Knowledge, attitudes, practices and barriers of medical research among undergraduate medical students in Jordan: a cross-sectional survey.

BACKGROUND: Integrating medical students in research at an early stage of their program is a crucial step to enhance the ability of future physicians to employ critical thinking and problem-solving processes, which in turn improves patients' health outcomes. METHODS: A cross-sectional questionnaire-based survey was administered to medical school students at Al-Balqa Applied University. This study aims to analyze the attitudes, practices, and barriers faced by medical students in regard to engaging in medical research. RESULTS: A total of 333 students participated in the study with a mean age of 21.2 ± 1.5 years. A total of 60.1% were females. Female students had significantly higher knowledge scores (µ = 3.97, SD ± 1.81, P = 0.009) than males (µ = 3.44, SD ± 1.69). As students progress to higher academic years of their clinical program, their knowledge in research significantly increases in comparison to their knowledge in basic medical years (P < 0.001). Student age and academic year significantly correlated with the knowledge scores; each additional year of study increased the knowledge score by 0.25 (ß = 0.25, P < 0.001, R2 = 0.63). The percentage of students who correctly answered each question on the knowledge scale was 37.5% (SD ± 12.5%). The most reported barriers to research participation were insufficient training in medical research, lack of sufficient research opportunities, and lack of stimulation and support from faculty. CONCLUSIONS: Medical students demonstrated a positive attitude toward research starting from their second year of study, despite having limited knowledge on the topic. They identified barriers that could be utilized to promote greater involvement of students in research. The implications for clinical practice suggest that policymakers and educators should consider the outcomes of this study and implement improvements in medical education, specifically by encouraging the early participation of students in the research process.

Prevalence of stress and types of coping strategies among adolescents (14-18 years) in collectivist communities.

BACKGROUND: Stress is highly prevalent among adolescents and might lead to maladaptive coping. METHODS: This cross-sectional study assessed the prevalence of stress and determined the types of coping strategies used by adolescents; and identified the predictors of stress levels among this cohort. The study recruited 1344 participants, aged 14 to 18 years, in schools. The study used the DASS-42 and the Brief COPE Inventory Scale for data collection. The findings of this study showed that more than two-thirds of adolescents suffer from stress, and moderate, severe, and extremely severe were 22.8%, 43.0%, and 16.8%, respectively. The most used coping behaviors among these adolescents were religious factors, with a Mean ± SD of (Mean 6.28 ± 1.16), followed by instrumental support (Mean 6.17 ± 1.18). The stress level has a significant negative correlation at (p < 0.001) with active coping (r = -0.183**), self-distraction (r = -0.190**), acceptance (r = -0.140**) and religion (r = -0.097**; P < 0.001). Binary logistic regression analyses revealed that the whole model had R2 (0.232); p < 0.005 and shows that those aged 15 had an odd of 0.272 to develop stress more than those at 18. Fathers' and mothers' education levels strongly influenced adolescents' stress levels. Those with an income between <500 and 500-750 Jordanian Dinars had an odds ratio of 5.241 and 3.514 of developing stress, respectively, compared to their counterparts. APPLICATION TO PRACTICE: This study highlights the significance of developing health intervention programs and counseling services for managing adolescents' psychological well-being and provides valuable insights for policymakers on addressing mental health issues.

Platelet-Rich Plasma for Treating Androgenic Alopecia: A Systematic Review.

PRP contains growth factors that promote tissue repair. The authors conducted a meta-analysis comparing PRP treatment to a control group. However, there are concerns about the lack of standardized protocols and specific details about PRP preparation. Factors such as platelet counts, leukocyte concentration, and the use of activated or non-activated platelets can affect treatment outcomes. Further analysis is needed to establish more reliable conclusions about the effectiveness of PRP for androgenic alopecia. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Use of Posterior Auricular Fascia Graft (PAFG) for Slight Dorsal Augmentation and Irregular Dorsum Coverage in Primary and Revision Rhinoplasty: A Prospective Study.

INTRODUCTION: Augmentation and coverage of irregularities of the nasal dorsum remain a challenge in rhinoplasty. Different techniques have been described in the current literature for this purpose. The aim of this study is to assess and illustrate the author experience and outcomes using the posterior auricular fascia graft (PAFG) for dorsal camouflage and augmentation in primary and revision rhinoplasty. MATERIAL AND METHODS: A prospective bicentric study was conducted, including patients with slight dorsal deficiencies and/or with dorsal irregularities following hump resection, trauma or previous rhinoplasty receiving PAFG to improve the rhinoplasty outcome. To objectively assess the graft resorption rate, MRI was performed 2 weeks and 18 months after surgery. To investigate patient satisfaction, the preoperative and 1-year postoperative scores obtained using the rhinoplasty outcomes evaluation (ROE) scale were compared. The scores following a normal distribution obtained for each patient were compared using a paired t-test. RESULTS: Forty-five patients were enroled in this study. Average follow-up duration was 35.4 months. Patients' age ranged from 17 to 57 years. No cases of infection or major graft resorption were observed. No postoperative scars were visible at the donor site. All patients were satisfied after surgery, and a statistically significant difference between pre- and postoperative scores (p<0.0001) was observed. CONCLUSION: This study showed that PAFG is a reliable technique for dorsal camouflage and slight augmentation in primary and revision rhinoplasty. The procedure is safe, easy and quick and only requires a small learning curve. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Jordanian nursing students' knowledge and attitudes of corneal donation.

A high success rate of corneal transplants is evident. However, there is still a lack of corneal grafts available to meet demand, largely because donors are reluctant to donate. Given their critical role in future healthcare teaching and advocacy. There has not been much research on Jordanian nursing students' perspectives on corneal donation, so it's critical to identify and eliminate any obstacles. This study aims to evaluate the knowledge and attitudes of Jordanian nursing students concerning corneal donation. A cross-sectional, descriptive design was used to recruit (n = 440) nursing students from four Jordanian universities. A self-reported questionnaire was used to obtain data on knowledge and attitudes regarding corneal donation. The average age of senior nursing students was (M = 23.07, SD = 3.63) years. Varying levels of understanding were revealed amongst university students toward corneal donation items. Generally, good attitude of nursing students toward corneal donation (M = 34.1, SD = 8.1). Weak positive relationship was found between total knowledge scores and age (r = 0.141, p = 0.003) while there is no significant relationship between age and total attitude score (r = 0.031, p = 0.552). Age was found to be a significant predictor (B = 0.01, Beta = 0.12, t = 2.07, p = 0.04). Also, the educational level of fathers is a significant positive predictor (Beta = 0.128, p = 0.008) for the total attitude scores among nursing students. Limited awareness of corneal donation, highlighting the need for focused educational interventions to improve their comprehension.

Exploring the lived experience of Arab male patients on intermittent catheterization after spinal cord injury: A phenomenological study.

BACKGROUND: Intermittent catheterization (IC) has been identified as one of the critical techniques used by spinal cord injury (SCI) patients to cope with emptying the bladder, despite several problems impeding this procedure. AIM: The study aimed accordingly to explore the lived experience of Arab male patients on IC after their SCI. DESIGN: This study was carried out by using a descriptive qualitative approach with a phenomenological analysis of data. METHODS: A qualitative study was carried out on 10 Arab male patients from the Rehabilitation Hospital at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia who were utilizing intermittent catheters following SCI. The interviews were analysed using Husserl's phenomenology and the Colaizzi method of data analysis. RESULTS: Two major themes and six sub-themes were identified from exploring the patients experience. These themes are as follows: Theme 1: The Way to IC; with two sub-themes: (i) 'service provided and acceptance' and (ii) 'educational experience'; Theme 2: Lifestyle and self-adaptation; with four sub-themes: (i) 'Flexibility and freedom', (ii) 'Physical access to the community', (iii) 'Traveling' and (iv) 'Work and Social life balance'. CONCLUSION: It is evident that using an intermittent catheter among patients with SCI influenced almost all aspects of the participant's life, including their social lives and body image appearance.

Psychosocial factors correlate with adherence to medications among cardiovascular outpatient clinics in Jordan.

BACKGROUND: Adherence to medications is a significant element of self-care behaviors for patients with cardiovascular diseases (CVDs). Non-adherence to cardiovascular medications is the major risk for poor outcomes following any cardiac event. However, there is a lack of studies that addressed medication adherence among patients with CVDs attending outpatient clinics in Arabic countries, including Jordan. Thus, this study purposed to assess the psychosocial factors (e.g. depression, anxiety, stress, social support and self-esteem) and their correlation with adherence to medications among patients with CVDs attending outpatient clinics in Jordan. METHODS: A total of 395 Jordanian patients attending CVDs outpatient clinics at government, military and private healthcare facilities were recruited. RESULTS: Our study findings showed that 31.4% of the patients reported complete adherence to their medications. The proportion of psychological reactions reported by the participants was 72.1% for depressive symptoms, 62.6% for anxiety and 50.1% for stress; 79.7% had moderate and normal social support, and 44% had low self-esteem. Depression, anxiety and stress had a significant negative correlation with adherence to medications; however, self-esteem had a significant positive relationship with adherence to medications. In addition, depression, anxiety and stress were the main predictors of adherence to medications. CONCLUSION: Our findings might aid in paving the road for designing and developing strategies and interventions to increase adherence to medications and minimize these psychosocial problems among CVD patients in outpatient clinics.

Effect of incredible years autism spectrum and language delays (IY-ASD) program on stress and behavioral management skills among parents of children with autism spectrum disorder in Palestine.

PURPOSE: This study purposed to evaluate the effect of the Incredible Years Autism Spectrum and Language Delays (IY-ASD) program in reducing parents' stress and improving aggressive and disruptive behaviors in the parents among parents of children with autism spectrum disorder in Palestine. DESIGN AND METHODS: A one-group pre-posttest design was used. Thirty-four parents who enrolled in the Palestinian Child Institute in Nablus were recruited. RESULTS: Findings revealed a significant difference between parents' total stress pre and post-IY-ASD (t = 1.2, p < 0.01 and parents' behavioral management skills toward their children with autism spectrum disorder. The study demonstrated that the IY-ASD program for 16 sessions reduced stress among parents of children with autism spectrum disorder in Palestine and improved aggressive and disruptive behaviors in the parents. CONCLUSION: The IY-ASD program can be successfully implemented for parents of this cohort group. PRACTICE IMPLICATIONS: Healthcare providers can adopt such a program for enhancing parenting roles with their children experiencing autism spectrum disorder.

The Impact of Duration and Force of Centrifugation on Platelet Content and Mass in the Preparation of Platelet-Rich Plasma.

The study "Strategies to Improve AFT Volume Retention after Fat Grafting" examines the impact of centrifugation duration and force on platelet-rich plasma (PRP) preparation. PRP, known for its potential in tissue healing and regeneration, lacks standardized protocols. The authors investigate the effects of centrifugation parameters on platelet concentrations and raise concerns about the lack of platelet count specification and characterization in previous studies. The concentration of leukocytes and the platelet-to-leukocyte ratio, as well as the use of non-activated platelets, are also discussed. Challenges in administering PRP gel and the morphological changes of activated platelets are noted. Further analysis is needed for reliable conclusions on PRP applications.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Platelet-Rich Plasma for Treatment of Hair Loss Improves Patient-Reported Quality of Life.

This study explores the psychological impact of platelet-rich plasma (PRP) treatment for hair loss. PRP, an autologous plasma enriched with platelets, has gained recognition in aesthetic and regenerative medicine for its potential to facilitate tissue healing and regeneration through the release of growth factors. However, concerns arise regarding the lack of standardized protocols for PRP preparation and characterization, including platelet counts and active substance concentrations. Additionally, the concentration of leukocytes and the platelet-to-leukocyte ratio in PRP are crucial factors that can affect treatment outcomes. Further analysis is necessary to establish reliable conclusions about the applications of PRP. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Protocol for Obtaining Platelet-Rich Plasma (PRP), Platelet-Poor Plasma (PPP), and Thrombin for Autologous use.

The reviewed article titled "Protocol for obtaining platelet-rich plasma (PRP), plateletpoor plasma (PPP), and thrombin for autologous use" by Franco et al. presents the authors' protocol for obtaining these substances. While acknowledging the potential of PRP in tissue healing and regeneration, concerns are raised regarding the lack of specific methodologies in PRP preparation and characterization, including platelet counts and leukocyte concentration. The use of non-activated platelets is suggested to yield better outcomes compared to activated platelets. Further analysis is needed to draw valid conclusions on PRP applications in aesthetic and regenerative medicine. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Impact of Duration and Force of Centrifugation on Platelet Content and Mass in the Preparation of Platelet-Rich Plasma.

Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

What About the Rheological Properties of PRP/Microfat Mixtures in Fat Grafting Procedure?

We reviewed the article "What About the Rheological Properties of PRP/Microfat Mixtures in Fat Grafting Procedure?" and found it highly intriguing. Fat grafting is widely used in plastic surgery, but the issue of inconsistent fat resorption poses a challenge. Platelet-rich plasma (PRP) has been incorporated to enhance fat revascularization, yet the ideal fat-to-PRP ratio remains undetermined. This study focused on analyzing the rheological properties of microfat combined with different proportions of PRP. The preparation protocol for PRP lacks standardization, and the absence of specific platelet and leukocyte information raises concerns. Further analysis is needed to establish reliable conclusions on PRP applications. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Moral Injury and its Correlates among Iranian Nurses in the Second Year of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study.

The COVID-19 pandemic has been associated with various health-related issues among nurses, including mental health problems such as moral injury. This study aimed to evaluate the relationship between moral injury, general health, post-traumatic stress disorder (PTSD), and type of hospital among Iranian nurses working in different clinical settings during the COVID-19 outbreak. This cross-sectional study employed convenience sampling to recruit 334 nurses working in various clinical settings, including teaching and referral hospitals, in Kerman, Southeastern Iran from October 2021 to February 2022. The study used three measures, including the General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), and The Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP). Data analysis was conducted using SPSS25. The results indicated that moral injury was highly prevalent among Iranian nurses, with 47% of the participants reporting experiencing it. A total, 26.9% of the participants reported experiencing mental health disorders and 57.2% of the participants reported experiencing this disorder. Significant correlations were found between moral injury, general health, and PTSD. Specifically, moral injury levels were higher among female nurses with a history of mental disorders and those designated to treat all kinds of cases, compared to other participants. The results suggest that Iranian nurses are at a high risk of experiencing moral injury during the COVID-19 pandemic. Policymakers and health authorities should establish related health educational programs, provide counseling services to promote general health, and pay particular attention to moral injury and PTSD. Additionally, nurse educators should integrate materials related to moral injury into the nursing curriculum.

COVID-19 vaccination intention in the first year of the pandemic: A systematic review.

AIMS AND OBJECTIVES: To synthesise evidence regarding vaccination intention, identify factors contributing to vaccine hesitancy among healthcare professionals and the general populations globally. BACKGROUND: As COVID-19 vaccine becomes available worldwide, attention is being directed to community vaccine uptake, to achieve population-wide immunity. A number of factors have been reported to influence vaccine intention. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of COVID-19 vaccination intention related literature published on or before 31 December 2020 from seven databases was undertaken. RESULTS: Thirty articles were included in this systematic review. Overall COVID-19 vaccination intention during the first year of the pandemic ranged from 27.7% to 93.3%. Findings highlighted that socio-demographic differences, perceptions of risk and susceptibility to COVID-19 and vaccine attributes influenced vaccination intention. Healthcare professionals particularly, nurses have higher vaccine hesitancy reportedly due to concerns regarding vaccine safety and efficacy and mistrust of health authorities. Negative information about COVID-19 vaccines in the social media and low confidence in the health system were associated with lower acceptability among the community. Interestingly, cumulative increase in COVID-19 caseloads of countries over time was not associated with vaccination intention. CONCLUSIONS: The significant variability in vaccine intention rates worldwide would hamper efforts to achieve immunity against COVID-19. Nurses' concerns about vaccine safety and efficacy need to be addressed to increase vaccine acceptance and maximise their influence on vaccination decision in the community. As misinformation through social media negatively impacts vaccination uptake, authoritative and reliable information on vaccine attributes, disease risks and vaccination benefits are needed. RELEVANCE TO CLINICAL PRACTICE: Concerns about vaccine safety and efficacy including misinformation are important contributors to vaccine hesitancy. Addressing these factors, particularly among nurses who are considered trusted influencers of vaccination decisions in the community is an important strategy for pandemic preparedness.

Self-esteem, stress, and depressive symptoms among Jordanian pregnant women: social support as a mediating factor.

This study purposed to assess the mediating role of social support between stress, depressive symptoms, and self-esteem among Jordanian pregnant women. Across-sectional study recruited a total of 538 pregnant Jordanian women using a cluster stratified random sampling technique, during the period from September 2019 to February 2020. The study used the following measures: The Perceived Stress Scale (PSS), Beck's Depression Inventory (BDI), Rosenberg Self-Esteem Scale, and Multidimensional Social Support Scale (MSPSS). Descriptive statistics and inferential statistics were used to test the mediating effect of social support in terms of the association between depression and self-esteem. The results were considered significant if p ≤ .05. The findings showed that 75.6% of participants had moderate-to-high stress levels. High levels of stress, depressive symptoms, and low self-esteem were highly correlated with low social support (p < .05). Depressive symptoms predict the self-esteem (F(2, 537) = 158.631 p < .05). Social support significantly mediates the relationship between the depressive symptoms and self-esteem with p = .01. Thus, during the antenatal care, administration of screening tools to identify pregnant women with low social support levels and at risk of developing psychological difficulties would allow primary healthcare to promote for positive health outcomes for the mothers and the babies.

An analysis of nursing and medical students' attitudes towards and knowledge of Alzheimer's Disease (AD).

OBJECTIVES: Little is known about how Jordanian undergraduate medical and nursing students perceive Alzheimer's disease (AD) care. This study aimed to investigate nursing and medical students' AD knowledge, attitudes, and associated factors with their knowledge to inform reforms to multidisciplinary AD education undergraduate programs in Jordan. METHODS: Cross-sectional research was carried out using a self-administered questionnaire. Students' knowledge was measured using the Alzheimer's Disease Knowledge Scale (ADKS) and attitudes were measured using the Dementia Care Attitude Scale (DCAS). The survey was completed by 423 nursing and medical students. RESULTS: The overall mean score on the ADKS for students' AD knowledge was 17.50 (SD=3.08) out of 30 and the DCAS for students' attitudes toward AD was 26.76 (SD=6.19) out of 40. CONCLUSIONS: Medical students had a higher level of AD knowledge and a lower level of positive attitude than nursing students (p<0.05).

Evaluation of psychological reactions among teenage married girls in Palestinian refugee camps in Jordan.

INTRODUCTION: Girls married at an early age are more likely to be victims of violence from their husbands or their in-laws. This may lead them to experience mental problems such as post-traumatic stress, depression, and/or anxiety. There are a lack of data related to the psychological reactions among teenage married girls living at the Palestinians refugee camps. AIM: This study aimed to evaluate depression, anxiety, and stress symptoms among teenage married girls in Palestinian refugee camps in Jordan. It also aimed to identify factors correlating with the study selected psychological reactions. METHODS: A cross-sectional, descriptive correlational design was used. The participants were recruited using non-probability sampling methods. The mental health symptoms were measured using the Depression, Anxiety, and Stress Scale (DASS). RESULTS: A total of 205 participants were included in the study. Their mean age was 16.90 (SD ± 0.96) years. Of the participants, 39.6%, 35.6%, and 9.8% experienced moderate to extremely severe levels of depression, anxiety, and stress symptoms, respectively. There were significant relationships between all the mental health symptoms and participant age, parent's educational level, and exposure to previous trauma. CONCLUSION: A high proportion of females living in Palestinian refugee camps married in their teenage years experienced moderate to severe mental health symptoms, particularly anxiety and depression. These results inform the need for psychological support to girls who are affected by teenage marriage.

Evaluation of Fatigue among Older Population in Jordan.

Objective: Fatigue among older adults has not received empirical attention in the Arabic region. Thus, this study aimed to assess the levels of fatigue and its related psychosocial factors and examine the predictors of fatigue in older Jordanians aged 60 years and more.Methods: This study used a cross-sectional design and our sample was 250 older adults receiving health services at comprehensive healthcare centers in Amman Governorate, the capital of Jordan. The study used the following scales: Fatigue scale, Rosenberg Self-Esteem Scale, Perceived Stress Scale, Multidimensional Social Support Scale, and sociodemographic and lifestyle behaviors datasheet.Results: The results showed that approximately 57% of the participants experienced severe fatigue. Nearly 90% of the older adults reported having moderate to high levels of stress, around 97% experienced moderate and high levels of social support, and almost 68% had normal self-esteem. The significant predictors of the total fatigue scores were, consuming soft drinks, practicing exercise, perceived levels of stress, and social support levels.Conclusions: Awareness of the magnitude and the factors predicting fatigue among elderlies in Jordan should inform the practice and encourage clinicians to implement individualized care plans that include fatigue reduction strategies, to elderlies visiting healthcare centers.

Assessment of Temper Tantrums Behaviour Among Preschool Children in Jordan.

PURPOSE: A good understanding of children's emotions, activities, and needs should be promoted. This study assessed temper tantrum behaviour, including frequency, severity, duration, common behaviours, reasons, locations, contexts, and parent's strategies, among Jordanian children aged 24-48 months. DESIGN AND METHODS: A cross-sectional design was used to conduct this study. A non-probability convenience sample was adopted to recruit 213 parents of children aged between 24 months to 48 months. All parents completed the Parents' Experience of Temper Tantrums in Children's questionnaire. RESULTS: Findings showed that about half of the children experienced weekly tantrums, however, half of the parents reported that mild tantrums were exhibited by their youngsters, with an average duration of minutes. The most frequently reported tantrum behaviour was 'screaming or shouting'. "Seeking attention" was the most frequent reason and most tantrums occurred when visiting someone else's home. Unfamiliar situations were the most commonly associated with tantrum episodes. The main strategies used by parents to lessen their child's tantrums were first, stating a consequence (e.g., timeout), and secondly, ignoring the behaviour. CONCLUSIONS: The results draw attention to significant aspects of tantrums, such as the duration, where children managed to maintain a tantrum episode for more than seven minutes on average. Tantrum behaviours, reasons, locations, context, and parents' strategies to control tantrums were significant in developing proper interv entions. PRACTICE IMPLICATIONS: The findings of this study are of practical use in equipping parents and caregivers with the appropriate strategies to enable them to halt tantrums among children.