Khader Almhdawi

Background: Musculoskeletal disorders (MSDs), particularly lower back (LB) pain are highly prevalent in emergency department (ED) healthcare professionals with significant health-related impacts due to the high and unexpected workload. Objective: This study aimed to identify the predictors of LB disability among ED healthcare professionals in Jordan, including physical, psychological, and ergonomic occupational factors. Methods: A multicenter convenience sample of ED healthcare professionals was recruited from Jordanian ED departments. Data collection included demographics, ergonomics-related factors and a group of validated outcome measures: the Oswestry Disability Index (ODI), Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety and Stress Scale (DASS-21). A stepwise multivariable linear regression model was used to identify predictors of LB disability. Results: The study included 447 participants, of whom 57% were male ( n = 255) and had a mean age of 35.1 ± 7.0 years. Predictors of the ODI ( R ² = .31) included depression ( B = 0.456, p < .001), taking sick leave in the past 12 months (β = 6.8, p < .001), safe handling and posturing practices ( B = −5.584, p < .001), age ( B = 0.32, p < .001) and presence of musculoskeletal injury in the past 12 months ( B = 4.6, p = .022). Conclusion: This study highlights the burden of LB disability among ED healthcare professionals. LB disability was significantly associated with depression, recent Musculoskeletal injury, Musculoskeletal-related sick leave and older age, with safe handling and posture practices showing a protective effect. Comprehensive interventions to integrate ergonomic improvements, mental health support, workload optimization, and exercise programs.

This study assessed infection prevention and control (IPC) compliance among allied health students during clinical practices and explored its association with knowledge, attitude and educational factors. A cross-sectional study was conducted among allied health students using a self-administered questionnaire on IPC knowledge, attitudes, and practices. Multivariable logistic regression identified predictors of compliance. Among 635 participants (mean age of 21.3 (± 1.5) years; 79.5% females), 59.1% were classified as IPC compliant. Higher compliance was independently associated with greater knowledge (adjusted odds ratio [aOR] = 1.16, 95% CI: 1.09–1.23; p < 0.001), more positive attitudes (aOR = 1.04, 95% CI: 1.01–1.07; p = 0.004), prior infection-prevention training (aOR = 1.64, 95% CI: 1.16–2.31; p = 0.005), and more seniority (aOR = 1.43, 95% CI: 1.01–2.02; p = 0.045). IPC compliance among allied health students was suboptimal. Integrating recurring, practical IPC training into allied health curricula may enhance compliance and strengthen infection control in clinical education.

Background: Telerehabilitation (TR) has emerged as a promising approach to improving access to rehabilitation services, particularly in low‐ and middle‐income countries such as Jordan. However, successful implementation largely depends on rehabilitation specialists’ knowledge, attitudes, and perceived barriers. Aims: This study is aimed at exploring rehabilitation specialists’ perspectives on TR in Jordan, focusing on their knowledge, attitudes, current use, and perceived implementation barriers. Methods: A cross‐sectional study was conducted among rehabilitation specialists including physical therapist, occupational therapist, and speech and language therapist practicing in Jordan. Participants completed a validated 27‐item Rehabilitation Specialists’ Knowledge, Attitudes, and Barriers to TR Questionnaire. Descriptive statistics were used to summarize participants’ demographic characteristics and their responses related to TR knowledge, attitudes, and perceived barriers. Results: A total of 300 rehabilitation specialists (mean age = 28.6 ± 6.1 years; 51% female) were included in the analysis, comprising equal numbers of physiotherapists, occupational therapists, and speech and language therapists. Overall, 81% of participants reported awareness of TR, and 57% indicated that TR was currently used in their workplace. Despite the generally favorable perceptions—59% considered TR socially somewhat acceptable and 75% believed it could save time, effort, or costs—actual engagement remained limited, with 35% reporting awareness without prior use and only 14% reporting regular use. Technological reliability and validity were endorsed by 78% and 72% of respondents, respectively. However, only 36% agreed that TR was comparable to face‐to‐face care. The most frequently reported barriers included limited public awareness (84%), technical issues such as poor internet connection (80%), provider willingness (74%), staff skill limitations including lack of training (71%), data privacy and security concerns (71%), location of healthcare institutions (69%), increased workload (69%), and lack of user‐friendly software (61%). Early‐career clinicians (< 5 years of experience), who constituted 67% of the sample, demonstrated greater openness toward TR compared with more experienced practitioners. Conclusion: Rehabilitation specialists in Jordan showed readiness to adopt TR. However, significant structural, educational, and cultural barriers appeared to hinder its widespread implementation.

Background/objectives Visual impairment (VI) is associated with significant disruptions in sleep quality. This study aimed to investigate the association between VI and sleep quality across varying severities of VI and ocular conditions in adults. Subjects/methods A cross-sectional, observational, study was conducted among 277 adults with VI and 278 age- and sex-matched controls from two hospitals. Participants underwent comprehensive ocular examinations and completed the Arabic version of the Pittsburgh Sleep Quality Index (PSQI). Sociodemographic and clinical data were collected, and ocular conditions were recorded. Multivariate logistic regression models were used to evaluate the association between VI, its severity, ocular conditions, and poor sleep quality while adjusting for potential confounders. Results VI patients had worse sleep quality than controls (mean PSQI: 6.83 ± 3.6 vs. 5.30 ± 3.5; p < 0.001), with 57.8% experiencing poor sleep (PSQI > 5) compared to 36.7% of controls(p < 0.001). In multivariate analysis, patients with VI had significantly higher odds of poor sleep quality compared to controls (OR = 2.0 (95% CI: 1.4–2.8); p < 0.001). Moderate VI (OR = 2.1, 95% CI: 1.4–3.2, p = 0.001) and blindness (OR = 2.9, 95% CI: 1.4–5.9, p = 0.004) were significantly associated with poor sleep quality. Diabetic retinopathy (OR = 2.2, 95% CI: 1.4–3.4; p < 0.001) and combined ocular conditions (OR = 3.6, 95% CI: 1.4–9.3; p = 0.009) were significantly associated with poor sleep quality. Conclusions VI is significantly associated with poor sleep quality, particularly in moderate VI and blindness. Diabetic retinopathy and combined ocular conditions were associated with poor sleep quality. Comprehensive management strategies addressing sleep in VI patients are essential for improving their overall well-being.

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

Background: University students face multiple stressors that negatively impact their mental well-being. Effective emotional regulation and physical activity are crucial for mood management and overall health. This study explored the connection between physical activity, emotional regulation, and mental health symptoms (depression, anxiety, and stress) in Jordanian university students. Methods: A cross-sectional online survey involved 416 students (146 male and 270 female) from Jordanian universities. The survey covered demographics, physical activity (International Physical Activity Questionnaire), emotional regulation strategies (Emotion Regulation Questionnaire), and mental health symptoms (Depression Anxiety Stress Scales). Pearson’s correlations examined relationships, and ANOVA compared differences in ‘low’, ‘medium’, and ‘high’ physical activity groups. Results: Greater use of expressive suppression was correlated with increased anxiety symptom severity (p = 0.029). Although physical activity levels were not significantly related to emotional regulation, the ‘high’ physical activity group reported lower depression (p < 0.001) and anxiety symptom severity (p < 0.001) than the ‘low’ and ‘medium’ groups. Conclusions: Increased physical activity and emotional expression suppression are independently associated with improved mental well-being in Jordanian university students. This study underscores the importance of integrating physical activity and emotional expression strategies to support student well-being.

Palliative care is directed to relieve the symptoms of serious and life-threatening illnesses. Unfortunately, it’s usually provided lately in the disease course in developing countries due to a lack of awareness about its concept, which deprives many patients of its benefits. This study aims to investigate the knowledge and attitude of the Jordanian general public toward palliative care. A cross-sectional study was conducted using an electronic questionnaire via social media platforms. Knowledge about palliative care was measured using the “Palliative Care Knowledge Scale” (PaCKS), whereas the attitude was measured using an edited version of the “Frommelt Attitudes Toward Care of the Dying -B(FATCOD-B)” tool. The inclusion criteria were adults older than 18 years old who live in Jordan. Any subject who was younger than 18 years old, refused to give informed consent, and working or studying in a healthcare-related profession was excluded. 329 respondents filled out the survey (females = 214 (65%), mean age = 32.7 ± (13.63) years). Only 67 respondents (20.4%) heard about palliative care previously. The average knowledge score (out of 13) was 6.8 (±4.2). The average attitude score (out of 5) was 3.0 (±.4). Higher knowledge self-evaluation, older age, and higher income were factors associated with a higher level of knowledge and favorable attitude toward palliative care. Our study showed a moderate knowledge and neutral attitude toward palliative care. Further awareness campaigns should be conducted to raise the awareness of the Jordanian society regarding the objectives of palliative care.

Objectives To systematically estimate the overall prevalence of attention-deficit hyperactivity disorder (ADHD) in children, adolescents and adults across the Middle East and North Africa (MENA) region. Design Systematic review and meta-analysis conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Data sources Medline and Scopus databases were comprehensively and systematically searched between 1990 and February 2023. Eligibility criteria for selecting studies We included all cross-sectional or cohort studies that diagnosed ADHD using validated diagnostic tools (eg, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, ADHD rating scales and ADHD diagnostic interview) or non-validated tools (eg, brain imaging techniques, computerised cognitive tests and quantitative electroencephalography). Data extraction and synthesis Two reviewers performed the data extraction independently using standardised data collection sheet. Newcastle-Ottawa Scale was used to assess the quality of the included studies. Individualised and pooled event rate and upper and lower limit at 95% CI were calculated according to the ADHD cases and the total sample size using a random-effect model. The subgroup prevalence analyses according to ADHD subtypes, gender, MENA country and age were also performed. Results A total of 63 articles met the inclusion criteria involving 849 902 participants. The overall prevalence of ADHD was 10.3% (95% CI 0.081 to 0.129). The prevalence rate ranged from 1.3% (Yemen) to 22.2% (Iran). Subgroup analyses showed that the prevalence in adults was 13.5 and 10.1 in children and adolescents. Males exhibited significantly higher prevalence compared with females as these were 11.1% and 7%, respectively. Attention-deficit subtype was significantly the most prevalent (46.7%) compared with hyperactivity/impulsivity (33.7%) and combined types (20.6%). Conclusion The overall prevalence of ADHD was high in the MENA region. It is crucial to allocate more attention and resources towards the prevention and treatment of ADHD in children, adolescents and adults within the region.

BACKGROUND: Nurses worldwide were exposed to increased levels of occupational stress during the COVID-19 pandemic which could have hindered their level of health-related quality of life (HRQoL). OBJECTIVES: This project investigated HRQoL level in nurses during the COVID-19 pandemic and its health and occupational predictors. METHODS: A cross-sectional design was adopted and targeted full-time nurses in Jordan. Study collected data included demographics, 12-item Short Form health survey (SF-12) to measure HRQoL, Nordic Musculoskeletal Questionnaire (NMQ), nurses’ evaluation of work conditions during COVID-19, and Depression Anxiety Stress Scale (DASS21). Data was analyzed descriptively to summarize main outcome measures and using multiple linear regression model to identify factors significantly associated with HRQoL. RESULTS: In total 245 nurses successfully completed the survey, 39.6% were males with a mean age of 35±6 years. Participant SF-12 scores were 65.94±17.85 for physical component and 50.09±19.36 mental component. The statistical model significantly explained 53.2% of variance in HRQoL (r2 = 0.534, F = 57.849, p < 0.001). Better sleep quality self-evaluation was significantly associated with higher HRQoL levels, while increased levels of depression, musculoskeletal pain, and financial burden on family were significantly associated with worse HRQoL level. CONCLUSION: Jordanian nurses’ HRQoL level was relatively low during COVID-19. Sleep quality, mental health status, musculoskeletal health status, and financial status were identified as factors possibly influenced HRQoL among nurses during the COVID-19 pandemic. Nurses’ quality of life along with their mental and physical health should be considered by healthcare administrators in the remaining period of COVID-19 and in future similar emergencies.