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Chinese enterprise personnel are faced with the problem of intercultural adaptation. Based on Black's theory of "three-dimensional" model of intercultural adaptation, this paper proposes a "four-dimensional" model of intercultural adaptation, namely, life adaptation, work adaptation, interpersonal adaptation and Chinese image adaptation. The research method of semi-structured in-depth interview is used to interview 23 Chinese people from one Chinese enterprise in Saudi Arabia, who have worked there for at least one year. We get findings as follows: (1) Life adaptation: maladjustment is mainly reflected in religious restriction. Especially, religious regulations and taboos make the life of Chinese enterprise personnel restricted. However, there are also many aspects of adaptation, such as Saudi cuisine, living environment and leisure life, which bring the satisfaction of life demands to Chinese enterprise personnel. (2) Work adaptation: foreign companies must employ a certain proportion of local people to work in their companies; the roles of buyers and sellers in Saudi Arabia and in China are different; the concept of time is different. (3) Interpersonal adaptation: Chinese people in Saudi Arabia still have the most frequent contact with their Chinese compatriots, and it is difficult for them to develop close friendship with foreigners. Chinese people are good at creating harmonious interpersonal relationships for work through some after-work activities, such as drinking tea, eating out and holding football matches. (4) Chinese image adaptation: Chinese enterprise personnel in Saudi Arabia have decent income, and Saudi police fail to check Chinese cars, all of which make the Chinese people have a positive face value. In view of the above four adaptation situations of Chinese enterprise personnel in Saudi Arabia, the following suggestions are proposed: (1) Be strict with yourself in life, respect local social and religious customs, and also keep a careful attitude and actively deal with disadvantageous factors. (2) While benefiting from working or doing business in Saudi Arabia, we should make contributions for the development of local economy and society, providing employment and training for local people. (3) We should observe the local laws and regulations, and also follow the local and international market rules. (4) In interpersonal communication, we should combine the maintenance mode of Chinese "guanxi" (relationship) with western "principle" on the one hand, and make a difference between them on the other hand. (5) In terms of image adaptation, besides maintaining a good image politically and economically, it is also necessary to improve our individual quality and our cultural cultivation overseas, be a communicator bridging Chinese and foreign excellent culture, and build a positive national image and individual image.

In an era of growing competition in the healthcare market, adopting a patient-centered approach is mandatory for the survival and growth of any public or private hospital. This requires a better understanding of patients' behavior and an increased focus on satisfying their needs and expectations. This paper was developed in this context and aims to study the main drivers of patients' behavioral intentions. A conceptual model was proposed, highlighting the linkages between service quality, doctors' reputation, patients' trust, service value, and patients' behavioral intentions. To examine the different research hypotheses, a quantitative study including 242 patients was conducted in Saudi Arabia using the convenience sampling method. The smart PLS approach was used to test the measurement and structural models. The findings indicated that trust and service value positively affected patients' behavioral intentions. Trust in the healthcare provider was positively affected by two dimensions of service quality: healthcare provider concern and physician concern. Trust in doctors was found to be positively related to the reputation of the doctor. Service value was positively influenced by the convenience of the healthcare process, healthcare provider concerns, and doctors' reputations. This study is original because it is among the few studies that investigate patients' behavioral intentions toward healthcare services in a developing country (Saudi Arabia). Furthermore, it is among the rare studies to examine the role of doctors' reputations in service values. The findings would offer meaningful implications for practitioners in the healthcare market for maintaining relationships with their patients. [ABSTRACT FROM AUTHOR]

Social networking sites and apps (SNSAs) are being used more frequently across the world and yet the nature of this online environment and associated interactions are not fully understood. With no restrictions for SNSAs use related to specific geographical regions, language, age, gender, educational level, or any other factors, it is important to find a concept to describe and explain the components of this online environment and their relationships. This paper describes the environment of SNSAs use by Saudi postgraduate students from the perspective of second-generation activity theory (AT). The findings supported the theoretical framework of AT as a useful lens in understanding SNSAs use from the perspective of students, particularly in a cultural environment where physical communication has restrictions based on gender. A similar AT model can be drawn for the use of SNSAs, taking the perspective of different groups of academic users. The flexibility of the AT model appears at the level of SNSAs as technical and physical tools, and at the level of users' community, which was managed by the explicit and implicit rules relating to communication. This feature reveals the way in which this extended framework can be used to indicate pertinent features of SNSAs. [ABSTRACT FROM AUTHOR]

This paper discusses the Saudi Arabian case by Abdallah Adlan and Henk ten Have, published in a 2012 issue of the Journal of Bioethical Inquiry, regarding a congenitally disabled child enrolled in a research project examining the genetics of her condition. During the course of the study, her father was found not to be genetically related, and the case discussed the dilemma between disclosing to the family all findings as promised in consent documents or withholding paternity information because of the likely severe social repercussions. Using Adlan and ten Have's example, this paper proposes a framework to consider cases outside of the conventional bioethics frame of reference, splitting the bioethical task into three elements: understanding the problem from the patient's and the clinician's perspective and then engaging in dialogue to decide what to do next. The process of dialogue between affected parties is vital. Presuming that there is a common morality undermines the effectiveness of the dialogue needed to find a resolution. [ABSTRACT FROM AUTHOR]

Introduction: Despite Saudi officials initiating a variety of smoking cessation programs, smoking in the country has not decreased. Thus, the objective of this study was to identify the factors associated with Saudi students' beliefs about available smoking cessation interventions. Methods: A cross-sectional, pre-tested, and validated paper-based survey was administered to a cohort from a university in the Qassim region. Bivariate analyses and logistic regression were conducted to explore the factors associated with the students' beliefs regarding behavioral and pharmacotherapy interventions for smoking cessation. Results: Out of 1158 surveys distributed, 958 responses were received (82.7% response rate). Students aged > 23 years were more likely to believe in a behavioral intervention (marginal effect = 10.4%; 95% CI, 2.3%– 18.6%). However, the respondents who indicated that they had smoked a hookah over the past 30 days were less likely to believe in either the pharmacotherapeutic (marginal effect = -7.9%; 95% CI, − 15.6 to − 0.3%) or the behavioral (marginal effect = -8.1%; 95% CI, − 16.2% to − 0.1%) interventions. Students who believed that the hookah was the same as or less harmful than cigarettes (marginal effect = − 25.6%; 95% CI, − 34.7% to − 16.6%) and (marginal effect = − 12.3%; 95% CI, − 22.3% to − 2.3%), respectively, were less likely to believe in pharmacotherapeutic interventions. Multiple logistic regression analyses found that hookah smokers with a willingness to quit smoking were more likely to believe in the effectiveness of cessation medications (marginal effect =  42.9%; 95% CI, 28.2%– 57.6%) and behavioral interventions (marginal effect =  28.6%; 95% CI, 9.3%– 48.0%). Conclusion: This study found that smoking a hookah and its harmfulness were negatively associated with smoking cessation medications interventions. Regarding beliefs about behavioral interventions, while age was positively associated, hookah smoking and its harmfulness had a negative association. Willingness to quit smoking was positively associated with both medication and behavioral interventions. [ABSTRACT FROM AUTHOR]

This paper develops an agent-based computational model of violent political revolutions in which a subjugated population of citizens and an armed revolutionary organisation attempt to overthrow a central authority and its loyal forces. The model replicates several patterns of rebellion consistent with major historical revolutions, and provides an explanation for the multiplicity of outcomes that can arise from an uprising. The relevance of the heterogeneity of scenarios predicted by the model can be understood by considering the recent experience of the Arab Spring involving several rebellions that arose in an apparently similar way, but resulted in completely different political outcomes: the successful revolution in Tunisia, the failed protests in Saudi Arabia and Bahrain, and civil war in Syria and Libya. [ABSTRACT FROM AUTHOR]

The objective of the paper is to evaluate the developmental potential of the Saudi bureaucracy in terms of the innovative or developmental attitudes of its members. The paper is divided into four sections: (1) a brief discussion of the research procedures used in the study, (2) an analysis of group perceptions of innovative values within the Saudi bureaucracy, (3) an analysis of the innovative attitudes of Saudi bureaucrats and (4) an analysis of the factors inhibiting the development of innovative behaviour among Saudi bureaucrats. The results of the study indicate low levels of innovative behaviour among Saudi bureaucrats. [ABSTRACT FROM AUTHOR]

Introduction: Perception of illness (PI) and self-medication (SM) have been thoroughly explored in the existing literature. However, there is a lack of understanding about the mediating effect of health literacy on PI and SM in a non-homogenous population like Saudi Arabia. As such, primary healthcare nurses who have constant interaction with the outpatients have difficulty addressing self-medication. This study aimed to investigate health literacy as mediator between PI and SM among outpatients in the Kingdom of Saudi Arabia (KSA). Methods: This study employed a cross-sectional approach and was conducted at 10 major primary healthcare (PHC) clinics serving 30 million individuals in 13 different regions of KSA. The 424 outpatients who participated in this study were selected through convenience sampling. Data collection started in November 2022 and concluded in February 2023. Results: The mean of the Brief Health Literacy Screening Tool, self-medication scale (SMS), and PI scores were 13.01 ± 3.32, 27.46 ± 7.01, and 45.56 ± 7.69, respectively. There was a significant relationship between the age and BRIEF scores (p = 0.039), and the level of education was significantly related to all variables, as were nationality and BRIEF scores (p = 0.001). Finally, occupation was significantly related to BRIEF and SMS scores (p = 0.001 and 0.003, respectively). Completing college and being non-Saudi had positively significant effects on health literacy (p < 0.01). The structural equation model (SEM) found no effect of PI on health literacy or SM behaviour (p = 0.263 and 0.84, respectively), but health literacy did have an effect on SM behaviour (p<0.001). Conclusion: Health literacy is an important factor in self-medication behavior and that PI is not directly related to health literacy or self-medication behavior, but that health literacy does influence self-medication behavior. Therefore, primary healthcare givers should promote public health literacy alongside the control of other conditions as one of the most effective ways to decrease the prevalence of self-medication and the risks associated with it. [ABSTRACT FROM AUTHOR]

Globally, the food retailing industry is seen as most dynamic and rapidly changing. In this paper we investigate the shopping behavior of shoppers in Saudi Arabia, the largest retail market in Arabian Peninsula. Using empirical research, this paper examines factors influencing shopping decisions and the attitude toward shop- ping of shoppers in Saudi Arabia. Comparisons based on demographic factors are also discussed. The article discusses the findings and makes recommendations to retail store management. Future research directions are also suggested. [ABSTRACT FROM AUTHOR]

Purpose — This paper aims to investigate the effects of gender, age and education on new technology implementation in Saudi Arabia, a technologically developing country, using the Theory of Planned Behavior (TPB). Design/methodology/approach — The research was an empirical investigation based on surveys completed by 1,088 Saudi knowledge workers. Findings — The TPB model performs well in Saudi Arabia. This validation accounts for 37 percent of the variance in behavioral intention among Saudi knowledge workers. For the moderator variables, there were no statistically significant interactions, with the exception of the moderation of perceived behavioral control on behavioral intention by level of education. Research limitations/implications — Saudi Arabia is an exemplar for many developing nations characterized by distinct intellectual and cultural traditions that differ from Western cultures. Demographic variables (e.g. gender and age) that have been reported to be significant moderators of the influences of attitude, subjective norm and perceived behavioral control on behavioral intention in other cultural samples were found to be non-significant in this Saudi Arabian sample. Practical implications — System developers using user-centered design approaches have different design criteria for the successful workforce adoption of information technology (IT) systems in a technologically developing nation, as compared to the workforce of a technologically developed nation. Originality/value — This paper validates TPB as a multi-cultural model for investigating the impact of attitudes, beliefs, and subjective norms on technology adoption, and, in contrast to previous studies, indicates the (non)effects of select demographic moderators on the model using a non-Western sample. [ABSTRACT FROM AUTHOR]

In Saudi Arabia, the Ministry of Health (MoH) has implemented strict rules to ensure COVID-19 vaccination uptake by the general public. However, there is hesitancy about COVID-19 vaccination among parents for their children worldwide. We aimed to determine the concerns, behaviors, perceptions, and hesitancy of COVID-19 vaccination among parents for their children in Saudi Arabia. Parents of children aged 5–11 years were included in this cross-sectional study. A total of 1507 responses were obtained using the convenience sampling technique. The data were analyzed using SPSS version 25.0 by applying descriptive and inferential statistics. Of the parents who responded, 74.5% believed that the COVID-19 vaccination could affect the genes of children, and 72.8% believed that the COVID-19 vaccination could have a greater number of positive impacts on the overall health of children. In total, 87% of the parents were satisfied with the vaccination services and effective policies of the MoH, Saudi Arabia. This study concluded that there is a greater need to increase public awareness regarding the beneficial impact of COVID-19 vaccination on the overall health of children. Effective awareness campaigns are also required to provide empirical information to the public that COVID-19 vaccination for children is safe and effective. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 lockdown affected oral health behaviors. This study aims to assess and compare the oral health attitudes and behaviors of first-time and previous patients undergoing dental extractions during the COVID-19 pandemic at private dental clinics in Riyadh City, Saudi Arabia.Methods: This cross-sectional study was conducted among patients aged 18– 65 years undergoing dental extractions at private dental clinics in Riyadh City, Saudi Arabia. Four hundred and eighty patients were selected using a convenient sampling methodology. A structured, close-ended questionnaire investigated demographic information, tooth extraction attendance, and oral health attitudes and behaviors using 20 items Hiroshima University Dental Behavioral Inventory (HUDBI).Results: A total of 480 exodontia patients [282 (58.8%) males and 198 (41.2%) females] participated in this study. All patients used a stiff-bristled toothbrush and were concerned about their teeth' color and bad breath. Similarly, all the participants did not feel brushed unless they used strong strokes, and the dentist told them to brush very well. An overall mean HUDBI score of 6.34± 1.12 was observed. Patients with a primary education (5.61± 0.79), income ≤ 5000 SAR (6.00± 0.92), residing in rural areas (5.84± 0.93), and government employees (5.62± 0.96) exhibited lower HU-DBI scores compared to their counterparts. The study revealed a significant variation in HUDBI scores across different demographic factors, including education, income, residence, occupation, and reason for extraction (p< 0.001). The HUDBI score of first-time attendees to dental extraction (5.88± 1.03) was found to be significantly poorer than to those of previous attendees (6.63± 1.09), (p< 0.001).Conclusion: Patients who underwent dental extractions at private dental clinics in Riyadh City, Saudi Arabia, during the post-lockdown COVID-19 pandemic exhibited average oral health attitudes and behaviors. Oral health attitudes and behaviors differed by socioeconomic status. Patients undergoing dental extractions for reasons other than dental caries and periodontal diseases and first-time attendees demonstrated poor oral health attitudes and behaviors. [ABSTRACT FROM AUTHOR]

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Introduction: Pregnant and breastfeeding women comprise a high-risk group for the development of severe COVID-19. Therefore, vaccination is highly recommended for perinatal women; however, vaccination levels for this group remain inadequate. This study explores the percentage of COVID-19 vaccination among Saudi pregnant and lactating women, as well as their attitudes toward it. Methods: We conducted a cross-sectional questionnaire-based survey on a sample of Saudi pregnant and breastfeeding women. The study included pregnant and lactating women. Results: The percentage of COVID-19 vaccine uptake was 78.2%. A total of 45 (21.8%) out of 206 women did not receive the vaccine. The overall vaccine hesitancy was 21.8%. Breastfeeding women were 2.86 more likely not to receive the vaccine as compared to pregnant women. Being a mother of over five children increased the vaccine uptake among our participating women (n = 20, 90%; p < 0.01). The majority of the subjects had taken the Pfizer vaccine (81.98%, 132/161). The availability of the COVID-19 vaccine was the most common factor for choosing a particular vaccine. Protection from infection (60.2%, 97/161) was reported as the main driver for vaccine uptake. The most common reason perceived for delaying COVID-19 vaccination was being worried about the side effects (176, 85.44%) on one's own body and the effects on the unborn child (130, 63.1%). Conclusion: We uncovered high levels of hesitancy, primarily induced by concerns about adverse effects and social media-related misinformation. These high levels of vaccine uptake are likely due to the large-scale obligatory vaccination program provided in Saudi Arabia, which was well-structured and far reaching. Our results provide further support for the so-called "protection motivation theory" in boosting vaccine acceptance. Counseling and educating pregnant and breastfeeding women about COVID-19 vaccination is the need of the hour. [ABSTRACT FROM AUTHOR]

The coronavirus (COVID-19) outbreak around the world has caused public health concerns and changes in peoples' behaviors and psychological distress. The pandemic impacts on human behavior, emotions, and cognition, leading to diverse reactions in relation to awareness of the disease. However, there is little understanding around the psychological impacts of the pandemic and strategies to overcome this impact. This study aimed to examine individuals' reactions toward the COVID-19 pandemic in relation to their psychological hardiness, their degree of awareness toward the pandemic, and precautionary measures taken. Individuals living in Saudi Arabia were invited to complete an online questionnaire which included demographic items, psychological responses to the pandemic, awareness of COVID-19, and measures of psychological hardiness. A total of 1272 individuals were recruited into the study, with the majority being female (85%). Results indicated that the average psychological responses to the COVID-19 pandemic in the study sample were 75.85%. This indicates that the sample generally has a high level of positive psychological responses to the COVID-19 pandemic. The awareness of COVID-19 among Saudi was 91.50%. This indicates a high level of awareness among the study sample. [ABSTRACT FROM AUTHOR]

Background: As the Saudi Food and Drug Authority (SFDA) has recently requested all food facilities to display the calorie count on their menus, this study aimed to identify the perceived changes in costumers' eating behaviours in response to the calorie count display (CCD) policy in the Eastern Province. Methods: This was a mixed methods study. The first being quantitative, using a cross-sectional questionnaire which included 400 customers of both genders, aged 10 years and older, and was collected at food facilities from three cities in the Eastern Province. Customers completed a self-administered questionnaire and handed their registered receipts. Collected receipts were used to calculate the total calories ordered per customer. The second method is a qualitative in-depth interview with food facility managers. Results: Customers who reported checking the CCD were 30.5% of the total sample, and 58.2% of them changed their order accordingly. The mean calories ordered were 36 kcal less in customers checking the CCD than those who do not (P=0.674). Customers who exhibit healthy lifestyle habits calculate their daily consumed calories, knowledgeable of the recommended daily caloric intake (RDCI), dining in a dine-in restaurant, and have an educational level of above high school were more likely to check the CCD. This study found that customers who cared to check the CCD were more likely to change their eating behavior. It has been found that only a small percentage (12% to 18%) of customers were knowledgeable regarding the RDCI. After the implementation of the policy, restaurant managers reported a positive change in customers eating behavior, which was more profound in females and athletes. Conclusion: There is a significant association between checking the CCD and positive behavioral changes in customers' eating behaviors. The results of this study suggest that further enforcement and awareness raising are crucial to increase the number of customers checking and using the CCD. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to assess public knowledge of breast cancer (signs, symptoms, and risk factors) and awareness of screening programs; and compare it among men and women. Materials and Methods: A cross-sectional study was conducted among male and female residents of five of the geographic regions of Saudi Arabia from February 2015 to May 2015. Information was collected using a questionnaire, and included sociodemographic data, general knowledge about breast cancer, and awareness of screening programs. Chi-squared test was used to compare the binary knowledge variables (correct/incorrect) between men and women. Logistic regression was utilized to assess predictors of breast cancer knowledge. Results: A total of 9691 men and 31,022 women were surveyed. Women had better knowledge regarding breast cancer symptoms than men, except for breast cancer being related to death. Men and women had similar knowledge of breast cancer risk factors; however, more women correctly identified family history (68%), large breast size (46%) as increasing risk, and breastfeeding (60%) as reducing the risk of breast cancer compared to men (56%, 32%, and 47%, respectively). Older age and higher education were related with high breast cancer knowledge, and it was more pronounced among men. Employment was a predictor for better knowledge among women. Participants with no history of breast cancer were less likely to have good breast cancer knowledge compared with those with a family history, (OR: 0.5, 95% CI: 0.5– 0.6) and (OR: 0.6, 95% CI: 0.5– 0.6) among men and women, respectively. More women (24%) than men (19%) knew of breast cancer screening programs, although the awareness was low in both genders. Conclusion: Awareness campaigns in Saudi Arabia, especially those aimed at men, remain critical to increase knowledge and change behavior toward early detection of breast cancer. [ABSTRACT FROM AUTHOR]

Background: Saudi Arabia's healthcare sector is growing at a hasty stride; nevertheless, the quality of healthcare consumption remains challenged by the growing caseload in free public health facilities. Insurance could ease this pressure by moving some healthcare demand to private facilities conditional on its ability to enact health-seeking behaviour. These potential effects remain under-investigated. Therefore, the aim of this study was to investigate whether health insurance nudges health-seeking behaviour using data from Saudi Arabia. Materials and Methods: The study used nationally representative secondary data, obtained from the Family Health Survey, conducted in 2018, in Saudi Arabia. Health-seeking behaviour was measured by individual attendance of medical check-up. To account for endogeneity due to non-random selection of individuals into insurance, the analysis employed the inverse propensity weighting and the instrumental variables methods. Results: The results revealed that health insurance leads to increased chances of going for medical check-up. The effects are higher amongst non-Saudi nationals relative to citizens. Furthermore, people who purchase personal health insurance schemes are more likely to go for checks-ups, followed by individuals provided by the private sector and government sector. Finally, the study found that insurance positively nudges hypertension, diabetes, and cholesterol specific medical check-ups. Conclusion: The findings indicated the need for health policy to increase access to health insurance in Saudi Arabia. A notable policy response is the introduction of national health insurance coverage, which has already proven in other countries as an effective measure to attain universal access to improved health. Nevertheless, results from this study highlighted variations in demand for health seeking based on type of insurance with highest returns in personal insurance. Policy should leverage on this behaviour response by introducing insurance packages that share premiums with citizens to incentivise utilisation. The results can also be used to design policy responses to demand for insurance, in the entire Arabian Gulf region, since these countries have similar health financing mechanism with Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: Clinical instructors are the key mediators in helping students conquer clinical experiences by preparing them for clinical workplaces. The caring behavior of instructors plays an important role in the instructor‐student relationship. Objective: This study aimed to (a) assess the perception of nursing students of clinical instructors' caring behavior and (b) explore the correlation between their perception of instructors' caring behavior and their self‐efficacy. Design: A quantitative descriptive correlation design was adopted. Setting: The sample was collected from the faculty of nursing at a major governmental university for females in the Kingdom of Saudi Arabia. Participants: A sample of nursing students (N = 200) was recruited. Methods: The data were collected using the inventory for nursing students' perceptions of instructor caring (NSPIC) and general self‐efficacy (GSE) scale. Descriptive and inferential statistics, such as Pearson r correlation and regression analysis, were used. Results: The total mean of NSPIC was moderate to high (mean = 3.06, SD = 1.04). The level of GSE among students was high (mean = 3.45, SD = 0.849). NSPIC is significantly correlated with its GSE (r =.282). In addition, GSE turned out to be a major indicator of caring behavior, with P =.021 and R2 = 0.642. Conclusion: Caring relationships between clinical instructors and nursing students enable students to grow as caring professionals. Therefore, nursing programs must have highly qualified clinical instructors to teach and train students and be a good role model in the workplace. [ABSTRACT FROM AUTHOR]

The relationship between the constructs of perceived control and symptoms of mood disorders has been demonstrated. The current study evaluates cultural values both as an individual difference moderating variable and as one of the mechanisms through which the association between perceived control and mood disturbances may operate. The hypotheses were examined with a sample of 615 participants recruited in Saudi Arabia. Participants completed measures of perceived control, individualism and collectivism, and symptoms of depression and bipolar disorder. In general, the results supported a model in which higher levels of perceived control promote a less symptomatic mood state. In most cases, cultural values positively mediated the relationship between perceived control and mood disturbance with lower symptom levels predicted. However, when the components of perceived control were examined separately, high perceived mastery together with highly individualistic values predicted higher levels of bipolar symptoms. In this sample, there was less evidence of cultural values moderating the control–mood disturbance relationship. Only one moderator relationship was identified, which showed low control linking to higher symptom levels only in those who disagreed with individualistic values. Overall, our data are in agreement with the notion that pre-existing cultural values have an important effect on mood disorder symptoms. [ABSTRACT FROM AUTHOR]

Background: Waterpipe and cigarette smoking have been found to be associated with each other as cigarette smokers were more likely to be waterpipe users than non-cigarette smokers. Also, waterpipe smokers were likely to be former daily cigarette users. The aim of this study is to examine the likelihood of waterpipe use leading to cigarette use among current waterpipe users using theory of planned behavior. Methods: Four hundred six current waterpipe smokers who initially had started tobacco use with the waterpipe were recruited from 15 waterpipe lounges in 2015. From a total of 70 waterpipe lounges in Riyadh, the 15 waterpipe lounges were selected randomly and participants were also selected randomly inside each waterpipe lounge based on the table or section number. The survey was developed using the Qualtrics Online Survey Software and participants completed a survey using iPad tablets. Results: Cigarette smoking and intention to smoke cigarettes were predicted by attitude and perceived behavioral control. There was no direct effect of subjective norm on the cigarette use behavior, yet subjective norm had a statistically significant indirect effect on intentions through attitude and perceived behavioral control. Conclusions: The findings of this study could be useful in prevention/intervention programs aimed at reducing tobacco smoking behaviors among waterpipe users. Intervention programs might be directed at the attitude and perceived behavioral control by targeting underlying behavioral and control beliefs. The theory of planned behavior provided solid explanations of intention to use cigarettes among waterpipe smokers. [ABSTRACT FROM AUTHOR]

Although most patients report wanting their physicians to address the religious aspects of their lives, most physicians do not initiate questions concerning religion with their patients. Although religion plays a major role in every aspect of the life of a Muslim, most of the data on the role of religion in health have been conducted in populations that are predominantly non-Muslim. The objectives of this study were to assess Muslim physicians' beliefs and behaviours regarding religious discussions in clinical practice and to understand the factors that facilitate or impede discussion of religion in clinical settings. The study is based on a cross-sectional survey. Muslim physicians working in a tertiary care hospital in Saudi Arabia were invited to complete a questionnaire that included demographic data; intrinsic level of religiosity; beliefs about the impact of religion on health; and observations, attitudes, behaviours, and barriers to attending to patients' religious needs. Out of 225 physicians, 91% agreed that religion had a positive influence on health, but 62.2% thought that religion could lead to the refusal of medically indicated therapy. Over half of the physicians queried never asked about religious issues. Family physicians were more likely to initiate religious discussions, and physicians with high intrinsic religiosity were more likely to share their own religious views. Residents and staff physicians tended to avoid such discussions. The study results highlight the fact that many physicians do not address patients' religious issues and that there is a need to clarify ethically sound means by which to address such needs in Islamic countries. Medical institutions should work to improve the capacity of medical personnel to appropriately address religious issues. The training of clinical religious advisors is a promising solution to this dilemma. [ABSTRACT FROM AUTHOR]

The current study was designed to explore the prevalence of attention-deficit hyperactive disorder (ADHD) in primary schools in Saudi Arabia. The study collected data from both teachers and parents for 708 primary school pupils attending grades 1-3 (7-9 years old), using DSM-IV criteria of ADHD. The result showed that the overall rate of ADHD was 2.7%, and in particular, the rate of attention types, 2.0%; hyperactive/impulsivity type, 1.4% and combined type, 0.7%. Teachers reported ADHD in a higher frequency than parents. However, applying a combination of reports from teachers and parents, screening of ADHD is likely to be more accurate. These findings highlight the importance of detecting ADHD in pupils at an early age and to develop a specific set of psychological clinical interventions for helping them. [ABSTRACT FROM AUTHOR]

Recently, there has been increasing concern about reducing and replacing chemical fertilizers with biofertilizers to enhance soil fertility and maintain agroecosystems and sustainable agricultural production. Given that knowledge of biofertilizers is information-intensive, the lack of information-seeking behavior (ISB) might be the primary constraint for farmers adopting biofertilizers. This study aimed to analyze how ISB influences farmers' adoption of biofertilizers, using a sample of 228 onion farmers in Al-Ahsa Governorate, Saudi Arabia. The results indicate that most farmers had a moderate level of ISB. The most frequently accessed sources were mobile applications, extension institutions, and progressive farmers. The results of cluster analysis show that farmers' ISB differed significantly according to their main occupation. Among the onion farmers, 35%had adopted biofertilizers. The findings also reveal that farm size, attitude toward biofertilizers, the credibility of information sources, and the usefulness of the information positively and significantly influence farmers' adoption of biofertilizers. It was concluded that understanding the relationship between adoption and ISB could assist policymakers in focusing on knowledge diffusion when designing extension programs and advisory services to facilitate better usage of biofertilizers. [ABSTRACT FROM AUTHOR]

Background: Workplace bullying (WPB) is a physical or emotional harm that may negatively affect healthcare services. The aim of this study was to determine to what extent healthcare practitioners in Saudi Arabia worry about WPB and whether it affects the quality of care and patient safety from their perception.Methods: A cross-sectional study was conducted in 2018. An online survey was distributed among all practitioners at a multi-regional healthcare facility. A previously validated tool was sourced from an integrative literature review by Houck and Colbert. Responses to 15 themes were rated on a 5-point Likert scale, converted to percentage mean scores (PMS) and compared across participants' characteristics using bivariate and regression analyses.Results: A total of 1074/1350 (79.5%) completed the questionnaire. The overall median [interquartile range] score of worrying about WPB was 81.7 [35.0]. Participants were mainly worried about the effect of WPB on their stress, work performance, and communication between staff members. A significant negative relationship developed between the quality of care and worrying about WPB, P < 0.001. More educated practitioners were 1.7 times more likely to be worried about WPB compared with their counter group, adj.P = 0.034. Junior practitioners were 1.6 times more likely to be worried about WPB, adj.P = 0.017. The group who has not been trained in handling WPB (1.7 times), and those who had been exposed to WPB (2.2 times) were both more likely to be worried about WPB compared with their counter groups, adj.P = 0.026 and adj.P < 0.001 respectively.Conclusions: Most healthcare practitioners worry about WPB, especially its negative impact on the quality of care and patient safety. A greater proportion of practitioners with higher levels of education and their less experienced counterparts were more worried about WPB. Previous exposure to a WPB incident amplifies the practitioners' worry, but being trained on how to counteract bullying incidents makes them less likely to be worried. [ABSTRACT FROM AUTHOR]