Evaluating the Performance Appraisal System in Public Universities in Saudi Arabia and its Impact on Human Resource Decisions

In the changing and dynamic world, whilst companies endeavour to achieve their short and long term objectives in an efficient and effective manner, evaluating their human resources (HR) is regarded as an essential and fundamental process for achieving organisational objectives. However, the performance appraisal (PA) process is not only important for being the main provider of data in order to make HR related administrative decisions, but it also helps to provide information for identifying and influencing the development and satisfaction of the employees in carrying out their duties. This, in turn, contributes towards the achievement of the organisational objectives. The universities are knowledge-based organisations dependent entirely on the commitment and innovation of their teaching staff, and, therefore, they are different in terms of the organisational activity from other institutions. However, the management of universities, as educational institutions, is not that much different from other organisations. Therefore, all the management issues faced in other organisations are also relevant to universities, including HR management strategies drawn from PA systems (PASs). Hence, this study aims to evaluate the current PAS in Saudi Arabian public universities according to the perceptions of the teaching members who are subject to the PA process. It also aims to develop a new PAS based on the results developed from the research. In responding to the aim of the study, a questionnaire schedule was developed and conducted in four major public universities in Saudi Arabia. The researcher sent out 351 questionnaires, of which 197 were returned, giving a return rate of 56%. The results of the empirical analysis demonstrate that the participants are not happy with the existing PAS. In addition, it reveals: communication, transparency and organisational problems related to both the ratees who are subject to the PAS and the raters who carry out the process; poorly designed forms are used in the process; and problems related to the procedures that regulate which may undermine the appraisal process. Thus, dissatisfaction with the existing PASs is established through various empirical analyses. According to the findings of the study and the in-depth of the discussion of the analysed data, the study proposes an integrated and dynamic model for conducting the PA process. This proposed model is constructed with six stages: (1) Planning for Performance Appraisal; (2) Performance Execution; (3) Assessment (Informal Appraisal); (4) Performance Assessment (Formal Appraisal); (5) Interview; and (6) Action. In each stage several issues have been emphasised to improve overall efficiency of the PAS. The study also provides certain assumptions and recommendations for the successful development and implementation of the proposed model, which top level management in each university has to take into consideration to ensure the efficiency and effectiveness of human resources

Enhancing dental practice: cutting-edge digital innovations

Digital technology offers many opportunities and challenges across various domains. Aim: This comprehensive review explores the transformative impact of digitalization on dental practices, encompassing digital Imaging, 3D printing, intraoral scanners, teledentistry, Artificial Intelligence, CAD-CAM technology, and virtual reality. Methods: A rigorous search was conducted across various electronic bases, including PubMed, Google Scholar, Scopus, and the National Center for Biotechnology Information (NCBI). The search employed keywords such as “Orthodontics,” “Dental Health,” “Dental Imaging,” “CAD-CAM,” “Digital Medicine,” “Teleconsultation,” “Intraoral Scanner,” “Artificial Intelligence (AI),” “Digital Health,” “Teledentistry,” and “3D Dentistry.” Papers published between 2017 and the present were considered, focusing on peer-reviewed journals and reviews providing comprehensive insights into digital dentistry. Results: The review highlights the diverse facts of digitalization in dentistry, emphasizing its potential benefits for patient practitioners and the dental industry. Digital impressions, 3D printing, and CAD-CAM are streamlining restorative dentistry. In orthodontics, digital models enable precise simulations. Artificial Intelligence promises more efficient diagnostics and treatment planning. Conclusion: Digital technology is poised to reshape dentistry, improving efficiency, patient outcomes, and practitioner experiences. However, challenges such as data security and ethical considerations must be addressed. The successful integration of digital dentistry into dental practice will require more research and innovation, even though this review offers a thorough overview of the field

Seroprevalence of hepatitis B and C virus infections among health students and health care workers in the Najran region, southwestern Saudi Arabia: The need for national guidelines for health students

BACKGROUND: The objectives of the study were to study the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among health college students (HS) and health care workers (HCWs) in the Najran Region of south-western Saudi Arabia and to study the students’ knowledge of occupational exposure to blood-borne viral infections. METHODS: A cross-sectional study of a representative sample of 300 HS and 300 HCWs was conducted. RESULTS: An overall seroprevalence of HBV of 1.7% and 8.7% was found among HS and HCWs, respectively. Two-thirds of HS (66.7%, 200) and 23.3% (70) of HCWs lack anti-HBs and are susceptible to HBV infection. An overall seroprevalence of HCV of 0% and 0.3% was found among the HS and HCWs, respectively. The present study indicates poor knowledge among HS and moderate knowledge among HCWs regarding occupationally transmitted blood-borne diseases, safe injection practices, and standard precautions to prevent occupationally transmitted blood-borne infections. CONCLUSION: It is mandatory to develop a structured program to raise awareness among HS, and current health colleges’ curricula should be upgraded to address these issues early. The HS should be considered new recruits to health services in terms of their initial screening for blood-borne infections and vaccination against HBV. The development of a novel continuing medical education and pre-employment awareness program for HCWs is recommended to address the following: blood-borne diseases transmitted occupationally, standard precautions to prevent occupationally transmitted blood borne infections, and safe injection practices

Mucosal immunity in COVID-19: a comprehensive review

Mucosal immunity plays a crucial role in defending against coronaviruses, particularly at respiratory sites, serving as the first line of defense against viral invasion and replication. Coronaviruses have developed various immune evasion strategies at the mucosal immune system, hindering the recognition of infected cells and evading antibody responses. Understanding the immune mechanisms and responses is crucial for developing effective vaccines and therapeutics against coronaviruses. The role of mucosal immunity in COVID-19 is significant, influencing both local and systemic immune responses to the virus. Although most clinical studies focus on antibodies and cellular immunity in peripheral blood, mucosal immune responses in the respiratory tract play a key role in the early restriction of viral replication and the clearance of SARS-CoV-2. Identification of mucosal biomarkers associated with viral clearance will allow monitoring of infection-induced immunity. Mucosally delivered vaccines and those under clinical trials are being compared and contrasted to understand their effectiveness in inducing mucosal immunity against coronaviruses. A greater understanding of lung tissue-based immunity may lead to improved diagnostic and prognostic procedures and novel treatment strategies aimed at reducing the disease burden of community-acquired pneumonia, avoiding the systemic manifestations of infection and excess morbidity and mortality. This comprehensive review article outlines the current evidence about the role of mucosal immune responses in the clearance of SARS-CoV-2 infection, as well as potential mucosal mechanisms of protection against (re-)infection. It also proposes that there is a significant role for mucosal immunity and for secretory as well as circulating IgA antibodies in COVID-19, and that it is important to elucidate this in order to comprehend especially the asymptomatic and mild states of the infection, which appear to account for the majority of cases. Moreover, it is possible that mucosal immunity can be exploited for beneficial diagnostic, therapeutic, or prophylactic purposes. The findings from recent studies on mucosal immunity in COVID-19 can be used to develop effective vaccines and treatments that can effectively target both mucosal and systemic immune responses

Acute severe hypothyroidism is not associated with hyponatremia even with increased water intake: a prospective study in thyroid cancer patients

BACKGROUND: Hypothyroidism, commonly induced in preparation for radioiodine treatment of differentiated thyroid cancer, is a text-book cause for hyponatremia. Nausea, stress, and increased fluid intake associated with the treatment are expected to exacerbate hyponatremia. METHODS: We prospectively studied 212 (80% females) consecutive thyroid cancer patients for the incidence of hypothyroidism-induced hyponatremia and associated risk factors. RESULTS: Mean(SD) age was 39.7(14.1) year, creatinine 82.0(20.8) μmol/l, TSH 141.6(92.0) mU/l, pre- and post-isolation sodium 139.5(2.3) and 137.8(3.0) mEq/l, respectively, and estimated fluid intake during isolation 9.7(6.2) L. Mild hyponatremia (≥130 mEq/l) was present in 18 patients (8.5%) and moderate hyponatremia (≥120 mEq/l) in 4(1.9%), 3 of the latter had elevated creatinine concentration and 2 were on diuretics. There was no significant correlation between post-isolation sodium concentration and TSH concentration (r = 0.03, p = 0.69) or estimated fluid intake (r = 0.10, p =0.17). There was significant correlation between post-isolation sodium concentration and age (r = −0.24, p < 0.0001) and creatinine concentration (r = −0.22, p = 0.001). Pre-post-isolation drop in sodium concentration was more in females (mean difference 1.21, p = 0.02). Compared to eunatremic patients, hyponatremic patients were more likely to have pre-isolation hyponatremia (9% vs. 0.5%, p = 0.03), elevated creatinine concentration (36% vs. 13%, p = 0.008), and to be on diuretics (23% vs. 1%, p = 0.0001). CONCLUSIONS: In the setting of acute severe hypothyroidism: 1) clinically-important hyponatremia is uncommon; sodium concentration may not need to be monitored unless patients have impaired renal function or are on diuretics, 2) age and female gender are associated with lower sodium concentration. Uncomplicated acute severe hypothyroidism didn’t cause clinically-important hyponatremia/SIADH in this cohort of patients

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Assessment of Primary Healthcare Physicians’ Awareness about Shingles in Al-Qassim Province: A Cross-sectional Study

Background: Despite the significant public health implications of shingles (Herpes Zoster), there is a paucity of research examining the awareness levels among primary healthcare physicians, particularly in specific regions such as Al-Qassim Province. Understanding the awareness gaps is crucial for designing targeted interventions that enhance early detection, prevention, and management of shingles. Methods: A descriptive, correlational cross-sectional design was employed for this study. The study was conducted at primary health care centers in Al-Qassim Province. Participants were be selected during the period from January to March 2023. Population of the current study were primary healthcare physicians in Al-Qassim Province, KSA. Study participants were selected by non-probability convenient sampling technique. Study instrument consists of two domains. First is sociodemographic characteristics of participants. Second is KAP assessment regarding shingles. Results: The study included 252 participants. The mean age among study participants was 34.58 + 8.53 years with median age of 31 years. More than half of study participants were males (n= 154, 61.1%) and half of study participants were general practitioners (n= 127, 50.4%). Majority of study participants were Family Medicine practitioners (n= 228, 90.5%). More than half of study participants were Saudi (n= 150, 59.5%). In addition, more than half of study participants had 1-5 years of experience (n= 131, 52%). Notably, 60 participants acknowledge the common occurrence of Shingles while 166 recognize the possibility of multiple occurrences. A significant proportion, 188 participants, are aware of Shingles' transmissibility, and 240 participants understand that older individuals and those with comorbid conditions face a higher risk. Additionally, 231 participants acknowledge the serious impact of Shingles on daily life, with 185 considering the potential need for hospital admission. Most of study participants believed that rash (n= 130, 51.6%) and post-herpatic neuralgia (n= 116, 46%) are the most common complications of shingles. Moreover, more than half of study participants reported that pain associated with shingles is moderate and has a duration of few weeks (n= 144, 57.1%). Furthermore, more than half of study participants said that polymerase chain reaction (PCR) test is the diagnostic tool for herpes zoster (n= 132, 52.4%). Noteworthy results include a significant association between age and awareness, with the younger age group (25-35) showing higher awareness compared to older age groups (36-45 and 46-60). Proficiency level also demonstrates a substantial impact, as specialists and consultants exhibit higher awareness compared to general practitioners and residents. Nationality is another significant factor, with Saudis having higher awareness than non-Saudis. Experience plays a role, with those having more than 10 years of experience demonstrating greater awareness. Conclusion: Awareness increased with younger age, competency, Saudi nationality, and professional experience. Shingles' frequency, transmissibility, and impact on susceptible populations were well-known, demonstrating sophisticated views about the illness. These findings show that demographically appropriate education will enhance public health and patient care in the region

Overview On Surgical Management Of Overactive Bladder

Overactive bladder syndrome is a persistent and incapacitating disorder that has profound medical, psychological, and social implications, greatly impacting the wellbeing of countless individuals globally. A significant number of individuals experience urine urgency, which can be extremely bothersome. The primary indicator of overactive bladder (OAB) is a sense of urgency, often accompanied by increased urine frequency and nocturia. After ruling out other medical conditions with similar symptoms, the initial approach to managing OAB is providing guidance on fluid consumption and bladder training. If needed, antimuscarinic medicines may be added as a supplement. If patients have significant distress from OAB symptoms even after maximizing medicinal treatment, they may choose to undergo invasive procedures. There is currently a limited understanding of the hierarchical structure of central nervous system control. However, the use of functional imaging is starting to reveal the difficulties that need to be addressed in this area. Current research is exploring the use of botulinum neurotoxin-A injection, oral β3-adrenergic agonists, and innovative methods for nerve stimulation as potential therapies. The inherent subjectivity of urine urgency, the absence of animal models, and the complex pathophysiology of overactive bladder (OAB) pose substantial obstacles to achieving effective clinical therapy

Potential bioactivity of Phoenix dactylifera fruits, leaves, and seeds against prostate and pancreatic cancer cells

The use of functional foods’ phytochemicals in the chemoprevention of different cancer diseases has become one of the hot scientific areas in the clinical nutrition field. For instance, the Khalas palm cultivar (KPC; Phoenix dactylifera) is one of the natural sustainable resources that have high bioactivity and functionality. This study aimed to investigate the antiproliferative activity and mode of action of KPC’s different parts on prostate (Pc3) and pancreatic (panc1) cancer cells at a molecular level. In the methods, KPC’s leaves, seeds, and fruits’ chemical composition and phytochemical analysis were analyzed. Also, the cytotoxic effects of each extract were assessed against pc3 and panc1 cell lines. Besides, induction of apoptosis, cell cycle analysis, and gene expression of both Cap3 and Cap9 were studied. The obtained results indicated that KPC leaves extract exhibited the highest significant (P &lt; 0.01) anti-proliferation activity against the utilized cancer cell lines compared to fruits and seeds extracts. Also, there were significant (P &lt; 0.05) differences in the phenolic contents, flavonoid of compounds, and antioxidant power of the leaves when compared to the seeds and fruits. Additionally, the highest cytotoxic effect (lowest IC50) was recorded with leave extract than seeds and fruits. Meanwhile, the seeds extract induced (P &lt; 0.05) the apoptosis and arrested cells in the G2/M phase as well as up-regulated the gene expression of the apoptotic-related genes (Casp3 and Casp9) compared to the control group. In conclusion, this study showed that the presence of bioactive components in the KPC different parts extracts have the significant ability to induce the apoptotic pathway that could down-regulate the proliferation of prostate (pc3) and pancreatic (panc1) cancer cells. The pathway mechanism of action was induced by the phytol molecule presented in its leaves extract

Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. Funding: Bill &amp; Melinda Gates Foundation