Ranking of E-Health Barriers Faced by Saudi Arabian Citizens, Healthcare Professionals and IT Specialists in Saudi Arabia

Many boundaries are hindering successful utilisation of e-health in the Kingdom of Saudi Arabia (KSA). We have previously proposed an integrated framework of knowledge management and knowledge discovery to overcome barriers of e-health in KSA. Our proposed framework facilitates diabetes self-management for diabetic citizens in the Kingdom. In this paper, we will investigate and rank the barriers of e-health in KSA from the prospective of three stakeholders. We designed a questionnaire which constituted of items related to eight different e-health barriers and its associated sub-barriers. Citizens participated in 51 items related to six barriers. Healthcare professionals answered 83 items related to eight barriers. IT specialists participated in 74 items related to six barriers. Within each group of respondents, we compared the mean scores for each factor and sub-factor. The highest possible score for the mean was 5.00 and the lowest was 0.00 where the higher the mean score was the more the barrier constituted an obstacle for e-health in KSA. Citizens ranked the connectivity of information system as the top barrier with the mean of 4.0 whereas the least barrier was the cultural barriers with the mean score of 3.1. Healthcare professionals ranked the connectivity of information systems as the top barriers with the mean score of 3.5 whereas the least barrier was the technical expertise and computer skills with the mean score of 2.2. The top ranked barrier from the perspective of IT specialists was the medication safety with the mean score of 3.5 and the least ranked barrier was security and privacy with the mean score of 2.2. The results showed consistency with the literature review. Our proposed framework will contribute to the successful implementation of e-health initiatives and assist citizens in KSA to self- manage diabetes.

Does the Hartman effect exist in triangular barriers

We study the phase,Larmor and dwell times of a particle scattered off triangular barriers(TBs).It is interesting that the dependences of dwell,reflective phase and Larmor times on the wave number,barrier width and height for a pair of mirror-symmetric(MS)exact triangular barriers(ETBs)are quite different,as the two ETBs have quite distinct scattering surfaces.In comparison,the dependence of the transmitted phase or Larmor times is exactly the same,since the transmitted amplitudes are the same for a pair of MS TBs.We further study the Hartman effect by defining the phase and Larmor velocities associated with the phase and Larmor times.We find no barrier width saturation effect for the transmitted and reflected times.This is indicated by the fact that all the velocities approach finite constants that are much smaller than the speed of light in vacuum for TBs with positive-slope impact faces.As for ETBs with vertical left edges,the naive velocities seem to also indicate the absence of the Hartman effect.These are quite distinct from rectangular barriers and may shed new light on the clarification of the tunneling time issues.

Assessing Barriers to Mental Healthcare Interventions for Deaf People in Ghana

While mental health issues are increasingly gaining attention in Ghana, little is known about the situation among deaf people. This study assessed the mental health care needs of deaf people in Ghana. A descriptive design, consisting of interviews and focus group discussions, was used to collect data from 97 participants. Findings indicated that participants had limited knowledge on mental health issues. Mental health stigma, inaccessible mental health information and exclusion from mental health programmes were the major barriers hindering access to mental health care services. This study bridges the knowledge gap and provides evidence for the implementation of deaf-friendly services.

Recent advances in zwitterionic nanoscale drug delivery systems to overcome biological barriers

Nanoscale drug delivery systems(nDDS)have been employed widely in enhancing the therapeutic efficacy of drugs against diseases with reduced side effects.Although several nDDS have been successfully approved for clinical use up to now,biological barriers between the administration site and the target site hinder the wider clinical adoption of nDDS in disease treatment.Polyethylene glycol(PEG)-modification(or PEGylation)has been regarded as the gold standard for stabilising nDDS in complex biological environment.However,the accelerated blood clearance(ABC)of PEGylated nDDS after repeated injections becomes great challenges for their clinical applications.Zwitterionic polymer,a novel family of antifouling materials,have evolved as an alternative to PEG due to their super-hydrophilicity and biocompatibility.Zwitterionic nDDS could avoid the generation of ABC phenomenon and exhibit longer blood circulation time than the PEGylated analogues.More impressively,zwitterionic nDDS have recently been shown to overcome multiple biological barriers such as nonspecific organ distribution,pressure gradients,impermeable cell membranes and lysosomal degradation without the need of any complex chemical modifications.The realization of overcoming multiple biological barriers by zwitterionic nDDS may simplify the current overly complex design of nDDS,which could facilitate their better clinical translation.Herein,we summarise the recent progress of zwitterionic nDDS at overcoming various biological barriers and analyse their underlyingmechanisms.Finally,prospects and challenges are introduced to guide the rational design of zwitterionic nDDS for disease treatment.

Assessment of Barriers and Challenges to the Screening and Linkages of Non-Communicable Diseases by Community Health Volunteers in Nyeri County, Kenya

Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.

Train-induced aerodynamic characteristics of vertical sound barriers influenced by several factors

Investigations into the aerodynamic properties of vertical sound barriers exposed to high-speed operations employ computational fluid dynamics.The primary focus of this research is to evaluate the influence of train speed and the distance(D)from the track centerline under various operating conditions.The findings elucidate a marked elevation in the aerodynamic effect amplitude on sound barriers as train speeds increase.In single-train passages,the aerodynamic effect amplitude manifests a direct relationship with the square of the train speed.When two trains pass each other,the aerodynamic amplitude intensifies due to an additional aerodynamic increment on the sound barrier.This increment exhibits an approximate quadratic correlation with the retrograde train speed.Notably,the impact of high-speed trains on sound barrier aerodynamics surpasses that of low-speed trains,and this discrepancy amplifies with larger speed differentials between trains.Moreover,the train-induced aerodynamic effect diminishes significantly with greater distance(D),with occurrences of pressure coefficient(CP)exceeding the standard thresholds during dual-train passages.This study culminates in the formulation of universal equations for quantifying the influence of train speed and distance(D)on sound barrier aerodynamic characteristics across various operational scenarios.

Utilizing sediment grain size characteristics to assess the effectiveness of clay–sand barriers in reducing aeolian erosion in Minqin desert area,China

The clay–sand barriers in Minqin desert area,China,represent a pioneering windbreak and sand fixation project with a venerable history of 60 a.However,studies on evaluating the long-term effectiveness of clay–sand barriers against aeolian erosion,particularly from the perspective of surface sediment grain size,are limited and thus insufficient to ascertain the protective impact of these barriers on regional aeolian activities.This study focused on the surface sediments(topsoil of 0–3 cm depth)of clay–sand barriers in Minqin desert area to explain their erosion resistance from the perspective of surface sediment grain size.In March 2023,six clay–sand barrier sampling plots with clay–sand barriers of different deployment durations(1,5,10,20,40,and 60 a)were selected as experimental plots,and one control sampling plot was set in an adjacent mobile sandy area without sand barriers.Surface sediment samples were collected from the topsoil of each sampling plot in the study area in April 2023 and sediment grain size characteristics were analyzed.Results indicated a predominance of fine and medium sands in the surface sediments of the study area.The deployment of clay–sand barriers cultivated a fine quality in grain size composition of the regional surface sediments,increasing the average contents of very fine sand,silt,and clay by 30.82%,417.38%,and 381.52%,respectively.This trend became markedly pronounced a decade after the deployment of clay–sand barriers.The effectiveness of clay–sand barriers in erosion resistance was manifested through reduced wind velocity,the interception of sand flow,and the promotion of fine surface sediment particles.Coarser particles such as medium,coarse,and very coarse sands predominantly accumulated on the external side of the barriers,while finer particles such as fine and very fine sands concentrated in the upwind(northwest)region of the barriers.By contrast,the contents of finest particles such as silt and clay were higher in the downwind(southeast)region of the sampling plots.For the study area,the deployment of clay–sand barriers remains one of the most cost-effective engineering solutions for aeolian erosion control,with sediment grain size parameters serving as quantitative indicators for the assessment of these barriers in combating desertification.The results of this study provide a theoretical foundation for the construction of windbreak and sand fixation systems and the optimization of artificial sand control projects in arid desert areas.

Impact Containment Barriers with Geotextile Tubes

Recently, tragic tailings dam collapses in Brazil have caused deaths and major destruction and the need to develop technologies capable of preventing damage to people and the environment. Brazilian tailings dams are in a situation of uncertainty due to new legislation that even requires decommissioning, an activity that involves many problems and where the risk of failure is the main one. An impact containment structure downstream of these dams can be effective and geotextile tubes, in a new approach, have emerged as an option with advantages in terms of execution, costs and safety. The technology is versatile and can bring many benefits such as the reuse of tailings or filling with low-energy or reused materials. In this research, geotextile tubes were tested as free containment barriers, experiencing impacts in reduced models. The safety factor for the stability of the structure was constructed using an equation which is the ratio between the self-weight of the barrier structure and its coefficient of static friction and the impact pressure, where the data showed an adequate correlation which suggests the viability of mitigating risks.

Effects of surface chlorine atoms on charge distribution and reaction barriers for photocatalytic CO_(2)reduction

Photocatalytic CO_(2)reduction to produce high value-added carbon-based fuel has been proposed as a promising approach to mitigate global warming issues.However,the conversion efficiency and product selectivity are still low due to the sluggish dynamics of transfer processes involved in proton-assisted multi-electron reactions.Lowering the formation energy barriers of intermediate products is an effective method to enhance the selectivity and productivity of final products.In this study,we aim to regulate the surface electronic structure of Bi_(2)WO_(6)by doping surface chlorine atoms to achieve effective photocatalytic CO_(2)reduction.Surface Cl atoms can enhance the absorption ability of light,affect its energy band structure and promote charge separation.Combined with DFT calculations,it is revealed that surface Cl atoms can not only change the surface charge distribution which affects the competitive adsorption of H_(2)O and CO_(2),but also lower the formation energy barrier of intermediate products to generate more intermediate*COOH,thus facilitating CO production.Overall,this study demonstrates a promising surface halogenation strategy to enhance the photocatalytic CO_(2)reduction activity of a layered structure Bi-based catalyst.

Analysis of the Impact of Technical Trade Barriers on the Export of Toys-Based on Analysis of Zhejiang,China

Technical barriers to trade,as a non-tariff barrier,have an increasing impact on the international market.As a major province in toy exports,Zhejiang Province’s toy export trade is therefore greatly hindered.This article aims to explore the impact of technical trade barriers on toy exports in Zhejiang Province and analyze countermeasures.Through literature review and some empirical analysis,it is found that technical trade barriers have greatly promoted the development of Zhejiang’s toy industry;however,they have also subjected it to impacts and pressures such as cost and technology.In response to the impact of technical trade barriers on toy exports,this article proposes corresponding countermeasures to avoid such barriers:firstly,establish a quality management system that complies with export product regulations to ensure that the products produced can meet international requirements and standards;secondly,reduce dependence on overseas markets;then enhance one’s own technology,and strengthen product innovation,in order to enhance the international competitiveness of the product and oneself;in addition,we should also explore diversified markets and expand the sales channels and coverage of our products.

Assessment of Barriers toward Initiating Insulin among Gestational Diabetes Pregnant Women, Diabetes Center, Hera’a General Hospital, Makkah

Background: Gestational diabetes mellitus (GDM) is one of the most common pathologies in pregnancy. Unfortunately, both clinicians and patients are often reluctant to begin insulin therapy, a phenomenon that has been known as psychological insulin resistance (PIR). Objectives: To assess the barriers of initiating insulin among GDM pregnant women. Patients and Methods: An observational cross-sectional study was conducted in the GDM clinic, Diabetes Center in Hera’a General Hospital, Makkah, Saudi Arabia in a period of 4 months. A self-administered validated questionnaire was adopted. It included socio-demographic data of women, perceived (personal, social, pharmacological, occupational and misconception) barriers towards insulin therapy and possible solutions to overcome these barriers. Results: A total of 164 pregnant women with gestational diabetes were included in the study. The age of 36.4% of them exceeded 35 years. Among personal barriers, preferring other treatment methods over insulin (56.4%) and unaware of insulin dose control method (45.4%) were commonly reported. Regarding family barriers, 23.6% reported past family experience of insulin-related complications. Concerning side effects, fear of hypoglycemia (59.4%) and fear of weight gain (50.9%) were most frequently reported barriers against use of insulin. Regarding misconceptions about insulin injections, 26% believed that insulin is addictive;the injection will continue for life. Among work-related barriers, irregular eating times during working hours and long working hours (55.2%) were barriers for insulin use. Facilitating access to healthcare services (94%), engage the patient in decision-making and development of the treatment plan (91.6%), activate virtual clinics and social media for remote follow-up (86.6%) and organize social support groups for pregnant women who use insulin to share their experiences were the most frequently reported possible solutions to initiate and commit to insulin therapy. Conclusion: Various barriers were identified against initiation of insulin therapy in the management of gestational diabetes;mostly due to personal factors, misconception and work-related factors. Prompt actions are needed to overcome these barriers.

Barriers in the Transition of Care for Heart Failure Patients Attending Clinics in Mwanza City, Tanzania

Introduction: Transition of care strategies have shown to improve quality of lives of heart failure patients, but it has little implemented in clinical settings. Objective: To evaluate context-specific perceived barriers and experiences of heart failure patients during their admission and after they were discharged from hospital. Methods: A cross-sectional qualitative study was conducted among 13 heart failure patients at two large referral hospitals in northwestern Tanzania. In-depth interviews among heart failure patients, in line with the Consolidated Criteria for Reporting Qualitative research checklist, were used to collect data. Interviews were audio recorded, transcribed, and translated into English. Results: Three key barriers were identified, as well as possible solutions that could improve the transition of care for heart failure patients. These include strengthening healthcare provider communications, organizing medication management, and assisting with follow-up appointments. Conclusion: The barriers identified are real and challenging in clinical resource- limited settings. Findings suggest they can be overcome when realistic and tailor-made interventions are in place.

Perceived Barriers to Cervical Cancer Screening Using Pap Smear Test among Women Attending Saad Abu Al Ella Hospital in Khartoum State, 2022

Background: Cervical cancer is the second common cancer among women worldwide. It is a preventable cancer, and early detection of precancerous conditions through the Papanicolaou cytology screening (Pap smear) is a key aspect of prevention;it is accepted worldwide as an efficient tool for secondary prevention. While the PS test is simple, inexpensive, and relatively reliable as a method of diagnosing cervical cancer, most women do not take the test. Therefore, this study is sought to describe the barriers to pap smear uptake among Sudanese women. Materials and Method: This total coverage observational, analytical and cross sectional, hospital-based study was conducted in Saad Abu El Ella Hospital in April 2022. The study was conducted using an anonymous questionnaire to assess the perceived barriers of 93 participants. All data were computerized using Microsoft Excel’17 and the data were described and analyzed using statistical package for social science (SPSS23). Results: The findings revealed that the mean age of the participants was 39.5 years and only 3.2% had ever undergone a pap smear test. Identified barriers were lack of information, not knowing where to go, and fear of pain. The majority, 72% are willing to routinely perform a pap smear test if well informed about it. The study also demonstrates that there is a significant correlation between perceived barriers score and willingness to perform the pap smear test (p value = 0.008), and between the perceived barriers score and the sociodemographic factors: Age (p value = 0.006), educational level (p value = 0.028) and occupation (p value = 0.040), but no association with the economic status was found (p value = 0.378). Conclusion: The detection rate is too low compared to the national target of over 70%. Therefore, more work is needed to reduce perceived barriers to cervical cancer screening by providing education/raising for popular awareness;addressing misconceptions and false beliefs;informing women about the necessity and importance of Pap smear;and health promotion using mass media such as national television, social media, radio, billboards, and newspapers and other print media.

System barriers to the provision of quality maternal health care in two regional teaching and referral hospitals in Kenya:a qualitative study

Objective:Sub-Saharan Africa accounts for 66%of global maternal deaths.In Kenya,362 maternal deaths occur in every 100000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during labor,delivery,or within 24h of delivery.This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods.Methods:A qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants'experiences.Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya.Eligible participants were nurse-midwives in charge of the maternity unit.The discussion was conducted in English,tape-recorded,and transcribed verbatim,Data were analyzed thematically,following Braun and Clarke 6-step framework.Nvivo version 7.0 computer software was used to facilitate this process.Results:Two focused group discussions each involving seven participants were conducted.The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern.Further,maternal care in the two hospitals was substandard.Themes that emerged as barriers were:inadequate supplies;inadequate obstetric knowledge and skills;shortage of nurse-midwives,and inadequate support supervision.The underlying factors include inadequate funding by the county government and high staff turnover.Conclusion:This study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care.This is mainly due to system failures and inadequate nursemidwife numbers.Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.

Investigation of the Severity of Modular Construction Adoption Barriers with Large-Scale Group Decision Making in an Organization from Internal and External Stakeholder Perspectives

Modular construction as an innovativemethod aids the construction industry in transforming to off-site construction production with high efficiency and environmental friendliness.Despite the obvious advantages,the uptake of modular construction is not booming as expected.However,previous studies have investigated and summarized the barriers to the adoption ofmodular construction.In this research,a Large-ScaleGroupDecisionMaking(LSGDM)-based analysis is first made of the severity of barriers to modular construction adoption from the perspective of construction stakeholders.In addition,the Technology-Organization-Environment(TOE)framework is utilized to identify the barriers based on three contexts(technology,organization,and environment).The Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)and LSGDM models are both implemented for the first time to analyze the severity of the barriers to modular adoption based on questionnaire results from internal and external stakeholders in an organization.Finally,in this research,in-depth insights into the severity of barriers are gained,providing a reference for construction organizations to manage modular adoption.

Open visitation in the NICU:nurses’perspectives on barriers and facilitators

Objective:This study aimed to investigate the nurses’perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units(NICUs).Methods:This is a descriptive,cross-sectional study.A total of 113 nurses employed in 3 main NICUs of Tabriz participated in the study through the census sampling method.Nurses’perspectives on open visitation and its facilitators and barriers were assessed and analyzed using the Beliefs and Attitudes toward Visitation in NICU Questionnaire(BAVNIQ)and descriptive and analytical statistics,respectively.Results:Approximately 74%of the nurses who participating in the study had a moderate perspective on open visitation.From the nurses’viewpoint,“Parents’low awareness of sensitivity and hygienic principles of the NICU”was the first(90.3%)barrier,and the 2 factors,namely,“physical structure of the ward/lack of sufficient space”and“far distance between family’s residence and the hospital/having another child,”were the second(86.8%)barrier with an equal percentage.Among the facilitating factors,“Supporting employed parents during the neonate’s hospitalization”and“providing facilities for family accommodation in the hospital”were the first(82.3%)and the second(79.6%)facilitators,respectively,for open visitation.Conclusions:The majority of NICU nurses had a moderate perspective on the family open visitation.This reluctance seems to be originated mainly from the factors inhibiting open visitation,making its implementation challenging for nurses.The perspective of the frontline staff in caring for vulnerable infants on facilitators and barriers to open visitation may help policymakers,managers,and relevant officials in decision-making and implementing new visiting policies in the NICUs.

The barriers of joining in vitro fertilization programs among infertile couples in developing countries:A scoping review

Objective:To determine the barriers of joining in-vitro fertilization(IVF)programs among infertile couples in developing countries.Methods:This study assessed infertile couples and the barriers or associated factors resulting in delayed decision-making of joining IVF program by searching databases PubMed,ScienceDirect,EBSCO,ClinicalKey,and Cochrane Library from inception until December 31,2021.Additional search strategies were snowballing literature search and citation tracking.Results:Eleven articles were included in the scoping review.The cost was the greatest barrier of joining IVF program.Limited access and lack of assisted reproductive technology centers,few qualified infertility trained staff,insufficient government support,low priority in government policy,along with sociocultural factors,such as religion and false beliefs or myths were also majorly considered to be associated obstacles.Conclusions:The main barrier associated with IVF program among infertile couples in developing countries is the high cost of the IVF services.

To explore patients’ perceptions about motivators and barriers of adherence to highly active antiretroviral therapy among people living with HIV: A qualitative study

Objective:For people living with HIV(PLHIV),strict adherence to highly active antiretroviral therapy(HAART)is the key to effective treatment and retention in human immunodeficiency virus(HIV)care.There are many factors which promote or halt the antiretroviral therapy(ART)adherence practices.Therefore,the present study aimed to examine the HAART adherence levels and to explore patients’views about barriers and facilitators to HIV treatment adherence.Methods:Semi-structured interviews were conducted among 15 PLHIV at the ART clinic of Dr.Ram Manohar Lohia Hospital,New Delhi.Interviews were audio-recorded in the local Hindi language,and bilingual experts(English and Hindi)transcribed verbatim.Qualitative data were coded for themes and subthemes and analyzed using a phenomenological approach as per thematic content analysis.Results:Feeling of hopelessness,delayed ART initiation,difficult initial phase of ART,forget to take ART on time,fear of disclosure of HIV diagnosis,lack of privacy and negative social support,and impact of lockdown due to COVID-19 were revealed as significant barriers to ART adherence.At the same time,commitment to raise and educate children,ART to increase life span,maintain oneself to be physically fit and healthy,only a single pill per day,very supportive counselors and health-care professionals,and hope to give birth to a healthy child were identified as facilitators of HIV retention.Conclusion:Understanding patient’s perception about ART adherence,its motivational and barrier factors which are directly affecting ART adherence and retention of PLHIV in HIV treatment and follow-ups are of utmost importance to improve ART adherence during HIV patient care services.

Exploring the motivation and barriers that nurses experience when enrolling for a Master’s in emergency and disaster nursing

Background:There is a growing interest in postgraduate nursing education in Saudi Arabia,including the availability of Master’s and PhD degrees in nursing.Consequently,various specialized studies in nursing have emerged,such as the Master’s in emergency and disaster nursing.However,only a limited number of studies have been conducted in Saudi Arabia to explore the factors that can have a positive or negative impact on a Master’s program from the students’perspective.Furthermore,no studies have investigated the motivation and barriers encountered by registered nurses when it comes to enrolling in a Master’s program in emergency and disaster nursing at Taif University.Methods:A qualitative descriptive approach was employed for this study.A total of 12 postgraduate nurses who had successfully obtained a Master’s degree in emergency and disaster nursing from Taif University participated in the research.Results:Two themes emerged from the analysis.The first theme centered around the motivation to enroll in the Master’s degree program,which encompassed the desire to improve knowledge and skills,enhance self-learning abilities,and achieve financial advancement.The second theme focused on the barriers faced when enrolling in the Master’s program,which included challenging admission criteria and requirements,high program costs,and difficulties in obtaining scholarships.Conclusions:This study identified several motivations and barriers related to the enrollment in a Master’s program in emergency and disaster nursing at Taif University.Therefore,it is recommended that efforts be made to increase financial support and facilitate fellowships to support students in their pursuit of this program.

Barriers to Early Pediatric Cochlear Implantation in Kenya

Background: Cochlear implantation is the best management option for children with profound hearing loss and has received no benefit from hearing aids. Early implantation for these children is associated with good speech and language outcomes. Objectives: To determine the barriers to early pediatric cochlear implantation. Methodology: A qualitative cross-sectional study was conducted at Hearing Implants Centre in Nairobi Kenya from August 2022 to February 2023. The target population was 40 children who had undergone cochlear implantation under the auspices of Cochlear Implant Group of Kenya but data was only collected from 30 of them. The remaining were ruled out because 3 were unreachable over the phone, 5 refused to participate and 2 did not meet the inclusion criteria. Results: Patient file reviews and parental telephone interviews were conducted to collect information and analyzed using Microsoft excel and presented using graphs, tables and pie charts. The analysis of the gender showed 46.67% were male and 53.33% were female. Analysis on newborn screening showed that none had it done. The mode age of hearing loss suspicion was between the ages of 2 - 3 years. The hearing loss suspicion done was done by the mothers at 20 children the reminder being 3 by the father, 1 by a family friend, 4 by the school-teacher and 2 by the child’s grandmother. A total of 17 participants noted a delayed in speech and language, 9 noted that the child did not respond to loud sounds, 4 noted that the children did not turn when called. Once hearing loss was identified, 73% saw the ENT, 17% saw a pediatrician, 7% went to see an Audiologist, and 3% saw a speech therapist. The mode age at diagnosis was 1.5 years. The mode age at implantation was 5 years. The mode time from diagnosis was 2 years. Conclusions: This study sought to investigate the barriers to pediatric cochlear implantation in Kenya. From the results it was determined that factors such as lack of newborn screening, high cost of cochlear implantation, lack of awareness have led to late cochlear implantation.