Attitudes and Stigma Toward Seeking Psychological Help Among the General Population of Makkah, Saudi Arabia.

Background and objective Depression and anxiety are among the most common mental health conditions globally, and, according to the World Health Organization (WHO), roughly 25% of people worldwide suffer from them. Serious mental diseases can cause a great deal of suffering and incapacity, lowering people's quality of life. Stigma and unfavorable attitudes toward mental illness often discourage people from seeking psychological assistance and achieving recovery from mental problems. This observational cross-sectional study aimed to investigate the attitudes of the general population of Makkah, Saudi Arabia, toward seeking psychological help, and to determine the degree to which stigma prevents individuals from seeking help. Methods An online, self-administered survey was distributed via social media platforms among the general population of Makkah between September and December 2023. Males and females over the age of 18 years living in Makkah were included. The exclusion criteria were participants who declined to participate in the study or those who were below 18 years of age. Results A total of 495 eligible participants completed the study survey. Of them, 378 (76.4%) were female, and most (390, 78.8%) were Saudi Arabian nationals. A total of 341 (68.9%) participants had symptoms of anxiety, and 319 (64.4%) had symptoms of depression. Regarding unfavorable attitudes, the scores were significantly higher among participants over 40 years of age (1.81 ± 0.46; p<0.05) and those with relatively low levels of education (1.93 ± 0.65; p<0.05). As for stigma, the scores were significantly higher among male participants (2.38 ± 0.83; p<0.05) and those with low levels of education (2.54 ± 0.8; p<0.05). Conclusion A significant negative correlation between participants' attitudes toward seeking psychological help and stigma was observed. However, in contrast, the psychological symptom scores did not significantly correlate with the participants' attitudes. Stigma scores showed significant positive correlations with depression and overall symptom scores. This research showed that stigma has a significant impact on attitudes toward help-seeking.

Assessing Medical Ethics Knowledge and Practice Among Healthcare Professionals in Al Majma'ah, Saudi Arabia.

Background The healthcare system is increasingly confronted with ethical challenges, necessitating a thorough exploration of healthcare providers' ethical knowledge and attitudes. This study aims to evaluate the ethical awareness and attitudes of healthcare providers in the Al Majma'ah region of the Kingdom of Saudi Arabia (KSA). Aim This research focuses on assessing the level of knowledge and practice regarding medical ethics among healthcare providers in a community hospital in Majmaah, KSA. Methods A comprehensive cross-sectional study was undertaken in the Majmaah governorate of Saudi Arabia. Data collection involved distributing a meticulously designed questionnaire to healthcare providers and faculty members affiliated with the College of Medicine. Subsequently, the acquired dataset underwent analysis utilizing SPSS software. Results A total of 183 participants were included in the study. The findings revealed that only 77 respondents (42.1%) considered ethical issues in their profession as extremely important. Moreover, 104 participants (56.8%) were aware of the existence of an ethics committee in their institution. A total of 113 respondents (61.7%) disagreed with the notion that ethical conduct is primarily important to avoid legal consequences, and 120 participants (65.6%) believed in the significance of in-service training on medical ethics for doctors. The study also highlighted that 100 participants (54.6%) believed that healthcare providers' opinions supersede patient preferences. However, a majority, 163 participants (89.1%), agreed that patients should be informed of any wrongdoing, contrasting with only 20 (10.9%) who disagreed. When asked about adhering to patients' wishes despite doctors' opinions, 112 (61.2%) responded affirmatively, while 71 (38.3%) disagreed. There was also a disparity in opinions regarding the necessity of obtaining consent, with 81 (44.3%) agreeing that consent is required not only for surgical procedures but also for medications or investigations. Furthermore, 137 participants (74.9%) recognized the importance of discussing ethical, social, and legal issues during clinical rounds alongside clinical aspects of patient care, while 46 (25.1%) disagreed. Conclusion Although medical ethics were introduced into the Saudi healthcare system more than a decade ago, this study underscores the ethical necessity of obtaining comprehensive informed consent prior to invasive and other medical procedures. It also highlights the significance of engaging patients in the decision-making process regarding their treatment. Well-informed patients typically exhibit higher satisfaction levels and are less inclined to pursue legal action.

Detection of male genital schistosomiasis (MGS) by real-time TaqMan® PCR analysis of semen from fishermen along the southern shoreline of Lake Malawi.

Background: Male genital schistosomiasis (MGS) is an underappreciated complication of schistosomiasis, first described in 1911. However, its epidemiology, diagnostic testing and case management are not well understood in sub-Saharan Africa. To shed new light on MGS prevalence in Malawi, a longitudinal cohort study was conducted among adult fishermen along the southern shoreline of Lake Malawi using detection of schistosome DNA in participants' semen by real-time TaqMan® PCR analyses. Methods: Upon recruitment of 376 participants, 210 submitted urine samples and 114 semen samples for parasitological tests. Thereafter, the available semen samples were subsequently analysed by real-time TaqMan® PCR. Praziquantel (PZQ) treatment was provided to all participants with follow-ups attempted at 1, 3, 6 and 12-months' intervals. Results: At baseline, real-time PCR detected a higher MGS cohort prevalence of 26.6% (n = 64, Ct-value range: 18.9-37.4), compared to 10.4% by semen microscopy. In total, 21.9% of participants (n = 114) were detected with MGS either by semen microscopy and/or by real-time PCR. Subsequent analyses at 1-, 3-, 6- and 12-month follow-ups indicated variable detection dynamics. Conclusions: This first application of a molecular method, to detect MGS in sub-Saharan Africa, highlights the need for development of such molecular diagnostic tests which should be affordable and locally accessible. Our investigation also notes the persistence of MGS over a calendar year despite praziquantel treatment.

Prospective pilot study on the relationship between seminal HIV-1 shedding and genital schistosomiasis in men receiving antiretroviral therapy along Lake Malawi.

Male genital schistosomiasis (MGS) is hypothesized to increase seminal shedding of HIV-1. This prospective pilot study assessed seminal HIV-1 RNA shedding in men on long-term ART with and without a diagnosis of MGS. Study visits occurred at 0, 1, 3, 6 and 12 months. MGS was diagnosed by egg positivity on semen microscopy or PCR of seminal sediment. After optimization of the HIV-RNA assay, we examined 72 paired plasma and semen samples collected from 31 men (15 with and 16 without MGS) over 12 months. HIV-1 RNA was detected in 7/72 (9.7%) seminal samples and 25/72 (34.7%) plasma samples. When comparing sample pairs, 5/72 (6.9%) showed HIV-1 RNA detection only in the seminal sample. Overall, 3/31 (9.7%) participants, all with MGS, had detectable HIV-1 RNA in semen while plasma HIV-1 RNA was undetectable (< 22 copies/mL), with seminal levels ranging up to 400 copies/mL. Two participants showing HIV-1 RNA in seminal fluid from the MGS-negative group also had concomitant HIV-1 RNA detection in plasma. The findings suggest that MGS can be associated with low-level HIV-1 RNA shedding despite virologically suppressive ART. Further studies are warranted to confirm these observations and assess its implications.

Preferences for Colorectal Cancer Screening Modalities Among the General Population in Saudi Arabia.

BACKGROUND: Colorectal cancer (CRC) could be a leading explanation for cancer-related death. Numerous studies have shown the benefit of early screening for colorectal cancer in reducing mortality. Screening for colorectal cancer is a rational and cost-effective strategy for reducing the incidence of colorectal cancer and related mortality. Despite endorsement by academic and healthcare organizations, patient awareness and compliance with screening are low, partly due to patient-related barriers to screening. AIM: This study aimed to explore the preferred screening method for colorectal cancer in Saudi Arabia in general. METHODS: This is a cross-sectional study conducted among the Saudi adult population from September 2021 through February 2022. A self-developed questionnaire was distributed among the population using an online platform. Data were tabulated in Google Forms, and all statistical analyses were performed using SPSS version 26 (IBM Corp., Armonk, NY). RESULTS: During this study, data from 10,781 participants were analyzed. Among them, the most preferred screening modality for colorectal cancer was the stool fecal immunochemical test (41.7%) and the most suitable (33.5%). The most commonly mentioned qualities that influenced choosing a particular screening test were "how the test was performed" (50.4%). CONCLUSION: Because the stool fecal immunochemical test is the most preferred screening modality for colorectal cancer, this study could serve as a database to aid in the implementation of a colorectal cancer screening program that meets the preferences of the general population of Saudi Arabia.

Biomphalaria pfeifferi (Gastropoda: Planorbidae) in Lake Malawi and Upper Shire River, Mangochi District, Malawi: Distribution, Genetic Diversity and Pre-Patent Schistosome Infections.

In November 2017, Biomphalaria pfeifferi, the key intermediate host for Schistosoma mansoni in Africa, was first reported in Lake Malawi, Mangochi District. Two subsequent malacological surveys in 2018 and 2019 confirmed its lacustrine presence, as well as its presence along the Upper Shire River. These surveys provided sufficient specimens for analyses of the genetic structure and a transmission assessment for intestinal schistosomiasis. A total of 76 collected snails were characterized by a DNA sequence analysis of a 650 bp fragment of the mitochondrial cytochrome oxidase subunit 1 (cox1); by size fractionation of six fluorescently labelled microsatellite loci (Bgµl16, Bgµl, Bpf8, rg6, U-7, and rg9);by denaturing PAGE; and by detection of pre-patent Schistosoma infection by real-time PCR with a TaqMan® probe. Five closely related cox1 haplotypes were identified, all present within a single location, with only one haplotype common across all the other locations sampled. No allelic size variation was detected with the microsatellites and all loci were monomorphic. Overall, the pre-patent prevalence of Schistosoma spp. was 31%, with infected snails found at several sampling locations. In this part of Lake Malawi, Bi. pfeifferi exhibits low genetic diversity and is clearly being exposed to the miracidia of S. mansoni, which is likely facilitating the autochthonous transmission of this parasite.

Exploring the opportunities and challenges to implementing interprofessional education in Saudi Arabia: a qualitative study among faculty.

Interprofessional education (IPE) has potential benefits for improving the quality of patient care, but its implementation is challenged with multiple barriers. The primary objectives of this study were to explore the challenges, benefits, and incentives to establishing IPE from the perspective of healthcare faculty at King Saud University. Forty-five faculty members attended six focus groups, each consisting of 6-8 faculty members representing the five colleges. The focus group interview guide included the benefits of and barriers to establishing IPE in this academic institution, curricular design, and the feasibility of support from the colleges and University administration. A SWOC (Strengths, Weaknesses, Opportunities, Challenges) frame work was utilized to guide the focus group discussions, and the data were analyzed inductively using thematic analysis. Three main themes emerged and were related to (i) barriers, (ii) benefits, (iii) opportunities to facilitate the introduction of IPE, and (iv) suggestions on how to implement IPE and overcome challenges to establish an IPE curriculum. Participants were generally supportive of IPE and aware of the constraints that might impede its implementation. Moreover, they identified potential barriers and incentives to promote IPE. Although participants appreciated the long-term benefits of IPE, creating a supportive environment will require the involvement of the academic community, including students, faculty members, and the University's top management.

Society's Misconceptions About Intra-articular Injections: A Cross-Sectional Study From Saudi Arabia.

Objective This cross-sectional study aimed to identify and analyze misconceptions prevalent in Saudi Arabian society regarding intra-articular injections and their sources. It also sought to explore factors influencing patients' decision-making in the context of osteoarthritis (OA) treatment. Methods A sample of 405 adult participants from various educational backgrounds residing in Saudi Arabia completed a self-administered questionnaire. The survey focused on participants' knowledge about intra-articular injections, their sources of information, and their beliefs and perceptions related to these injections. Results The study unveiled a significant lack of awareness among the participants, with almost half (48.4%) reporting no knowledge of intra-articular injections. Of all, 16.1% held misconceptions about these injections, including believing that they are painful or they liquify the bone. Participants expressed varied thoughts on the effects of intra-articular injections, with 69.6% associating them with short-term pain relief. While 60.2% disagreed that intra-articular injections could provide long-term pain relief, 65.2% believed that these injections could delay the need for surgery. The source of knowledge varied, with 34.4% relying on orthopedics and 32.5% on friends and relatives. In those who had received intra-articular injections (n = 62), 83.9% cited the desire to delay or avoid surgery as a reason. While 56.5% were very satisfied with their doctor's guidance, 46.8% expressed concerns about relying on injections in the future. Furthermore, educational levels were correlated with knowledge, highlighting the need for more accessible and tailored patient education materials. However, even among those with a university education, misconceptions persisted. Effective patient-doctor communication was associated with secondary or university education (χ² = 11.05, p = 0.011). Conclusion The prevalence of misconceptions regarding intra-articular injections in Saudi Arabia underscores the need for comprehensive patient education and improved communication between healthcare providers and patients. Addressing these misconceptions is essential for empowering patients to make informed decisions about their healthcare and enhancing the overall quality of care they receive. This study's findings have implications not only for Saudi Arabia but also for healthcare systems globally, emphasizing the significance of patient-centered care and informed decision-making.

Patients' experience of service quality in government and private hospitals in the Qassim Region, Kingdom of Saudi Arabia.

Patients' experience of the quality of healthcare services has gained momentum during the last few decades. This study aimed to assess and compare the experience of patients on the service quality in government and private hospitals in the Qassim region of the Kingdom of Saudi Arabia. A cross-sectional online survey was conducted using a Service Quality (SERVQUAL) questionnaire translated into the Arabic language to collect the responses from 381 patients who were hospitalized at government and private hospitals in the Qassim region from April 1, 2022, to March 31, 2023. The patients' overall satisfaction with the service quality showed that there were significant differences among government and private hospitals. Although the study revealed positive experiences for patients on all dimensions of service quality in both types of hospitals, private hospitals scored a higher value than government hospitals in all the dimensions of service quality. Patients' feedback on service quality can assist hospital management in identifying key quality issues encountered by the patients during their treatment and rectifying those problems to improve overall healthcare quality and thus patients' satisfaction.

The comparison of self-management group education and the standard care for patients with type 2 diabetes mellitus: An updated systematic review and meta-analysis.

To investigate the efficacy of self-management group education versus the standard care for patients with type 2 diabetes mellitus (DM). An electronic search was performed in nine databases including PubMed for selecting eligible studies. Meta-analysis was used for pooling of the results. Of 3446 records screened, we included ten studies for this systematic review and meta-analysis. Regarding assessment of effectiveness, there was a significant superiority reported in the intervention group when compared to the usual/standard care (standardized mean difference [95% confidence interval] = 0.24 [0.15; 0.32]). The intervention group had a significant reduction in the levels of hemoglobin A1C (HbA1C), fasting blood glucose, low-density lipoprotein, total cholesterol, and body mass index compared to the usual/standard care (p < 0.05). Moreover, no significant difference was observed in the levels of high-density lipoprotein, systolic blood pressure (SBP), or diastolic blood pressure (DBP) between the two groups (p > 0.05). Self-management group education interventions are recommended in patients with type 2 DM for their effectiveness in different clinical aspects.

Celiac Trunk Thrombosis a Rare Cause of Acute Abdomen. Case Presentation.

Thrombosis of the celiac artery trunk is a rare cause of acute abdominal pain which is associated with high mortality and morbidity if not diagnosed and treated early. We present an unusual case of celiac trunk artery thrombosis associated with aortic thrombosis and partial splenic infarction in a 52-year-old female who presented with acute abdominal pain. Hematological investigations failed to predict any predisposing factors. This case demonstrates the importance of considering such clinical presentation in the differential diagnosis of acute abdomen.

First Molecular Identification of Bulinus africanus in Lake Malawi Implicated in Transmitting Schistosoma Parasites.

The freshwater snail genus Bulinus plays a vital role in transmitting parasites of the Schistosoma haematobium group. A hybrid schistosome between S. haematobium and S. mattheei has been recently detected using DNA-based identification methods in school children along the Lake Malawi shoreline in Mangochi District. This finding raised the need for contemporary revaluation of local interactions between schistosomes and snails, with a particular focus on snail species within the Bulinus africanus group. In 2017 and 2018, malacological surveys sampled several freshwater sites in Mangochi District. Collected snails (n = 250) were characterised using cytochrome oxidase subunit 1 gene (cox1), with DNA barcoding of the 'Folmer' region and a rapid PCR-RFLP typing assay with double digestion with HaeIII and SacI restriction enzymes. DNA cox1 sequence analysis, with phylogenetic tree construction, suggested the presence of at least three B. africanus group taxa in Lake Malawi, B. globosus, alongside first reports of B. africanus and B. angolensis, which can be differentiated by PCR-RFLP methods. In addition, a total of 30 of the 106 B. africanus group snails (28.30%) were positive to the Schistosoma-specific screen using real-time PCR methods. This study provides new insight into the recent changes in the epidemiology of urogenital schistosomiasis as likely driven by a new diversity of B. africanus group snails within the Lake.

Organizational Factors Associated with Evidence-Based Practice Knowledge, Attitudes, and Implementation among Nurses in Saudi Arabia.

Evidence-based practice (EBP) is crucial in keeping nurses aware of the current knowledge and improving clinical decision-making. The integration of nurses' EBP competencies and organizational support has been suggested to create an effective arena in implementing EBP. The purpose of the study was to examine organizational factors influencing nurses' EBP knowledge, attitudes, and implementation and identify staff nurses' perceptions of EBP nursing leadership and hospital supports in Saudi Arabia. Data were collected from a convenience sample of staff nurses (N = 227) working in four hospitals using a cross-sectional, correlational descriptive design. Level of education (p < 0.05), EBP training (p < 0.05), unit type (ICU (p < 0.001) and ER (p < 0.01)), perceived nursing leadership (p < 0.001), and work environment (p < 0.05) supports were found significantly associated with nurses' knowledge. Magnet recognition (p < 0.01) and knowledge (p < 0.001) had significant influence on nurses' attitudes. Unit type (ER) (p < 0.05), knowledge (p < 0.001), and attitudes (p < 0.001) were associated with implementation. Encouragement to attend EBP trainings from nursing leadership was perceived by most nurses (51.1%). Nurses reported their hospitals support EBP through training (68.2%). Findings support the need for healthcare systems to create a culture that facilitates EBP implementation to enhance nurses' EBP competencies and improve patients' outcomes. Nursing managers may consider preparing nurses through education.

Evaluation of Knowledge, Awareness, and Factors Associated with Diabetes: A Cross-Sectional Community-Based Study.

Methods: A cross-sectional study was carried out for over 4 months from May to August 2020 using a self-administered, anonymous online questionnaire. All adults of both genders were invited to participate in the study. Individuals who are able to read and understand the English language were included in the study. Data were descriptively analyzed using a statistical package for social science version 26 (SPSS). Results: A total of 427 subjects responded to the questionnaires. More than half of them were male 253 (59.3%), while 174 (40.7%) were female, approximately 49% had a university degree, and 196 (45.9%) were postgraduates. The mean age of the participants was 25.7 ± 6.2 (mean ± SD). Most of them were single 230 (53.9%). The majority of the respondents 367 (85.9%) had heard of hyperglycemia, while a comparable number of 366 (85.7%) were aware of it being a lifelong disease. About 305 (71.4%) of participants knew that genetic factors were associated with hyperglycemia, and more than half of 250 (58.5%) knew that diabetes causes foot problems. There was a significant association between the cause of diabetes with income and educational status (p < 0.05) and diabetic complications with age, education, and family income (p < 0.05). Conclusion: In conclusion, there is a need for greater awareness and additional education regarding hyperglycemia among the general community in the state of Telangana, India, to reduce the incidence of diabetes and associated risk factors. Public health campaigns that encourage healthier lifestyles might help achieve this aim.

Types of Variants Among Increased Cases of COVID-19 in the Western Region of Saudi Arabia in June 2021.

Background The western region of Saudi Arabia is the most populous and diverse. This study aimed to identify the types and distribution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants causing cases of coronavirus disease 2019 (COVID-19) in this region in June 2021. Methods We conducted a cross-sectional study. All genetically tested COVID-19 patients were included. We investigated the types, distribution, and magnitude of SARS-CoV-2 variants among cases of COVID-19 in June 2021. We gathered patient demographic data, clinical profiles, and epidemiology data. Results Of 115 COVID-19 confirmed patients (mean age, 40 years), 56.5% were males and 43.5% were females. Of those vaccinated, 47.1% had received a one-dose vaccination; 52.9% had received two-dose vaccinations, and 23.6% were unvaccinated. Of those vaccinated, 72.1% had received the Pfizer BioNTech vaccine, and 16.5% had received the Oxford-AstraZeneca vaccine. The Delta variant of SARS-CoV-2 was prevalent in most (87.8%) patients. Among those infected, 28.8% reported contact with another COVID-19 case, and 19.8% reported a travel history. Most cases (68.6%) were moderate, 99.4% of patients recovered, and one patient died from COVID-19. Conclusion Most of the cases were primary infections, and the Delta variant was predominant and highly transmissible. Most COVID-19 patients were mild to moderately ill. A better understanding of the transmission and diagnosis of these variants will help in early detection and reduction of infection by application of the best preventive measures.

Cyberloafing behaviours in nursing: The role of nursing stressors.

AIM: To assess the prevalence of minor and serious cyberloafing behaviours among nurses and examine the impact of the nursing stressors on nurses' cyberloafing behaviours. BACKGROUND: Cyberloafing could have a negative influence on employees' job performance, but it also has been argued that it could serve as a coping mechanism to deal with stressful work environments. DESIGN: A cross-sectional descriptive, correlational design. METHODS: Data were collected between September and December 2020 from a convenience sample of staff nurses (N = 291) providing care at a tertiary hospital in Saudi Arabia. Sample characteristics, nursing stressors and cyberloafing behaviours information were collected using self-reported questionnaires. Descriptive, bivariate and multivariate analyses were performed. FINDINGS: Nurses in Saudi Arabia exhibited low levels of minor and serious cyberloafing behaviours. However, they engaged more frequently in minor cyberloafing behaviours more than serious cyberloafing behaviours. Stressors and Internet usage frequency influenced the frequency of minor and serious cyberloafing behaviours. Level of education and nationality impacted serious cyberloafing behaviours only. CONCLUSION: Nursing stressors were associated with cyberloafing behaviours. Other studies on cyberloafing and job stress yielded inconsistent results. Efforts should be taken to avoid the adverse effects of cyberloafing by establishing a clear policy on using the advanced technology for non-work purposes.

Prevalence, Beliefs, and the Practice of the Use of Herbal and Dietary Supplements Among Adults in Saudi Arabia: An Observational Study.

Background and Aim: Alternative treatments for respiratory disorders attempt to prevent or relieve symptoms and enhance functions. Furthermore, substantial evidence shows that several herbal medicines have been clinically effective against respiratory disorders. Thus this study assesses the Saudi students' use, beliefs, and practices related to herbal and dietary supplements for the possible prevention of respiratory infections. Methods: A cross-sectional web-based survey was designed using Google Forms to collect the data from the healthcare and non-healthcare students currently pursuing their courses at King Saud University, Riyadh, Saudi Arabia. The data was collected over 4 months, from November 2021 to February 2022, using convenience sampling with a 25-item questionnaire. A statistical package for social sciences, SPSS 26, was used to analyze the data. Results: A total of 274 participants responded to the study. The mean age of the respondents was 21.9 ± 3.08 (mean (SD)). The prevalence of herbal medicine (HM) was found to be 62.7% (n = 172). Around 48.5% (n = 133) of the respondents occasionally used some form of HM during the period of an illness associated with a respiratory infection. About 66% of the respondents agreed that using HMs prevents or controls respiratory symptoms and strengthens immunity. A majority (75.2%) of the respondents agreed that ginger extract possesses antiviral and immunity-boosting properties, followed by garlic extract (59.5%), cinnamon (39.4%), and lemongrass (38.3%). In addition, between 37% and 45.6% of the respondents agreed that vitamin C and vitamin D intake helps in boosting immunity and reducing the likelihood of developing respiratory infections. The overall mean of the positive beliefs and practice score was 9.6 (range 0-14). The mean positive beliefs and practice scores were significantly higher for males (11.4 ± 3.2) compared to females (8.6 ± 3.6) (P < .001). The numbers were not significantly different regardless of the source of information (9.6 ± 3.5), respondents being in health colleges (8.9 ± 4.1) or non-health colleges (9.8 ± 3.7), them being previously or currently infected (9.7 ± 3.8), the absence of infection (9.7 ± 3.8), or the respondents possessing a history of chronic diseases (10.5 ± 3.9) or not (9.5 ± 3.7) (P > .05). Conclusions: This study found a relatively high prevalence of herbal and dietary supplements' use, positive beliefs, and practices to strengthen one's immunity against respiratory symptoms.

TransVis: Integrated Distant and Close Reading of Othello Translations.

Studying variation among time-evolved translations is a valuable research area for cultural heritage. Understanding how and why translations vary reveals cultural, ideological, and even political influences on literature as well as author relations. In this article, we introduce a novel integrated visual application to support distant and close reading of a collection of Othello translations. We present a new interactive application that provides an alignment overview of all the translations and their correspondences in parallel with smooth zooming and panning capability to integrate distant and close reading within the same view. We provide a range of filtering and selection options to customize the alignment overview as well as focus on specific subsets. Selection and filtering are responsive to expert user preferences and update the analytical text metrics interactively. Also, we introduce a customized view for close reading which preserves the history of selections and the alignment overview state and enables backtracing and re-examining them. Finally, we present a new Term-Level Comparisons view (TLC) to compare and convey relative term weighting in the context of an alignment. Our visual design is guided by, used and evaluated by a domain expert specialist in German translations of Shakespeare.

A Qualitative Investigation of Factors Affecting Saudi Patients' Communication Experience with Non-Saudi Physicians in Saudi Arabia.

(1) Background: Communication is the main issue between the patient and physician. Communication gaps lead to medical errors, mistakes, and wrong diagnoses and treatments. It would certainly be a cause of patient dissatisfaction, the physicians' job dissatisfaction, and the increase in the cost of health services. (2) Objectives: The objective of the study was to explore the perception of Saudi patients when they meet non-Saudi consultants at hospitals. (3) Material and Methods: This study is exploratory in nature. Semi-structured face to face interviews were conducted. Study participants were patients from the outpatient department of the Hospitals of Qassim province, Saudi Arabia. A total of eight respondents, four male and four female, participated in the study. (4) Results: Interviews were transcribed verbatim and analyzed using a thematic analysis approach. Two main themes emerged: the first theme is encountering difference, with three sub-themes, while the second one is the absence of partnering, with four sub-themes. (5) Conclusions: The analysis of the patients' experiences of their medical encounters revealed that the effectiveness of the physician-patient communication was jeopardized by two challenges: encountering differences and the absence of partnering. (6) Limitations: This study was conducted in one site only and hence findings must be tested in application to other sites in other parts of Saudi Arabia and in other similar countries. A further limitation of this study was the cultural barrier that was encountered by the researcher during the interview process.

Impact of Illness Perception on the Health-Related Quality of Life of Patients Receiving Dialysis: A Cross-Sectional Study.

Background End-stage renal disease (ESRD) is a major health problem worldwide that is increasing in incidence, prevalence, and cost. Both the disease itself and negative illness perceptions negatively affect patients' health-related quality of life (HRQoL), morbidity, and mortality. This study assessed the relationship between illness perception and HRQoL. Methods This cross-sectional study was conducted among 342 patients at five dialysis centers in Jeddah, Saudi Arabia. We used a self-administered questionnaire that containing demographic questions, the Revised Illness Perception Questionnaire, and the Short Form 36 Health Survey Questionnaire. The data were analyzed using t-tests, analyses of variance, Pearson's correlation coefficients, and multiple linear regression analyses. Results The mean (SD) age was 46.1 (16.5) years and the majority were men (53.8%). Except for treatment control, all domains of illness perception were significantly correlated with HRQoL; however, the correlations were positive only for personal control and illness coherence. Identity, disease timeline (acute/chronic), consequences, illness coherence, and emotional representations were independent predictors of HRQoL; together explaining 35% of the variance. Lower emotional response was the only domain of illness perception significantly associated with better HRQoL in both dialysis modalities across all dialysis centers. Conclusion There were clear effects of illness perception on HRQoL, with emotional representations being the strongest predictor. As such, emotional representations should be targeted in interventions.