Breastfeeding initiation and duration and acute otitis media among children less than two years of age in Jordan: results from a case-control study.

BACKGROUND: Acute otitis media (AOM) is one of the most common infectious diseases that affects children. Breastfeeding has been linked to a lower risk of AOM in the first three years of childhood. The aim of this study was to identify the association between exclusive breastfeeding and the development of acute otitis media (AOM) and investigate the influence of breastfeeding duration on the presence of AOM. METHODS: In a retrospective case-control study, a sample of 98 children (cases) who were diagnosed with AOM and 98 children (controls) who were not diagnosed with AOM and were younger than two years old were selected from the Jordan University Hospital. Medical records were used to identify children with AOM. For both the case and control groups, the children's mothers completed a self-administered questionnaire about factors linked to the incidence of AOM.The type of feeding and the duration of breastfeeding were assessed using a validated questionnaire. RESULTS: The data indicated that among children who developed AOM, 23.5%were artificiallyfed, while 22.4% and 13.3% were exclusively breastfed for 3 months and 6 months, respectively. Approximately 70.7% of the children without AOM were exclusively breastfed for 6 months, compared with only 29.3% of the children without AOM who were exclusively breastfed for 3 months.Logistic regression revealed that nonexclusive breastfeeding, exclusive breastfeeding for 3 months, and exclusive breastfeeding for 6 months were protective factors against AOM (OR = 0.23, 0.18, and 0.25, respectively; P < 0.05). A short duration of exclusive breastfeeding was considered a risk factor for the development of AOM (OR = 1.7, P < 0.05). CONCLUSIONS: The escalation of AOM is tightly connected to the early introduction of formula feeding in the first six months of life. Breastfeeding had a protective impact on the occurrence of AOM. Understanding factors that are associated with the occurrence of AOM in children may support the role of public health institutions and primary health care in the prevention and reduction of AOM episodes and the need for national health strategies to promote breastfeeding.

The prevalence of diabetic peripheral neuropathy among diabetic Palestinian refugees in the Nuzha area, Jordan: a cross-sectional study.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most common type of diabetic neuropathy. It accounts for significant morbidity, including lower extremity amputations. There are few studies on the prevalence of DPN among Palestinian refugees in Jordan. This study aimed to determine the prevalence of DPN and its associated factors among Palestinian refugees with diabetes in the Nuzha area of Jordan, using the Michigan Neuropathy Screening Instrument (MNSI). METHODS: A cross-sectional study was conducted at the UNRWA Nuzha Health Centre, Amman, Jordan, during the first quarter of 2016 (Jan 2-Mar 31, 2016). The Nuzha Health Centre was randomly chosen from the UNRWA clinics in Jordan. Study participants were selected by systematic random sampling. The number of participants was decided with Cochran's formula and adjusting the sample size by use of the finite population correction equation. 343 patients with diabetes were assessed for DPN using the history and physical assessment sections of the MNSI. We generated descriptive statistics, and tested for associations between variables using univariate and multivariate logistic regression analysis to identify the best subset of predictors for the presence of DPN. We used SPSS version 22 to input and analyse data. This study was approved by the UNRWA Jordan Field Office and the Institutional Review Board at the University of Jordan, and by the Michigan Diabetes Research Centre, which gave its permission to use the MNSI. Written informed consent was obtained from each participant. FINDINGS: Prevalence of DPN was 11% (37 of 343) based on the history section and 36% (122 of 343) based on the physical assessment section of the MNSI. Multivariate logistic regression revealed that significant predictors for DPN based on the history section of the MNSI were education level and duration of diabetes. Compared with participants with no education, the odds ratio (OR) for DPN was 0·13 (95% CI 0·04-0·49, p=0·0023) for participants with elementary education, 0·11 (0·03-0·49, p=0·0035) for those with high school education, and 0·04 (0·01-0·41, p=0·0070) for those with a diploma. Compared with participants who had diabetes for less than 10 years, the OR for DPN was 7·69 (1·99-30·30, p=0·0031) for those who had diabetes for 10-19 years and 32·26 (6·76-142·86, p<0·0001) for those who had diabetes for 20 years or longer. However, the predictors for DPN based on the physical assessment part of MNSI were age, duration of diabetes, and type of treatment for diabetes. Compared with participants aged 70 years or older, the OR for DPN was 0·18 (0·04-0·89, p=0·036) for those aged 40-49 years and 0·22 (0·06-0·82, p=0·024) for those aged 50-59 years. Compared with participants who had diabetes for less than 10 years, the OR for DPN was 32·26 (13·70-76·92, p<0·0001) for those who had diabetes for 10-19 years and 200 (34·48-1000, p<0·0001) for those who had diabetes for 20 years or longer. The OR for DPN was 0·23 (0·08-0·70, p=0·0094) for participants who were treated with oral hypoglycemic agents alone, compared those who were treated with insulin and oral hypoglycaemic agents. INTERPRETATION: The prevalence of DPN is high among Palestinian refugees with diabetes in the Nuzha area, Jordan, consistent with the results of other studies of DPN in individuals with diabetes. There is a need for early detection and regular screening for DPN in patients with diabetes, with special attention given to patients with risk factors for DPN. FUNDING: None.

Regional lessons from the COVID-19 outbreak in the Middle East: From infectious diseases to climate change adaptation.

Global health threats including epidemics and climate change, know no political borders and require regional collaboration if they are to be dealt with effectively. This paper starts with a review of the COVID-19 outbreak in Israel, Palestine and Jordan, in the context of the regional health systems, demography and politics. We suggest that Israel and Palestine function as one epidemiological unit, due to extensive border crossing of inhabitants and tourists, resulting in cross-border infections and potential for outbreaks' transmission. Indeed, there is a correlation between the numbers of confirmed cases with a 2-3 weeks lag. In contrast, Jordan has the ability to seal its borders and better contain the spread of the virus. We then discuss comparative public health aspects in relation to the management of COVID-19 and long term adaptation to climate change. We suggest that lessons from the current crisis can inform regional adaptation to climate change. There is an urgent need for better health surveillance, data sharing across borders, and more resilient health systems that are prepared and equipped for emergencies. Another essential and currently missing prerequisite is close cooperation within and across countries amidst political conflict, in order to protect the public health of all inhabitants of the region.

Navigational aid use by individuals with visual impairments.

Navigation is a multifaceted task, which requires using a combination of strategies and cues from the environment. Navigation can be particularly challenging for individuals with impaired vision, because many informative cues are visual. As mobile computing technology rapidly advances, the range of potential approaches to assist visually impaired people with navigation is also broadening. For computer-based navigational aids, the way in which information is gathered, processed, and presented is key to success and represents a vast space of potential approaches. In an effort to improve understanding and provide guidance on this issue, we present the results of a phone survey about navigational aids from a sample of individuals with impaired vision. The survey assessed the usefulness of existing navigational aids (both low-tech and high-tech) for different aspects of navigation. With an emphasis on indoor wayfinding (orienting oneself and following a route in a building), we also collected responses about specific targets the survey participants search for while navigating, and strategies they commonly use. Our results indicate that indoor wayfinding is a relatively under-supported task during navigation despite rapid advances in technology. These results also provide insights for creating navigational aids that are designed more specifically for the current challenges individuals with impaired vision may experience during this task.

Different periods of forced abstinence after instrumental learning for food reward of different macronutrient value on responding for conditioned cues and AMPAr subunit levels.

Food craving can be viewed as an intense desire for a specific food that propagates seeking and consuming behavior. Prolonged forced abstinence from rewarding foods can result in escalated food-seeking behavior as measured via elevated responding for food-paired cues in the absence of the primary reward. Palatable food consumption and food-seeking is associated with changes in the abundance and composition of AMPA receptors in the nucleus accumbens (NAc) but differing results have been reported. The present study examined whether different food types could produce escalated food-seeking behavior after various abstinence periods and whether this was associated with changes in AMPA receptor protein levels. Rats were trained for 10 days to bar press for purified, sucrose, or chocolate-flavored sucrose pellets. Rats were tested at 24 hrs, 7 d or 14 d whereby bar pressing resulted in presentation of cues paired with food but no food reward was delivered. Western blotting was used to determine protein levels of GluR1, GluR1pSer845, and GluR2 in the NAc. Three separate groups were assessed: 1) a group that was trained on the operant task and tested for conditioned responding (tested group); 2) a group that was trained on the operant task but not tested (non-tested group); 3) a group that was neither trained nor tested (control). The purified food group showed a time-dependent elevation in conditioned bar pressing over the 3 abstinence periods. GluR1 AMPAr subunit levels were higher in the purified and sucrose groups tested at 24 hours compared to the non-tested and control values. GluR1 levels subsequently declined at the 7- and 14-day abstinence periods in the purified and sucrose tested and non-tested groups compared to control values. GluR2 and pSer845 Glur1 levels were similar across all groups and abstinence periods. These results show that food-seeking behavior associated with forced abstinence from different food rewards may depend on the macronutrient composition of the food reward or the food type given during the abstinence period. A clear link with AMPAr subunit levels in this model was not established.

IGLIAS: A new experimental set-up for low temperature irradiation studies at large irradiation facilities.

We designed and built a mobile experimental set-up for studying the interaction of ion beams with solid samples in a wide temperature range from 9 to 300 K. It is either possible to mount up to three samples prepared ex situ or to prepare samples by condensation of molecules from gases or vapours onto IR or Visible-ultraviolet (Vis-UV) transparent windows. The physico-chemical evolution during irradiation can be followed in situ with different analysis techniques including Fourier transform infrared spectroscopy, Vis-UV, and quadrupole mass spectrometry.

Media use for seeking health/cancer-related information: findings from knowledge, attitudes and practices towards cancer prevention and care survey in Jordan.

Understanding of public health/cancer information-seeking behaviour could play key role in promoting health behaviour and reducing cancer burden. In the current study, data from 'Knowledge, Attitudes and Practices toward Cancer Prevention and Care Survey in Jordan' were used. A total of 3196 participants (18 years and older) were included in the study. The results indicated that 82% (n = 2609) of the participants had never looked for health/cancer information from any sources. The majority of those surveyed (97%) reported watching TV habitually, whereby 948 participants (26%) indicated that they watched health information on the local/satellite TV channels, whereas 1603 (45%) reported doing so on non-local/satellite TV channels. Internet was the most searched source for information (36%); however, it is one of least preferred sources. Health-care providers are the most preferred source for cancer-related information, followed by TV and someone with cancer. The majority of participants (82%; n = 489) indicated the absence of barriers in seeking information about cancer. The results suggest that although the Jordanian public use of different media and channels for seeking health/cancer-related information, health-care providers and TV might be effective tools for health education. In addition, joint efforts must be established to initiate awareness programmes at the local and regional levels.

Online in situ x-ray diffraction setup for structural modification studies during swift heavy ion irradiation.

The high energy density of electronic excitations due to the impact of swift heavy ions can induce structural modifications in materials. We present an x-ray diffractometer called ALIX ("Analyse en Ligne sur IRRSUD par diffraction de rayons X"), which has been set up at the low-energy beamline (IRRadiation SUD - IRRSUD) of the Grand Accélérateur National d'Ions Lourds facility, to allow the study of structural modification kinetics as a function of the ion fluence. The x-ray setup has been modified and optimized to enable irradiation by swift heavy ions simultaneously to x-ray pattern recording. We present the capability of ALIX to perform simultaneous irradiation-diffraction by using energy discrimination between x-rays from diffraction and from ion-target interaction. To illustrate its potential, results of sequential or simultaneous irradiation-diffraction are presented in this article to show radiation effects on the structural properties of ceramics. Phase transition kinetics have been studied during xenon ion irradiation of polycrystalline MgO and SrTiO(3). We have observed that MgO oxide is radiation-resistant to high electronic excitations, contrary to the high sensitivity of SrTiO(3), which exhibits transition from the crystalline to the amorphous state during irradiation. By interpreting the amorphization kinetics of SrTiO(3), defect overlapping models are discussed as well as latent track characteristics. Together with a transmission electron microscopy study, we conclude that a single impact model describes the phase transition mechanism.