Lack of interpretation services for limited English and Arabic proficiency patients in Saudi hospitals: challenges and perceptions

Purpose – The motivation for the current exploration follows from the fact that one-third of the population in Saudi Arabia (SA) is expatriates. According to the Saudi General Authority for Statistic (https://www.stats.gov.sa/en), the total population in SA in 2021 is estimated at 33,413,660 people, 20,768,627 of whom are Saudi citizens whereas 12,645,033 are expatriates coming from different countries across the world, such as Afghanistan, Bangladesh, Egypt, India, Indonesia, Jordan, Pakistan, Philippines, Sudan, Sri Lanka, among many others. In this study, the author targeted limited English and Arabic proficiency patients (LEAPPs) from only three countries in the Near East: (1) Bangladesh, (2) India and (3) Pakistan. The author selected these three countries because they represent the high number of expatriates in SA. According to www.globalmediainsight.com, the population of the abovementioned nationalities in SA in 2021 is as follows: India (2,550,000 million), Pakistan (2,450,000 million) and Bangladesh (1,300,000 million) (see https://bit.ly/3NR6SfT). The main official languages for Pakistan, India and Bangladesh are Urdu, Hindu and Bengali respectively. Although the English language is the second official language in both Pakistan and India, it comes as a second language, not as a mother tongue. In other words, these LEAPPs are unlikely to have a full command of the English language. Design/methodology/approach – The current study makes use of both quantitative and qualitative approaches. The quantitative component follows from the use of questionnaires whereas the qualitative part comes from the execution of face-to-face interviews. This mixed approach has been influential in earlier explorations (see, e.g. Terrel, 2012; Dawadi et al., 2021) and was used in this study to achieve two objectives: (1) to explore whether LEAPPs suffer linguistically when they visit a Saudi hospital, and this data can be elicited via questionnaires, and (2) to gain insights from LEAPPs' experience and attend to their suggestions towards the improvement of the linguistic landscape of the Saudi health system, and this can be gleaned from the interviews. Findings – Based on questionnaires and interviews, the study shows that 64.5% of LEAPPs cannot express their health issues to Arabic-speaking physicians, while 54.8% cannot understand the details of their diagnoses and the guidelines of the prescriptions. Although there is a strong consensus among LEAPPs that interpretation services should be introduced to the Saudi health sector to achieve a better experience, 67.7% are generally satisfied with the current healthcare. Contra previous claims that patients are concerned about their privacy with the introduction of interpreters (see, e.g. Hadziabdic, 2011; Floyd and Sakellariou, 2017; MacFarlane et al. 2020), the present study shows that 70.9% of LEAPPs express no concerns regarding their privacy, whereas 19.3% adopt a neutral position. Originality/value – Unlike Al-Khathami et al. (2010) who explored the perspective of Saudi patients towards nonArabic speaking nurses and contra Alhammami (2020) who examined the attitudes of the nonArabic speaking doctors towards Saudi patients, the current study shed more light on a neglected sample, namely the laborers, janitors and other craftsmen who have limited knowledge of both Arabic and English and who visited a Saudi clinic/hospital and were met by Arabic-speaking physicians

In Silico Study, Synthesis, Characterisation And Cytotoxicity Activity Of New Chalcone, Pyrazoline And Pyrimidine Derivatives

Three new series of novel chalcone derivatives with promising anti-cancer activity were studied which are two series of tri-chalcone derivatives S1(1-7) and S2(1-7) and a series of mono-chalcone derivatives S3(1-7). Another three series of pyrazoline Ai-Aiii and pyrimidine Bi-Biii from mono-chalcone were also studied by AutoDock 4.2.6. The intermolecular interactions and binding energies of the proposed compounds were determined to be synthesised and characterized. The best compounds were selected for further investigation by MD simulation using AMBER 14. The following compounds of chalcone derivatives S1-1, S1-2, S2-1, S2-2, S3-1, S3-(3-5), pyrazoline derivatives Ai-Aiii and pyrimidine Bi-Biii from mono-chalcone S3-(1,3-5) demonstrated the highest binding affinity for the interaction with the active EGFR binding site. These selected chalcones, pyrazoline and pyrimidine derivatives were synthesised to test their cytotoxicity activity against breast cancer cell lines and EGFR inhibitory activity. Synthesis of the chalcone derivatives was performed via a Claisen-Schmidt condensation while the ring-closing of mono-chalcones formed the pyrazoline and pyrimidine derivatives. The chemical structures of the synthesised compounds were confirmed using spectroscopic techniques such as FTIR, 1H NMR, 13C NMR and elemental analysis (CHN analysis). Antiproliferative activity of the synthesised compounds against breast cancer cell lines (MCF-7 and MDA-MB-231) were evaluated using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide assay (MTT)

Microsatellite Instability in Colorectal Cancer

Cancer is a genetic disease. Cancer cells contain various mutations, which includes SNPs to chromosomal aberrations. Together, these changes are referred to as genome instability. Genetic instability is one of the common characteristics of colorectal cancer. In colorectal cancer three major types of genetic instability have been reported. They are chromosomal translocations, microsatellite instability (MSI), and chromosome instability (CIN). Microsatellite instability occurs due to variations in DNA mismatch repair genes, while chromosomal instability is distinguished by major chromosomal alterations occurring at cell division and usually involves β‐catenin and Adenomatous polyposis coli protein (APC) mutations. This chapter summarizes the major molecular mechanisms leading to genomic and microsatellite instability and tumorigenesis

Turnover among foreign nurses in Saudi Arabia

Background: Globally, nursing turnover has become a contemporary concern that significantly influences the financial proficiency of healthcare systems. Not only costs, but healthcare accessibility and quality also reverberate the consequence of the phenomenon.Design and methods:  The study explores the factors that attribute to turnover among foreign registered nurses working in Saudi Arabia. A quantitative-based cross-sectional descriptive study design that uses survey data to make statistical inferences about foreign nurse turnover in Saudi Arabia, was conducted to ascertain factors influencing the termination of foreign nurses working with the Ministry of Health (MOH) hospitals.Results: Factors influencing turnover were categorized into 9 dimensions, professional growth and development, leadership style, management, wage and benefits, workload, interpersonal relationship, housing facilities and services, hospital facilities and intent to stay and turn-over intention, of which the professional growth (4.1±0.7) and development had the highest mean agreement scores (4.0±1.1), whereas housing (2.3±1.3) and hospital facilities (2.1±1.0) showed the lowest mean scores. Conclusions: Wage benefits and workload factors were found to be the most significant causes of expatriate nursing turnover, closely followed by inadequate housing and hospital facilities. Recommendations from nursing staff on how to improve retention were also noted

Association Between Voice Handicap Index and Reflux Symptom Index: A cross-sectional study of undiagnosed general and teacher cohorts in Saudi Arabia

Objectives: This study aimed to assess potential associations between self-reported symptoms of laryngopharyngeal reflux (LPR) and voice disorders among two undiagnosed cohorts in Saudi Arabia. Methods: This cross-sectional study was conducted from February to April 2017 in Khobar, Saudi Arabia. Validated Arabic versions of the Reflux Symptom Index (RSI) and 10-item Voice Handicap Index (VHI-10) were distributed to 400 teachers at 13 schools and 300 members of the general population attending an ear, nose and throat clinic in Khobar. Scores of >13 and >11 on the RSI and VHI-10 indicated a potential subjective diagnosis of LPR and voice disorders, respectively. Results: A total of 446 individuals took part in the study, including 260 members of the general population (response rate: 86.7%) and 186 teachers (response rate: 46.5%). The mean age was 32.5 years. In total, 62.2% complained of voice and/or reflux problems, with the remaining 37.8% not reporting/unaware of any problems in this regard. Among the teachers, 30.6% and 18.3% had positive RSI and VHI-10 scores, respectively, while 43.1% and 14.6% of the individuals from the general population had positive RSI and VHI-10 scores, respectively. Overall, VHI-10 scores were significantly associated with RSI scores (P <0.001). Conclusion: A significant association between RSI and VHI-10 scores suggests that there may be an association between LPR and voice disorders. These tools would therefore be a valuable method of monitoring patients; however, they cannot be used to confirm a diagnosis. Thus, more detailed studies are needed to confirm this association using a larger sample size.Keywords: Voice Disorders; Laryngopharyngeal Reflux; Hoarseness; Diagnostic Self Evaluation; School Teachers; Saudi Arabia

Awareness of Dental Interns to Treat Pregnant Patients

BACKGROUND: Pregnancy causes major changes in maternal physiology and metabolism, which may lead to increased susceptibility to oral infection. AIM: Aim of this study is to assess the awareness of dental interns regarding the management of the dental needs of pregnant patients. METHODS: A cross-sectional questionnaire survey was conducted among 188 interns of a private dental college in Saudi Arabia. The questionnaire comprised of 14 knowledge-based questions regarding their training, awareness and practice management of the pregnant patient in dental clinics. Four questions to record and evaluate their training, the number of pregnant patients treated by them and their confidence level in the dental management of the pregnant patient. Excel spreadsheet was used for mathematical calculations. RESULTS: Almost 62% of our participants never treated a pregnant female during their training. About 65% of the interns knew using antibiotics, almost 55% have a clear idea of the safest NSAIDS, and 43% regarded local anaesthesia to be safe when used among pregnant females. Conversely, about 50% of the participants had no clear knowledge of the FDA category of drugs. Only 24% considered dental radiographs to be safe in pregnant patients. 57% thought to postpone the dental treatment in an acute active dental infection in expecting mothers. Results also showed a lack of confidence among interns to provide dental care to gestating female. CONCLUSION: On analysing the results, we found that there is a need to improve the knowledge, awareness and confidence levels among the interns who are the future dentists treating these patients

The role of lifestyle habits in the prevalence of overweight and obesity among students

The key objective of the present study is to explore the prevalence of being overweight and/or being obese using the body mass index (BMI). We investigated the relationship between lifestyle habits (sleeping patterns, dietary habits, physical activities, and screen times) and obesity. We used a cross-sectional study involving male students of medical and non-medical at the College of Medicine and College of Management and Economics at Saudi Arabia’s Qassim University. To gather data, a tailor-made, self-administered questionnaire was the tools of choice. The first part of the form collected a data pertaining to the height and weight of respondents. This measured BMI. Participants then categorized as underweight (BMI < 18.5), normal weight (BMI = 18.5–24.9), overweight (BMI = 25–29.9), and obese (BMI >30.0). The second part of the study involved questions about the participants’ lifestyle habits. To assess the significance of the questions, aChi-squared test was applied. We found that prevalence of being overweight and obese among medical students was (24.4%) and (19%) respectively. for non-medical students the prevalence of being overweight and obesity was (25.6%) and (16.5%) respectively. regarding dietary habits more than half of the students (54.2%) who had three meals or more have a positive relation with obesity. A positive relation was noticed between lack of physical activity and high BMI. Positive relation was found between high BMI and screen time. Regarding sleep hours more than half of the students spend 6-8 hours in sleeping per day

IoT-Based Remote Health Monitoring System Employing Smart Sensors for Asthma Patients during COVID-19 Pandemic

COVID19 and asthma are respiratory diseases that can be life threatening in uncontrolled circumstances and require continuous monitoring. A poverty stricken South Asian country like Bangladesh has been bearing the brunt of the COVID19 pandemic since its beginning. The majority of the country's population resides in rural areas, where proper healthcare is difficult to access. This emphasizes the necessity of telemedicine, implementing the concept of the Internet of Things (IoT), which is still under development in Bangladesh. This paper demonstrates how the current challenges in the healthcare system are resolvable through the design of a remote health and environment monitoring system, specifically for asthma patients who are at an increased risk of COVID19. Since on-time treatment is essential, this system will allow doctors and medical staff to receive patient information in real time and deliver their services immediately to the patient regardless of their location. The proposed system consists of various sensors collecting heart rate, body temperature, ambient temperature, humidity, and air quality data and processing them through the Arduino Microcontroller. It is integrated with a mobile application. All this data is sent to the mobile application via a Bluetooth module and updated every few seconds so that the medical staff can instantly track patients' conditions and emergencies. The developed prototype is portable and easily usable by anyone. The system has been applied to five people of different ages and medical histories over a particular period. Upon analyzing all their data, it became clear which participants were particularly vulnerable to health deterioration and needed constant observation. Through this research, awareness about asthmatic symptoms will improve and help prevent their severity through effective treatment anytime, anywhere.Comment: Wireless Communications and Mobile Computing (2022