Application of NMI-TfCl-mediated amide bond formation in the synthesis of biologically relevant oxadiazole derivatives employing less basic (hetero)aryl amines

We herein report a modified methodology for the synthesis of some oxadiazoles linked to amides under mild conditions. The developed protocol using NMI-TfCl has been found to be effective and tolerant for the amide bond formation reaction of a series of electronically deactivating and sterically challenging amines. The antioxidant potential of the newly synthesized compounds has been evaluated at the later stage. Graphic abstract: [Figure not available: see fulltext.

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Hospital managers’ perception of the implementation of electronic health records in Saudi Arabia public hospitals

Despite the potential of using Electronic Health Record (EHR) in hospitals for enhancing the quality of patient care and safety, it has been shown that the implementation of EHRs is low. Much research has focused on the clinical healthcare professionals’ perceptions of EHRs, but little is known about hospital managers. The hospital manager is in a position to serve as an agent for change in implementing EHR technology. The managers are pivotal in leading the implementation of the systems changes required to successfully implement EHRs and thus their perceptions and methodologies. This thesis focuses on hospital managers working in the secondary and tertiary care hospitals managed by the Ministry of Health (MOH) in Saudi Arabia. It examines the current status of EHR implementation and hospital manager perceptions’ of the introducing of integrated EHRs in Saudi Arabia public hospitals. Also, challenges facing hospital managers prior to the implementation of EHRs and their need to implement EHR successfully are addressed. A descriptive design, using a collective cross-sectional quantitative census survey was used to address the research questions. The survey was developed from the literature comprising a self-administered postal questionnaire. Saturation survey sampling was used to achieve completed questionnaires from each of the MOH hospital managers in Saudi Arabia. The questionnaires were distributed to all hospital managers working in MOH hospitals. A total of 220 hospital managers participated, of these 163 completed the questionnaires, representing a 74% response rate which contained complete information on key variables of sufficient validity to be included in subsequent analysis. An open-ended question was also included in the survey where hospital managers were asked to provide dialogue on their experience with EHR. The results show that none of the public hospital had fully implemented EHR and only third of the hospitals had partially implemented EHR. In addition, 41.1% of the hospital managers were not familiar with the concept of EHR and 73.6% had not used the EHR system. The Saudi Arabia hospital managers had a positive attitude towards the introduction of EHR, but were over confident in dealing with resistance from hospital staff. Moreover, the majority of respondents believed that current information technology IT infrastructures did not support the EHR implementation and also hospital staff were not prepared. Financial resources and unclear EHR implementation process model were identified as the most significant barriers to implement EHR in their hospitals. The primary facilitators to support the implementation of EHR were adequate EHR infrastructures, customising training and education program in health informatics, financial support and information on change management implementation. Since hospital managers are the core individuals in each hospital, this study has highlighted the significance of considering the hospital managers’ perception when implementing EHR. The findings may serve as a guiding tool for hospital managers that have not implemented EHR as well as for the MOH in Saudi Arabia

Hospital managers’ perception of the implementation of electronic health records in Saudi Arabia public hospitals

Despite the potential of using Electronic Health Record (EHR) in hospitals for enhancing the quality of patient care and safety, it has been shown that the implementation of EHRs is low. Much research has focused on the clinical healthcare professionals’ perceptions of EHRs, but little is known about hospital managers. The hospital manager is in a position to serve as an agent for change in implementing EHR technology. The managers are pivotal in leading the implementation of the systems changes required to successfully implement EHRs and thus their perceptions and methodologies. This thesis focuses on hospital managers working in the secondary and tertiary care hospitals managed by the Ministry of Health (MOH) in Saudi Arabia. It examines the current status of EHR implementation and hospital manager perceptions’ of the introducing of integrated EHRs in Saudi Arabia public hospitals. Also, challenges facing hospital managers prior to the implementation of EHRs and their need to implement EHR successfully are addressed. A descriptive design, using a collective cross-sectional quantitative census survey was used to address the research questions. The survey was developed from the literature comprising a self-administered postal questionnaire. Saturation survey sampling was used to achieve completed questionnaires from each of the MOH hospital managers in Saudi Arabia. The questionnaires were distributed to all hospital managers working in MOH hospitals. A total of 220 hospital managers participated, of these 163 completed the questionnaires, representing a 74% response rate which contained complete information on key variables of sufficient validity to be included in subsequent analysis. An open-ended question was also included in the survey where hospital managers were asked to provide dialogue on their experience with EHR. The results show that none of the public hospital had fully implemented EHR and only third of the hospitals had partially implemented EHR. In addition, 41.1% of the hospital managers were not familiar with the concept of EHR and 73.6% had not used the EHR system. The Saudi Arabia hospital managers had a positive attitude towards the introduction of EHR, but were over confident in dealing with resistance from hospital staff. Moreover, the majority of respondents believed that current information technology IT infrastructures did not support the EHR implementation and also hospital staff were not prepared. Financial resources and unclear EHR implementation process model were identified as the most significant barriers to implement EHR in their hospitals. The primary facilitators to support the implementation of EHR were adequate EHR infrastructures, customising training and education program in health informatics, financial support and information on change management implementation. Since hospital managers are the core individuals in each hospital, this study has highlighted the significance of considering the hospital managers’ perception when implementing EHR. The findings may serve as a guiding tool for hospital managers that have not implemented EHR as well as for the MOH in Saudi Arabia

Registered Nurses' beliefs about end‐of‐life care: A mixed method study

Abstract Aims To examine registered nurses' (RNs) behavioural, normative and control beliefs about end‐of‐life care for patients who are diagnosed with advanced and life‐limiting illnesses; and to identify the barriers and facilitators they experience when providing end‐of‐life care. Design A sequential explanatory mixed methods study. Method An online cross‐sectional survey was conducted using the Care for Terminally Ill Patient tool among 1293 RNs working across five hospitals in the Kingdom of Saudi Arabia. Online individual semi‐structured interviews with a subgroup of survey respondents were then undertaken. Data were collected between October 2020 to February 2021. Results A total of 415 RNs completed the online survey, with 16 of them participating in individual interviews. Over half of the participants expressed the belief that end‐of‐life care is most efficiently delivered through multidisciplinary team collaboration. The majority of participants also believed that discussing end‐of‐life care with patients or families leads to feelings of hopelessness. Paradoxically, the study revealed that more than half of the participants held the negative belief that patients at the end of life should optimally receive a combination of both curative and palliative care services. The results showed that nurses' beliefs were significantly associated with their age, religion, ward type, level of education and frequency of providing end‐of‐life care. Data from the qualitative interviews identified four themes that explored RNs' beliefs and its related factors. The four themes were ‘holistic care’, ‘diversity of beliefs’, ‘dynamics of truth‐telling’ and ‘experiences of providing end‐of‐life care.’ Implications for the Profession and/or Patient Care Wherever possible, patients at the end‐of‐life should be cared for in specialist settings by multidisciplinary teams to ensure effective, high‐quality care. Where this is not possible, organisations should ensure that teams of multidisciplinary staff, including nurses, receive education and resources to support end‐of‐life care in non‐specialist settings. Hospitals that employ foreign‐trained nurses should consider providing targeted education to enhance their cultural competence and reduce the impact of different beliefs on end‐of‐life care

Registered Nurses\u27 attitudes towards end-of-life care: A sequential explanatory mixed method study

Aims: To examine registered nurses\u27 attitudes about end-of-life care and explore the barriers and facilitators that influence the provision of high-quality end-of-life care. Design: A sequential explanatory mixed methods research design was used. Methods: An online cross-sectional survey was distributed to 1293 registered nurses working in five different hospitals in the Kingdom of Saudi Arabia. The Frommelt Attitudes Towards Care of the Dying Scale was used to assess nurses\u27 attitudes towards end-of-life care. Following the survey, a subset of registered nurses were interviewed using individual semi-structured interviews. Results: Four hundred and thirty-one registered nurses completed the online survey, and 16 of them participated in individual interviews. Although nurses reported positive attitudes towards caring for dying patients and their families in most items, they identified negative attitudes towards talking with patients about death, their relationship with patients\u27 families and controlling their emotions. The individual interview data identified the barriers and facilitators that registered nurses experience when providing end-of-life care. Barriers included a lack of communication skills and family and cultural and religious resistance to end-of-life care. The facilitators included gaining support from colleagues and patients\u27 families. Conclusion: This study has identified that while registered nurses hold generally favourable attitudes towards end-of-life care, they have negative attitudes towards talking with patients and families about death and managing their emotional feelings. Relevance to clinical practice: Education providers and leaders in healthcare settings should consider developing programmes for undergraduate nurses and nurses in clinical practice to raise awareness about the concept of death in a cross-section of cultures. Nurses\u27 attitudes towards dying patients will be enhanced with culture-specific knowledge which will also enhance communication and coping methods. Reporting method: This study used the Mixed Methods Article Reporting Standards (MMARS)

Assessment of Knowledge about Traditional Medicine Reveals Overuse as a Potential Risk for Aggravating COVID-19 and Underlying Diseases in Geriatrics and Women’s Health in the Saudi Population

The devastating COVID-19 pandemic has created several gaps in the management of viral infections, leaving biocontainment and supportive measures as the only resorts for control. As such, there has been a dramatic increase in the use of dietary supplementations and herbal medicine for COVID-19. However, serious concerns regarding the efficacy, safety, and recommended doses of these medicines have been raised. In this study, we aimed to assess the population knowledge about alternative medicine administration for COVID-19 and the associated factors. Using a self-administered cross-sectional survey, we analyzed a total of 2042 valid responses. Most of the included participants were females (69.7%), with an overall mean age of 20.8 ± 11.8 years. Most respondents (62.8%) obtained their knowledge from social media while only 16.6% received knowledge from the health care workers. Half of the participants (50.6%) correctly identified all COVID-19 symptoms, where fever (18.5%) and loss of smell and taste (17.1%) were the most frequent answers. On the use of traditional medicines and supplements for COVID-19, 57.8% did not answer, 23.7% admitted regular use, and 18.5% used sometimes. Family members or friends suggested the use of traditional medicines and dietary supplements to 28.0% of the participants while only 14.7% were advised by a nutritionist, physician, pharmacist, nurse, or a health worker. Moreover, seniors and illiterate portions of society had lower knowledge scores and increased utilization of alternative medicine. Marital status, income, and previous COVID-19 were all significant predictors of the awareness and knowledge score. Thus, this study has identified overuse of unregulated medicinal products in the region, which potentially aggravates COVID-19 or other underlying risks of the disease, making clinical management challenging, particularly in geriatrics and women’s health. Regulation of medicinal products and establishment of educational campaigns about the disease have become imperative