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.

Prevalence and Associated Factors of Toenail Onychomycosis Among Patients with Diabetes in Jordan.

BACKGROUND: Toenail onychomycosis is common in patients with diabetes and it can increase the risk of secondary infections and foot complications. Despite several studies investigating the prevalence and associated factors of toenail onychomycosis from different parts of the world, there are no data from Jordan. OBJECTIVE: To determine the prevalence and the associated factors of toenail onychomycosis among patients with diabetes in Jordan. METHODS: A cross-sectional study was conducted on 375 patients with diabetes at the National Centre for Diabetes, Endocrinology, and Genetics in Amman, Jordan. Several socio-demographic and health-independent variables including foot self-care practices were collected. Toenail onychomycosis was assessed by a specimen culture and microscopic examinations. Descriptive and inferential statistics were used for data analysis. RESULTS: The prevalence of toenail onychomycosis was 57.6% (n=216). Multiple logistic regression revealed four significant associated factors; the presence of neuropathy (ß=1.87, p=0.02), being an ex-smoker (ß=2.69, p=0.01), being treated by both insulin and oral hypoglycemics drugs (ß=1.32, p=0.03), and using antibiotics in the last year (ß=1.78, p=0.02). CONCLUSION: The prevalence of toenail onychomycosis among patients with diabetes in Jordan is high. Regular foot screening and podiatric care are recommended especially among patients with diabetic neuropathy, current treatment by insulin and oral hypoglycemics drugs, previous history of smoking, and previous use of antibiotics.

Factors Associated With Foot Self-Care in Patients With Diabetes-Related High-Risk Feet: A Cross-Sectional Design.

Foot self-care has been commonly studied among people with diabetes. Previous research on foot self-care among those with diabetes-related high-risk feet is almost unavailable or very limited. The current study aims to fill this gap and provide a contemporary unprecedented analysis of this area of specialization. To assess the levels of, and factors associated with foot self-care among people with diabetes-related high-risk feet. A multi-center cross-sectional study from Jordan assessed the foot self-care of 107 participants with diabetes-related high-risk feet. Multiple socio-demographic, physiological, and psychosocial factors were collected, and the Arabic version of the diabetes foot self-care behavior scale was used to estimate the foot self-care of the study population. A multiple linear regression model was employed to identify factors associated with foot self-care. The mean score of foot self-care was 25.4 ± 7.1 (35 is the highest) indicating ~73% of adherence to foot self-care. Factors associated with higher foot self-care were being treated at the King Abdullah University Hospital (ß = .30, P < .01) and reporting higher scores of patients' interpretations about neuropathy physical causes of foot ulcers (ß = ".22," P = .02). People with diabetes-related high-risk feet reported a relatively adequate foot self-care practice. However, clinicians are still required to enhance foot self-care among this population. Health promotion programs may benefit from engaging people in understanding the pathophysiology of diabetes-related foot ulcers to improve foot self-care practices.

A qualitative exploration of adherence to wearing removable cast walkers in patients with diabetic foot ulcers.

OBJECTIVE: To explore adherence to wearing removable cast walkers (RCWs) among patients with diabetic foot ulcers (DFUs). METHOD: A qualitative study was conducted by interviewing patients with active DFUs and using knee-high RCWs as their offloading treatment. The interviews were undertaken at two diabetic foot clinics in Jordan, using a semi-structured guide. Data were analysed through content analysis by developing main themes and categories. RESULTS: Following interviews with 10 patients, two main key themes with a total of six categories were identified: theme 1-reporting of adherence levels was inconsistent, included two categories: i) a belief in achieving optimal adherence, and ii) non-adherence was often reported indoors; and theme 2-adherence was a consequence of multiple psychosocial, physiological and environmental factors, which included four categories: i) specific offloading knowledge or beliefs influenced adherence; ii) severity of foot disease influenced adherence; iii) social support benefitted adherence; and iv) physical features of RCWs (the usability of the offloading device) impacted adherence. CONCLUSION: Patients with active DFUs reported inconsistent levels of adherence to wearing RCWs which, after deeper investigation, seemed to be due to participants' misperceptions of the optimal adherence. Adherence to wearing RCWs also seemed to be impacted by multiple psychosocial, physiological and environmental factors.

The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers.

Adherence to using offloading treatment is crucial to healing diabetes-related foot ulcers (DFUs). Offloading adherence is recommended to be measured using objective monitors. However, self-reported adherence is commonly used and has unknown validity and reliability. This study aimed to assess the validity and reliability of self-reported adherence to using removable cast walker (RCW) offloading treatment among people with DFUs. Fifty-three participants with DFUs using RCWs were included. Each participant self-reported their percentage adherence to using their RCW of total daily steps. Participants also had adherence objectively measured using dual activity monitors. After one week, a subset of 19 participants again self-reported their percentage adherence to investigate test-retest reliability. Validity was tested using Pearson's r and Bland-Altman tests, and reliability using Cohen's kappa. Median (IQR) self-reported adherence was greater than objectively measured adherence (90% (60-100) vs. 35% (19-47), p < 0.01). There was fair agreement (r = 0.46; p < 0.01) and large 95% limits of agreement with significant proportional bias (ß = 0.46, p < 0.01) for validity, and minimal agreement for test-retest reliability (K = 0.36; p < 0.01). The validity and reliability of self-reported offloading adherence in people with DFU are fair at best. People with DFU significantly overestimate their offloading adherence. Clinicians and researchers should instead use objective adherence measures.

Factors Associated With Self-Efficacy of Foot Self-Care Among Patients With Diabetes Attending a Tertiary Care Center in Saudi Arabia.

Several reports have shown self-efficacy to be a reliable way of predicting foot self-care behavior in patients with diabetes. However, at a global level in general, and in Saudi Arabia in particular, investigation of the factors related to self-efficacy in executing foot self-care continues to remain inadequate. This study endeavors to identify the factors associated with the self-efficacy of foot self-care among patients with diabetes in Saudi Arabia. From a tertiary diabetes care center in Saudi Arabia, 175 patients with diabetes were selected to participate in this cross-sectional study. Employing the Arabic version of the Foot Care Confidence Scale (FCCS), the principal end results and the sociodemographic, clinical, and psychosocial independent variables were collected and assessed. From the total reported FCCS score, the mean was found to be 28.1 ± 8.2. Multiple linear regression analysis indicated 2 independent factors were positively associated with a higher reported FCCS score; being middle-aged (< 60 years old) (ß=0.31, P< .01) and having a higher score on the Foot Care Outcome Expectations Scale (FCOES) (ß=0.36, P< .01). In conclusion, patients with diabetes in Saudi Arabia have a mild level of self-efficacy to perform the needed foot self-care. Therefore, this has turned the spotlight on the young or middle-aged < 60-year-old Saudi population with diabetes as the target group, making them the priority for future self-efficacy promotion programs to upgrade the level of foot self-care.

Differences in adherence to using removable cast walker treatment during daytime and nighttime weight-bearing activities in people with diabetes-related foot ulcers.

Aims: Patients' adherence to using knee-high offloading treatment is critical to effective healing of diabetes-related foot ulcers (DFUs). Previous studies have found that patients generally have low adherence to using removable knee-high offloading treatments, yet no study has investigated whether their adherence differs during daytime and nighttime. This study aimed to investigate the levels and factors associated with adherence to using knee-high removable cast walker (RCW) treatment during daytime and nighttime weight-bearing activities in people with DFUs. Methods: This was a secondary analysis of data collected from a multi-centre cross-sectional study investigating adherence to using knee-high RCWs among 57 participants with DFUs. All participants had multiple socio-demographic, physiological and psychosocial factors collected, before having their adherence to using RCWs during weight-bearing activity monitored over a 1-week period using the dual activity monitor method. Adherence data were categorised into daytime (06:00-18:00) and nighttime (18:00-06:00) periods and calculated separately. Multiple linear regression was used to identify factors associated with daytime and nighttime adherence. Results: Mean adherence to using RCW during weight-bearing activities in people with DFUs was higher during daytime compared with nighttime [39.9% (SD = 18.9) versus 20.4% (SD = 16.7), p < 0.001]. Factors independently associated with lower adherence during daytime were being male, longer diabetes duration, not having peripheral artery disease (PAD), and higher perceived RCW heaviness. Factors associated with lower adherence during nighttime were higher mean daytime steps, not having retinopathy and having dyslipidaemia. Conclusions: Adherence to using RCWs during weight-bearing activities reduced significantly at nighttime compared with daytime among people with DFUs, and this was associated with different factors. Interventions to improve adherence, in research and clinical practice, should incorporate methods to target daytime or nighttime adherence specifically.

Cross-Cultural Adaptation and Reliability Testing of Arabic Versions of Several Diabetic Foot Psychosocial Scales.

The main aims of this study were cross-cultural adaptation and reliability testing of an Arabic version of Foot Care Confidence Scale (FCCS), Foot Care Outcomes Expectations Scale (FCOES), Patient Interpretation of Neuropathy Scales (PINS), Neuropathy-specific Quality of Life Scales (NQOLS), and offloading-related Visual Analog Scales (VAS). Two phases of translation and reliability testing were conducted in Jordan. Phase 1 included 2 forward and backward translations with 2 panel consensuses (translators, clinicians, and experts). In Phase 2, Cronbach's alpha (α) and intraclass correlation coefficient (ICC) were used to test the internal consistency and stability (test-retest) of the Arabic scales in a sample of a total of 90 Jordanian participants with diabetic foot ulcers. Phase 1 resulted in Arabic translation and cross-cultural adaptation of the study scales. Phase 2 resulted in acceptable internal consistency of the translated scales (α = 0.74-0.91), except for the PIN "self/practitioner blame" and "acute ulcer onset" scales (α = 0.57, 0.49, respectively). Test-retest results (ICC) were: FCCS (0.85); FCOES (0.78); PINS (0.043-0.85); NQOLS (0.76-0.90); and offloading-related VAS (0.43-0.90). This study showed evidence of cultural appropriateness and reliability of most of the translated scales, for possible future implementation for the Arabic population.

Factors associated with adherence to using removable cast walker treatment among patients with diabetes-related foot ulcers.

INTRODUCTION: Adherence to using knee-high offloading treatment is critical for healing diabetes-related foot ulcers (DFUs). However, few studies have investigated patients' adherence to using knee-high offloading treatment. We aimed to investigate the levels and factors associated with adherence to using knee-high removable cast walker (RCW) treatment among patients with DFUs. RESEARCH DESIGN AND METHODS: In this multicenter cross-sectional study, we investigated adherence to using knee-high RCWs in 57 participants with DFUs. All participants were clinically examined for multiple sociodemographic, physiological, and psychosocial factors. Each participant's adherence level to using RCWs was then objectively measured using dual activity monitors (attached to the wrist and RCW) over a 1-week period. Multiple linear regression was undertaken to determine those factors independently associated with adherence levels. RESULTS: The mean adherence level to using RCWs was 33.6% (SD 16.5) of weight-bearing activity. Factors independently associated with lower adherence levels were being male, longer diabetes duration, not having peripheral artery disease (PAD), and having higher perceived RCW heaviness (p≤0.05). No associations were found with psychosocial factors. CONCLUSIONS: Patients with DFUs adhered to using their RCWs on average for only a third of their prescribed weight-bearing treatment duration. Factors linked to lower RCW adherence levels were being male, longer diabetes duration, not having PAD, and perceived heavier RCWs. These findings highlight the importance of using gold standard non-removable knee-high offloading device treatment. Furthermore, these findings suggest, when gold standard devices are containdicated, that these factors be considered when prescribing the second choice RCW offloading treatment to optimise adherence. Regardless, further longitudinal studies are needed to confirm these factors.

ESTIMATION OF THE ORGAN AND EFFECTIVE DOSE TO PATIENTS UNDERGOING MEDICAL DIAGNOSTIC X-RAY EXAMINATIONS IN SAUDI ARABIA.

Quantifying the radiological risk from diagnostic radiography is essential for patients' safety. Effective dose is considered the best quantity to determine the stochastic risk associated with the radiological examinations. Therefore, the present work investigated organ and effective dose for adult patients in the most common type of X-ray examinations, such as the chest (PA/LAT), abdomen (AP) and lumbar spine (AP/LAT) projections. The PCXMC version 2 Monte Carlo program was used to estimate the organ and effective dose for 547 patients who underwent a radiographic examination at the King Abdulaziz Hospital, Saudi Arabia. The results showed wide variation in organ doses. The largest organ dose in each X-ray examination were 2.72 mGy for the spleen in the lumbar spine (LAT), 1.98 mGy for the urinary bladder in the lumbar spine (AP), 0.40 mGy for the spleen in the chest (PA), 0.11 mGy for the kidney in the chest (LAT) and 1.78 mGy for the testicles in the abdomen (AP) examinations. Values for the effective dose were estimated for each investigated X-ray examination, and the results were compared with the published values available in the literature. The obtained values for effective dose were relatively lower than those reported by the European Commission and the United Nations Scientific Committee on the Effects of Atomic Radiation for the same examinations. The results presented here will help establish a database that will be useful for future comparisons and monitoring in radiographic procedures.

MEASUREMENT OF THE ACTIVITY CONCENTRATIONS OF GAMMA EMITTING RADIONUCLIDES IN TOOTHPASTE SAMPLES AND ASSESSMENT OF THE CORRESPONDING ANNUAL EFFECTIVE DOSES.

It is inevitable that we are exposed to radiation daily from various sources and products that we consume on daily basis. The use of toothpaste for oral hygiene is one of the most common daily practices by humans and yet very little data are available regarding its radiation content. In this work, we investigated the concentrations of gamma emitting radionuclides in toothpaste samples consumed in Jordan. 40K and 226Ra were detected in almost one-third of the samples, whereas 228Ra was detected in nearly half of them. The corresponding activity concentrations in the detected samples were in the ranges of 68.7-154.2, 4.6-14.1 and 1.3-10.0 Bq/kg, respectively. Dose assessment of accidental ingestion of toothpaste for children and adults was made, and its contribution to the annual effective dose was found to be very minimal with maximum doses of ~2.9 and 1.3 µSv for children and adults, respectively.

ASSESSMENT OF THE RADIOACTIVITY OF GAMMA EMITTERS IN BABY FORMULA FOR DIFFERENT AGE GROUPS AND BABY CEREAL CONSUMED IN JORDAN.

In the present work, different brands of baby formula and cereal consumed in Jordan were analyzed for their radioactivity content. The activity concentrations of 40K varied with the designated age group in formula with the average concentrations being (in Bq/kg): 160.2 ± 33.5, 219.0 ± 35.0 and 265.2 ± 56.3 for the age groups of 0-6 months, 6-12 months and 1-3 years, respectively. 226Ra was not detected in any of the samples, while 232Th was detected in nearly half the samples with concentrations ranging from 0.22 to 0.82 Bq/kg. 137Cs was detected in only two samples with concentrations of 0.94 and 3.15 Bq/kg. The concentrations of 40K and 232Th in cereal were in the ranges of 23-294 and 0.49-1.48 Bq/kg, respectively. The resulting committed dose was assessed and found in the range of 154-613 µSv, with insignificant contribution from 137Cs, which is within the worldwide range but generally higher than the worldwide average of 290 µSv.

Assessment of Patient Radiation Dose during Conventional Diagnostic X-ray Examinations in Three Public Hospitals in Northern Jordan using TLDs.

This study aims to measure entrance surface doses during routine chest and abdomen x-ray examinations of adult and child patients. Radiation dose measurements were performed using thermoluminescent dosimeters TLD-100s in three major public hospitals in northern Jordan on a total of 100 patients. Wide variations in entrance surface doses were observed within and between hospitals, which might be attributed to significant variations of the selected exposure parameters. For adult patients, the results have shown that the majority of entrance surface dose values from both chest and abdomen examinations were within recommended values of diagnostic reference levels. For child patients, the mean entrance surface dose from chest examinations in three age groups were 0.131 mGy (0-1 y), 0.136 mGy (1-5 y), and 0.191 mGy (5-10 y). These values were considered relatively high compared to the European reference levels and published results in the literature. However, for abdomen examinations, entrance surface dose values were relatively lower than European reference levels. Patient effective doses were estimated using a PCXMC 2.0 Monte Carlo program. The results for both adults and children were found to be relatively lower than the values reported by international publications. Due to the wide variations of entrance surface dose and the higher radiation doses delivered to child patients, this study recommends implementing a quality assurance program in such hospitals to achieve optimization between good image quality and minimum dose according to the as low as reasonably achievable principle. Moreover, the results of this work will provide a useful base for establishing local diagnostic reference levels for chest and abdomen examinations in Jordan.

Prevalence and Associates of Foot Deformities among Patients with Diabetes in Jordan.

OBJECTIVES: To determine the prevalence of, and factors associated with, people with foot deformities, among patients with diabetes in Jordan. METHODS: A cross-sectional study was conducted on 1000 diabetic participants recruited from the National Center for Diabetes, Endocrinology, and Genetics in Jordan. Participants had their feet clinically examined to detect the following foot deformity outcomes: Hallux valgus, claw/hammer toe, prominent metatarsal heads, limited joint mobility, pes cavus, Charcot foot, and amputations. Sociodemographic and health variables were also collected from participants' interviews, medical records, or clinical examination. Logistic regression was used to analyse associations between variables and each foot deformity outcome. RESULTS: Of the 1000 diabetic patients: Hallux valgus was found in 17.4%, claw\hammer toe in 16%, prominent metatarsal head in 14.2%, limited joint mobility in 9.4%, pes cavus in 3.2%, Charcot foot in 2.1%, and amputations in 1.7%. Hallux valgus was associated with gender (p=0.012), age (p<0.01) and shoe choices (p=0.031); claw\hammer toe was associated with age (p=0.04), retinopathy (p<0.001), sensory and painful neuropathy (p<0.001); limited joint mobility was associated with age only (p=0.001); Charcot foot was associated with glycemic control (p=0.016), hypertension (p<0.000), sensory neuropathy (p<0.001), and painful neuropathy (p<0.001); and, amputations were associated with duration of diabetes (p<0.043), sensory neuropathy (p=0.001), and painful neuropathy (p=0.001). CONCLUSION: Prevalence of different foot deformities in Jordan variedbetween 1.7% - 17.4%. Sociodemographic factors such as age, gender and shoes choices or presence of diabetes-related microvascular complications (neuropathy and retinopathy) or hypertension were independently associated with foot deformities among the Jordanian diabetic population.

Assessment of the committed effective dose due to the 210Po intake from fish consumption for the Arabian Gulf population.

This study aims to assess the committed effective dose due to the intake of 210Po from the consumption of fish in Arabian Gulf countries. Twenty different kinds of fish, which represent the most common fish species consumed in the Arabian Gulf countries, were analyzed using alpha spectrometer technique. 210Po activity concentrations in fish samples were found to vary over a wide range from 0.1 to 14.7 Bq kg-1 fresh weight. This variation of 210Po concentrations between various type of fish samples might be attributed to the feeding type pattern and the size of fish. The annual committed effective dose due to ingestion of 210Po in fish species for adults in the Arabian Gulf countries was estimated and found to vary from 38 µSv in Bahrain to 85 µSv in Oman with an average value of 59 µSv. These values are considered relatively high compared to those reported in some other regions. However, it is still much lower than the world average ingestion dose due to natural radiation sources.

A STUDY OF THE RADIOACTIVITY IN THE DUST STORM EVENT OF APRIL 2015 IN ARABIAN PENINSULA.

Gulf countries are often affected by dust storms which have a significant influence on the environment and public health. The present work examines the radioactivity content in the intense dust storm occurred over Gulf countries on 1 April 2015. The results showed that the average value of 137Cs in dust samples (±SD) is 14.4 ± 1.6 Bq/kg, which is almost two orders of magnitude larger than those in soil samples. 7Be was detected with a considerable amount only in dust samples. The activity concentrations of the natural radionuclides (234,238U, 228,230,232Th, 226,228Ra and 40K) in dust samples were found to be approximately two to three times higher than the corresponding values in soil samples, which is attributed to the abundance of the finest particle size in the dust samples. Also, the activity ratios and the correlations between the detected radionuclides were investigated to assess the origin and activities associated with any variation of the radionuclides in the environment. Moreover, the total annual effective dose due to ingestion of dust was estimated to be 89.7 and 34.9 nSv for infants and adults, respectively, which is well below the world average internal dose of 290 µSv. The main contributor to the annual effective dose was 228Ra, which contributes ~69.6 and 43.3% for infants and adults, respectively, followed by: 226Ra ¼ 232,230,228Th > 234,238U > 40k, 137Cs ¼ 7Be.

Radiological assessment of water treatment processes in a water treatment plant in Saudi Arabia: Water and sludge radium content, radon air concentrations and dose rates.

There is an increase demand for clean water sources in Saudi Arabia and, yet, renewable water resources are very limited. This has forced the authorities to explore deep groundwater which is known to contain large concentrations of radionuclides, mainly radium isotopes. Lately, there has been an increase in the number of water treatment plants (WTPs) around the country. In this study, a radiological assessment of a WTP in Saudi Arabia was performed. Raw water was found to have total radium activity of 0.23Bq/L, which exceeds the international limit of 0.185Bq/L (5pCi/L). The WTP investigated uses three stages of treatment: flocculation/sedimentation, sand filtration and reverse osmosis. The radium removal efficiency was evaluated for each stage and the respective values were 33%, 22% and 98%. Moreover, the activity of radium in the solid waste generated from the WTP in the sedimentation and sand filtrations stages were measured and found to be 4490 and 6750Bq/kg, respectively, which exceed the national limit of 1000Bq/kg for radioactive waste. A radiological assessment of the air inside the WTP was also performed by measuring the radon concentrations and dose rates and were found in the ranges of 2-18Bq/m(3) and 70-1000nSv/h, respectively. The annual effective dose was calculated and the average values was found to be 0.3mSv which is below the 1mSv limit.

Activity Concentrations and Dose Assessment of Gamma Emitting Radionuclides in Canned Tuna and Sardines Produced after the Fukushima Nuclear Accident.

The aim of the present work was to investigate the radioactivity concentrations of gamma emitting radionuclides in canned tuna and sardines that were produced after the Fukushima nuclear accident and to assess the resulting radiation doses to the public. Fifty-eight brands of canned tuna and sardines consumed in the Middle East and produced from different parts of the world were analyzed using a germanium detector. Cesium-137 (137Cs) was not detected above the minimum detectable activity in any of the samples. Natural radionuclides 40K, 226Ra and 228Ra were detected with wide activity concentration ranges and with average values of (in Bq kg(-1) wet weight): 68 ± 36, 0.31 ± 0.45, 0.34 ± 0.25, respectively, in tuna samples and with averages of 129 ± 67, 0.20 ± 0.33, 0.60 ± 0.31 in sardine samples. The results of the activity concentrations of 40K and 226Ra showed some regional dependence. Tuna samples produced in Europe have almost twice the concentration of 40K and half the concentration of 226Ra as compared to samples produced in either East or South Asia and North America. Moreover, sardine samples produced in North Africa and Europe have almost twice the concentrations of 40K and 226Ra as those produced in East or South Asia and North America. Dose assessment due to ingestion of canned seafood was also performed, and the committed effective dose was found to be well within the worldwide average.

The radioactivity of seasonal dust storms in the Middle East: the May 2012 case study in Jordan.

Dust storms in the Middle East are common during spring. Some of these storms are massive and carry a large amount of dust from faraway regions, which pose health and pollution risks. The huge dust storm event occurred in early May, 2012 was investigated for its radioactive content using gamma ray spectroscopy. Dust samples were collected from Northern Jordan and it was found that the storm carried a large amount of both artificial and natural radioactivity. The average activity concentration of fallout (137)Cs was 17.0 Bq/kg which is larger than that found in soil (2.3 Bq/kg), and this enrichment is attributed to particle size effects. (7)Be which is of atmospheric origin and has a relatively short half-life, was detected in dust with relatively large activity concentrations, as it would be expected, with an average of 2860 Bq/kg, but it was not detected in soil. Despite the large activity concentration of (7)Be, dose assessment showed that it does not contribute significantly to the effective dose through inhalation. The concentrations of the primodial nuclides (40)K, (232)Th and (238)U were 547, 30.0 and 49.3 Bq/kg, respectively. With the exception of (40)K, these were comparable to what was found in soil.

Isometric elbow extensors strength in supine- and prone-lying positions.

The purpose of this study was to compare isometric strength of elbow extensors measured in supine- and prone-lying positions at elbow flexion angles of 45 and 90 degrees. Twenty-two male subjects under single-blind procedures participated in the study. Each subject participated in both supine-lying and prone-lying measuring protocols. Calibrated cable tensiometer was used to measure isometric strength of the right elbow extensors and a biofeedback electromyography was used to assure no substitution movements from shoulder girdle muscles. The mean values of isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees were 11.1  ±  4.2 kg and 13.1  ±  4.6 kg, while those measured from prone-lying position were 9.9  ±  3.6 kg and 12  ±  4.2 kg, respectively. There is statistical significant difference between the isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees compared to that measured from prone-lying position (p  <  0.05). The results suggest that in manual muscle testing starting position can affect the isometric strength of elbow extensors since supine-lying starting position is better than prone-lying starting position.