Abstract
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.
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.
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.
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.
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.
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).
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.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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.
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),
< 0.01). There was fair agreement (r = 0.46;
< 0.01) and large 95% limits of agreement with significant proportional bias (β = 0.46,
< 0.01) for validity, and minimal agreement for test-retest reliability (K = 0.36;
< 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.
Abstract
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.
IntroductionAdherence 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 methodsIn 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.ResultsThe 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.ConclusionsPatients 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.
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.
•We investigated the activity concentrations of 210Po in most popular fish species consumed in Arabian Gulf region.•Committed effective dose due to the intake of 210Po from the consumption of fish in Arabian Gulf countries are reported.•The calculated values for dose lie within the reported values in the literature.
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.
To determine the prevalence and the associated factors of toenail onychomycosis among patients with diabetes in Jordan.
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.
The prevalence of toenail onychomycosis was 57.6% (n=216). Multiple logistic regression revealed four significant associated factors; the presence of neuropathy (β=1.87, p=0.02), being an ex-smoker (β=2.69, p=0.01), being treated by both insulin and oral hypoglycemics drugs (β=1.32, p=0.03), and using antibiotics in the last year (β=1.78, p=0.02).
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.