SACM - United Kingdom
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Item Restricted Dental Hygienists’ Contribution to the Oral Health Workforce in Supporting the Oral Health of People in the Kingdom of Saudi Arabia (KSA)(Saudi Digital Library, 2025) Alolayah, Anfal; Gallagher, JennyIntroduction The oral health workforce plays a central role in the World Health Organization's Global Strategy and Action Plan on Oral Health, which highlights the need for transformative changes in workforce models to address population oral health needs. In the Kingdom of Saudi Arabia (KSA), poor oral health is a significant public health concern alongside other non-communicable diseases. Despite advancements in healthcare aligned with Saudi Vision 2030, the oral healthcare system faces challenges, including workforce imbalances, limited preventive oral healthcare, and disparities in oral healthcare access. Globally, dental hygienists play a role in prevention and oral health education, significantly contributing to both clinical and community settings to enhance access to oral healthcare; however, in KSA, their capacity is limited, and their role are unclear. Research is needed to evaluate the current role of dental hygienists in KSA, identify barriers to their optimal integration into oral healthcare delivery, and explore opportunities to expand their contributions in line with national and international goals, for better oral health outcomes. Aim To explore dental hygienists’ current role and practice in the Kingdom of Saudi Arabia, and how this may possibly change in future to better support the oral health of the population as part of the oral health workforce. Methods A sequential mixed-methods approach was adopted, comprising a questionnaire survey followed by semi-structured interviews. Study 1 (Quantitative Survey): An online questionnaire was distributed to dental hygienists across KSA to collect data on their demographic profiles, working environments, service delivery practices, career motivations, and job satisfaction. Statistical analysis included tests like chi- 3 square tests, correlation coefficients, and binomial tests to identify key patterns and associations. Study 2 (Qualitative Interviews): Purposive sampling was used to recruit participants for virtual semi-structured interviews, including dental hygienists, dentists, and dental nurses. Interviews explored perceptions of the dental hygiene profession, its role in oral healthcare, and the barriers and facilitators to its integration into the healthcare system. Framework thematic analysis was applied to identify and interpret key themes. Findings of each study were reported separately and later integrated into the discussion. Results This study draws on diverse perspectives and shows trends within the dental hygiene workforce in KSA. While the survey response rate (9%, n=91) from dental hygienists and qualitative sample size (20) from dental team members present certain limitations, the findings still offer insights into the profession, highlighting areas for further exploration. A strong desire to work in healthcare, serve others, and contribute to public health motivated 97% of responding hygienists, while 51% of those for whom dental hygiene was their first career were influenced by early exposure to dental hygiene, either through personal dental care experiences or professional experience in the field. The findings from interviews highlighted the importance of informed decision-making in achieving career satisfaction, as participants pursued the profession seeking professional recognition, high-income potential, and job security. When these expectations were unmet, dissatisfaction and retention issues arose, with 58% of survey respondents considering leaving the profession. Findings suggested limitations in the scope and settings in which responding dental hygienists operate with a focus on the provision of oral hygiene instruction (95%) and scaling (87%), in predominantly urban locations (59%), hospital environments (86%), and public sector facilities (59%). Limited involvement in community-based care or with vulnerable groups restricts their contributions to broader public health goals. Fifty percent of the respondents to the survey were satisfied with their job, citing the extent 4 to which hygienists could fully utilise their skills as a key factor. Those working independently of dentists reported higher satisfaction levels. Findings from the interviews highlighted barriers that hinder the optimal utilisation of dental hygienists including limited skillsets, insufficient delegation of tasks by dentists, and inadequate access to essential resources. Participants proposed strategies to address these issues, such as enhancing undergraduate programmes, offering tailored continuous professional development, and fostering interprofessional collaboration through joint education and training. Developing a clearly defined scope of practice and establishing clear clinical guidelines were also recommended. Participants in the interviews, including hygienists, dentists, and dental nurses, perceived that the profession is underutilised but envisioned opportunities for growth. While individual views on specific areas of expansion varied, collectively, they pointed toward a more expanded role for dental hygienists. Proposed expansions included a stronger presence in primary oral healthcare, increased involvement in community settings, and broader responsibilities within dental practices. Participants recognised that achieving this requires improvements in both the profession and the healthcare system. For the profession, key areas include career counselling, standardised education and licensing, a comprehensive scope of practice, expanded training programmes, and leadership development. These measures would attract motivated students, strengthen professional identity, and sustain workforce commitment. For the healthcare system, strong governance is important, including a dedicated oral health department, data-driven planning, efficient resource allocation, preventive care pathways, policies addressing health risks, and improved oral health literacy. These initiatives would secure role for hygienists and enhance oral healthcare delivery in Saudi Arabia. Conclusion The findings suggest that while dental hygienists' current role, scope of practice and workplace locations in KSA are limited, opportunities exist to expand their role within the oral healthcare workforce to better support oral healthcare delivery which relate to careers, education and training, governance, care delivery and leadership. Expanding the role of dental hygienists aligning the oral health care system in KSA with global best practice is recommended.3 0Item Restricted THE USE OF BIM IN HEALTHCARE FACILITIES MANAGEMENT AND OPERATIONS IN SAUDI ARABIA: INVESTIGATE ITS BENEFITS AND CHALLENGES AND SUGGEST AN IMPLEMENTATION ROADMAP(Saudi Digital Library, 2025) Alqahtani, Ghanem Hamed; Rolla, Monib; Supervisor's, NameDigital technologies have significantly impacted construction and facility management globally. Building information modelling (BIM) is a powerful tool intended to improve the performance and management of a building as it progresses through its lifecycle. However, its application in Healthcare Facility Management (HFM) in the Kingdom of Saudi Arabia (KSA) remains limited. This dissertation examines BIM's advantages, disadvantages, and potential for implementation in KSA healthcare operations. This study uses a mixed-method approach to investigate BIM awareness, implementation, perceived barriers, and the roadmap to adoption through quantitative surveys and qualitative interviews. The results found that BIM provides numerous benefits, including increased maintenance planning, energy efficiency, and cost control. Adoption challenges include high initial costs, expertise shortage, resistance to change, and data security concerns. The study is in line with Saudi Vision 2030 and, therefore, supports the integration of technology and sustainable FM to improve the healthcare infrastructure of the Kingdom. This study adds insights into BIM's potential to improve HFM and recommends it for professionals and researchers. To address existing challenges and utilise BIM technology, this research aims to improve the efficiency, cost-effectiveness, and technological advancement of the healthcare system in the KSA.2 0Item Restricted Shaping Minds: A Critical Discourse Analysis of George W. Bush’s Use of Imagery in His Speeches Leading to the Iraq War(Saudi Digital Library, 2024-08) Alhamami, Tahani; Mazzola, FranciscoThis study investigates how the use of imagery in President George W. Bush’s speeches from the aftermath of 9/11 to the onset of the Iraq War had an impact on the public’s emotions and opinion, eventually leading them to support the military intervention. It argues that employing imagery in political discourse can create mental images in the mind of the audience which can stir their emotions and impair their critical thinking, and thus make them susceptible to manipulation. Through van Dijk’s framework of CDA and Le Bon’s theory of the crowd, the study identifies instances of imagery in six speeches by Bush and analyzes the mental images they evoke to assess the emotive effect on the audience. The research also uses secondary source polls to measure the public perception of the Iraq War. The findings reveal that Bush strategically employed imagery to revive past fears and traumas, reinforce preexisting ideologies, and warn of impending threats, thereby manipulating public perception to justify the war. Finally, the study discusses the ethical implications of using imagery in political discourse to manipulate people.8 0Item Restricted STRIVING TO CONTROL ASTHMA SYMPTOMS: A CONSTRUCTIVIST GROUNDED THEORY STUDY OF BEING A MOTHER OF A CHILD WITH ASTHMA IN SAUDI ARABIA(Saudi Digital Library, 2025) Alsunitan, Randa; Susan, Kirk; Christie, JaniceIntroduction: Asthma is a common chronic lung disease among children in Saudi Arabia. Parents play an important role in recognising, monitoring, and managing their children’s symptoms, which depends on their knowledge and skill, especially for young children. Yet, no study has been identified that explores mothers’ experiences of caring for a child with asthma in Saudi Arabia. Aim: To generate a Grounded Theory to explain the experiences and perceptions of being a mother of a child with asthma in Saudi Arabia. Methods: A Constructivist Grounded Theory approach was adopted, and 24 in-depth semi- structured interviews (n=22 mothers) were used to collect data from May 2022 to September 2023. Mothers in Saudi Arabia whose children were attending one of three hospitals in Qassim were initially convenience sampled, progressing to theoretical sampling until theoretical saturation was reached. Interviews were transcribed and translated into English and analysed using Charmaz’s principles: initial, focused, and theoretical coding, constant comparison, theoretical sampling and sensitivity, and memo-writing and diagramming. Results: The Grounded Theory, ‘Striving to Control Asthma Symptoms,’ was constructed from the data, which consists of a core category, ‘striving to control asthma symptoms,’ and two sub-categories: ‘managing the triggers of asthma symptoms’ and ‘using treatments to manage and prevent asthma symptoms.’ The theory explains mothers' experiences and the cultural beliefs and social influences that underpin their experiences. Mothers control asthma symptoms by preventing triggers and using preventive treatments, such as inhalers or traditional and religious methods. When symptoms appear, they manage them with either traditional or modern treatments. Conclusion: The emergent theory suggests that striving to control asthma symptoms is central to the mother’s experience in the Saudi context. It highlighted how cultural beliefs and social influences impact the management of asthma symptoms in Saudi Arabia. This study provides an in-depth understanding of Saudi mothers' experience of being a mother of a child with asthma. This understanding could assist healthcare professionals and policymakers in supporting mothers and providing better culturally tailored care.Item Restricted Preventive Strategies and Health Promotion Initiatives for Osteoporosis in the United States(Saudi Digital Library, 2024) Aldekhayel, Marwan; Verma, ArpanaThis review critically examines the preventive strategies and health promotion initiatives implemented to mitigate osteoporosis in the United States (US). Osteoporosis, a progressive bone disease characterised by low bone mineral density, poses a significant public health challenge due to its association with an increased risk of fractures, particularly in the elderly and postmenopausal women. In a high-income country like the US, with population ageing becoming a major public health concern, the prevention and control of osteoporosis and its related health consequences have become paramount. This review highlights the rising prevalence of osteoporosis, leading to substantial healthcare costs in the US, where it impacts approximately 54 million adults over the age of 50, contributing to over two million fractures annually. It also details various initiatives and organisations working to address this problem. These include the Bone Health and Osteoporosis Foundation (BHOF), which focuses on public education and advocacy, and government-led programs such as Healthy People 2030 and initiatives by the National Institutes of Health (NIH) and the United States Preventive Services Task Force (USPSTF). These efforts aim to enhance screening, promote bone health, and support osteoporosis prevention and treatment research. Despite such efforts for several decades, the burden of osteoporosis does not seem to have declined. Many initiatives operate independently, leading to overlapping activities, redundant research, and fragmented outreach efforts. By fostering stronger partnerships and creating a more unified national strategy, these organisations could pool resources, share data more effectively, and streamline their health promotion activities. The review's findings underscore the importance of continued investment in public health strategies to manage the growing burden of osteoporosis in the US population, with a particular focus on addressing the needs of the vulnerable and marginalised.Item Restricted Enhancing Project Resilience through project Management -Driven Stakeholder Communication; A Case Study of Sainsbury’s COVID-19 Response in the UK.(Saudi Digital Library, 2025) Benqadeb, Ziad Fahad A; Agroudy, Mohamed ElThis dissertation explores how using project management-driven stakeholder communications influenced Sainsbury’s and contributed to the success of its Online Delivery Expansion and In-Store Safety Implementation Projects during the COVID-19 crisis. Analysing secondary information from the company’s reports, news and industry material, the research investigates the relation of communication to cost, time and quality. To analyse the situation, the IRCRF, supported by Situational Crisis Communication Theory, the Resilience Engineering concept and PRINCE2 Agile, was used. The results show that Sainsbury’s clear communication allowed for quick growth in delivery services by adding 600,000 slots and ensuring customers’ \safety with over 40,000 plexiglass screens, despite struggles with 30% shortage of stock. The company managed the strong online sales by using flexible strategies which cut down on employee absenteeism by 15% and drove digital sales growth to 117%. Sainsbury’s way of operating gave it an edge, allowing for fewer issues reported by a 18% decrease in complaints when compared to Tesco and Asda. This research points out the importance of organised communication in successful projects and it provides valuable tips for retail crisis management. It provides tools for improved future resilience, highlights the value of involving all stakeholders and helps develop frameworks for managing crises which is significant for retail project outcomes.Item Restricted Nonparametric Predictive Inference for Multivariate Data using Copulas(Saudi Digital Library, 2025) Almasoud, Taghreed; Coolen, Frank; Coolen-Maturi, ThahaniModelling dependence among random quantities is a core aspect of multivariate data analysis. Copulas provide a flexible and powerful approach to capturing the dependence structure between random quantities. Several dependence models have been proposed in the literature, including classical copulas, vine copulas, and fully nested Archimedean copulas (FNAC). In parallel, several statistical methods have been developed within the imprecise probability framework, including nonparametric predictive inference (NPI). NPI is based on minimal modelling assumptions and quantifies uncertainty using lower and upper probabilities. Recently, NPI has been applied to bivariate data using both parametric and nonparametric copulas. This thesis contributes to the use of NPI for multivariate data by presenting different approaches for prediction. The focus is on copulas for modelling dependence, as they provide high flexibility for modelling complex dependency patterns. A generalization is proposed for the method that combines NPI with bivariate data, using a parametric copula with a single parameter to model dependence. The approach is further extended by introducing a fully nonparametric version that uses a nonparametric copula. A novel method for combining NPI with vine copulas is also presented, motivated by the vine copulas ability to capture several dependence structures in a model. In addition, a new method integrating NPI with FNAC is developed, where FNAC is a promising model for capturing different dependencies within a model using Archimedean copulas. The proposed methods are illustrated using examples from the literature. Simulation studies are conducted to evaluate the predictive performance of the proposed methods and to compare the methods, highlighting their strengths and differences. The results indicate that the methods with either vine copulas or FNAC perform well compared to other methods.Item Restricted Investigation of Novel Type III Secretion System Protein Effectors of Aeromonas veronii(Saudi Digital Library, 2025) Alfaify, Abdulkhaleg; Shaw, JonathanThe type III secretion system (T3SS) plays a crucial role in the pathogenesis of various Gram-negative bacteria, enabling them to directly inject effector proteins into host cells. This study focuses on the identification, characterization, and functional analysis of putative T3SS effector proteins (AopX, PteB, and PteA) in Aeromonas veronii. Insertional gene mutants were generated and evaluated using the Galleria mellonella larvae infection model, showing significant alterations in virulence phenotypes. Transcriptomic analysis of an exsD mutant strain provided insights into the regulation of these novel effectors and demonstrated that they were part of theT3SS regulon. The study further characterized these proteins through expressing them in both Saccharomyces cerevisiae and A549 mammalian cells. Fluorescence imaging analysis showed that these proteins had significant impacts on host cell morphology and cytoskeletal organization. Additionally, BioID proximity labelling combined with mass spectrometry proteomics analysis identified host protein interactions and key cellular pathways that influenced by these bacterial effectors. Furthermore, protein purification was optimized using various chromatography approaches and computational modelling via AlphaFold and Phyre2 was used to predict and align protein structures. Overall we found that AopX, PteB, and PteA are regulated by the T3SS regulon. AopX primarily disrupts the actin cytoskeleton in both yeast and A549 cells, most probably through interacting with Filamin A, while PteB prevents bud formation and affects cell cycle progression by interacting with Serine/Threonine phosphatases. This comprehensive investigation enhances our understanding of T3SS effector proteins in A. veronii pathogenesis and provides insights into their regulation, structural features, and specific mechanisms of host cell manipulation.23 0Item Restricted Design and Analysis of Next Generation Wireless Networks(Saudi Digital Library, 2025) Altuwairgi, Khaled Humaid; Hamdi, KhairiRecent advancements in wireless communications have increased the demand for high data rates, massive connectivity, high spectral and energy efficiency, and low latency, which cannot be met by existing systems. The sixth-generation (6G) wireless network is envisioned as the next step to support these demands by integrating technologies, including intelligent reflecting surface (IRS), backscatter communication, non-orthogonal multiple access (NOMA), integrated sensing and communication (ISAC), and terahertz (THz) communications. Specifically, the IRS enhances the energy and cost efficiency by controlling the propagation environment through an array of reflecting elements. Backscatter communication enables passive battery-free devices to communicate using external RF signals, offering an energy-efficient and low-cost solution for the Internet of Things (IoT) paradigm. NOMA improves spectral efficiency and massive connectivity by allowing multiple users to share the same time-frequency resources, while ISAC combines sensing and communication functionalities into a single system for efficient spectrum and hardware usage. Finally, THz communication addresses the current limited spectrum by providing extensive bandwidth that supports ultra-high data rates. This thesis studies the integration of these technologies with a special focus on IRS and backscatter communications, considering various system models and realistic scenarios. It evaluates the performance of IRS-aided backscatter communication in both dedicated and ambient configurations using different detection techniques and transmission schemes. It also investigates IRS-assisted THz to serve multiple users through NOMA and wireless powered communication under various practical scenarios. Moreover, it explores the integration of ISAC with ambient backscatter communication. The thesis identifies the potential benefits of these technologies and examines the adverse impacts of practical factors such as beam misalignment, co-channel interference, imperfect successive interference cancellation, phase shift quantization errors, and hardware imperfection. Accurate analytical expressions are developed for key metrics, including bit error rate, ergodic capacity, and outage probability, under various system models and transmission schemes. Numerical and simulation results are provided to validate the accuracy of the theoretical analysis and provide valuable insights into the system design.12 0Item Restricted Sustainable Waste Management of Date Palm Fronds in Saudi Arabia: Pyrolysis-Derived Biochar Integration into Construction Materials for Carbon Sequestration(Saudi Digital Library, 2024-09) Shaiban, Saad; Scott, BanksThis study focuses on integrating biochar derived from date palm fronds into cement production in Riyadh, Saudi Arabia (KSA), to optimise carbon sequestration (CCS) and reduce carbon emissions. Employing a mixed-method approach, the research combines quantitative Life Cycle Assessment (LCA) using SimaPro software with qualitative sustainability analysis through the Bioeconomy Sustainability Indicator Model (BSIM) and Sustainable Development Goals (SDGs) indicators. Phase 1 compares the environmental impact of traditional open combustion versus pyrolysis for biochar production, revealing that pyrolysis significantly reduces carbon emissions from 3.5 tons CO₂-equivalent per ton of waste to 646 kg CO₂-equivalent. This substantial reduction supports Riyadh's climate goals and aligns with KSA’s Vision 2030 sustainability objectives. Phase 2 evaluates the integration of biochar into cement mortar, showing that a 20% substitution of cement with biochar reduces emissions by 24.81 kg CO₂-equivalent per ton of mortar, potentially saving up to 1,796 million tons of CO₂-equivalent annually based on current cement production levels. The sustainability analysis using BSIM highlights benefits such as job creation and economic growth while identifying transportation logistics risks and production efficiency risks. Additionally, the study assesses contributions to SDGs, particularly in climate action, sustainable cities, and responsible consumption and production. The study recommends optimising the supply chain, investing in advanced pyrolysis technology, and supporting market development through policy incentives. Future research should focus on the long-term performance of biochar, explore additional applications in agriculture and water treatment, and further integrate biochar into sustainable construction practices. This research provides valuable insights for advancing sustainable waste management and construction practices in Riyadh, contributing to climate action and supporting regional and global sustainability efforts.18 0