Search Results (57)

Background: Antidepressant medications are the cornerstone of depression treatment worldwide, playing a central role in reducing the burden of depressive disorders. Their appropriate use is particularly important in low- and middle-income countries (LMICs), where the prevalence of mental health conditions is high and health systems face increasing demand. Despite the clinical importance of antidepressants, limited evidence exists on how psychiatrists in LMICs prescribe these medications. Jordan, a middle-income country with a growing mental health burden, provides a valuable case study for understanding prescribing patterns and identifying areas for improvement. Objectives: This study examined (1) the knowledge, attitudes, and prescribing practices of Jordanian psychiatrists regarding antidepressant medications, and (2) the perceived challenges hindering optimal prescribing. Methods: A mixed-methods design was employed. Quantitatively, a cross-sectional survey was administered to licensed psychiatrists in Jordan (n = 108; response rate 79.4%). The instrument was adapted from previously published tools on psychotropic prescribing practices and refined using international guidelines and recent reviews on antidepressant use. Qualitatively, semi-structured interviews were conducted with a purposive sample of four psychiatrists to explore systemic, clinical, and contextual barriers to antidepressant prescribing. Survey data were analyzed using descriptive statistics and regression analyses, while interview transcripts were subjected to thematic analysis. Results: Although psychiatrists demonstrated a reasonable understanding of antidepressant pharmacology, important gaps were evident. Only one-third (34.3%) recognized Ministry of Health (MOH) guidelines, while nearly four in ten (37.4%) felt international guidelines did not fully apply to Jordan’s population. Laboratory monitoring for metabolic side effects was inconsistently applied, with just 17.6% always requesting such tests and 11.1% never doing so. Consultation with internal medicine for patients on multiple medications was not routine, reported as “sometimes” by 69.4% of psychiatrists. Attitudes toward prescribing reflected caution, particularly in managing pregnant or lactating women, where only half (51.0%) supported discontinuation and three-quarters (75.9%) preferred dose or drug adjustment. Early-career psychiatrists showed lower engagement, as knowledge and attitude scores were significantly higher among those with 11–20 years of experience compared to those with ≤10 years (p < 0.001). Overall, the findings highlight uneven application of evidence-based practices, reliance on personal clinical judgment, and limited engagement with national standards. Conclusions: Although safety and patient outcomes are valued, systemic, clinician, and patient-related barriers constrain optimal practice. Strengthening national guideline dissemination, ensuring medication access, and supporting continuing professional development could improve prescribing practices in Jordan and similar LMIC contexts. Full article

This study aims to explore and enhance sustainable design practices for improving indoor environmental quality (IEQ) in residential buildings in Jordan, particularly within government institutions. It focuses on integrating design capabilities, core technologies, and human-centered values to develop a context-specific framework for green IEQ management. A mixed-method approach is employed, combining qualitative and quantitative methods. The study includes a comprehensive literature review, expert interviews, and focus group discussions, followed by a structured survey with 100 residential building occupants. Three key pillars—core technologies and competences, business models, and human values—are identified and analyzed to guide the development of an innovative IEQ framework. The proposed framework is validated by domain experts to ensure alignment with Jordan’s socio-economic and environmental conditions. The findings reveal that integrating technological innovation, adaptable business models, and occupant well-being significantly enhances the implementation of sustainable IEQ strategies. This research offers a novel design-led framework tailored to the Jordanian context, addressing the underexplored intersection between human-centered design and sustainable IEQ practices. Unlike traditional approaches focused primarily on energy efficiency, this study incorporates social and institutional dimensions to enable more holistic and implementable solutions. Full article

Financial fragility among non-financial corporations (NFCs) has become a critical concern in developing economies, where both firm-specific and macroeconomic conditions shape corporate financial stability. Understanding these dynamics is essential to enhancing corporate resilience and informing effective regulatory interventions. This study is motivated by Minsky’s Financial Instability Hypothesis (FIH), to empirically investigate the determinants of financial fragility in Jordanian non-financial firms (NFCs) using panel data from 71 companies listed on the Amman Stock Exchange (ASE) between 2015 and 2021. By employing a panel logistic regression analysis, results reveal that Return on Assets (ROA) significantly supports financial stability, while inflation negatively impacts it, underlining the detrimental impact of increasing inflation rates on corporate financial health. The beneficial effects of GDP growth and institutional quality also emphasize how important governance and economic conditions are in promoting financial stability. The study offers an original insight on the dynamics of financial fragility in a developing market, with important ramifications for regulators, business managers, and policymakers looking to boost institutional quality, control inflation, and increase corporate profitability. The findings extend Minsky’s hypothesis to a developing-market context and provide implications for policymakers seeking to strengthen institutional frameworks, contain inflationary pressures, and promote corporate financial stability. Full article

Background/Objectives: Childhood obesity rates in Jordan have reached alarming levels, with 28% of school-age children classified as overweight or obese. School-based gardening interventions show promise for promoting healthy eating behaviors, yet limited research exists in Middle Eastern contexts. This study evaluated the effectiveness of a five-month school-based vegetable gardening and nutrition education intervention on anthropometric measures, dietary intake, and knowledge, attitudes, and practices (KAP) regarding vegetable consumption among Jordanian primary school children. Methods: A quasi-experimental controlled trial was conducted with 216 students (ages 10–12 years) from two demographically matched schools in Amman, Jordan. The intervention group (n = 121) participated in weekly one-hour gardening sessions combined with nutrition education and vegetable tasting activities over five months, while the control group (n = 95) continued the standard curriculum. Outcomes measured at baseline and post-intervention included anthropometric assessments, dietary intake via 24 h recalls, and vegetable-related KAP using a validated questionnaire. Data were analyzed using paired t-tests and repeated measures ANCOVA. Results: The intervention group demonstrated significant improvements in body composition, including reductions in BMI (−1.57 kg/m²), weight (−1.88 kg), and BMI z-score (−0.37), while controls showed minimal increases. Vegetable intake showed significant time × group interaction (p-value = 0.003), with a non-significant increase in the intervention group (2.7 to 2.9 times/day) and a non-significant decrease in the controls (2.5 to 2.4 times/day). Dietary quality improved, including increased fiber intake (+2.36 g/day) and reduced saturated fat consumption (−9.24 g/day). Nutrition knowledge scores increased substantially in the intervention group (+22.31 points) compared to controls (+1.75 points; p-value ≤ 0.001). However, attitudes and practices toward vegetable consumption showed no significant changes. Conclusions: This intervention effectively improved body composition, dietary quality, and nutrition knowledge among Jordanian primary school children. These findings provide evidence for implementing culturally adapted school gardening programs as childhood obesity prevention interventions in Middle Eastern settings, though future programs should incorporate family engagement strategies to enhance behavioral sustainability. Full article

Introduction: Drug–drug interactions (DDI) are a major, preventable cause of patient harm, a challenge amplified in Jordan by rising polypharmacy and documented high rates of medication errors. To date, no study in Jordan has systematically compared hospital and community pharmacists. This study aimed to conduct the first national, comparative assessment of DDI management among these two cadres. Materials and Methods: A national, cross-sectional study was conducted with 380 licensed pharmacists (175 hospitals, 205 community) recruited via proportionate stratified random sampling. A validated online questionnaire assessed demographics, objective DDI knowledge, professional attitudes, practices, and barriers. Multivariable logistic regression was used to identify independent predictors of high knowledge and optimal practice. All collected data were coded, cleaned, and analyzed using the Statistical Package for the Social Sciences (SPSS V28.0). Results: Hospital pharmacists achieved significantly higher mean objective knowledge scores than community pharmacists (10.3 vs. 8.1 out of 15, p < 0.001), a gap particularly wide for interactions involving high-risk OTC medications. The primary barrier for community pharmacists was a lack of access to patient data (85.4%), contrasting with high workload and physician resistance in hospitals. Optimal practice was independently predicted by higher knowledge (AOR = 1.25), a hospital practice setting (AOR = 3.65), and was inhibited by perceived physician resistance (AOR = 0.45). Conclusions: Jordanian hospital and community pharmacists operate in distinct worlds of knowledge and practice. A tailored, dual-pronged national strategy is essential. For hospitals, interventions should target interprofessional dynamics. For community pharmacies, health policy reform to provide access to integrated patient data is the most urgent priority. These findings highlight a globally relevant challenge of practice-setting disparities, offering a model for other nations to develop tailored, context-specific interventions to improve medication safety. Full article

Background/Objectives: Childhood and adolescent obesity is a growing public health concern in Jordan, with implications for both physical and psychological well-being. While obesity’s physical effects are well-documented, less is known about its broader association with adolescents’ quality of life (QoL), particularly in Middle Eastern contexts. This study aimed to investigate the associations between weight status, psychosocial factors, and health-related quality of life (HRQOL) among Jordanian adolescents. This study aimed to investigate the associations between weight status, psychosocial factors, and HRQoL among Jordanian adolescents. Methods: A cross-sectional study was conducted with 719 adolescents (63.3% female) aged 11–18, recruited from public schools and pediatric clinics in three regions of Jordan. Data were collected using validated questionnaires assessing demographics, health behaviors, mental health (PHQ-9, GAD-7, SMFQ), and HRQoL (PedsQL 4.0). Structural equation modeling (SEM) was used to examine direct and indirect pathways predicting physical and psychological QoL. Results: Bullying emerged as a key mediator between weight status and QoL, particularly for physical well-being. Depression and anxiety were significant predictors of poorer psychological QoL. Positive school experience, academic performance, physical activity, and paternal education were positively associated with QoL. Nutritional habits were inversely associated with anxiety levels. Model fit indices supported the adequacy of both the physical and psychological QoL models. Conclusions: The findings highlight the interconnected relationship of weight-related stigma, school environment, and lifestyle behaviors on adolescent well-being. Multi-component, school-based interventions targeting bullying, physical activity, and mental health literacy may be effective in improving QoL in this population. Full article

This study investigates the colloquial expression ʔinno that serves as a complementizer (C) and a discourse marker (DM) in Jordanian Arabic (JA). The data includes (422) instances of ʔinno collected from social media conversations of (60) JA speakers. The analysis shows that for ʔinno as a (C), there are (259) instances that are used to introduce subordinate clauses, and it is inflected with pronoun suffixes that specify person, gender, and number. It also serves various functions in verbal and nominal sentences. As a DM, Ɂinno are (163) instances that appear in the middle of sentences between two propositions. A list of contexts is developed featuring Ɂinno in JA. The pragmatic functions of Ɂinno are determined in each situation and validated by an Acceptability Judgment Task which is completed by 20 native speakers of JA. The pragmatic functions of ʔinno fall into six primary categories with sub-functions, such as explanatory functions (like giving reasons or expressing results), elaborative functions (including elaboration and giving examples and clarification), emotional and assessment functions (such as expressing surprise or criticism), emphatic and assertive functions (for emphasizing or warning), epistemic and uncertainty functions (covering hesitation and hedging), and a turn-taking function (specifically urging for continuity). This study concludes that Ɂinno is well established among social media users in the Jordanian context and the varied contexts play a vital role in exploring its pragmatic and syntactic functions. Full article

Background: This research aims to comprehensively evaluate the influence of firm capabilities, resources, and Artificial Intelligence (AI) on supply chain financing within the Jordanian context. It also analyzes the mediating role of blockchain technology and trust in these relationships. Methods: A conceptual model was utilized to empirically examine the suggested relationships. Data were gathered from a sample of 349 Jordanian start-ups focusing on AI and blockchain technologies via a five-point Likert scale questionnaire. Partial Least Square regression-based Structural Equation Modeling (PLS-SEM) facilitated by SmartPLS4 was used to perform the analysis. Results: The findings reveal that firm capabilities/resources and AI positively impact supply chain financing. Blockchain technology and trust serve as mediators, enhancing the effects of these factors on supply chain financing. Conclusions: The study highlights the role of innovative technologies in improving financial information security and collaboration among supply chain partners. It emphasizes how firm capabilities, resources, and emerging technologies such as AI and blockchain influence supply chain financing as they foster trust and security in financial transactions, offering valuable insights for decision-makers in the supply chain domain. Full article

Sustainable marketing emphasizes the integration of social and environmental responsibility into business strategies, positioning employer branding as a vital tool for advancing sustainable organizational practices. Within the healthcare context of Jordan—a country facing unique socio-cultural and systemic challenges—employer branding may foster a culture that promotes safety and employee well-being. While the findings are context-specific, they offer preliminary insights that may be useful in similar healthcare environments in the Middle East or other collectivist settings. This study explores the use of employer branding as a strategic lever to enhance nurses’ safety voice behavior, a critical component of organizational safety and patient care, through the mediating role of employee engagement. Drawing on employer brand theory and self-determination theory, this research investigates how a strong employer brand image contributes to a more engaged nursing workforce, thereby encouraging proactive communication regarding safety concerns. Data were collected from 240 nurses employed at Jordanian hospitals between September and November 2024. The findings reveal that sustainable employer branding—characterized by transparent, ethical, and inclusive organizational values—significantly enhances employee engagement and, in turn, motivates safety voice behavior. By cultivating a supportive work environment that aligns with nurses’ intrinsic motivations, hospitals can improve not only internal communication around safety but also long-term organizational resilience and trust. This aligns with sustainable marketing principles, which advocate for responsible internal stakeholder engagement as part of a broader sustainability agenda. Full article

Smart technology is essential for integrating circular economy principles. This research investigates how conflict management strategies (collaboration, accommodation, avoidance, compromise, and competition) impact the adoption of smart technology, particularly blockchain, in Jordanian SMEs. Additionally, the study explores the moderating role of customer-centric green supply chain management in the relationship between blockchain adoption and circular economy principles. This research addresses a gap in the literature by focusing on Jordanian SMEs, an under-explored context. Data were collected from 421 senior managers, department heads, and executives of Jordanian SMEs, and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM), to test the hypotheses and analyze complex relationships. The findings reveal that conflict management strategies are critical in blockchain adoption, with collaboration and compromise emerging as the most influential. Moreover, blockchain adoption positively impacts the implementation of circular economy principles. The moderating effect of customer-centric green supply chain management enhances the sustainability and competitiveness of SMEs through blockchain technology. This research contributes to theory and practice by providing valuable insights into the strategic role of conflict management in driving technological innovation and sustainability within the circular economy framework, particularly in the context of Jordanian SMEs. Full article

Objective: The present study explores the cross-cultural validation of neuropsychological assessments and their clinical applications in cognitive behavioral therapy (CBT), focusing on culturally adapted CBT (CA-CBT) across diverse populations and settings. Methods: Following the PRISMA guidelines, a comprehensive search was conducted in multiple academic databases, including PubMed, PsycINFO, Scopus, and Web of Science. Keywords related to cognitive behavioral therapy, cultural adaptation, and specific populations were used. The inclusion criteria encompassed randomized controlled trials (RCTs) and pilot studies that assessed CA-CBT for various mental health conditions. Results: The review included studies involving Chinese Americans, Latino caregivers, Syrian refugees, Jordanian children, Malaysian Muslims, Afghan refugees, Iraqi women, Japanese children and adolescents, and Tanzanian and Kenyan children. CA-CBT demonstrated significant effectiveness in reducing symptoms of depression, anxiety, PTSD, and psychosis. For instance, research has shown that CA-CBT is more effective than standard CBT in reducing depressive symptoms among Chinese Americans and in significantly lowering PTSD symptoms in Syrian refugee women. This method has been well-received and is feasible for use in diverse populations, such as Jordanian children and Afghan refugees. The long-term benefits are promising, with sustained improvements being reported in various studies. Additionally, digital and remote delivery methods have demonstrated potential for expanding the accessibility of CA-CBT. Conclusions: CA-CBT is a valuable and effective intervention for diverse cultural populations, significantly improving mental health outcomes. However, future research must address limitations such as small sample sizes, short follow-up periods, and variability in assessment tools. Future studies should include larger and more diverse sample sizes, longer follow-up periods, rigorous control groups, and comprehensive outcome measures to further validate and enhance the application of CA-CBT across different cultural contexts. Full article

Maximising financial performance while maintaining adequate liquidity is a crucial and ongoing challenge for bank management, particularly in emerging markets. This study focuses on the relationship between capital structure and financial performance in Jordanian banks, with the mediating role of liquidity risk. Using panel data from 13 central Jordanian banks over the 2015–2022 period, we employ structural equation modelling (SEM) to analyse how capital structure ratios (equity-to-asset, debt-to-loan, and deposit-to-asset) influence financial performance metrics (return on assets and net income-to-expenditure ratio). Our findings reveal a significant positive association between capital structure and financial performance. However, liquidity risk fully mediates this effect. Capital structure primarily impacts performance by influencing a bank’s liquidity risk profile. Furthermore, the strength of this mediating effect is noteworthy—capital structure exhibits a statistically more robust association with liquidity risk than its direct impact on performance. This highlights the crucial role of managing liquidity risk within the complex dynamics of bank operations. This research makes a significant contribution to the existing literature by demonstrating the positive impact of capital structure on performance using the underlying mechanism through which this effect occurs. The insights of this research provide several implications for practice in the context of banking industries. Full article

In today’s dynamic organizational landscape, characterized by rapid technological advancements and evolving workplace dynamics, understanding the factors influencing employee well-being is paramount. This study investigates the interplay between ethical leadership, organizational climate, role overload, and job burnout in public healthcare organizations across northern Jordan. By focusing on ethical leadership, organizational climate, and role overload as determinants of job burnout, this research provides insights into strategies for enhancing employee well-being. Drawing on ethical leadership theory, social exchange theory, and the job demands–resources model, this study employs PLS-SEM to analyze data collected from 260 employees working in Jordanian government hospitals. The findings reveal negative associations between ethical leadership and job burnout, highlighting the importance of ethical leadership behaviors in mitigating employee burnout. Additionally, a positive organizational climate is associated with lower levels of burnout, underscoring the impact of the broader organizational context on employee well-being. The study also explores the mediating role of organizational climate and the moderating effect of role overload in the relationship between ethical leadership and job burnout, providing insights into the complex dynamics at play in healthcare organizations. These findings enrich our understanding of the factors influencing employee well-being in healthcare contexts and underscore the importance of fostering ethical leadership and supportive organizational climates to mitigate job burnout. Full article

Companies have shown interest in advanced human resource management as a means to secure distinctive competitive advantages for organizational survival and growth through sustainable management systems. Hence, in the current context, where sustainability in business is a growing concern, the objective of this study was to investigate the relationship between high-performance work systems and a company’s social performance, taking into account the organizational climate as a situational variable. Specifically, this study aimed to analyze the impact of perceptions of a high-performance work system on the perception of a company’s social responsibility (CSR) among employees of Jordanian companies with an organizational size of 300 or more. This study used 175 valid questionnaires, and SPSS and AMOS 24 were used to test the hypotheses. The results showed that there was a positive relationship between the perception of a high-performance work system and the perception of a company’s CSR. Furthermore, this study found that a positive diversity climate could enhance the positive relationship between the two. These findings suggest that high-performance work systems can contribute to the development of sustainable human resource management systems and that a positive diversity climate is essential in shaping these systems. Based on these results, it is recommended that companies implement HPWSs and encourage workforce diversity to maximize the value of CSR activities and ensure their sustainability. Full article

The persistent underrepresentation of women in leadership positions within the construction industry remains a global concern. In Jordan, despite comprising 60.45% and 22.4% of the total workforce of architects and civil engineers, respectively, women’s contribution to management roles is significantly low. Therefore, there is an urgent necessity to examine the factors hindering women’s advancement in the construction sector and their ability to attain leadership positions. This research aims to provide an overview of the current situation in Jordan, focusing specifically on the architectural and civil engineering professions. It presents findings from a desktop study, a survey questionnaire, and focus groups. The Severity Index (SI) formula is utilised to identify critical barriers in the Jordanian context, derived from both the literature review and questionnaire responses. Additionally, the Interpretive Structural Modelling (ISM) technique is employed to establish a hierarchy of critical barriers and analyse their interrelationships. The study reveals that the obstacles impeding women from assuming leadership roles in the Jordanian construction sector primarily stem from 20 critical barriers categorised across 11 levels in ISM. Notably, the lack of childcare programmes is identified as a fundamental barrier at the lower level, while informal networks formed by men emerge as the highest-rated barrier at level 11. Addressing and mitigating these challenges is crucial to facilitating women’s progression into leadership positions within the sector and is anticipated to contribute significantly to addressing the growing complexity of modern construction projects. Full article