SACM - United States of America
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9668
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Item Restricted The Relationship Between Caregivers' Contribution to Heart Failure Self-Care and Patient Self-Care: Exploring the Moderating Effect of Patient Cognitive Status(Case Western Reserve University, 2025-05) Aldossary, Heba Mohammed; Dolansky, Mary; Irani, Elliane; Schiltz, Nicholas; Sundaram, VarunHeart failure (HF) impacts millions worldwide and necessitates ongoing self-care, including maintenance, monitoring, and management, to prevent symptom worsening and hospitalization. Cognitive impairment, impacting memory, attention, and decision-making, is prevalent among patients with HF and may impede their self-care capabilities. In these instances, family caregivers frequently offer essential assistance. The effectiveness of this support in cases of cognitive impairment is not well established. Furthermore, other factors, including patient and caregiver self-efficacy, mental quality of life, and satisfaction with dyadic care may impact self-care, yet they remain insufficiently examined. This research employed a secondary analysis of data from 277 HF patient-caregiver dyads (N = 554) participating in a descriptive cross-sectional study conducted in Italy. Regression analyses, both multiple and moderated, were performed to investigate the relationships between caregiver contributions and patient HF self-care behaviors while evaluating the moderating effect of patient cognitive status and the impact of the covariates. The findings indicated that caregiver contributions were significant predictors of patient self-care in the domains of maintenance, monitoring, and management. Patient self-efficacy was identified as a significant and reliable predictor in all domains of self-care. The relationship between caregiver contribution and patient self-care maintenance and monitoring was significantly moderated by cognitive status, with caregiver support proving more effective for patients without cognitive impairment. Furthermore, caregiver satisfaction with dyadic care exhibited a negative correlation with self-care maintenance, while showing a positive correlation with self-care monitoring. The findings underscore the critical importance of caregiver support and patient self-efficacy in HF self-care, while also indicating that caregivers provide more support when there is no cognitive impairment. The results highlight the necessity of regular cognitive assessments and caregiver training when cognitive impairment exists to assist with HF self-management. The role of caregiver satisfaction indicates that relational dynamics may affect different aspects of self-care, necessitating further investigation. This research informs the creation of tailored interventions that include caregivers, with the goal of enhancing HF management.1 0Item Restricted Weather, Sustainability and Islamic Finance(University of New Orleans, 2025) AlKatheery, Nouf; Hassan, MohammadThe first essay examines how weather conditions affect stock market performance in the Saudi Stock Exchange (TASI). To investigate this relationship, the study employs multiple regression analysis in conjunction with the GJR-GARCH model. we analyze the effects of Air Temperature, Relative Humidity, Wind Speed, and Rainfall on TASI returns. Results indicate Air Temperature has the most significant influence. The impact of weather weakened after foreign investors entered the market, suggesting a shift in investor behavior. Sectoral analysis reveals that the Energy, Information Technology, and Utilities sectors are the most resilient to weather variations. This second essay examines the impact of Environmental, Social, and Governance factors on the profitability of conventional and Islamic banks. Using structural equation modeling, the findings reveal that the Environmental pillar positively impacts profitability in Islamic banks. The Social pillar negatively affects profitability in Islamic banks, while the Governance pillar increases profitability in conventional banks but reduces it in Islamic banks. These results highlight the need for Islamic banks to optimize social initiatives and governance frameworks while conventional banks should enhance environmental strategies.11 0Item Restricted INVESTIGATING THE NATURE AND IMPLEMENTATION OF GOVERNMENTAL POLICIES ON THE INCLUSION OF STUDENTS WITH MILD/MODERATE DISABILITIES IN GENERAL EDUCATION SETTINGS IN SAUDI ARABIA(Kent State University, 2025) Alanazi, Hani Hulayyil; Stevenson, NathanThe government of Saudi Arabia has made significant efforts to provide inclusive education for students with disabilities. Inclusive education enables students with disabilities to receive the same educational services and opportunities as their non-disabled peers. However, the current educational system still faces challenges in achieving effective inclusion. The broad goal of effective inclusion is to provide appropriate services and accommodations for individual educational programs and supports that ensure quality education for all children. Many governments, including Saudi Arabia, have advanced specific policies for the inclusion of students with disabilities, particularly those with mild to moderate disabilities, in general education programs. Nevertheless, Saudi Arabia is still in the preliminary stages of integrating students with disabilities into general educational environments. This study focuses specifically on the perspectives and lived experiences of special education teachers working in elementary schools in Riyadh. The study examines the extent to which existing educational policies in Saudi Arabia encourage the inclusion of students with moderate to severe disabilities in general education classrooms, according to teachers charged with enacting such policies. By analyzing how these teachers interpret and apply inclusive education policies in their everyday practice, the study seeks to illuminate the real-world challenges and contextual dynamics influencing policy implementation. The study identifies systemic gaps and areas where major changes or further improvements are needed to increase the number of students with disabilities in inclusive educational settings. By investigating the current state of inclusive education policies and practices in Saudi Arabia, this research aims to contribute to the development of a more equitable and inclusive educational system for all students.5 0Item Restricted The Impact of Privacy Awareness on Sharenting and Privacy Management Practices Among Saudi Parents(Kent State University, 2025) alnemre, Afnan; Hollenbaugh, Erin; Egbert, NicholeIn the digital age, parents frequently engage in the practice of sharenting—sharing their children's photos and information on social media—raising concerns about privacy and its implications for identity theft and other risks. This phenomenon has significant impacts on the violation of children’s privacy and their psychological and social well-being. Guided by communication privacy management (CPM) theory, this study aimed to identify the role of privacy awareness and religiosity in sharenting and privacy management practices among Saudi parents, using a quantitative approach and relying on a survey as a data collection method, N =139 were collected from Saudi parents. The findings revealed that extrinsic religiosity demonstrated positive relationship with all sharenting dimensions self-control, social behaviors and implications also with boundary linkages and boundary permeability in CPM. Also, intrinsic religiosity has a negative correlation with boundary permeability, while the study does not find a relationship between intrinsic religiosity and all sharenting dimensions. Additionally, there was a significant negative correlation between privacy awareness and boundary ownership in CPM. Moreover, the study has shown gender differences in sharenting behavior, showing that mothers post more pictures of children. This research aspires to inform initiatives promoting privacy-conscious digital practices among parents and aims to support the development of child protection policies in Saudi Arabia to safeguard children's online privacy.22 0Item Restricted Emotional Walls: Designing Architecture That Speaks the Unspoken(Virginia Polytechnic Institute and State University (Virginia Tech), 2025-05) Alkhomairi, Hatim Abdulrahman; Jones, JamesThis thesis investigates how architecture and human emotions connect, linking the physical characteristics of spaces to psychological experiences. It explores how design can evoke emotional responses and how different architectural elements, including light, trigger specific emotional reactions. Using a "Gallery of Emotions" as a foundational project for experimentation, the aim is to develop concepts that are applicable to diverse architectural settings. The design process begins with words that are used to craft atmospheres that evoke targeted emotions. Two complementary approaches guide decision-making: digital software for testing ideas and physical techniques, including sketching and model-making, to achieve a cohesive final design.4 0Item Restricted ASSESSING PRELAMIN A PROCESSING AND PHENOTYPIC EFFECTS OF LMNA MUTATIONS IN A RESIDUE ADJACENT TO THE ZMPSTE24 CLEAVAGE SITE(Johns Hopkins University, 2025) Alkhamis, Danyah; Michaelis, SusanLamin A is a nuclear scaffold protein, synthesized as a precursor called prelamin A, which undergoes several steps of posttranslational processing. This study explores the impact of mutations that affect the final proteolytic processing step, which is mediated by the zinc metalloprotease ZMPSTE24. We assessed the effects of these LMNA mutations, specifically at the L647 residue, on nuclear morphology and protein processing. After establishing a HeLa T-REx cell culture system, we expressed wild-type GFP-tagged LMNA and 11 GFP-tagged LMNA mutants. These mutations were examined against the abnormalities seen in cells from patients with Hutchinson-Gilford Progeria Syndrome (HGPS) and other disorders characterized by the accumulation of unprocessed prelamin A. Results in mammalian cells were compared to previous work performed in a humanized yeast system. Our findings indicate that diminished processing of prelamin seen in the yeast system is recapitulated in mammalian cells. Our results also indicate significant nuclear morphological abnormalities. However, there were no specific correlations between mutations with low cleavage efficiency and higher abnormal nuclei count. This research marks a significant step in understanding the impact of mutations at L647 in prelamin A processing and associated cellular defects. Overall, this study lays the foundation for future investigations into understanding the molecular mechanisms of how LMNA mutations may result in diseases.35 0Item Restricted Assessing the Impact of Certificate of Need Laws on Organ Transplantation Outcomes(Middle Tennessee State University, 2025) Alaohaid, Mohammed; Baum, CharlesThis dissertation examines how institutional regulations and regional dynamics influence the availability and quality of organ transplantation services in the United States. The first chapter assesses the average effect of certificate-of-need (CON) regulations on transplant outcomes across five organs—heart, kidney, liver, lung, and pancreas—using center-level data from 2010 to 2023. Although CON regulations generally enhance availability, they are associated with lower average quality, particularly for heart and liver transplants, possibly due to expanded access for higher-risk patients. The second chapter employs a synthetic difference-in-differences approach to evaluate the effects of repealing and reinstating CON laws on kidney transplants in two states: New Hampshire and Indiana. The findings indicate significant changes in market share, while the changes in availability and quality are either modest or not statistically significant after policy changes. This suggests that the impact of CON regulations may be influenced by regional factors and the initial market conditions of each state. The third chapter investigates knowledge spillovers in heart transplantation using an instrumental variable approach. It finds that centers in regions with higher transplant activity benefit from shared expertise, improving patient selection and procedural efficiency. However, increased transplant rates may also coincide with lower average survival outcomes, likely due to the inclusion of more clinically complex patients. Collectively, these chapters contribute to the literature on healthcare regulation by providing empirical evidence on how policy design and regional specialization influence outcomes in high-stakes medical services. The findings highlight the importance of interpreting average outcome metrics in light of patient heterogeneity and institutional context and suggest that regulatory and regional collaboration strategies can play a critical role in improving transplant care.13 0Item Restricted INVESTIGATING THE NATURE AND IMPLEMENTATION OF GOVERNMENTAL POLICIES ON THE INCLUSION OF STUDENTS WITH MILD/MODERATE DISABILITIES IN GENERAL EDUCATION SETTINGS IN SAUDI ARABIA(Kent State University, 2025) Alanazi, Hani Hulayyil; Stevenson, NathanThe government of Saudi Arabia has made significant efforts to provide inclusive education for students with disabilities. Inclusive education enables students with disabilities to receive the same educational services and opportunities as their non-disabled peers. However, the current educational system still faces challenges in achieving effective inclusion. The broad goal of effective inclusion is to provide appropriate services and accommodations for individual educational programs and supports that ensure quality education for all children. Many governments, including Saudi Arabia, have advanced specific policies for the inclusion of students with disabilities, particularly those with mild to moderate disabilities, in general education programs. Nevertheless, Saudi Arabia is still in the preliminary stages of integrating students with disabilities into general educational environments. This study focuses specifically on the perspectives and lived experiences of special education teachers working in elementary schools in Riyadh. The study examines the extent to which existing educational policies in Saudi Arabia encourage the inclusion of students with moderate to severe disabilities in general education classrooms, according to teachers charged with enacting such policies. By analyzing how these teachers interpret and apply inclusive education policies in their everyday practice, the study seeks to illuminate the real-world challenges and contextual dynamics influencing policy implementation. The study identifies systemic gaps and areas where major changes or further improvements are needed to increase the number of students with disabilities in inclusive educational settings. By investigating the current state of inclusive education policies and practices in Saudi Arabia, this research aims to contribute to the development of a more equitable and inclusive educational system for all students.17 0Item Restricted EXAMINING READINESS FOR PATIENTS AND THEIR COMPANIONS TO TRANSFER FROM HOSPITALS TO SKILLED NURSING FACILITIES IN SAUDI ARABIA(University of San Diego, 2025) Noshili, Fahad; Connelly, CynthiaAbstract Purpose/Aim: This study assessed the readiness of chronically ill patients in Saudi Arabia for transfer from hospitals to skilled nursing facilities (SNFs). It aimed to identify factors that influence this readiness and provide suggestions for making transitions easier. Background: Maintaining chronic patients' ability to transition from hospitals to SNFs is critical for healthcare continuity and quality. However, patients' preparedness for this transition may vary by various factors, including clinical status, caregiver support, and demographics. Conceptual Framework: This study is based on Meleis's Transitional Theory, which highlights the significance of understanding the processes and factors that affect transitions in healthcare environments. This framework is especially pertinent for analyzing the transfer of patients with chronic illnesses from hospitals to SNFs in Saudi Arabia. Methods: A descriptive correlational cross-sectional design was employed. A convenience sample of 123 chronic patients and their companions (families) in hospitals was recruited and enrolled in Saudi Arabia hospitals. After providing informed consent, participants completed surveys that included standardized measures to assess chronic patients' readiness to transition from hospitals to SNFs. The study utilized descriptive and inferential statistical analyses to evaluate variables such as sociodemographic characteristics, clinical profiles, caregiver support, and perceived barriers to transition. Findings: Education, income, chronic illness, self-rated health, and caregiver preparedness significantly predicted readiness to transfer patients from hospitals to SNFs in Saudi Arabia. Education level, income, and self-reported health predicted greater readiness; caregiver involvement positively influenced transition quality. Length of stay, age, and sex made no difference. The findings underscore the importance of interventions to improve caregiver training, financial support, health literacy, and standardizing discharge planning to improve patient transitions. Implications: Policy interventions are needed to help the patient transition from hospital to SNFs in Saudi Arabia. The most common recommendations addressed improving caregiver education, financial support resources, resource allocation using a standardized discharge planning process, and caregiver training programs promoting preparedness. In line with Saudi Arabia's Vision 2030, these measures are intended to create patient- centered care, create fewer obstacles to readiness, and improve overall healthcare outcomes.39 0Item Restricted Demonstration and Assessment of Dark Field and Phase X-ray Computed Tomography(University at Albany State University of New York, 2025) Allahyani, Wadiah Hamed; MacDonald, Carolyn AConventional computed tomography produces a 2D slice or 3D image from multiple conventional images to avoid overlapping structures and increase visualization of the internal features of the object. A set up, macro controls and processing for computed tomography was created for the Center for X-ray Optics for the first time, and demonstrated in this work. Adding differential phase contrast to conventional x-ray images highlights edges. Two more channels of information, dark field and integrated phase, improve the contrast and increase the signal-to-noise ratios of the image. Combining these channels with computed tomography is an important development. This work is the first demonstration of phase and dark field tomography for the Center. Mesh-based x-ray phase imaging is a technique used to extract five computed channels: computed attenuation along with vertical and horizontal dark field and differential phase contrast images. The integrated phase image is computed from the differential phases. A periodic, metal, inexpensive mesh is employed to visualize the distortion of the x-ray beam when a sample present. Fourier transform techniques are utilized to produce those channels. A simple set up was developed to demonstrate computed attenuation, dark field and phase x-ray CT. The signal-to-noise ratios were quantified for the first time for mesh-based CT with a conventional source. The SNR for a strong scatterer was demonstrated to be a factor of 10 higher than the attenuation contrast for a slice through a CT image. Geometric-flow x-ray phase imaging (also known as optical-flow) is another method used in this research for phase reconstruction and combined with computed tomography to produce a phase channel in addition to the conventional CT. This may be the first demonstration of this technique with a conventional, large spot, source. The differential phase images in orthogonal directions map the deformation of the reference pattern. A wire mesh or sandpaper can be used as a reference pattern in the optical-flow technique. The quality of the differential phase x-ray computed tomography was measured for the first time, by edge enhancement and the signal-to-noise ratio SNR. Optimization experiments were performed for the edge enhancement by varying the x-ray voltage and adjusting the distance between the sample to the detector. Similarly, the contrast SNR was examined versus the exposure time for the integrated phase CT.10 0