SACM - Canada
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9651
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Item Restricted The impact of nurse work environment on nurse outcomes, nurse-perceived quality of care and patient safety in Saudi Arabia(University of British Columbia, 2018) Alharbi, Amal Ali; Dahinten, SusanBackground: The current shortage of nurses jeopardizes the quality and safety of patient care globally, and is particularly serious in Saudi Arabia. There is ample evidence that nurse work environments are important to nurses’ job satisfaction, burnout, and retention, and the quality and safety of patient care. However, most of this research has been conducted in the United States and Europe with very little emanating from Saudi Arabia or the Middle East. Purpose: This study investigated relationships between components of nurse work environment and nurse outcomes and nurse-perceived quality of care and patient safety. Methods: This correlational study was conducted using cross-sectional data collected from 496 registered nurses working in a large tertiary hospital in Riyadh, Saudi Arabia. Participants completed an online survey similar to that used in RN4Cast studies. Nurse-reported measures were used to assess nurses’ perceptions of their work environments, nurse-outcomes (i.e., job satisfaction, burnout, and intent to leave), and nurses’ perceptions of quality of care and patient safety. Hierarchical logistic regression was conducted to examine the relationships between components of nurse work environment and nurse and patient outcomes, after controlling for nurse and patient characteristics. Findings: Nurses’ perceptions of staffing and resource adequacy was predictive of all nurse outcomes except for intent to leave whereas nurse manager ability and leadership was found to be predictive only of job satisfaction. In terms of patient outcomes, staffing and resources adequacy and nursing foundation for quality of care were found to be the only independent predictors of quality of care and patient safety. Implications for Nurse Leaders: Nurse leaders in Saudi Arabia should give special attention to staffing and resources adequacy, nursing management and leadership, and nursing foundation for care delivery at the unit level. Hospitals in Saudi Arabia should strive for magnet-like qualities as they play a critical role in the recruitment and retention of nurses and contribute to better quality and safe care delivery. Conclusion: Magnet-like work environments that are culturally sensitive are critical to attracting and retaining Saudi nurses and nurses from other countries who are currently vital to alleviating the nursing shortage in Saudi Arabia.16 0Item Restricted Investigating Targeted Driver Mutations And Pd-L1 Expression For Improved Therapy Of Non-Small Cell Lung Cancer(Dalhousie University, 2018-05-24) Alwithenani, Akram Ibrahim; Xu, Zhaolin; Marcato, PaolaMost lung cancer patients are diagnosed at an advanced stage, limiting their treatment options to chemotherapy with very low response rate or other palliative managements. New therapies that target driver gene mutations (e.g. EGFR, ALK, BRAF), are being used to treat patients who have tumours with these mutations. In addition, a type of immunotherapy called immune checkpoint inhibitor is being used to treat lung cancer patients. For instance, patients with tumours that express PD-L1 may be responsive to anti PD-1/PD-L1 therapy. Thus, being able to identify the presence of driver mutations and PD-L1 in tumours will help patients to benefit from different therapies. A total of 851 cases of non-small cell lung cancer samples have been profiled for the presence of EGFR, KRAS, BRAF, and PIK3CA mutations by SNaPshot/sizing genotyping. Immunohistochemistry was used to identify the protein expression of ALK and PD-L1. Histological examination was performed to determine the pathological type, grade, and lymphatic/vascular invasion. Moreover, PD-L1 mRNA expression was quantified by RT-qPCR in a sub-group of the cohort to assess its correlation with PD-L1 protein level. Statistical analysis revealed correlations between the presence of the mutations, PD-L1 expression, and the pathological data. Specifically, it was determined that women had lung tumours with a significantly greater number of EGFR mutations than men. EGFR mutations were significantly linked to the absence of vascular invasion and PD-L1, and KRAS mutations do not associate with PD-L1 expression. Moreover, we found a positive correlation between mRNA levels of PD-L1 by RT-qPCR with PD-L1 expression by IHC. Together, these data provide insights into driver gene mutations and immune checkpoint status in relation to lung cancer subtypes and pathological characteristics and provide useful information for clinical implications.42 0Item Restricted General And Special Education Teachers’ Perceptions Of Knowledge And Beliefs About Dyslexia(Concordia University, 2013-11-07) Alsaig, Alaa; Alagar, Vangalur; Mohammad, MubarakModern societies have become very dependent on information and services. Technology is adapting to the increasing demands of people and businesses. Context-Aware Systems are becoming ubiquitous. These systems comprise mechanisms to acquire knowledge about the surrounding environment and adapt its behaviour and service provision accordingly. Service oriented computing is the main stream software development methodology. In Service-oriented Applications (SOA), service providers publish the services created by them in service registries. These services are accessed by service requesters during discovery process. For large scale SOA, the registry structure and the type of quires that it can handle are central to efficient service discovery. Moreover, the role of context in determining services and affecting execution is central. This thesis investigates the structure of a context-aware service registry in which context-aware services are stored by service producers and retrieved by service requesters in different contexts. The thesis builds on an existing rich theoretical service model in which contract, functionality, and contexts are bundled together. The thesis investigates generic models and structures for context, context history, and context-aware registry. Also, it studies state of the arts database technologies to analyse its suitability for implementing a registry for rich services. Specifically, the thesis provides a thorough study of the structures, implementation, performance, limitations, and features of Key-Value, Documented Oriented, and Column Oriented databases while considering options for implementing a rich service registry. Database models of contexts and context-aware services are discussed and implemented. The relative performance of the models are discussed after evaluating the test results run on large data sets. Based upon test results a justification for the selected model is given.7 0