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The motivation for the current exploration follows from the fact that one-third of the population in Saudi Arabia (SA) is expatriates. According to the Saudi General Authority for Statistic (https://www.stats.gov.sa/en), the total population in SA in 2021 is estimated at 33,413,660 people, 20,768,627 of whom are Saudi citizens whereas 12,645,033 are expatriates coming from different countries across the world, such as Afghanistan, Bangladesh, Egypt, India, Indonesia, Jordan, Pakistan, Philippines, Sudan, Sri Lanka, among many others. In this study, the author targeted limited English and Arabic proficiency patients (LEAPPs) from only three countries in the Near East: (1) Bangladesh, (2) India and (3) Pakistan. The author selected these three countries because they represent the high number of expatriates in SA. According to www.globalmediainsight.com, the population of the abovementioned nationalities in SA in 2021 is as follows: India (2,550,000 million), Pakistan (2,450,000 million) and Bangladesh (1,300,000 million) (see https://bit.ly/3NR6SfT). The main official languages for Pakistan, India and Bangladesh are Urdu, Hindu and Bengali respectively. Although the English language is the second official language in both Pakistan and India, it comes as a second language, not as a mother tongue. In other words, these LEAPPs are unlikely to have a full command of the English language.

The current study makes use of both quantitative and qualitative approaches. The quantitative component follows from the use of questionnaires whereas the qualitative part comes from the execution of face-to-face interviews. This mixed approach has been influential in earlier explorations (see, e.g. Terrel, 2012; Dawadi et al., 2021) and was used in this study to achieve two objectives: (1) to explore whether LEAPPs suffer linguistically when they visit a Saudi hospital, and this data can be elicited via questionnaires, and (2) to gain insights from LEAPPs' experience and attend to their suggestions towards the improvement of the linguistic landscape of the Saudi health system, and this can be gleaned from the interviews.

Based on questionnaires and interviews, the study shows that 64.5% of LEAPPs cannot express their health issues to Arabic-speaking physicians, while 54.8% cannot understand the details of their diagnoses and the guidelines of the prescriptions. Although there is a strong consensus among LEAPPs that interpretation services should be introduced to the Saudi health sector to achieve a better experience, 67.7% are generally satisfied with the current healthcare. Contra previous claims that patients are concerned about their privacy with the introduction of interpreters (see, e.g. Hadziabdic, 2011; Floyd and Sakellariou, 2017; MacFarlane et al. 2020), the present study shows that 70.9% of LEAPPs express no concerns regarding their privacy, whereas 19.3% adopt a neutral position.

Unlike Al-Khathami et al. (2010) who explored the perspective of Saudi patients towards nonArabic speaking nurses and contra Alhammami (2020) who examined the attitudes of the nonArabic speaking doctors towards Saudi patients, the current study shed more light on a neglected sample, namely the laborers, janitors and other craftsmen who have limited knowledge of both Arabic and English and who visited a Saudi clinic/hospital and were met by Arabic-speaking physicians.

Work engagement denotes to a state of positive and affective motivation of elevated power joined with high educational levels and a great concentration on occupation and it is negatively affected by psychological problems. This study aims to assess the stress and work engagement among Palestinian nurses working in intensive care units.

A cross-sectional design was adopted. A convenience sample consisting of 225 intensive care nurses from governmental hospitals was recruited to participate. Data collection used the Nursing Stress Scale and Utrecht Work Engagement Scale-9, and demographic data were used to gather data throughout the period from February 10 to March 30, 2023.

Findings demonstrated that nurses’ stress levels were high (M = 105.9 ± standard deviation [SD] = 11.91). Concerning work engagement, the nurses endorsed moderate work engagement levels with a mean of 3.7 (SD = 0.4). Regarding work engagement subscales, the mean of vigor was 3.7 (0.6), dedication with a mean of 3.7 (0.6) and absorption with a mean of 3.7 (0.6). Also, the findings showed that stress, gender and monthly income were predictors of work engagement (p < 0.05).

Despite the significant results, this study had the following limitations: the design was cross-sectional, which limits the ability to explore the cause and effect of the study variables, thus longitudinal studies are recommended. In addition, the study adopted a self-reported questionnaire based on participants’ understanding, culture and work context which could influence their responses.

The intensive care nurses had high stress levels and moderate work engagement. Stress, gender and monthly income were predictors of the work engagement. Thus, interventions should be encouraged to minimize stress, which has a significant influence on work engagement.

A comparative analysis of the validity of business excellence models (BEMs) has rarely been empirically pursued. In addition to their similarities, BEMs exhibit differences in terms of their criteria, relations and emphasis, and some researchers have claimed that it is because these models tend to represent underlying cultural, economic, or social dynamics, as well as global best practices. Based on three such BEMs (the Malcolm Baldrige National Quality Award (MBNQA) model, the European Foundation for Quality Management (EFQM) model and the King Abdul Aziz Quality Award (KAQA) model), this paper introduces a four-phase study to analyse these models comparatively.

This paper: (1) conceptually delineates the distinctive natures of and differences between the three models; (2) develops a comprehensive measurement model based on the content of these models; (3) reviews the relevant literature on BEMs; (4) discusses the motivation behind this comparative approach and (5) introduces a four-phase study to comparatively analyse these models.

A comprehensive measurement model and three structural models are developed, but empirical tests have not been performed. This developed approach is introduced here as a first step in the advancement of our understanding of BEMs and their underlying theory.

The range of variability and complexity of BEMs—i.e. a holistic and comparative empirical view of BEMs—have not so far been fully considered, and findings in this domain tend to be inclusive, while some of the underlying relations of these models have not been investigated. This paper contributes to filling these research gaps.

The purpose of this study is to explore the experiences of Saudi Arabian university students returning home after having spent time away studying internationally. The investigation focused exclusively on female students who for diverse reasons were unable to complete their studies abroad.

A thematic analysis was applied to analyze the seven in-depth interviews conducted by the authors. By using an open coding method analytic patterns across the entire data set were identified and then analyzed.

The findings suggest that the students experienced reverse culture shock reintegrating and assimilating into their former lives in the Kingdom of Saudi Arabia and its conservative culture. This was especially surprising considering not one of the participants experienced culture shock when they first traveled to their host country – the USA, Canada or England.

The study is limited to a small group of seven female undergraduates who are comparatively well educated and come from a middle and upper socioeconomic demographic. As a result, without additional research, the findings cannot be extended to groups outside of this demographic.

Students who have studied abroad need improved academic and social support networks when they return home, according to the findings. The authors want to raise awareness about the difficulties that students face upon their return. Teachers, counselors, and advisors need to be on the lookout for the symptomatology associated with these types of problems.

Female Saudi students returning home after an extended period of study abroad face a variety of problems. They must fit into a restrictive, partriarchal culture in which they are not legally equal to men.

To date, there are no studies that shed light on reverse culture shock for students who returned to Saudi Arabia without a degree. Due to the large number of Saudi scholarship holders who study in English-speaking countries with government support, the study is the first attempt in this direction.

The purpose of this study is to address a critical gap in the existing literature on business excellence implementation. While various studies have examined different aspects of business excellence, there is still a lack of comprehensive research on the optimal organizational excellence architecture (OEA) for an award-winning business excellence journey. The absence of a unified framework has led to inconsistent practices across organizations. The aim of this research based on data collected from 50 organizations across 17 countries is to address this gap and present a refined OEA model.

This study employed quantitative and qualitative data collection methods. Member organizations from the Global Excellence Model (GEM) Council participated through an online survey administered via the Qualtrics software platform. Quantitative data were analyzed using the SPSS and Microsoft Excel software tools, while content analysis techniques were applied to the qualitative data to gain detailed insights.

The findings refine and extend the OEA model. These contributions lead to a refined OEA definition and open avenues for future research, enriching the current understanding of BE implementation.

This study introduces a novel concept of OEA to the literature on business excellence implementation. The refined OEA model provides a fresh perspective on the critical components necessary for an award-winning business excellence journey. This research offers significant value to both practitioners and academics by presenting a unified approach to BE implementation, effectively addressing the previously identified gap in BE research.

The adoption of digital technology has not been able to overcome the problem of patient healthcare service quality in Indonesian hospitals, especially in lower middle-class hospitals that are widely distributed in the regions, because its utilization has not been well coordinated. This research explores the influence of Digital Adoption Capability (DAC) on Hospital Performance (HP) for these service problems.

This research used a quantitative methodology design approach. Survey data were collected from 285 leaders of class C and D hospitals throughout Indonesia, who were selected at simple random from March to August 2023. Data analysis was carried out using the structural equation modeling method with the help of LISREL version 8.80 software.

The research found a positive and significant influence of DAC on HP. Digital Leadership (DL) plays an important role in performance, both directly and indirectly. ICT Literacy (ICT) and Patient-Centric (PC) do not have a direct influence on HP but provide significant results through DAC. This research also found Environmental Dynamism (ED) factors that significantly drive the need to improve performance through digital adoption.

Providing insight into increasing the role of digital technology to connect healthcare workers and patients to produce safe and quality healthcare services in an ever-changing environmental condition.

This model is very important for the management of small hospital organizations in the context of adopting digital technology to be able to provide better services to patients and improve hospital performance.

This study aims to examine the underlying determinants that may influence external audit fees paid by Emirati nonfinancial companies listed on Dubai Financial Market (DFM).

Data used in this study are mainly collected from the 2011 annual reports and corporate governance reports published by the Emirati nonfinancial companies listed on DFM. Backward regression analysis is used to measure the impact of a set of company characteristics on Emirati non-financial listed firm’s audit delays.

The findings pointed to a significant and positive association between audit fees and each of corporate size and audit committee independence variables. A significant and negative relationship has been detected between external audit fees and business complexity. The findings also revealed that audit fees are not significantly associated with company’s profitability, risk, industry type, status of audit firm and audit report lag.

The paper helps in expanding limited existing literature about the determinants of audit fees in the Arab and Middle East countries generally and in the UAE context particularly. No prior attempt had been made to investigate the determinants of audit fees paid by Emirati firms listed on DFM because the disclosure of audit fees services provided by external auditors only became effective after April 30, 2010. The findings of the study may be generalized to other Arab countries, particularly neighboring Gulf Cooperation Council states, that have a similar socio-cultural environment.

The purpose of this study was to examine how cost, network and technology factors affect the use of mobile technologies for clients’ care in internal medicine department in Nigeria’s premier teaching hospital, the University College Hospital, Ibadan.

The study adopted a survey design covering a cross-section of medical doctors, pharmacists, nurses and medical laboratory technologists in the Department of Internal Medicine. A questionnaire guided data collection.

There is a high level of consciousness and use of mobile technologies for meeting healthcare needs of internal medicine clients in the University College Hospital, Ibadan and medical practitioners are deploying the technology most. However, there is no similar evidence of consciousness and use of wearable health-care technologies and solutions. The hospital makes some provision for mobile technology support for relevant medical staff and purposes. However, about three in 10 of the respondents reported that they use their own funds to recharge hospital-provided mobile phones means.

The study focusses only on one institution but the result reflects the situation in other hospitals, University College Hospital, Ibadan, Nigeria being the major supplier of health and medical human resources in the country.

The hospital requires undertaking institutional assessment of mobile service need and consumption for clients’ care and thereafter make adequate provision to match the need. Furthermore, the institution could work out various forms of collaboration with mobile technology operators in the country to subsidise the cost of the use of telephones for clients’ care as part of their corporate social responsibility.

The institution could work out collaboration with mobile technology operators in the country to subsidise cost of mobile client care as part of the philanthropic and corporate social responsibility of telecom companies.

This study focusses mainly on internal medicine and has implication for a more proper understanding of adult deployment of mobile phones for client care.

The pandemic's health and social issues have significantly altered the character and manner of teaching and learning in higher education across the country. The use of technology to replace or integrate face-to-face learning with online learning has become a necessary requirement for promoting and continuing learning processes. Furthermore, integrating technology is a goal of Sustainable Development Goal 4 (SDG 4) to make teaching and learning more innovative and sophisticated. This paper is based on a systematic review grounded in a synthesis of research papers and documents analyzing the current status of teachers' pedagogy through online learning modes in the context of Pakistan.

Through content analyses of academic studies in higher education and reflection on the online teaching experiences, this study discusses how students' learning is associated with teachers' teaching approaches in the modern era of digitalization and innovation.

The review and analysis suggest that online teaching is not viewed as an innovative phenomenon; rather, teachers simply teach their traditionally designed face-to-face courses through the use of technology. The paper suggests that transforming teachers' pedagogical insight to make online learning sustainable is an urgent need for higher education.

The analysis provides a basis for consideration of teacher learning and quality education (SDG #4) to fulfill the nation’s agenda for sustainable development. The analysis helps educators and administrators in higher education institutions reflect on their policies and practices that have short- and long-term effects on students' learning outcomes.

Bullying negatively affects victims’ mental health and has been shown to be associated with anxiety and depression. Moreover, many studies have reported the prevalence of mistreatment among medical students (MS), interns and junior physicians. However, there are limited studies on bullying in the Middle East, and no studies on higher education in Bahrain. The authors’ aim was to investigate and compare the prevalence of bullying between MS at a major public university and non-medical students (NMS) at a private university in Bahrain. The authors also sought to explore the associations between bullying, depression and anxiety.

The authors conducted a survey-based cross-sectional study from October 1 to December 31, 2018, using convenient sampling method. A total of 300 students (150 MS and 150 NMS) participated in the study by answering a questionnaire that explored exposure to different types of bullying. In addition, standard anxiety and depression instruments were distributed to students.

The results showed that MS were more exposed to bullying than NMS, with a significant number (41%) reporting mistreatment from multiple sources, including teachers, consultants and peers. Furthermore, the authors found that bullying was significantly correlated with psychological health, anxiety and depression.

There are limited studies on bullying in the Middle East and no studies on the topic of higher education in Bahrain. Furthermore, the learning environment of tertiary education institutions can be improved by addressing the concerns associated with bullying identified in this study.