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AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo evaluate the measurement properties of the Arabic Patient-Specific Functional Scale (PSFS) in individuals with upper extremity musculoskeletal disorders.Participants with upper extremity musculoskeletal disorders (N = 139) completed the PSFS, Upper Extremity Functional Index (UEFI), the Disabilities of the Arm, Shoulder and Hand (DASH), Numeric Pain Rating Scale (NPRS) and the Global Assessment of Function scale (GAF). The same outcome measures were completed again with one week in addition to the Global Rating of Change Scale. The test-retest reliability, measurement error, floor and ceiling effects, and construct validity of the PSFS were examined.The PSFS demonstrated very good test-retest reliability (ICC2,1 = 0.82; 95% CI: 0.71–0.88), with no evidence of floor or ceiling effects. The standard error of measurement was determined to be 0.74 while the minimal detectable change was 1.73 points. The PSFS demonstrated significant negative correlation with DASH, NPRS (−0.58, −0.35), and significant positive correlation with the UEFI and GAF (0.56, 0.50). The PSFS demonstrated statistically higher correlation with the DASH and UEFI compared with the NPRS (p < 0.004) supporting our predefined construct validity hypotheses.The Arabic PSFS is an applicable, reliable, and valid outcome measure of upper-extremity activity limitations for patients with upper extremity musculoskeletal disorders.Patients who exhibit no changes in their clinical condition will consistently exhibit similar scores in the Arabic Patient-Specific Functional Scale (PSFS) when the scale is administered multiple times over a period of time.A patient’s score in the Arabic PSFS can be accurately interpreted by rehabilitation professionals to reflect the degree of activity limitation with confidence.The Arabic PSFS can be effectively utilized in both daily clinical practice and research studies to accurately measure the extent of activity limitation experienced by Arabic-speaking individuals with upper extremity musculoskeletal disorders.The Arabic PSFS allows rehabilitation professionals to quantitatively assess activity limitation in a manner that is culturally and lifestyle-appropriate for Arabic-speaking individuals with upper extremity musculoskeletal disorders.Patients who exhibit no changes in their clinical condition will consistently exhibit similar scores in the Arabic Patient-Specific Functional Scale (PSFS) when the scale is administered multiple times over a period of time.A patient’s score in the Arabic PSFS can be accurately interpreted by rehabilitation professionals to reflect the degree of activity limitation with confidence.The Arabic PSFS can be effectively utilized in both daily clinical practice and research studies to accurately measure the extent of activity limitation experienced by Arabic-speaking individuals with upper extremity musculoskeletal disorders.The Arabic PSFS allows rehabilitation professionals to quantitatively assess activity limitation in a manner that is culturally and lifestyle-appropriate for Arabic-speaking individuals with upper extremity musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is prevalent among the elderly and significantly affects their quality of life (QoL). Pain intensity scales are crucial tools in evaluating the severity of pain and tailoring management strategies. This study investigates the relationship between various pain intensity scales and QoL among elderly patients with chronic pain, highlighting the implications for nursing practice. Methods: A cross-sectional study was conducted with 150 elderly patients (aged 65 and above) in Riyadh, Saudi Arabia. Participants were assessed using the Numeric Rating Scale (NRS), Visual Analog Scale (VAS), and McGill Pain Questionnaire (MPQ) alongside the 36-Item Short-Form Health Survey (SF-36) to evaluate QoL. Data analysis involved Pearson correlation and multiple regression to explore the association of pain intensity on QoL. Results: All pain scales showed significant negative correlations with QoL. The MPQ exhibited a significant association, suggesting its comprehensive nature captures the multidimensional association of pain more effectively. Regression analysis identified pain intensity, age, and duration of chronic pain as significant predictors of reduced QoL. Conclusions: The findings emphasize the importance of selecting appropriate pain assessment tools that reflect the complex nature of pain in elderly patients. Implementing comprehensive pain assessments like the MPQ can enhance individualized care strategies and potentially improve the QoL in this population. This study underscores the role of nurses in optimizing pain management approaches tailored to the elderly. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction and loyalty are essential indicators of healthcare quality, directly impacting patient outcomes and the long-term success of healthcare facilities. Despite the growing importance of patient-centered care in Saudi Arabia, there is limited research exploring the factors that influence patient satisfaction and loyalty, particularly in the Riyadh region. Aim: This study aims to identify the key factors influencing patient satisfaction and loyalty among Saudi patients attending public and private healthcare facilities in the Riyadh region. The study focuses on how healthcare service quality, communication, and demographic factors contribute to patient satisfaction and loyalty. Methods: A cross-sectional study was conducted with a sample of 350 Saudi patients from 10 healthcare facilities in Riyadh. Data were collected using the Patient Satisfaction Questionnaire (PSQ-18) and the Patient Loyalty Questionnaire (PLQ). Descriptive statistics, Pearson correlation, and multiple linear regression were employed to identify predictors of patient satisfaction and loyalty. Results: Significant predictors of patient satisfaction included general satisfaction (β = 0.48, p < 0.001), communication (β = 0.35, p < 0.001), and the frequency of healthcare visits (β = 0.13, p = 0.011). Private healthcare facilities had higher satisfaction (p < 0.001) and loyalty scores (p < 0.001) compared to public facilities. Patient loyalty was strongly predicted by general satisfaction (β = 0.55, p < 0.001) and communication (β = 0.42, p < 0.001). Conclusions: Communication quality and patient satisfaction are key drivers of patient loyalty in Saudi healthcare facilities. Private facilities outperform public ones in patient satisfaction and loyalty. These findings emphasize the need for healthcare providers to enhance communication and service quality to foster patient loyalty. Tailored approaches to meet the diverse needs of patients, particularly in terms of education and visit frequency, are crucial for improving healthcare outcomes in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: Nurses working in palliative and end-of-life care settings face significant emotional challenges due to the demanding nature of their profession. This study aimed to explore the emotional resilience of these nurses, understanding the factors that contribute to their resilience, the impact on their professional well-being and performance, and strategies to enhance resilience. Methods: A qualitative study was conducted involving 15 registered nurses from various healthcare facilities in Riyadh, Saudi Arabia. Data were collected through semi-structured interviews, document analysis, and observational data. Thematic analysis was employed to identify recurring themes. Results: The study identified three key themes: Emotional Challenges and Resilience-Building, Support Systems and Resources for Resilience, and Professional Growth and Fulfillment as Resilience Factors. The findings revealed the emotional toll of patient suffering, highlighting resilience-building strategies, such as peer support, mindfulness, and reflective practices. Support systems, including workplace support, organizational resources, and mentorship, were identified as crucial for fostering resilience. Professional growth, a sense of purpose, and recognition emerged as factors contributing to resilience. Conclusions: This study underscores the importance of emotional resilience for nurses in palliative and end-of-life care settings. Healthcare organizations can enhance resilience by implementing resilience training, providing counseling services, fostering a supportive culture, and offering professional development opportunities. Addressing the emotional needs of nurses is vital for their well-being and the delivery of compassionate care. [ABSTRACT FROM AUTHOR]

Background: Nursing and midwifery professionals' well-being may be affected by various factors, including the bullying of new nurses. Purpose: To analyze the relationship between bullying behaviors, perceived stress, and acute stress among undergraduate nursing and midwifery students in Saudi Arabia, as well as the moderating role of gender and academic majors in this relationship. Method: A cross-sectional correlation design was used, and data were collected from 322 undergraduate nursing and midwifery students enrolled in four major nursing universities in Saudi Arabia. Results: Educational level, environment, and personal attacks had a significant negative impact on perceived and acute stress (social and non-social), while hostility toward academic achievement and direct negative behaviors had significant positive impacts on perceived and acute stress (social and non-social). Female nursing students reported a stronger impact of bullying behavior on their perceived stress, while male students reported a greater impact on social and non-social stress. Nursing students reported a stronger impact of bullying on perceived stress, while midwifery students reported a greater impact on social and non-social stress. Discussion: Nursing educators should raise awareness about the harmful effects of bullying and emphasize the importance of creating a safe, supportive learning environment. [ABSTRACT FROM AUTHOR]

This study explores the ethical and legal challenges faced by nurses in caring for older adults with multimorbidities, focusing on issues related to patient autonomy, polypharmacy, and end-of-life care. Through semi-structured interviews with 15 nurses in Riyadh, Saudi Arabia, the research highlights the complexities of obtaining informed consent from patients with cognitive impairments and the ethical dilemmas of balancing autonomy and safety. The management of polypharmacy emerged as a significant concern, with nurses emphasizing the importance of thorough documentation and coordination among healthcare providers to prevent adverse drug interactions. End-of-life care and advance directives posed further challenges, particularly when family members disagreed with patients' documented wishes. The study underscores the need for comprehensive strategies, including ongoing education, clear communication, and supportive institutional policies, to address these issues effectively. The findings suggest that enhancing nurses' understanding of ethical principles and legal requirements is crucial for improving patient care and ensuring compliance with regulatory standards. Future research should aim to develop evidence-based guidelines to support nursing practice in managing these ethical and legal challenges. [ABSTRACT FROM AUTHOR]

This study provides a comprehensive review and comparative analysis of existing Information Flow Tracking (IFT) tools which underscores the imperative for mitigating data leakage in complex cloud systems. Traditional methods impose significant overhead on Cloud Service Providers (CSPs) and management activities, prompting the exploration of alternatives such as IFT. By augmenting consumer data subsets with security tags and deploying a network of monitors, IFT facilitates the detection and prevention of data leaks among cloud tenants. The research here has focused on preventing misuse, such as the exfiltration and/or extrusion of sensitive data in the cloud as well as the role of anonymization. The CloudMonitor framework was envisioned and developed to study and design mechanisms for transparent and efficient IFT (eIFT). The framework enables the experimentation, analysis, and validation of innovative methods for providing greater control to cloud service consumers (CSCs) over their data. Moreover, eIFT enables enhanced visibility to assess data conveyances by third-party services toward avoiding security risks (e.g., data exfiltration). Our implementation and validation of the framework uses both a centralized and dynamic IFT approach to achieve these goals. We measured the balance between dynamism and granularity of the data being tracked versus efficiency. To establish a security and performance baseline for better defense in depth, this work focuses primarily on unique Dynamic IFT tracking capabilities using e.g., Infrastructure as a Service (IaaS). Consumers and service providers can negotiate specific security enforcement standards using our framework. Thus, this study orchestrates and assesses, using a series of real-world experiments, how distinct monitoring capabilities combine to provide a comparatively higher level of security. Input/output performance was evaluated for execution time and resource utilization using several experiments. The results show that the performance is unaffected by the magnitude of the input/output data that is tracked. In other words, as the volume of data increases, we notice that the execution time grows linearly. However, this increase occurs at a rate that is notably slower than what would be anticipated in a strictly proportional relationship. The system achieves an average CPU and memory consumption overhead profile of 8% and 37% while completing less than one second for all of the validation test runs. The results establish a performance efficiency baseline for a better measure and understanding of the cost of preserving confidentiality, integrity, and availability (CIA) for cloud Consumers and Providers (C&P). Consumers can scrutinize the benefits (i.e., security) and tradeoffs (memory usage, bandwidth, CPU usage, and throughput) and the cost of ensuring CIA can be established, monitored, and controlled. This work provides the primary use-cases, formula for enforcing the rules of data isolation, data tracking policy framework, and the basis for managing confidential data flow and data leak prevention using the CloudMonitor framework. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is the predominant aetiology of dementia among the elderly population, accounting for about 60–70% of all instances of cognitive decline. Diffusion tensor imaging (DTI) is a contemporary methodology that enables the cartography of alterations in the microstructure of white matter (WM) in neurological diseases. Nevertheless, the effort of analysing substantial amounts of medical pictures poses significant challenges, prompting researchers to shift their focus towards machine learning. This approach encompasses a collection of computer algorithms that possess the ability to autonomously adjust their output to align with the desired goal. This work proposed the use of a combined approach using Hidden Markov Model (HMM) and MR-DTI, where Diffusion Tensor Imaging (DTI) is employed as a magnetic resonance imaging technique. The purpose of this method is to forecast the occurrence of AD. Furthermore, the statistical analysis demonstrated a significant correlation between microstructural WM changes with both output in the patient groups and cognitive functioning. This finding suggests that these abnormalities in WM might potentially serve as a biomarker for AD. The proposed method is named as Graphcut Hidden MorkovModel (Graph_HMM) is evaluated on ADNI database with statistical analysis and found that it achieves 99.8% of accuracy, 96.4% of sensitivity, 97.4% of specificity and 12.3% of MSE. [ABSTRACT FROM AUTHOR]