PHYSICIAN AS A MANAGER: PERSONAL AND MANAGERIAL CHARCTERISTICS, SAUDI ARABIA

BACKGROUND: The emergence of physicians' roles in key adminstrative positions within many King Saudi Arabia health care organizations has represented a major change in the medical profession over the last two decades. This have created a need for physicians who are willing to assume a high level of responsibility for managing evovling health care organizations. The study explores the perception of physician managers regarding their work, personal and managerial characteristics. METHODS: The data for this study were obtained from a sample of 200 physicians working in management positions in different health care organizations in Riyadh. Physicians were selected at random with probability proportional to size from a list containing managers in all health care organization to participate in the study RESULTS: Our results indicated that physician managers lack admistration skills. No formal training in medical adminstration and management because management principles are not integrated in the medical context and the majority were experienced in management for less than four years.  Very few possess the technical comptencies such as strategic planning, financial and economics knowledge. Boredom with medical practice, improvement of personal position and encouragement from others are related to being older, having more years in medicine and interest in medicine is reduced. The finding also supported the notion that physician manager can maintain stable levels of loyality to professional interest and organization. This dual commitment is related to work-relate characteristics involving sharing his time favorably to management job and to patient care. Recommendation: To improve their management skills physicians can benefit from mamagement education programs such as those offered by King Saud University

Assessment of economic, thermal and hydraulic performances a corrugated helical heat exchanger filled with non-Newtonian nanofluid

Improved heat transfer efficiency with considering economic analysis in heating systems is an interesting topic for researchers and scientists in recent years. This research investigates the heat transfer rate (HTR) and flow of non-Newtonian water-Carboxyl methyl cellulose (CMC) based Al2O3 nanofluid in a helical heat exchanger equipped with common and novel turbulators using two-phase model. The requirements for dimensions and cost reduction and also energy saving in thermal systems are the main goal of this study. According to gained results usage of corrugated channel in helical heat exchanger has a considerable influence on thermal and hydraulic performance evaluation criteria (THPEC) index of helical heat exchanger and can improve the THPEC index. Thus, Re = 5000 is obtained as an optimum value, in which the maximum THPEC value is achieved. As it is found in this paper, in case of using novel heat exchanger instead of the basic smooth system, the thermal properties (by considering Nusselt number) increases about 210%, the hydraulic performance (friction factor) reduces about 28%, performance evaluation criteria index increases about 57% and the material consumption (in case of similar THPEC) decreases about 31%. In another word, with considering economic analysis for the basic and novel system which has same efficiencies, the novel one has lower length and consequently 31% lower material

Neisseria meningitidis nasopharyngeal carriage during the Hajj: A cohort study evaluating the need for ciprofloxacin prophylaxis

Background The annual Muslim pilgrimage has the potential of increase risk for acquisition of Neisseria meningitidis. Here, we evaluate the Hajj impact on the prevalence of N. meningitidis carriage in a paired and non-paired cohort of pilgrims. Secondary objectives were to calculate the compliance with recommended vaccination. Methods This is a prospective paired (arriving and departing), non-paired arriving and non-paired departing cohort study with the collection of nasopharyngeal samples at the start and the end of the Hajj. Results The study included unpaired arriving pilgrims at King Abdul Aziz International Airport (N = 1055), unpaired departing cohort (N = 373), and a paired cohort (N = 628) who were tested on arrival and departure. Meningococcal vaccination was received by all pilgrims, 98.2% received quadrivalent polysaccharide vaccine (ACWY), and 1.8% received meningococcal quadrivalent conjugate vaccine (MCV4). Only 1.61% and 23.03% received pneumococcal and influenza vaccines, respectively. Of the 1055 arriving unpaired pilgrim, 36 (3.4%) tested positive for nasopharyngeal carriage of N. meningitidis, and 24 (66.7%) of these were serogroup B, the remainder were non-groupable. Haemophilus influenza was detected among 45 (4.3%), and 11 (1%) carriers were positive for both N. meningitidis and H. influenzae. Out of 373 in the unpaired departing cohort, 6 (1.61%) tested positive for N. meningitidis, and 34 (9.1%) were positive for H. influenzae. Of the 628 paired cohort pilgrims, 36 (5.7%) pilgrims were positive for N. meningitidis at arrival and 16 (2.5%) pilgrims were positive after the hajj. Conclusion This the largest study of the epidemiology of N. meningitidis among pilgrims. The study showed a significant difference in the carriage between pilgrims from high endemicity and other pilgrims with a predominance of serogroup B. The continued use of ciprofloxacin as prophylactic antibiotics should be reconsidered as well as the consideration to add serogroup B as a required vaccination

A nationwide survey of public COPD knowledge and awareness in Saudi Arabia: A population-based survey of 15,000 adults

BACKGROUND: There is a concerning lack of representative data on chronic obstructive pulmonary disease (COPD) awareness in Saudi Arabia, and a significant proportion of the population is vulnerable to developing a smoking habit, which is a major risk factor for the disease. METHODS: Population-Based Survey of 15,000 people was conducted to assess the public knowledge and awareness of COPD across Saudi Arabia from October 2022 to March 2023. RESULTS: A total of 15002 responders completed the survey, with a completion rate of 82%. The majority 10314 (69%) were 18–30 year and 6112 (41%) had high school education. The most common comorbidities among the responders were depression (7.67%); hypertension (6%); diabetes (5.77%) and Chronic Lung Disease (4.12%). The most common symptoms were dyspnea (17.80%); chest tightness (14.09%) and sputum (11.19%). Among those who complains of any symptoms, only 16.44% had consulted their doctor. Around 14.16% were diagnosed with a respiratory disease and only 15.56% had performed pulmonary function test (PFT). The prevalence of smoking history was 15.16%, in which current smokers were 9.09%. About 48% of smokers used cigarette, 25% used waterpipe and around 27% were E-cigarette users. About 77% of the total sample have never heard about COPD. Majority of current smokers (73.5%; 1002), ex-smokers (68%; 619), and non-smokers (77.9%; 9911) are unaware of COPD, p value <0.001. Seventy five percent (1028) of the current smokers and 70% (633) of the ex-smokers have never performed PFT, p value <0.001. Male, younger age (18–30 years), higher education, family history of respiratory diseases, previous diagnosis of respiratory disease, previous PFT, and being an ex-smokers increases the odds of COPD awareness, p-value <0.05. CONCLUSION: There is a significantly low awareness about COPD in Saudi Arabia, especially among smokers. A nationwide approach must include targeted public awareness campaigns, continued healthcare professional education, community-based activities encouraging diagnosis and early detection, advice on smoking cessation and lifestyle changes, as well as coordinated national COPD screening programs

A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia

Background: Lung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases. Method: A cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer. Results: Majority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor’s degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p &lt; 0.001). Conclusion: Public awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms

A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia

Background: Lung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases. Method: A cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer. Results: Majority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor’s degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p &lt; 0.001). Conclusion: Public awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms

Perspectives, practices, and challenges of online teaching during COVID-19 pandemic: A multinational survey

The result of the movement restrictions during the COVID-19 pandemic was an impromptu and abrupt switch from in-person to online teaching. Most focus has been on the perception and experience of students during the process. The aim of this international survey is to assess staffs' perspectives and challenges of online teaching during the COVID-19 lockdown. Cross-sectional research using a validated online survey was carried out in seven countries (Brazil, Saudi Arabia, Jordan, Indonesia, India, the United Kingdom, and Egypt) between the months of December 2021 and August 2022, to explore the status of online teaching among faculty members during the COVID-19 pandemic. Variables and response are presented as percentages while logistic regression was used to assess the factors that predict levels of satisfaction and the challenges associated with online instruction. A total of 721 response were received from mainly male (53%) staffs. Most respondents are from Brazil (59%), hold a Doctorate degree (70%) and have over 10 years of working experience (62%). Although, 67% and 79% have relevant tools and received training for online teaching respectively, 44% report that online teaching required more preparation time than face-to-face. Although 41% of respondents were uncertain about the outcome of online teaching, 49% were satisfied with the process. Also, poor internet bandwidth (51%), inability to track students' engagement (18%) and Lack of technical skills (11.5%) were the three main observed limitations. Having little or no prior experience of online teaching before the COVID-19 pandemic [OR, 1.58 (95% CI, 1.35–1.85)], and not supporting the move to online teaching mode [OR, 0.56 (95% CI,0.48–0.64)] were two main factors independently linked with dissatisfaction with online teaching. While staffs who support the move to online teaching were twice likely to report no barriers [OR, 2.15 (95% CI, 1.61–2.86)]. Although, relevant tools and training were provided to support the move to online teaching during COVID-19 lockdown, barriers such as poor internet bandwidth, inability to track students’ engagement and lack of technical skills were main limitations observed internationally by teaching staffs. Addressing these barriers should be the focus of higher education institution in preparation for future disruptions to traditional teaching modes

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

A review of friction models in interacting joints for durability design.

This paper presents a comprehensive review of friction modelling to provide an understanding of design for durability within interacting systems. Friction is a complex phenomenon and occurs at the interface of two components in relative motion. Over the last several decades, the effects of friction and its modelling techniques have been of significant interests in terms of industrial applications. There is however a need to develop a unified mathematical model for friction to inform design for durability within the context of varying operational conditions. Classical dynamic mechanisms model for the design of control systems has not incorporated friction phenomena due to non-linearity behaviour. Therefore, the tribological performance concurrently with the joint dynamics of a manipulator joint applied in hazardous environments needs to be fully analysed. Previously the dynamics and impact models used in mechanical joints with clearance have also been examined. The inclusion of reliability and durability during the design phase is very important for manipulators which are deployed in harsh environmental and operational conditions. The revolute joint is susceptible to failures such as in heavy manipulators these revolute joints can be represented by lubricated conformal sliding surfaces. The presence of pollutants such as debris and corrosive constituents has the potential to alter the contacting surfaces, would in turn affect the performance of revolute joints, and puts both reliability and durability of the systems at greater risks of failure. Key literature is identified and a review on the latest developments of the science of friction modelling is presented here. This review is based on a large volume of knowledge. Gaps in the relevant field have been identified to capitalise on for future developments. Therefore, this review will bring significant benefits to researchers, academics and industrial professionals