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"Mohammad, Laila"
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Turnover among Foreign Nurses in Saudi Arabia
Background: Globally, nursing turnover has become a contemporary concern that significantly influences the financial proficiency of healthcare systems. Not only costs, but healthcare accessibility and quality also reverberate the consequence of the phenomenon. Design and methods: The study explores the factors that attribute to turnover among foreign registered nurses working in Saudi Arabia. A quantitative-based cross-sectional descriptive study design that uses survey data to make statistical inferences about foreign nurse turnover in Saudi Arabia, was conducted to ascertain factors influencing the termination of foreign nurses working with the Ministry of Health (MOH) hospitals. Results: Factors influencing turnover were categorized into 9 dimensions, professional growth and development, leadership style, management, wage and benefits, workload, interpersonal relationship, housing facilities and services, hospital facilities and intent to stay and turn-over intention, of which the professional growth (4.1±0.7) and development had the highest mean agreement scores (4.0±1.1), whereas housing (2.3±1.3) and hospital facilities (2.1±1.0) showed the lowest mean scores. Conclusions: Wage benefits and workload factors were found to be the most significant causes of expatriate nursing turnover, closely followed by inadequate housing and hospital facilities. Recommendations from nursing staff on how to improve retention were also noted.
Significance for public health
The nursing workforce is considered the backbone of the healthcare delivery system. In Saudi Arabia, foreign nurses employ a large percentage of human resources required in healthcare institutions. Thus, foreign nurses’ increasing turnover rates remain a significant problem affecting healthcare institutions across the country. Staff turnover rate is the prime source of workforce shortage that impacts the operational domain, thereby negatively affecting productivity and revenues. The high turnover rates negatively impact organizational in quality of care and resources to recruit and train new staff, prompts many scholars to investigate possible causes, and to develop a comprehensive staff retention strategies. Determining associated factors on staff turn-over, provides insights that will guide facility policy makers and stakeholders to keep pace with the demand of public health system.
Journal Article
Myeloid-specific estrogen receptor α deficiency impairs metabolic homeostasis and accelerates atherosclerotic lesion development
ERα is expressed in macrophages and other immune cells known to exert dramatic effects on glucose homeostasis. We investigated the impact of ERα expression on macrophage function to determine whether hematopoietic or myeloid-specific ERα deletion manifests obesity-induced insulin resistance in mice. Indeed, altered plasma adipokine and cytokine levels, glucose intolerance, insulin resistance, and increased adipose tissue mass were observed in animals harboring a hematopoietic or myeloid-specific deletion of ERα. A similar obese phenotype and increased atherosclerotic lesion area was displayed in LDL receptor-KO mice transplanted with ERα–/– bone marrow. In isolated macrophages, ERα was necessary for repression of inflammation, maintenance of oxidative metabolism, IL-4–mediated induction of alternative activation, full phagocytic capacity in response to LPS, and oxidized LDL-induced expression of ApoE and Abca1. Furthermore, we identified ERα as a direct regulator of macrophage transglutaminase 2 expression, a multifunctional atheroprotective enzyme. Our findings suggest that diminished ERα expression in hematopoietic/myeloid cells promotes aspects of the metabolic syndrome and accelerates atherosclerosis in female mice.
Journal Article
Spreading Depolarization After Chronic Subdural Hematoma Evacuation: Associated Clinical Risk Factors and Influence on Clinical Outcome
Background
Chronic subdural hematoma (cSDH) is a common neurosurgical condition responsible for excess morbidity, particularly in the geriatric population. Recovery after evacuation is complicated by fluctuating neurological deficits in a high proportion of patients. We previously demonstrated that spreading depolarizations (SDs) may be responsible for some of these events. In this study, we aim to determine candidate risk factors for probable SD and assess the influence of probable SD on outcome.
Methods
We used two cohorts who underwent surgery for cSDH. The first cohort (
n
= 40) had electrocorticographic monitoring to detect SD. In the second cohort (
n
= 345), we retrospectively identified subjects with suspected SD based on the presence of transient neurological symptoms not explained by structural etiology or ictal activity on electroencephalography. We extracted standard demographic and outcome variables for comparisons and modeling.
Results
Of 345 subjects, 80 (23%) were identified in the retrospective cohort as having probable SD. Potential risk factors included history of hypertension, worse clinical presentation on the Glasgow Coma Scale, and lower Hounsfield unit density and volume of the preoperative subdural hematoma. Probable SD was associated with multiple worse-outcome measures, including length of stay and clinical outcomes, but not increased mortality. On a multivariable analysis, probable SD was independently associated with worse outcome, determined by the Glasgow Outcome Scale score at the first clinic follow-up (odds ratio 1.793, 95% confidence interval 1.022–3.146) and longer hospital length of stay (odds ratio 7.952, 95% confidence interval 4.062–15.563).
Conclusions
Unexplained neurological deficits after surgery for cSDH occur in nearly a quarter of patients and may be explained by SD. We identified several potential candidate risk factors. Patients with probable SD have worse outcomes, independent of other baseline risk factors. Further data with gold standard monitoring are needed to evaluate for possible predictors of SD to target therapies to a high-risk population.
Journal Article
Case of intracranial penetration of a metallic pipe through the orbit
A CT scan demonstrated that 13.3 cm of the 23 cm metallic pipe extended through his right orbit though his anterior cranial fossa, into the middle cranial fossa (figure 2). Removal of metal pipe followed by head CT scan for making decision regarding decompressive craniectomy. Following the dural opening, contused hemorrhagic temporal lobe was found to be budging out under high pressure. [...]a partial temporal lobectomy was performed, which allowed access to the tip of the metal pipe intracranially, with exposure of the frontal and temporal lobes, as well as anterior and middle fossa floors (figure 3).
Journal Article
Unusual persistent primitive trigeminal artery with a superior duplicated basilar system
A 67-year-old patient who presented with a right cerebellar hemorrhage underwent vascular workup for suspicion of underlying vascular anomalies. A diagnostic cerebral angiogram demonstrated a duplicated basilar system fed solely by a persistent primitive trigeminal artery. The findings proved to be incidental and unrelated to the patient’s hemorrhage. These developmental abnormalities are consistent with embryological development.
Journal Article
Exploring Leadership and Management in Nursing
Leadership and management have remained overlapping concepts in the minds of many. Although managers may never act as leaders, there is no management without leadership. Nurses comprise the largest workforce in health care, and leadership and management roles are fundamental aspects of formal nursing practice. Clinical and specialist teaching and learning approaches for nursing may not provide a reflective orientation to the tasks, roles, or goals of leadership and management that any nurse could face in any clinical environment. Roles for clinical leaders and managers are ripe for analysis, especially concerning the content of their actions and interactions. Nurses practice in a range of communities, in the real aspect of health care right across the continuum of need, and in all kinds of scenarios, including homes, clinics, community health centers, and hospital wards. They offer support and advice during illness and help individuals be as independent and well as possible using community resources and health care. (Health Organization, 2022)(Smiley et al.2021)Some nurses expand their clinical function and become clinical leaders and managers. Of late, there is evidence of a bias against managers and management. Clinical leaders are thought to be closer to patients, developing and providing care. This paper is aimed at providing nurses with the opportunity to explore the challenges faced by the leaders and managers of the health care sector, dissecting extensive literature inherent in what defines a leader and a manager, and a need to investigate the power and influence leaders may yield for reference in a situational context. The paper is also aimed at aiding leadership and management education, developing nurse attributes for leadership and managerial roles, and empowering and supporting the education reform agenda in the nursing profession for relevance. Moreover, it may be used by policy-making bodies to create strategic policies in health care practice. (Stanley et al., 2022)
Journal Article
Entrepreneurial Orientation towards Business Performance of Women-Owned Small and Medium Enterprises in Sabah: A Conceptual Study
Originality/value: The present study may assist related ministries and agencies involved with women entrepreneurs in formulating policies and various programs in supporting the growth and survival of businesses.
Journal Article