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Background and Objectives: Venous thromboembolism is one of the leading causes of mortality and disability worldwide. Treatment with anticoagulation therapy is essential and requires a delicate approach to select the most appropriate option to improve patient outcomes, including the length of hospital stay (LOS). The aim of this study was to determine the LOS among patients with acute onset of VTE in several public hospitals in Jordan. Materials and Methods: In this study, we recruited hospitalized patients with a confirmed diagnosis of VTE. We reviewed the electronic medical records and charts of VTE admitted patients in addition to a detailed survey to collect the patients' self-reported data. Hospital LOS was categorized into three levels: 1–3 days, 4–6 days, and ≥7 days. An ordered logistic regression model was used to study the significant predictors of LOS. Results: A total of 317 VTE patients were recruited, with 52.4% of them were male and 35.3% aged between 50 and 69 years. Most patients had a deep vein thrombosis (DVT) diagnosis (84.2%), and most of the VTE cases were admitted for the first-time (64.6%). The majority of the patients were smokers (57.2%), overweight/obese (66.3%), and hypertensive (59%). Most of the VTE patients received Warfarin overlapped with low molecular weight heparins as their treatment regimen (>70%). Almost half of the admitted VTE patients (45%) were hospitalized for at least 7 days. Longer LOS was significantly associated with hypertension. Conclusions: We recommend using therapies that have been proven to reduce hospital LOS, such as non-vitamin K antagonist oral anticoagulants or direct oral anticoagulants, to treat VTE patients in Jordan. Additionally, preventing and controlling comorbidities such as hypertension is essential. [ABSTRACT FROM AUTHOR]

Background and Objectives: There is consensus on the negative effects of obesity on the development of heart failure. However, several studies have suggested that obesity may have paradoxical survival benefits in heart failure patients. Therefore, the aim of this study is to investigate whether the obesity paradox exists in heart failure with reduced ejection fraction (HFrEF) patients in Jordan. Materials and Methods: In this retrospective cohort study, data were retrieved from electronic hospital records of heart failure patients admitted to King Abdullah University Hospital between January 2010 and January 2020. Patients were divided into five BMI (kg/m2) subgroups: (1) Less than 25.0, (2) Overweight 25.0–29.9, (3) Obese Class I 30.0–34.9, (4) Obese Class II 35.0–39.9, and (5) Obese Class III ≥40.0. Changes in patients' clinical and echocardiographic parameters over one year were analyzed. Results: Data of a total of 297 patients were analyzed to determine the effect of obesity on heart failure. The mean age was 64.6 ± 12.4 years, and most patients (65.7%) were male. Among several co-morbidities, diabetes mellitus and hypertension were the most common and were present in 81.8% and 81.1% of patients, respectively. Over all patients, there was no significant change in EF after 1 year compared to baseline. However, only patients in the Obese Class I group had a statistically significant improvement in EF of 38.0 ± 9.81% vs. 34.8 ± 6.35% (p = 0.004) after 1 year. Importantly, among non-diabetic individuals, only Obese Class I patients had a significant (p < 0.001) increase in EF after 1 year compared to other BMI subgroups, a feature that was not observed among patients with diabetes. On the other hand, only Obese Class I patients with hypertension had a significant improvement (p < 0.05) in EF after 1 year compared to other BMI subgroups, a feature that was not observed among patients without hypertension. Conclusions: Our study demonstrates an inverted U-shaped relationship between BMI and EF such that patients with mild obesity (i.e., Obese Class I) had significant improvement in EF compared to those having a lower and higher BMI. We, therefore, suggest the existence of the obesity paradox among HFrEF patients in Jordan. [ABSTRACT FROM AUTHOR]

Objective: To explore barriers and facilitators to antiretroviral therapy adherence among human immunodeficiency virus patients in Jordan from their perspectives. Methods: Qualitative one-to-one interviews with HIV patients took place in a private support center that works on the inclusion of HIV patients in the society. The inclusion criteria for the study included patients who were currently receiving treatment for HIV for more than one year, has a Jordanian citizenship or residency, were at least 18 years old, and were physically and mentally competent to conduct a reliable, spoken interview. Results: The participants reported several barriers that negatively influenced their medication experience and adherence. These barriers included the following subthemes: accessibility, adverse reactions, financial burden, lack of support, medication manageability, psychological factors, and stigma. These facilitators included the following subthemes: benefits and QOL, fear, and support and additional services. Conclusion: In summary, this is the first study in Jordan regarding HIV patients discuss the barriers and facilitator for ART adherence from their perspectives. [ABSTRACT FROM AUTHOR]

Background: Deprescribing refers to the partnered discontinuation of chronic medications to limit the negative impacts of polypharmacy. Polymedicated patients play a key role in the success of deprescribing efforts. eHealth literacy reflects patients' ability to appraise electronically available health-related information to make informed health care decisions, which partly reflect their desire to deprescribe. Objectives: The current study aimed to explore the relationship between eHealth literacy and willingness to deprescribe among patients with chronic diseases. Additionally, the predictors of willingness to deprescribe were examined. Materials and Methods: This cross-sectional study was conducted among adult patients with chronic diseases in Jordan. An online questionnaire comprising two validated tools, namely the Electronic Health Literacy Scale (eHEALS) and the Revised Patients' Attitudes Toward Deprescribing (rPATD) Questionnaire, was used for data collection. The questionnaire targeted adult patients with chronic medical conditions in Jordan and was posted to social media portals, following a convenience sampling technique. Results: A total of 719 responses were recorded and included in the final analysis. Participants with higher levels of eHealth literacy were more willing to get their medications deprescribed, as indicated by the perceived use of unneeded medications (p = 0.042). Meanwhile, participants with low levels of eHealth literacy were more likely to report fear of missing out on the potential benefits of deprescribed medications (p = 0.003). Other items that were commonly agreed upon by both the low and high eHealth literacy groups, respectively, included desire for dose reduction (p < 0.001, p < 0.001), belief in the lack of effectiveness of some prescribed medications (p < 0.001, p < 0.001), and fear of precipitating side effects (p = 0.001, p = 0.007). Conclusions: The present study highlighted the relationship between eHealth literacy and a number of items reflecting willingness to deprescribe, and these indicators can be used to guide future deprescribing efforts among eligible patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate predictors of the use of anti-plagiarism detection tools (APTs) in higher education institutions. Methods: An online survey based on the theory of planned behavior was sent to members of science faculties in Jordan. Multivariate Logistic regression was conducted to determine predictors of previous use of APTs, and multivariate linear regression to predict future intentions. Results: A total of 173 faculty members completed the survey, with 78.13% indicating previous APTs use. Turnitin® (43%) and Ithenticate® (32.8%) were the most commonly used APTs. These tools were mainly used to evaluate papers before sending them to journals (65.5%) and to detect plagiarism in theses/dissertations (50.4%). Predictors of previous use were academic rank (p = 0.02) and perceived understanding of APT use (p = 0.043). Intentions for future use were predicted by attitudes (p < 0.001) and perceived behavioral control (p = 0.036). Conclusion: The theory of planned behavior successfully predicted intentions to use APTs. The use of APTs should be encouraged to all faculty members and students. [ABSTRACT FROM AUTHOR]

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Although the importance of Total Quality Management (TQM) practices in improving hotel service performance is well known since it is a key to achieving service excellence, the role of TQM practices in improving service recovery performance through service innovation in service businesses has remained a relatively untapped research field. Thus, the purpose of the current study is to investigate the impacts of TQM practices on service recovery, as well as the mediating role of service innovation between TQM and service recovery. This study used a quantitative survey method, with data collected from a sample of 414 staff working at Jordan's five-star hotels using a questionnaire. The results indicated a significant positive effect of TQM on service innovation and service recovery, and that service innovation fully mediates the relationship between TQM and service recovery. The current study presents an innovative approach since it is one of the first and few research papers that provide empirical evidence for the mediating effect of service innovation between TQM and service recovery. This study contributes to the existing literature by examining the roles of TQM and service innovation in increasing service recovery performance, and it helps practitioners understand how TQM practices support service innovation and the latter's role in improving service recovery performance. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to explore community pharmacists' perspectives on administering COVID-19 vaccine in community pharmacies in Jordan. Methods: Purposeful sampling was used to identify a list of 100 community pharmacies which were approached to participate in the study. Twenty-three interviews were needed to reach data saturation. In-depth interviews were conducted, recorded, transcribed and analysed using NVivo 11 software. Interviews followed a previously prepared and validated 12-item interview guide. The interview guide discussed pharmacists' perspectives on providing the COVID-19 vaccine in community pharmacies. Key findings: The three overarching themes which described the participating pharmacists' views towards administrating the COVID-19 vaccine in community pharmacies were advantage, support and barriers. The reported advantages included expediting the COVID-19 vaccination process, convince people to take the vaccine, increased patient accessibility to vaccines and aiding the healthcare system in the vaccination process. Respondents indicated that they would be more willing to administer the COVID-19 vaccine if they received the needed support from the Ministry of Health and the Pharmacists Association. Furthermore, from the respondents' perspectives, the main barriers to this practice were having no confidence in the vaccine, risk of adverse effects and lack of training and expertise. Conclusions: Respondents reported a positive attitude towards administering the COVID-19 vaccine in community pharmacies. Respondents highlighted that they could help fighting the pandemic through administering the vaccine and expedite the vaccination process. [ABSTRACT FROM AUTHOR]

Self-medication can facilitate patients' access to medicinal products, save time, and reduce financial and health-care service use burden. On the other hand, irresponsible use of self-medications can result in adverse consequences. Self-medication is common among different demographic groups including pregnant women. In general, medicinal products might have harmful effects on mothers and baby. This study aimed to assess self-medication practices among pregnant women in the northern region of Jordan. A cross-sectional study was conducted on pregnant women attending outpatient clinics in the northern region of Jordan. Self-medication practices among the target population were assessed using a survey questionnaire that was administered through interviewer-assisted mode. Data were collected between December 2019 and September 2020, and descriptive statistics and inferential analysis were applied. A total of 1,313 pregnant women were surveyed (response rate = 95.50%). Self-medication and the use of herbal remedies were practiced by 33.10% and 32.14% of the participant, respectively. Headaches and general pains were the most frequently reported conditions treated by self-medication practice with either conventional medicinal products or herbal remedies. The gravidity (≥4) and the gestational stage (≥28 weeks) were the predictors of self-medication practice. This study showed that self-medication was not widely practiced by pregnant women in the northern region of Jordan. Disease simplicity and previous history were the main motives for self-medicating. Efforts should be made by health-care providers to address pregnant women and educate them to increase their awareness about the unsafe use of medicines and the harmful effects on fetus. [ABSTRACT FROM AUTHOR]

This study aims to assess the Jordanian pharmacy students' attitudes and perceptions toward providing rational pharmaceutical care. The study was conducted by administering an anonymous online survey (Standard Pharmaceutical Care Attitude Survey; PCAS) to pharmacy students at five public universities in Jordan. Descriptive statistics were used to describe participants response on the questionnaire items and one-way ANOVA were used for inferential statistics. A total of 884 responses met the eligibility criteria. The majority of participants (n=614, 69.5%) reported that they have been introduced to the pharmaceutical care concept in their program. The majority of participants reported positive attitudes toward the professional duty and benefit of pharmaceutical, more negatives attitudes were reported toward the return on effort. Participants who had a clerkship experience had significantly more positive attitudes toward six items of the PCAS. In conclusion, pharmacy students in Jordan have positive attitudes toward providing rational pharmaceutical care. The majority, however, perceived pharmaceutical care to be time-consuming and not worth the additional workload that it places on pharmacists. This study highlights opportunities to achieve more positive attitudes by mandating pharmaceutical care courses in pharmacy schools in Jordan and exposing students to real-world scenarios. [ABSTRACT FROM AUTHOR]

Research in service recovery and service innovation has attracted significant attention in recent years but few studies have focused on achieving service recovery through service innovation. The current study aims to bridge this gap in research – to investigate the effect of service innovation on service recovery. Additional emphasis is also given to examining whether employee empowerment serves as a mediator between service innovation and service recovery in the hotel industry. A quantitative survey method was applied by using a 60-item questionnaire and data collected from a sample of 381 employees from five-star hotels in Jordan. The findings confirmed the hypotheses, revealing a direct effect of service innovation on employee empowerment which, in turn, had a significant influence on service recovery. Additionally, this study proposed a model of influence of service innovation in service recovery, whereby employee empowerment fully mediates this relationship. The current study contributes to the existing literature on service innovation and service recovery as it identifies the role of service innovation in enhancing service recovery performance in hotels. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to explore community pharmacists' views on providing influenza vaccine administration services in community pharmacies in Jordan. Methods: The current study is a cross-sectional exploratory study conducted using semi-structured telephone interviews. The semi-structured interview schedule was developed by the researchers and comprised open-ended questions aligned with the study objectives. The telephone interviews were recorded and fully transcribed, and the transcripts were quantitatively coded following a generic qualitative approach. Results: A total of 19 pharmacists took part in this study. Eight participants (42.1%) reported that they had administered the influenza vaccine during their practice. The three overarching themes which described the participating pharmacists' views towards providing influenza vaccine administration services in community pharmacies were benefits, enablers, and barriers. The reported benefits included enhanced therapeutic relationships with patients and increased patient accessibility to vaccines. The majority of the participants indicated that they would be more willing to provide influenza vaccine administration if they received the support they needed from the Jordan Pharmacists Association, third-party insurance companies, and drug stores. Further, from the participants' perspectives, the main barriers to this change in practice were physicians, regulations, and lack of sufficient training. Conclusion: Overall, the participating pharmacists had positive attitudes towards administering the influenza vaccine in community pharmacies. The participants highlighted the need for support from regulatory bodies and stakeholders to change the current scope of practice in Jordan. Moreover, the study highlighted the need to incorporate vaccine administration in the curricula used to train new pharmacy graduates. [ABSTRACT FROM AUTHOR]

Objectives: The overall objective of this study is to assess the views and attitudes of Jordanian pharmacists on expanded pharmacist prescribing role. Methods: A cross‐sectional, questionnaire‐based study was conducted using a web‐based questionnaire. Pharmacists were invited to take part in this study through pharmacists' Facebook groups for pharmacists in Jordan. Descriptive statistics were used to analyze the data in addition to the t‐test to compare the mean difference of support levels toward supplementary and independent prescribing. Key findings: A total of 521 pharmacists took part in this study. The majority of respondents (n = 482; 92.5%) believe that pharmacists in Jordan should have an expanded prescribing role. Respondents were significantly in favour of supplementary prescribing (P < 0.05) than independent prescribing for various medical condition (e.g. diabetes and asthma). Respondents identified securing more roles in healthcare (n = 464; 89%) and increasing pharmacy profits (n = 420; 80.7%) as key facilitators to adopt this new role. Whereas inadequate training in the diagnosis of disease (n = 457; 87.7%), and inadequate training in patient assessment and monitoring (n = 453; 86.9%) were reported as the most likely barriers. Conclusion: Overall, Jordanian pharmacists strongly supported the expanded prescribing role and favoured supplementary prescribing for chronic conditions (e.g. diabetes). The study highlighted the need for additional training in various areas (e.g. diagnosing and managing some clinical conditions) to prepare Jordanian pharmacists for this new role. [ABSTRACT FROM AUTHOR]

Background Pediatric pharmaceutical care is a new concept in the pharmacy profession. In Jordan, the knowledge of pediatric pharmaceutical care is limited, which may have negative consequences on pediatric pharmaceutical care and treatment efficacy and safety. Objectives The main objective of the present study is to assess parental needs for pediatric pharmaceutical care services and explore their current experiences of pharmaceutical services provided to their children. Setting Parental Facebook Groups in Jordan. Methods A descriptive, cross-sectional survey was designed and distributed online via Social Media networks, mainly Facebook. The validated survey contained 4 main sections addressing different themes related to pediatric pharmaceutical care services including: (1) parental perception of pediatric pharmaceutical care services. (2) Parental needs, wants, and expectations from the pharmacist when providing care to their children. (3) Parental awareness about pediatric pharmaceutical care, and parental satisfaction with current pediatric pharmaceutical care. Respondents who agreed to complete the survey signed and electronic informed consent form to access it. Main outcome measure The main outcomes measure was parental need for pediatric pharmaceutical care services. Results A total of 1104 respondents took part in the study. Of those 71% were female and 44% were 31-40 years old. The majority of respondents (78%) were not familiar with the pediatric pharmaceutical care term. The calculated overall mean perception score was 63.4%. The majority of respondents (89%) reported to need pediatric pharmaceutical care and the mean need score was 71.7%. Only 10.5% agreed/strongly agreed that their children were offered good pediatric pharmaceutical care services and respondents has a total mean satisfaction score of 65.7%. Conclusion The majority of the respondents reported that they need pharmaceutical care services for their children. Pharmacists in Jordan have to develop their role to incorporate pediatric pharmaceutical care services in their practice. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the content available on Facebook pharmacy groups in Jordan regarding the perception of the pharmacists' role during the coronavirus pandemic in Jordan. Methods: Researchers identified Facebook pharmacy groups through the search engine on the Facebook website. The main search keywords were pharmacy, pharmacist, pharmacists, and Jordan using both Arabic and English. Two researchers analyzed the posts and discussion threads on local pharmacy Facebook groups in a period between March 20th and April 3rd. A total of 184 posts and threads were identified for the purpose of the study. Results: Identified threads and responses resulted in three overarching themes: pharmacists having a positive role during the pandemic, taking additional responsibilities and services, and having passive or negative roles. A positive role was seen in pharmacists acting as first-line healthcare providers, creating public's awareness regarding COVID-19, and being responsible for chronic medication refill during the pandemic. Taking additional responsibilities was summarized in home deliveries and involvement in industrial and corporate efforts to deal with the pandemic. A passive/negative role was seen mostly among hospital pharmacists not being proactive during the pandemic and by pharmacists trying to maximize profits during pandemic time. Conclusions: Pharmacists perceived their role as a positive role during the coronavirus pandemic. Not only they took responsibilities for their daily services during the crises, but they took additional responsibilities to assure patient safety and satisfaction. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study was to explore the barriers and supporting factors for adherence among HIV patients and to explore their needs for pharmaceutical care services.Methods: This study utilizes in-depth interviews with HIV patients. Out of 50 patients approached, a total of 30 patients agreed to participate in the study. The researchers used a predesigned topic guide. The interview guide included two parts; the first one focused on the assessment of HIV patients' adherence to their treatment. The second part focused on patients' need for pharmaceutical care services.Results: Three main themes emerged from the interviews. Those included patient-related factors, medication-related factors and Healthcare professional related factors. This study found that a number of barriers that decreased adherence in HIV patients included stigmatisation, fear from disclosure, dosage form of the drug, adverse events and poor cooperation from healthcare professionals. On the other side supporting factors included family and friends support, electronic mobile reminders, feeling responsible to raising children, religious beliefs and feeling improvement while using therapy. Furthermore, the study illustrated that HIV patients need to have a specialist pharmacist in their healthcare team who delivers specialised pharmaceutical care services which may increase patients' adherence.Conclusions: The current study reveals a margin for medication adherence improvement in HIV patients. Patients in this study demonstrated the need for a pharmaceutical care. Future disease management and clinical pharmacy services programs should address the current study findings in order to improve the health service for HIV patients. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to validate an Arabic version of the revised Patients' Attitudes Toward Deprescribing (rPATD) translated tool and to describe polypharmacy patients' attitudes toward deprescribing in Jordan. Methods: rPATD translation was guided by ISPOR's Principles of Good Practice. A convenient sample of adult outpatients with polypharmacy was recruited from a major teaching hospital in Jordan. Reliability was assessed using Cronbach's alpha and the intraclass correlation coefficient (ICC). Validity was assessed using face and construct validity using confirmatory factor analysis. Key findings: A total of 358 questionnaires were collected from patients (mean age: 60.4 ± 12.03). Overall, polypharmacy patients were willing to stop one or more of their medications upon a physician's recommendations and were not concerned about deprescribing. Similar to the original rPATD tool, factor analysis resulted in four factors (burden, appropriateness, concern about stopping, and involvement). Internal consistencies for constructs ranged from 0.718 (appropriateness) to 0.85 (concerns about stopping). ICC ranged from 0.718–0.972, indicating good to excellent reliability. Conclusions: This study provided an Arabic translation of the rPATD with evidence of validity and reliability comparable to the original tool. The Arabic rPATD could be used for adult patients in Arabic‐speaking countries to ultimately contribute to the global literature of deprescribing. Overall, the patients in this study showed a favourable attitude towards deprescribing through a shared decision‐making process with their physicians. This can be seen as an opportunity to reduce the burden of polypharmacy and unnecessary medications. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to describe the prevalence and predictors for parental antibiotics self‐medication of their children and to characterize their knowledge, practice and attitude within this area. Methods: This is a cross‐sectional study which targeted parents of children between the ages of 1–12 years. Parents were asked to fill out an online validated questionnaire that aimed to assess their knowledge, practice and attitude to self‐medication of children with antibiotics. Key findings: In this study, 332/855 (39.2%) participants had previously self‐medicated their child(ren) with antibiotics. The overall score in the knowledge section was satisfactory (mean = 3.48 out of five); however, the majority of participants (72.1%) did not have the knowledge that antibiotics are solely indicated for bacterial infections. Parents with older age, lower education, not working in a medical field, families with low‐income and lived away from the capital were found to have higher rates of self‐medication (P‐value <0.05). Conclusion: The findings of this study show that there is a high prevalence of parental self‐medication practice of antibiotics in Jordan that should be considered as alarming problem. The lack of adequate parental knowledge about the use of antibiotics may be a major cause of the increased self‐medication among them. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic diseases require long-term use of medications and are at risk for prescription of unnecessary drugs.Objective: To determine the prevalence, risk factors, and costs associated with unnecessary drugs in patients with chronic diseases at outpatient settings.Methods: Clinical and demographic data, unnecessary drug therapy and prices of drugs were obtained from 2,677 patients from the outpatient setting of six major hospitals in Jordan. Multivariate logistic regression was used to determine risk factors associated with unnecessary drug therapy.Results: A total of 936 unncessary medications were identified with an average of one unnecessary medication per every three patients. Monthly costs of unnecessary medications, at the national level, were estimated to range between JD 438,930.24 [(618,821.41 USD) (payer's perspective)] and JD 744,765.5 [(1,050,000.19 USD) (patient's perspective)]. Unnecessary drug was associated with cardiac catheterization (adjusted odds ratio [AOR] = 1.29, 95% CI: 1.01-1.71, p = 0.041), increased number of medications (AOR = 3.11, 95% CI: 2.51-3.86, p < 0.001), and inadequate knowledge/understanding of drug use (AOR = 2.4, 95% CI: 1.24-4.64, p = 0.009).Conclusion: Unnecessary drug therapy is common in the outpatient setting. Identified risk factors should be specifically targeted to reduce its burden. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to explore the views and attitudes of the general public in Jordan towards medicines used in children and the role of the pharmacists in delivering effective and safe treatments to this age group. Methods: The public opinion questionnaire was administered using a structured interview technique to a sample of a thousand member of the public. All interviews were conducted in public areas in all the main cities in Jordan. Key findings: Almost half (45.8%) of the participants were males. The majority of the participants were parents; 81.4 and 4% had children with health problems. The majority of respondents (82.4%) thought that medicines prescribed for children were effective. This was for both originator medications and local generic medications used in children. Respondents (88.1%) had good confidence in the safety of medicines prescribed to children. The majority of respondents (94.1%) indicated that the pharmacist had an important role in giving advice and information to parents and guardians on medicine use and administration to their children. Conclusions: The majority of respondents thought that medicines used in children were effective and safe. It was thought that local generics used in children were as effective as originator medicines. However, almost one‐third of respondents thought that local generics were not as safe as originator medicines. Respondents reported high levels of confidence in the pharmacist as an important part of the healthcare team when treating children. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to explore faculty (i.e., professors of various ranks) opinions and views regarding the pediatric content in courses taught to pharmacy students in Jordan. Methods: Purposeful sampling was used to identify faculty from ten pharmacy schools. Participants were identified through their institutions' websites. After obtaining required approvals, twelve in-depth interviews were conducted, recorded, transcribed and analyzed using NVivo 11 Software. Interviews followed a previously prepared and validated interview guide. The interview guide covered various aspects of pediatric undergraduate education and training. Results: Twelve professors (eight assistants and four associate professors) agreed to take part in the study. Qualitative analysis revealed four themes each with regard to respondents' knowledge of the pediatric content and their students' competency in dealing with pediatric patients. The emerging themes were: the lack of pediatric content in their current curriculum, the need for exposing students to more courses teaching pediatrics, and future aspirations to deal with this, and implications on practice. Conclusions: This study highlights the deficiency of pediatric courses in pharmacy curriculum in Jordan. Respondent believed that this will have negative implications on pediatric pharmaceutical care and treatment efficacy and safety. It was thought that adding more pediatrics topics to undergraduate curricula, offering pediatric specialized postgraduate education, and implementing pre-registration training could alleviate the current situation. [ABSTRACT FROM AUTHOR]

Listed as a World Heritage Site since 1985, the city of Petra is well regarded as the most important attraction in Jordan that is internationally recognized for its rare archaeological remains, monuments and façades that date back to Nabataean times. This paper presents an inter-disciplinary approach, which is co-constructed by an academic archaeologist and a sustainable tourism researcher that considers the integration of three rare and significant Neolithic villages as a unique extension of the cultural and heritage tourism experience in Petra. The paper begins by deliberating the implications of World Heritage Status for iconic and flagship destinations such as Petra. From this, results of a review of secondary research and interviews with local tour operators are presented which explored the issues and challenges that may inhibit the inclusion of the Neolithic villages as part of the Petra attraction system. The authors propose that an attraction diversification strategy and a sustainable tourism-planning approach are necessary to sustain the destination’s long-term future, conserve Petra’s archaeological sites, ensure economic benefits and appropriate participation of local communities within the region, and to serve as a way to attract more appreciative visitor markets to the region. [ABSTRACT FROM PUBLISHER]

This paper presents new evidence, based on systematic fieldwork, concerning the most likely path of the Roman road, the via nova Traiana, in the area between Petra and Ayn al-Qana in southern Jordan. Special attention is given to the work of David Graf, the most recent fieldwork study, prior to the present investigation, dealing with the same issue, that of the via nova Traiana. It also presents a detailed description of the route of the Roman road, adds new information to Graf's study, and challenges some of his suggestions. The paper also considers other ancient roads that were directly connected to the Roman highway. [ABSTRACT FROM AUTHOR]

Survey work was carried out in the region of Mushash Hudruj near the Jordanian- Saudi borders in 2004, 2005 and 2009. The finds of this project include a north Arabian inscription, a cairn, an animal trap, stone circles, flint mines and water harvesting systems. These features demonstrate that this region was utilized by pastoral nomads who depended purely on a mobile subsistence pattern, governed by the availability of pasture and water. This pattern of seasonal movement is still practiced by modern Bedouin who move mainly within the wadi system which have become the main areas of attraction for Bedouin since prehistoric times, and have played a major role in the survival of these groups and their flocks. [ABSTRACT FROM AUTHOR]

Investigates the temporal distribution of chlorophyll a, suspended matter and vertical flux of chlorophyll a and organic carbon at sites along the north-eastern coast of the Gulf of Aqaba in Jordan from January 1991 to December 1992. Interannual variations shown in the suspended matter and its organic carbon content; Temporal distribution of chlorophyll a in the water column.

Abstract: Newcastle disease (ND) is a highly contagious viral disease and is a continuous threat to the poultry industry worldwide. In the early months of 2011, several devastating ND outbreaks occurred in Jordan affecting broilers, layers and breeders. The fusion gene of the isolated Newcastle disease virus (NDV) was partially amplified by RT-PCR, then directly sequenced. The NDV isolates were found to have the motif112RRQKRF117. This motif and a mean death time (MDT) of 46h are indicative of the velogenic nature of these NDV isolates. Phylogenetic analysis showed that the new NDV strain belongs to the lineage 5d (Aldous et al., 2003) and is closely related to the Chinese strain SG/Liaoning/2009. NDV outbreaks in 2010 and 2011 have been noted in neighboring countries. Based on the high nucleotide similarity between our isolated NDV isolates and the Chinese NDV strain, the origin of these recent NDV isolates might be from China. [Copyright &y& Elsevier]

Introduction: Evidence-based practice (EBP) has gained attention globally from healthcare professionals and researchers. The aim of this study was to assess Jordanian diagnostic radiographers' knowledge, attitude, education/knowledge, and skills related to EBP; and identify specific terms related to EBP., Methods: A paper-based, self-administered questionnaire with two sections was used. The first section included 11 socio-demographic questions and the second section contained 56 questions regarding EBP categorized under seven distinct subscales. The data were imported into SPSS for analysis., Results: Responses were received from 203 radiographers, most of them 135 (66.5%) aged 21-30 years. The majority of radiographers agreed or strongly agreed that the application of EBP is necessary for radiography practice, and 129 (63.6%) of radiographers learned the foundations of EBP as part of their academic preparation. Less than half of the participants stated that they completely understood the research terminology listed in the survey. Most participants had access to the internet and research databases, 79.3% (n = 161). The majority of participants, 63.1% (n = 128) stated that they always used their personal experience, as a source to make a clinical decision in radiography practice. The most common barrier to the implementation of EBP was insufficient time (63.5%, n = 129)., Conclusion: This study showed that despite the positive attitude, and beliefs of radiographers toward EBP, and access to information resources, radiographers still need a higher level of confidence in their ability to engage in and implement EBP; including increased education to support the research skills needs to search and interpret publications., Implications for Practice: The findings of this study may help inform restructure of the undergraduate radiography curriculum, training programs or other interventions required to promote or facilitate the adoption of EBP in Jordan., Competing Interests: Conflict of interest statement None., (Copyright © 2023 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.)

Background: In the absence of definitive treatment, vaccination against COVID-19 emerged as an effective solution to the spread of the pandemic. This study aimed to investigate the factors impacting the rates of COVID-19 vaccine acceptance in Jordan, in addition to examining the relationship between COVID-19 risk perception and vaccine acceptance among the Jordanian population., Methods: This cross-sectional study was conducted among a sample of adults (aged ≥18) residing in Jordan. Data were collected using an online questionnaire disseminated using social media platforms between December 2nd and December 29th, 2020., Results: A total of 2,268 (72.3%) participants demonstrated willingness to receive the COVID-19 vaccine. The mean COVID-19 risk perception score among the participants was 4.65 out of 10 (median 5; IQR 3-6). Higher risk perception scores were significantly associated with being female ( p = .001), young ( p < .001), or a smoker ( p = .005). A significant positive correlation was identified between COVID-19 vaccine acceptance and risk perception scores (OR = 1.319, 95%, CI = 1.261-1.380, p < .001). Moreover, male participants (75%, OR = 1.220, 95% CI = 1.007-1.479, p = .043), participants aged 18-24 years (78.1%, OR = 1.635, 95% CI = 1.189-2.246, p = .002), and participants with children aged under 18 years (73.9%, OR = 1.210, 95% CI = 1.010-1.450, p = .039) were more willing than their counterparts to get vaccinated., Conclusion: COVID-19 risk perception and certain sociodemographic characteristics (i.e., being male, being young, and having children aged under 18 years) were found to be significantly associated with vaccine acceptance. Policymakers are recommended to develop public educational campaigns to enhance people's trust in and willingness to take the COVID-19 vaccine.

Human microbiota have a significant impact on the health of individuals, and reciprocally, lifestyle choices of individuals have an important effect on the diversity and composition of microbiota. Studies assessing microbiota knowledge among the public are lacking, although it is hypothesized that this knowledge can motivate healthier behavior. Hence, this study aimed to measure microbiota knowledge among university students, and the effect of this knowledge on behavioral beliefs. A descriptive cross-sectional study was conducted among students from various fields of study enrolled at the University of Jordan, using an online questionnaire. The questionnaire consisted of 3 parts: demographics, general knowledge of microbiota, and behavioral beliefs related to microbiota. Four hundred and two responses were collected from verified university students. Participants were divided into two groups depending on whether they took a formal microbiology course (45 h) or not. Results from those two groups were compared using appropriate statistical methods. Results showed that most participants, even those who did not take a formal microbiology course, displayed good knowledge of what microbiota is and how they can be influenced by personal and environmental factors. Participants who took a microbiology course had significantly higher microbiota knowledge scores and were more aware of the effect of antibiotics on microbiota. Participants' behavioral beliefs regarding their antibiotic use, but not their diet and lifestyle choices, were affected by their knowledge of microbiota. The study indicates that disseminating knowledge regarding microbiota and microbiology in general, can improve behaviors related to antibiotic use.

Objectives: Polypharmacy is usually associated with duplication of therapy, unnecessary medications and adverse drug reactions. Therefore, it is crucial to study the factors that increase the risk of polypharmacy. The objective of this study was to assess the risk factors for polypharmacy (i.e. the concomitant use of at least five medications) with a special focus on comorbidity in Jordan., Methods: Using a retrospective cross-sectional study design, medical records of patients (age ≥55 years), which covered slightly over one-fourth of the population, found in a national electronic healthcare database from 2018 to 2019 were retrieved. Polypharmacy, the main outcome, was defined as the current use of at least five medications (the patient should have at least one chronic condition, one medication refill and continuous use of the medication for at least 30 days). Comorbidity, the main exposure, was summarized using the Charlson Comorbidity Index (CCI). Potential predictors of polypharmacy were examined using a multivariable logistic regression analysis., Key Findings: An eligible sample of 113 834 individuals (mean age 68 years, 51.5% female) were included in the analysis, of whom 38% met the polypharmacy definition (28% were categorized as having major [5-9 medications] and 10.2% exhibited excessive polypharmacy [≥10 medications]). Approximately, 20% of the patients had a CCI of ≥1. The most significant predictors of polypharmacy were a CCI score between 3 and 4 (adjusted odds ratio [AOR] = 5.89; 95% CI, 5.10 to 6.80; P < 0.001), gender (AOR = 0.86; 95% CI, 0.82 to 0.86; P < 0.001), and age ≥75 years (AOR = 1.62; 95% CI, 1.57 to 1.67; P < 0.001)., Conclusions: Polypharmacy is common among patients in Jordan. Comorbidity is positively, independently and strongly related to polypharmacy. Identifying groups who are at the greatest risk for polypharmacy can help optimize patients' treatment, which can lead to better outcomes and improved quality of life., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Aims of the Study: This study aims to determine females' views, experiences and attitudes regarding the caesarean section (CS) and to explore the factors that increase the prevalence of CS in Jordan., Design: This is a cross-sectional study using a questionnaire that was distributed electronically through social media websites. Study participants included 1005 females with a history of at least one CS. Awareness, experiences about CS, complications and reasons for performing CS were investigated., Settings: The participants were recruited from all Jordan cities by social media and emails., Findings: Most of the respondents stated that the source of their knowledge about CS was from the internet (36.2%) followed by family and friends (31.6%). The majority of respondents were satisfied with their CS experience (72.8%). More than half of the participants (56.9%) reported that CS carries no risk for infants. About 53% of respondents stated that the most common reason leading women to choose to give birth via CS is the fear of labour pain. However, the majority of the respondents disagree with performing CS under maternal request (59.2%)., Conclusions and Implications: This study indicated that Jordanian females do not have reliable sources of information about CS. This leads to lower awareness of CS and its complications, and, as expected, CS is more likely to be performed by privately insured women., (© 2021 John Wiley & Sons Ltd.)

Background: Self-medication with antibiotics is one of the leading causes of antibiotic resistance and drug therapy problems, making antibiotic self-medication practices a global concern. Despite global efforts to limit these practices, self-medication with antibiotics remains prevalent in developing countries. This study aimed to investigate the prevalence and patterns of self-medication with antibiotics in Jordan and to compare the findings of self-medication practices with antibiotics with results from 2006., Method: A cross-sectional community-based study used a convenient sampling technique and recruited a large sample from all over Jordan. Between February and April 2019 trained 5th-year pharmacy students recruited participants (eg, door to door) who had taken antibiotics in the preceding month. The questionnaire consisted of 14 questions that aimed to describe the patterns of self-medication with antibiotics., Results: A total of 1928 participants took part in this study. Of the 1928 respondents, 40.4% reported having used an antibiotic without a prescription in the previous month. Participants who had self-medicated with antibiotics had primarily used them for sore throat and influenza. Self-medicated participants had obtained antibiotics primarily from pharmacies (57.2%) and relied primarily on pharmacists (34.8%) and their own previous experience (35.2%) for information on the proper use of antibiotics. The rate of self-medication with antibiotics in Jordan in 2019 (40.4%) had not changed significantly since 2006 (39.5%, P = .295). However, self-medication practices (eg, source of antibiotic supply and information) have changed over the year., Conclusion: The findings of this study revealed that the prevalence of self-medication with antibiotics in Jordan remains high. This is a significant concern that requires a quick response from the government authorities to develop a collaborative approach to stop the dispensing of antibiotics without a prescription., (© 2020 John Wiley & Sons Ltd.)

Objectives: The aim of this study was to determine the incidence of metabolic syndrome in patients treated with second-generation antipsychotics (SGAs). Methods: In this retrospective study, we reviewed patients' electronic medical records (EMRs) of all patients who received one SGA for at least six months, excluding patients who were taking other medications that are associated with significant effect on metabolic syndrome. Relevant clinical information was collected prior to starting the SGA and after six months of continuous use of the same SGA. Results: A total of 91 patients were included in the study. The majority of patients (72%) were diagnosed with schizophrenia. After six months of taking the SGA, 44% of patients experienced elevated systolic pressure, 54.9% had elevated triglyceride, and 31.9% had impaired glucose levels ( p value < 0.05). Prior to initiating SGA therapy, 14.3% of patients had metabolic syndrome, while 37.4% had metabolic syndrome after six months of therapy, and it was more prominent in males compared to female patients ( p value < 0.05) . Conclusion: This study found a strong correlation between SGA use and the appearance of metabolic alterations, such as weight gain, glucose intolerance, and increased triglyceride levels. These findings highlight the importance of assessing metabolic deregulations to minimize SGA associated metabolic abnormalities., Competing Interests: The authors declare no conflict of interest.

Bovine leukemia virus (BLV) is distributed worldwide. BLV has many effects on the health status and productivity of infected animals and is a potential risk for humans. In this study, we aimed to investigate the presence of and genotype bovine leukemia viruses on Jordanian dairy farms. Nested PCR coupled with RFLP and direct sequencing of a partial fragment of the env gene were carried out. Two BLV genotypes were found, genotypes 1 and 6. These genotypes were identified by nested PCR-RFLP of 444 bp of the env gene by restriction digestion with HaeIII, Bcl I and Pvu II. However, BLV-Jordan-10 seems to represent an entirely new genotype in our phylogenetic analysis. The nucleotide sequence identity between these two Jordanian BLV genotypes (1 and 6) was 96.2 %. The nucleotide sequence identity between Jordanian BLV genotype 1 and other reference BLV genotype 1 strains ranged from 99 % to 99.5 %. The nucleotide sequence similarity of the Jordanian BLV genotype 6 to other BLV genotypes ranged from 90 % to 96.7 %. A neutralizing motif and CD8(+) T-cell epitope were found in the env protein of both Jordanian isolates. In this study, we documented the presence of two BLV genotypes (1 and 6) on Jordanian dairy farms.