SACM - United Kingdom
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Item Restricted An Exploration of Occupational Therapists’ Understanding of Mental Health in Saudi Arabia: A Qualitative Investigation.(Saudi Digital Library, 2025-03-03) Alrashidi, Raiyad Abbad D Alrashidi; Whitcombe, SteveObjectives: This study explores the understanding of mental health among occupational therapists in Saudi Arabia. The objectives of the research were to examine the professional and cultural factors that influence occupational therapists’ perceptions of mental health, to assess opportunities and challenges faced by occupational therapists working in mental health settings and to explore the perceived value and role of occupational therapy in mental health care in Saudi Arabia. Methodology: This study used an exploratory- descriptive qualitative approach. Data was collected through semi-structured interviews from eight occupational therapists practising in Saudi Arabia. The data was analysed using reflexive thematic analysis, a framework that facilitated identification and development of key themes. Findings: The findings were categorised into four main themes. Firstly, occupational therapists’ perceptions of mental health. The study revealed varying levels of understanding and awareness of mental health which attributed to lack of professional training in this area. Secondly, inadequacies in training and education showed the need for improved professional development opportunities in mental health among occupational therapists in Saudi Arabia. The third theme examined current challenges and cultural influences in that occupational therapists in Saudi Arabia face systematic barriers since there are no policies to support their role in mental health. They are challenges related to stigma surrounding mental health and limited collaboration between OTs and other healthcare professionals. The final theme centred on future perspectives and recommendations, where participants advocated for increased awareness of their role - occupational therapy in mental health situations. There is a need for policy reforms and integration of occupational therapy into mental health services through professional training. Conclusion: This study provides information on whether mental health has been integrated into occupational therapy in Saudi Arabia and examines the opportunities and challenges facing OT professionals working in the mental health field. The study highlights the importance of addressing challenges such as cultural and systematic barriers limiting the integration of metal health in OT and a need to enhance education opportunities promoting the role of occupational therapy in mental health. The findings of this study will inform future policies and research that will support the integration of mental health into occupational therapy.4 0Item Restricted Plumage Mimicry and Drumming Patterns in Woodpeckers: Unraveling the Complexity of Visual and Acoustic Signals in Species Recognition(Saudi Digital Library, 2024) Alharbi, Sahar; Kort, SelvinoWoodpeckers are known for their distinctive drumming behaviours and diverse plumage patterns, which play crucial roles in communication and species identification. While previous research has highlighted the importance of ecological and geographical factors in driving plumage mimicry among sympatric woodpecker species, the relationship between plumage similarity and drumming behaviour remains underexplored. Specifically, it is unclear whether woodpeckers that exhibit plumage mimicry also share similar drumming rhythms or if they diverge in their drumming patterns to maintain species boundaries. This study aims to fill this knowledge gap by investigating the drumming behaviors of five woodpecker species: Downy Woodpecker (Dryobates pubescens), Hairy Woodpecker (Leuconotopicus villosus), Smoky-brown Woodpecker (Leuconotopicus fumigatus), Checkered Woodpecker (Veniliornis mixtus), and Golden-collared Woodpecker (Veniliornis cassini). Drumming sound recordings were collected from the Xeno-canto website, and key drumming parameters—drum duration, beat number, speed, and cadence—were analysed using Raven Lite 2 software. These findings indicate that while plumage convergence may occur to reduce interspecific competition, behavioural divergence in drumming ensures effective species identification. The study highlights the complex interplay between visual and auditory signals in woodpecker species, providing new insights into the ecological and evolutionary factors driving species coexistence and adaptation.4 0Item Restricted Defining the Core Gene Regulatory Network of PDAC cell Identity(Saudi Digital Library, 2025) Alshaikh, Amani; Soufi, AbdenourPancreatic cancer is one of the deadliest forms of cancer and is the sixth leading cause of cancer-related deaths. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma (PDAC), which originates in the exocrine pancreas and accounts for the majority of pancreatic cancer cases. PDAC is aggressive, rapidly advancing from asymptomatic stages to metastatic disease in most patients. Due to the limited treatment options available, which currently only address a small subset of PDAC cases and the expected rise in PDAC incidence in the coming years, there is an urgent need for early diagnosis at treatable stages. To meet this demand, numerous studies have focused on identifying early diagnostic markers, understanding disease progression, and developing novel treatment approaches. Yet, the PDAC regulatory network that drives its progression remains elusive. This is partly due to the heterogeneity of PDAC and a lack of appropriate controls. In this project, I aim to define the core regulatory network of PDAC using patient-derived xenograft to specifically enrich the aggressive squamous basal-like PDAC type. As a control, I used normal pancreatic exocrine-enriched samples derived from healthy donors. This enabled a comprehensive comparison between PDAC transcriptome and chromatin landscape and normal exocrine cells. Using ChIP-seq, I reveal that PITX1 in combination with other TFs act as master regulators that control PDAC-specific gene expression. Loss of function of PITX1 confirms its crucial role in promoting PDAC cell proliferation and tumour progression. Furthermore, I show that PITX1 sustain PDAC cell identity, by resisting reprogramming to induced pluripotency. Overall, my findings provide a deep insight into the core gene regulatory network of PDAC that is responsible for the disease progression and reoccurrence.8 0Item Restricted The Impact of Animosity, Ethnocentrism, Religiosity and Service Performance on Saudis’ Attitude Towards Airline Services(Saudi Digital Library, 2025-06-05) Albishi , Fahad Saeed Daghsh; Oriade, Ade & Wang, YongAbstract: This thesis examined the impact of animosity, ethnocentrism, religiosity and service performance (moderator variable) on the attitudes of Saudi consumers towards airline services (dependent variable). This was noteworthy and timely, given the context of Vision 2030 and its National Transformation Plan having introduced significant changes in the Kingdom of Saudi Arabia. Airline services in the country are changing demonstrably. Previous research has shown service performance and quality significantly impact consumer behaviour, with dissatisfied customers readily switching to alternative providers; a gap remained in studies around this combination of variables within this geographic area. A wide literature review of themes related to consumer psychology, cultural influences, and service quality models led to the consideration of several potential variables. Animosity, ethnocentrism, and religiosity were selected for their particular relevance to the Saudi context, particularly with the regional cultural and religious significance of air travel for many consumers. Literature revealed studies suggesting that consumer animosity can significantly affect brand perception and loyalty, particularly in markets undergoing transformation (Odeh, 2015). Including service performance as a moderator was influenced by its critical role in shaping consumer experiences and perceptions of airline services. The Theory of Planned Behaviour (TPB) and the Theory of Consumption Values (TCV) provided a robust, holistic framework to examine the dynamics and nuances within the data. A quantitative approach was used, with survey methodology. A purposive sampling frame selected a homogenous study population consisting of 100 passengers at 5 different regional airports (adjusted response rate n= 426, 85.2%). Data analysis used Structural Equation Modelling (SEM) and WarpPLS 7.0 regression with Stable3 resampling technique; testing the model revealed it met the criteria for model fit and quality indices. Age, Gender and Education were controlled for following Marsh’s (1982) elaboration approach. Results revealed both consumer animosity and religiosity positively impacted consumer attitudes, consumer ethnocentrism did not have a significant influence. Service performance was seen to moderate the relationship between consumers’ ethnocentrism and attitude, while consumer animosity was not moderated by service performance. This research offers actionable insight for airlines applying for operational licenses in Saudi Arabia: they inform marketing (e.g. incentivising travel for pilgrims), and emphasise that positive service encounters mitigate the negative impact of ethnocentrism and amplify the positive effect of religiosity on consumer attitudes. Animosity alone did not impact consumer uptake, therefore international airline brands could capitalise on demonstrating cultural sensitivity and high functional value. This study provides policymakers with evidence that supports investment in the sector under Vision 2030. The small effects seen in the results demonstrate that even subtle factors can have cumulative or situational importance. The use of TPB with TCV offers a nuanced lens to offer understanding of consumer behaviour within this unique context.3 0Item Restricted Problems and Benefits Faced by Joint Ventures between MNCS in the Real Estate Sector, as Illustrated by the Joint Venture between the Al-Futtaim Group and the Smith Group(Saudi Digital Library, 2011-12-07) Albishi , Fahad Saeed Daghsh; Durant, AlanAbstract: This study describes benefits and risks the Al-Futtaim Group and the Smith Group are likely to experience as a result of participating in a joint venture tie-up. A structured questionnaire was administered to a set of forty respondents chosen from the managerial levels of the two firms using random and purposive sampling methods. Thirty usable responses are obtained, yielding a survey rate of 75%, and the data thus collected was analyzed by means of the spearman correlation coefficient. Since the findings are based on responses given by managers from the two firms, it is quite possible that a number of risks and benefits beyond the perception of these managers (notwithstanding their experience) may have been overlooked by the study. However, those identified by the study include: the reduction of market entry costs and risks, increased access to new markets, and increased access to new resources and distribution channels. While the preponderance of research studies indicate that national cultural disparities negatively affect the performance of the joint venture, this study finds that this is not the case with the joint venture between the Al-Futtaim Group and the Smith Group. Instead, it suggests that in the case of Al-Futtaim and Smith Group, organizational culture plays a much more substantive role in the success of the merger than do national cultures. The study affirms that the two firms have indeed enjoyed the benefits associated with joint ventures, and finds that such benefits can be generalized for other joint venture partnerships. However, it finds that the impact of culture is context-specific and therefore finds no grounds to make generalizations on that score. A number of recommendations are made, and directions for future research in the same area given.4 0Item Restricted A Focused Ethnographic Study on Kangaroo care of Preterm Infants in a Neonatal Intensive care Unit in Saudi Arabia(University of Dundee, 2025) Almutairi, Amal; McFadden Alison ، Gavine Anna, Malcolm CariBackground: Kangaroo Care (KC), a globally recognised practice involving skin-to-skin contact (SSC) between parents and their preterm infants, is widely endorsed for its physiological, neurobehavioral, developmental, and parental benefits. Despite its significant role in improving survival rates and promoting bonding and breastfeeding, the implementation of KC varies across healthcare settings, often influenced by organisational, practical, and resource-related factors. To initiate this study, a systematic review of the literature was conducted, highlighting a research gap in the Eastern Mediterranean Region (EMR), including Saudi Arabia, where cultural and organisational factors may pose additional barriers to KC adoption. Moreover, KC in Saudi Arabia remains underutilised and insufficiently studied, particularly in NICU setting. Aim: This PhD aimd to explore how KC was perceived, practiced by parents and HCPs in one NICU. It sought to provide insights into the factors that influenced KC implementation, examining the cultural, contextual, and organisational processes, as well as the challenges and opportunities for integrating KC as a standard practice in Saudi neonatal care. Design and methods: A focused ethnographic study was conducted in a large neonatal unit in Saudi Arabia. Data generation, employing purposive sampling with maximum variation, was carried out in three iterative steps: observations and fieldnotes, interviews and a focus group, and document collection. One hundred and fifty hours of observations, 13 interviews with parents (n=13), and 15 interviews and one focus group with HCPs (n=19), and documentary analysis were conducted. Reflexive thematic analysis adapted from Braun and Clarke, (2021) was applied informed by a social-ecological model and family integrated care model. Findings: The systematic review showed generally positive attitudes toward KC among HCPs but identified barriers, including unclear guidelines, staff shortages, and inadequate training. Parents were often uninformed about KC and relied on HCPs for guidance. Practical challenges, such as discomfort with prolonged KC, medical equipment, and lack of private spaces, hindered implementation. The ethnographic study found parents were often unaware of KC before their NICU experience, relying heavily on HCPs for guidance. Initial apprehension, driven by their infants’ fragility and the medicalised NICU environment, highlighted the lack of formal KC training among both parents and HCPs. A hierarchical NICU structure prioritised physician-led decision-making, limiting nurses’ autonomy and excluding parents, particularly in unstable infant cases. Cultural norms, including modesty expectations and traditional gender roles, restricted paternal involvement, while religious practices and open NICU layouts added barriers. Restrictive visitation policies, rigid routines, and an overemphasis on hygiene protocols led to KC being viewed as supplementary rather than integral, deviating from WHO guidelines promoting prolonged SSC. Organisational barriers like inconsistent policies and inadequate staffing further impeded KC implementation. Facilitators included supportive HCP attitudes, particularly among those with international experience, and private NICU spaces that encouraged greater parental participation. Conclusions and implications: The findings of this study emphasise the need for culturally informed, systemic changes to integrate KC as a routine practise of neonatal care in this NICU. There is need for integrating KC into healthcare education, policies, and practices through mandatory training for HCPs, parental education, and infrastructural improvements to ensure privacy. Aligning NICU protocols with WHO guidelines and FiCare can address organisational and cultural barriers, enhancing KC adoption and neonatal outcomes. Future research should focus on scaling up KC implementation, standardising practices, and exploring strategies to promote consistent adherence to evidence-based guidelines.6 0Item Restricted An Investigation of a New Pulse Echo Ultrasound Scanner, the Bindex®, for the Assessment of Osteoporosis in an English Population(Saudi Digital Library, 2025) Algahtani, Abdulkareem; Knapp, Karen; Fulford, Jonathan; Meertens, Robert; Strain, DavidWith its characteristic decrease in bone mass and deteriorated bone structure, osteoporosis increases fracture risk, resulting in a decreased quality of life, increased morbidity and mortality. To avoid fractures and minimise long-term health consequences, early diagnosis is key in terms of providing timely preventative healthcare treatments and interventions. Dual energy X-ray absorptiometry (DXA) remains the gold standard for assessing bone mineral density (BMD), but its limited accessibility and high cost restrict its use in many settings. Bindex®, a portable and radiation-free device using pulse-echo ultrasound, presents a promising alternative. Comparing its diagnostic performance to DXA may support its utility as a point-of-care tool for early osteoporosis detection and triage. This thesis assesses the diagnostic utility of the Bindex® scanner, as a convenient alternative to DXA. Participants aged 40 and above were recruited, based on diabetes status, fracture history, and general health. Bone health was assessed using the Bindex® and compared with DXA. Bindex® was used to calculate the Density Index (DI) at the tibia and radius, while DXA scans were performed at the lumbar spine, both femurs, right knee and right forearm. Statistical analysis included precision testing, correlation and agreement using Pearson’s correlation and Bland Altman plots, and diagnostic accuracy through ROC curve analysis. Linear regression was applied to assess age related changes, and participant acceptability of both scanning methods was also evaluated. The study demonstrated moderate to strong correlations between Bindex® DI measurements and DXA-derived BMD, particularly at the femoral neck. A key finding was that Bindex® showed good diagnostic performance in identifying individuals at risk of osteoporosis, with sensitivity improving to 100% when a population-specific DI threshold of 1.056 g/cm² was applied. Precision analysis confirmed acceptable inter- and intra-operator reliability. Age was found to have a significant but modest association with both DI and BMD values. Participant feedback indicated a high level of acceptability for Bindex® scanning, supporting its potential as a practical and accessible tool for osteoporosis screening, particularly in primary care settings.8 0Item Restricted Characterisation of the Extracellular Vesicles Role in the Mediation of Embryo-Maternal Communication at the Time of Implantation(Saudi Digital Library, 2025) Bafana, Noor; Fazeli, AlirezaThe pregnancy rates after employing Assisted Reproductive Technologies (ART) treatments are relatively low. The most common cause of pregnancy failure appears to be impaired uterine receptivity and inefficient embryo-maternal communication. In recent years, membranous nanoparticles secreted from eukaryotic cells, known as Extracellular Vesicles (EVs), have been identified as essential mediators of intercellular communication and regulators of reproductive processes, including implantation. However, their role in embryo-endometrium communication during early implantation is not fully understood. This thesis investigates the role of EVs in bidirectional embryo-endometrial communication during early implantation, focusing on the impact of a non-receptive endometrium. An in vitro co-culture model, utilising 3D trophoblast spheroids and endometrial monolayers, simulated the dynamic interactions during implantation. The impact of EVs on embryo-maternal communication was investigated at both functional and transcriptomic levels, including the influence of endometrial EV miRNA cargo. Findings revealed a critical interplay between preimplantation embryo surrogates and the receptive endometrium. Receptive endometrial cells responded significantly to trophoblast EVs, and trophoblast spheroids responded uniquely to receptive endometrial EVs. These findings suggest that the receptive endometrium establishes an environment that actively supports embryo development and enhances implantation potential. Conversely, our findings highlighted the potential detrimental impact of a non-receptive endometrium. EVs from a non-receptive endometrium may impair early embryo development and function. Embryo-derived EVs may struggle to elicit a response from compromised endometrial cells. This disrupted communication may contribute to recurrent implantation failure, where inadequate endometrial receptivity and compromised embryo-maternal dialogue underlie repeated failures. In additional work, EVs derived from bovine milk were investigated as a potential natural source of EVs. Their role in enhancing trophoblast spheroid binding and the effect on the trophoblast transcriptome were evaluated, with a focus on milk EV miRNAs. The results demonstrated the promise of bovine milk EVs as a potential therapeutic avenue for improving implantation outcomes.5 0Item Restricted How Flooding is Putting Historical Heritage at Risk(Saudi Digital Library, 2024-08-29) Hanbuli, Waad ALI; Duarte, Natalia VillamizarUrban Flash Flooding is referred to excessive rainfall for a time period of more than six hours in an urban area which has hard surface development stopping the water to soak in ground resulting in to water running through roads and streets and damaging the overall urban land. As per the recent study by world bank, it has been revealed that urban areas are becoming more vulnerable to urban flooding and the key reasons behind are rapid urbanization, climate change and lack of resilient urban management. Floods in the kingdom of Saudi Arabia is considered the most horrific among all-natural disaster and accounted for 34% of death tolls. Emissions from transportation and urban development significantly aggravate the problem and the city of Jed dah is experiencing extreme flash floods causing loss of lives and damage to property. Considering the ancient importance of the Jeddah Historic area, Al-Bald, it suggests the need to conduct research that aims to revitalize this area with innovative urban design techniques to protect it from this horrific incident while preserving its historic character. Moreover, analysis like flood risk analysis, flood susceptibility analysis as well as rainfall analysis have been carried out to analyse the vulnerability of the study area to flash flooding. The analysis revealed that the area is more likely to be impacted by floods during extreme rainfall events. This demands for a sustainable urban design that increase the sponginess of the area to avoid water accumulation. Resultantly, the multilevel strategy-based design optimization incorporates the sponge city theme. Therefore, including wetland, roof gardens, rainwater garden as well as permeable pavements in the existing design of the historic area, which reduces the area’s overall vulnerability to flood and rain-related calamities and serves as a model for comparable urban design practices. This study advances flood prevention in the realm of urban design by providing a broad framework for architectural and urban design.12 0Item Restricted Exploring zero-gap Water Electrolysis Technologies: Benchmarking, Evaluation, and Comparative Analysis(Saudi Digital Library, 2025) Faqeeh, Abdulhai; Symes, MarkWater electrolysis is a promising process to produce green hydrogen, a sustainable and environmentally friendly fuel and a crucial chemical used in numerous industrial applications. Zero-gap water electrolysers have become a key technology for green hydrogen production, mainly due to their high efficiency and hydrogen purity and their rapid response to a wide range of operating conditions and intermittent electricity, facilitating their coupling with renewable energy sources. In Chapter 1, the fundamentals and history of the water electrolysis process are discussed, and the low-temperature water electrolyser technologies are introduced. Moreover, the key evaluation parameters of water electrolysis electrocatalysts are reported. In Chapter 2, all the experimental techniques used throughout this work are introduced and discussed, covering their theoretical background and operation principles. In Chapter 3, a standard anion exchange membrane water electrolyser, a type of zero-gap electrolyser design, is developed and optimised to be used as a universal testbed for evaluating novel electrocatalysts and other components of (anion exchange membrane) water electrolysis. The benchmark is developed because of the absence of a reliable evaluating protocol due to variations in testing conditions and water electrolyser components across studies, obstructing a comprehensive and cohesive comparison of new electrocatalysts (or other components of anion exchange membrane water electrolysis technology). The construction and operation of the standard water electrolyser are described in detail. In addition, 3D drawings of the water electrolyser components are provided (located in the University of Glasgow’s open access data repository, https://researchdata.gla.ac.uk/1672/), enabling others to construct and operate their own identical flow cell. In Chapter 4, the flow cell introduced in Chapter 3 is used to evaluate a new commercially available polymer membrane as an alternative proton exchange membrane to Nafion and Aquivion membranes, which have been in short supply recently. The performance, stability, and hydrogen crossover characteristics of the new membrane is evaluated and compared to those of the Nafion and Aquivion membranes. In Chapter 5, the standard water electrolyser developed and optimised in Chapter 3 is adopted to evaluate a radiation-grafted anion exchange membrane supplied by a research team based at the University of Surrey. The membrane is assessed and compared to a commercial anion exchange membrane (FAA-3-50).6 0