SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted Cultivating Compliance: Building a Robust Information Security Culture in Higher Education Institutions Through Organisational Culture(Saudi Digital Library, 2025) ALSHAREEF, ASMA AHMED F; Craggs, Barnaby; Ramokapane, MarvinInformation security threats have been seen to severely impact higher education institutions (HEIs), with over 61 major incidents 2020-2023 in the UK alone, with numerous accounts of attacks globally on the sector. These implications might manifest in adverse effects on the institutions, such as reputational damage and financial loss, or on employees, such as disruptions to workflow, research projects, or mental well-being. HEIs have invested heavily in advanced technology to mitigate or eliminate these security threats. However, it is well known that the primary role in safeguarding organisations from such threats lies with employees in terms of their compliance with information security policies (ISPs). Unfortunately, HEIs worldwide still face an alarming pattern of noncompliance among their employees. The literature has suggested that cultivating a robust information security culture can improve employees' compliance with ISPs. Despite this, recent data shows that this culture remains relatively weak in HEIs. Further, the literature indicates that there is still uncertainty regarding which factors are essential to build and nurture a desirable security culture at HEIs, possibly exacerbating the problem. Moreover, the role of the broader organisational culture that underlies the security culture has not been investigated in the higher education setting. To address gaps in the literature, through a mixed-methods approach with participants in the United Kingdom (UK) and Saudi Arabia (SA), the two primary locations of this research, this thesis identifies the key factors of the culture of information security within HEIs, examines the relationships between this culture and the organisational culture, and examines the potential impact of both cultures on employees' compliance behaviours within the HEI setting. This thesis offers three key contributions to the literature, being: 1- validation of seven key factors, previously attributed in other geographies, that are present in developing an information security culture among HEI employees in the UK and SA, 2- evidence of the true positive impact of organisational culture upon the inherent security culture within HEIs, and 3- a model of compliance behaviour which integrates cultural aspects and explains their effects on shaping HEI employee compliance with security policies. This thesis, in its conclusion, offers up practical guidance to leaders and security professionals on how to implement the seven key factors of information security culture along with a how to approach organisational culture with appropriate strategies to help foster a robust information security culture within HEIs and promote good compliance with security policies and procedures.18 0Item Restricted Evaluating Acceptance of Lateral Wedge Insoles for Knee Osteoarthritis in Saudi Arabia: A Mixed-Methods Study(University of Nottingham, 2024) Al Assiri, Abdullah; Loagn, PipBackground: Knee osteoarthritis (KOA) is a degenerative cartilage condition marked by inflammation and mechanical processes. In Saudi Arabia (SA), one in ten older individuals suffer from it. KOA often leads to pain, functional limitations, reduced daily activities, and diminished quality of life. For those with medial knee osteoarthritis, lateral wedge insoles (LWI) can alleviate knee pain and enhance function. While LWI offers biomechanical and symptomatic benefits, the perspectives of Saudi KOA patients and physiotherapists on its clinical use are not well-understood. In addition, there is limited research on gait modification treatment for other types of KOA, especially regarding facilitators and barriers in the Saudi context. Aims: This study aims to identify the suitability and acceptable use of the gait modification approach for reducing knee pain and enhancing functional ability among KOA patients in Saudi Arabia using a mixed methods approach. Methods & Findings: A sequential exploratory mixed-methods approach was employed for this evidence-based study, following the Medical Research Council's (MRC) Framework for Developing Complex Interventions. The research consisted of a systematic review and qualitative investigations, along with the development and testing of a feasibility study. The first component (Background, chapter 2) assesses the efficacy of various gait modification approaches on knee loading, pain, and function with KOA patients, with evidence from the Saudi healthcare system highlighted. Research goals and questions were set. The second component (Systematic reviews and meta-analyses, chapter 4) identifies the most effective gait modification approaches and their primary clinical outcomes during walking. The analysis revealed that most gait modification methods did not significantly reduce the KAM 1st peak in the short and mid-terms. However, the systematic review indicated that lateral stiffener shoes could reduce the KAM 1st peak in the short term, and re-gait training with toe-out positioning might significantly improve the KAM 2nd peak. Furthermore, in the short term, LWI significantly impacted both the KAM 2nd peak and the knee adduction angular impulse (KAAI). Despite these specific benefits, the overall effectiveness of gait modification in reducing knee loading was limited. Subsequently, the third section (Qualitative – chapter 5) utilised semi structured interviews and focus group discussions to grasp KOA patients' and physiotherapists' views on various gait modification techniques before adapting the LWI approach to the Saudi healthcare setting. This approach aimed to identify key features of gait modification and further understanding of stakeholders' knowledge, attitudes, and challenges in its application for KOA patients. The research indicated that implementing knee braces, canes, footwear and insoles was straightforward for patients and therapists, providing notable benefits and improving daily activities. Drawing from prior research, a feasibility study was designed, outlining the suggested LWI as a gait modification, implementation duration, outcomes, and satisfaction survey. The fourth component (Feasibility - chapter 7) evaluated the acceptability, tolerability, and feasibility of personalised LWI for KOA patients at a Saudi centre. This section implemented LWI as a gait modification, measuring recruitment, retention, adherence rates, the Numerical Rating Pain Scale (NRPS), the Osteoarthritis Index (WOAMC), and conducting satisfaction surveys for both patients and therapists. In the initial session, KOA patients were assigned LWI with baseline records, followed by self-reported outcomes, Then, at the 6th week, clinical outcomes (NRPS & WOAMC) were reassessed, and a survey was collected. Of the 21 KOA participants who consented for the quantitative analysis, 17 completed the final evaluation. The study achieved an 87.5% recruitment rate and an 81% retention rate after six weeks. However, it is important to note that comfort was an issue for some participants, as two withdrew citing insole discomfort. The compliance rate assisting at 5.47 hours/day, indicating a 71% adherence, which was below the targeted value. After six weeks, KOA participants showed significant improvements in the NRPS. A t-test revealed that these improvements were statistically significant (p = 0.007) with a large effect size (Cohen's d = 0.98). Similarly, the WOMAC results also demonstrated statistically significant improvements (p < 0.001) and large effect size (Cohen's d = 1.56). Seventeen KOA patients, who completed a survey, approved the LWI and expressed their satisfaction. They rated their satisfaction with the LWI application's clarity at 5 (extremely satisfied) and their symptoms improved satisfaction with the LWI at (64.7% - very satisfied). In the survey, KOA patients rated LWI as straightforward, well-tolerated and adverse-effect-free. The overall therapists’ satisfaction median was "Very satisfied," highlighting a positive response towards the practical skills enhancement provided by the insole, while the overall median for agreement items was "Agree," indicating a consensus among therapists on the insole's beneficial impact on their treatment routine. Given these results, the suitability of LWI in KOA recovery remains debatable. Conclusion: The LWI was viewed as a viable treatment option for KOA in the Saudi context. Both patients and physiotherapists had shown significant interest in this approach. The results of a six-week intervention highlighted its practical benefits, such as reduced knee pain and improved walking capability. Continuous support and guidance from physiotherapists contributed to high levels of adherence, contributing to maintaining activity levels. While LWI offered a promising option in KOA rehabilitation, its full potential remained unexplored. Factors like the current SA KOA clinical protocol, infrastructure difficulties, therapist expertise and LWI availability needed consideration. In the Saudi context, a follow-up trial was essential after this initial intervention to assess the programme's long-term viability and cost-effectiveness. Furthermore, Although the physiotherapists' satisfaction survey indicated that the LWI programme was debatable, the physiotherapy educators needed to integrate knowledge about assistive gait modification (LWI) into their academic and clinical programmes to enhance evidence-based practice.7 0Item Restricted An Exploration of the Suitability of Pharmacy Education in Saudi Arabia to Prepare Graduates to Meet Healthcare Needs: a Mixed-Methods Study(2023-08-01) Alfaifi, Salihah Hadi; Bridges, Stephanie; Arakawa, NaokoThe key role of pharmacists within the health system, particularly in optimising safe, responsible and effective use of medicines, underpins the demand for a highly skilled and competent workforce. Therefore, developing the capacity of pharmacists to attain and maintain essential competencies relevant to the population’s health needs is required to ensure a high standard of patient care, thereby helping to improve patient and population health. In Saudi Arabia, little evidence exists regarding the assessment of national educational programmes’ structure and outcomes. Moreover, no national competency framework exists for pharmacists in any sector or stage of practice. In the absence of such core quality elements to inform pharmacy education assessment and development, the extent to which pharmacy schools in Saudi Arabia prepare competent pharmacists to address societal needs from pharmacy services is unclear. Therefore, this study aimed to explore the extent to which pharmacy education can prepare competent pharmacists to address the healthcare needs for pharmacy practice in Saudi Arabia. An exploratory sequential mixed methods research design was used to address the aim of this study in three phases: individual interviews and focus groups were employed with a purposively selected sample of pharmacy policy makers, pharmacists and the public to explore societal healthcare needs and the roles required of pharmacists to meet those needs; a national online survey of pharmacists and an online nominal group consensus method of pharmacy experts were used to identify competencies considered essential to develop a profession-wide national foundation level competency framework; and a case study in which curriculum mapping of two purposively selected Doctor of Pharmacy (PharmD) curricula was used to assess the extent to which the current pharmacy programme in Saudi Arabia meets the identified competencies of the developed national competency framework. Based on qualitative and quantitative analyses of societal healthcare needs, pharmacists’ roles, core competencies and curricular contents within the local context of Saudi Arabia, findings showed that there is a mismatch between initial education and real practice needs and expectations. While the country’s current needs from pharmacists are to optimise health system capacity and increase access to primary care services and medicines expertise in community pharmacies, the study indicated local education is product-oriented with a focus of curricular content and experiential training opportunities in most schools on preparing future pharmacists for hospital pharmacy practice. The study also identified several gaps between current initial education programmes and the competencies required to practise the expected roles, suggesting that current initial education might not prepare the students sufficiently to provide the full range of quality pharmaceutical services as per the country’s pharmacy practice needs. The study provided a new understanding of graduates’ readiness to practise as per the country’s pharmacy practice needs, the quality of educational programmes and pharmacists' professional development opportunities in Saudi Arabia. Findings maybe used to inform the development of competency-based education and maximise graduates’ capacity to deliver and develop pharmaceutical services effectively to best meet societal healthcare needs in Saudi Arabia.45 0