Investigating the Willingness to Pay for a Contributory National Health Insurance Scheme in Saudi Arabia:A Cross-sectional Stated Preference Approach

Background: The Saudi Healthcare System is universal, financed entirely from government revenue principally derived from oil, and is ‘free at the point of delivery’ (non-contributory). However, this system is unlikely to be sustainable in the medium to long term. This study investigates the feasibility and acceptability of healthcare financing reform by examining households’ willingness to pay (WTP) for a contributory national health insurance scheme. Methods: Using the contingent valuation method, a pre-tested interviewer-administered questionnaire was used to collect data from 1187 heads of household in Jeddah province over a 5-month period. Multi-stage sampling was employed to select the study sample. Using a double-bounded dichotomous choice with the follow-up elicitation method, respondents were asked to state their WTP for a hypothetical contributory national health insurance scheme. Tobit regression analysis was used to examine the factors associated with WTP and assess the construct validity of elicited WTP. Results: Over two-thirds (69.6%) indicated that they were willing to participate in and pay for a contributory national health insurance scheme. The mean WTP was 50 Saudi Riyal (US$13.33) per household member per month. Tobit regression analysis showed that household size, satisfaction with the quality of public healthcare services, perceptions about financing healthcare, education and income were the main determinants of WTP. Conclusions: This study demonstrates a theoretically valid WTP for a contributory national health insurance scheme by Saudi people. The research shows that willingness to participate in and pay for a contributory national health insurance scheme depends on participant characteristics. Identifying and understanding the main influencing factors associated with WTP are important to help facilitate establishing and implementing the national health insurance scheme. The results could assist policy-makers to develop and set insurance premiums, thus providing an additional source of healthcare financing

GÊNEROS DISCURSIVOS E ENSINO: UMA PROPOSTA DE APLICAÇÃO EM SALA DE AULA

Os gêneros discursivos são formas de agir e interagir discursivamente e são inerentes à comunicação humana. Neste artigo, nos propomos, a partir de um percurso teórico, discutir sobre o conceito de gênero discursivo com base nas reflexões de Bakhtin (2000) e Marcuschi (2003, 2005), considerando sua aplicabilidade no ensino como condição para assegurar à construção de conhecimentos fundamentais para as práticas sociais de linguagem. Para isso, refletimos sobre o gênero discursivo como atividade sociocomunicativa de interação social, produzido para as necessidades de comunicação, constituído de componentes sociais, históricos, culturais e cognitivos. Além disso, analisamos a sequência didática na perspectiva de Dolz e Schneuwly (2004) como possibilidade de auxiliar o ensino através dos gêneros.  Entendemos ser essencial, por essa razão, que as aulas de língua portuguesa centrem-se, nos diferentes níveis de ensino, nas dinâmicas sociais de interação por meio dos gêneros discursivos.       &nbsp

The Learning Preferences among Nursing Students in the King Saud University in Saudi Arabia: A Cross-Sectional Survey

Objective. The present study aimed to identify the most common learning preferences among the nursing students in Saudi Arabia and to investigate the associations of certain demographic variables with the learning preferences. Methods. All the undergraduate nursing students in the nursing college were requested to participate in this descriptive cross-sectional study. An Arabic version of the Felder-Silverman learning style model (FSLSM) questionnaire was used to examine the learning preferences among undergraduate nursing students. Results. A total of 56 (43%) completed questionnaires were included in the final analysis. Results of the present study indicate that the most common learning preferences among the nursing students were visual (67.9%), followed by active (50%) and sequential (37.5%) learning preferences. The verbal style was the least common learning preference (3.6%) among the nursing students. There was no association between gender and learning preferences ( > .05). Conclusion. The present study concluded that the visual, active, and sequential styles are the commonest learning preferences among the nursing students. The nursing educators should emphasize the use of this information in their teaching methods to improve learning skills among the nursing students

An assessment of job satisfaction: A cross-sectional study among orthodontists of Saudi Arabia

AIM OF THE STUDY: The main objective of the present study was to investigate the level of job satisfaction among professional orthodontists in relation to some significant intrinsic and extrinsic factors that generally affect their performance. MATERIALS AND METHODS: A cross-sectional study was conducted among orthodontists working in the Kingdom of Saudi Arabia using an online survey questionnaire through Survey Monkey. A total of 161 responses were received; among those, 57.8% of the respondents were Saudi and 42.2% were non-Saudi. RESULTS: On an overall satisfaction basis, a majority of orthodontists (80.7%) were satisfied with orthodontics as their profession irrespective of their gender. Only 4.4% showed dissatisfaction, whereas the remaining 14.9% were moderately satisfied with orthodontics as a profession. In-depth analysis revealed that a majority of the respondents (56.2%) showed reservations over having ample time for their family life. 52.8% of the respondents strongly agreed that they are assigned significant paperwork. Likewise, 66.5% of the orthodontists showed moderate to dissatisfaction over time adherence by the patients. CONCLUSION: The findings of the present investigations depicted a higher level of passion and commitment among the male and female respondents for the profession in spite of the fact that they do not have adequate time for their personal life. The working efficiency of orthodontists may be significantly enhanced by sparing them from too much paperwork and ensuring that their patients appear on time

Upfront Alternative Donor Transplant versus Immunosuppressive Therapy in Patients with Severe Aplastic Anemia Who Lack a Fully HLA- Matched Related Donor: Systematic Review and Meta-Analysis of Retrospective Studies, on Behalf of the Severe Aplastic Anemia Working Party of the European Group for Blood and Marrow Transplantation

Idiopathic aplastic anemia is a rare and life-threatening disorder, and hematopoietic stem cell transplantation (HSCT) from a matched sibling donor (MSD) is the standard treatment strategy for young patients. Alternative donor transplantation (ADT) from a matched unrelated donor or an HLA haploidentical donor is not commonly used in the frontline setting. This systematic review/meta-analysis was conducted to compare ADT as an upfront, rather than delayed, treatment strategy in the absence of an MSD to immunosuppressive therapy (IST) in severe aplastic anemia (SAA). We searched PubMed/MEDLINE and Embase (1998 to 2019) for studies that compared the outcomes of ADT with IST as upfront therapy in patients with SAA. We included studies with 5 patients or more in each arm. Studies that included patients with inherited forms of bone marrow failure syndromes were excluded. The primary outcome was the 5-year overall survival (OS) rate. Five studies met the inclusion criteria and were included in this meta -analysis. The pooled 5-year odds ratio (OR) for OS was statistically significant at 0.44 (95% confidence interval [CI], 0.23 to 0.85) in favor of upfront ADT. In addition, survival was compared between upfront ADT versus salvage ADT in 6 studies. The pooled 5-year OR for OS was statistically significant at 0.31 (95% CI, 0.15 to 0.64) in favor of upfront ADT. Although this analysis has some limitations, including the retrospective nature of the included studies, the lack of ethnic diversity, the predominantly pediatric population, and the relatively suboptimal IST regimen used in some of the studies, it indicates that upfront ADT is a potential alternative treatment option in young and pediatric SAA patients who lack an HLA identical sibling donor, particularly when optimal IST is not available.Immunobiology of allogeneic stem cell transplantation and immunotherapy of hematological disease