Exploring Vaccination Challenges among Syrian Refugees in Jordan: Insights from Camps and Communities, and Perceived Parental Barriers to Childhood Vaccination Uptake

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 p p p p 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

Evaluating Research Impact Based on Semantic Scholar Highly Influential Citations, Total Citations, and Altmetric Attention Scores: The Quest for Refined Measures Remains Illusive

Background: The evaluation of scholarly articles&rsquo; impact has been heavily based on the citation metrics despite the limitations of this approach. Therefore, the quest for meticulous and refined measures to evaluate publications&rsquo; impact is warranted. Semantic Scholar (SS) is an artificial intelligence-based database that allegedly identifies influential citations defined as &ldquo;Highly Influential Citations&rdquo; (HICs). Citations are considered highly influential according to SS when the cited publication has a significant impact on the citing publication (i.e., the citer uses or extends the cited work). Altmetrics are measures of online attention to research mined from activity in online tools and environments. Aims: The current study aimed to explore whether SS HICs provide an added value when it comes to measuring research impact compared to total citation counts and Altmetric Attention Score (AAS). Methods: Dimensions was used to generate the dataset for this study, which included COVID-19-related scholarly articles published by researchers affiliated to Jordanian institutions. Altmetric Explorer was selected as an altmetrics harvesting tool, while Semantic Scholar was used to extract details related to HICs. A total of 618 publications comprised the final dataset. Results: Only 4.57% (413/9029) of the total SS citations compiled in this study were classified as SS HICs. Based on SS categories of citations intent, 2626 were background citations (29.08%, providing historical context, justification of importance, and/or additional information related to the cited paper), 358 were result citations (3.97%, that extend on findings from research that was previously conducted), and 263 were method citations (2.91%, that use the previously established procedures or experiments to determine whether the results are consistent with findings in related studies). No correlation was found between HICs and AAS (r = 0.094). Manual inspection of the results revealed substantial contradictions, flaws, and inconsistencies in the SS HICs tool. Conclusions: The use of SS HICs in gauging research impact is significantly limited due to the enigmatic method of its calculation and total dependence on artificial intelligence. Along with the already documented drawbacks of total citation counts and AASs, continuous evaluation of the existing tools and the conception of novel approaches are highly recommended to improve the reliability of publication impact assessment

Cognitive behavioural therapy and medication for treatment of adolescent depression: a network meta-analysis

BACKGROUND: Cognitive behavioural therapy (CBT) and medication are widely accepted and useful interventions for individuals with depression. However, a gap remains in our current understanding of how CBT directly benefits adolescents with depression. AIMS: The purpose of this study was to examine the short- and long-term effectiveness of CBT only, CBT+Medication, or Medication alone in reducing the duration of major depressive episodes, lessening internalizing and externalizing symptoms and improving global functioning. METHODS: Data were extracted from 14 unique studies with a total of 35 comparisons. Network meta-analysis was conducted and p-scores, a measure of the extent of certainty that one treatment is better than another, were used to rank treatments. RESULTS: There was no significant difference between any two treatments for depression, nor internalizing or externalizing symptoms. For global functioning, CBT had significantly greater effect at the longest follow-up than CBT+Medication. CBT+Medication had the highest p-score for depression, short- and long-term effects, and internalizing and externalizing symptoms long-term effects. No indication of publication bias was found. CONCLUSIONS: Neither modality, CBT nor medication, is superior for treating adolescent depression. However, CBT was superior in improving global functioning, which is essential for meeting developmental goals

Personal, Familial, Psychosocial and Behavioral Characteristics of Arab Juvenile Delinquents: The Context of Jordan

Delinquency in adolescence is rooted in a complex multifaceted system that comprises several factors such as personal characteristics, family, school, peers, and community, all of which are embedded in the sociocultural context in which they are present. There is a paucity of research on juvenile delinquency and its risk factors across many regions, especially low- and middle-income countries, including Arab countries. This study aimed to develop an understanding of the personal, familial, and behavioral characteristics of Arab juvenile delinquents in the distinctive sociocultural context of Jordan. All juveniles who were incarcerated at the time of data collection (N = 197) were targeted using a convenience sampling approach from a total of 11 juvenile rehabilitation centers distributed over the northern, middle, and southern regions of the country. Anonymous surveys were used to collect data on juvenile delinquents’ personal, familial, psychosocial, and behavioral characteristics. A total of 186 juvenile delinquents completed the study questionnaire (9.7% females). About 52% were not attending school regularly, 32% had divorced, separated, or deceased parents, 6% reported receiving a diagnosis of mental illness, and 91% reported they never sought psychological support of any kind. Regarding substance consumption, 70% were smokers, 26% were alcohol consumers, and 15% were on drugs. About 12% spent more than 7 h on their cellphones, and 43% reported dedicating no time for physical activity. Theft was the most frequently reported offense (35%), followed by quarreling with peers (25%), and possession of drugs (9%). Approximately 42% reported that their friends encouraged them to cause trouble, while the majority (74%) reported that their school had no positive or negative influence on their behavior. Several behavioral problems were detected, with females showing significantly higher scores in impulsivity, inattention, emotional lability, and social problems compared to their male counterparts. Severity of the conduct problems was negatively associated with the length of engagement in physical activities, while both impulsivity and inattention scores were positively associated with the length of engagement in watching TV and using cellphones (all p < 0.05). Overall, these juvenile delinquents have unsatisfactory academic and schooling experiences, engage in unhealthy lifestyles and exhibit several behavioral problems. Differences in juvenile delinquency risk factors across different sociocultural contexts can influence prevention efforts. Comprehensive prevention strategies that reduce risk and develop protective factors need to target juveniles early in their development and consider factors related to their families, schools, peers, and communities

Personal, Familial, Psychosocial and Behavioral Characteristics of Arab Juvenile Delinquents: The Context of Jordan

Delinquency in adolescence is rooted in a complex multifaceted system that comprises several factors such as personal characteristics, family, school, peers, and community, all of which are embedded in the sociocultural context in which they are present. There is a paucity of research on juvenile delinquency and its risk factors across many regions, especially low- and middle-income countries, including Arab countries. This study aimed to develop an understanding of the personal, familial, and behavioral characteristics of Arab juvenile delinquents in the distinctive sociocultural context of Jordan. All juveniles who were incarcerated at the time of data collection (N = 197) were targeted using a convenience sampling approach from a total of 11 juvenile rehabilitation centers distributed over the northern, middle, and southern regions of the country. Anonymous surveys were used to collect data on juvenile delinquents&rsquo; personal, familial, psychosocial, and behavioral characteristics. A total of 186 juvenile delinquents completed the study questionnaire (9.7% females). About 52% were not attending school regularly, 32% had divorced, separated, or deceased parents, 6% reported receiving a diagnosis of mental illness, and 91% reported they never sought psychological support of any kind. Regarding substance consumption, 70% were smokers, 26% were alcohol consumers, and 15% were on drugs. About 12% spent more than 7 h on their cellphones, and 43% reported dedicating no time for physical activity. Theft was the most frequently reported offense (35%), followed by quarreling with peers (25%), and possession of drugs (9%). Approximately 42% reported that their friends encouraged them to cause trouble, while the majority (74%) reported that their school had no positive or negative influence on their behavior. Several behavioral problems were detected, with females showing significantly higher scores in impulsivity, inattention, emotional lability, and social problems compared to their male counterparts. Severity of the conduct problems was negatively associated with the length of engagement in physical activities, while both impulsivity and inattention scores were positively associated with the length of engagement in watching TV and using cellphones (all p &lt; 0.05). Overall, these juvenile delinquents have unsatisfactory academic and schooling experiences, engage in unhealthy lifestyles and exhibit several behavioral problems. Differences in juvenile delinquency risk factors across different sociocultural contexts can influence prevention efforts. Comprehensive prevention strategies that reduce risk and develop protective factors need to target juveniles early in their development and consider factors related to their families, schools, peers, and communities

Evaluating a stepped care model of psychological support for adults affected by adversity: study protocol for a randomised controlled trial in Jordan

Background The burden of common mental disorders in low and middle-income countries (LMICs) is growing with little known about how to allocate limited resources to reach the greatest number of people undergoing instances of significant psychological distress. We present a study protocol for a multicentre, parallel-group, superiority, randomised controlled trial.Methods and analysis Adults with significant psychological distress (K10 score ≥20) will be randomised to receive a stepped care programme involving a self-guided course (Doing What Matters) followed by a more intensive group programme (Problem Management Plus) or the self-guided course alone, both of which will take place in addition to enhanced treatment as usual comprising of a follow-up referral session to available services within the community. We will include 800 participants. An intent-to-treat and completer analysis will explore the impact of the stepped model of care on anxiety and depression symptoms (as measured by the Hopkins Symptom Checklist; HSCL-25) at 24 weeks from baseline. Secondary outcomes include positive psychological well-being, agency, changes in patient-identified problems, quality of life and cost-effectiveness. Linear mixed models will be used to assess the differential impact of the conditions over time. Analyses will focus on the primary outcome (HSCL-25) and secondary outcomes (agency subscale, WHO Well-Being Index, WHO Disability Assessment Schedule V.2.0, EQ-5D, Psychological Outcomes Profiles Scale) for both conditions, with the main outcome time point being the 3-month follow-up, relative to baseline.Ethics and dissemination This will be the first randomised controlled trial to assess the benefits of a stepped model of care to addressing psychological distress in a LMIC setting. Results will provide important insights for managing limited resources to mental healthcare in these settings and will be accordingly disseminated to service providers and organisations via professional training and meetings, and via publication in relevant journals and conference presentations. We will also present these findings to the Jordanian Ministry of Health, where this institute will guide us on the most appropriate format for communication of findings, including written reports, verbal presentations and/or brochures. Ethical approval was obtained from the University of Jordan School of Nursing Research Ethics Committee (number: PF.22.10).Trial registration number ACTRN12621000189820p; Australian New Zealand Clinical Trials Registry

Quality of life in Arab children with congenital heart disease.

Background and purposeManagement strategies for children with congenital health diseases (CHDs) should encompass more than just the medical aspect of the disease and consider how heart diseases affect their everyday activities and, subsequently, their quality of life (QoL). Global studies witnessed a greater emphasis on studying the QoL associated with CHD. However, there is still a great lag in such data in the Arab region. The purpose of this study was to evaluate QoL in children with CHD using an Arab sample from Jordan. The specific objectives were twofold: (1) to contrast the assessments of children's QoL reported by their parents with those reported by the children themselves, and (2) to assess the factors that influence the QoL of children with CHD.MethodsA total of 79 children aged 2-18 with a confirmed diagnosis of CHD were included in the study, along with their mothers. Of them, 38.0% were girls, 67.1% were diagnosed with non-cyanotic CHD, 58.2% had a severe CHD, 92.4% had undergone at least one operation, 81.0% had repaired defects, 13.9% underwent palliated procedures, and 24.1% were admitted to a neonatal intensive care unit after delivery. The Pediatric Quality of Life Inventory was used to assess QoL of children with CHD. Both children's and parents' reports of QoL were analyzed using paired-sample t-tests, ANOVAs, and multiple linear regression.ResultsOlder children reported significantly lower QoL scores, whereas there were no differences in parents-reported QoL scores across different children age groups. There was a divergence in perceptions of QoL between parents-reported and children-reported scores with parents reporting significantly lower scores. The children-reported QoL in this study seemed to be significantly associated with their gender, age, and the presence of learning difficulties, whereas the parent-reported QoL was only associated with the presence of learning difficulties.ConclusionsResponses from both children and parents need to be considered to understand the similarities and differences between them and to provide further insight into the optimal way to help children with CHD effectively navigate the transition into adulthood. Future research studies of outcomes for survivors of children with CHD are needed to identify high-risk survivors for worse psychosocial functioning and assess prevention measures and treatment interventions to improve their QoL

Participants’ characteristics (N = 79).

Background and purposeManagement strategies for children with congenital health diseases (CHDs) should encompass more than just the medical aspect of the disease and consider how heart diseases affect their everyday activities and, subsequently, their quality of life (QoL). Global studies witnessed a greater emphasis on studying the QoL associated with CHD. However, there is still a great lag in such data in the Arab region. The purpose of this study was to evaluate QoL in children with CHD using an Arab sample from Jordan. The specific objectives were twofold: (1) to contrast the assessments of children’s QoL reported by their parents with those reported by the children themselves, and (2) to assess the factors that influence the QoL of children with CHD.MethodsA total of 79 children aged 2–18 with a confirmed diagnosis of CHD were included in the study, along with their mothers. Of them, 38.0% were girls, 67.1% were diagnosed with non-cyanotic CHD, 58.2% had a severe CHD, 92.4% had undergone at least one operation, 81.0% had repaired defects, 13.9% underwent palliated procedures, and 24.1% were admitted to a neonatal intensive care unit after delivery. The Pediatric Quality of Life Inventory was used to assess QoL of children with CHD. Both children’s and parents’ reports of QoL were analyzed using paired-sample t-tests, ANOVAs, and multiple linear regression.ResultsOlder children reported significantly lower QoL scores, whereas there were no differences in parents-reported QoL scores across different children age groups. There was a divergence in perceptions of QoL between parents-reported and children-reported scores with parents reporting significantly lower scores. The children-reported QoL in this study seemed to be significantly associated with their gender, age, and the presence of learning difficulties, whereas the parent-reported QoL was only associated with the presence of learning difficulties.ConclusionsResponses from both children and parents need to be considered to understand the similarities and differences between them and to provide further insight into the optimal way to help children with CHD effectively navigate the transition into adulthood. Future research studies of outcomes for survivors of children with CHD are needed to identify high-risk survivors for worse psychosocial functioning and assess prevention measures and treatment interventions to improve their QoL.</div

Mean (M), standard deviation (SD), and Cronbach’s alpha (α) of QoL scores by age group (N = 79).

Mean (M), standard deviation (SD), and Cronbach’s alpha (α) of QoL scores by age group (N = 79).</p

Estimated determinants of QoL from regression analysis.

Estimated determinants of QoL from regression analysis.</p