which included a demographic information sheet, and the Mini Nutritional Assessment (MNA). RESULTS: Among the sample, only 60 participants (26.7%) showed normal nutritional status. Most of the participants (n = 156; 68.3%) were found to be at risk of malnutrition, and nine participants (4%) were found to suffer from malnutrition. Advanced age (r = -0.631; p = 0.001), body mass index (BMI) (r = 0.546; p = 0.001), being single (mean (M) = 20.43, SD = 3.55), being male (M = 21.10, SD = 3.73), being unemployed (M = 21.71, SD = 3.51), being dependent in activities of daily living (ADLs) (M = 21.35; SD = 3.62), eating only two meals per day (M = 19.60; SD = 3.39), having suffered from illness or anxiety in the preceding 3 months (M = 21.11; SD = 2.39), having a mid-arm circumference of less than 31 cm (M = 19.51; SD = 3.47), low consumption of fruit and vegetables (M = 20.79; SD = 2.53), and polypharmacy (M = 20.62, SD = 4.09) were found to predict susceptibility to malnutrition among the participating older adults. Amongst the variables, age was identified as the most significant predictor of nutritional status and explained approximately 40% of the variance in nutritional status. CONCLUSION: Malnutrition in older adults is a multifaceted phenomenon that needs to be integrated into the comprehensive assessment of older adults. It is essential that health-care professionals, particularly nurses, are fully aware of the associated risks of malnutrition among the elderly population. The high prevalence of the risk factors for malnutrition warrants conducting a controlled national-based assessment, using probability sampling, of the nutritional status among older adults in Jordan. Specifically, there is a real need to assess nutritional status among older adults who are at high risk of malnutrition, including senior, unmarried, male, unemployed, ADL dependent, and/or poly-medicated older adults.

Prevalence and predictors of return to work among stroke survivors in Jordan.

BACKGROUND: Returning to work (RTW) is an essential goal for many stroke survivors. Currently, the prevalence of RTW post stroke in developing countries such as Jordan is unknown. Additionally, more research is required to identify factors that contribute to RTW post stroke. OBJECTIVES: This study aims to (1) determine the prevalence of RTW among stroke survivors in Jordan, and (2) determine the predictors of RTW from a holistic perspective using the Occupational Therapy Practice Framework (OTPF) 3rd edition. METHODS: Recruitment was carried out from different Jordanian hospitals and rehabilitation centers. A complete battery of outcome measures was used to reflect OTPF domains. These included outcome measures of occupations, client factors, performance skills, and context and environment. Logistic regression was used to determine factors that predicted RTW. RESULTS: 69 participants were enrolled; 45 Males, 24 females; mean age±SD, 52.2±11.07 years. Only 29% succeeded in RTW during the first year after stroke onset. The highest percentage of RTW was among craft workers (40% ), and those who were self-employed (60% ). Of those who resumed work, 35% returned to their previous work, while 65% needed to make work modifications, or change positions or jobs. Factors that predicted higher rates of RTW were walking speed (Odds ratio (OR)=0.004, 95% confidence interval (CI)=0.00-0.55, P < 0.02), as well as absence of environmental restrictions (OR = 21.16, 95% CI = 1.91-233.5, P < 0.013). CONCLUSIONS: The alarming low prevalence of RTW among stroke survivors in Jordan emphasizes the essential need to develop vocational rehabilitation programs. Clinicians should pay attention to enhancing walking abilities and reducing environmental restrictions post stroke, in order to improve the occurrence of RTW.

Therapeutic Effects of Bilateral Anodal Transcranial Direct Current Stimulation on Prefrontal and Motor Cortical Areas in Children with Autism Spectrum Disorders: A Pilot Study.

Dysfunctional frontal cortical areas associated with clinical features are observed in children with autism spectrum disorder (ASD). This study attempted to identify any potential therapeutic effects of bilateral anodal transcranial direct current stimulation (tDCS) applied over the left and right prefrontal and motor areas on the clinical characteristics of children with ASD. Fifty children with confirmed ASD medical diagnoses were divided equally and randomly into a tDCS treatment group and a control group. The tDCS treatment group underwent 10 sessions (20-min durations, five per week) of bilateral anodal tDCS stimulation applied simultaneously over the left and right prefrontal and motor areas, whereas the control group underwent the same procedures but with the use of sham tDCS stimulation. Total scores and sub-scores of autism treatment evaluation checklist (ATEC) (language and communication; sociability; sensory awareness; and behavioral, health, and physical conditions) were measured before and after the tDCS treatment sessions of both groups. There were significant decreases in total ATEC scores (P = 0.014), sociability sub-scores (P = 0.021), and behavioral, health, and physical condition sub-scores (P = 0.011) in the tDCS treatment group. No significant changes were observed in total ATEC scores and sub-scores in the control group. In conclusion, compared to the control group, bilateral anodal tDCS showed potential therapeutic effects on children with ASD in terms of improvements in sociability, behavior, health, and physical conditions with no reported side effects. Autism Res 2020, 13: 828-836. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Dysfunctional frontal cortical areas are associated with clinical features in children with autism spectrum disorder (ASD). Transcranial direct current stimulation (tDCS) is found to be a safe, noninvasive method to stimulate cortical regions and thus have therapeutic effects on children with ASD. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

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.

Living with multiple sclerosis: A Jordanian perspective.

BACKGROUND: Multiple sclerosis (MS) symptoms are very heterogeneous and may lead to reduced physical, cognitive, and psychosocial functioning that can consequently impair aspects of individual's life. Many studies have examined the living experiences of individuals with MS and its impact on their daily lives. In developing countries and particularly in Jordan, there has been little attempt to conduct studies exploring the experiences of people living with MS. Such knowledge will provide a background to hidden aspects of human concepts, such as culture, perception, and attitudes about chronic diseases. OBJECTIVE: The purpose of this qualitative study was to explore and describe the daily living experiences and challenges of Jordanian individuals with MS. METHODS: A qualitative design was utilized. Sixteen individuals with MS took part in the study; they were interviewed and divided into 4 focus groups. Conversations were digitally recorded followed by a verbatim transcription. Transcripts were analysed using thematic analysis and validated via researcher triangulation and peer checking. RESULTS: Experiences of 16 Jordanian individuals with MS who participated in this study were categorized into the following major themes: (a) experiences related to the disease itself and (b) experiences related to the healthcare system. Disease-related experiences include physical decline, psychosocial withdrawal, and fear of the future. Participants' experiences with the healthcare system include difficulty of diagnosis, poor communication and rapport with healthcare providers, and lack of awareness about MS and its rehabilitation. CONCLUSIONS: Findings of this study suggests that more attention should be given to the people with MS in Jordan. In particular, awareness about the disease should be improved among healthcare providers and the general public. Furthermore, rehabilitation services should be emphasized during the management of MS disease.

Lived experiences of Jordanian mothers caring for a child with disability.

PURPOSE: Caring for a child with a disability in the family is associated with a major increase in care-giving demands and burden. This qualitative study explores the perspectives, challenges and adaptations of Jordanian mothers living with a child with disability. METHODS: Phenomenological qualitative tradition was utilized. Seven Jordanian mothers of children with disability were purposefully selected as having rich experiences for caring for a child with a disability. In-depth interviews were conducted using a semi-structured guide, audio-taped and transcribed verbatim. Interpretive phenomenological analysis was used to extract main themes and subthemes. RESULTS: Mothers' experiences were reflected into four main themes: (1) increased perceived stigma, (2) fear for the future, (3) increased perceived care-giving burden and (4) adaptations to the child's disability. CONCLUSIONS: This study highlights key gaps in the provision of family-centered services for this population as well as multiple sociocultural issues impacting participation and quality of life. Healthcare professionals must deal with the child's disability from a family-centered and cultural perspective. Implications for rehabilitation When therapists meet the whole family's needs through a family-centered approach, the child with disability is less likely to be ignored, maltreated or abused. Family-centered practice adopts a sociocultural model which looks at the child from a wider point of view rather than just the disability itself. It requires therapists to review the context in which the child lives and address the specific needs of parents, siblings and other involved family members. Culture plays a huge role in shaping the family's perspective on disability and has a huge impact and implications for service delivery and development, quality of life and participation for children with disability and their families. Rehabilitation professionals must accommodate their time schedules to provide families with the communication, education, advocacy and consultations needed.

Cleft Lip and Palate: Demographic Patterns and the Associated Communication Disorders.

PURPOSE: This study investigated demographical characteristics, health status, and associated communication disorders in patients with orofacial clefts (OFCs) in Northern Jordan. METHODS: A retrospective study of 226 cleft patients and their families was carried out between March 2012 and September 2016 at the Speech and Hearing Clinic and the Maxillofacial Center at King Abdullah University Hospital. Data were collected by interviewing patients and caregivers, having patients or caregiver to complete a questionnaire and reviewing the patient's medical records. The frequencies of OFC type, demographic, health status, and communication disorders variables were calculated. χ analysis was used to test for significance of associated demographic and communication disorders variables with OFC type. RESULTS: Results revealed higher percentage of males compared with female patients. The majority of OFC patients were born to families who lived in urban areas, obtained high school diploma or lower educational level, lived below poverty cutoff, and showed nonconsanguineous marriages. Most mothers took the prescribed pregnancy supplements. Only one-third of the families received health education and reported other incidences of OFCs. Twenty percent of the patients had other congenital anomalies, 80% experienced dysphagia prior to the cleft repair, dropped to 14% after the repair. Higher percentage of patients with isolated cleft palate and cleft lip and palate exhibited hearing loss, hypernasality, articulation and phonological disorders, and dysphagia compared with those with cleft lip only. None of the demographic variables was associated with OFC type. CONCLUSIONS: Data suggested that families who had children with OFCs displayed poor socioeconomic status and low educational level which may impede the delivery of health education by health practitioners. Increased risk of comorbid communication disorders and malformations in OFC patients must be emphasized and disseminated to health professionals involved in the management of patients with OFC.

Work-related musculoskeletal disorders among Jordanian dental technicians: Prevalence and associated factors.

BACKGROUND: Dental technology is a profession that requires precise manual skills and dexterous handling of small tools. There is an abundance research on work-related musculoskeletal disorders (WMSDs) affecting dentists, dental hygienists and dental assistants, yet very few articles investigated WMSDs among dental technicians. OBJECTIVES: This study aimed to determine the prevalence of WMSDs among Jordanian dental technicians and their associated factors. METHODS: A cross-sectional design was conducted. A sample of Jordanian dental technicians (n = 81) were asked to complete a validated structured self-administrated questionnaire to measure WMSDs and its associated factors. RESULTS: A sample of 81 dental technicians completed the survey (50.6% younger than 30 years, 61.7 were males). Pain complains were significantly higher in female, younger technicians, and with increased workload. All participants reported WMSDs in at least one body part in the last 12 months. The most common pain areas reported were in the neck (70.4%) and shoulders (71.6%). CONCLUSION: This study found a high prevalence of musculoskeletal complaints in dental technicians. Future studies are indicated to investigate the actual mechanisms causing WMSDs among dental technicians.

A pilot study of a minimally supervised home exercise and walking program for people with Parkinson's disease in Jordan.

AIM: This study aimed to evaluate the feasibility and cultural considerations of a minimally supervised, home-based exercise program in Jordan. METHODS: Quantitative and qualitative approaches were used. Thirty participants were randomly allocated to either an 8-week intervention group (n = 16), or a standard care group (n = 14). The intervention incorporated the home use of an exercise DVD, walking program and initial instructional sessions and weekly phone calls provided by a physiotherapist. Interviews were used to explore feasibility. Unified Parkinson's disease rating scale (UPDRS-III); balance and walking speed were assessed. RESULTS: The retention rate was 86.7% and mean adherence rate was 77%. Personal and sociocultural barriers of adherence to the exercise program were identified. UPDRS-III at follow-up was lower in the intervention group. CONCLUSION: A home exercise program was feasible. Sociocultural barriers specific to Arabic culture may affect the uptake of such an intervention in Parkinson's disease in these countries.

Living with Parkinson's disease: A Jordanian perspective.

BACKGROUND: Parkinson's disease (PD) has a major impact on mobility, as well as cognition which can consequently impair aspects of individual's lives. Many studies have examined the living experiences of individuals with PD and its impact on their daily lives. None of these studies have explored the life experiences of Jordanian individuals living with PD. Therefore, the purpose of this qualitative study was to describe the daily living experiences and impact on lives of Jordanian individuals with PD. METHODS: A qualitative phenomenological design was used. Interviews were recorded and transcribed. Transcripts were analysed using thematic analysis. RESULTS: Experiences of 8 Jordanian individuals with PD who participated in this study can be categorized in the following major themes: (1) challenging perspectives and (2) adaptations. Challenging perspectives included stigma, emotional drainer, and experience of decreased independence and difficulty in occupational performance. Adaptations included embracing early acceptance and intervention, spiritual experience, and family support. CONCLUSIONS: Study provided a wealth of knowledge related to the effect of PD and its intersection with the Arabic Jordanian culture. Such knowledge should aid healthcare professionals involved with providing services to Jordanian individuals with PD to provide better holistic services.

Parkinson's disease in Jordan: Barriers and motivators to exercise.

BACKGROUND: Perceived barriers to engaging in exercise in people with Parkinson's disease (PD) are becoming more defined in countries such as the UK and the US. This, however, may vary by culture and environment. This study aimed to explore the perceptions of exercise and barriers that may affect participation in people with PD from Jordan. METHODS: Two focus groups and seven individual interviews were conducted with people with PD. Additionally, individual interviews were conducted with two neurologists. Conversations were digitally recorded and transcribed. Transcripts were analyzed using thematic analysis and validated via researcher triangulation and peer checking. RESULTS: Most of the PD participants lacked previous participation in any disease-specific exercises. Several barriers were perceived by PD participants for such lack of participation. Barriers included difficulty of diagnosis, lack of informational support provided by neurologists, lack of referral to physiotherapy services, disease-specific issues, and setting-related issues. Neurologists indicated a number of barriers in counseling their PD patients on exercise including lack of time and lack of health system resources. Motivators to participate in future exercise included outcome expectations and family support. CONCLUSIONS: Findings of the study shed light into large areas of unmet needs of supporting exercise and physiotherapy for people with PD in developing countries as per Jordan. For better patient outcomes, findings of the study suggest that it is crucial to raise awareness among all PD-related stakeholders on the benefits of early referrals to physiotherapy and early engagement in exercise programs.

Factors related to cognitive function among elementary school children.

OBJECTIVE: The purpose of this study was to investigate cognitive functioning among elementary school children in Jordan. METHODS: A total of 468 children aged 6-12 years were recruited to participate in this study. Cognitive functioning was assessed using the LOTCA battery (Loewenstein Occupational Therapy Cognitive Assessment; Itzkovich et al., 2000). Information obtained from the parents included demographics, work and income data and child's daily behavior and school achievement. RESULTS: The results of this study showed that the cognitive functioning increased by 3.8 points for each increase in the child's GPA and increased by 2.35 points when the child ate breakfast regularly. By contrast, living in rural areas and smoking by a parent decreased cognitive functioning. CONCLUSIONS: Understanding of the child's cognitive abilities is critical to establishing intervention goals and to planning therapeutic activities. Screening of cognitive abilities and associated factors is essential for a comprehensive and accurate understanding of the child's abilities and limitations. Further research is recommended to investigate other factors in different populations.

Work-related Stress, Musculoskeletal Disorder Complaints, and Stress Symptoms among Radiographers in the Northern Part of Jordan.

OBJECTIVE: The aims of this study were to report the variation in work-related stressor (WRS) and musculoskeletal disorder (MSD) complaints across three major hospitals in the northern part of Jordan and to examine the correlations between stressors, MSD complaints, and stress symptoms using a questionnaire. METHODS: A qualified radiographer distributed a questionnaire in the radiology department at three hospitals, including a governmental public hospital (GH), a university educational hospital (UH), and a private hospital (PH). The questionnaire included demographic, WRS, management and responsibility stressors, stress symptoms, stress relievers, and MSD complaints sections. A total of 74 radiographers (GH = 28, UH = 29, PH = 17) agreed to participate after signing a consent form. RESULTS: The average age ranged from 30.8 ± 3.3 to 33.6 ± 1.4 (P = .6), and the average experience ranged from 6.2 ± 2.5 to 8 ± 1.2 years (P = .7) in the hospitals. The number of men was higher than women only in the UH (ratio = 2.6). The number of diploma degree holders was higher than the number of bachelor's degree holders only in the GH (ratio = 3). Stress symptoms such as depression and MSD complaints such as low back pain in the GH were significantly higher than the other hospitals. There was a significant correlation (Spearman correlation coefficient = 0.61, P = .04) between WRS and MSD complaints. CONCLUSION: The GH had more MSD complaints and stress symptoms than the other hospitals. WRSs were correlated significantly with MSD complaints. Encouraging the radiographers to attend work stress management sessions may help in reducing the level of stress.