Self-Concept and Its Relationship with Academic Procrastination Among the Secondary Stage Students at Ajloun Governorate "Evaluation Study"

The study aimed to reveal the level of prevalence of the academic procrastination phenomenon among the secondary stage students at Ajloun Governorate center, and to reveal the differences between the male and female students from the scientific and literary streams, in addition to identifying the relationship between the self-concept and academic procrastination among the study sample, and the extent to which the self- concept explains the variance in the academic procrastination behavior. The population of the study consisted of (3445) male and female secondary stage students at Ajloun Directorate of Education, the study sample was (344) male and female students. To achieve the objectives of the study, the researchers used two scales: self- concept scale developed by El-Ghamdi (2009), and academic procrastination scale developed by Tamimi (2012) after checking their reliability and validity. The results of the study showed that there is prevalence of academic procrastination and to a medium degree, and the level of self-concept in the research sample was medium. In addition to the absence of statistical significance differences in the degree of academic procrastination due to gender variable. As well as the existence of statistical significant differences in the degree of academic procrastination due to the specialization variable and the differences were in favor of (scientific specialization) with a mean of (2.18). Finally, the results showed a statistically significant relationship between self-concept and academic procrastination. Keywords: Academic procrastination, Self- concept, Secondary Stag

Assessment of the impact of the West Virginia Medicaid\u27s prior authorization policy for NSAIDs on chronic patients: Economic and humanistic outcomes.

The West Virginia Medicaid prior authorization (PA) policy requires patients to have tried and failed two different classes of generic NSAIDs for two weeks each before a branded NSAID is approved. However, the implementation of PA may lead to increase in utilization and cost of unrestricted medications and/or medical services and compromise patient care. Therefore, the goals of the study were: (1) to assess the net economic impact of PA for NSAIDs, and (2) to determine the impact of the policy on patients\u27 health-related quality of life (HRQoL). The study was conducted in two phases. In phase I, retrospective utilization and expenditures data were analyzed of recipients with continuous Medicaid enrollment over the 3-year period of the study, who were diagnosed with rheumatoid arthritis, osteoarthritis, spondylitis, and chronic pain syndromes. Time series analysis was used to model the impact of the policy. In Phase II, a randomly selected sample of patients who were diagnosed with the above mentioned disorders, and who have been prescribed an NSAID product was identified. Patients were classified into two groups based on whether or not they were approved the use of a branded NSAID. HRQoL was measured at the time the patient was identified and at two months after baseline using a modified version of the Arthritis Impact Measurement Scales (AIMS). Results indicate that the policy was associated with: (i) increased overall rate of utilization and expenditures for NSAIDs; (ii) increased rate of utilization of unrestricted drugs including GI medications, narcotic analgesics, and non-narcotic analgesics; (iii) increased rate of monthly expenditures for outpatient hospital services; (iv) increased level of utilization of health clinic services; and (v) increased rate of utilization of physician visits. However, these effects cannot be generalized to elderly patients or to those who used NSAIDs for acute health conditions. In regard to patients\u27 HRQoL, findings reveal that the use of generic NSAIDs did not result in a negative impact on the HRQoL for patients. For patients who were approved a branded NSAID, improvement were detected on several domains of HRQoL including mobility, hand and finger function, walking and bending, and social activities

Epidemiology, Risk Factors, and Predictors of Disability in a Cohort of Jordanian Patients with the First Ischemic Stroke

Objective. To identify the risk factors, etiologies, length of stay, severity, and predictors of disability among patients with the first ischemic stroke in Jordan. Methods. A retrospective cohort study of 142 patients who were admitted to the Neurology Department at King Abdullah University Hospital between July/2017 and March/2018 with a first ischemic stroke. Etiology was classified according to the TOAST criteria. Severity was represented by NIHSS score, disability by mRS score, and prolonged length of stay as hospitalizations more than 75th percentile of the cohort’s median length of stay. Analysis of the sample demographics and descriptive statistics were done, including frequencies of prevalence of independent variables (risk factors) and frequencies of stroke and etiology work-up. Chi-square and univariate analysis of variance “ANOVA” were used to investigate the relationship between risk factors and type of stroke. Finally, logistic regression analysis was used to measure the contribution of each of the independent variables. IRB approval was obtained as necessary. Results. The mean age for the cohort was 66.5 years. The most common risk factors were hypertension (78.8%), diabetes mellitus (60.5%), and ischemic heart disease (29.4%). The most common stroke etiology was small-vessel occlusion (54.2%). Median length of stay was 4 days. Prolonged length of stay was observed in 23.23% of patients, which was associated with several factors, the most common of which were persistent dysphagia (57.5%), nosocomial infection (39.3%), and combined dysphagia and nosocomial infection (21.2%). The mean admission NIHSS score was 7.94, and on discharge was 5.76. In-hospital mortality was 2.81%, while 50% of patients had a favorable outcome on discharge (mRS score between 0-2). The mean discharge mRS score for the cohort was 2.47 (SD±1.79). Large artery atherosclerosis was associated with the highest residual disability with a mean score of 3.67 (SD±1.88), while the stroke of undetermined etiology was associated with the lowest residual disability with a mean score of 1.60 (SD±1.78). Significant predictors of mRS score were smoking (t 3.24, P<0.001), age (t 1.98, P<0.049), and NIHSS score (t 9.979, P 0.000). Conclusion. Ischemic strokes have different etiologies that are associated with different levels of impact on the patient’s clinical status and prognosis. Large artery atherosclerosis was associated with the highest residual disability. Regarding predictors of prognosis, current smoking status, age above 50, gender, and NIHSS on admission appear to be the strongest predictors of prognosis. Finally, higher NIHSS score on admission resulted in a longer hospital stay

Clinical, radiological, and electroencephalographic features of HHV-6 encephalitis following hematopoietic stem cell transplantation

To study the clinical, radiological, electroencephalographic, and cerebrospinal fluid (CSF) features of Human Herpes Virus 6 (HHV-6) encephalitis in leukemia patients underwent allogeneic hematopoietic stem cell transplantation (HSCT). We retrospectively reviewed all leukemia patients who underwent allogeneic HSCT between January 2010 and December 2018. The clinical, radiological, electroencephalographic, and CSF features of those with HHV6 encephalitis were recorded. A total of five cases of HHV6 encephalitis were identified. Three patients had Chronic Myelogenous Leukemia, one had Chronic Lymphocytic Leukemia and one had Acute Lymphoblastic Leukemia. All of them presented a few months after transplantation with altered mental status. Comorbidities included pancytopenia, sepsis, graft versus host disease, and multi-organ failure. EEG showed focal seizures originating from temporal lobes in two patients, generalized or focal periodic discharges in three patients, focal slowing in two patients, and diffuse slowing in three patients. MRI brain showed T2/FLAIR hyper-intensities in four patients; two of them in bilateral temporal lobes, one in the thalamus/hypothalamus/brainstem/cerebellum/basal ganglia, and one in the periventricular areas. CSF showed pleocytosis, high protein, and positive HHV-6 PCR. Foscarnet was used as an anti-viral agent. Anti-epileptics used were phenytoin, levetiracetam, and valproic acid. Four patients died in a few months, whereas one recovered completely. HHV-6 encephalitis can add significant morbidity and mortality to leukemic patients following allogeneic HSCT. Patients present with typical clinical features of encephalitis. Salient EEG characteristics include periodic discharges or overt temporal lobe seizures. MRI findings are T2/FLAIR signal hyperintensities, mainly in the temporal lobes. •HHV-6 encephalitis is a fatal complication of allogeneic hematopoietic stem cell transplantation (HSCT).•Common features include confusion, fever, headache, and seizures.•EEG can show focal or generalized periodic discharges or overt temporal lobe seizures.•MRI may show temporal lobe hyperintensities and diffusion restriction.•Starting Foscarnet and antiepileptic drugs as early as post HSCT patients develop confusion is recommended

Use of Innovative SPECT Techniques in the Presurgical Evaluation of Patients with Nonlesional Extratemporal Drug-Resistant Epilepsy

Up to 30% of patients with epilepsy may not respond to antiepileptic drugs. Patients with drug-resistant epilepsy (DRE) should undergo evaluation for seizure onset zone (SOZ) localization to consider surgical treatment. Cases of drug-resistant nonlesional extratemporal lobe epilepsy (ETLE) pose the biggest challenge in localizing the SOZ and require multiple noninvasive diagnostic investigations before planning the intracranial monitoring (ICM) or direct resection. Ictal Single Photon Emission Computed Tomography (i-SPECT) is a unique functional diagnostic tool that assesses the SOZ using the localized hyperperfusion that occurs early in the seizure. Subtraction ictal SPECT coregistered to MRI (SISCOM), statistical ictal SPECT coregistered to MRI (STATISCOM), and PET interictal subtracted ictal SPECT coregistered with MRI (PISCOM) are innovative SPECT methods for the determination of the SOZ. This article comprehensively reviews SPECT and sheds light on its vital role in the presurgical evaluation of the nonlesional extratemporal DRE

Piloting the development of a cost-effective evidence-informed clinical pathway: managing hypertension in Jordanian primary care

The UK's National Institute for Health and Clinical Excellence (NICE) and the Jordan office of the Medicines Transparency Alliance embarked on a pilot project to design an evidence-based guideline for cost-effective pharmacological treatment of essential hypertension in Jordan. The project's objectives were to directly address a major health problem for Jordan by producing a guideline; and to delineate the strengths and weaknesses of Jordan's healthcare process to allow similar future efforts to be planned more efficiently