University Students' Physical Activity: Perceived Barriers and Benefits to Physical Activity and Its Contributing Factors.

Introduction: In general, undergraduate university students in the north of Jordan have a low level of physical activity. Objectives: To examine the physical activity level, perceived barriers and benefits to physical activity, and the contributing factors among university students in north of Jordan. Methods: A cross-sectional study design was used, and data was collected from 235 university students through a self-reported questionnaire. The International Physical Activity Questionnaire (IPAQ) was utilized to calculate the amount of physical activity, while the exercise benefits and barriers scale (EBBS) was used to measure the perceived benefits and barriers of physical activity. Results: According to the findings, less than half of the students (48.1%) reported engaging in physical activity. Several factors were found to be significantly related to higher levels of physical activity, including being younger, single, having a normal body weight, and reporting excellent health status. Logistic regression analysis revealed that overweight (OR = -0.068, 95% CI 0.025-0.183) and obese (OR = -0.250, 95% CI 0.068-0.924) were less likely to be physically active, while those who rated their health as excellent had higher rates of physical activity (OR = 3.590, 95% CI 1.263-10.201). The students agreed most strongly with the perceived benefit item "Exercise improves the way my body looks," while the perceived barrier item they identified most strongly with was "There are too few places for me to exercise." Conclusion: This study provides important data for health promotion programs aimed at supporting physical activity among university students.

Prevalence, Predictors, and the Role of Social Support in Posttraumatic Stress Disorder Among Cancer Patients in Oman.

BACKGROUND: Cancer, regardless of type, presents a formidable life challenge affecting patients' psychological well-being. Many perceive cancer diagnosis and treatment as traumatic. OBJECTIVES: This study aimed to estimate posttraumatic stress disorder (PTSD) prevalence in Omani adult cancer patients, identify predictors, and probe its correlation with social support. METHODS: This cross-sectional study enrolled 343 adult cancer patients undergoing treatment from 3 hospitals in the Middle East country of Oman. Posttraumatic stress disorder was assessed via the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and perceived social support was measured using the Multidimensional Scale of Perceived Social Support. RESULTS: The prevalence of PTSD among Omani adult cancer patients was 27.4%. Enhanced social support correlated with lower PTSD risk (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93-0.97; P < .001). Predictors included shorter time since diagnosis (OR, 0.98; 95% CI, 0.97-0.99; P = .017), no psychiatric referral (OR, 0.46; 95% CI, 0.23-0.96; P = .04), and insufficient social support (OR, 0.96; 95% CI, 0.94-0.98; P < .001). CONCLUSIONS: Social support significantly mitigates PTSD risk. Routine assessment and psychiatric referrals, especially for recent diagnoses, can enhance patients' lives. Reevaluating the PTSD diagnostic cutoff score (33) merits consideration for improved clinical use. IMPLICATIONS FOR PRACTICE: Early PTSD assessment, particularly for low-social support new-diagnosed patients, is crucial for timely intervention. Psychiatric referrals can guide specialized treatments. Stressing social support's role can guide healthcare providers, including oncology nurses, in supporting patients effectively.

Prevalence of Anxiety, Depression, and Sleep Disturbance Among Emergency Nurses in Oman.

INTRODUCTION: Anxiety, depression, and sleep disturbances among accident and emergency nurses not only harm their well-being but also affect patient care and organizational outcomes. This study examines anxiety, depression, and sleep prevalence and associations among accident and emergency nurses. METHODS: We conducted a cross-sectional correlational survey with 331 accident and emergency nurses in 12 Omani governmental hospitals. RESULTS: Results showed that 28.7% of accident and emergency nurses reported symptoms indicative of anxiety, with 13.6% experiencing symptoms of depression, 16.6% reporting mild sleep disturbances, and 1.5% experiencing moderate disturbance. Those with symptoms of anxiety (r = 0.183, P = .001) or depression (r = 0.152, P = .005) were more likely to experience sleep disturbances. Being single (t [170.7] = 2.5, P = .015), childless (t [169.7] = -2.807, P = .008), Omani (t [215] = 7.201, P < .001), younger (r = -0.375, P < .001) and having less clinical experience (t [329] = 4.6, P < .001) were associated with a higher anxiety score. For depression, being of Omani nationality (t [215] = 7.201, P < .001), having less than 10 years of experience (t [329] = 3.2, P =.002), and being of younger age (r = -0.285, P < .001) were associated with a higher score. DISCUSSION: Accident and emergency nurses commonly experience anxiety, depression, and sleep disturbances. Implementing interventions to promote their mental well-being or manage these issues is crucial. Organizational support is vital for ensuring their mental health, and individual-level interventions may also prove beneficial.

The Lived Experience of Parent Caregivers of Adolescents with Mental Illness: A Phenomenological Study.

Background: The challenges faced by parents of adolescents with mental disorders are profound and multifaceted. Therefore, this study aimed to explore the lived experiences and concerns of parents of adolescents with mental disorders in Oman. Methods: Interpretative phenomenological analysis was employed in this study. In-depth interviews were done with twenty caregivers from June 2021 to the end of December 2022. Data collection continued until saturation was reached, ensuring a thorough understanding of the phenomena under investigation, and thematic analysis was applied to identify and examine the recurring patterns within the data. Results: Three primary themes emerged from the data analysis including Emotional Burden and Guilt, Treatment Concerns, and Fear of the Future. Parents' experiences during their adolescents' diagnosis revealed a profound emotional struggle, encompassing anxiety, frustration, and occasional confusion as they grappled with understanding their children's illness and navigating unpredictable behaviors. The exploration of seeking treatment highlighted the complexity of their experiences. However, a persistent sense of uncertainty regarding their children's future was a consistent thread irrespective of the chosen treatment path. Conclusion: This study aimed to investigate the complex challenges faced by caregivers of adolescents suffering from mental disorders, underscoring the vital need for tailored interventions and robust support systems to address these intricate issues. The findings highlight the importance of heightened awareness, improved access to psychotherapeutic resources, and comprehensive caregiver support.

Stress and loneliness: exploring adolescents' use of social media as a coping strategy during COVID-19.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, adolescents used various coping strategies to manage stress and loneliness. One such strategy was to engage in active coping, social relations coping and humour coping via social media. Such coping strategies can be helpful but can also reinforce stress and loneliness. AIM: To explore adolescents' use of social media to manage stress and loneliness at a time of restricted social contacts due to the COVID-19 pandemic, including potential differences between adolescents according to gender, age, area of residence and extent of social media use. METHOD: A cross-sectional design and an online questionnaire were used to survey a convenience sample of adolescents aged between 12 and 18 years in Jordan. Three data collection tools were used - the modified Brief Coping Scale, the six-item Revised UCLA Loneliness Scale and the Perceived Stress Scale. RESULTS: A total of 770 adolescents participated, half of whom were using social media more than before the pandemic. Increased use of active coping, social relations coping and humour coping was associated with decreases in stress and loneliness. Active coping contributed the most to reducing levels of stress while social relations coping contributed the most to reducing levels of loneliness. Younger participants made more use of active coping and humour coping than older participants. CONCLUSION: Social media use can be a positive coping strategy for adolescents to manage stress and loneliness during a crisis such as the COVID-19 pandemic.

Disparities in Lung Cancer Clinical Trial Discussion and Enrollment at a Safety Net Hospital.

BACKGROUND: In the United States, less than 5% of all adult cancer patients enroll in clinical trials. Few studies explore participation in cancer clinical trials at safety net hospitals, which disproportionately care for minoritized, low-income, uninsured, and underinsured populations. Our study aims to investigate disparities in clinical trial discussions and enrollment among lung cancer patients at Boston Medical Center, the largest safety net hospital in New England. METHODS: We included 1121 patients diagnosed with lung cancer between January 2015 and December 2020. Electronic Medical Records (EMR) were queried, and patients were categorized into three groups: (1) clinical trial discussed and the patient enrolled, (2) clinical trial discussed but the patient not enrolled, and (3) clinical trial not discussed. Sociodemographic variables such as age, gender, race, ethnicity, city, primary language, median household income, medical insurance type, and education level were also collected. Chi-squared,t test, and multivariate regression analysis was done using SPSS version 26.0. RESULTS: Of the 1121 patients, clinical trials were discussed in 141 patients (12.6%), of which 22 (15.6%) were enrolled. Clinical trial discussions were conducted more with younger patients (68.19 vs 71.37, p = .001), but on multivariate analysis there was no significant difference (OR = 1.023; 95% CI 0.998-1.048; p = .068). There was no significant difference in clinical trial discussion or enrollment between the other sociodemographic factors. CONCLUSION: Additional study of barriers to cancer clinical trial discussion and enrollment at safety net institutions can serve as a prerequisite to ameliorating racial disparities observed on a national scale.

Prevalence of Variants of Uncertain Significance in Patients Undergoing Genetic Testing for Hereditary Breast and Ovarian Cancer and Lynch Syndrome.

Hereditary Breast and Ovarian Cancer (HBOC) and Lynch Syndrome (LS) are the most common inherited cancer syndromes identified with genetic testing. Testing, though, commonly reveals variants of uncertain significance (VUSs). This is a retrospective observational study designed to determine the prevalence of pathogenic mutations and VUSs in patients tested for HBOC and/or LS and to explore the characteristics of the VUS population. Patients 18-80 years old that met NCCN criteria for HBOC and/or LS genetic screening were tested between 2006 and 2020 at Mount Auburn Hospital in Cambridge, Massachusetts. A total of 663 patients were included in the study, with a mean age of 50 years old and 90% being females. Pathogenic mutations were identified in 12.5% and VUSs in 28.3%. VUS prevalence was associated with race (p-value = 0.019), being particularly higher in Asian populations. Patients with a personal history of breast cancer or family history of breast or ovarian cancer were more likely to have a VUS (personal breast: OR: 1.55; CI: 1.08-2.25; family breast: OR: 1.68; CI: 1.08-2.60, family ovarian OR: 2.29; CI: 1.04-5.45). In conclusion, VUSs appear to be detected in almost one third patients tested for cancer genetic syndromes, and thus future work is warranted to determine their significance in cancer development.

The lived experience of Omani adolescents and young adults with mental illness: A qualitative study.

There is currently limited knowledge about the firsthand experiences of adolescents and young adults with mental health problems and the meanings they ascribe to these experiences, particularly within Arab countries. This study, therefore, aimed to explore the lived experience of Omani adolescents and young adults with a mental health problem. A sample of 15 participants aged 13-22 diagnosed with a range of mental health problems took part in the study. A qualitative interview guide consisting of open-ended questions was used to allow participants to speak in-depth about their experiences. Using the thematic analysis approach to uncover patterns in the data, three major themes emerged: "living in darkness", "perilous journey" and "uncertain future". Results show that the progress of adolescents and young adults with mental health problems is characterized by several challenges; the most significant of which is having insufficient knowledge about their illness, leading to unnecessary delays in their treatment. These findings shed light on the breadth and depth of the experience of adolescents and young adults with mental health problems and lay the groundwork for further examinations. Implications lie in the development of approaches for preventing or mitigating difficulties faced by adolescents and young adults with mental health problems.

Burden of AML, 1990-2019: Estimates From the Global Burden of Disease Study.

PURPOSE: AML accounts for 80% of acute leukemia in adults. While progress has been made in treating younger patients in the past 2 decades, there has been limited improvement for older patients until recently. This study examines the global and European Union (EU) 15+ trends in AML between 1990 and 2019. METHODS: We extracted age-standardized incidence rates (ASIRs), age-standardized death rates (ASMRs), and disability-adjusted life years, stratified by sex from the Global Burden of Disease Study database, and mortality-to-incidence ratio (MIR) were computed. Trends were compared using Joinpoint regression. RESULTS: The findings show a global increase in AML incidence for both sexes from 1990 to 2019. In the EU15+ countries, most countries exhibited an increase in ASIR for both sexes. Joinpoint revealed that globally for male patients, ASIR steadily increased until 2010, remained stable until 2015 followed by a decline till 2019. Similar trends were observed in female patients. For ASMR, although there was an increase globally and in most EU15+ countries, there was a statistically significant decrease in mortality rates globally and in the majority of EU15+ countries in recent years. MIR improved in both sexes globally. On age stratification, AML burden was highest among older groups (55 years and older), while the lowest rates were observed in younger than 20 years. CONCLUSION: The findings from our study indicate a global rise in AML incidence and mortality in both sexes and decrease in MIR from 1990 to 2019 suggesting a better survival. However, on Joinpoint analysis, there is no change in MIR in women in the past decade and past 4 years in men indicating plateau in survival trends despite recent advances.

Psychometric Properties of the Posttraumatic Stress Disorder Checklist among the Lebanese Population Exposed to the Beirut Explosion: A Cross-Sectional Study during the COVID-19 Pandemic.

Objective: This study was aimed at testing the psychometric properties of the posttraumatic stress disorder (PTSD) checklist for the Diagnostic Statistical Manual version 5 (DSM-5) (PCL-5) among the Lebanese population and at identifying the prevalence of PTSD. Design: A cross-sectional survey of PCL-5 among 950 Lebanese, using the online survey platform by Google Form, was conducted. Snowball recruitment was used to identify participants for the survey. Results: Face, content, construct, discriminant, and convergent validity had been accomplished through the survey. The reliability using Cronbach's alpha, composite, and average variance extracted was identified as superior. We also found that more than half of the participants (55.6%) scored 33 or above which is the cut-off score for a likely diagnosis of PTSD. Conclusion: The current study provides further support for the validity and reliability of the Arabic version of PCL-5 among non-Western populations. This supports using the checklist in the screening of probable PTSD.

The influence of the pulmonary recruitment maneuver on post-laparoscopic shoulder pain in patients having a laparoscopic cholecystectomy: a randomized controlled trial.

BACKGROUND: Post-laparoscopic shoulder pain is very common after laparoscopy. One method to reduce postoperative shoulder pain is the pulmonary recruitment maneuver. It is used to reduce post-laparoscopic shoulder pain. This study utilizes a truly experimental, double-blinded, prospective randomized design to assess the effect of pulmonary recruitment maneuvers on post-laparoscopic shoulder pain after laparoscopic cholecystectomy. METHODS: Sixty patients were allocated randomly into two groups. The intervention group received five manual pulmonary inflations for 5 s at a maximum pressure of 25 cm H2O. The control group included patients whose residual CO2 gas was evacuated from the abdominal cavity using passive exsufflation as the routine method at the end of surgery by abdominal massage. Gentle abdominal pressure was applied to facilitate CO2 gas removal. RESULTS: When Ramsay's Sedation Score's results were compared between the two groups after the operation, there was no statistically significant difference between the two groups during the first and (p value = 0.20) second (p value = 0.61) hours. A repeated measures ANOVA revealed that the pulmonary recruitment maneuver is significant (p-value 0.001) and had a high effect size (0.527) in reducing shoulder pain among laparoscopic cholecystectomy patients after controlling the effect of other covariate patient characteristics. CONCLUSION: Utilizing a pulmonary recruitment maneuver at the end of laparoscopic surgery reduces shoulder pain.

Enhancing Medication Adherence Among Patients With Schizophrenia and Schizoaffective Disorder: Mobile App Intervention Study.

Introduction: Technology has permeated every aspect of our existence and the mental health sector is not exempt from this. Objectives: The aim of this study was to test the impact of using a mobile phone app (MyTherapy pill reminder and medication tracker) on medication adherence in patients with schizophrenia and/or schizoaffective disorder. Methods: Time series design was used. Fifty-one participants were recruited from tertiary hospitals in Oman. The Medication Adherence Rating Scale was used for assessing medication adherence. The data related to medication adherence were collected at baseline, 3 months later and 3 months after installing the program on participants' smartphones. SPSS data set used to analyze the data. Results: A repeated-measures ANOVA found no significant change in the level of adherence among patients with schizophrenia and schizoaffective disorders at the start and 12 weeks later when the mobile app was installed (p = .371). However, adherence scores improved significantly 12 weeks after installation of mobile app compared with the same group at the baseline and 12 weeks before the installation of mobile app (p < .001). Conclusion: The mobile phone app was effective in improving the adherence level among patients. Installation of the program and teaching patients how to use it to improve their level of adherence is recommended.

The Impact of an Educational Programme on Jordanian Intensive Care Nurses' Knowledge, Attitudes, and Practice Regarding Delirium and their Levels of Self-Efficacy: A Quasi-Experimental Design.

Background: Delirium is a common problem among patients in Intensive Care Units (ICUs); however, it remains underdiagnosed. We aimed to determine the impact of a nursing education program on Jordanian nurses' knowledge, practice, attitudes, self-efficacy, and ability to detect delirium among ICU patients. Materials and Methods: We conducted a nonequivalent, quasi-experimental design from January 2019 to January 2020. A total of 175 nurses who work in an ICU were included at the baseline and divided into two groups: (1) intervention (86 nurses), who received education for 6 hours each day across two different days and (2) a control group (89 nurses), who maintained their usual routine of care. Data were collected by means of a booklet of questionnaires about the nurses' knowledge and practice, attitudes, and self-efficacy. Results: Data from 160 nurses were included in the analysis. The education program intervention (n = 81) significantly increased nurses' knowledge and practice, positive attitudes, and self-efficacy compared with the control group (n = 79, p < 0.001). In addition, nurses who received the educational intervention were able to detect more cases of delirium (28%, from a total of 51 patients) than the controls, who detected three (6.50%) out of a total of 31 patients (p = 0.003). Conclusions: The ICU nurses who received the delirium-focused educational program increased their knowledge and practice, positive attitudes, and their self-efficacy; in addition, their ability to detect delirium was increased. The implementation of such a program is recommended for the health policymakers and stakeholders.

Translating and Testing the Validation of the Arabic Peer Mental Health Stigmatization Scale.

Objective: Attitudes toward mental difficulties are influenced by culture, and different cultural backgrounds have different effects on people's behavior. This study aimed to prepare the Arabic version of the Peer Mental Health Stigmatization Scale (PMHSS) and validate it among Omani adolescents. Method : The study was conducted from October 2020 to the end of February 2021. The 24-items PMHSS was translated into Arabic and tested in a sample of 369 adolescents from different governmental schools in Oman. Both exploratory factor analysis (a principal component analysis (PCA) technique with Varimax rotation) and confirmatory factor analysis were performed to examine the construct validity of the PMHSS. Results: Confirmatory factor analysis was performed to examine the construct validity of the PMHSS. Cronbach's α was 0.86 for the total scale and 0.84 and 0.81 for awareness and agreement, respectively. Therefore, the goodness-of fit-indicators support the two-correlated factor 16-item model to measure stigma (χ2 / df = 2.64 (p > 0.001), GFI = 0.92, AGFI = 0.89, CFI = 0.90, IFI = 0.90, RMSEA = 0.067). Conclusion: The Arabic version of the Peer Mental Health Stigmatization Scale (PMHSS) could assess adolescents' stigmatizing attitudes toward various types of mental health problems within the Arabic context, and it can be utilized by researchers in Arab countries to screen for stigmatizing attitudes and to suggest suitable, effective, and outcome-focused interventions based on its results.

Self and public stigma towards mental illnesses and its predictors among university students in 11 Arabic-speaking countries: A multi-site study.

This study aimed to explore self and public stigma towards mental illness and associated factors among university students from 11 Arabic-speaking countries. This cross-sectional study included 4241 university students recruited from Oman, Saudi Arabia, the United Arab Emirates (UAE), Syria, Sudan, Bahrain, Iraq, Jordan, Lebanon, Palestine and Egypt. The participants completed three self-administrative online questionnaires-Demographic Proforma (age, gender, family income, etc.), Peer Mental Health Stigmatization Scale and Mental Health Knowledge Questionnaire. There was a significant difference in the average mean between the 11 countries (p < 0.01) based on stigma agreement (self) and stigma awareness (public). The mean stigma agreement towards mental illnesses among university students was 19.7 (SD = 6.0), with the lowest in Lebanon, 15.9 (SD = 5.1) and the highest in UAE, 24.1 (SD = 5.6). The factors associated with stigma agreement included poor knowledge, being male, high family income, age, weak cumulative grade point average (cGPA), mothers with primary education, an unemployed parent, students in scientific colleges and fathers who completed secondary or university degrees. Furthermore, the factors associated with stigma awareness included good knowledge, acceptable cGPA and having a father who has a low income and is illiterate. Stigma towards mental illness varies among university students across Arabic-speaking countries. There is a need to sensitize youngsters to the need for a humanitarian approach in society to individuals affected by mental health concerns. Major governmental reforms must be initiated for the provision of mental health services for individuals with mental illnesses.

Pulmonary hypertension associated mortality in the United States from 2003 to 2020: an observational analysis of time trends and disparities.

Background: Pulmonary hypertension (PH) is an independent risk factor for morbidity and mortality. In the last two decades, significant advances have been made in management of World Health Organization (WHO) group 1 PH. However, there are no approved targeted pharmacotherapies for PH secondary to left-sided heart diseases or chronic hypoxic lung diseases which are thought to account for more than 70-80% of the disease burden. No recent investigation has analyzed and compared the mortality burden related to WHO group 1 PH with the mortality burden with WHO groups 2-5 PH at the national level in the United States (US). We hypothesize that WHO group 1 PH-related mortality has improved over the last two decades in comparison to WHO groups 2-5 PH. Methods: In this study, we used data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) the underlying cause of death database to study age-standardized mortality rates related to PH in the US from 2003 to 2020. Results: A total of 126,526 deaths were recorded from PH in the US between 2003 and 2020. Across the study period, PH-related ASMR increased from 17.81 per million population in 2003 to 23.89 in 2020 with a percentage change (PC) of +34%. However, there are contrasting mortality trends in WHO group 1 PH when compared to WHO groups 2-5 PH. Data demonstrated a decline in mortality from group 1 PH regardless of gender. In contrast, an increase in mortality from WHO groups 2-5 PH was observed, accounting for the major proportion of the overall PH mortality burden in recent years. Conclusions: PH-related mortality continues to an increase primarily due to increase in mortality attributed to WHO groups 2-5 PH. These findings have notable public health implications. Screening and risk assessment tools for secondary PH, risk factor modification, and novel management strategies are vital to improve outcomes.

Stress Factors, Stress Levels, and Coping Mechanisms among University Students.

Aims: To explore university students' levels of stress, stressors, and their coping style. Methods: A cross-sectional correlational design with a convenience sample (n = 676) of university students who completed the Student-Life Stress Inventory (SSI) and Coping Strategies Indicator (CSI) was used. Findings. Overall, two-thirds of the participant reported moderate levels of stress. Students with chronic illness, living alone, low CGPA, and having exams today experienced a statistically higher mean level of stress. Students who are living alone used the "avoidance" method more significantly and the "social support" method significantly less compared with students who are living with their families and friends. Conclusion: This study concurs with others that university students are prone to distress. To our knowledge, this is the first study in the region to explore the students' coping skills. Some of the employed coping and associated factors could be used to lay the groundwork for evidence-based prevention and mitigation.