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Introduction: Children with Special Healthcare Needs (CSHCN) are considered difficult to maintain oral hygiene and challenging for caregivers and dentists to attain cooperation in dental treatment under general anaesthesia. Family Impact Scale (FIS) and Parental-Caregiver Perceptions Questionnaire (P-CPQ) are useful tools to assess patient's oral health quality of life and caregivers perception. Aim: To assess the impact of dental treatment under general anaesthesia on the quality of life and oral hygiene of CSHCNs, as perceived by caregivers. Materials and Methods: This prospective follow-up survey study was carried out at Dammam Medical Complex, Saudi Arabia, from December 5th, 2019 to December 15th, 2021. The CSHCN of either gender, aged 12 years, and falling within the American Academy of Pediatric Dentistry (AAPD) definition of special-needs patients referred for invasive procedures under general anaesthesia (American Society of Anaesthesiologists (ASA) class I or II), were included. The baseline and, after a one-year follow-up, information obtained from two surveys that were altered from Thompson's P-CPQ and FIS were decoded into the numeric ordinal scales Never ("0"), Once or Twice ("1"), Sometime ("2"), Always ("3"), and Daily ("4"). Analysis of the collected data was done by Statistical Package for Social Sciences (SPSS) version 20.0. Results: A total of 84 participants were caregivers of CSHCN who underwent dental procedures under General Anaesthesia (GA), of whom 77 (91.7%) were mothers and 7 (8.3%) were fathers of the CSHCN. The mean age of children was 8.29±2.14 years (Range= 3-12 years); 38 (45.2%) were males and 46 (54.8%) were females. The median FIS after treatment was zero, compared to the median before treatment which was 2, revealing a significant impact on being absent from work, a child requiring more care, the impact of presence, sleeping disturbances, feeling angry, feeling guilty, and a child disputing or blaming either parent (p<0.001). Following the pattern of one year post-treatment FIS, median was 0 (Never) for all items including halitosis, pain, food trapped in palate and teeth, swallow, breath, time, sleep, irritable, frustrating, nervous, shy, absent, laugh, and continue school (p<0.001). Conclusion: The modified FIS and P-CPQ evaluations before and after dental treatment under GA revealed a significant improvement in the oral health quality of life for those CSHCN, as well as the impact on their caregivers. Regular check-ups would be useful for early and non invasive intervention without GA. [ABSTRACT FROM AUTHOR]

The Kingdom of Saudi Arabia (KSA) is an arid country facing the challenge of renewable freshwater availability. KSA has an area of about 2.25 million km2. KSA has no perennial rivers or permanent freshwater bodies. KSA has low rainfalls with high evaporation rates which makes it very dry country. After discovering oil, KSA has witnessed remarkable economic development and rapid increase in population with migration to the urban areas in the past four decades. KSA population increased from about 4 million in 1960 to about 32.5 million in 2018. These developments lead to more pressure due to increased demand on the scarce freshwater resources. In order to meet the growing water demands, the limited renewable freshwater resources have been heavily overexploited. Groundwater aquifers are the main natural renewable freshwater source in the country. The average per capita municipal daily water use in KSA has been increasing since 2009 when it hit 227 L/d and recorded a gradual increase to touch 270 L/d in 2016 which is the 3rd highest in the world. Faced with increasing water scarcity and gaps between water supply and demand, policymakers in KSA started to consider the treated wastewater as a major renewable water source and aim to achieve full utilization and reuse of treated wastewater by 2025. With a desalination capacity of about 2,500 million cubic meters per year which represents 30% of the world's desalination capacity, KSA is the largest seawater desalination producing country. However, desalinated water alone will not be able to supply enough freshwater to meet the increasing future water demand. However, with only 10% of the total municipal wastewater generated currently being reused, KSA is projected as the third largest reuse market after China and the USA, and reuse capacities are projected to increase by 800% by 2025. The projected growth and change in water portfolios offer tremendous opportunities to integrate novel approaches of water reclamation and reuse such as aquifer recharge and groundwater quality enhancement, district cooling and irrigation of reactional areas. Recent statistics in 2018 indicated that the volume of treated wastewater used to produce freshwater in KSA was approximately 390 million cubic meters per year. This statistic shows the revenue of the industry "sewerage" in Saudi Arabia from 2012 to 2017, with a forecast to 2024. It is projected that the revenue of sewerage in Saudi Arabia will amount to approximately 739.3 million U.S. Dollars by 2024. The KSA's treated wastewater utilization status up to date and the main key challenges facing KSA such as the substantial growth in wastewater services demand; low coverage of existing wastewater collection systems, treatment facilities, and reuse options; and the needed governmental capital investment in wastewater infrastructure development were analyzed. It has been recommended that there are initiatives that should be taken thus far to tackle these challenges towards successful achievement of KSA's efficient wastewater treatment and reuse. [ABSTRACT FROM AUTHOR]

Background: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection had been investigated utilizing serology. Materials and methods: This community-based sero-survey was carried out in the neighborhoods of three cities in Saudi Arabia. Results: Of 5629 participants, 2766 (49.1%) were women; and 2148 (38.1%) were 18–34 years of age, and 3645 (64.7%) were from South East Asia. Positive serology was seen in 2825 (50.2% (95% CI: 48.8–51.5%) for SARS-CoV-2 anti-S1 IgG antibodies by ECLIA. Being in the age category of 18–34 years and being from Eastern Mediterranean Region (country A) were associated with higher COVID-19 seropositivity with estimated odds ratio of 1.3 [95% CI 1.1–1.8] and 2.5 [95% CI 1.1.5–4.2] respectively. Gender, social status, education, nationality, symptoms, presence of comorbidities and activity style were positively associated with increased seropositivity. Factors associated negatively with the rate of seropositivity were higher education and having outdoor activity with estimated OR of 0.92 [95% CI 0.46–0.95] and 0.59 [95% CI 0.47–0.74], respectively. Conclusion: The study showed high seroprevalence of SARS-CoV-2 among high density population. Health education campaigns should target middle-aged, those with low education, those living in lower standards and indoor workers. [ABSTRACT FROM AUTHOR]

A gap in the literature was found in terms of customer satisfaction before and after faults occurred in service delivery, i.e., pre-service failure satisfaction and post-service recovery satisfaction. The aim of this study is fivefold. First, to identify the effect of service quality and food quality on pre-service failure satisfaction. Second, to explore the effect of compensation and apology on post-service recovery satisfaction. Next, to test the effect of pre-service failure satisfaction on post-service recovery satisfaction. Fourth, to investigate the effect of pre-service failure satisfaction on repurchase and word-of-mouth intentions. Finally, to determine the effect of post-service recovery satisfaction on repurchase and word-of-mouth intentions. Convenience sampling method was adopted to ensure a high level response rate. Data were collected by a questionnaire developed on the ground of prior research. A total of 311 questionnaires were received valid out of 400 questionnaires distributed to restaurant customers in Saudi Arabia. The results revealed that service quality and food quality exerted significant effects on pre-service failure satisfaction, compensation and apology exerted significant effects post-service recovery satisfaction, pre-service failure satisfaction had a significant effect on post-service recovery satisfaction. Finally, the results showed that both preservice failure satisfaction and post-service recovery satisfaction had significant effects on repurchased and word-ofmouth intentions. It was concluded that service quality, food quality, compensation and apology were predictors of customer satisfaction in service failure and service recovery context in restaurants. The paper contributed to the literature can be seen through studying customer satisfaction as a variable of two sub-dimensions: pre-service failure satisfaction and post-service recovery satisfaction. Although the two variables are different, their effects on consumer outcomes are significant. Note that the effect of the second variable is greater than the effect of the first variable. The study recommends restaurants to use service recovery strategies such as compensation and apology in order to maintain customer satisfaction and to improve the intention of repurchase and positive word-of-mouth. [ABSTRACT FROM AUTHOR]

To investigate a cluster of Middle East respiratory syndrome (MERS) cases in a women-only dormitory in Riyadh, Saudi Arabia, in October 2015, we collected epidemiologic information, nasopharyngeal/oropharyngeal swab samples, and blood samples from 828 residents during November 2015 and December 2015-January 2016. We found confirmed infection for 19 (8 by reverse transcription PCR and 11 by serologic testing). Infection attack rates varied (2.7%-32.3%) by dormitory building. No deaths occurred. Independent risk factors for infection were direct contact with a confirmed case-patient and sharing a room with a confirmed case-patient; a protective factor was having an air conditioner in the bedroom. For 9 women from whom a second serum sample was collected, antibodies remained detectable at titers >1:20 by pseudoparticle neutralization tests (n = 8) and 90% plaque-reduction neutralization tests (n = 2). In closed high-contact settings, MERS coronavirus was highly infectious and pathogenicity was relatively low. [ABSTRACT FROM AUTHOR]

• Among blood donors in May 2020, the overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4%. • Non-citizens had higher prevalence compared to citizens (OR 13.6, p = 0.001). • There was geographic variation in seroprevalence of anti-SARS-CoV-2 antibodies within Saudi Arabia. Serologic testing provides better understanding of SARS-CoV-2 prevalence and its transmission. This study was an investigation of the prevalence of antibodies to SARS-CoV-2 among blood donors in Saudi Arabia. To estimate the seroprevalence of anti-SARS-CoV-2 antibodies among blood donors in Saudi Arabia during the early phase of the COVID-19 pandemic. Serology results and epidemiological data were analyzed for 837 adult blood donors, with no confirmed SARS-CoV-2 infection, in Saudi Arabia from 20th to 25th May 2020. Seroprevalence was determined using electrochemical immunoassay to detect anti-SARS-CoV-2 antibodies. The overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4% (12/837). Non-citizens had higher seroprevalence compared with citizens (OR 13.6, p = 0.001). Secondary education was significantly associated with higher seroprevalence compared with higher education (OR 6.8, p = 0.005). The data showed that the highest seroprevalence was in Makkah (8.1%). Uisng Makkah seroprevalence as the reference, the seroprevalence in other areas was: Madinah 4.1% (OR 0.48, 95% CI 0.12−1.94), Jeddah 2.3% (OR 0.27, 95% CI 0.31−2.25), and Qassim 2.9 % (OR 0.34, 95% CI 0.04−2.89) and these were not statistically different from seroprevalence in the Makkah region. At the early months of the COVID-19 pandemic in Saudi Arabia, the seroprevalence of antibodies to SARS-CoV-2 among blood donors was low, but was higher among non-citizens. These findings may indicate that non-citizens and less educated individuals may be less attentive to preventive measures. Monitoring seroprevalence trends over time require repeated sampling. [ABSTRACT FROM AUTHOR]

Healthcare workers (HCWs) stand at the frontline for fighting coronavirus disease 2019 (COVID-19) pandemic. This puts them at higher risk of acquiring the infection than other individuals in the community. Defining immunity status among health care workers is therefore of interest since it helps to mitigate the exposure risk. This study was conducted between May 20th and 30th, 2020. Eighty-five hospitals across Kingdom of Saudi Arabia were divided into 2 groups: COVID-19 referral hospitals are those to which RT-PCR-confirmed COVID-19 patients were admitted or referred for management (Case-hospitals). COVID-19 nonaffected hospitals where no COVID-19 patients had been admitted or managed and no HCW outbreak (Control hospitals). Next, seroprevalence of severe acute respiratory syndrome coronavirus 2 among HCWs was evaluated; there were 12,621 HCWs from the 85 hospitals. There were 61 case-hospitals with 9379 (74.3%) observations, and 24 control-hospitals with 3242 (25.7%) observations. The overall positivity rate by the immunoassay was 299 (2.36%) with a significant difference between the case-hospital (2.9%) and the control-group (0.8%) (P value <0.001). There was a wide variation in the positivity rate between regions and/or cities in Saudi Arabia, ranging from 0% to 6.31%. Of the serology positive samples, 100 samples were further tested using the SAS2pp neutralization assay; 92 (92%) samples showed neutralization activity. The seropositivity rate in Kingdom of Saudi Arabia is low and varies across different regions with higher positivity in case-hospitals than control-hospitals. The lack of neutralizing antibodies (NAb) in 8% of the tested samples could mean that assay is a more sensitive assay or that neutralization assay has a lower detection limits; or possibly that some samples had cross-reaction to spike protein of other coronaviruses in the assay, but these were not specific to neutralize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). [ABSTRACT FROM AUTHOR]