The Saudi Majlis Ash-Shura : domestic functions and international role, 1993-2003

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Disseminated nocardiosis in a female patient with idiopathic thrombocytopenic purpura: A case report

Nocardiosis is a life-threatening disease if unrecognized and maltreated. We describe a case of disseminated nocardiosis in a patient with idiopathic thrombocytopenic purpura under steroid therapy. She presented with a 2-week history of progressive symmetrical limb weakness, fatigue, and profuse sweating. Brain MRI revealed ring-enhanced lesions at the cerebellum and left parietal lobe with brain oedema. Chest CT revealed a left upper lobe nodule. Aspirate culture confirmed the diagnosis of nocardiosis. We administered antibiotics and dexamethasone to ameliorate the brain oedema. The patient improved clinically after 2 weeks. Follow-up brain MRI showed improvement. Clinicians should consider nocardiosis in immunocompromised patients with non-specific symptoms

Pengaruh tahap stres terhadap kepuasan kerja dalam Kalangan pengajar kolej vokasional di Negeri Pahang

Kajian ini dijalankan bertujuan untuk mengkaji mengenai pengaruh stres terhadap kepuasan kerja dalam kalangan pengajar KV di negeri Pahang dengan memberikan tumpuan kepada tiga aspek iaitu aspek beban kerja, aspek karenah pelajar serta aspek penghargaan dan sokongan. Seramai 240 orang responden yang terdiri daripada kalangan pengajar di lapan buah KV di negeri Pahang telah dipilih secara rawak mudah. Nilai kebolehpercayaan Alpha Cronbach bagi keseluruhan soal selidik ini ialah 0.898. Soal selidik berkaitan pengaruh stres terhadap kepuasan kerja dibina sendiri dan selebihnya diubahsuai berpandukan instrumen yang digunakan oleh penyelidik terdahulu bagi menyediakan pelbagai jenis soalan berdasarkan objektif kajian. Kajian sebenar dijalankan dengan mengedarkan borang soal selidik mengandungi 58 item soalan kepada 240 responden. Data yang diperolehi dianalisis menggunakan Statistical Packages for Social Sciences (SPSS) versi 22. Analisis statistik deskriptif iaitu skor min dan sisihan piawai digunakan bagi mengenal pasti tahap stres bagi aspek beban tugas, karenah pelajar serta penghargaan dan sokongan dalam kalangan pengajar. Manakala analisis ujian regrasi pelbagai digunakan bagi mengesan pengaruh stres terhadap kepuasan kerja. Dapatan kajian mendapati min keseluruhan tahap stres bagi aspek beban tugas dan karenah pelajar adalah sederhana dengan nilai skor min 3.49. Manakala hasil dapatan keseluruhan nilai min bagi konstruk tahap stres aspek penghargaan dan sokongan berada pada tahap yang tinggi iaitu 3.81. Dapatan analisis ujian regrasi pelbagai pula menunjukkan tahap stres bagi aspek beban tugas, aspek karenah pelajar dan aspek penghargaan dan sokongan mempengaruhi kepuasan kerja. Oleh itu, beberapa cadangan telah dikemukakan dalam kajian ini dalam usaha menangani stres yang berterusan serta boleh mempengaruhi tahap kepuasan kerja. Antara cadangan pengkaji adalah tenaga pengajar diberi lebih banyak pendedahan berkaitan perubahan sistem pendidikan vokasional yang dialami sekarang agar mereka lebih bersedia dalam menggalas tugas yang baharu seterusmya akan memberi kepuasan kerja dalam kalangan pengajar KV

Impact of Aberrant Myeloid Antigen Expression on Outcomes of Patients with T-cell Acute Lymphoblastic Leukemia

Objectives: To evaluate the impact of myeloid antigen expression on complete remission (CR), event-free survival (EFS), and overall survival (OS) in patients with T-cell acute lymphoblastic leukemia (T-ALL) treated with intensive chemotherapy. Methods: We retrospectively reviewed consecutive patients diagnosed with T-ALL and treated in Sultan Qaboos University Hospital and Royal Hospital in Oman between 2004 and 2010. The diagnosis of T-ALL was established using French-American-British classification or World Health Organization criteria. Patients were considered having myeloid antigen expression if they expressed CD13, CD33, or both (My+ and My–). Results: Of the 39 patients, 38 were included in the study (25 patients with My– and median age of 18.4 years, 13 patients with My+ and median age of 22.0 years). Median follow-up was 12 months. Thirty-two out of the total cohort were eligible for response-rate assessment. Twenty-nine patients (90.6%) achieved CR with one or two courses of chemotherapy with similar CR rates between the two groups (p = 0.880). Twenty-five percent (5/20) of the patients with My– required two courses of induction, whereas 58.3% (7/12) of My+ required two courses of induction and the difference was statistically significant (p = 0.040). In the multivariable analysis; age, gender, initial white blood cell count, central nervous system disease, and myeloid antigen expression were not statistically significant predictors of CR. The EFS and OS were similar between the My+ and My– groups p = 0.180 and p = 0.440, respectively. Conclusions: Patients with T-ALL with myeloid antigen expression need more courses of induction; however, rates of CR, EFS, and OS are not different from those without myeloid antigen expression. Larger prospective studies are required to confirm these findings

Work stress, work-family conflict, and psychological distress among resort employees: a JD-R model and spillover theory perspectives

The hospitality industry is well-known for its challenging and high-pressure work settings. In this context, employees commonly face a multitude of stressors originating from their roles and job responsibilities, which can significantly impact their psychological wellbeing. Hence, based on the job demands-resources (JD-R) model and the spillover theory, this study aims to empirically explore the direct and indirect effect of work stress (assessed by role overload, ambiguity, and conflict) on psychological distress among frontline employees in 3- and 4-star Egyptian resorts while considering the mediating influence of work-family conflict (WFC). Four hypotheses were put to the test through the application of the PLS-SEM 4.0 version (4.0.9.9). Based on the findings from 563 frontline employees who participated in this research, the study supports the four hypotheses affirming that work-related stressors significantly contributed to employees' psychological distress. Further, the findings highlighted that these stressors significantly spill over into employees' family lives, generating conflicts between work and family roles. In addition, the results emphasized the significance of WFC as a contributing factor to employees' psychological distress. Finally, the study concluded that WFC partially mediates the link between work stress and employees' psychological distress. Based on these findings, some theoretical and practical implications for hospitality scholars, resort management, and policymakers were suggested to enhance the employees' wellbeing and mitigate psychological distress in this vital sector

Bedside testing of CYP2C19 gene for treatment of patients with PCI with antiplatelet therapy

BACKGROUND: To mitigate the risk of stent thrombosis, patients treated by percutaneous coronary intervention (PCI) are administered dual anti-platelet therapy comprising aspirin and a platelet P2Y12 receptor inhibitor. Clopidogrel is a prodrug requiring activation by the cytochrome P450 enzyme, CYP2C19. In Saudi Arabia, it has been reported that approximately 26% of the population carries CYP2C19*2 and/or *3 loss-of-function polymorphisms in addition to a high prevalence of CVD. METHODS: This prospective (April 2013-December 2020) parallel assignment clinical trial focuses on ST-Elevation Myocardial Infarction (STEMI) patient outcomes. The clinical trial includes 1500 STEMI patients from two hospitals in the Eastern Province of Saudi Arabia. Patients are assigned to one of two groups; the control arm receives conventional therapy with clopidogrel, while in the active arm the Spartan RX CYP2C19 assay is used to determine the *2 genotype. Carriers of a CYP2C19*2 loss-of-function allele receive prasugrel or ticagrelor, while non-carriers are treated with clopidogrel. Follow-up is one year after primary PCI. The primary end point is the number of patients who develop an adverse major cardiovascular event, including recurrent MI, non-fatal stroke, cardiovascular death, or major bleeding one year after PCI. DISCUSSION: The risk of stent thrombosis in PCI patients is usually reduced by dual anti-platelet therapy, comprising aspirin and a P2Y12 inhibitor, such as clopidogrel. However, clopidogrel requires activation by the cytochrome P450 enzyme, CYP2C19. Approximately 20% of the population are unable to activate clopidogrel as they possess the CYP2C19*2 loss-of function (LoF) allele. The primary goal of this trial is to study the benefits of treating only those patients that cannot activate clopidogrel with an alternative that has shown to be a more effective platelet inhibitor and does not require bioactivation by the cytochrome P450 enzyme. We expect an improvement in net clinical benefit outcome in the active arm patients, thus supporting pharmacogenetic testing in PCI patients post STEMI. TRIAL REGISTRATION: Trial registration name is "Bedside Testing of CYP2C19 Gene for Treatment of Patients with PCI with Antiplatelet Therapy" (number NCT01823185) retrospectively registered with clinicaltrials.gov on April 4, 2013. This trial is currently at the patient recruitment stage

A cognitive task approach on the influence of office automation software in secretarial practice

Inefficiency in secretarial services in the application of office automation software has been of great concern to both secretaries and their employers. This inefficiency causes unnecessary delays in information processing and dissemination in the organization. The problem is rooted from the secretaries’ lacking in appropriate application of cognitive skills, proficiency in information handling as well as working experiences, and these establish the problem statement of the study. One of the important gaps this study has bridged is establishing the key elements that can assist the secretaries to perform their office tasks effectively. Efforts made to identify similar studies on secretaries’ profession were to no avail perhaps due to its non-availability or absence. It was discovered that the secretary’s level of applying perception and attention during working hours is extremely limited which contributed to poor or slow pace of service delivery. The objectives of this study are to explore the secretaries office automation software cognitive task, to investigate elements of office automation software cognitive tasks that influence secretarial practice and to investigate how office automation software supports the secretaries in the execution of tasks. Snowballing sampling was used to identify participants who have fulfilled a criterion set out in the study. Therefore, twelve (12) UTHM secretarial staff who are using office automation software in their office duties were chosen to participate in the study. The study employs qualitative method, thus interviews were carried out to collect data. Thematic data analysis was done using card index. Findings revealed that the secretaries need short and long term training in order to be relevant in their working places as well as to be updated in the use of office automation software. Further results revealed that office automation software supports the secretaries in the execution of cognitive tasks. The result also revealed the development of components of office automation software cognitive tasks in secretarial practice. These components were used by the secretaries in the execution of tasks such as word processing, scheduling of appointments and other secretarial duties. Another important finding revealed that, technology has changed the working environment of the secretaries which has made it imperative for them to continue using office automation software in the execution of their tasks. This has brought the idea of how office automation software supports the secretaries in the execution of their office tasks

Managing chronic conditions in primary care: Best practices and emerging technologies

Background: Chronic conditions like diabetes, cardiovascular diseases, and COPD are leading global health challenges, contributing significantly to mortality and healthcare costs. Fragmented care services often struggle to meet the complex needs of these patients, making integrated care models a promising approach to improve outcomes and efficiency. Aim: This scoping review aims to explore existing literature on integrated care models for managing chronic conditions, identify best practices and technologies, and pinpoint areas for future research, particularly in alignment with the Irish Sláintecare program. Methods: A scoping review was conducted following Arksey and O’Malley’s framework. The review process involved defining research questions, searching relevant literature, and analyzing data from 22 studies published between 2009 and 2019. Studies were selected based on their relevance to primary care integration and chronic disease management. Results: Integrated care models, including multidisciplinary teams and community-based interventions, have shown promise in improving patient outcomes and cost-effectiveness. Technologies like EHRs and telemedicine facilitate integration by enhancing communication and monitoring. However, results varied, with some studies reporting mixed outcomes related to cost and implementation. Conclusion: Integrated care can enhance chronic disease management but requires ongoing research to address implementation challenges and optimize practices.&nbsp

Interfacial Bonding Mechanisms of Natural Fibre-Matrix Composites: An Overview

The development of natural fiber (NFr) composites for a variety of applications is on the rise. The optimization of the interfacial bonding (IFB) between the reinforcing NFr and polymer matrix is perhaps the single most critical aspect in the development of natural fibre polymer composites (NFPCs) with high mechanical performance. While the IFB is critical in determining the mechanical properties of the NFPCs, such as stress transfer, it is one of the least understood components. This article offers a summary of IFB mechanisms, different modification approaches targeted at lowering incompatibility and improving IFB, and evaluation of the impact of IFB. It has been found that 1) In general, interdiffusion, electrostatic adhesion, chemical reactions, and mechanical interlocking are accountable for the IFB; 2) the incompatibility of the fibre and matrix, which results in poor dispersion of the fiber, weak IFB, and ultimately worse composite quality, may be addressed through strategic modifications; and 3) Interfacial interactions between polymers and nanoparticles (NPs) are significantly improving their performance in areas like thermal, mechanical, robust IFB, and moisture absorption. As a result, this review study could be an important resource for scholars interested in coating and treating NFr to further enhance their surface characteristics