Exploring strategic planning of family firms in Saudi Arabia

Researchers have called for the studying of strategic planning of family firms, especially in countries such as Saudi Arabia to cater for cultural differences. So far, it is not known how family firms formulate or practice their strategic planning. This research aimed to investigate and evaluate the extent and nature of the strategic planning processes in a sample of family firms in Saudi Arabia. Data from six family firms was collected by semi-structured in-depth interviews using open ended questions. The study employed convenience sampling. A total of 16 interviews were made to collect the data and confirm understanding. Secondary data from company documentation and websites were also utilized. Collected data was analysed (qualitatively) to produce observations on family firms‘ strategic planning process. A pilot study was used to confirm suitability of the methodology and data analysis. The idea for this research came from an actual need of the researcher and many of his friends. The study has many practical implications on family firms both locally and internationally. Therefore, it is hoped that family firms can increase their chances of success and continuation to the following generations. The study found that the businesses tended not to have systematic processes and that analysis was typically unsophisticated and often ignored, while implementation in the sense of resource allocation, setting of sales targets, monitoring of performance, and providing incentives was often approached more systematically. Some interesting strategic patterns across firms were identified such as "Sales is king", "Let‘s do it" and "Just grow". Despite geographical and sample limitations, this study has opened many avenues for further research into the strategy process in family business, both in Saudi Arabia and in other countries and cultures. Therefore, this study contributed by illuminating an under researched part of the world and by addressing a practical problem and knowledge gap

Analisis Area Banjir Serta Kerugian Di Kabupaten Gresik Akibat Luapan Sungai Kali Lamong

Kabupaten Gresik merupakan kabupaten yang terletak di provinsi Jawa Timur. Terletak di sebelah barat laut Kota Surabaya yang merupakan Ibu Kota Provinsi Jawa Timur. Luas dari Kabupaten gresik adalah 1.191,25 km2, yang terdiri dari 18 kecamatan. Di dalamnya, terdapat 26 kelurahan dan 330 desa. Kabupaten Gresik merupakan wilayah dataran rendah dengan ketinggian antara 2-12 meter di atas permukaan laut. Sungai Kali Lamong merupakan Sungai utama yang mengalir melewati Kabupaten Gresik. Sungai Kali Lamong merupakan anak dari Sungai Bengawan Solo. Sungai Kali Lamong memiliki luas Daerah Aliran Sungai (DAS) ± 720 km2 dengan panjang alur sungai ± 103 km serta memiliki 7 anak sungai. Pada musim penghujan, sungai Kali Lamong tidak bisa menampung semua debit yang masuk, akibatnya terjadi banjir di sekitar sungai Kali Lamong. Penyebab banjir yang utama adalah curah hujan yang tinggi namun tidak diimbangi oleh kapasitas sungai. Oleh karena itu, banyak pemukiman yang terkena luapan dari Sungai Kali Lamong sehingga mengalami kebanjiran. Selain dari pemukiman, banyak dari persawahan yang terendam banjir. Karena banyaknya pemukiman dan persawahan yang terendam banjir, Kabupaten Gresik mengalami kerugian yang cukup besar. Dengan kondisi dari sungai Kali Lamong yang hampir setiap musim penghujan selalu meluap, maka dibutuhkan prediksi yang akurat untuk mengetahui Lokasi mana saja yang terkena banjir akibat luapan sungai Kali Lamong. Sehingga, bisa dilakukan pencegahan sebelum banjir datang. Dan kerugian yang akan terjadi selanjutnya, dapat terminimalisir. Hasil debit banjir rencana yang digunakan untuk menentukan lokasi banjir dan kerugian yang diterima, yaitu 335,512 m3/dt. Luapan dari sungai Kali Lamong mengakibatkan terendamnya 3,259 km2 persawahan dan terendamnya 201 unit rumah. Kerugian yang didapatkan akibat meluapnya sungai Kali Lamong yaitu sebesar Rp. 17.503.256.500

Optimalisasi Waktu Penyelesaian Pekerjaan Proyek Konsultan Pengawasan Pada Dinas Pekerjaan Umum Di Kota Tarakan

Penelitian yang dilakukan ini bertujuan untuk mengetahui waktu optimal pekerjaan proyek dan pengawasan. Proyek pada umumnya memiliki batas waktu (deadline), artinya proyek harus diselesaikan sebelum atau tepat pada waktu yang telah ditentukan. Selain itu adanya keterlambatan berakibat kehilangan peluang pekerjaan pengawasan lain. adapun bagi owner keterlambatan penyelesaian pekerjaan proyek akan menyebabkan catatan yang tidak baik, sehingga penggunaan hasil pembangunan proyek menjadi mundur atau terlambat. Dengan metode PERT dan CPM dapat menentukan lintasan kritis (network planning) dalam suatu kegiatan proyek tahap demi tahap secara berurutan untuk penyelesaian kegiatan proyek tersebut.Dengan time schedule dapat menyusun network planning dan menentukan hitungan maju mundur dan kelongaran waktu.Hasil analisa pelaksanan dan pengawasan yang diambil tiga bidang PSDA,Bina Marga dan Cipta Karya terdiri dari 120 hari kalender,150 hari kalender dan 360 hari kalender. Dapat optimalisasi waktu fisik menjadi 91 hari kalender menjadi 118 dan menjadi 280 hari kalender dan Bidang PSDA, Bina Marga dan Cipta Karya pengawasan dapat menyelesaikan 104 hari kalender, 134 dan 300 hari kalender,kesimpulan dari penelitian ini ketiga bidang Optimal waktu dapat menyelesaikan pekerjaan,nilai Z= (99.99%, 98.98%, and 99.99%) dan pengawasan dapat meyelasaikan dilapangan kegiatan proyek tepat pada waktu yang telah ditentukan (95,91%, 93,94%, 99,99%)

Perbandingan Kapasitas Kuat Lentur Pada Balok Tulangan Bambu Pilin Dengan Kulit Dan Tanpa Kulit

Pembangunan konstruksi semakin mengalami peningkatan, begitu pula penggunaan beton bertulang dan baja sebagai tulangannya. Baja merupakan mineral,yang tidak dapat diperbaharui, sehingga perlu adanya alternatif pengganti baja sebagai tulangan. Bambu dapat digunakan sebagai tulanganLbeton pengganti baja, karena bambu mempunyai kuat tarik yang tinggi yang mendekati kekuatan baja.Pemakaian bambu pada tulangan beton perlu dilakukan perlakuan khusus, seperti permasalahan pada lekatan antara bambu dan semen yang kurang baik, kemudian sifat bambu yang higroskopis. Sehingga perlu dilakukan perlakuan khusus dengan menggunakan bambu yang sudah tua usianya,:memanfaatkan bagian kulit sehingga sifat higroskopiknya:rendah, danJmelakukan pilinan untuk memperbaiki lekatan:antara bambu dan beton.Tulangan yang digunakan pada penelitian ini untuk uji kuat lentur dengan membelah bambu menjadi dua bagian, bagian luar dengan kulit dan bagian dalam tanpa kulit. Tulangan bambu memiliki ukuran 18 cm x 25 cm x 160 cm dengan pola pilinan ukuran 0,4 x 0,4 cm dengan”variasi kulit dan tanpa kulit. Hasil pengujian kuat lentur pada variasi kulit didapatkan nilai P Maks:rata-rata:3400 kg dengan lendutan rata-rata 9.25 mm sedangkan pada variasi tanpakulit P Maks rata-rata yang dihasilkan 2400 kg dengan nilai lendutan 1.92 mm. Hasil variasi pada penelitian ini menunjukkan perbedaan yang:signifikan pada P maks dan lendutan, sehingga dapat?disimpulkan kulit berpengaruh pada kuat lentur balok bertulangan}bambu pilin. Namun, hasil pola retak, lebar retak, dan panjang retak menunjukkan hasil yang hampir sama pada setiap benda uji, baik dengan kulit maupun tanpa kulit

Physicians’ perception and barriers to cardiopulmonary rehabilitation for heart failure patients in Saudi Arabia: a cross-sectional study

Background: Cardiopulmonary rehabilitation (CR) serves as a core component of the management strategy for patients with heart failure (HF). CR is administered by multidisciplinary healthcare providers, but their perceptions toward delivering CR to HF patients, and the factors and barriers that might influence referral, have not been studied. This study aims to assess physicians’ perceptions toward delivering CR programs to HF patients and identify factors and barriers that might influence their referral decisions. Methods: Between 15 February and 5 June 2022, a cross-sectional online survey with ten multiple-choice items was distributed to all general and cardiac physicians in Saudi Arabia. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. The statistical significance of the difference between categorical variables was determined using the chi-square (2) test. Logistic regression was used to identify referral factors. Results: Overall, 513 physicians (general physicians (78%) and cardiac doctors (22%)) completed the online survey, of which 65.0% (n = 332) were male. Of the general physicians, 236 (59%) had referred patients with HF to CR. Sixty-six (58%) of the cardiac doctors had referred patients with HF to CR. A hospital-supervised program was the preferred mode of delivering CR programs among 315 (79%) general physicians, while 84 (74%) cardiac doctors preferred to deliver CR programs at home. Apart from the exercise component, information about HF disease was perceived by 321 (80%) general physicians as the essential component of a CR program, while symptom management was perceived by 108 (95%) cardiac doctors as the essential component of a CR program. The most common patient-related factor that strongly influenced referral decisions was “fatigue related to disease” (63.40%). The availability of CR centers (48%) was the most common barrier preventing the referral of patients to CR. Conclusions: CR is an effective management strategy for HF patients, but the lack of CR centers is a major barrier to the referral of patients. A hospital-supervised program is the preferred method of delivering CR from the general physicians’ perspective, while cardiac doctors prefer home-based CR programs. Apart from the exercise component, information about HF disease and symptom management is essential components of CR programs from general physicians’ and cardiac doctors’ perspectives, respectively

Global trends in symptomatic medication use against dementia in 66 countries/regions from 2008 to 2018

Background and purpose: The aim was to determine trends and patterns of symptomatic medication used against dementia in 66 countries and regions. Methods: This was a cross-sectional study that used the wholesale data from the IQVIA Multinational Integrated Data Analysis System database. Sale data for symptomatic medication against dementia from 66 countries and regions from 2008 to 2018 were analysed and stratified by income level (low/middle-income countries [LMICs], n = 27; high-income countries [HICs], n = 37; regions, n = 2). The medication use volume was estimated by defined daily dose (DDD) per 1000 inhabitants per day (World Health Organization DDD harmonized the size, strength and form of each pack and reflects average dosing). Changes in medication use over time were quantified as percentage changes in compound annual growth rates (CAGRs). Results: Total symptomatic medication against dementia sales increased from 0.85 to 1.33 DDD per 1000 inhabitants per day between 2008 and 2018 (LMICs 0.094–0.396; HICs 3.88–5.04), which is an increase of CAGR of 4.53% per year. The increase was mainly driven by the LMICs (CAGR = 15.42%) in comparison to the HICs (CAGR = 2.65%). The overall medication use from 2008 to 2018 increased for all four agents: memantine (CAGR = 8.51%), rivastigmine (CAGR = 6.91%), donepezil (CAGR = 2.72%) and galantamine (CAGR = 0.695%). In 2018, the most commonly used medication globally was donepezil, contributing to 49.8% of total use volume, followed by memantine (32.7%), rivastigmine (11.24%) and galantamine (6.36%). Conclusion: There was an increasing trend in the use of symptomatic medications against dementia globally, but the use remained low in LMICs. Interventions may be needed to support the medication use in some countries

Trends in lipid-modifying agent use in 83 countries

Background and aims: Lipid-modifying agents (LMAs) are increasingly used to reduce lipid levels and prevent cardiovascular events but the magnitude of their consumption in different world regions is unknown. We aimed to describe recent global trends in LMA consumption and to explore the relationship between country-level LMA consumption and cholesterol concentrations. / Methods: This cross-sectional and ecological study used monthly pharmaceutical sales data from January 2008 to December 2018 for 83 countries from the IQVIA Multinational Integrated Data Analysis System and total and non-high-density lipoprotein (non-HDL) cholesterol concentrations from the NCD Risk Factor Collaboration. Compound annual growth rate (CAGR) was used to assess changes in LMA consumption over time. / Results: From 2008 to 2018, use of LMAs increased from 7,468 to 11,197 standard units per 1000 inhabitants per year (CAGR 4.13%). An estimated 173 million people used LMAs in 2018. Statins were the most used class of LMA and their market share increased in 75% of countries between 2008 and 2018. From 2013 to 2018, consumption of low-density lipoprotein lowering therapies increased (statins 3.99%; ezetimibe 4.01%; proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors 104.47%). Limited evidence supports a clear relationship between country-level changes in LMA consumption and mean total and non-HDL cholesterol concentrations in 2008 versus 2018. / Conclusions: Since 2008, global access to LMAs, especially statins, has improved. In line with international lipid guideline recommendations, recent trends indicate growth in the use of statins, ezetimibe, and PCSK9 inhibitors. Country-level patterns of LMA use and total and non-HDL cholesterol varied considerably

Healthcare providers’ attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study

Objectives: To assess the attitude of healthcare providers (HCPs) towards the delivering of pulmonary rehabilitation (PR) to patients with chronic obstructive pulmonary disease (COPD) and identify factors and barriers that might influence referral. Design: A cross-sectional online survey consisting of nine multiple-choice questions. Settings: Saudi Arabia. Participants: 980 HCPs including nurses, respiratory therapists (RT) and physiotherapists. Primary outcome measures: HCPs attitudes towards and expectations of the delivery of PR to COPD patients and the identification of factors and barriers that might influence referral in Saudi Arabia. Results: Overall, 980 HCPs, 53.1% of whom were men, completed the survey. Nurses accounted for 40.1% of the total sample size, and RTs and physiotherapists accounted for 32.1% and 16.5%, respectively. The majority of HCPs strongly agreed that PR would improve exercise capacity 589 (60.1%), health-related quality of life 571 (58.3%), and disease self-management in patients with COPD 589 (60.1%). Moreover, the in-hospital supervised PR programme was the preferred method of delivering PR, according to 374 (38.16%) HCPs. Around 85% of HCPs perceived information about COPD, followed by smoking cessation 787 (80.3%) as essential components of PR besides the exercise component. The most common patient-related factor that strongly influenced referral decisions was ‘mobility affected by breathlessness’ (64%), while the ‘availability of PR centres’ (61%), the ‘lack of trained HCPs’ (52%) and the ‘lack of authority to refer patients’ (44%) were the most common barriers to referral. Conclusion: PR is perceived as an effective management strategy for patients with COPD. A supervised hospital-based programme is the preferred method of delivering PR, with information about COPD and smoking cessation considered essential components of PR besides the exercise component. A lack of PR centres, well-trained staff and the authority to refer patients were major barriers to referring patients with COPD. Further research is needed to confirm HCP perceptions of patient-related barriers

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere