Search Results (26)

Cultural norms, beliefs, and practices influence parental expectations, children’s responses, and the acceptance of behaviour management techniques (BMTs) in paediatric dentistry. Despite this, the existing guidelines often adopt a standardized approach, overlooking critical cultural differences. This scoping review maps the links between culture and behaviour management strategies in paediatric dental settings. A scoping review following PRISMA guidelines was conducted across PubMed, Cochrane Library, Web of Science, Google Scholar, and hand-searched sources from the inception of the databases to 31 January 2025. A total of 671 studies were identified, with 15 meeting the inclusion criteria. Data on the key findings were inductively analyzed to assess cultural influences on parental acceptance, child behavior, and communication. The findings show that non-invasive BMTs such as TellShow–Do and positive reinforcement were the most accepted across cultures, while passive and active restraints were least accepted, especially in Western populations. Parental preferences varied; Jordanian parents were more accepting of passive restraint than German parents, while general anaesthesia was preferred in Bahrain. Cultural norms shaped communication styles—Latino families emphasized warm interpersonal interactions, whereas Pakistani families exhibited limited parental involvement due to language barriers. Black and Hispanic Medicaid-enrolled mothers in the U.S. reported lower satisfaction with pain management, highlighting disparities in culturally competent care. In conclusion, cultural factors significantly influence paediatric behaviour management in dental clinics. Integrating cultural competence into practice can enhance communication, improve patient compliance, and promote equitable care. Further research is needed, particularly in Africa and South America, to inform globally inclusive behaviour management guidelines. Full article

Background: Head circumference (HC) is a key indicator of growth and brain development in children, used to identify abnormalities like microcephaly and macrocephaly. While WHO growth standards are widely adopted, they may not account for regional variations due to genetic, environmental, and socio-economic factors. This study aimed to develop and validate national HC growth charts for Jordanian children aged 0–5 years and compare them with WHO standards. Method: This study analyzed 628,456 HC measurements from 250,276 Jordanian children (51.6% boys, 48.4% girls) aged 0–1800 days, using data from the Hakeem program. Only healthy children were included. HC measurements followed international guidelines, and data were analyzed using the Lambda–Mu–Sigma (LMS) statistical method. Percentiles were calculated, and growth patterns were compared with WHO standards. Results: National HC-for-age growth charts were developed for the 3rd, 15th, 50th, 85th, and 97th percentiles. Median percentiles for Jordanian children aligned with WHO standards, but the 3rd percentile was lower, particularly for girls after 840 days. The 97th percentile diverged after 240 days, with larger HC measurements observed in Jordanian children. Conclusions: This study provides the first validated HC growth charts for Jordanian children, addressing the limitations of international standards in reflecting regional variations. These charts offer clinicians and public health professionals a precise tool for assessing and monitoring growth, promoting better health outcomes in Jordanian children. Full article

Objectives: The rise of obesity and other nutrition-related conditions among children and adolescents is a global challenge, particularly in the Middle East. This study aimed to determine the prevalence of being underweight, overweight, and obese among Jordanian children and adolescents using the body mass index (BMI) percentiles of the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) standards. Methods: This retrospective cross-sectional/longitudinal study analyzed 58,474 (42.6% males; 57.4% females) height, weight, and BMI-for-age records from 31508 healthy Jordanian children and adolescents aged 2–19 years. The data were retrieved from the Ministry of Health’s nationwide electronic database (2017–2023) and assessed using the CDC and WHO growth standards. Logistic regression was performed to assess the variables associated with overweight/obese status. Results: The prevalence of being underweight, overweight, and obese varied by the reference used, as more cases of being obese and underweight were reported when applying the CDC standards. The regression models showed the males had significantly lower odds of being overweight and obese than the females. Increased age was associated with higher odds of being overweight and obese, with annual increases observed across all age groups. Conclusions: Using the WHO and CDC standards, the prevalence of being underweight was higher in the males aged 6 years and older, while being overweight and obese was more prevalent in the females. The observed annual increase in the prevalence of being overweight and obese underscores the need for targeted strategies. Growth references tailored to regional profiles may improve national nutrition policies for Jordanian children and adolescents. Full article

Among children with special needs, those with autism spectrum disorder (ASD) are more susceptible to school bullying, due to communication challenges. In this study, the severity and types of school bullying, mainly physical, verbal, and social, experienced by children with ASD were identified and assessed from their mothers’ perspectives in Jordan. Additionally, the mothers’ levels of agreement with a set of anti-bullying interventions targeted at preventing bullying or attenuating its adverse consequences on children with ASD were evaluated. The results revealed that verbal and physical bullying were the most common types of school bullying experienced by children with ASD. Furthermore, the frequency of bullying has not been correlated to gender or school type; however, children in primary school experienced a higher frequency of school bullying. The results also revealed a set of proposed anti-bullying interventions that received a high level of agreement from the mothers. These interventions include arranging for various training sessions and programs targeted to children with ASD and their mothers to guide them on handling bullying and assigning specialists at schools to evaluate, monitor, and prevent bullying behaviors and support bullied students. Such interventions are considered promising opportunities for addressing school bullying among children with ASD. Full article

Objective: The present study explores the cross-cultural validation of neuropsychological assessments and their clinical applications in cognitive behavioral therapy (CBT), focusing on culturally adapted CBT (CA-CBT) across diverse populations and settings. Methods: Following the PRISMA guidelines, a comprehensive search was conducted in multiple academic databases, including PubMed, PsycINFO, Scopus, and Web of Science. Keywords related to cognitive behavioral therapy, cultural adaptation, and specific populations were used. The inclusion criteria encompassed randomized controlled trials (RCTs) and pilot studies that assessed CA-CBT for various mental health conditions. Results: The review included studies involving Chinese Americans, Latino caregivers, Syrian refugees, Jordanian children, Malaysian Muslims, Afghan refugees, Iraqi women, Japanese children and adolescents, and Tanzanian and Kenyan children. CA-CBT demonstrated significant effectiveness in reducing symptoms of depression, anxiety, PTSD, and psychosis. For instance, research has shown that CA-CBT is more effective than standard CBT in reducing depressive symptoms among Chinese Americans and in significantly lowering PTSD symptoms in Syrian refugee women. This method has been well-received and is feasible for use in diverse populations, such as Jordanian children and Afghan refugees. The long-term benefits are promising, with sustained improvements being reported in various studies. Additionally, digital and remote delivery methods have demonstrated potential for expanding the accessibility of CA-CBT. Conclusions: CA-CBT is a valuable and effective intervention for diverse cultural populations, significantly improving mental health outcomes. However, future research must address limitations such as small sample sizes, short follow-up periods, and variability in assessment tools. Future studies should include larger and more diverse sample sizes, longer follow-up periods, rigorous control groups, and comprehensive outcome measures to further validate and enhance the application of CA-CBT across different cultural contexts. Full article

We aimed to examine vaccine hesitancy and knowledge towards influenza vaccines among Jordanian parents. Data were collected via an online questionnaire distributed between October 2023 and March 2024. They included sections on demographics, parental attitudes towards childhood vaccines (PACVs), and knowledge and practices towards influenza vaccines. Associations were examined using the chi-squared test. A binary logistic regression model was utilized to determine predictors of vaccine usage. A total of 3208 participants were included, of which 9.3% were vaccine hesitant per the PACV categorization. Fathers were more likely to be vaccine hesitant (OR: 1.40; 95CI: 1.07–1.85). Similarly, divorced parents (OR: 1.80; 95CI: 1.05–3.12) were significantly more vaccine hesitant compared to their married counterparts. Conversely, higher monthly income (OR: 0.66; 95CI: 0.48–0.92), working in healthcare settings (OR: 0.71; 95CI: 0.51–0.98), and adherence to national vaccination policies (OR: 0.07; 95CI: 0.04–0.13) were significantly associated with a lower likelihood of vaccine hesitancy. Multivariate analysis shows that a healthcare-related occupation (OR: 0.62; 95CI: 0.44–0.87), semi-compliance (OR: 0.37; 95CI: 0.22–0.64), full compliance (OR: 0.08; 95CI: 0.05–0.13) with national vaccine guidelines, and knowledge scores of influenza and vaccines (OR: 0.79; 95CI: 0.75–0.84) were the only independent factors influencing vaccine hesitancy. Finally, non-hesitant participants were significantly more likely to give the influenza vaccine to their children at the present or future time (OR: 2.07; 95CI: 1.53–2.80). Our findings highlight the complexity of vaccine hesitancy and underscore the importance of tailored interventions. Cultural, socioeconomic, and individual factors play significant roles in shaping attitudes toward vaccination. An understanding of the aforementioned among Jordanian parents provides insights for public health initiatives. Compliance with national vaccination guidelines and addressing concerns about vaccine safety are essential for improving childhood vaccination rates in Jordan. Full article

Background: the variations in a child’s overall body shape and figure among different countries are attributable to differences in genetics, environmental factors, and the interaction between these elements. This study aims to evaluate the validity, reliability, and appropriateness of applying international growth standards to Jordanian children and adolescents aged 2–19 years old. Methods: 65,828 Jordanian children and adolescents (43% males; 57% females) aged 2–19 years old were selected from the Hakeem Program database and various private schools across Jordan. Height-for-age, weight-for-age, and body mass index (BMI)-for-age were analyzed comparatively for Jordanian children and adolescents against international growth standards. The z-score for each record was computed based on international equations. Results: Mean z-scores for height-for-age, weight-for-age, and BMI-for-age for both genders showed significant deviation from international standards across most age intervals. It was found that in most age groups, Jordanian children and adolescents were shorter and lighter than CDC and WHO standards, except for females at ages ≥ 16 years, who were heavier with higher BMI-for-age values than CDC standards based on weight-for-age and BMI-for-age equations. Moreover, Jordanian males at ages ≥ 12 years had lower BMI-for-age values than CDC standards. Conclusions: Jordanian children and adolescents showed significant deviations in their measurements from international standards and growth reference values. The development of a population-specific growth chart is highly recommended to enhance the accuracy of evaluating children’s and adolescents’ wellness. Full article

Glycogen storage diseases (GSDs) are a group of carbohydrate metabolism disorders, most of which are inherited in autosomal recessive patterns. GSDs are of two types: those that have to do with liver and hypoglycaemia (hepatic GSDs) and those that are linked to neuromuscular presentation. This study aims to assess the impact of dietary intervention, including medium-chain triglyceride (MCT) oil, on anthropometric measurements, body composition analysis and metabolic parameters among Jordanian children and is expected to be the first in the country. A sample of 38 children with glycogen storage disease type 1 (GSD-1) (median age = 6.4 years) were on a diet that included uncooked cornstarch therapy and a fructose-, sucrose- and lactose-restricted diet. Patients started to take MCT oil along with the prescribed diet after the first body composition test. Patients’ nutritional status was re-evaluated three months later. The study results show that the percentage of patients who suffered from hypoglycaemia at the beginning of the study decreased significantly from 94.7% to 7.9% (p < 0.0001). The serum levels of triglycerides, cholesterol, uric acid and lactate decreased significantly after three months of intervention (100–71.1%, 73.7–21.1%, 97.4–52.6% and 94.7–18.4%, respectively). In contrast, there was no statistical difference in neutrophil count. Regarding clinical parameters, liver span was significantly reduced from (16.01 ± 2.65 cm) to (14.85 ± 2.26 cm) (p < 0.0001). There were significant improvements in growth parameters, including height-for-age and BMI-for-age for children aged ≥2 years (p = 0.034 and p = 0.074, respectively). Significant improvements in skeletal muscle mass and bone mineral content were also noticed at the end of the trial (p ≤ 0.05). In conclusion, medium-chain triglyceride therapy is found to improve biochemical and growth parameters in children with GSD-1 in Jordan. Full article

There is a critical need to understand vaccine decision-making in high-risk groups. This study explored flu vaccine acceptance among Jordanian parents of diabetic children. Employing a cross-sectional approach, 405 parents from multiple healthcare centers across Jordan were recruited through stratified sampling, ensuring a broad representation of socioeconomic backgrounds. A structured questionnaire, distributed both in-person and online, evaluated their knowledge, attitudes, and acceptance of the flu vaccine for their diabetic children. The results indicated that only 6.4% of the study sample reported vaccinating their children against the flu annually, and only 23% are planning to vaccinate their children this year. A multinomial logistic regression analysis revealed notable variability in responses. Specifically, parents with a positive attitude towards the flu vaccine and those with older children had less odds to reject the vaccine (OR = 0.589, 95% CI (0.518–0.670), p < 0.001 and OR = 0.846, 95% CI (0.736–0.974), p = 0.02, respectively). Conversely, prevalent misconceptions regarding vaccine safety and efficacy emerged as significant barriers to acceptance. Our findings advocate for targeted educational programs that directly address and debunk these specific misconceptions. Additionally, strengthened healthcare communication to provide clear, consistent information about the flu vaccine’s safety and benefits is vital to help enhance vaccine uptake among this vulnerable population, emphasizing the need to address specific concerns and misinformation directly. Full article

Purpose: To identify and understand the multifaceted barriers faced by Syrian refugees when seeking vaccination services for their children. Methods: A survey questionnaire was administered through structured interviews to a sample of Syrian refugees residing inside the Al-Zaatari camp and in various urban areas across Jordanian communities. This process utilized a multi-stage sampling approach, beginning with a random selection from clusters or strata, and then employing convenience sampling within each to select participants. The survey covered demographics, barriers to vaccination, and vaccine hesitancy. Results: A total of 332 participants completed the survey with a mean age of 32.7 ± 10 years ranging from 18 to 67. More than half of the sample (59%) had an education of 11th grade or less. Sociodemographic disparities regarding barrier perception were evident among participants. Middle-aged adults (older than 32), males, and those with a monthly income less than USD 200 had scored significantly higher on barrier perceptions across all categories (p < 0.05). In-camp residents were less likely to face vaccination barriers compared to those living outside the camps (p < 0.001). Psychological antecedents of vaccine assessments showed that younger individuals had significantly higher scores in complacency, calculation, and constraints (p < 0.05). Participants with lower income had lower constraints and calculation scores (p < 0.05). In-camp residents had significantly higher scores in complacency, constraints, and calculation constructs compared outside camps counterparts (p < 0.05). Participants with no formal education had higher scores in complacency and constraints, and those with less than a 12th-grade education and higher education degrees scored significantly higher on the collective responsibility construct (p < 0.05). Conclusions: Efforts to promote vaccination among refugees should consider the specific challenges faced by this population, including financial barriers, healthcare access inequalities, and the impact of living arrangements. Public health strategies should address not only individual and psychological factors but also the physical and logistical challenges in obtaining vaccines. Full article

(1) Background: The lockdown that was forced by the Jordanian government as part of the attempt to contain the COVID-19 outbreak included extreme measures such as home confinement and the shutting down of schools’ special education centers. This study explores the experiences of mothers of children with autism spectrum disorder (ASD) during this significant life disturbance. (2) Methods: Eleven mothers of children with ASD took part in semi-structured telephone interviews, which were transcribed verbatim and underwent thematic analysis. (3) Results: The analysis was conducted in an iterative consensus-building process to identify mothers’ experiences, concerns, challenges, coping strategies, and perceived needs during the lockdown. The main themes that emerged from the analysis were maternal stress, maternal fears, and maternal hopes. Our findings indicate that the COVID-19 outbreak greatly affected the family lives of the mothers interviewed, which required them to optimize their coping strategies and resilience. (4) Conclusions: The mothers faced significant difficulties during the pandemic and there is an urgent need to support them on multiple levels. Additionally, our findings reveal the need for more research that takes Jordan’s cultural context into account when determining how best to support children with ASD and their parents. Full article

Although extensive research has been conducted worldwide to investigate the diagnostic process of Autism Spectrum Disorder (ASD), Jordanian parents’ experiences have been overlooked. This study explored parents’ journeys toward receiving diagnoses for their children with ASD. In particular, it aimed to provide a clear picture of the process for obtaining these diagnoses for children in Jordan. Methods: Eighteen semi-structured interviews were carried out with 12 mothers and six fathers of children with ASD aged 5 to 11 years old. Results: The coding process was based on a thematic analysis method and resulted in the identification of three overlapping themes: dissatisfaction with professionals’ abilities to approach parents, an unstructured diagnostic process, and perspectives on diagnosis tools. Conclusions: Our data upheld the idea that parental satisfaction with the diagnostic process is influenced by the duration of the process, the information provided, the support offered, and the communication approach used by professionals. Within the local cultural context, parents were significantly impacted by the societal stigma associated with disability when they sought diagnoses for their children with ASD. Full article

Asthma is the most common chronic disease in childhood. Exacerbation is a significant problem for asthmatic patients, and viral infections remain the most frequent triggers of asthma exacerbations. This study explored knowledge, attitudes, and practices (KAP) of parents of asthmatic children towards providing influenza vaccine to their children. This cross-sectional study enrolled parents of asthmatic children who visited the outpatient respiratory clinics of two Jordanian hospitals. The present study enrolled 667 parents of asthmatic children (62.8% female). The median age of the participants’ children was 7 years. The results showed that 60.4% of the children with asthma never received a flu vaccine. Most of those who had received the flu vaccine reported that the side effects were mild (62.7%). Asthma duration was positively and significantly associated with increased vaccine hesitancy/rejection (OR = 1.093, 95% CI = (1.004–1.190), p = 0.04; and OR = 1.092, 95% CI = (1.002–1.189), p = 0.044, respectively). As the attitude towards flu vaccine score increases, odds of vaccination hesitancy/rejection decreased (OR = 0.735, 95% CI = (0.676–0.800), p < 0.001; and OR = 0.571, 95% CI = (0.514–0.634), p < 0.001, respectively). The main reasons for vaccination hesitancy/refusal included “I don’t think my child needs it” (22.3%) followed by “I forget it” (19.5%). The rate of vaccination among children was low and emphasized the necessity of encouraging parents with asthmatic children to vaccinate their children by conducting health awareness campaigns and also emphasized the role of doctors and other healthcare professionals. Full article

Background and Objectives: We aimed to assess the work–life balance, job satisfaction, and life satisfaction and their correlates among physicians in Jordan. Materials and Methods: This study utilized an online questionnaire to collect information about work–life balance and related factors from practicing physicians in Jordan from August 2021 until April 2022. The survey consisted of 37 detailed self-report questions covering seven main categories: demographics, professional and academic information, impact of work on personal life, impact of personal life on work, work/personal life enhancement, the Andrew and Withney Job Satisfaction scale, and the Satisfaction with Life Scale developed by Diener et al. Results: The study included 625 participants. Overall, 62.9% were found to have a work–life conflict. The work–life balance score was negatively correlated with age, number of children, and years practicing medicine, while it was positively correlated with number of hours per week and number of calls. Regarding job and life satisfaction, 22.1% had a score indicating job dissatisfaction, while 20.5% disagreed with the statements indicating life satisfaction. Conclusion: Our study demonstrates that work–life conflict is highly prevalent among Jordanian physicians and highlights the significance of work–life balance in supporting physicians’ well-being and performance. Full article

Background: H. pylori antimicrobial resistance causes increasing treatment failure rates among H. pylori gastritis in children. This study investigates the molecular mechanisms of H. pylori antimicrobial resistance among Jordanian children. Methods: Demographic, clinical, and laboratory data were recorded for children referred to Prince Hamzah Hospital. Clarithromycin, Metronidazole, and Levofloxacin susceptibility were tested via E-test. Clarithromycin-related mutations were investigated using Real-Time (RT)-PCR and Levofloxacin resistance was analyzed with DNA sequencing of the gyrA gene. Results: 116 children were recruited, including 55.2% females and 55.2% in the age range of 10.1 to 14 years. A total of 82.7% were naïve to eradication therapy. H. pylori positivity was 93.9%, 89.6%, 61.7%, and 84.3% according to Rapid Urease Test, histology, culture, and RT-PCR, respectively. Resistance rates were 25.9% for Clarithromycin, 50% for Metronidazole, and 6.9% for Levofloxacin via E-test. A2142G or A2143G or a combination of both mutations concerning Clarithromycin resistance were documented in 26.1% of samples, while mutations in gyrA gen-related to Levofloxacin resistance were reported in 5.3% of samples. Antibiotic resistance was significantly affected by abdominal pain, anemia, hematemesis, and histological findings (p < 0.05). Conclusion: H. pylori resistance was documented for Metronidazole and Clarithromycin. RT-PCR for H. pylori identification and microbial resistance determination are valuable alternatives for cultures in determining antimicrobial susceptibility. Full article