Saudi Cultural Missions Theses & Dissertations
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Item Restricted Quality of Accounting Information, Corporate Governance, and Economic Crises: Evidence from the Asia-Pacific Countries(Saudi Digital Library, 2025) Basahi, Ahmed; Chand, ParmodEconomic crises pose significant challenges to financial systems, affecting corporate performance, accounting practices, and governance structures globally. During crises, accounting information’s relevance and earnings quality often come under scrutiny as firms face financial stress and managers grapple with meeting performance expectations. This amplifies the importance of reliable and transparent financial reporting. This thesis explores the multifaceted impact of such crises on the quality of accounting information, corporate governance mechanisms, and firm value, focusing on the Asia-Pacific region. Specifically, it delves into how economic disruptions, like the COVID-19 pandemic, influence the value relevance of accounting information and earnings quality, as well as how corporate governance can serve as a stabilising factor, influencing firm value and mitigating the adverse effects of economic shocks. By examining the Asia-Pacific, the thesis provides a unique perspective on a region marked by institutional diversity and significant economic influence. The overarching aim of this thesis is to enhance the understanding of how economic crises impact accounting, with a particular focus on the Asia-Pacific region. This region, with its diverse institutional frameworks, regulatory environments, and financial systems, provides a fertile ground for examining this issue. The first paper investigates the effects of economic crises on the value relevance of accounting information in 14 major Asia-Pacific economies. Using a comparative analysis of pre-pandemic and pandemic periods, the study reveals a significant decline in the explanatory power of accounting information during the pandemic. Institutional factors, such as investor protection, legal systems, and financial systems, are shown to moderate this relationship. The findings underscore the importance of regional diversity in shaping how accounting information is utilised by investors during periods of economic instability, offering actionable insights for policymakers and regulators. The second paper provides a comparative analysis of earnings quality during two major economic crises: the 2008 global financial crisis (GFC) and the COVID-19 pandemic. The results reveal that earnings quality deteriorated during both crises. Interestingly, the results also reveal that the GFC had a more significant impact on accrual-based earnings management when compared with COVID-19, although COVID-19 had a more severe effect on economies. This highlights the role of improved regulatory reforms and accounting standards in recent years in the Asia-Pacific region in limiting accounting manipulation. By comparing these distinct crises, the paper advances the understanding of how financial and operational challenges impact earnings quality in diverse economic contexts. The final paper examines the influence of corporate governance on firm value in the Asia- Pacific region, emphasising the moderating effect of economic conditions. The findings demonstrate that robust country-level governance and firm-level corporate governance, including board size, board independence, and audit committee independence, positively affect firm stock performance. Furthermore, their positive effects become more evident during times of economic uncertainty, such as during COVID-19. By illustrating the protective role of governance mechanisms during economic downturns, this paper offers critical insights for fostering resilience in firms facing volatile environments. Taken together, the findings of the three papers collectively emphasise the critical interplay between economic crises and accounting information quality and the important role of governance systems in enhancing firm resilience during periods of economic uncertainty. By conducting a comprehensive cross-country analysis, the thesis enhances our understanding of the implications of economic conditions on the accounting profession and provides valuable insights into the broader implications of economic uncertainty on corporate decision-making, investor behaviour, and financial transparency.7 0Item Restricted Assessing Dental Patients' Acceptance and Trust of Dentists in COVID-19-related Services: A Cross-Sectional Study(Saudi Digital Library, 2025) Alzunaydi, Ayoub; Aguilar, Maria L; Psoter, Walter JBackground: Dentists have traditionally been underutilized in public health crises, despite their clinical expertise and trusted role within communities. The COVID-19 pandemic highlighted the need for an expanded healthcare workforce, yet the extent to which dental patients trust and accept dentists providing pandemic-related services remains unclear. Objective: This study aimed to assess dental patients’ acceptance and trust in dentists conducting COVID-19 testing, vaccination, and public health communication while examining the influence of demographic and insurance-related factors. Materials and Methods: A cross-sectional, self-administered, structured questionnaire-based study was conducted at multiple clinics within the University of Florida College of Dentistry. A total of 150 adult dental patients participated, providing self-reported responses on their trust in dentists discussing COVID-19 topics and their acceptance of dentists administering COVID-19 services. Data were analyzed using descriptive statistics and logistic regression to identify associations between demographic variables and trust levels. Results: Trust in dentists discussing COVID-19 topics was high, particularly for face masking (85.4%) and COVID-19 disease (76.4%), but was lower for discussing vaccination (70.2%). Patient acceptance of dentists administering COVID-19 vaccines was divided, with 51% expressing comfort and 49% expressing hesitancy. Private insurance holders were significantly less trusting of dentists in administering COVID-19-related services, while Medicare recipients exhibited the highest levels of trust. Age trends suggested older individuals were more trusting, while demographic variables such as sex, race, and ethnicity were not statistically significant predictors of trust. Conclusion: These findings highlight the potential role of dentists in public health crises beyond traditional oral healthcare. While dentists are trusted for public health communication, hesitancy in accepting them as vaccine providers suggests a need for further public education and policy reinforcement. Recognizing dentists as part of the frontline healthcare workforce could enhance healthcare system resilience in future crises.22 0Item Restricted Impact of the COVID-19 pandemic on labour market outcomes in the UK(University of Leeds, 2025-03) Abugamza, Amwaj; Howdon, Daniel; Martin, Adam; Charlwood, AndyThis thesis investigates changes in labour market outcomes and their links to physical and mental health. It uses the exogenous nature of the COVID-19 pandemic as a unique opportunity to compare pre- and post-pandemic periods through four studies. Study One, a systematic review, assessed international literature up to January 2022 on COVID-19's effects on employment. It critically evaluated the methodological tools used in prior research and provided recommendations for improved study design. The review identified key moderators, mediators, and confounders using a theoretical diagram (DAG). Following these recommendations, Study Two employed Interrupted Time Series analysis using UK Office for National Statistics (ONS) data (up to June 2023) to investigate changes in key labour market outcomes following two policy interventions: the COVID-19 lockdown and the final stage of easing lockdown restrictions. The results show that the initial disruption caused by the lockdown was followed by a recovery in employment as restrictions were lifted, but a persistent rise in economic inactivity, which became the focus of the two final studies. Study Three used the UK Household Longitudinal Study (UKHLS), showing that being aged 50–66 (OR= 2.18, 95% CI: 1.53, 3.10) and reporting long-standing illness (OR= 1.44, 95% CI: 1.12, 1.84) were statistically significant predictors of transitioning from pre-pandemic employment to post-pandemic economic inactivity. This transition was associated with higher psychological distress. Study Four focused on individuals aged 50–66 and explored why economic inactivity has risen. It found that the prevalence of reported poor health increased among this age group post-pandemic, suggesting that rising economic inactivity is driven by deteriorating health rather than changes in propensities of healthy or unhealthy people leaving the labour force after the pandemic. It also compared ONS and UKHLS data to explore concerns about the reliability of government statistics. This thesis identified key drivers of economic inactivity in the UK post-COVID-19 and their links to health, highlighting policy interventions to support people in remaining in or returning to work.8 0Item Restricted RISK MANAGEMENT IN THE HOSPITALITY SECTOR DURING TIMES OF CRISIS.(Saudi Digital Library, 2025-07-17) Alanazi, Abdulrahman; Samaradheera, AmaThis research explores how the Ritz-Carlton Hotel in Saudi Arabia managed risks during the COVID-19 pandemic. The study investigates the effectiveness of health and safety protocols, identifies operational challenges, and evaluates risk management strategies implemented during the crisis. Using a qualitative methodology based on interviews with hotel managers, the study highlights the role of emergency response teams, digital innovations, and employee welfare in maintaining operational resilience. Key findings emphasize the importance of crisis communication, proactive scenario planning, and mental health support in the hospitality sector. Recommendations are made to enhance future preparedness and sustainability in hotel operations during crises.16 0Item Restricted Firm Performance Sustainability and Reputation(University of New Orleans, 2025-05) Alharbi, Mohammed; Hassan, M.KabirThe first essay investigates the impact of the COVID-19 pandemic on the performance of Sharia-compliant and non-compliant firms within the Organization of Islamic Cooperation (OIC) member countries. Employing panel data from 337 publicly listed non-financial firms between 2016 and 2022, the research compares profitability and growth metrics, specifically Return on Assets (ROA), Return on Equity (ROE), and firm growth rates. Using ordinary least squares (OLS) and random effects (RE) regression models, the analysis incorporates firm-specific variables. The findings indicate that both Shari'ah compliance and the COVID-19 pandemic negatively impacted firm performance. Sharia-compliant firms experienced significantly greater declines in ROA and ROE compared to non-compliant firms. Furthermore, compliant firms exhibited reduced growth rates, which highlights potential vulnerabilities stemming from ethical financing constraints and conservative investment practices. The interaction between Shari’ah compliance and the COVID-19 pandemic further worsened these adverse outcomes, indicating an increased vulnerability among compliant firms during times of economic disruption. A comprehensive regional analysis has identified that firms in Asia were particularly affected, thereby emphasizing the geographic variations in the impacts observed. The second essay is an empirical study of the relationship between Environmental, Social, and Governance (ESG) performance and corporate reputation. The goal is to address the existing gap in sustainability literature. This study employs a comprehensive panel dataset that includes 4,000 US firms from 2014 to 2023. The aim of this study is to investigate how ESG performance influences corporate reputation through annual and cumulative corporate responsibility awards. The study utilizes various econometric techniques to tackle issues concerning endogeneity and sample selection bias. The econometric techniques include logistic regression, Ordinary Least Squares (OLS), Two-Stage Least Squares (2SLS), Propensity Score Matching (PSM), Entropy Balancing, and Heckman selection models. The results consistently show that companies with better ESG performance are significantly more likely to be acknowledged with corporate responsibility awards. The strength of these findings is supported by various robustness analyses. The study examines how firm-specific characteristics, including company size, financial performance, and research and development, influence the relationship between ESG engagement and reputation outcomes. The evidence indicates that these factors enhance the positive impact of ESG performance on corporate reputation. The findings highlight the strategic value of ESG initiatives for corporate leaders and policymakers, which emphasizes their role in enhancing stakeholder trust and securing long-term competitive advantages.42 0Item Restricted comparative study of the framing of COVID-19 by the BBC and Al Arabiya(University of Leicester, 2024) Shbber, Saud; Qian, GongThe COVID-19 pandemic required public service media (PSM) outlets to respond swiftly and adapt their communication strategies. This thesis examines how two major PSM organisations—BBC in the UK and Al Arabiya in Saudi Arabia—framed the COVID-19 crisis, focusing on eight key news frames identified in the study: human-interest, vaccination safety/hesitancy, war, commitment and transparency, uncertainty, economic consequences, government handling; criticism vs. firm state control, and authority-centric frames. This thesis uses corpus linguistic analysis (CLA) to assist the framing analysis process, building two corpora from tweets and the attached full news articles on X (formerly Twitter) from both outlets. This method allows for a detailed comparison of how COVID-19 was communicated in the different political, social, and media contexts of the UK and Saudi Arabia. The findings show that BBC’s coverage often highlighted public engagement, transparency, criticism and economic impact, while Al Arabiya focused more on government authority and firm state control. The thesis also tracks how these frames changed over time, noting both similarities and differences between the two outlets. Early coverage in both media focused on uncertainty and health risks but later shifted to issues such as vaccination, economic recovery, and government handling. However, the degree to which each outlet emphasised these frames varied, reflecting the differences in media landscapes and political environments. This change shows how PSM adapted their messages as COVID-19 progressed. This thesis offers new academic contributions by providing fresh insights into the role of PSM in risk communication and how PSM frames health crises and demonstrates the value of integrating CLA with framing analysis. It provides valuable lessons for policymakers on how to effectively manage public health messaging during future global emergencies.4 0Item Restricted A comparative study of the framing of COVID-19 by the BBC and Al Arabiya(University of Leicester, 2024) Shbeer, Saud; Qian, GongThe COVID-19 pandemic required public service media (PSM) outlets to respond swiftly and adapt their communication strategies. This thesis examines how two major PSM organisations—BBC in the UK and Al Arabiya in Saudi Arabia—framed the COVID-19 crisis, focusing on eight key news frames identified in the study: human-interest, vaccination safety/hesitancy, war, commitment and transparency, uncertainty, economic consequences, government handling; criticism vs. firm state control, and authority-centric frames. This thesis uses corpus linguistic analysis (CLA) to assist the framing analysis process, building two corpora from tweets and the attached full news articles on X (formerly Twitter) from both outlets. This method allows for a detailed comparison of how COVID-19 was communicated in the different political, social, and media contexts of the UK and Saudi Arabia. The findings show that BBC’s coverage often highlighted public engagement, transparency, criticism and economic impact, while Al Arabiya focused more on government authority and firm state control. The thesis also tracks how these frames changed over time, noting both similarities and differences between the two outlets. Early coverage in both media focused on uncertainty and health risks but later shifted to issues such as vaccination, economic recovery, and government handling. However, the degree to which each outlet emphasised these frames varied, reflecting the differences in media landscapes and political environments. This change shows how PSM adapted their messages as COVID-19 progressed. This thesis offers new academic contributions by providing fresh insights into the role of PSM in risk communication and how PSM frames health crises and demonstrates the value of integrating CLA with framing analysis. It provides valuable lessons for policymakers on how to effectively manage public health messaging during future global emergencies.16 0Item Restricted Adult Foster Homes in an Aging America: Trends, Effects, and Operational Challenges (2017–2023)(Oregon Health and Science University, 2024) Albalawi, Wafi; Chair, Paula Carder; Tunalilar, Ozcan; Messer, Lynne; Carlson, BryantBackground: As the aging U.S. population grows, the demand for long-term care services (LTCS) is rising. Adult Foster Homes (AFHs), small residential care settings providing personalized support for older adults, play a critical role in meeting this demand. However, limited research has focused on AFHs compared to other LTCS options. This dissertation examines Oregon’s AFH holistically by assessing home characteristics, resident’s status and health needs, and the experiences of operators, particularly during the COVID-19 pandemic. Methods: Utilizing data from the Oregon Community-Based Care study (2017–2023), this mixed methods research integrates quantitative trend analyses and qualitative content analysis. It explores three key aims: (1) identifying trends in residents' health conditions, service utilization, and medication use; (2) assessing associations between AFH characteristics and healthcare outcomes; and (3) capturing operators' perspectives on rewards and challenges during the pandemic. Results: Findings reveal high prevalence rates of dementia and polypharmacy among residents, with increasing medication use and stable trends in ADL needs. Family involvement significantly declined during the pandemic but showed partial recovery post-restrictions. Operators highlighted meaningful rewards, such as resident care and autonomy, alongside challenges like regulatory burdens and low Medicaid reimbursement rates. Conclusion: By highlighting the unique attributes, resident health needs, and operational challenges of AFHs in Oregon, this study brings critical attention to an often-overlooked long-term care option19 0Item Restricted Objective and Subjective Long-Term Cognitive Outcomes in COVID-19 Survivors Managed with ECMO: A Case Series(Royal Holloway, University of London, 2024) Alanazi, Abeer; Crabtree, AnnaCOVID-19 has been associated with significant health complications, including cognitive impairments, particularly among patients requiring intensive care interventions. A subset of these patients, especially those needing extracorporeal membrane oxygenation (ECMO), face heightened vulnerability due to prolonged Intensive Care Unit (ICU) stay and extended ECMO duration, placing them at an increased risk of developing post intensive care syndrome (PICS), a multifaceted condition that affects cognitive and psychological functions among other health- related domains. This study aims to investigate the cognitive screening outcomes and characteristics of cognitive impairments among COVID-19 survivors managed with ECMO, enhancing our understanding of cognitive outcomes in this high-risk group. Eighty-five COVID-19 patients who had been treated with ECMO were contacted after their ICU admission. The Telephone Montreal Cognitive Assessment (T-MoCA) was employed to detect cognitive impairment. Neuropsychological assessment was completed with ten survivors. A case series design was employed to characterise the cognitive profile of these ten COVID-19 survivors. The mean T-MoCA score for the 49 cohort was 16.20 (SD = 2.93), indicating cognitive impairment among COVID-19 survivors managed with ECMO. T-MoCA scores for the ten patients who completed neuropsychological assessments ranged from 10 to 19, with a mean score of 16.2 (SD = 2.94). The case series analysis demonstrated impairments across domains of attention, working memory, processing speed, and memory. Cognitive impairments are evident in COVID-19 survivors managed with ECMO, presenting cognitive profiles similar to those documented in acute respiratory distress syndrome (ARDS) patients (non-COVID-19). Key words: ICU, COVID-19, ECMO, Cognitive Impairment, PICS13 0Item Restricted Understanding the Factors Influencing the Acceptance and Adoption of Mobile Health Applications by Physicians during the COVID-19 Pandemic: The Case of Saudi Arabia(University of Technology Sydney, 2025-01) Alsahli, Sultan; Lam, Mary; Hor, Su-yin; Rogers, KrisBackground: The rapid evolution of mobile health applications has become increasingly crucial in enhancing healthcare delivery, particularly during the COVID-19 pandemic. Despite the critical role of these technologies, acceptance and adoption rates among physicians in developing countries, especially Saudi Arabia, have remained relatively low. This highlights the need to explore the determinants of their acceptance and adoption. Aim: This thesis aimed to investigate the key factors influencing Saudi physicians’ intentions toward using mHealth applications during the COVID-19 pandemic. Methods: This mixed methods research was conducted in three phases, each addressing specific objective and research question. In phase 1, a systematic review was conducted to present all available evidence of mHealth acceptance and adoption from the perspectives of physicians. Phase 2 applied a quantitative design based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model to investigate key factors influencing physicians’ behavioural intentions to adopt mHealth apps. Data were collected via an online survey and analysed using structural equation modeling. Phase 3 employed a qualitative design, exploring additional context-specific factors not accounted for by the UTAUT model through semi- structured interviews. The qualitative data were analysed using template analysis. Results: The systematic review identified technological, individual, and organizational factors affecting physicians’ acceptance of mHealth apps during the pandemic. The quantitative study found that performance expectancy, effort expectancy, social influence, and facilitating conditions significantly influenced physicians’ intention to use mHealth applications. Qualitative findings highlighted additional factors unique to the Saudi context, such as concerns about data privacy, patient engagement, compatibility with religious and cultural norms, and the impact of COVID-19 pandemic. These factors shaped physicians’ perceptions and adoption behaviours, emphasizing the need for tailored strategies to promote mHealth in Saudi Arabia. Conclusions: This thesis extends the UTAUT model by incorporating context-specific factors relevant to developing countries like Saudi Arabia during the COVID-19 pandemic. The findings emphasize the need for investments in infrastructure, targeted training programs, and policies that address both technological and cultural concerns. By fostering an environment that supports the integration of mHealth applications into routine practice, healthcare organizations can improve both healthcare delivery and patient outcomes during health crises and beyond. The study provides critical insights for policymakers and healthcare managers seeking to enhance the acceptance and use of mHealth technologies in similar global contexts. Future research should examine the perspectives of other healthcare workers and patients for a comprehensive understanding of mHealth adoption while also exploring its long-term impact on patient outcomes and healthcare professionals.26 0