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OBJECTIVES: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic systemic disease that leads to neurological, immunological, autonomic, and energy metabolism dysfunction. COVID-19 has been reported to cause similar symptoms to ME/CFS. The study aims to investigate the prevalence of myalgic encephalomyelitis in patients post-COVID-19 infection by assessing acute and long-term COVID-19 symptoms. METHODS: A cross-sectional questionnaire was developed based on the ME/CFS diagnostic criteria, as specified by the IOM clinical diagnostic criteria, and administered to participants with confirmed COVID-19 who are more than 18 years old and have BMI below 40 Kg/m2. Data from 437 participants were completed. RESULTS: The current study results revealed that 8.1% of the study participants met the ME/CFS diagnostic criteria. Interestingly, 2.8 of the study participants were classified to have COVID-19 related to ME/CFS. While 4.6% of participants were determined to have disease-related fatigue, 0.7% of participants showed ME/CFS that was not related to COVID-19, and 3.7% of participants were considered to have long COVID-19. Almost one-fourth of the study participants had a family history of ME/CFS. The current study demonstrated that the prevalence of ME/CFS is similar to slightly higher than reported in the literature. CONCLUSION: The presence of a relationship between ME/CFS and COVID-19 has been supported by the results of our study. Follow-up of COVID-19 patients is strongly recommended to ensure proper management of ME/CFS symptoms.

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OBJECTIVE: This study aimed to (1) investigate the expectations and preferences of PharmD students and practitioners regarding their role in the health care system, and (2) to contrast those expectations and preferences of PharmD practitioners with real-life practice in Jordan. METHODS: Two cross-sectional descriptive questionnaires were used to collect data from PharmD students and PharmD practitioners in Jordan. A total number of 330 students and 280 practitioners were interviewed. The responses to all questions were encoded, entered, and summarized as frequencies and percentages or as means and standard deviations. Comparisons between groups were performed using Chi-square test. A p-value of < 0.05 was considered significant. RESULTS: Both PharmD students and practitioners chose working as a clinical pharmacist in a hospital as their first-choice job. However, their second and third jobs choices were significantly different as practitioners opted for income as a main criterion for job selection. Interestingly, salary expectations by PharmD students were significantly higher than the reality as reported by PharmD practitioners. Both students and practitioners placed the work environment as the highest priority criterion for making a work choice on the work environment. In general, both students and practitioners agree on the ideal roles of PharmD graduate with the issues of prescribing and compounding responsibilities being the ones with the highest disparity between practitioners and students. Significant differences were found between the student's and practitioner's perceptions of the ideal role of a PharmD in and the current professional practice in Jordan. CONCLUSION: Job preferences and salary expectations differ significantly between students and practitioners. Professional orientation of PharmD. students should be implemented to minimize misconceptions of their job nature, availability, and compensations. The fact that students do not prefer to work in a community pharmacy should be addressed by educational institutions and professional organizations. The prescribing and compounding responsibilities of pharmacists should be also emphasized in the curricula of pharmacy schools and worked in by professional organization to achieve optimal implementation in real-life practice.

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Health literacy (HL) is an essential component of public health. Few tools are used to measure HL in Arabic-speaking countries, essentially the Short Test of Functional Health Literacy in Adults and the Single Item Literacy Screener. The new 12-item version of the European Health Literacy Survey Questionnaire (HLS-Q12), has not been validated in the Arabic language. This study aimed to translate the English version of HLS-Q12 into Arabic, test its structure and explain any variance in HLS-Q12 scores, allowing its use in Arabic-speaking healthcare contexts. A forward-backward translation was adopted. Reliability was assessed using Cronbach's α. Confirmatory factor analysis (CFA) and Rasch Model evaluated the model fit of the Arabic version of HLS-12. The effects of different patient-related variables on HLS-Q12 scores were tested using linear regression. A total of 389 patients visiting the site hospital outpatient clinics participated in the study. HLS-Q12 mean ± SD score was 35.8 ± 5.0, 50.9% of the participants showed an intermediate HL score. Good reliability (α = 0.832) was observed. CFA confirmed the scale unidimensionality. Rasch analysis indicated HLS-Q12 items to be within the fit acceptable thresholds except for Item 12. The only item that displayed unordered response categories was Item 4. Most of the items were considered relatively easy by respondents. Linear regression revealed age, education, healthcare-related education and income to have effects significantly different from zero on HLS-Q12 score. Interventions targeting the most health-disparate groups of individuals with characteristics contributing to lower HL, are needed.

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Healthcare professionals are standing against the widespread use of e-cigarettes among the population, especially young adults. E-cigarettes are generally introduced, especially via social media platforms, as a safer alternative to conventional cigarette smoking. The aim of this study was to measure the prevalence of e-cigarette use among healthcare professions students at the University of Jordan, as well as to explore their knowledge and attitudes toward the use of e-cigarettes. An anonymous Google-Form®-based cross-sectional questionnaire was presented to potential participants at the University of Jordan. Students' responses were analyzed using SPSS® 23.0 software. A total of 679 online surveys were completed. About 37.4% of students reported using e-cigarettes at least once in their lifetime and about 20% of students were current e-cigarette users. The multivariate analysis showed that the factors associated with E-cigarette smoking are being male, having mothers, siblings, or friends using e-cigarettes, having easy access to e-cigarettes, and having social media as the main source of knowledge regarding e-cigarettes. The relatively high acceptance level and use of e-cigarettes among health professions students should be an alarming sign to decision-makers to give more attention to legislation that controls tobacco products including e-cigarette selling and advertising.

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The Morisky Green Levine (MGL) adherence scale is a 4-item tool used for the detection of medication nonadherence among patients with chronic health conditions. Despite being widely used in Arabic-speaking research contexts, it has never been validated in Arabic language. The aim of this study was to translate and validate the MGL tool into Arabic. A standard forward-backward process was used to translate the questionnaire. Cronbach's alpha coefficient was measured to assess internal consistency of the scale. The test-retest reliability measured the consistency of participants' responses over time. Construct validity was evaluated by Explanatory factor analysis (EFA); Kaiser-Meyer-Olkin value and Bartlett's test of sphericity were determined. Convergent validity was assessed using a preexisting medications Arabic Adherence Assessment Tool (AAAT). The model fit was evaluated using confirmatory factor analysis (CFA). Associations between the MGL scale scores and the patient demographic/clinical characteristics were tested by linear regressions. A total of 201 participants were included into the study. The MGL scale categorization revealed that 20.9%, 59.2% and 19.9% of the participants had high, moderate and low levels of adherence respectively. Adequate internal consistency (alpha = 0.593) was observed. A significant strong ICC and Pearson's correlations were generated between responses at time 1 and time 2. EFA results elucidated the suitability of the data for factor analysis. Pearson's coefficient (r) revealed a significant strong correlation between MGL scale and AAAT. CFA results confirmed a good fit for the suggested model. Linear regression revealed higher number of medications, more frequent outpatient clinic visits and not experiencing medication adverse effect factors significantly associated with better adherence. The Arabic version of MLG scale is a reliable valid tool to assess adherence among Arabic-speaking communities. Implementing interventions targeting patients not compliant to regular clinic visits and those at higher risk of experiencing medication side effects can greatly enhance medication adherence.

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Stigmatization towards COVID-19 patients can lead to negative outcomes like social exclusion and bullying, and it may hinder the willingness of people to undergo testing. This study aimed to measure and explore the perception of stigmatization and bullying towards COVID-19 patients in Jordan. This was a web-based cross-sectional survey. Participants were recruited from social media platforms employing a snowball convenience sampling. The perception of bullying, beliefs regarding social consequences of infection, views on measures towards violators of patients' privacy, and how to reduce the stigma were assessed by self-reported measures. 397 participants returned completed questionnaires. The majority of respondents believed that COVID-19 patients in Jordan are getting bullied (n = 255, 64.3%) and over 80% believed that people enjoy sharing identities, or news about COVID-19 patients. Although most respondents had adequate knowledge regarding transmission/prevention of COVID-19, they believed that all or some of the COVID-19 patients practiced something wrong to get infected (n = 358, 90.2%). Moreover, 86.9% of respondents reported that people in Jordan were crossing their lines with bullying behaviors towards COVID-19 patients. However, these negative views would not discourage most respondents to get tested and follow the government's instructions if they or any of their acquaintances were suspected to be infected. Our study sheds the light on a high degree of stigma and bullying of COVID-19 patients during the early stage of the pandemic in Jordan. Hence, there is a need to develop and implement effective anti-stigma/anti-bullying campaigns that refute the misperception, raise public knowledge about COVID-19, and spread encouraging messages.

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OBJECTIVES: To assess knowledge, attitude, and beliefs about the right to privacy and confidentiality from the viewpoints of the general public (GP) and the health system (HS) professionals in Jordan. METHODS: An online-based cross-sectional descriptive questionnaire was distributed across Jordan during May & June of 2020. A total number of 388 respondents filled in the online survey assessing their knowledge, attitude, and opinion about the right to privacy and confidentiality being practiced during the professional contact between the patients and their health care providers. RESULTS: Amongst the respondents, 44 (11.3%) participants were health care professionals, and 344 (88.6%) participants were from the general public. Most of the respondents were females (69.6%) and the mean age was about 27 years. The main sources of knowledge about patients' right to privacy and confidentiality regulations were from school and media platforms. Only 18.1% of the GP respondents reported that they have been introduced to patients' right to privacy and confidentiality regulations by medical staff during professional contact. Almost about 97% of GP respondents and 93.2% of HS professionals valued patients' right to assure the level of their data privacy prior to receiving medical care. A significantly (P = .012) higher percentage (93%) of GP respondents believed that there should be no prioritisation of privacy based on the gender of the patient. Most of the GP respondents had concerns about electronic medical records being violated and their data being reached by unauthorised parties. CONCLUSION: The general public and health system professionals in Jordan are familiar with the patients' right to privacy and confidentiality regulations. More efforts must be put in place to inform patients about their rights to privacy and confidentiality practices when they are in professional contact with their healthcare providers. In addition, rules, laws, and legal agreements must be effectively established and monitored to prevent privacy violations.

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BACKGROUND: Examinations are the traditional assessment tools. In addition to measurement of learning, exams are used to guide the improvement of academic programs. The current study attempted to evaluate the quality of assessment items of sixth year clinical clerkships examinations as a function of assessment items format and type/structure and to assess the effect of the number of response choices on the characteristics of MCQs as assessment items. METHODS: A total of 173 assessment items used in the examinations of sixth year clinical clerkships of a PharmD program were included. Items were classified as case based or noncase based and as MCQs or open-ended. The psychometric characteristics of the items were studied as a function of the Bloom's levels addressed, item format, and number of choices in MCQs. RESULTS: Items addressing analysis skills were more difficult. No differences were found between case based and noncase based items in terms of their difficulty, with a slightly better discrimination in the latter. Open-ended items were easier, yet more discriminative. MCQs with higher number of options were easier. Open-ended questions were significantly more discriminative in comparison to MCQs as case based items while they were more discriminative as noncase based items. CONCLUSION: Item formats, structure, and number of options in MCQs significantly affected the psychometric properties of the studied items. Noncase based items and open-ended items were easier and more discriminative than case based items and MCQs, respectively. Examination items should be prepared considering the above characteristics to improve their psychometric properties and maximize their usefulness.

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