Riyadh Region Research Articles

Religious Mosque Leaders (Khateebs): Awareness, Perceptions, Practices and Attitude towards Mental Health, Riyadh Region, Saudi Arabia

Background: Mosques are the most holy places in the eyes of Allah-Exalted and Glorified, and the religious mosque leaders (Khateebs) who read 15-20 minutes Khutbah prior to Friday Prayers have great knowledge in religion of Islam and are considered the peace-building leaders through delivering the pertinent Friday sermons around the world.
 Objective: This online consenting cross-sectional survey explored the mental health awareness, perceptions, attitudes and practices of Khateebs of Riyadh region, Saudi Arabia.
 Methods: This survey used 14-items self-designed culturally competitive questionnaire and sociodemographic proforma to tap religious mosque leaders’ knowledge, perceptions, practices and attitude towards mental health.
 Results: Majority of mosque leaders were middle aged with higher education and extensive experience as a model of true interlocutor (Khateeb). Their knowledge and practices revealed were replete with religious and spiritual healing approaches but religious mosque leaders did not completely overlook the role of psychiatric medications and mental health professionals in the management of mentally ill persons. However, religious mosque leaders showed some negative attitudes towards patients with mental disorders, and recommended 10 corrective guides including integration of mosques and religious leaders into mental health system.
 Conclusion: Despite mosque leader’s good mental health literacy, they need further training to plug certain loopholes traced in their mental health literacy. Researchers should conduct further similar research overcoming the caveats of this survey not only in Saudi Arabia but also globally in Muslim world.

Development of low concentrated solar photovoltaic system with lead acid battery as storage device

Energy storage system powered by renewable energies is a viable option to meet energy requirement without addition of carbon footprints to the environment. This study involves development of theoretical and computational models for a solar photovoltaic (PV) system coupled with a lead acid battery. The study commenced with selection of most appropriate lead acid battery and PV system for installation in a representative location in Riyadh, Kingdom of Saudi Arabia. Various technical and economic parameters were assessed and calculated by computational approach. The optimized lead acid battery was integrated with low concentration solar PV panels (CPV) followed by a feasibility study. Theoretical model was developed for the integrated system to calculate various parameters of the CPV and lead acid battery. Technical and economic assessment of this coupled unit was calculated using a theoretical approach. The developed model was then subjected to computational approach for verification and validation analysis of the integrated system. The detailed assessment of batteries and integrated system show the applicability of this system in Riyadh region. The research will be extended to develop energy storage systems for remote areas using lead acid batteries.

The Incidence Rate of Liver Cancer in Saudi Arabia: An Observational Descriptive Epidemiological Analysis of Data from the Saudi Cancer Registry (2004-2014).

ObjectiveThis study describes the epidemiological pattern of liver cancer in all regions of Saudi Arabia. It explores the frequency of cases diagnosed, the age-specific incidence rate (AIR), the crude incidence rate (CIR), and the age-standardised incidence rate (ASIR) stratified by age group, year of diagnosis, and region.MethodsA retrospective descriptive epidemiological analysis of all liver cancer cases documented in the Saudi Cancer Registry (SCR) between 2004 and 2014 was performed. The data were analysed using descriptive statistics, t-test, Kruskal–Wallis, and sex ratio with the Statistical Package for the Social Sciences version 20.0 (SPSS).ResultsA total of 4723 liver cancer cases were registered in the SCR between January 2004 and December 2014. The highest overall ASIR of liver cancer among Saudi males was observed in the regions of Riyadh, Najran, and Tabuk at 10.4, 7.7, and 7.0 per 100,000 males, respectively. Furthermore, Riyadh, Eastern Region, and Tabuk recorded the highest overall ASIR among Saudi females at 4.9, 2.8, and 2.6 per 100,000 females, respectively. Jazan had the lowest overall ASIR (1.7 per 100,000 males) of liver cancer among male Saudis, while the Northern region and Baha had the lowest overall ASIR (0.6 and 0.9 per 100,000 females, respectively) of liver cancer among female Saudis. However, the overall ASIR of liver cancer was statistically higher in males than females (P-value <0.05), and the overall male-to-female ratio in ASIR of liver cancer in Saudi Arabia was 2.4 per 100,000.ConclusionThere was a slight increase in the CIRs and ASIRs of liver cancer in Saudi Arabia between 2004 and 2014. Riyadh, Najran, and Tabuk were the areas most affected by liver cancer among Saudi males, and Riyadh, Eastern Region, and Tabuk among female Saudis. The areas least affected by liver cancer were observed in Jazan among Saudi males, and the Northern region and Baha among Saudi females. The rates of liver cancer in Saudi Arabia were significantly higher among males compared with female Saudis.

Decision making process by senior residents of Saudi Board in restorative dentistry for nonsurgical endodontic retreatment: A retrospective study

BackgroundDespite the general guidelines for retreatment, differences in decision making exist for secondary endodontic treatment and may be related to many factors including education, clinical experience, dentist specialty, patient preferences and economic resources. Aim of the study was to evaluate the decision making of the Saudi Board in Restorative Dentistry (SBRD) senior residents in the endodontic retreatment of molar teeth as per the scientific guidelines of the American Association of Endodontists (AAE) and also to identify the causes of retreatment and measure how far they become deviated from their taught retreatment principles and inter-individual variability. Materials and methodsCase histories have been obtained from the files of cases treated in the SBRD Resident Comprehensive Case Archives in the SCHS from 2003 to 2015 in Riyadh region. The cases were only confined to Complex I and Complex II cases according to RDITN (Restorative Dental Index of Treatment Need), and seen by R3 and R4 residents only. Residents’ diagnosis was recorded as well as their treatment plan and any given notes regarding their decisions to retreat. Differences between the two groups (R3 and R4) residents and within the same group, regarding endodontic retreatment decisions and reasons for their treatment options were analyzed using Chi-Square test and Fisher’s Exact test. ResultsThe majority of residents in both R4 and R3 groups followed the recommended guidelines. R3 residents preferred to retreat all cases while R4 chose ‘no to retreat’ in few cases. Although R4 residents preferred nonsurgical retreatment more than R3 residents, the difference was insignificant. R4 residents preferred ‘no therapy’ or ‘follow up’ more frequent than R3 residents. Members of the R3 residents agreed more or less with each other as did those of the R4 residents without significant inter-individual variations within each group regarding the choice of retreatment). ConclusionsR4 residents appeared more likely, although not significant, to choose no retreatment or follow up than R3 residents. Conventional nonsurgical retreatment had the highest selection by both R3 and R4 residents. No significant inter-individual variations within each group regarding the choice of retreatment. There is a need to establish evidence based guidelines for more uniform management of failed root treated teeth.

A prospective Saudi dental stem-cell bank from the perspective of the public and dental practitioners: A cross sectional survey.

Objectives:The aim of this study (1) To evaluate the Saudi public's knowledge and attitude on dental stem cells (DSC) for therapeutic/banking purposes, (2) To evaluate the perception of Saudi dentists towards DSC and their attitude towards banking of DSC.Methodology:This was a cross-sectional study based on an electronic survey distributed through the social media nationwide among the Saudi public, and through paper-based surveys among dentists in Riyadh. By convenience, eligible study participants were Saudi adults from the community and dentists from 17 dental centers in different regions of Riyadh. Using SPSS v. 25, descriptive statistics (n,%; PMS ± SD) and bivariate analyses (Pearson's Chi square, Mann Whitney) were conducted to determine factors associated with the study outcomes, with a P value statistically significant at <0.05.Results:For the Saudi public, 1494 participants completed the survey. The PMS ± SD of public knowledge was 25.5 ± 25.9, while their attitude was 80.2 ± 27.0. Factors associated with higher knowledge scores were younger age groups, while female participants, older age groups, university educated and employed participants had higher attitude. For Saudi dentists, 246/262 (94%) dentists responded to the questionnaire. Their PMS ± SD of perception towards DSC research for regenerative purposes was 74.5 ± 15.6. Factors associated with higher perception scores were those with more experience. Dentists who had higher perception scores towards DSCs were significantly more willing to save teeth for regenerative dental treatment.Conclusion:The Saudi public community had poor knowledge about the therapeutic and research benefits of DSC, yet high degree of attitude to enroll in a future Saudi DSC bank. Saudi dentists had moderately high levels of perception towards DSC research.

Previous Involvement in Research and Knowledge Regarding Basic Research Methods Among Doctors Working at Primary Care in Central Region, Saudi Arabia.

Introduction:The cumulative outcomes of health research in the modern times had a huge effect on human health and longevity. The primary care physicians are the first point of contact between the health system and the society. Therefore their responsibility is higher to provide the latest information to their patients, in the context of rapidly changing field of medical science. Doctors are expected to have a basic knowledge of research methodology in order to develop a critical thinking and this is the rationale to include the research activity is an integral part of post-graduate medical training.Aim:We aimed to assess the previous involvement in research activities and knowledge in basic research methods among primary care physicians in central region, Saudi Arabia.Methods:It was a cross sectional descriptive study conducted on a conveniently selected sample of doctors (N=80) working under general directorate of health affairs in Riyadh region, Ministry of Health. The data was collected through a pre-designed, self-administered survey instrument containing closed ended questions.Results:The mean age of the physicians was observed to be 44.7 ± 9.6 years. About 32% doctors had previous experience of writing a research proposal while only 20% had any publication in a scientific journal. About 45% had attended workshop on research methodology within last five years. Only one item related to ‘consent in medical research’ was answered correctly by 60% respondents. The correct responses in other knowledge items scored less than 50% (ranging from 18.8% to 37.5%). The proportion of doctors having any publication was observed to significantly higher among younger age (p<0.05). Significantly higher proportion was observed for “having experience of proposal writing” and “paper presentation in a scientific conference” among family medicine and other specialties as compared to general practice (p<0.05).Conclusion:We found low previous engagement with research among doctors with low level of knowledge regarding basic research methods. This was particularly evident among general practitioners as compared specialist doctors. Regular conduction of research workshop with encouragement to undertake small research activities at the primary care should be promoted.

Knowledge, Attitude, and Practice of Pediatricians and Family Physicians about Early Childhood Caries in Riyadh City

ABSTRACT Introduction Early childhood caries (ECC) has an impact on deciduous teeth of infants and children. Pediatricians and family physicians are often in a better position to evaluate children at an early age and are capable of assessing the oral health of children during regular visits. The purpose of this study was to assess the knowledge, attitude, and practice of ECC among pediatricians and family physicians in Riyadh region. Materials and methods A close-ended self-administered questionnaire was hand-circulated and mailed to pediatricians and family physicians in 5 tertiary hospitals in Riyadh (King Khalid University Hospital, King Saud Medical City, King Fahad Medical City, Prince Sultan Medical Military City, Security Forces Hospital) to assess the knowledge, attitude, and practice (KAP) about ECC. Results A total of 207 medical practitioners participated in the study. The mean KAP scores were compared across different categories by applying Kruskal Wallis tests. Pediatricians showed higher knowledge [5.05 vs 4.28, p = 0.000], attitude [2.38 vs 2.30, p = 0.565], and practice [4.0 vs 3.58, p = 0.003] scores toward early childhood caries compared to the family physicians. The mean knowledge and practice scores were significantly higher among pediatricians compared to the family physicians. However, no significant difference was observed in attitude scores. Conclusion Most of the physicians have knowledge regarding some aspects of early childhood caries but not the identification of early childhood caries. It is the need of the hour to formulate oral health information programs catering to both pediatricians and family physicians. How to cite this article Alshammari TM, Ingle NA, Baseer MA, et al. Knowledge, Attitude, and Practice of Pediatricians and Family Physicians about Early Childhood Caries in Riyadh City. J Oral Health Comm Dent 2020;14(2):54–61.

Awareness of adult population toward palpitation and its risk factors in Riyadh region, Saudi Arabia

Awareness of adult population toward palpitation and its risk factors in Riyadh region, Saudi Arabia

Knowledge and attitude among dental interns toward the conservative approach for incipient decay in Riyadh Region

Knowledge and attitude among dental interns toward the conservative approach for incipient decay in Riyadh Region

Hospital-based surveillance of influenza A(H1N1)pdm09 virus in Saudi Arabia, 2010-2016.

ABSTRACTBACKGROUND: Influenza is a highly contagious acute viral respiratory tract infection. The emergence of influenza A(H1N1)pdm09 in 2009 caused a pandemic. Since then it has become a seasonal influenza virus. It causes symptoms ranging from mild to severe illness, which might be fatal, particularly in people with underlying chronic medical conditions, immunocompromised people, the elderly, and pregnant women.OBJECTIVE: Describe the data generated by the influenza A(H1N1) pdm09 surveillance in Saudi Arabia from 2010 to 2016.DESIGN: Retrospective, descriptive.SETTING: Hospitals reporting to the Ministry of Health.MATERIALS AND METHODS: We studied aggregate data on hospitalized cases of influenza A(H1N1)pdm09 in Saudi Arabia between 2010 and 2016. The surveillance system used the case definition proposed by the WHO. The cases were confirmed by performing the real-time PCR (polymerase chain reaction) on upper respiratory samples.MAIN OUTCOME MEASURES: Suspected and confirmed influenza A(H1N1)pdm09 cases.SAMPLE SIZE: 113 502 suspected H1N1 cases and 17 094 (15.1%) confirmed cases.RESULTS: Most of the reported cases were registered in the Riyadh region. During the period of the study, the highest number of confirmed cases, 9262 (54.2 %), was in 2015. The case fatality rate for confirmed cases was 3.6%.CONCLUSION: Influenza A(H1N1)pdm09 showed seasonal trends. The number of suspected influenza cases each year was proportionate to the number of confirmed cases for that year. Riyadh, Jeddah and the Eastern areas (regions with the highest population) reported most of the cases.LIMITATION: Only one strain of H1N1 was tested.CONFLICT OF INTEREST: None.

Estilo de liderazgo y motivación de los empleados: un estudio del ambiente de trabajo de Arabia Saudita

Leaders motivate employees through setting in place structures aimed at taking full advantage of employee’s potential, organization resources and providing direction. Conversely, they can severely cause difficulty in inspiring confidence, buying into firm’s goals, promoting alignment and fostering collaborative environment. Therefore, this research aims at investigating relationship leadership style and motivation of employees. An intensive review of literature has been conducted highlighting employee motivation, leadership style (Authoritarian, Paternalistic, Transformational, Laissez-faire). The data were collected through questionnaire which was distributed to government employees working in Alkharj (Riyadh region) and 130 valid responses were received. SPSS 22 was used to carry out statistical analysis and the results indicated an overall positive significance of leadership styles and motivation. The overall impact of leadership styles together on motivation was found as 66.5% (R 2 =0.665). The unique effects of each Paternalistic, Transformational and Laissez-faire style on motivation was found positive and significant. Whereas, the relationship between authoritarian leadership style and motivation was found insignificant. It is recommended that leaders in Saudi Arabia work environment must follow paternalistic and transformational leadership styles to enhance motivation level of their employees.

Determine Relief and Morphometric Proprieties of Wadi Al Aysen Drainage Basin in Riyadh Region

Determine Relief and Morphometric Proprieties of Wadi Al Aysen Drainage Basin in Riyadh Region

The Relationship between Nurses Job Satisfaction and Organizational Commitment

Nurses satisfaction has been linked to and impacted on many issues in the health care system, such as the outcome of care, patient satisfaction and organizational commitment. Organizational commitment and job satisfaction are attitudes related to jobs that have received considerable attention from researchers worldwide. Nurse role considered as very important to provide health care for patient with respect the improving the quality of care in health institutions. This study aimed: To assess the relationship between nurse's job satisfaction and organizational commitment in Saudi hospitals. Study design: A quantitative descriptive correlational survey of registered nurses (RNs) in Riyadh region. The data collection tools: Satisfaction Questionnaire and the Organization Commitment Questionnaire. Result: The study shows the correlations between nurse's job satisfaction and each dimension of organizational commitment were examined using the Pearson Correlation Coefficient. The correlation between nurse's job satisfaction and Affective commitment was positive and significant (r=0.636), Continue commitment (r=0.654) and Normative commitment (r=0.723) with (p<0.0) which means that nurses who are satisfied with their job have organizational commitment.

Saudi English Teachers’ Perception of their Own Pronunciation and Use of Teaching Practices of Pronunciation Skills

This descriptive quantitative analytical study sought to investigate English pronunciation skills of English language teachers themselves, who often neglect to teach this skill owing to lack of availability or awareness about pronunciation teaching practices. This study filled the gap of identifying the right teaching pronunciation practices as well as examining teachers' own pronunciation skills. This study investigated pronunciation practices of 67 EFL school teachers at Az Zulfi, a small city in the Riyadh region of Saudi Arabia. This study investigated how they taught pronunciation, and their priorities regarding pronunciation; what factors affected their teaching of pronunciation; how they perceived pronunciation, and whether they felt confident and skilled enough to teach and develop it. To collect data, we used an online Google form questionnaire, which was subjected to SPSS analysis. The study uncovered the following results: a) the majority of the EFL teachers in the sample considered pronunciation an essential skill in learning English, b) the teachers stated that communicative practice is the best way to teach pronunciation, c) the teachers considered both segments and supra segments in their teaching, d) audio/visual labs may enhance the teaching of pronunciation, and e) and the majority the teachers were certain that they needed to complete more training courses. The study suggests that future researches should consider larger number of teachers. Besides it would better to use more than one research tool for data collection.

A Comparison of Pre-Hospital Emergency Medical Services’ Response and Duration Times in Urban versus Rural Areas of Saudi Arabia

Background Response impacts on treatment outcomes, particularly for time-sensitive illnesses, including trauma. This study compares key outcome measures for emergency medical services (EMS) operating in urban versus rural areas in the Riyadh region of Saudi Arabia. Methods A cross-sectional study of EMS users was conducted using a random sampling method. Primary outcome measures were response time, on-scene time, transport time interval and survival rates. Secondary outcomes were the length of stay in the intensive care unit and hospital. Data were compared between the urban and rural groups using the t-test and chi-square test. Results Eight-hundred patients (n=400 urban, n=400 rural) were included in the final analysis. Cases in rural areas had significantly higher response times and duration times (median response 15 vs. 22 minutes, median duration 43 vs. 62 minutes). Response times were significantly longer for rural areas for MVC, industrial accidents, medical incidents and trauma, but there was no significant difference in duration time for industrial accidents. While urban areas had significantly shorter response times for all incident types, there was no difference with rural areas in duration time for chest injury, gastrointestinal, neurological or respiratory problems. Conclusion The findings indicate that response time and duration differs between urban and rural locations in a number of key areas. The factors underlying these differences need to be the subject of specific follow-up research in order to make recommendations as to the best way to improve EMS in Saudi Arabia and to close the gap in rural and urban service delivery.

Tuberculosis in Saudi Arabia: Prevalence between Saudis and Non-Saudis from 2013 to 2018 with a special concern about regions of the KSA

The Kingdom of Saudi Arabia is one of the largest Arab countries with a moderate annual problem of tuberculosis that is either pulmonary or extra-pulmonary. TB is still one of the most significant health troubles in the KSA, affecting different nationalities (Saudis, non-Saudis), ages, provinces, and genders. The control of TB still faces some challenges in different provinces of the KSA. Data were collected, arranged, analyzed and presented in tables and figures. In this retrospective study, we appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). Data were handled using Microsoft Excel and SPSS version 23. Data were checked for normality using Shapiro-Wilk normality test at 0.05 levels to determine whether they are parametric or nonparametric. Chi-squared, Kruskal Wallis, and analysis of variance tests were used to evaluate trends at a significance level of p&lt; 0.05. Statistical analyses were performed using IBM-SPSS version 23 for Mac OS. We appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). The data included the region of the country (province), age, sex, and nationality (Saudis, non-Saudis). The study evaluated the impact of TB on various nationalities (Saudis and non-Saudis), age groups (0-14, 15-34, 35-55, more than 55 years old), and genders (males and females). Non-Saudis had a higher incidence rate than Saudis in 2013-2018. The number of cases and incidence rates of TB recorded in males between 2013 to 2018 were about two to three times greater than estimates for females. The Makkah, Riyadh, and Jeddah regions attract enormous numbers of non-Saudi migrant workers, who account for ~60% of all TB cases in the KSA. Assessing the main TB risk factors contributing to high TB rates in non-Saudi workers is essential. Furthermore, periodical accurate studies, including evidence-based studies for optimum surveillance, avoidance, spread risk, inspection, control procedures and treatment of TB, should be conducted. These assessments would lead to evaluating the strengths and weaknesses of KSA-NTP’s TB action plan.

Climate factors and incidence of Middle East respiratory syndrome coronavirus

BackgroundOur understanding of climate factors and their links to the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreaks is incomplete. This study aimed to estimate the monthly incidence of MERS-CoV cases and to investigate their correlation to climate factors. MethodsThe study used aggregated monthly MERS-CoV cases that reported to the Saudi Center for Disease Prevention and Control from the Riyadh Region between November 1, 2012 and December 31, 2018. Data on the meteorological situation throughout the study period was calculated based on Google reports on the Riyadh Region (24.7136°N, 46.6753°E). The Poisson regression was used to estimate the incidence rate ratio (IRR) and its 95% confidence intervals (CI) for each climate factor. ResultsA total of 712 MERS-CoV cases were included in the analysis (mean age 54.2±9.9 years), and more than half (404) (56.1%) MERS-CoV cases were diagnosed during a five-month period from April to August. The highest peak timing positioned in August 2015, followed by April 2014, June 2017, March 2015, and June 2016. High temperatures (IRR=1.054, 95% CI: 1.043–1.065) and a high ultraviolet index (IRR=1.401, 95% CI: 1.331–1.475) were correlated with a higher incidence of MERS-CoV cases. However, low relative humidity (IRR=0.956, 95% CI: 0.948–0.964) and low wind speed (IRR=0.945, 95% CI: 0.912–0.979) were correlated with a lower incidence of MERS-CoV cases. ConclusionThe novel coronavirus, MERS-CoV, is influenced by climate conditions with increasing incidence between April and August. High temperature, high ultraviolet index, low wind speed, and low relative humidity are contributors to increased MERS-CoV cases. The climate factors must be evaluated in hospitals and community settings and integrated into guidelines to serve as source of control measures to prevent and eliminate the risk of infection.

Lysimeter-Based Water Use and Crop Coefficient of Drip-Irrigated Potato in an Arid Environment

The determination of the water requirements and crop coefficient (Kc) of agricultural crops helps to create an appropriate irrigation schedule, and with the effective management of irrigation water. The aim of this research was to estimate the water requirement, Kc, and water-use efficiency (WUE) of potato using non-weighing-type lysimeters in four regions of the Kingdom of Saudi Arabia (Qassiem, Riyadh, Al-Jouf, and Eastern). Our results clearly show that the accumulated values of the measured crop evapotranspiration of potato derived from the lysimeters were 573, 554, 592, and 570 mm, while the accumulated values of the predicted crop evapotranspiration from Penman-Monteith equation based on FAO (Food and Agriculture Organization) were 651, 632, 672, and 647 mm for the Qassiem, Riyadh, Al-Jouf, and Eastern regions, respectively. The Kc values of potato obtained from the lysimeters were Kc initial (0.58, 0.54, 0.50, and 0.52), Kc middle (1.02, 1.05, 1.13, and 1.10), and Kc end (0.73, 0.74, 0.74, and 0.75) for the Qassiem, Riyadh, Al-Jouf, and Eastern regions, respectively. Based on the amount of water used and the yield achieved, the highest WUE (3.6 kg m−3) was observed in the Riyadh region, while the lowest WUE (1.5 kg m−3) was observed in the Al-Jouf region.

The relationship between TQM and SMEs’ performance

PurposeThe purpose of this paper is to empirically test the association between total quality management (TQM) and small and medium enterprises’ (SMEs) performance. In particular, it examines whether organizational culture (OC) has a mediating effect on the TQM–SME performance relationship.Design/methodology/approachThe conceptual model for this study was developed based on the literature review of TQM, OC and SME performance. As the research framework, a self-administered questionnaire was used to collect data from managers/owners of SMEs in the Riyadh, Mecca and Eastern regions of the Kingdom of Saudi Arabia. The instrument was evaluated for its validity and reliability. A structural equation model was designed to examine the relationships, using PLS 3.0.FindingsStatistical outcomes add to the literature through displaying a positive direct effect of TQM and OC on SMEs’ performance, and a significant and positive indirect effect of TQM on SMEs’ performance through OC.Research limitations/implicationsThe quantitative cross-sectional research design investigated a sample of manufacturing SMEs. Future research could use qualitative techniques or a case study approach for further information analysis.Practical implicationsThe findings of this research provide insights into SMEs’ owners/managers in today’s dynamic manufacturing environment, focussing on TQM as a mechanism for improving their performance. The results can help SMEs by providing guidance on OC, because of its effect on the successful implementation of TQM, therefore improving the level of performance.Originality/valueThe research extends the literature of TQM with a comprehensive understanding of TQM from the perspective of SMEs in Saudi Arabia. It fills the gap in empirical studies that investigate the joint effect of TQM and OC on SMEs’ performance. This paper highlights the theoretical contribution and managerial implications as well as making recommendations for future research.

Trends in implant dentistry: Implant systems, complications and barriers in Riyadh, Saudi Arabia.

Patients who are partially dentate or edentulous can receive both conventional and implantsupported fixed prostheses, which leads to improvement in function, esthetics and self-esteem. Currently, implant dentistry is one of the fastest-growing disciplines in dentistry. The aim of the study was to assess the education and training of dentists practicing implant therapy in the Riyadh region of Saudi Arabia, including their preferred dental implant systems, the clinical complications experienced as well as the barriers to implant therapy they encounter. A self-administered questionnaire was distributed among dentists in Riyadh performing dental implants in both the state and private sectors. The questionnaire included demographic data, such as nationality, the practitioner's affiliated specialist category and their respective qualifications. Other data included their main sources of education pertaining to implant dentistry, the most commonly used implant systems, common clinical complications, and barriers to implant therapy. A descriptive statistical analysis of the data was carried out. A significant majority of non-Saudi dental practitioners were employed in the private sector (p = 0.001), whereas a significant majority of Saudi dental practitioners were employed in the state sector (p = 0.001). The largest group of practitioners performing implants were general dentists (48.1%). The 3iTM implant system was the most widely utilized (35.4%). Failed osseointegration (12.6%) and peri-implantitis (12%) were the most common clinical complications. The biggest barrier to placing implants was the cost of implants to patients (59.1%). Fundamental to implant practice is the clinical practitioner and patient selection. The utilization of implant systems should preferably be based on the chemical properties of implant surfaces which promote early osseointegration. Comparative studies investigating the reasons for failed osseointegration and other clinical complications are needed locally and internationally. Further research, together with advanced clinical specialist training, can lead to improvement in the quality of implant therapy for the benefit of patients.