Decentralization Implementation in Saudi Arabian Educational System: A Qualitative Study

Research Focus. In the unique context of Saudi Arabian high schools, this qualitative study aimed to understand how decentralization, a significant reform initiative, was experienced by principals and teachers. It explored their perspectives, challenges, and successes and actively sought their recommendations for enhancing decentralization\u27s implementation. By focusing on the voices of these key stakeholders, the study aimed to provide practical guidance to inform future reforms and improve education quality for Saudi high school students. Research Methods. This qualitative study employed an interpretive design to explore the experiences and perspectives of high school principals and teachers in Saudi Arabia regarding decentralization implementation. Data collection involved in-depth semi-structured interviews with a purposive sample of participants who had direct experience with decentralization. The study was conducted in Jeddah, Saudi Arabia, where decentralization reforms were implemented. Thematic analysis was used to analyze the interview data, identifying recurring themes and patterns within participants\u27 narratives. This approach allowed for an in-depth examination of participants\u27 insights and recommendations regarding decentralization, providing a rich understanding of their experiences and the challenges they faced. The research design aimed to capture the nuanced and context-specific aspects of decentralization implementation within the Saudi high school system. Research Results/Findings. The study\u27s findings shed light on the multifaceted experiences of high school principals and teachers with decentralization implementation in Saudi Arabian high schools. Participants shared their perceptions, challenges, and successes in navigating the decentralization process. The main findings revealed that while decentralization was seen as a positive step toward school autonomy, it also presented challenges related to decision-making, resource allocation, and communication among stakeholders. Participants emphasized the importance of effective leadership, professional development, and clear communication in successful decentralization implementation. Moreover, the study unveiled valuable recommendations from participants on enhancing the decentralization process for improved educational outcomes. These findings contribute to a deeper understanding of decentralization in the Saudi high school context and provide insights for educational policymakers and practitioners. Conclusions From Research. Based on the research findings, it is evident that decentralization in Saudi Arabian high schools is a complex and multifaceted process. High school principals and teachers perceive both advantages and challenges associated with decentralization. Effective leadership, professional development, and clear communication emerge as key factors in successful implementation. The study\u27s recommendations emphasize the importance of ongoing support and training for educators and the need for clear communication channels to enhance the decentralization process. These insights have significant implications for educational policymakers and practitioners in Saudi Arabia. The study underscores the importance of considering the perspectives and recommendations of those directly involved in the educational process when implementing decentralization reforms. Ultimately, this research contributes to a more nuanced understanding of decentralization in the Saudi high school context and offers practical guidance for improving the quality of education in the region

Ocular Myasthenia Gravis; a Case Report

Abstract Background: Myasthenia gravis (MG) is an autoimmune disease disorder that affects the skeletal muscles causing increased fatigability and weakness. When it affects the ocular muscles only, it is known as ocular myasthenia gravis (OMG). Patients with OMG will often have symptoms of diplopia and ptosis, which will be worse towards the end of the day. This case report will discuss the common symptoms of OMG as well as the appropriate treatment and management. It will also review the diagnostic tests used to aid in the diagnosis of OMG and discuss the prognosis of OMG. Case Report: A 67-year-old male presented with a chief complaint of diplopia that was variable throughout the day. Additionally, he complained that his left eyelid was drooping. Clinical examination revealed a mild ptosis of the left eye and right adduction deficit. An MRI/MRA of the head and orbits was ordered, along with a myasthenia panel. His MRI and MRA were unremarkable, and he tested negative for acetylcholine receptor antibodies. A neurologic exam was completed, and the patient was diagnosed with late-onset, triple antibody negative, ocular myasthenia gravis. His symptoms improved once he was placed on prednisone. Conclusion: When a patient presents with pupil-sparing, painless, diplopia, ptosis or ophthalmoloplegia, OMG should always be considered. While the diagnosis relies heavily on history and physical examination, serologic, radiographic, and electrophysiologic testing are used to support the diagnosis. First line treatment for patients with OMG is pyridostigmine; however, patients will often require corticosteroids. Some may continue to have diplopia or ptosis even with maximal medical therapy. When this occurs, prism or surgery is an option. The prognosis for OMG is good with most patients reaching remission

Herpes Zoster Ophthalmicus Associated with Ipsilateral Bell\u27s Palsy

Abstract Background: Herpes zoster is caused by reactivation of the varicella zoster virus with spread along the dorsal root ganglion and sensory nerve to a dermatome. In herpes zoster ophthalmicus (HZO), involvement of the ophthalmic (V1) branch of the trigeminal nerve results in ocular sequelae and often presents with a characteristic pseudodendrite. Reactivation within cranial nerve VII can lead to the neurologic complication of facial nerve palsy on the affected side. Case Report: This case report describes a patient diagnosed with HZO and subsequent same-sided facial nerve palsy (Bell’s palsy) and discusses the potential link between the two conditions. Conclusion: Treatment for HZO and Bell’s palsy is fluid and conservative treatment must be weighed against issues with polypharmacy and the severity of the disease. The prognosis of HZO and Bell’s palsy is dependent on how well symptoms are managed, including close observation beyond resolution

EXPLORING EFFECTIVE LEADERSHIP QUALITIES OF RURAL HOSPITAL CEOs: A QUALITATIVE INVESTIGATION

ABSTRACT Exploring Effective Leadership Qualities of Rural Hospital CEOs: A Qualitative Investigation By: Karl Hittle University of the Incarnate Word, 2024 Competent healthcare executives who successfully lead the healthcare delivery systems in small communities are limited in number despite the tremendous need for their expertise. Information describing the specific characteristics of successful Chief Executive Officers (CEOs) for rural medical centers is lacking in the current body of literature. This study investigates the leadership characteristics of successful rural hospital CEOs using information gleaned from those who have proven to be successful in this critical section of the healthcare industry. A qualitative phenomenological approach to the investigation was used with the intentional selection of ten subjects using face-to-face interviews. Interview questions were designed to solicit in-depth, personal responses from those hospital CEOs in Texas who have achieved success and are recognized as successful amongst their peers. Using the MAXQDA software (VERBI Software, 2022), interview data were coded and condensed into three themes that revealed the characteristics the participants believed to be important for success in their roles. Those themes include Authenticity Personally and Professionally, Approachable and Accessible, and Integrity Builds Trust and Credibility. This study will provide valuable insights for hospital CEOs and hospital board members seeking the development or recruitment of a CEO to lead their organization. It may also serve as a resource for healthcare leaders in general who seek enhancement of their leadership effectiveness

Effectiveness of EScoop® lenses on a Select Group of Veterans

Purpose: The purpose of this study was to perform a retrospective chart review to see if the use of EScoop® lenses improved the referred veterans\u27 contrast acuity and subjective visual discomfort of glare, photophobia, or difficulty with night driving. Methods: We retrospectively reviewed examinations of 23 veterans aged 36 to 91 who chose EScoop ® for their spectacle prescription. The EScoop ® set available in our clinic included two shades, yellow or orange, two center lens thicknesses (LT), 6 or 9 mm, and with or without 4 prism diopters yoked base up (BU) prism. Results: The largest diagnostic group tested was with traumatic brain injury (12 of 23), and they preferred the orange-tinted lens (10 of 12). The orange 9 mm LT with 4 prism diopters BU was the most commonly chosen EScoop® lens overall (5 of 23). Pre and post lens visual acuity testing with Sloan EDTRS LogMAR Low Contrast Chart at 25% contrast was available for 13 of the 23 patients. A small but statistically significant improvement of 0.11 decimal mean acuity (about one-line Snellen) under a low contrast condition was noted while wearing the preferred EScoop ® lenses (Wilcoxon Signed Rank P=0.015). Conclusion: Our retrospective study reviewed visually impaired patients with varied clinical conditions, including traumatic brain injury, age-related macular degeneration, glaucoma, and optic atrophy. Upon informal questioning, the patients reported improvements in glare, photophobia, and night glare symptoms. Objectively, we measured approximately one line of improvement in contrast Snellen acuity, which was statistically significant. Further research is needed to discern the actual effectiveness of this lens

Financial Self-Efficacy Among Puerto Rican Women in the United States: An Ethnographic Action-Based Research Study

The purpose of this ethnographic action research study was to better understand the financial self-efficacy of Puerto Rican women in the United States. There is a gap in the literature in identifying the relationship between middle-class Puerto Rican women and financial literacy. In a pilot study, four major findings emerged from the survey about Puerto Rican women and their relationship with finances: (a) as children, mothers taught them to save, and as adults, they rely on the male figures in their families; (b) the traditional education systems did not provide financial education; (c) the childhood culture of poverty and scarcity shaped their need for financial security as adults; and (d) as adults, the struggle still exists to find financial guidance. There is a paucity of literature written to understand the financial self-efficacy of Puerto Rican women. This study had the following primary research question: What is the financial self-efficacy among Puerto Rican women? Fourteen codes were identified through the course of the five weeks: discussions about money, financial struggles, generational wealth, parental roles, family, never giving up, faith, health, parental influence, accounts for life events, credit as a tool, learning by trial and error, investing encouraged by employment, and financial self-efficacy. The codes were then synthesized into four categories: culture, family, perseverance, and education as power. The categories were further synthesized into three emerging themes: Lo Cotidiano, Financial Self-Efficacy, and Financial Cultural Humility

An Exploration of How Education Stakeholders Perceive the Implications of Grade Repetition in Secondary Education in Western Uganda: A Qualitative Multiple-Case Study

Grade repetition is one of the bottlenecks to Uganda’s vision of producing skilled human capital to transform the nation’s status from peasant to middle class. This study explored how education stakeholders perceived the implication of students’ grade repetition at a secondary school level. I employed a qualitative approach with an embedded multiple-case study design, through which cross-case synthesis on each school’s perspective revealed similarities and differences in understanding grade repetition at a secondary school level. Individualism-collectivism theory guided the study, to understand how students realized educational expectations through an interplay of educational and cultural influence on a school’s instructional process. I purposely selected 10 participants from four secondary schools (two private and two government), including four teachers and four administrators with at least 5 years of instruction, and two Parent-Teachers Association (PTA) chairpersons. I triangulated data collection through interviews, observation, document analysis, and focus group discussions and thematically analyzed the data through codes and categories to condense the voluminous field data into five themes without losing their intended meaning and focus. Study findings revealed a lack of standardized educational controls in regional schools as they raced for national examinations, ignoring the students’ individualized needs. It established how schools’ safeguards of their image and status led to more student expulsions for not meeting percentage pass marks, disparaging averages, and slow learners, impacting students’ emotional and psychological well-being. As schools overlooked government directives to satisfy their missions and belief systems, they widened the gap between rich and poor in accessing preferred schools. This study recommended the government’s intervention with financial controls and enhanced supervision to create equal access to desired schools for well-to-do and low-income families and support students’ holistic education. Schools’ academic decisions also should reflect students’ gender differences for inclusion

Transport of The Fluorescent Substrate ASP+ by Organic Cation Transporter-3 in Human Corneal Epithelial Cells

ABSTRACT Organic cation transporter-3 (OCT3) is expressed abundantly throughout the body, but little is known about the presence of these transporters within the eye and, more specifically, the cornea epithelium. An extensive library of compounds interacts with OCT3, including the fluorescent molecule ASP+ and metformin. Metformin is an OCT3 substrate and antidiabetic medication that can lower the risk of eye-related diseases like keratopathy and retinopathy linked to hyperglycemia. Utilizing high throughput microplate assays in a human cornea epithelial cell line (HCE-S), the time-dependent saturation of ASP+ uptake and the competition of ASP+ uptake by corticosterone (CORT), a known selective inhibitor of OCT3 was evaluated. The hypothesis is that OCT3 is present and functional in human corneal epithelial HCE-S cells. The specific aims are to determine the functionality of OCT3 using saturation and competition assays that provide uptake capacity, transporter kinetics, and potency information. Saturation (Bmax and Kd) and competition (IC50) data help to establish the expression and function of OCT3 in HCE-S cells as a model to understand better the transporter’s function in the human cornea epithelial cells. The findings suggest OCT3 is robustly expressed in HCE-S cells and can function to transport ASP+. At baseline (25 mM glucose levels), the HCE-S cell line expresses transporters like OCT3 (and likely other isoforms) that can bind and transport the fluorescent substrate ASP+, which can be blocked by CORT and decynium22 (D22). The ASP+ saturation assay and time trial 30-minute uptake experiments are better for uptake capacity and affinity (Bmax ≅ 1100 RFU; Kd ≅ 272 µM). CORT competition assay using higher glucose levels may potentially decrease the potency of CORT to inhibit ASP+ uptake in HCE-S cells (IC50 ≅ 283 µM (baseline); ≅1717 µM (50 mM glucose, 24 hrs.). Our results also imply that other non-OCT3 transporters are present in this endogenous cell model capable of ASP+ uptake, as evidenced by our non-specific binding measurements using a non-selective inhibitor, D22. The next stage of competition experiments will use metformin to confirm that OCT3 is active in the HCE-S cell line. This work has future implications for establishing corneal cells as a new model to study OCT3 activity, test the pharmacological characteristics of ligands, and develop alternate administration routes for metformin (e.g., as eye drops)

Cultivar Relaciones: Exploring Trust and Transparency in Building Relationships in an Action Research Study Within a Community-Based Participatory Research Project

Research Focus. In San Antonio, Texas, health disparities are a critical issue, shaped by a range of social determinants impacting health and contributing to inequities in healthcare. The World Health Organization defines healthcare inequity as unjust and avoidable differences in health status observed across different population groups. The Centers for Disease Control and Prevention (CDC) further clarifies that disparities are evident when health outcomes or determinants vary significantly between populations. These disparities not only impose a toll on human life but also have profound societal costs affecting its citizens’ morbidity and mortality. The focus spreads across entities working in silos not working collaboratively. An opportunity exists to approach a notable fragmentation in these initiatives. This action research study sought to explore and discover ways to intentionally build productive, trusting, and transparent relationships between the University of the Incarnate Word (UIW) Dreeben School of Education and Ila Faye Miller School of Nursing and Health Professions research team, the San Antonio Metro Health District Healthy Neighborhoods (HN) city organization and select communities in an RWJF-supported participatory action research project in San Antonio, Texas. Research Methods. Combining an action research approach with qualitative features permitted active engagement in an actual community-based participatory action research (CBPAR) project to collaboratively seek a solution for a practical problem. I used basic action research and social constructivist grounded theory-lite design regarding improving relationship development within the project, emphasizing trust and transparency. Participants were grouped into three distinct categories: (1) AR4CHW Team (2) Community Members (3) National CBPAR Thought Leaders. Data collection consisted of three primary participatory methodologies: rewriting the script for equitable healthcare (RWTS), digital storytelling (DS), and photovoice. Data collection methods involved observation, semi-structured interviews, meeting and workshop attendance, and facilitation. Data analysis focused on the participants’ concerns regarding what could be done to build productive, trusting, and transparent relationships. Research Results/Findings. The study produced five key findings that are instrumental in cultivating trusting, transparent, and productive relationships within CBPAR. These findings are encapsulated in the following themes: (1) Trust: Authentic Belonging and Respect, (2) Transparency: Facilitator of Trust and Inclusion, (3) Participatory Methodology: Remarkable Potential, (4) Equitable Inquiry: Reflection and Focus, and (5) Multiverse: Relationship Enabler and Inhibitor. Key findings or core concepts of the five findings included (1) intentional development of the research team, (2) participatory methodology, and (3) equity-minded inquirers. The core findings support a model that responds to how this SA-based research team can build productive, trusting, and transparent relationships. Conclusions From Research. I identified three key strategies to build trusting and transparent relationships to improve building productive alliances. (1) Deliberate Team Development, (2) Use of Participatory Methodologies, and (3) Equity-Focused Inquiry. This study has potential limitations regarding generalizability as it is contextual and relevant to a local practice problem only, and bias since the researcher was also a participant. Recommendations from this study support the AR4CHW team and CBPR/CBPAR practice

Book Review: Visual Secrets for School Success

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