Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
Browse
27 results
Search Results
Item Restricted Approaches to Mask the Bitter Taste of Pharmaceuticals for Improved Therapeutic Efficacy(Saudi Digital Library, 2025) Alharbi, Norah Sayer; Schlindwein, WalkiriaAbstract Purpose Bitterness is a significant barrier to patient adherence with oral medications, particularly in vulnerable populations such as children and the elderly. This dissertation investigates taste-masking strategies, specifically focusing on ibuprofen formulations, and applies the Quality by Design (QbD) framework to enhance therapeutic efficacy through patient centered drug development. Methods A systematic literature review was conducted following PRISMA guidelines. Over 5,000 articles were screened to identify studies on pharmaceutical taste masking and compliance outcomes. The taste-masking strategies were classified into four categories: chemical, physical, organoleptic, and receptor-blocking approaches. Building on these insights, a case study on pediatric oral ibuprofen dry emulsion was undertaken, interpreted through QbD methodology. Critical quality attributes (CQAs), material attributes (CMAs), and process parameters (CPPs) were identified using Failure Modes and Effects Analysis (FMEA). A Design of Experiments (DoE) approach was applied to optimize formulation factors, with the aim of balancing palatability, dissolution, and stability. Results The review revealed that no single method universally achieves effective taste masking. However, cyclodextrin complexation, ion exchange resins, and lipid encapsulation emerged as particularly effective strategies for highly bitter active pharmaceutical ingredients (APIs). In the case study of ibuprofen, QbD principles provided a structured framework for defining a Quality Target Product Profile (QTPP), which linked CQAs to process parameters. Compared to conventional empirical approaches, the QbD-based strategy offered clearer mechanistic insights, reduced the experimental burden, and enhanced robustness in controlling formulation variability. The dry emulsion system effectively reduced bitterness perception and demonstrated improved bioavailability while ensuring attributes suitable for pediatric use. Conclusions This research emphasizes the importance of integrating taste masking into patient-centric pharmaceutical design. The application of QbD principles transforms formulation development from trial-and-error methods into proactive, risk-based, and scientifically grounded strategies. The outcomes demonstrate that QbD not only strengthens the consistency and regulatory acceptability of taste-masked formulations but also directly improves patient compliance and therapeutic success. Keywords: Bitter taste, Taste-Masking Approaches, Patient Adherence, Children, Quality by Design, QbD.4 0Item Restricted The relationship between the length of hospital stay and innate cell function at admission or discharge(University of Glasgow, 2025) Alharbi, Samirah; Bourke, ClaireThis prospective observational study evaluated the association between length of hospital stay and the production of key macrophage-associated cytokines at admission and discharge in children with severe acute malnutrition (SAM). A total of 142 children aged 6–59 months from hospitals in Zimbabwe and Zambia were consecutively enrolled upon admission, with SAM diagnosed according to World Health Organization criteria. Peripheral blood samples were collected within 24 hours of admission and at discharge. Whole blood cultures were stimulated with three conditions: unstimulated control medium, lipopolysaccharide (LPS), and heat-killed Salmonella typhimurium. Concentrations of interleukin-1 beta (IL-1β), interleukin-4 (IL-4), interleukin-10 (IL-10), interferon gamma (IFN-γ), and vascular endothelial growth factor (VEGF) were measured by ELISA. Non-parametric tests, Spearman’s correlations, and logistic regression adjusted for confounders were applied. Lower pro-inflammatory responses (IL-1β, IFN-γ) and reduced VEGF production at admission were significantly associated with longer hospital stays (>17 days), while higher IL-10 responses correlated with prolonged recovery. IL- 4 showed a weaker, non-significant association. These findings suggest that immune profiles at admission may serve as early prognostic biomarkers for recovery time in pediatric SAM, supporting the integration of bedside immunological assessments into clinical triage and targeted care strategies13 0Item Restricted Comparative analysis of magnetic resonance imaging- and computed tomography-based finite element approaches in estimating bone strength in children(Saudi Digital Library, 2025) Alasmari, Nayef Mohammed; Li, Xinshan; Offiah, AmakaThis PhD thesis compares magnetic resonance imaging (MRI)- and computed tomography (CT)-based finite element analysis (FEA) in estimating bone strength in children. A systematic review and meta-analysis (Chapter 3) was conducted and confirmed the reliability of MRI and FEA in assessing bone material properties and strength in adults but revealed limited paediatric research, identifying only one study. As segmentation is a critical step in FEA, we then conducted a comparative study (Chapter 4) to assess the accuracy and efficiency of ITK-SNAP, 3D Slicer and Amira™ using paired paediatric CT/MRI scans. ITK-SNAP and Amira™ were the most accurate, while 3D Slicer provided comparable results with greater efficiency and was selected for this thesis. Chapter 5 outlines the methodology used to compare MRI- and CT-based FEA in estimating bone strength in children without (n = 9; Chapter 6) and with (n = 8; Chapter 7) bone disease. In children without bone disease, MRI- and CT-based FEA exhibited strong correlation for tensile (ICC = 0.83) and moderate correlation for compressive (ICC = 0.61) failure loads, with MRI-based FEA consistently underestimating the failure loads. In children with bone disease, the modalities demonstrated moderate correlation for tensile (ICC = 0.60) and fair correlation for compressive (ICC = 0.40) failure loads, with similar underestimation of failure loads by MRI-based FEA. Discrepancies between MRI- and CT-based FEA tensile and compressive estimates did not significantly differ between children without and with bone disease (p = 0.386 and p = 0.441, respectively). Chapter 8 summarises the findings, limitations and future directions. Overall, MRI-based FEA showed similar trends to CT-based FEA in estimating bone strength in children, despite underestimating failure loads, particularly in proximal femurs and under compressive loading. With continued improvements in MRI resolution and FEA modelling, MRI-based FEA holds potential as a radiation-free alternative for paediatric bone strength assessment.55 0Item Restricted Artificial Intelligence for Automatic Attachment Assessment in School-Age Children: An Approach Based on Language and Paralanguage.(Saudi Digital Library, 2025-06-17) Buker, Areej; Vinciarelli, AlessandroAttachment is a psychological construct that provides a framework for understanding how individuals perceive and interpret social interactions, navigate relational dynamics, and experience and regulate their emotional states, particularly under conditions of stress. An attachment style begins to develop within the first few months of life, shaped by a child’s interactions with their primary caregivers. Consistent and nurturing care promotes the development of a secure attachment style, whereas inconsistent or inadequate caregiving often gives rise to insecure attachment patterns. Insecure attachment is linked to a range of challenges, including behavioural issues such as antisocial tendencies; mental health difficulties like anxiety, emotional dysregulation, and body image concerns; and heightened risks of physical health problems, including sleep disturbances. Early recognition and intervention for insecure attachment increases the likelihood of reshaping maladaptive patterns into secure ones, potentially reducing attachment-related challenges. Automated approaches for attachment recognition offer significant benefits, including consistent delivery of assessments, such as the MCAST, and broader accessibility to a wider population. While there are a few available systems for delivering attachment tests (e.g., CMCAST and SAM), the limited studies focused on developing automated classifiers to analyse the collected data have shown a suboptimal performance. These classifiers often struggle to recognise insecure attachment, achieving a maximum Accuracy of only 62.7%. Furthermore, these studies fail to offer insights into the reasoning behind their classifications, missing an opportunity to advance the understanding of attachment in early to middle childhood. This developmental stage—characterised by significant changes that include the expansion of social circles and the internalisation of emotional representations—has historically received less attention in a field predominantly focused on studying attachment markers in infants and adults. This thesis focuses on two primary objectives: enhancing the automated classification of attachment styles in children, particularly insecure attachment, and identifying markers associated with these styles. The study employs two modalities—language and paralanguage— along with emotions derived from both modalities. These modalities are utilised within a unimodal and a multimodal framework. Among all classifiers developed using the same dataset, the language-based unimodal approach demonstrated the highest effectiveness, achieving exceptional performance in recognising insecure attachment with an Accuracy of 82.2%, all while relying on relatively simple methodologies. Furthermore, this research identified linguistic, acoustic, and emotional markers of attachment, offering valuable insights into attachment representations in children.53 0Item Restricted The Impact of Privacy Awareness on Sharenting and Privacy Management Practices Among Saudi Parents(Kent State University, 2025) alnemre, Afnan; Hollenbaugh, Erin; Egbert, NicholeIn the digital age, parents frequently engage in the practice of sharenting—sharing their children's photos and information on social media—raising concerns about privacy and its implications for identity theft and other risks. This phenomenon has significant impacts on the violation of children’s privacy and their psychological and social well-being. Guided by communication privacy management (CPM) theory, this study aimed to identify the role of privacy awareness and religiosity in sharenting and privacy management practices among Saudi parents, using a quantitative approach and relying on a survey as a data collection method, N =139 were collected from Saudi parents. The findings revealed that extrinsic religiosity demonstrated positive relationship with all sharenting dimensions self-control, social behaviors and implications also with boundary linkages and boundary permeability in CPM. Also, intrinsic religiosity has a negative correlation with boundary permeability, while the study does not find a relationship between intrinsic religiosity and all sharenting dimensions. Additionally, there was a significant negative correlation between privacy awareness and boundary ownership in CPM. Moreover, the study has shown gender differences in sharenting behavior, showing that mothers post more pictures of children. This research aspires to inform initiatives promoting privacy-conscious digital practices among parents and aims to support the development of child protection policies in Saudi Arabia to safeguard children's online privacy.52 0Item Embargo Healthcare Management for Children with Burn Injuries from the Perspectives of Parents/Carers: A Qualitative Systematic Review(Queen’s University Belfast, 2025) Albishi, Manal; McConnell, KarenBackground: Paediatric burns are a global public health concern, leading to physical, psychological and social consequences for affected children. Despite the challenges faced by parents and caregivers during the hospitalisation and recovery phases, their perspectives on healthcare management remain underexplored. Aim: This systematic review aimed to synthesise the perspectives of parents and carers concerning the healthcare management of their children with burn injuries. The findings aim to inform clinical practice, policy and future research to enhance family-centred care and improve outcomes for children with burn injuries and their parents. Methodology: A systematic search was conducted across five electronic databases: CINAHL, Medline, PsycINFO, Maternity & Infant Care, and ProQuest. Supplementary searches were conducted in Google Scholar. The inclusion criteria focused on qualitative studies exploring parents’ and carers’ perspectives on paediatric burn management. The search results were screened in Covidence by two reviewers independently. Data relating to the experiences of parents and caregivers on the healthcare management of paediatric burns were extracted by one reviewer. The quality of the included studies was assessed by one reviewer using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research. A second reviewer checked 20% of the extracted data and quality appraisals. Data were then synthesised through thematic analysis by the method established by Thomas and Harden. Results: Fourteen studies were included in this review. The quality of the included studies ranged from six, indicating low quality, to ten, indicating high quality. Three main themes emerged: (i) parents’/caregivers’ perspectives on burn care challenges and support during hospitalisation and after discharge, highlighting barriers to and facilitators of parental involvement in their children’s treatment, non-professional support needs during hospitalisation, and financial, logistical and transition to home challenges; (ii) caregivers’ experiences of healthcare providers, showcasing both positive and negative experiences and gaps in communication and information needed for carers; and (iii) current and future concerns regarding the recovery and treatment of burn-injured children, including physical, psychological and social challenges. Conclusion: Effectively implementing family-centred care in paediatric burn care and incorporating social support are vital to address caregivers’ needs during hospitalisation and after discharge care. Improving healthcare providers’ communication skills, fostering a supportive environment for healthcare providers and integrating multidisciplinary care are essential to addressing parental challenges and optimising patient outcomes. Additionally, incorporating telehealth and parental feedback into care protocols can further enhance care delivery and collaboration among healthcare providers and caregivers, contributing to enhanced patient outcomes. Finally, cooperation among healthcare providers, policymakers and researchers is needed to bridge the gaps in paediatric burn management, improve outcomes, and support caregivers and burned children.37 0Item Restricted Systematic Review of Asthma Exacerbations Impact on Children’s Quality of Life in Low-Income Countries and Lower-Middle-Income Countries(King's College London, 2024-09-25) Alrashed, Rana; Laurence, YokoBackground: Asthma is a major cause of morbidity and disability in children, especially in low-income countries and lower-middle-income countries (LICs and LMICs). This systematic review evaluates the impact of asthma exacerbations on the quality of life (QoL) of children and adolescents in LICs and LMICs. Methods: A comprehensive literature search was conducted in major medical databases, including PubMed, Medline, Embase, Global Health, and Cochrane Library. Studies involving children and adolescents aged 0-18 years residing in LICs and LMICs were included. The review considered a range of study designs, including cross-sectional studies, randomized controlled trials, systematic reviews, and meta-analyses. The quality of the included studies was assessed using the relevant Joanna Briggs Institute (JBI) checklists. Results: The review found seven relevant studies. The cross-sectional studies showed that poorly controlled asthma and frequent exacerbations have a significant negative impact on various aspects of children's QoL, including physical functioning, emotional well-being, and social interactions. The narrative review and meta-analysis supported these findings, emphasizing the considerable burden of asthma on the overall well-being of children in low-resource settings. The randomized controlled trial provided evidence that targeted interventions, such as comprehensive asthma education and management programs, have the potential to improve the QoL of affected children. Conclusions: This systematic review emphasizes the significant negative impact of asthma exacerbations on the quality of life of children in LICs and LMICs. Factors such as socioeconomic status, access to healthcare, and environmental exposures were identified as key determinants of the QoL in this population. The findings emphasize the urgent need for interventions and policies to address the challenges faced by children with asthma in LICs and LMICs and improve their overall well-being.9 0Item Restricted Ethical Implications of Social Media Marketing Targeting Children: A Case Study of YouTube's Influence on Consumer Behaviour.(DE MONTFORT UNIVERSITY, 2024-09) Shabbaj , Ebraheem; Obey GM, PriscillaThe dissertation delves into the ethical considerations surrounding social media marketing aimed at children, specifically focusing on YouTube. Since YouTube has emerged as a key source of entertainment for children and a significant platform for advertisers, this study seeks to explore the impact of marketing strategies such as influencer marketing, branded content, and interactive ads on children's purchasing behaviour. The research aims to provide a comprehensive understanding of these marketing tactics using a mixed-methods approach involving content analysis of popular YouTube channels and surveys with parents. The findings indicate that YouTube marketing significantly shapes children's consumer behaviour, largely due to their relationships with influencers they perceive as friends. This makes children more receptive to ads that seamlessly integrate with their entertainment experiences. Moreover, the study highlights concerns about unclear advertising disclosures that many children struggle to comprehend. The research offers recommendations for policymakers, marketers, parents, and digital platforms. These suggestions include stricter regulations, more transparent advertising practices, improved parental guidance, and culturally sensitive content. The insights gleaned from this study contribute to the ongoing discourse about ethical marketing practices and lay the groundwork for future research aimed at protecting young audiences online.31 0Item Restricted Determinants of Traumatic Dental Injuries Among Adolescents in England A secondary analysis of the Children’s Dental Health Survey 2013(University College London, 2024-09) Asiri, Ali; Tsakos, Georgios; Blokland, AlexBackground: Adolescents are particularly vulnerable to traumatic dental injuries (TDI), which have a higher global prevalence in this age group. This study aimed to explore the associations between various demographic, clinical, behavioral, and socioeconomic risk factors with TDI among 12- and 15-year-old adolescents in England. Methods: This is a cross-sectional study and secondary data analysis of the Children’s Dental Health Survey 2013 (CDHS2013), using a nationally representative sample. A total of 2,126 adolescents were included after excluding cases with missing data (differences between the analytical sample and those with missing data were negligible). The analysis employed appropriate survey weights and examined demographic (age, sex, ethnicity), clinical (positive overjet, dental caries), behavioral (smoking, alcohol drinking), and socioeconomic factors (free school meals (FSM) eligibility , area deprivation, rural/urban classification) using multivariable logistic regression to model associations with TDI. Results: The overall prevalence of TDI in the sample was 10.98%. In the fully adjusted model, male adolescents were more likely to experience TDI compared to females (OR=0.64, 95% CI= 0.43-0.95). Adolescents who had never consumed alcohol had 37% lower odds of developing TDI (OR=0.63, 95% CI= 0.42-0.94). All other demographic and behavioral risk factors, as well as clinical and socioeconomic factors were not significantly associated with TDI. Conclusions: The study identified two key risk factors for TDI: being male and alcohol consumption. These findings highlight the importance of emphasizing on these risk factors while planning for preventive interventions and public health campaigns on TDI. Future research should adopt longitudinal designs to better assess the temporal relationship between these risk factors and TDI and include a broader range of variables for a more comprehensive understanding of TDI etiology.52 0Item Restricted The Association Between Head and Neck Injuries Requiring Medical Attention and Behavioural Problems Among 7- and 14-Year-Old Adolescents Living in the United Kingdom A Secondary Data Analysis of the UK Millennium Cohort Study (MCS)(University College London, 2024-09) AlRugaibah, Norah; Blokland, Alex; Sifaki, MariaBackground: Injuries are major public health problems that affect children’s lives. Behavioural problems have been linked to increased risk of injury incidence. However, few studies discussed the association between externalising and internalising behavioural problems and head and neck injuries among children and adolescents. Aim: This study aims to examine the association between head and neck injuries requiring medical attention and behavioural problems among 7- and 14-year-old youth living in the UK. Methods: A secondary analysis of data from the Millennium Cohort Study (MCS) was conducted using the fourth and sixth sweeps when the participants were 7 and 14 years old. The outcome indicated whether the child had sustained any head and neck injuries since the last survey. Behavioural problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) subscales of externalising and internalising behaviour. In the analysis both scales were dichotomised (10% highest scores) to discern those experiencing severe difficulties. Demographic, family, and socioeconomic factors were used as covariates. Weighted analysis using regression modelling was used to examine the associations between behavioural problems and head and neck injuries. Results: The prevalence of head and neck injuries for 7- and 14-year-olds were 9.35% and 6.23% respectively. Externalising behavioural problems at age 7 were reported for just under 10% of the children, and nearly 9% were reported to experience Internalising problems. At age 14, over 10% of the sample presented with externalising behavioural problems, and nearly 8% with Internalising behaviours. Children aged 7 years who presented with externalising difficulties had a significantly higher risk of head and neck injuries in the crude model (OR=1.41, 95%CI: 1.02–1.93). However, this association became non-significant after controlling for child characteristics. In the crude model, there was no difference in head and neck injury odds between children with internalising behavioural problems and their peers at age 7 (OR=1.00, 95%CI: 0.67–1.48). The association remained non-significant after subsequent adjustments. For 14-year-olds, those who with externalising problems appeared to have higher odds of head and neck injuries compared to their peers, although not statistically significant in the crude model (OR=1.25, 95%CI: 0.79–1.98) or after adjustments (final model: OR=1.27, 96%CI: 0.80 – 2.02). There was no difference between children aged 14 experiencing internalising difficulties and their peers in the crude model (OR=0.69, 95%CI: 0.35–1.36) or after adjustments (final model: OR=0.69, 96%CI: 0.36 – 1.32). Conclusion: This study indicated that children aged 7 with externalising behavioural problems were at higher risk for head and neck injuries. However, after adjusting for confounding factors, this association became non-significant. In early adolescence (age 14), such injuries were not significantly associated with externalising difficulties. Internalising problems showed no significant association with head and neck injuries in either age group.22 0
- «
- 1 (current)
- 2
- 3
- »