Saudi Cultural Missions Theses & Dissertations
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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.5 0Item Restricted Towards Legal Reform of the Enforcement of Directors' Duties in the Context of Shareholders' Rights Protection.(Saudi Digital Library, 2025-05-16) Alotaibi, Ayman; STEVEN D ROSEN, ESQUIRECorporate Governance, Directors' Duties, and Shareholders' Rights Protection Legal Landscape of Directors’ Duties in Saudi Arabia Legal Landscape of Directors’ Duties in the USA6 0Item Restricted Exploring Al Balad(Saudi Digital Library, 2025-05-23) alqunfuzi, danah; Mitchell, JacobAl Balad is a well-known destination for Jeddah’s visitors. With its inclusion in UNESCO World Heritage, the site has been transforming to fit the standards and become a more tourist destination. The reason the site is included in UNESCO is due to its diversity and unique architecture and sense of place. Preservation of this type is problematic because it threatens to suppress the dynamics that gave rise to Al Balad, freezing it in time. This thesis asks: How can landscape representation capture agents of change, the present moment, and the past so that the forces that breathe life in historically preserved areas are identified and these sites don’t lose their sense of place?3 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.8 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.5 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 Evaluation of Resveratrol and BioDendrimer-Resveratrol in Models of Dental Pulp Inflammation – In-vitro(Saudi Digital Library, 2025-05-30) Alzahrani, Lina; Gibbs, JenniferVital pulp therapy (VPT) aims to preserve dental pulp tissues and maintain tooth function, while alleviating dental pain. However, persistent pain may necessitate more invasive treatments like root canal therapy (RCT). Current clinical VPT protocols lack options for treatments that might enhance tissue healing and improve post-operative pain outcomes. Resveratrol (RESV), a naturally occurring bioactive compounds, that exists in 72 plant species such as grapevines, blueberries, and others. RESV is known for its anti-inflammatory, antimicrobial, and neuroprotective effects, and it holds promise for VPT. Our aim is to determine the effects of two formulations of resveratrol (resveratrol (RESV) and biodendrimer- resveratrol (BD- RESV) on cytokine expression, mineralization and migration of dental pulp stem cells (DPSCs) challenged with LPS as an in-vitro model of pulpitis. Commercially available (Lansa) DPSCs from healthy adult teeth were grown using a-Minimum Essential Medium (Sigma-Aldrich, St Louis, MO) supplemented with other agents. Cells were maintained at 37 °C / 5% CO2 and plated for experiments at passage 2 or 3. Cells were treated for 2 to 7 days with varying doses of RESV (0.001-100μM), BD-RESV (0.001-100μM) and challenged with LPS or vehicle control (0.001-100μg/ml). Cell viability was assessed using the MTT assay on day 7, cell migration and cytokine expression (qRT-PCR) were evaluated on day 2 and mineralization was evaluated with alizarin red staining on day 28. We found that BD-RESV decreased LPS -induced DPSC cytotoxicity with statistically significant effect on LPS dose of 1μg/ml (p< 0.05), while RESV had no effect. However, both RESV and BD-RESV significantly prevented LPS induced upregulation of IL1-β, IL-6, IL-8 mRNA (p< 0.05). RESV and BD-RESV also induced the formation of calcium nodules (alizarin Staining) with the most significant effect observed at RESV 5μM and BD-10 μM (p< 0.05) and significantly increased DPSC migration (p< 0.05). Resv and Biodendrimer demonstrated a similar ability to mitigate LPS-induced cytokine upregulation and induce mineralization and DPSC migration suggesting its properties are particularly relevant to improve tissue healing in dental pulpas an inflammatory response modulator. However, further in-vivo research that incorporates RESV and BD-RESV as a direct pulp capping material in pulp exposure model of pulpitis is necessary to confirm that RESV's would be useful as a VPT supplementary component.9 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 0