Saudi Cultural Missions Theses & Dissertations
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Item Restricted Evaluating Reported Patient Perspectives of Teledentistry Use for Dental Care Provision During the COVID-19 Pandemic in Saudi Arabia: A Scoping Review(University of Exeter, 2024) Althabit, Thabet; Carrieri, DanieleBackground: The COVID-19 pandemic significantly impacted dental services, increasing interest in teledentistry as an alternative. In Saudi Arabia, dental clinics' temporary closure in March 2020 made teledentistry crucial for maintaining dental care. Despite advanced technology, teledentistry use was low. Understanding patient perspectives is key to improving its adoption. Objective: This review synthesizes evidence on patient perspectives, satisfaction, and perceived outcomes of teledentistry during the COVID-19 pandemic in Saudi Arabia to guide future strategies and research. Methods: Following a scoping review methodology, we searched multiple databases from 2020 to 2024, identifying studies involving Saudi patients using teledentistry during the pandemic. Data were extracted and analyzed thematically. Results: Eleven studies from 2020 to 2023 were included. Key themes were accessibility, convenience, patient satisfaction, and security concerns. Teledentistry improved access and reduced costs, with high satisfaction for minor issues. However, data privacy concerns and limitations in handling complex cases were noted. Conclusion: Teledentistry offered significant benefits during the pandemic, enhancing accessibility and patient satisfaction for minor issues. Yet, managing complex cases and ensuring data security remain challenges. A hybrid model of teledentistry and in-person visits is recommended. Further research on long-term effects, cost-effectiveness, and data security is needed.27 0Item Restricted The Cross-Section of Stock Returns and Factor Premiums in the Saudi Stock Market(Victoria University, 2024-04) Alshaikhmubarek, Asim; Seelanatha, Lalith; Kulendran, NadaThe recent reformation and globalisation of the Saudi stock market have underscored the necessity of investigating the patterns that drive market returns, with factor premiums and asset pricing models serving as crucial analytical tools for this purpose. Therefore, this study examines whether the Fama and French (2015) five-factor model (FF5FM) provides a better explanation for the cross-section of stock returns than the Fama and French (1992) three-factor model (FF3FM), and whether the factors utilised in these asset pricing models have a significant premium in the Saudi stock market. Furthermore, this study introduces a new factor, the Islamic premium, to the Fama and French asset pricing models and examines whether this factor has a significant premium or enhances the models’ ability to describe the variation in average returns. The research also investigates whether the recent global market integration has altered the significance of the factor premiums and the explanatory power of asset pricing models. Finally, to understand the market behaviour during crises, the impact of COVID-19 on stock performance and factor premiums is analysed. A one sample t-test is employed first to examine the significance of all factor premiums. Then, the GRS test for portfolio efficiency is used to compare the performance of the asset pricing models and to identify the most effective model based on the lowest GRS value. Then, this study divides the sample period into two subperiods – pre- and post-global integration – to assess the significance of the factor premiums (using a one-sample t-test) and the performance of the asset pricing models (using the GRS test) in each subperiod. Additionally, a two-sample t-test is conducted to ascertain any significant changes in the factor premiums, and robustness checks are performed using monthly/weekly returns and value-weighted/equal-weighted portfolios across all the methods applied in this study. Finally, panel regression analysis and the Wald test are used to examine the implications of COVID-19 on the performance of stocks in the market. This study finds that the value premium is the only factor that has a significant equity premium across all the examined portfolios. This indicates that future investors in the Saudi stock market could generate higher returns if they invest in stocks with a higher B/M ratio. However, the study also finds that the inverse of the investment premium is significant, which means the stocks with higher investment growth have a significant equity premium. This may be attributed to investors’ potential overreaction to positive news, such as investment growth, and herding behaviour. The study further finds that Fama and French’s FF5FM generally outperforms FF3FM, particularly when using factors constructed from the 2 × 3 sort. Conversely, when employing factors from the 2 × 2 sort, the Islamic premium notably enhances the explanatory power of FF5FM and FF3FM. The study finds evidence that the size effect started to reappear in the market after global integration. More substantial evidence shows that the value premium emerged following changes in market demographics. On the other hand, the inverse of the investment premium was significant before global integration but has disappeared since then. These findings show that after market reforms, investors in the Saudi market have made more informed investment decisions and paid more attention to factor premiums. The study also found that the best asset pricing model for describing variation in the cross-section of stock returns differed before and after the global market integration. From 2018 onward, incorporating Islamic premiums have improved the explanatory power of the Fama and French asset pricing models. Additionally, value-weighted portfolios always give higher returns than equal-weighted portfolios. This could be due to the poor performance of smaller stocks and higher exposure to larger stocks in value-weighted portfolios. Finally, there is evidence that Islamic and less profitable stocks performed poorly compared to non-Islamic and more profitable stocks during the COVID-19 crisis, most likely due to liquidity challenges. Most firms experienced a revenue decline during COVID-19, particularly stocks with low profitability, as they already had cash flow issues. However, the limited financial sources available to Islamic stocks compared to non-Islamic stocks worsened their liquidity position and made them more vulnerable.9 0Item Restricted Analyzing the Spread of COVID-19 Misinformation on Twitter: Patterns, Impact, and Countermeasures(Auckland University of Technology, 2024) Abokhanjar, Hissah; Li, Weihua; Wang, XiaodanTwitter, as a significant information hub during the pandemic, has facilitated the rapid spread of accurate updates and false narratives, contributing to the ‘infodemic.’ This study investigates the most common types of COVID-19 misinformation spread on Twitter and examines their impact on public perception and behavior. By analyzing a substantial dataset of COVID-19-related tweets, the research identifies recurring misinformation themes, including erroneous claims about the virus’s origin, prevention strategies, treatments, and vaccine efficacy. Prominent misinformation types include theories falsely attributing the virus’s origin to human engineering or intentional release, unproven prevention methods like natural remedies, and misleading treatment options, such as the promotion of unapproved drugs. Additionally, vaccine-related misinformation, including baseless claims about vaccine safety, side effects, and hidden agendas, contributed significantly to public skepticism and hesitancy. The study explores how these misinformation narratives influenced public attitudes and behaviors, revealing that exposure led to increased vaccine hesitancy, reduced compliance with public health guidelines, and the widespread acceptance of conspiracy theories. These effects complicated public health efforts and deepened social and political divisions, further impeding effective pandemic management. The findings highlight the urgent need for strategies to counter misinformation and promote accurate public health information, especially during global crises. Public health authorities, social media platforms, and educators must collaborate to enhance information literacy, improve content moderation, and develop targeted interventions. These efforts are crucial to mitigating the spread and impact of misinformation, thereby safeguarding public health and trust in scientific expertise.22 0Item Restricted THE RELATIONSHIP BETWEEN ESG AND FINANCIAL PERFORMANCE OF UK FTSE 250 LISTED FIRMS.(University of Sussex, 2024-09) Alhuqayl, Nouf; Hawas, AmiraIn this dissertation, the relationship between the Environmental, Social and Governance (ESG) principles in relation to the financial performance of FTSE 250 companies pre-and during COVID-19 was studied. Utilizing data from Bloomberg and to conduct regression panel models with fixed and random effects, a Hausman test was performed in order to choose the most effective model. The study reveals that ESG including its sub-dimension exhibit minimal influence on financial outcomes pre-pandemic with only slight improvements noted during the pandemic. The data corroborates the assertion that despite virtually no clear monetary advantages of ESG integration is seen at once, its contribution keeps increasing over time. The study emphasizes the complexities of ESG impacts and the need for companies to tailor their ESG strategy to specific operational and economic settings in order to maximize advantages. This study contributes to the nuanced understanding of ESG integration and encourages more research into its long-term effects in various businesses and regulatory situations.5 0Item Restricted THE RELATIONSHIP BETWEEN ESG AND FINANCIAL PERFORMANCE OF UK FTSE 250 LISTED FIRMS.(University of Sussex, 2024-09) Alhuqayl, Nouf Khalid; Hawas, AmiraIn this dissertation, the relationship between the Environmental, Social and Governance (ESG) principles in relation to the financial performance of FTSE 250 companies pre-and during COVID-19 was studied. Utilizing data from Bloomberg and to conduct regression panel models with fixed and random effects, a Hausman test was performed in order to choose the most effective model. The study reveals that ESG including its sub-dimension exhibit minimal influence on financial outcomes pre pandemic with only slight improvements noted during the pandemic. The data corroborates the assertion that despite virtually no clear monetary advantages of ESG integration is seen at once, its contribution keeps increasing over time. The study emphasizes the complexities of ESG impacts and the need for companies to tailor their ESG strategy to specific operational and economic settings in order to maximize advantages. This study contributes to the nuanced understanding of ESG integration and encourages more research into its long-term effects in various businesses and regulatory situations.10 0Item Restricted COVID-19 and global health governance: past and future(University of Sheffield, 2024) Alqurashi, Wedyan; Caterina, MiloThis dissertation explores the critical role of global health governance, focusing primarily on the World Health Organisation (WHO) and its effectiveness in managing pandemics. It analyses WHO’s involvement in past pandemics, such as SARS, H1N1, Ebola, and COVID-19, identifying challenges and lessons learned. The dissertation also examines the global impact of the COVID-19 pandemic, emphasising the disparities in health outcomes and access to resources. Utilising a qualitative research design, it delves into the mechanisms, key players, and frameworks involved in global health governance, particularly the International Health Regulations (IHR). Findings highlight the importance of rapid, transparent communication and the need for stronger enforcement mechanisms within the IHR. The dissertation underscores WHO’s pivotal role in providing technical guidance, coordinating international efforts, and promoting equitable access to health resources. It also reveals significant challenges, including delays in response, political pressures, and the spread of misinformation. Recommendations include enhancing WHO’s autonomy and funding, ensuring binding compliance with health directives, and integrating mental health into global health strategies. This research aims to inform future policy and practice, promoting a more resilient and equitable global health governance framework to better prepare for future pandemics.12 0Item Restricted UNDERSTANDING THE LIVED EXPERIENCES OF SAUDI ARABIAN INTERNATIONAL STUDENTS IN THE UNITED STATES DURING THE FIRST STRIKE OF THE COVID-19 PANDEMIC: A PHENOMENOLOGICAL STUDY(Oakland University, 2024) Aldaej, Sarah Adel; Smith, JuliaThis research aimed to explore the lived experiences of Saudi Arabian international students studying in the United States during the first strike of the coronavirus (COVID-19) pandemic. Three research questions guided my study: What challenges did Saudi Arabian international students studying in the United States experience at the onset of the COVID-19 pandemic? What type of support or services did the students receive from their institutions or the government? How did the students cope and adjust as the COVID-19 pandemic persisted? This research applied segmented assimilation theory to the students' integration theory and drew on higher education research literature to suggest some indicators that could be employed to study international students' perceptions of their higher education experiences. The aim was to gain a deeper understanding of students' experiences from underrepresented groups better. I employed a qualitative research design to develop an understanding and identify common challenges Saudi Arabian international students experienced during the first strike of the coronavirus pandemic. I collected data from 10 participants by conducting in-depth phenomenological interviews. I developed the interview protocol with a list of semi-structured interview questions prepared in advance and used to guide the interviews. The findings revealed six major themes: (a) Financial impact, (b) Impact on academic life, (c) Institutional communication and support, (d) Impact on social life and social support, (e) Emotional and psychological impact and support, and (f) Strategies for adaptation and persistence. The themes from the participants' experiences revealed intersections with and ties to the scholarly literature. My research developed an understanding of the perspectives expressed by Saudi Arabian international students in the early stages of the COVID-19 pandemic. Understanding the lived experiences of underrepresented groups is crucial for policymakers and regulators, as well as for those developing support initiatives, to effectively serve these populations. The recommendations for future research and professionals provide a clear direction in developing support programs for international students and enhancing the services provided to them, with the aim of promoting their well-being and facilitating their progress.22 0Item Restricted Equity in Health: Analysing the Accessibility of Australia's Tertiary Public and Private Healthcare(The University of Western Australia, 2026-01-01) azeem, Mazen Ba; Kruger, Estie; Tennant, MarcThis thesis undertakes an exhaustive analysis of tertiary healthcare accessibility in Australia, juxtaposing public and private sector distribution against the backdrop of the socio-economic landscape. It critically assesses healthcare services availability, particularly during the unprecedented challenges posed by the COVID-19 pandemic. The study employs geospatial analysis and GIS mapping to evaluate the socioeconomic status of the population residing near the facilities, location and accessibility of Emergency Departments (EDs) in tertiary public and private healthcare facilities across the country and explore their readiness in the face of potential pandemics. The socio-economic variables within different buffer zones are scrutinised to reveal the impact on healthcare access during the health crisis. By integrating Australian experiences during COVID-19, the research highlights the variances in healthcare accessibility, accentuating the strains on hospitals with EDs and the innovative implementation of field centres in high-density regions to counteract service gaps. The thesis also discusses the socioeconomic determinants that exacerbate disparities in healthcare provision, offering insights into the stratification of health equity. The findings suggest that, despite Australia's robust healthcare system, critical areas require strategic enhancement to ensure preparedness for future pandemics. Recommendations include the need to address healthcare inequalities and improve service accessibility in Australia’s urban, rural and remote areas, as well as the establishment of temporary healthcare facilities in strategically identified locations to bolster the resilience of healthcare infrastructure. The conclusions drawn herein provide a pathway for policymakers to fortify healthcare systems against the backdrop of socio-economic disparities, aiming for an equitable distribution of healthcare resources.33 0Item Restricted Evaluating the Effectiveness of Unconventional Monetary Policy Measures in the Global Financial Crisis and COVID- 19 Periods(Newcastle Unversity, 2024-06-18) Al jarah, Khaled; Stancu, AndreiThis study examines unconventional monetary policy's (UMP) efficacy on the U.S. economy during the Great Financial Crisis and the COVID-19 pandemic. Given the popularity of these policies during the recent COVID-19 pandemic, it is essential to examine how they support economic recovery. Utilising both ordinary least squares (OLS) and VAR models, the present study examined if the announcement of unconventional monetary policies helped to forestall the deterioration of the U.S. economy following the respective crisis. The study found the following using data spanning 2005 and 2023 and covering two of the most devastating crises in recent history (GFC and COVID-19). First, the announcement of UMPs during the GFC and COVID-19 pandemic did not significantly impact several macroeconomic variables in a cross-sectional context. Second, the results from the VAR model, which traces the spillover effect following the announcement, indicate that it only negatively affected industrial output, not GDP, CPI, and S&P 500 index. By evaluating research hypotheses and UMP measures' effectiveness, the study adds to the body of literature. In conclusion, our study sheds light on the complex dynamics of UMP in traversing financial crises, offering useful insights for academics, businesses, and regulators.32 0Item Restricted Impact of SARS-CoV-2 Salivary Gland Infection on the Production of the Antifungal Peptide Histatin-5, Candida Colonization, and the oral Microbiota(University of Maryland, Baltimore, 2024) Alfaifi, Areej; Rizk, Mary Ann; Warner, Blake; Schneider, Abraham; Meiller, Timothy; Sultan, AhmedDespite the myriad oral manifestations during COVID-19 and presence of SARS-CoV-2 in saliva, the oral cavity remains an underappreciated site. However recent findings have shown that SARS-CoV-2 can replicate in salivary gland cells, leading to inflammation and tissue destruction. Saliva contains antimicrobial peptides considered integral components of innate immunity crucial for oral health, with the most notable being histatin-5. This peptide is exclusively produced in salivary glands and exhibits unique potent antifungal activity against Candida albicans. In this dissertation, we discovered that destruction of salivary gland by SARS-CoV-2 can compromise histatin-5 production, predisposing patients to oral candidiasis and dysbiosis in the oral microbiome. First, we utilized our novel customized immunoassay to measure salivary histatin-5 levels in a prospective study involving stratified COVID-19 cohorts. Our data indicates a trend showing a decrease in salivary histatin-5 and increase in Candida during COVID-19, persisting post-COVID-19 recovery, potentially contributing to the long COVID-19 syndrome. To provide lacking mechanistic insights into the pathophysiology of salivary gland dysfunction during COVID-19, we performed in situ hybridization coupled with immunofluorescence to co-localize SARS-C0V-2 and histatin-5, respectively, in salivary gland tissue from deceased COVID-19 patients. Our findings indicated diminished or absent histatin presence in salivary gland acini with proliferating SARS-CoV-2 providing the first direct evidence associating SARS-CoV-2 with histatin-5 production. Next, we conducted a comprehensive metagenomic analysis on clinical oral samples and identified potential COVID-19 associated pathologic dysbiotic shifts in the oral microbiome. Lastly, we conducted in-vitro experiments coupled with scanning electron microscopy and confocal imaging to identify the effect of histatin-5 on candida cells and biofilm concluding the antifungal effect of histatin-5 on candida albicans. This clinical study clearly shows the effect of SARS-CoV-2 on oral microbiota, highlighting the importance of understanding and managing the complex dynamics within the oral cavity of COVID-19 patients.15 0