Factors influencing gestational diabetes self-care among pregnant women in a Syrian Refugee Camp in Jordan

AIM

The main objective of this study is to identify the level of self-care practices and the determinants of Gestational Diabetes Mellitus (GDM) among pregnant women residing in one of the refugee camps in Jordan.

METHOD

A cross-sectional study was conducted on a convenient sample of forty women diagnosed with GDM from the high-risk maternity clinic in one of the Syrian refugee camps in Jordan. The study used the Gestational Diabetes Management Self-Efficacy Scale (GDMSES), Diabetes Knowledge (DMK) assessment, and Diabetes Self-Care Activities Questionnaire (SDSCA) to measure the variables of interest. Descriptive analysis and Multiple logistic regression were used to assess for significant factors.

RESULTS

Significant associations were found between the subcategories of diet, exercise, and blood sugar control in both the self-efficacy and self-activity scales (p < 0.01, p < 0.01, p < 0.05), respectively. Two factors were associated with higher GDM self-care: diabetes knowledge and higher self-efficacy toward GDM self-care (p < 0.05).

CONCLUSION

The findings of this study highlight that pregnant women with GDM who have higher levels of self-efficacy and diabetes knowledge are more likely to achieve higher levels of GDM self-care. Beside developing health promotion programs to enhance women's self-efficacy in adhering to GDM care, adequate support and relevant resources to facilitate GDM management among refugee women are recommended. Future research for identifying other potential factors affecting GDM self-care among refugees is highly recommended.

Analysis of the nutritional status in the Palestinian territory: a review study

Background

Food insecurity, occupation, and poverty contribute to the poor nutritional status of Palestine. This review study aimed to analyze the nutritional status in the Palestinian Territory by analyzing published data from 2011 to 2023.

Method

Searching for relevant publications yielded 67 studies. Based on reviewing these studies, five major themes were identified: low birth weight, breastfeeding, obesity and overweight, protein-energy malnutrition, and micronutrient deficiency.

Results

Based on the review of these studies, five major themes were identified, namely, low birth weight, breastfeeding, obesity and overweight, protein-energy malnutrition, and micronutrient deficiency. Based on the literature, the prevalence rate of exclusive breastfeeding was 24.4% in the Gaza Strip, compared to a national rate of 39.9% in 2020. Smoking, anemia in mothers, diet during pregnancy, and indoor pollution were associated with low birth weight. One-fifth of the boys and girls were stunted by 2 years of age in the Gaza Strip, and girls were more stunted than boys. The prevalence rates of underweight, overweight, and obesity among school children in the West Bank were 7.3%, 14.5%, and 15.7%, respectively. Age, gender, and living area were significant predictors of being overweight among school children. The prevalence rates of overweight and obesity among adults in Palestine were 57.8% and 26.8%, respectively. Obesity is associated with a family history, chronic diseases, and low physical activity among adults. Exclusive breastfeeding was below the WHO recommendations, while significant rates of obesity and overweight were found among children and adults. Iron-deficiency anemia (IDA) among pregnant women and children remains a challenging public health issue, while other micronutrient deficiencies are high among children.

Conclusion

This review emphasizes the need for multi-sectoral interventions to address malnutrition and nutritional shifts. It identifies gaps and addresses nutrition-related issues in the Palestinian Territory, which can serve as a basis for guiding United Nations agencies and governments in formulating evidence-based policies and strategies for prioritizing nutritional interventions to meet sustainable development goals.

Depression among Jordanian women during pregnancy in COVID-19: Role of social support

<b>Aims:</b> To describe the level of depression and social support experienced by pregnant Jordanian women and assess the role of support and other factors on depression level among a sample of Jordanian women during pregnancy during the COVID-19 pandemic.<br /> <b>Method</b>: The study invitation and link to an online survey were shared during November 2021 via social media and through word of mouth. A convenience sample of 434 pregnant women completed the study questionnaire, which included questions on their COVID-19 status, demographics, depression, and social. Depression was assessed using the Center for Epidemiologic Studies Depressive Scale (CES-D).<br /> <b>Results</b>: The prevalence of depression among women during pregnancy was 28.3%. The mean of depression score among women during pregnancy was 24.3±4.4. The prevalence of social support among women during pregnancy were (63%). The mean social support score among the participants was 39.3±9.1. Factors associated with a higher depression score included not get influenza vaccination, not having insurance, described life as poor, having pressure, and not having social support.<br /> <b>Conclusion:</b> This is a national study among women during pregnancy in Jordan. The study found that people who took influenza vaccination, having insurance, described life as poor, and having pressure, they experience more depression than other people. Moreover, our study found as social support increased, the depression decreased.

Nutrition Situation Analysis in the UAE: A Review Study

This review study aimed to assess the nutrition situation in the UAE using published data from 2010 to 2022. It highlights the gaps and challenges that prevail in addressing the nutrition-related problems in the UAE and the opportunities that have been overlooked. The available literature indicates that the UAE is burdened with more than one form of nutrition-related problems, including being underweight, being overweight, obesity, micronutrient deficiencies, and nutrition-related chronic diseases. It is clear that data on micronutrient deficiencies, protein-energy malnutrition, obesity, diabetes, and other nutrition-related diseases among the UAE population are extremely scarce. The UAE has a high prevalence of obesity and diabetes; however, limited studies have been conducted to document this nutritional phenomenon. Few examples of published data are available assessing the burden of stunting, wasting, and being underweight among children under five years of age. Despite the importance of protein-energy malnutrition, no recent publications analyze its prevalence within the UAE population. Therefore, future studies must be conducted, focusing on malnutrition. Based on the literature, and bearing in mind the magnitude of the health issues due to the UAE population's nutrition negligence, there is an urgent need to assess the population's nutrient behaviors, to aid policy decision-makers in developing and implementing effective health policies and strategies.

Impact of COVID-19 lockdown on smoking (waterpipe and cigarette) and participants' BMI across various sociodemographic groups in Arab countries in the Mediterranean Region

INTRODUCTION

Tobacco smokers are at high risk of developing severe COVID-19. Lockdown was a chosen strategy to deal with the spread of infectious diseases; nonetheless, it influenced people's eating and smoking behaviors. The main objective of this study is to determine the impact of the COVID-19 lockdown on smoking (waterpipe and cigarette) behavior and its associations with sociodemographic characteristics and body mass index.

METHODS

The data were derived from a large-scale retrospective cross-sectional study using a validated online international survey from 38 countries (n=37207) conducted between 17 April and 25 June 2020. The Eastern Mediterranean Region (WHO-EMR countries) data related to 10 Arabic countries that participated in this survey have been selected for analysis in this study. A total of 12433 participants were included in the analysis of this study, reporting their smoking behavior and their BMI before and during the COVID-19 lockdown. Descriptive and regression analyses were conducted to examine the association between smoking practices and the participant's country of origin, sociodemographic characteristics, and BMI (kg/m²).

RESULTS

Overall, the prevalence rate of smoking decreased significantly during the lockdown from 29.8% to 23.5% (p<0.05). The percentage of females who smoke was higher than males among the studied population. The highest smoking prevalence was found in Lebanon (33.2%), and the lowest was in Oman (7.9%). In Egypt, Kuwait, Lebanon, and Saudi Arabia, the data showed a significant difference in the education level of smokers before and during the lockdown (p<0.05). Smokers in Lebanon had lower education levels than those in other countries, where the majority of smokers had a Bachelor's degree. The findings show that the BMI rates in Jordan, Lebanon, Oman, and Saudi Arabia significantly increased during the lockdown (p<0.05). The highest percentages of obesity among smokers before the lockdown were in Oman (33.3%), followed by Bahrain (28.4%) and Qatar (26.4%), whereas, during the lockdown, the percentage of obese smokers was highest in Bahrain (32.1%) followed by Qatar (31.3%) and Oman (25%). According to the logistic regression model, the odds ratio of smoking increased during the pandemic, whereas the odds ratio of TV watching decreased. This finding was statistically significant by age, gender, education level, country of residence, and work status.

CONCLUSIONS

Although the overall rates of smoking among the studied countries decreased during the lockdown period, we cannot attribute this change in smoking behavior to the lockdown. Smoking cessation services need to anticipate that unexpected disruptions, such as pandemic lockdowns, may be associated with changes in daily tobacco consumption. Public health authorities should promote the adoption of healthy lifestyles to reduce the long-term negative effects of the lockdown.

Prevalence of smoking (cigarette and waterpipe) and its association with obesity/overweight in UAE and Palestine

Aim

This study aimed to assess the prevalence rate of smoking behavior (cigarette and waterpipe) and its association with obesity/ overweight among university students in the United Arab Emirates (UAE) and Palestine.

Methods

A cross-sectional study was conducted at a convenient sample of 10 largest universities in the West Bank- Palestine and Dubai- UAE. In total, 3800 students were randomly selected from the universities, with an 87.6% response rate. A self-administered questionnaire was used to collect the data. The key measures were: waterpipe smoking, weight, height, cigarette smoking, dieting to reduce weight, and perception and knowledge related to tobacco waterpipe smoking (TWP). Body Mass Index (BMI) was calculated using the WHO cutoffs.

Results

The analysis included 3,327 students (54% from the West Bank and 46% from Dubai). About 16% of students in Dubai and 18% of students in the West Bank smoke cigarettes. Quarter (26%) of the students in Dubai and 32% of the students in West Bank smoke water pipes. 17% of students in Dubai and 18% of students in the West Bank reported that they smoke waterpipes to reduce their weight. Waterpipe smoking was found to have a significant positive association with obesity/overweight (p < 0.001).

Conclusions

Smoking is very common among university students. Waterpipe smoking was associated with obesity. More research is still needed in this field to better understand the relationship between cigarette smoking and obesity.

The Impact of COVID-19 on Physical (In)Activity Behavior in 10 Arab Countries

Insufficient physical activity is considered a strong risk factor associated with non-communicable diseases. This study aimed to assess the impact of COVID-19 on physical (in)activity behavior in 10 Arab countries before and during the lockdown. A cross-sectional study using a validated online survey was launched originally in 38 different countries. The Eastern Mediterranean regional data related to the 10 Arabic countries that participated in the survey were selected for analysis in this study. A total of 12,433 participants were included in this analysis. The mean age of the participants was 30.3 (SD, 11.7) years. Descriptive and regression analyses were conducted to examine the associations between physical activity levels and the participants' sociodemographic characteristics, watching TV, screen time, and computer usage. Physical activity levels decreased significantly during the lockdown. Participants' country of origin, gender, and education were associated with physical activity before and during the lockdown (p < 0.050). Older age, watching TV, and using computers had a negative effect on physical activity before and during the lockdown (p < 0.050). Strategies to improve physical activity and minimize sedentary behavior should be implemented, as well as to reduce unhealthy levels of inactive time, especially during times of crisis. Further research on the influence of a lack of physical activity on overall health status, as well as on the COVID-19 disease effect is recommended.

Determinants of Exclusive Breastfeeding and Mixed Feeding Among Mothers of Infants in Dubai and Sharjah, United Arab Emirates

Background

Breastfeeding (BF) is considered the ultimate method of infant feeding for at least the first 6 months of life. Exclusive breastfeeding (EBF) is one of the most effective interventions to improve child survival. The main objective of this study was to assess the prevalence and duration of exclusive breastfeeding and the associated factors among women in Dubai and Sharjah, UAE.

Methods

A cross-sectional study was conducted in four hospitals and four healthcare centers in Dubai and Sharjah between September 2017 and December 2017. Hospitals and centers are governmental and provide maternal and child health services. A convenience sample of 858 Arab and Emirati mothers with children under the age of 2 years participated in the study. Face-to-face interviews were conducted by using structured questionnaires. The study was approved by the University Ethical Committee and the UAE Ministry of Health before data collection. Descriptive statistics were computed to describe all the questionnaire items. The chi-square test was used to compare the study's categorical variables. A binary logistic regression analysis was used to predict the relationship between BF and its associated factors. Statistical tests with P-values < 0.05 were considered statistically significant.

Results

The mean age of the participating mothers was 30.6 (SD 5.5) years. Results showed that the prevalence of exclusive breastfeeding among the study participants was 24.4% (31.1% in Sharjah and 22% in Dubai; P = 0.003). The binary logistic regression reported that mother's and father's education, skin-to-skin period, number of children, mothers' health, and place of living were significantly associated with exclusive breastfeeding (P < 0.05). The results reported a significant association between EB and duration of breastfeeding (OR = 6.9, P = 0.002), husband education (OR = 2.1, P = 0.015), mother education (OR = 1.3, P = 0.027), number of children (OR = 7.9, P = 0.045), having any health problem (OR = 1.2, P = 0.045), and living place (OR = 1.4, P = 0.033), and a non-significant positive effect of family size and family income. Furthermore, the result reported a significant association between mixed breastfeeding and duration of breastfeeding (OR = 0.1, P = 0.000), skin-to-skin period (OR = 0.3, P = 0.002), underweight (OR = 4.7, P = 0.034), last infant's sex (OR = 1.6, P = 0.010), having maid at home (OR = 2.1, P = 0.000), number of children (OR = 0.2, P = 0.013), and living place (OR =1.1, P = 0.014), and a non-significant association with family size and family income.

Conclusions

Therefore, a health promotion program for exclusive breastfeeding during antenatal health visits, together with initiating health policies in maternal hospitals to encourage the initiation of breastfeeding during the first hour of birth and the introduction of skin-to-skin contact during the first 5 min of birth are highly recommended.

Chronic obstructive pulmonary disease patients' quality of life and its related factors: A cross-sectional study of the Jordanian population

Background: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death globally, mostly in low- and middle-income countries. It is estimated that 6.5% of Jordanians under 50 and 37.5% of those over 70 years of age are affected. The country's air pollution levels surpass recommended levels, increasing the disease incidence and burden on individuals and the health system. COPD is a long-term, severe, and exhausting condition. In Jordan, patients are highly dependent and frequent users of the healthcare services; therefore, their Quality of Life (QoL) is highly influenced by the health care they receive. The QoL of COPD patients must be studied to devise interventions that can help patients cope with this disease and for healthcare systems to improve their service.  Method: A cross-sectional correlational study of 200 COPD patients. The Arabic WHO Quality of Life Questionnaire Short Form was used to collect data.   Results: The mean COPD patient QoL score was 10.66 (SD=1.58), showing poor QoL perception. The physical domain had the lowest perceived QoL (10.232, SD=1.912), while the environmental domain had the highest (10.948, SD=1.636). Unmarried, non-smokers, and employed had better QoL (M=11.04, M=10.92, M=12.04). Age categories 50-61 exhibited greater mean QoL than age category 61 or higher (M=11.44, M=10.84, M=10.08). Private health services are characterized by short waiting times, availability of different diagnostic and treatment services, and skilled staff was related to better QoL.  Conclusions: QoL for COPD patients seems to be an area requiring urgent attention from Health service providers and planners. Patients should be adequately supported and cared for to have a good QoL. In Jordan, COPD patients' QoL is highly influenced by lack of physical activity, emotional distress, and anxiety. Therefore, better health care services is needed to address all these areas adequately.

Perceived Occupational Stressors and the General Health of Critical Care Nurses During COVID-19 Pandemic

INTRODUCTION

The COVID-19 situation is placing nurses under great stress which may negatively influence their health.

OBJECTIVE

The purpose of this study was to examine the association between occupational stress and general health of critical care nurses during COVID-19 pandemic.

METHODS

A descriptive, cross-sectional design was used. A convenience sample of 150 Jordanian critical care nurses completed the study.

RESULTS

Occupational stress was a significant predictor of nurses' general health. Female gender, young, living with elderly or persons having chronic diseases, and little nursing experience were associated with worse general health, while living with elderly or persons having chronic diseases were associated with more occupational stress.

CONCLUSION

Providing psychological support services for critical care nurses is required to reduce the impact of occupational stress on nurses' poor general health.