Saudi Cultural Missions Theses & Dissertations
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Item Restricted Enhancing Colorectal Cancer Screening Participation via Text Message Interventions(King's College London, 2024-09) Almoallem, Ghader; Round, Thomas; Hamad, WasimBackground: Colorectal cancer (CRC) ranks as the third most frequently diagnosed cancer globally and is a significant contributor to cancer-related deaths. Early detection through regular screening is crucial, as it greatly improves treatment outcomes and survival rates. However, screening participation for CRC remains insufficient, especially among minority groups. Text message interventions have been proposed as a cost-efficient and scalable solution to increase screening adherence. Objective: This systematic review and meta-analysis aimed to assess the effectiveness of text messaging interventions in enhancing CRC screening participation. Methods: A comprehensive search was conducted across four major databases Embase, PubMed, MEDLINE, and Cochrane up to August 2024. The review included randomized controlled trials (RCTs), observational studies, mixed-methods studies, and qualitative research that evaluated the impact of text message reminders on CRC screening rates. Data were extracted on study characteristics, intervention specifics, and screening outcomes. Meta-analyses were carried out to calculate pooled effect sizes of text message interventions compared to usual care. Results: Eighteen studies met the inclusion criteria, consisting of 12 RCTs, two observational studies, two mixed-methods studies, and two qualitative studies. The meta-analysis indicated that text message interventions significantly improved CRC screening uptake compared to usual care (pooled relative risk: 1.23, 95% CI: 1.12–1.36, p < 0.001). Sensitivity analyses validated the robustness of these results across different study designs and populations. Text message interventions were especially effective in low-income and underserved groups, where traditional outreach methods tend to be less successful. Furthermore, cost analysis from the reviewed studies highlighted that text messaging is a highly cost-effective method for promoting CRC screening. Conclusion: Text message interventions offer a scalable and effective approach to increasing participation in CRC screening programs. Their affordability, wide reach, and simplicity make them an ideal tool for public health systems, particularly those operating in resource-constrained settings. Despite these encouraging results, further research is needed to refine the content, timing, and cultural relevance of messages to ensure maximum impact across diverse populations. Incorporating text messaging into broader public health strategies could be crucial in alleviating the global burden of colorectal cancer.48 0Item Restricted The impact of project govrenance on the project performance(Saudi Digital Library, 2023-08-17) Alfaqih, Abdulrahim Hasaan; abualqumboz, MoheebThis dissertation thoroughly investigates the relationship between project governance and results. The study uses a literature review to answer four fundamental research questions on the relationship between project governance and results. This study aims to improve comprehension and provide practical insights for efficient project management by methodically evaluating themes that arose from the investigation. The first research question delves into the most important aspects of project governance that affect performance. Governance framework, governance process, and stakeholder involvement are the three overarching topics that emerge from the thematic analysis. These motifs collectively help project success by encouraging timely and appropriate decision-making, proactive risk management, and open and honest dialogue4 0Item Restricted Using Continuous Positive Airway Pressure with Hypoxemic Acute Respiratory Failure: A Systematic Review and Meta-Analysis of Randomised Controlled Trials(Saudi Digital Library, 2023-11-25) Alenazi, Bushra; Parekh, Dhruv; Grudzinska, FrancesBackground: Hypoxemic acute respiratory failure (hARF) is a common cause of emergency room and intensive care unit (ICU) admissions. Although the use of continuous positive airway pressure (CPAP) in this group of patients generally has steadily increased, the evidence supporting its use remains sparse. This systematic review and meta-analysis aims to summarise the findings of randomized controlled trials (RCTs) that have evaluated the need for intubation, and in-hospital mortality rate in patients with hARF treated specifically with CPAP compared to any other interventions. Method: CENTRAL, Embase, PubMed, CINAHL and Medline databases were searched. Studies including adults aged ≥ 18 years with hARF and RCTs that compared CPAP to any comparator/control were included. The studies were narratively and statistically analysed, and the outcomes assessed are intubation and in-hospital mortality rate. The risk of bias was assessed using the Cochrane risk of bias checklist for randomized control trials. Studies were reviewed in accordance with PRISMA guidelines. Results: Among 3488 studies identified. Six studies were eligible for inclusion involving 2,966 participants included in the meta-analyses and were descriptively synthesised. Results from the meta-analysis suggest reductions in intubation rate with CPAP compared to standard oxygen therapy (SOT) and high-flow nasal cannula (HFNC) (RR= 0.81, CI= 0.70 to 0.95, P-value=0.007). When doing subgroup analysis, CPAP suggests a reduction in the intubation rate with non-COVID-19 compared to COVID-19 studies. (P-value= 0.0010, 0.10, respectively). This study also suggests that helmet CPAP decreases the intubation rate in comparison to face mask CPAP (P-value <0.00001, 0.08, respectively). On the other hand, the study found that there was no significant difference in the in-hospital mortality rate between CPAP and other comparators (SOT and HFNC), (RR= 0.86, CI= 0.71 to 1.05) and a P-value of 0.13. This lack of significance was observed also in subgroup analysis in COVID-19 and non-COVID-19 studies. However, when looking at CPAP interventions using different interfaces, the risk ratio for face mask studies was not statically significant (RR=0.92, P-value=0.43), but the use of helmet CPAP was found to have a significant effect (risk ratio=0.23, P-value=0.0009). Conclusion: This systematic review highlights the available evidence to support the use of CPAP with hARF patients. Findings suggest that CPAP may reduce the need for intubation, especially in non-COVID-19 patients. However, CPAP has not been shown to have an effect on the in-hospital mortality rate. Using CPAP therapy with a helmet has shown to be a promising approach to lowering intubation and in-hospital mortality rates among this group of patients (hARF). Further studies are needed for a higher certainty of evidence. Other: This systematic review is registered with PROSPERO, CRD420234520233 0