Knowledge and information sources towards Helicobacter pylori in Jordan.

In 2017, the Jordanian Ministry of Health reported that gastric cancer was one of Jordan's most diagnosed cancers. Gastric cancer is often linked to Helicobacter pylori, one of the foremost risk factors. Despite the high prevalence of H. pylori in Jordan, no information is available regarding the general population's awareness of the harmful effects of this pathogen. The study aims to assess the knowledge and the impact of the source of knowledge on H. pylori among the general population in Jordan. A cross-sectional study involving 933 participants was conducted between May and July of 2021. After meeting the inclusion criteria and consenting to participate in this study, participants completed the questionnaire. An interview-based questionnaire covered the following sections: sociodemographic data and knowledge related to H. pylori infection. 63% of the participants had a high level of education, 70.5% got their information about H. pylori infection from non-medical sources, and 68.7% had a low level of knowledge. Working in the medical field, attaining information from medical resources, and having a history of self-reported or family member of H. pylori infection showed a significant association with a high level of knowledge. The Mann-Whitney U test showed that the mean ranks of all knowledge items in the medical source group significantly exceed those of the non-medical source group (p-values < 0.05). In Jordan, the awareness of H. pylori was unsatisfying, like in other countries. Nevertheless, misconceptions in knowledge about H. pylori were identified and further awareness must be spread and advocated. Close observation of the non-medical sources of information is essential for delivering sufficient amount of knowledge to the general population.

Prevalence of Depression in Patients with Type 1 Diabetes between 10 and 17 Years of Age in Jordan.

Methods: The study was conducted by distributing the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to adolescents with T1D seen at Jordan University Hospital between February 2019 and February 2020. Demographic, clinical, and socioeconomic data were collected using electronic clinical charts. Possible predictors of depression were assessed using logistic regression analysis. Results: A total of 108 children were enrolled in the study with mean age of 13.7 ± 2.3 years. Fifty-eight children (53.7%) had a CES depression score less than 15, and 50 children (46.3%) had a depression score of 15 or more. The number of diabetes-related hospital admissions and the frequency of self-monitoring of blood glucose (SMBG) were significantly different between the two groups. In the multivariable analysis, both gender and SMBG frequency were statistically significant. Girls were more likely to have a depression score ≥ 15 (OR = 3.41, p = 0.025) than boys. Patients who were rarely testing blood glucose levels were more likely to have a depression score ≥ 15 compared to those who were testing regularly (OR = 36.57, p = 0.002). Conclusion: The prevalence of depressive symptoms is relatively high in adolescents with T1D, especially in those living in developing countries. Longer diabetes duration, higher glycated hemoglobin level, and less frequent blood glucose monitoring are associated with higher depression scores.

Current Awareness Status of and Recommendations for Polycystic Ovarian Syndrome: A National Cross-Sectional Investigation of Central Jordan.

Polycystic ovary syndrome (PCOS) is a common reproductive disorder that is related to a number of health issues and has an influence on a variety of metabolic processes. Despite its burden on the health of females, PCOS is significantly underdiagnosed, which is associated with lack of disease knowledge among females. Therefore, we aimed to gauge the awareness of PCOS in both the male and female population in Jordan. A descriptive cross-sectional study was conducted, targeting individuals over the age of 18 from Jordan's central region. Participants were recruited through stratified random sampling. The questionnaire consisted of two domains, including demographics and knowledge of PCOS domains. A total of 1532 respondents participated in this study. The findings revealed that participants have overall adequate knowledge regarding PCOS's risk factors, etiology, clinical presentation, and outcomes. However, participants demonstrated subpar familiarity of the association between PCOS and other comorbidities and the effect of genetics on PCOS. Women had more knowledge than men about PCOS (57.5 ± 6.06 vs. 54.1 ± 6.71, p = 0.019). In addition, older, employed, and higher-income populations showed significantly better knowledge than younger, unemployed, self-employed, and lower-income populations. In conclusion, we demonstrated that Jordanian women demonstrate an acceptable yet incomplete level of knowledge towards PCOS. We recommend establishing educational programs by specialists for the general population as well as medical personnel to spread accurate medical information and clarify common misconceptions about signs, symptoms, management, and treatment of PCOS, and nutritional knowledge.

Knowledge, Attitude, and Practices toward Hepatitis B Infection among Healthcare Students-A Nationwide Cross-Sectional Study in Jordan.

The World Health Organization has estimated that around 66 thousand HBV infection cases are caused by needlestick injuries annually. Healthcare students should be aware of HBV transmission routes and preventive measures. This study assessed the knowledge, attitudes, and practices toward HBV among Jordanian healthcare students and its associated factors. A cross-national study was conducted from March to August 2022. The questionnaire was composed of four sections: participants' sociodemographics, knowledge, attitudes, and practices about HBV, and 2322 participants were enrolled. The collected responses were analyzed with SPSS software (version 25 (IBM Corp., Armonk, NY, USA)) using descriptive statistics, unpaired t-tests, chi-square tests, and multivariate regression analyses. A p-value ≤ 0.05 was considered statistically significant. The results showed that 67.9% were females, 26.4% were medical students, and 35.9% were in their 3rd year. Overall, 40% of the participants held high levels of knowledge and attitudes. Further, 63.9% of participants had good practices toward HBV. Gender, year of study, encountering HBV patients, college, and having extra HBV courses were associated with high levels of KAP. This study demonstrated insufficient knowledge and attitudes toward HBV; however, the practice level toward HBV among healthcare students was promising. Therefore, public health efforts should modify the knowledge and attitude gaps to reinforce awareness and minimize the risk of infection.

A risk-based decision framework for policy analysis of societal pandemic effects.

Introduction: In this article, we summarize our findings from an EU-supported project for policy analyses applied to pandemics such as Covid-19 (with the potential to be applied as well to other, similar hazards) while considering various mitigation levels and consequence sets under several criteria. Methods: It is based on our former development for handling imprecise information in risk trees and multi-criteria hierarchies using intervals and qualitative estimates. We shortly present the theoretical background and demonstrate how it can be used for systematic policy analyses. In our model, we use decision trees and multi-criteria hierarchies extended by belief distributions for weights, probabilities and values as well as combination rules to aggregate the background information in an extended expected value model, taking into criteria weights as well as probabilities and outcome values. We used the computer-supported tool DecideIT for the aggregate decision analysis under uncertainty. Results: The framework has been applied in three countries: Botswana, Romania and Jordan, and extended for scenario-building during the third wave of the pandemic in Sweden, proving its feasibility in real-time policy-making for pandemic mitigation measures. Discussion: This work resulted in a more fine-grained model for policy decision that is much more aligned to the societal needs in the future, either if the Covid-19 pandemic prevails or for the next pandemic or other society-wide hazardous emergencies.

Investigating medical students' satisfaction towards video-based learning versus face-to-face lectures: a Jordanian tertiary teaching hospital experience.

PURPOSE: We aimed to evaluate the disparity between video-based learning and lecture-based learning on Jordanian medical students' satisfaction. METHODS: We conducted this cross-sectional study using a web-based questionnaire adapted from Student Evaluation of Educational Quality survey. Using convenience sampling, medical students studying at the University of Jordan and Jordan University Hospital were recruited. Participants in either clinical or basic-science years that have completed the entire survey were included in the final analysis. RESULTS: We surveyed a total 487 participants among which male to female ratio was 1.19:1. Participants perceived greater benefit in terms of learning, instructor enthusiasm, content organization, breadth of teaching, and quality and number of assignments when using video-based learning (all p<0.01). In contrast, face-to-face learning was associated with significantly higher benefits in terms of group interactions (p<0.01) and capacity for rapport building (p<0.01). There was no significant difference in perceived examination performance between the two learning modalities (p=0.11). CONCLUSION: Video-based learning is the preferred learning modality among Jordanian medical students. Despite its dominance across multiple domains, it should be implemented as an adjunct to traditional classroom teaching for it is vital in the development of good communication skills and building rapport in medical students.

The relationship between maternal health and neonatal low birth weight in Amman, Jordan: a case-control study.

This study aimed to examine the relationship between maternal health during pregnancy and low birth weight (LBW), as well as the impact of COVID-19 on the socio-economic status of pregnant women and its effect on LBW. The study was conducted in Amman, Jordan, and included 2260 mothers who visited Abu-Nusair comprehensive health center between January and December 2020. A matched case-control design was used with 72 cases and 148 controls selected for data collection through medical records and face-to-face interviews. Results showed that factors such as a monthly income of 400 JD or less, living with an extended family, exposure to passive smoking, maternal weight gain of 6-10 kg, maternal anemia, maternal hypertension, delivery by cesarean section, and previous history of LBW newborns were positively associated with an increased risk of LBW. Conversely, factors such as a monthly income above 700 JD, living with a core family, daily intake of iron, calcium, and vitamin D, prenatal visits, healthy food intake, and planning for pregnancy were associated with a lower risk of LBW. COVID-19 infection and its effects on work, family finances, antenatal care visits, and food supply were also positively linked with LBW. In conclusion, socioeconomic status, maternal health, COVID-19, and its impacts were significant risk factors for LBW.

Understanding Mental Health Status of Syrian Refugee and Jordanian Women: Novel Insights from a Comparative Study.

(1) Background: War and displacement are well-known predictors of negative mental health outcomes among affected populations. This is especially relevant for refugees of war, particularly women, who often repress their mental health needs due to family responsibilities, social stigma, and/or cultural pressures. In this study, we compared the mental health status of urban Syrian refugee women (n = 139) with local Jordanian women (n = 160). (2) Methods: Psychometrically validated Afghan Symptom Checklist (ASC), Perceived Stress Scale (PSS), and Self-Report Questionnaire (SRQ) examined psychological distress, perceived stress, and mental health, respectively. (3) Results: According to independent t-tests, Syrian refugee women scored higher than Jordanian women on the ASC [mean score (SD): 60.79 (16.67) vs. 53.71 (17.80), p < 0.001], PSS [mean score (SD): 31.59 (8.45) vs. 26.94 (7.37), p < 0.001], and SRQ [mean score (SD): 11.82 (4.30) vs. 10.21 (4.72), p = 0.002]. Interestingly, both Syrian refugee and Jordanian women scored higher than the clinical cutoff in the SRQ. Regression analyses indicated that more educated women were less likely to score high on the SRQ (ß = -0.143, p = 0.019), particularly in the anxiety and somatic symptoms subscale (ß = -0.133, p = 0.021), and were less likely to exhibit symptoms of ruminative sadness (ß = -0.138, p = 0.027). Employed women were more likely to exhibit high coping ability than unemployed women (ß = 0.144, p = 0.012). (4) Conclusions: Syrian refugee women scored higher than Jordanian women in all used mental health scales. Access to mental health services and enhancing educational opportunities would help mitigate perceived stress and may enhance stress-coping abilities.

Breast Cancer Beliefs and Screening Practices among Syrian Refugee Women and Jordanian Women.

Despite significant declines in breast cancer (BC) incidence in the West, this disease is widespread in Jordan, where cancer detection occurs at much advanced stages. This is particularly concerning for Syrian refugee women resettled in Jordan, who are less likely to undergo cancer preventative procedures because of poor health literacy and lack of health services access. The present work assesses and compares breast cancer awareness and breast cancer screening behaviors among Syrian refugee women and Jordanian women residing close to the Syrian-Jordanian border city of Ar-Ramtha. A cross-sectional survey was conducted using a validated Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A total of 138 Syrian refugee women and 160 Jordanian women participated in the study. Results indicate that 93.6% of Syrian refugee women and Jordanian women ≥ 40 years of age reported never having undergone a mammogram. Syrian refugee women and Jordanian women reported low attitudes toward general health checkup (mean score for Syrian refugees 45.6 vs. 42.04 among Jordan women; p = 0.150). Barriers for BC screening were higher among Syrian refugees (mean score = 56.43) than Jordanian women (mean score = 61.99, p = 0.006). Women with higher education were more likely to report fewer barriers to screening (p = 0.027). The study documents a significant lack of BC screening awareness among Syrian refugee women and Jordanian women, indicating that future work is needed to alter current attitudes towards mammograms and early detection measures especially for Syrian refugee women and Jordanian women residing in rural areas of Jordan.

Workplace Violence against Health Care Providers in Emergency Departments of Public Hospitals in Jordan: A Cross-Sectional Study.

Workplace violence (WPV) against healthcare providers is a serious problem that carries health, safety, and legal consequences. Healthcare providers working in emergency departments (ED) are more susceptible to WPV compared to other healthcare settings. This study aimed to assess the prevalence of physical and verbal violence against ED physicians and nurses in public hospitals in Amman, Jordan, and to explore the relationship between WPV and the socio-demographic characteristics of the participants. A quantitative descriptive cross-sectional study design was used to assess physical and verbal violence against ED physicians and nurses. A self-administered questionnaire was completed by 67 physicians and 96 nurses from three public hospitals in Amman. In the past year, 33% and 53% of the participants experienced physical and verbal violence, respectively. Compared to their female counterparts, males were more frequently physically (43.7% vs. 2.3%, p-value < 0.001) and verbally (61.3% vs. 29.5%, p-value < 0.001) abused. The main perpetrators of physical and verbal violence were the patients' relatives. Out of 53 physical and 86 verbal abuse incidents, only 15 cases (10.8%) were followed up with legal persecution. In conclusion, there is a widespread occurrence of physical and verbal violence against ED physicians and nurses in the public sector hospitals in Jordan. A collaborative effort by all stakeholders should be instituted to ensure the safety of the physicians and nurses and to improve the quality of the healthcare provided.

First evidence for the existence of Simkania negevensis in the genitalia of human females / Primera evidencia de la existencia de Simkania negevensis en los genitales femeninos humanos

Introduction: Simkania negevensis has been linked to some respiratory and non-respiratory diseases. However, there is still a serious lack of clinical investigations that attempt to determine possible body sites that could be inhabited by this microorganism and evaluate its true pathogenic capacity. The goal of this study was to examine the potential presence of Simkania and its prevalence in the genital tract of human adult females. Methods: Lower vaginal swabs from 169 Jordanian adult females who attended Obstetrics and Gynecology clinic were collected and tested for Simkania DNA by PCR method. Results: The presence of bacterial nucleic acids was confirmed in the genital system of adult females with an overall prevalence of 24.26% (41/169). Interestingly, the positivity of Simkania DNA was significantly higher in women of reproductive age than females of non-reproductive age (28.03% versus 10.81%; p≤0.05). Moreover, the presence of S. negevensis was evident in approximately 43% of females suffering from vaginal itching and/or abnormal discharge, exhibiting about two-fold increase in the positivity rate compared to detection rates assessed for women who attended the clinic for routine checkup or menstruation problems. However, the current work failed to find any link between the bacterial agent and spontaneous abortion (miscarriage). Conclusions: This study showed for the first time the presence of S. negevensis in the genitalia of human females. These novel data could provide a basis to clarify the exact role of S. negevensis in the female genitalia and its potential involvement in genital system disorders.(AU)

Introducción: Simkania negevensis se ha asociado a algunas enfermedades respiratorias y no respiratorias. Sin embargo, todavía existe una importante carencia de investigaciones clínicas para intentar determinar posibles lugares del cuerpo que puedan ser colonizados por este microorganismo, y evaluar su auténtica capacidad patogénica. El objetivo de este estudio era examinar la potencial presencia de Simkania y su prevalencia en el tracto genital de mujeres adultas. Métodos: Se recogieron hisopos vaginales de 169 mujeres adultas de Jordania que acudieron a una clínica de obstetricia y ginecología y se analizaron para detectar ADN de Simkania mediante PCR. Resultados: Se confirmó la presencia de ácidos nucleicos bacterianos en el aparato genital femenino adulto, con una prevalencia global del 24,26% (41/169). Una observación interesante fue que la positividad a ADN de Simkania fue significativamente superior en mujeres en edad reproductiva en comparación con las mujeres en edad no reproductiva (28,03 frente al 10,81%; p≤0,05). Además, la presencia de S. negevensis era evidente en aproximadamente el 43% de las mujeres que sufrían picor vaginal y/o flujo vaginal anormal, mostrando un incremento cercano al doble en la tasa de positividad en comparación con las tasas de detección evaluadas para mujeres que acudían a la clínica para revisiones de rutina o por problemas menstruales. Sin embargo, la investigación no logró encontrar una asociación entre el agente bacteriano y el aborto espontáneo (aborto natural). Conclusiones: Este estudio mostró por primera vez la presencia de S. negevensis en los genitales femeninos humanos. Estos nuevos datos pueden sentar una base para clarificar con precisión el papel de S. negevensis en los genitales femeninos humanos y su potencial implicación en trastornos del aparato genital.(AU)

Jordanian nursing students' engagement and satisfaction with e-learning during COVID-19 pandemic.

BACKGROUND: Nursing education was affected by the COVID-19 pandemic as most institutions shifted to e-learning. The aim of the current study was to examine students' engagement and satisfaction levels with e-learning during the COVID-19 pandemic. METHODS: A descriptive correlation design was used to guide this study. A voluntary response sampling method was used to recruit undergraduate nursing programs in Jordan. Data were collected using an electronic link to a self-reported questionnaire. RESULTS: A total of 1,562 undergraduate nursing students responded to the questionnaire. The study showed that most students have high engagement in the emotional, skills, and performance subscales and low engagement in the participation subscale. Further, they were moderately satisfied with e-learning during the COVID-19 pandemic. CONCLUSIONS: Students identified several issues regarding their e-learning, which must be considered to improve their engagement and satisfaction. Further, the study revealed several shortcomings in preparing students to attend e-learning classes.

Eco-innovation influence on business performance in Jordanian micro, small and medium enterprises operating in the food processing sector.

Innovative performance is a fundamental asset for building competitive advantage of micro, small and medium enterprises MSMEs. This research empirically examines the direct and indirect relationship between eco-innovation and business performance in Jordanian MSMEs enterprises working in the food processing sector. This research draws on the resource-based view theory to investigate the inter-relationships among three types of eco-innovation (process, product, organizational) and their relative impact on business performance. Furthermore, the researchers used structural equation modelling of 86 samples collected from Jordanian MSMEs operating in the food processing sector. The major contribution of this research is providing a holistic view that explains the inter-relationship among eco-process, eco-product, and eco-organizational innovation. The research reveals the impact of eco-innovation variables on business performance. The greatest is the impact of eco-process on business performance followed by eco-product and eco-organizational respectively. Regarding the effect of eco-organizational and eco-process innovation on eco-product, the findings of the study showed that the greatest is the effect of eco-organizational followed by eco-process. According to the post hoc, the mean differences show that there is statically significant difference in the responses of the respondents towards eco- process regarding different organization age.

Incidence Trends of Melanoma and Nonmelanoma Skin Cancers in Jordan From 2000 to 2016.

PURPOSE: Skin cancers are among the commonest cancers worldwide, and the incidence of melanoma and non-melanoma skin cancer (NMSC) continues to rise worldwide. However, there are no comprehensive reports on skin cancer incidence in Jordan during the past two decades. This report investigates the incidence of skin cancers in Jordan, in particular their time trends for the period 2000-2016. MATERIALS AND METHODS: Data on malignant melanomas (MMs), squamous cells carcinomas (SCCs), and basal cell carcinomas (BCCs) were extracted from the Jordan Cancer Registry for the period between 2000 and 2016. Age-specific and overall age-standardized incidence rates (ASIRs) were computed. RESULTS: Two thousand seventy patients were diagnosed with at least one BCC, 1,364 with SCC, and 258 with MM. ASIRs were 28, 19, and 4 per 100,000 person-years for BCC, SCC, and MM, respectively. The BCC:SCC incidence ratio was 1.47:1. The risk of men developing SCCs was significantly higher than women (relative risks [RRs], 1.311; 95% CI, 1.197 to 1.436), but significantly lower for BCCs (RR, 0.929; 95% CI, 0.877 to 0.984) or melanomas (RR, 0.465; 95% CI, 0.366 to 0.591). Persons older than 60 years were at a significantly higher risk of developing SCCs (RR, 1.225; 95% CI, 1.119 to 1.340) or melanomas (RR, 2.445; 95% CI, 1.925 to 3.104), but at a significantly lower risk of developing BCCs (RR, 0.885; 95% CI, 0.832 to 0.941). The overall incidence rates of SCCs, BCCs, and melanomas increased over the 16-year study period, but this was not statistically significant. CONCLUSION: To our knowledge, this is the largest epidemiologic study regarding skin cancers in Jordan and in the Arab world. Despite low incidence rates in this study, rates are higher than reported regional figures. This is likely due to standardized, centralized, and mandatory reporting of skin cancers, including NMSC.

The frequency of cytochrome 4F2 rs2108622 genetic variant and its effects on the lipid profile and complications of type II diabetes among a sample of patients in Jordan: A pilot study.

BACKGROUND: Cytochrome 4F2 (CYP4F2) is a major arachidonic acid-metabolizing enzyme which produces 20-Hydroxyeicosatetraenoic acid (20-HETE). It is found that 20-HETE is involved in the pathophysiology of many diseases, including diabetes mellitus. The genetic variants of CYP4F2 can affect its enzymatic activity as well as the 20-HETE production. AIMS: Our aim with this paper was to find out the genotype frequency of CYP4F2 rs2108622 C>T, the major functional variant in the CYP4F2 gene, among a sample of type II diabetes (TIIDM) and its effects on diabetes complications and lipid profile. METHODS: The CYP4F2 rs2108622 variant was genotyped among 90 healthy volunteers and 90 TIIDM patients that attending the University of Jordan Hospital, using the DNA Sanger sequencing method. The data of lipid profile and diabetes complications were obtained from the electronic records available in the hospital. RESULTS: We found that the frequency of CYP4F2 rs2108622C>T variant is significantly (P = 0.02) lower among TIIDM patients in comparison to healthy subjects using both co-dominant and dominant genotyping models. In addition, the CYP4F2 rs2108622 T/T genotype was significantly (P = 0.02) more frequent among TIIDM patients with retinopathy complications (OR=4.36, CI: 1.32-14.37). Lastly, the CYP4F2 rs2108622C>T variant was not associated (P > 0.05) with the glycaemic and lipid profile of patients. CONCLUSIONS: It can be concluded from this study that the frequency of CYP4F2 rs2108622 T/T genotype is lower among TIIDM, but this genotype is associated with an increased risk of retinopathy complications in patients of Jordanian origin. Further studies with a larger sample size are needed to validate the findings of this study.

Assessment of Hospital Readiness to Respond to COVID-19 Pandemic in Jordan-A Cross Sectional Study.

During the global COVID-19 pandemic, hospitals faced tremendous pressure to cope with the emergency preparedness situations needed to cater for the influx of patients while maintaining their essential services. This study aimed to assess the level of readiness of hospitals in Jordan to respond to the COVID-19 pandemic using the WHO hospital readiness checklist. A cross-sectional survey using the modified and validated checklist was conducted in Jordan between 15 May and 15 June 2021. The checklist entailed ten key response functions with a total of 60 activities. Data from 22 hospitals were collected through a structured survey process by two surveyors for each hospital. The overall readiness score of hospitals was 1.77 ± 0.20, with a lower overall score in the northern region (1.65 ± 0.24) than the middle (1.86 ± 0.07) or southern (1.84 ± 0.14) regions. The diagnosis response function scored highest (1.95); but despite efforts, contingency plan development was not met by most hospitals, with a total score ≤ 1.45. Provision of psychological support and occupational health support to ensure the wellbeing of staff scored below average. Outcomes from this survey exposed gaps while offering a framework for upcoming endeavors to improve hospital readiness for any potential pandemic.

Impact of the COVID-19 Pandemic and Governmental Policies on Rehabilitation Services and Physical Medicine in Jordan: A Retrospective Study.

Background: Although the COVID-19 pandemic led to a series of governmental policies and regulations around the world, the effect of these policies on access to and provision of rehabilitation services has not been examined, especially in low and middle- income countries. Aims: The aim of this study was to investigate the impact of governmental policies and procedures on the number of patients who accessed rehabilitation services in the public sector in Jordan during the pandemic and to examine the combined effect of sociodemographic factors (age and gender) and the governmental procedures on this number of patients. Methods: A retrospective cohort study was conducted based on records of 32,503 patients who visited the rehabilitation center between January 2020 and February 2021. Interrupted time-series analysis was conducted with three periods and by age and gender. Results: The number of patients who visited the rehabilitation clinics decreased significantly between January 2020 and May 2020 due to government-imposed policies, then increased significantly until peaking in September 2020 (p = 0.0002). Thereafter, the number of patients decreased between October 2020 and February 2021 as a result of the second wave of the COVID-19 pandemic (p = 0.02). The numbers of male and female patients did not differ (p > 0.05). There were more patients aged 20 years and older attending rehabilitation clinics than younger patients during the first strict lock down and the following reduction of restriction procedures periods (p < 0.05). Conclusions: The COVID-19 public measures in Jordan reduced access to rehabilitation services. New approaches to building resilience and access to rehabilitation during public health emergencies are needed. A further examination of strategies and new approaches to building resilience and increasing access to rehabilitation during public health emergencies is warranted.

Public knowledge of antibiotics, self-medication, and household disposal practices in Jordan.

BACKGROUND: This study aimed to assess public understanding of antibiotics, self-medication, and drug disposal practices. METHODS: A cross-sectional self-administered online survey was undertaken in Jordan. RESULTS: The study was completed by 1,105 participants. When asked about their knowledge of antibiotics, rational antibiotic use, and disposal practices, 16% percent believed they should discontinue antibiotics once they felt better, and 12% agreed to take the same antibiotics prescribed to others for the same illness. Self-medication with antibiotics was practiced by 44% of the participants. Prior experience, healthcare costs, and pharmacy location were all major determinants of self-medication. Only 6.4% of unneeded antibiotics were returned to the pharmacy, 60% were kept at home, and 26.6% were disposed of at home. Almost half of those who kept the antibiotics said they would use them again, and one-third said they would give them to friends and family. Respondents who had used antibiotics within the previous 6 months (p = 0.052) and relied on medication leaflets (p = 0.031) and physician recommendations (p = 0.001) were less likely to self-medicate with antibiotics. CONCLUSIONS: The study highlighted areas of inappropriate use of antibiotics, self-medication and the improper antibiotic disposal that can inform antimicrobial stewardship.

COVID-19 and non-communicable diseases in complex vulnerable populations: evidence from Jordan.

More than three in 10 people living in Jordan are immigrants, with the majority being Palestinian and Syrian refugees, who have a very similar non-communicable diseases (NCDs) profile to the hosting Jordanian community. We conducted a rapid review of the literature of studies, reports, and documents on the evidence of the impact of COVID-19 on vulnerable populations in Jordan with regard to NCD during the first year of the pandemic. COVID-19-related mobility constraints and often lack of awareness of NCDs put additional burden on vulnerable populations like refugees and migrants, in particular on non-registered migrants. COVID-19 pandemic and associated mitigation measures led to disruption in routine health services, significantly impacting people living with NCDs. Ensuring to deliver a people-centered and inclusive approach that works well during COVID-19 is of paramount importance toward Universal Health Coverage (all people have access to the health services they need, when and where they need them, without financial hardship).

The Impact of COVID-19 National Lockdown on Myocardial Infarction (MI) Hospitalizations in Northern Jordan.

Background: During COVID-19 lockdown periods, several studies reported decreased numbers of myocardial infarction (MI) admissions. The lockdown impact has not yet been determined in developing countries. The aim of this study was to investigate the impact that of the lockdown measures might have had on the mean number of MI hospital admissions in Northern Jordan. Methodology: A single-center study examined consecutive admissions of MI patients during COVID-19 outbreak. Participants' data was abstracted from the medical records of King Abdullah University Hospital between 2018 and 2020. Mean and percentages of monthly admissions were compared by year and by lockdown status (pre-lockdown, lockdown, and post-lockdown time intervals). Results: A total of 1380 participants were admitted with acute MI symptoms: 59.2% of which were STEMI. A decrease in number of MI admissions was observed in 2020, from 43.1 (SD: 8.017) cases per month in 2019 to 40.59 (SD: 10.763) in 2020 (P < 0.0001) while an increase in the numbers during the lockdown was observed. The mean number during the pre-lockdown period was 40.51 (SD: 8.883), the lockdown period was 44.74 (SD: 5.689) and the post-lockdown was 34.66 (SD: 6.026) (P < 0.0001 for all comparisons). Similar patterns were observed when percentages of admissions were used. Conclusion: Upon comparing the lockdown period both to the pre- and post-lockdown periods separately, we found a significant increase in MI admissions during the lockdown period. This suggests that lockdown-related stress may have increased the risk of myocardial infarction.