Saudi Cultural Missions Theses & Dissertations
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Item Restricted Medication Safety Education in Undergraduate Pharmacy and Nursing Schools in the UK and Saudi Arabia(Imperial College London, 2023) Albadali, Hind; Woloshynowych, Maria; Franklin, BryonyIntroduction: This thesis focused on medication and patient safety from a global perspective (UK and Saudi Arabia), the rationale being the increase in medication error incidents resulting from a lack of proper patient safety education in nursing and pharmacy programmes which contribute to serious patient safety issues. Literature revealed the limitations on achieving positive outcomes in nursing and pharmacy education. Aim: to identify current medication and patient safety education in these countries and to analyse factors affecting adequate teaching and recommendations for improvement. Research Methodology: A systematic narrative review and mixed method research design were used to investigate many educational issues. Data Collection: used literature search for published papers, document review, semi-structured individual interviews and focus group for qualitative data and a questionnaire for quantitative data. Data Analysis: used systematic narrative analysis, thematic analysis and various statistical techniques to analyse data (separate data review for pharmacy and nursing). Results: revealed a disagreement on the explicitness and mode of integration, diverse content delivery, many educational didactic and interactive methods, a growing interest in simulation methods, the inter-professional learning method, curriculum guides and educational framework were rarely used and obstacles to integrating medication safety were identified. Furthermore, students’ confidence in learning about patient safety domains between classroom and clinical settings differed. Conclusion: Although medication and patient safety education is well received, strategies are needed to improve medication and patient safety education to allow for effective integration in the curriculum. UK and Saudi Arabian educational and health sector policymakers should prioritise improving medication and patient safety education. Recommendations: Future researches should investigate the content, methods of delivering medication and patient safety education, curriculum guides, framework for teaching and factors that prevent the effective integration of medication safety education. Students’ confidence in patient safety topics in classroom and clinical settings needs evaluation.17 0Item Restricted Kinetic Parameters Estimation & Population Balanced Modelling (gFormulated) of Micro-Scale Mefenamic Acid in Ethyl Acetate Crystallisation(University of Strathclyde, 2018-11-07) Wan, Ghadeer Yousef; Brown, Cameron; Florence, AlastairMefenamic acid is an analgesic anti-inflammatory drug. It is commonly used for pain associated with menstruation. The crystallisation kinetics of mefenamic acid in ethyl acetate solvent was investigated. The experiments were carried out at small scales, using 1-5 ml vessels. These experiments were conducted in a high throughput reactor system (Crystalline instrument from Technobis). The experimental data was then used as the input for estimating the kinetic parameters. This methodology aims to obtain the sequential parameter estimation which is validated for the determination of the kinetic parameters of mefenamic acid in ethyl acetate. Another aim is to estimate the parameters of the following; primary, secondary nucleation, growth and agglomeration kinetics. Population balanced modelling (PBM) in the gFormulated products program (gPROMS) was used to predict the optimum parameters of kinetic growth and nucleation. The resulting crystallisation model has been able to obtain the quantiles d25, d50, d75 of particle size distribution, although, some errors and deviation in prediction might have arisen due to inaccurate measurements used. In this work, the comprehensive methodology proposed is intended to be an efficient estimation strategy for modelling mefenamic acid of crystallisation processes.41 0Item Restricted MANUFACTURING AND DEVELOPMENT OF IMPLANTABLE DRUG DELIVERY DEVICE FOR THE LOCALISED TREATMENT OF GLIOBLASTOMA(University of Birmingham, 2024-03-04) Wan, Ghadeer Yousef; McConville, ChristopherGlioblastoma (GBM) is an aggressive brain tumour with low survival rates. The blood-brain barrier (BBB) limits drug penetration into brain tissue, affecting the effectiveness of systemic chemotherapy. Localised drug delivery devices have emerged as a promising solution to address these limitations. This study focuses on developing and investigating biodegradable implantable devices to directly deliver chemotherapeutic drugs to brain tissue, reducing systemic administration and recurrence risk. Irinotecan (IRN) has shown success in clinical trials against GBM. However, large intravenous doses of IRN lead to severe systemic side effects. The study investigates the local delivery of IRN through implantable drug delivery devices to improve therapeutic outcomes while minimising adverse effects. The first study develops IRN-loaded poly(lactic-co-glycolic acid) (PLGA) implants using injection moulding (IM) and hot melt extrusion (HME) techniques. The study compared IM and HME implants, finding that HME implants showed better drug content uniformity and homogeneous drug distribution due to high shear mixing. Factors such as PLGA type, drug load, and implant size influenced drug release behaviour. HME implants exhibited slower drug release due to their denser matrix. Accelerated release studies showed both IM and HME implants had sustained release over seven days, with HME implants considered preferable based on drug content, stability, and distribution results. Pitavstatin (PTV) effectively slows tumour growth, but its limited BBB penetration suggests potential benefits of local administration. The second study involves the development of PTV-loaded PLGA implants using IM and HME techniques. Both IM and HME implants demonstrate an amorphous state of PTV. HME implants show higher drug content and uniformity due to homogeneous drug distribution facilitated by high shear mixing force, making them preferable over IM. In vitro drug release studies revealed slower drug release from HME implants due to denser matrices, and accelerated release studies confirmed sustained release over seven days for HME implants. In the third study, the high-performance liquid chromatography (HPLC) method was developed and validated for quantifying IRN and PTV in multi-layered implantable drug delivery devices. This method allowed precise drug release quantification, ensuring accurate safety and efficacy assessment of the devices. The final study involves the development of IRN-PTV-loaded PLGA implants as multi-layered devices using HME. The purpose of combining IRN and PTV in these implants is their synergistic effects against the GBM. The multi-layered implants were characterised using HPLC, differential scanning calorimetry (DSC), X-ray diffraction (XRD), and Raman spectroscopy. They demonstrated uniformity in size, weight, and drug content, validating the reliability of the HME technique. XRD and DSC analyses confirmed crystalline IRN in the IRN-PLGA layer and amorphous PTV in the PTV-PLGA layer, suggesting enhanced drug bioavailability and therapeutic effectiveness. Raman mapping reveals homogeneous drug distribution within the implants, ensuring consistent drug release. In vitro studies show biphasic drug release over seven days, characterised as non-Fickian behaviour by the Korsmeyer-Peppas model. This enhances our understanding of the release mechanism. This thesis presents advancements in implantable drug delivery devices for localised GBM treatment, offering valuable insights into formulation compositions and manufacturing techniques. Further research is necessary to assess in vivo performance and therapeutic efficacy.48 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.42 0