Search Results (381)

Universities worldwide face escalating financial pressures while simultaneously confronting demands to adopt sustainable practices. This study examines whether Sustainable Green Innovation (SGI) serves as the central transmission mechanism through which AI-Driven Entrepreneurial Orientation (AI-DEO) and Green Metrics for Self-Efficacy (GMSE) influence University Financial Sustainability (UFS) in higher education institutions, within the broader framework of Circular Economy Principles (CEP). Cross-sectional survey data were collected from 1279 faculty and staff members at King Faisal University (Saudi Arabia) and Benha University (Egypt) between October 2025 and January 2026. Regression-based structural path analysis with nonparametric bootstrapped mediation testing (5000 resamples) was employed to test four hypotheses. The results show that AI-DEO emerged as the dominant positive predictor of SGI (β = 0.732, p < 0.001), while GMSE did not show a statistically significant association with SGI once AI-DEO was included in the model (β = −0.034, p = 0.246). SGI emerged as the strongest predictor of UFS (β = 0.369, p < 0.001), supporting an innovation-mediated route to financial sustainability. The indirect effect of CEP on SGI through AI-DEO was statistically significant (indirect = 0.3473; 95% CI [0.3123, 0.3835]), supporting full mediation. Hypotheses H1, H2a, H2b, and H3 were supported; H4 was not supported. These findings indicate that financial resilience in universities is primarily innovation-mediated and orientation-driven. The study contributes to the sustainability-in-higher-education literature by clarifying SGI as a central transmission mechanism and highlighting the importance of building operational green competence alongside strategic AI-Driven entrepreneurial orientation. Full article

This comparative case study investigates the impact of digital transformation (DT) on the development of a digital organisational culture (OC) within two distinct university settings: one in Saudi Arabia and the other in the United Kingdom. Adopting a qualitative interpretive methodology, the research examines the intricate dynamics of cultural shifts triggered by digital transformation. Drawing on Alvesson and Sveningsson’s framework, the study explores how changes in the nature of work and the emergence of new collective meanings influence organisational culture within the context of digital change. Through in-depth qualitative analysis, the research offers valuable insights into the complexities of transformation within two culturally diverse higher education institutions (HEIs). The study identifies digital strategy as the primary catalyst for this shift, emphasising that robust leadership and management support are essential to aligning strategic initiatives with cultural objectives. The research further establishes that a digital strategy capable of fostering a digital organisational culture is built upon three key pillars: a culture of compliance, performance reshaping, and a culture of continuous learning. However, existing studies identify leadership, resistance, strategy and training as important DT factors. This study extends the literature by demonstrating that these are not independent variables but interconnected forms of cultural change work through which digital organisational culture emerges. These findings contribute to a deeper understanding of the complexities of digital transformation and organisational culture change, providing practical implications and recommendations for successful digital integration within university environments. Full article

This study examined whether a single total-score cutoff in the Mawhiba Multiple Cognitive Aptitude Test (MMCAT) may conceal meaningful cognitive profile differences between students across four domains: mental flexibility, verbal reasoning and reading comprehension, mathematical–spatial reasoning, and scientific–mechanical reasoning. Archival score data from 5146 school-nominated students across three assessment levels in Al-Ahsa, Saudi Arabia, were analyzed. Latent profile models were estimated separately for each assessment level. A three-profile solution was retained for Levels 1 and 2, and a four-profile solution for Level 3. The retained profiles differed mainly in the overall performance level rather than the profile shape. The operational cutoff of 1540 captured globally high-performing profiles at considerably higher rates than adjacent middle-range profiles, and the identified groups remained internally heterogeneous across all levels. The findings indicate that the current identification rule effectively captures broad, high-level performance, yet it does not represent all adjacent cognitive profiles equally. This has implications for identification policy and educational programming for gifted students. Full article

Background and aim: Primary care physicians are central to the early detection and management of chronic kidney disease (CKD), yet knowledge gaps in this setting remain a global concern. This study assessed CKD-related knowledge and self-reported competence among primary healthcare physicians in Jazan Province, Saudi Arabia. Methods: A cross-sectional survey was administered to 233 physicians. Knowledge was evaluated using an 11-item questionnaire, and self-reported confidence was measured using a numerical rating scale. Results: The median number of correctly answered knowledge questions was 5 out of 11 (IQR 4–6), reflecting considerable variability in knowledge levels across the study population. While most participants correctly identified diabetes as the leading cause of CKD (91%) and recognized its asymptomatic nature (82.8%), significant deficiencies were identified in nephrology referral criteria (35.6%), microalbuminuria-based diagnosis (50.2%), and metformin discontinuation thresholds (58.8%). Notably, only 6.4% correctly identified finerenone as an approved agent for reducing CKD progression in diabetic kidney disease. The median self-reported confidence score was 7 (IQR 5–8). Higher confidence was significantly associated with greater CKD patient exposure (p = 0.001) and with higher knowledge scores (τ = 0.207; p < 0.0001). Conclusions: These findings highlight critical gaps and variability in CKD knowledge among primary care physicians and underscore the need for targeted educational interventions and system-level support to improve early CKD detection and management. Full article

Background: Family caregivers of children with autism spectrum disorder (ASD) increasingly utilize large language models (LLMs) for health information. This study presents a systematic comparative evaluation of three widely used LLMs as localized ASD health information tools in Saudi Arabia. Methods: Twenty-four clinically validated, caregiver-oriented questions were posed to Google Gemini 1.5 Pro, OpenAI ChatGPT (GPT-4o), and DeepSeek-V3 using a standardized prompt. Three expert raters independently evaluated responses across four dimensions: scientific accuracy, PEMAT-P understandability, PEMAT-P actionability, and neurodiversity (ND)-affirming language. Readability was assessed via Flesch–Kincaid Grade Level (FKGL) and SMOG indices. Non-parametric Kruskal–Wallis tests with post hoc Mann–Whitney U comparisons and one-sample t-tests were applied. Results: Gemini achieved the highest mean accuracy (2.96/3.00), significantly outperforming DeepSeek (p = 0.003, r = −0.37). Accuracy failures across all LLMs clustered on regional epidemiological, genetic risk, and financial inquiries. ChatGPT achieved significantly higher understandability than Gemini (p < 0.001, r = 0.55), while DeepSeek achieved significantly higher actionability than Gemini (p < 0.001, r = 0.59). However, all three LLM scores fell short of the Agency for Healthcare Research and Quality (AHRQ) 80% actionability benchmark (all p < 0.001). All LLMs exceeded patient education readability benchmarks (FKGL ≤ 6, SMOG ≤ 8; all p < 0.001); ChatGPT was the most readable (FKGL = 7.86; SMOG = 9.97) and Gemini the most complex. No model differed significantly on ND-affirming language, defaulting to a mixed medical-affirming register. Conclusions: Evaluated LLMs demonstrated distinct, specialized strengths: Gemini was the most accurate, ChatGPT the most readable, and DeepSeek the most actionable. Importantly, all models failed to meet established consumer education standards for readability and actionability. LLMs require extensive plain-language adaptation and cultural customization. Clinicians must guide families on navigating LLM outputs, particularly concerning country-specific epidemiological, economic, and healthcare service queries. Full article

This study examines alignment between higher education graduate output and observed labor market demand in Saudi Arabia using aggregated quantitative data. Drawing on graduate supply data from Saudi universities for the period 2021–2023 and job advertisement data from the first quarter of 2025 (Q1 2025), the study employs descriptive statistics, Pearson correlation, and exploratory regression analysis to document quantitative surpluses and shortages across fields of study. The findings indicate a positive but not significant association between graduate output and advertised job demand across matched fields of study (r = 0.486, p = 0.155), while also revealing noticeable quantitative imbalances, including oversupply in some non-technical disciplines and shortages in health-, engineering-, and service-related fields. The analysis further highlights sectoral and geographic concentration of job demand, suggesting structural patterns in how labor market opportunities are distributed across regions and sectors. Rather than implying causal relationships, the results provide a descriptive empirical basis to inform discussions on higher education planning, workforce alignment, and curriculum responsiveness within the context of Saudi Arabia’s ongoing education and labor market reforms under Vision 2030. Full article

Self-ear cleaning is widespread in Saudi Arabia, yet public knowledge about proper ear hygiene and associated risks remains variable. This study aimed to assess knowledge, attitudes, and practices regarding self-ear cleaning among adults in the Northern Border Region and to situate the findings within the context of previous studies from other Saudi regions. A cross-sectional online survey was conducted among 534 adults (ages 18–60) residing in the Northern Border Region of Saudi Arabia. Data were collected using a validated questionnaire that assessed sociodemographic characteristics, knowledge, attitudes, practices, and self-reported complications related to self-ear cleaning. Knowledge was evaluated using 8 items, with 1 point per correct response (total score 0–8), and good knowledge was defined as ≥5 correct responses. Most participants (89.1%) reported practicing self-ear cleaning, predominantly using cotton buds (73.7%). Although many recognized potential harms (81.4% believed cotton buds could push wax deeper and 78.1% were aware of the risk of eardrum perforation), 64.1% still believed regular self-ear cleaning was necessary, indicating a knowledge–practice gap. Reported complications included otitis externa (50.6%), pain (44.0%), and bleeding (18.9%). In multivariable logistic regression, higher knowledge was independently associated with postgraduate education, healthcare employment, non-smoking status, and a history of hearing problems. Comparative synthesis with previous surveys from other Saudi regions revealed broadly similar prevalence, preferred tools, and complications, suggesting that self-ear cleaning is a common and often risky behavior nationwide. In conclusion, self-ear cleaning is prevalent in the authors’ region despite substantial awareness of its risks, and a persistent knowledge–practice gap was observed. While the cross-sectional, convenience-sample design limits causal inference and generalizability, these region-specific findings may help inform targeted educational messages and future interventional studies aimed at promoting safer ear hygiene and reducing avoidable ear-related morbidity in similar settings. Full article

Background/Objectives: Tinnitus is a significant global health concern with substantial geographic variation in prevalence. However, data on tinnitus epidemiology in southern Saudi Arabia remain limited, despite emerging evidence suggesting a relatively high regional burden. Therefore, this study aimed to estimate the prevalence of tinnitus and identify its epidemiological determinants among adults in southern Saudi Arabia. Methods: A community-based cross-sectional study was conducted among 501 adults from four regions in southern Saudi Arabia (Jazan, Aseer, Najran, and Al-Baha). Data were collected on sociodemographic characteristics, chronic medical conditions, noise exposure patterns, and clinical features of tinnitus. Multivariable logistic regression analysis was used to identify factors independently associated with tinnitus. Results: The overall tinnitus prevalence was 31.1% (156/501). The mean age of participants was 30 ± 11 years, and 61.7% were female. Bilateral tinnitus was the most common (47.4%). Symptom duration was reported as <3 months in 31.4% of cases and between 3 months and 1 year in another 31.4%. The mean severity score was 3.7 ± 1.9. Most affected individuals (76.9%) did not seek medical care. Primary exacerbating factors included sleep deprivation (41.7%), noise exposure (41.0%), and stress (39.1%). Multivariable analysis identified two significant independent predictors: weekly noise exposure exceeding 5 h (odds ratio [OR] = 2.14; 95% confidence interval [CI]: 1.34–3.42; p = 0.001) and higher body mass index (BMI) (OR = 1.06; 95% CI: 1.02–1.10; p = 0.005). The most commonly associated underlying conditions were ear infections (25.6%) and hearing loss (24.4%). Conclusions: Tinnitus prevalence in southern Saudi Arabia (31.1%) substantially exceeds global estimates. Noise exposure and elevated BMI are key modifiable factors associated with tinnitus. The substantial healthcare gap, with most affected individuals not seeking treatment, represents a critical public health challenge requiring targeted prevention programs, provider education, and improved access to evidence-based care. Full article

Background/Objectives: End-stage renal disease (ESRD) profoundly affects patients’ daily functioning and well-being, particularly among individuals receiving long-term hemodialysis. Evaluating quality of life (QoL) is therefore essential for understanding the broader impact of ESRD and its treatment. This study aimed to assess QoL and identify demographic and treatment-related factors associated with QoL among patients undergoing maintenance hemodialysis at a regional dialysis center in Al Ahsa, Eastern Saudi Arabia. Methods: A cross-sectional study was conducted among 79 adult patients receiving maintenance hemodialysis for at least three months at King Abdulaziz Hospital, Al Ahsa. Quality of life was assessed using the WHOQOL-BREF questionnaire, with domain scores transformed to a 0–100 scale. Statistical analyses included descriptive statistics, independent t-tests, one-way ANOVA, Spearman’s correlation analysis, and multinomial logistic regression. Results: The physical domain demonstrated the lowest QoL score (49.69 ± 18.77), followed by the social domain (48.02 ± 24.92), whereas the psychological (63.83 ± 19.15) and environmental (67.56 ± 19.27) domains showed comparatively higher scores. Female sex, lower educational attainment, and night-shift dialysis were associated with poorer physical QoL. Significant positive correlations were observed among all QoL domains (p < 0.01), indicating strong interrelationships between different aspects of quality of life. Conclusions: Patients undergoing maintenance hemodialysis experienced substantial impairment in the physical and social dimensions of quality of life, while psychological and environmental well-being remained relatively preserved. These findings support the routine assessment of QoL in dialysis care and highlight the need for targeted interventions, including optimized dialysis scheduling, structured physical activity programs, and psychosocial support, to improve overall patient well-being with ESRD. Full article

Consumer resistance remains a major barrier to the effectiveness of AI-enabled social media marketing despite advances in content personalisation, influencer marketing, and intelligent recommendation systems. This study investigates how content personalisation, influencer trust, and platform interactivity influence consumer resistance, user engagement, and purchase intention by proposing a behaviourally informed Deep Reinforcement Learning (DRL) framework that integrates empirical behavioural modelling with adaptive optimisation. Survey data were collected from 619 higher education students in Saudi Arabia and analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM), Multi-Group Analysis (MGA), and a Deep Q-Network (DQN)-based optimisation framework. The results show that content personalisation, influencer trust, and platform interactivity significantly increase user engagement while reducing consumer resistance. User engagement positively influences purchase intention, whereas consumer resistance negatively affects purchasing behaviour. Multi-Group Analysis revealed that Generation Z responded more strongly to personalisation and platform interactivity, whereas Generation Y showed greater responsiveness to influencer trust. The proposed behaviourally informed DQN framework incorporated latent behavioural constructs and statistically validated structural relationships into the reinforcement learning environment to generate adaptive marketing policies. Compared with conventional static and rule-based strategies, the proposed framework achieved approximately 36% higher optimisation performance across repeated behavioural simulations. The study contributes by positioning consumer resistance as the central behavioural construct, introducing an integrated behavioural–computational framework that embeds empirical behavioural relationships into the DRL state representation, reward mechanism, and policy-learning process, and providing practical guidance for developing transparent, trust-sensitive, and adaptive social media marketing strategies that enhance user engagement, reduce consumer resistance, and improve purchase intention in digital commerce environments. Full article

This systematic narrative review synthesizes 42 distinct sources including peer-reviewed journal articles, selected conference papers, and policy documents to examine the role of knowledge management (KM) processes in Saudi higher education accreditation, with specific focus on the National Center for Academic Accreditation and Evaluation (NCAAA) standards. Drawing on literature published between 2005 and 2025, the review investigates how KM frameworks, including Nonaka and Takeuchi’s SECI model (socialization, externalization, combination, and internalization), may be associated with accreditation outcomes in Saudi universities. The reviewed literature suggests an association between systematic KM approaches and more effective accreditation processes; causal conclusions are not warranted given the observational and case study nature of the evidence base. Certainty of the overall evidence body is rated as low to moderate. The study reveals significant challenges, including information decentralization, inadequate training, resistance to change, and the absence of dedicated governance structures that appear to impede effective knowledge transfer during accreditation processes. A secondary sustainability coding pass identified associations between KM-driven accreditation practices and institutional sustainability, environmental sustainability, and alignment with SDG 4 (Quality Education) and SDG 16 (Strong Institutions); these findings are hypothesis-generating rather than confirmatory. It should be noted that all screening and data extraction were conducted by a sole reviewer; a post hoc validation exercise achieved Cohen’s kappa = 0.81 (95% CI: 0.72–0.90) for inclusion/exclusion decisions, providing retrospective assurance of acceptable consistency. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Full article

Background: Effective notifiable disease surveillance depends on healthcare providers’ ability to identify and report cases. Evidence on factors associated with surveillance performance remains limited in high-risk regions such as Jazan, Saudi Arabia. Objective: This study examined factors associated with healthcare providers’ notification and case management skills, prevention and training competencies, and perceptions toward the Notifiable Disease Surveillance System (NDSS). Methods: A cross-sectional analytical study was conducted among 420 healthcare providers working in government hospitals and primary healthcare centers in Jazan. Data were collected using an adapted self-administered questionnaire. Composite scores were analyzed using t-tests, ANOVA, and linear regression. Results: Higher NDSS-related scores were associated with professional category, HESN+ training, epidemiology or surveillance training, and years of experience. In multivariable analyses, HESN+ training, formal epidemiology or surveillance training, professional category, and experience remained associated with notification and prevention-related outcomes. Notification and case management skills were also associated with more favorable NDSS perceptions. Conclusions: NDSS-related competencies and perceptions were associated mainly with training exposure, professional role, and experience. Strengthening HESN+ training and integrating surveillance education into workforce development programs may support disease reporting and surveillance capacity in Jazan. Full article

Background: Complementary Medicine and Therapies (CMTs) are increasingly used worldwide, particularly in Saudi Arabia, due to growing interest in holistic and integrative healthcare. However, concerns regarding safety, regulatory awareness and evidence-based use persist, while comparative knowledge data between family physicians and the general population remain limited. This study aimed to compare knowledge of CMTs between family physicians and the general population in Saudi Arabia. Methods: A comparative cross-sectional analysis was conducted using two independent datasets collected in Saudi Arabia from a total of 1307 participants. Variables related to the participants’ demographic characteristics, and their knowledge of and information sources on CMTs, were harmonised prior to analysis. Between-group comparisons were performed using Chi-square and Fisher’s exact tests, with statistical significance set at p < 0.05. Results: The family physicians demonstrated significantly higher levels of knowledge of CMTs than the general population. While 35.5% of the physicians demonstrated good knowledge levels, 82.0% of the public participants exhibited poor or low knowledge. However, knowledge of regulatory and quality control measures governing CMTs remained limited among both the physicians (21.0%) and the public (24.6%). Both the physicians (66.1%) and the members of the public (34.8%) primarily relied on healthcare professionals as major sources of information on CMTs. Significant associations were observed between the participant group and the knowledge-related variables, overall knowledge levels and information sources (p < 0.001). Conclusions: Strengthening public education, physician training and regulatory awareness may support safer and more evidence-based integration of CMTs within healthcare systems. Full article

Background/Objectives: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Individuals with hypertension (HTN) and type 2 diabetes mellitus (T2DM) are at particularly high risk; however, awareness of cardiovascular risk within the broader community and among high-risk subgroups remains suboptimal. This study aimed to assess CVD risk awareness and its correlates among adults in the Northern Border Region of Saudi Arabia, with a particular focus on individuals with HTN and/or T2DM. Methods: A descriptive, quantitative, cross-sectional survey was conducted among adults aged 18–50 years residing in the Northern Border Region of Saudi Arabia. An anonymous online questionnaire was distributed via social media between October 2025 and January 2026. The survey incorporated a 22-item scale assessing HTN knowledge, T2DM knowledge, and CVD risk awareness (Heart Disease Fact items). Participants were categorized according to self-reported diagnosis (no diagnosis, HTN, T2DM, or both). Descriptive statistics, non-parametric tests, and multivariable regression analyses were used to evaluate knowledge scores and predictors of CVD risk awareness. Results: A total of 458 participants completed the survey. Overall knowledge was moderate (mean 12.40/22; 56.4%), with relatively higher scores for HTN (73.2%) and T2DM knowledge (68.8%), but markedly lower CVD risk awareness (30.8%). Fewer than half of participants correctly answered key CVD items, particularly those related to asymptomatic disease progression and lipid (HDL) concepts. Only 21.6% achieved good awareness (≥75%). In multivariable analyses, higher educational level, positive family history of cardiometabolic disease, and the presence of HTN and/or T2DM were independent predictors of higher awareness. Conclusions: CVD risk awareness is suboptimal among adults in the Northern Border Region, including those with established HTN and T2DM. The observed gap between disease-specific knowledge and CVD risk awareness highlights the need for targeted, structured risk communication strategies in primary care, particularly for individuals with lower educational attainment and no family history of CVD. Full article

Background: Health literacy plays an important role in medication understanding, self-management, and engagement with healthcare services among older adults. Limited health literacy may contribute to medication-related problems and reduced utilization of pharmacist-led services in geriatric populations. Methods: A cross-sectional, questionnaire-based survey was conducted among geriatric outpatients (≥60 years) attending a tertiary-care teaching hospital in Saudi Arabia. Health literacy was assessed using a four-domain functional tool—covering prescription label comprehension, understanding of healthcare instructions, confidence in completing medical forms, and comprehension of written health information—developed in alignment with established health literacy frameworks, including the Health Literacy Survey—European Union (HLS-EU) model and Baker’s conceptual framework. Participants were classified as having higher health literacy (0–2 domains impaired) or lower health literacy (3–4 domains impaired). Sociodemographic characteristics, clinical burden, medication self-management behaviors, and awareness of clinical pharmacist services were recorded. Multivariable logistic regression was used to identify factors independently associated with lower health literacy. Results: A total of 200 participants were included. Impairment in three or more domains was observed in 55.5% of participants. Lower health literacy was independently associated with older age, lower educational attainment, lower income, female sex, multimorbidity, and polypharmacy. Participants with lower health literacy reported higher rates of missed or incorrect medication dosing and unreported adverse drug reactions and lower use of medication management aids. Awareness of clinical pharmacist services and prior exposure to pharmacist counseling were significantly lower among participants with lower health literacy. Willingness to receive pharmacist counseling was higher among participants with higher health literacy and greater awareness of pharmacist roles. Conclusions: Health-literacy impairment is common among geriatric outpatients and is associated with medication self-management behaviors and engagement with pharmacist-led services. These findings highlight the relevance of functional health literacy in geriatric medication use and support further research on literacy-sensitive pharmacist-led interventions. Full article