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In a world demanding climate action, the oil-rich Gulf states face a defining crossroads: can they transform economies built on fossil fuels into resilient, climate-aligned powerhouses? This timely and original study offers a rigorous, multidimensional analysis of how Saudi Arabia, the United Arab Emirates, and Qatar are navigating the high-stakes transition to decarbonization. Weaving together historical political economy, postcolonial state formation, economic pressures, geopolitical realignments, and environmental imperatives, it explores the difficult trade-offs and strategic decisions forging the region's trajectory. Through incisive analysis, it reveals emerging policy innovations, evolving social contracts, and institutional strategies that are redefining the Gulf's energy future—while critically evaluating the macroeconomic consequences of climate-driven transformation. Essential reading for policymakers, financiers, energy professionals, multilateral institutions, and scholars, The Gulf's Climate Reckoning offers an intellectual and strategic framework for understanding the Gulf's climate-industrial transformation and its far-reaching implications for the emerging global energy and governance landscape.
Mental health disorders, including depression and anxiety, pose significant public health challenges globally, and in Saudi Arabia. Despite this, psychiatry suffers from a critical shortage of specialists. This study investigates factors influencing medical students’ career decisions in regard to psychiatry, aiming to enhance understanding of, and address workforce deficiencies in, mental healthcare.
Aims
This study aims to investigate the factors influencing medical students’ decision to choose psychiatry as a future career.
Method
This cross-sectional study conducted an online survey among Saudi Arabian medical students from 28 December 2023 to 28 April 2024, employing validated questions refined through pilot testing. Participant selection included male and female students across preclinical and clinical stages, excluding non-medical students and those outside Saudi Arabia.
Result
This study explores the perceptions and interest of 430 medical students in Saudi Arabia regarding psychiatry as a career. The majority were female (69.3%), with most in their preclinical years (60.2%). Key findings include limited personal connections to psychiatry (9.5% with a family psychiatrist), and primarily influenced by medical school (55.3%) and social media (42.1%). While 65.1% perceive psychiatry as mentally demanding, uncertainties exist about career prospects and stigma persists (39.1%). Gender differences were observed, with more females (34.6%) than males (22.7%) interested in psychiatry (P = 0.014). Early inspiration in medical education significantly increased interest (P = 0.001).
Conclusion
Early exposure, personal connections and gender-specific factors significantly influence medical students’ interest in psychiatry as a career. Integrating psychiatry education early in medical curricula and addressing stigma are critical for fostering positive perceptions and attracting diverse students to the field.
How do secular and religious national role conceptions (NRCs) influence interstate rivalry? To explore this, we examine the rivalry between Iran and Saudi Arabia, two theocratic states. Drawing on scholarship that integrates power politics and religion, we examine how instrumental motivations shape religion-based policymaking. Using semantic network and regression analyses on data from eight official Twitter/X accounts of Iranian and Saudi foreign policy officials (2015–2021), we find that both states’ officials strategically use secular and religious NRCs in response to foreign policy roles adopted by their rival. Our findings underscore the coexistence of these NRCs and their selective application in managing rivalry. Methodologically, the study contributes to foreign policy analysis research by employing quantitative semantic analysis of social media data. It also offers a novel lens for understanding Iran-Saudi competition and the broader intersection of religion and foreign policy.
We identified three centers in Saudi Arabia that implemented observation units (OUs). The presence of an OU helps with patient flow, reduces overcrowding, enhances patient care, safety and experience, and improves daily key performance indicators. Following this chapter, the authors’ own organizations are keen to develop observation units.
To enhance the emergency response preparedness of public health professionals in Saudi Arabia, the World Health Organization Rapid Response Team Advanced Training Package (WHO RRT ATP) was adapted. It was designed to align with local cultural and operational contexts.
Methods
A 2-day workshop was conducted involving experts who reviewed and modified the adapted WHO RRT ATP training materials. The process was structured into 7 phases: needs assessment, stakeholder analysis, cultural tailoring, content adaptation, module selection, implementation planning, and evaluation framework development.
Results
Key challenges revealed included inadequate hospital coordination, shortage of trained personnel and medical services, and insufficient knowledge of disease transmission. Core training modules were adapted, and supplementary materials were reviewed. Key considerations included addressing existing gaps, cultural sensitivity, and current outbreak trends in KSA. Participants’ feedback showed high satisfaction, with 86.7% of participants providing a mean rating of 4.77 on day 1 and 80% of participants giving an average rating of 4.67 on day 2 on a Likert scale of 1-5.
Conclusions
Cultural and country needs were key factors in the workshop’s successful outcomes. The adapted training program is anticipated to significantly enhance the preparedness of health care professionals in KSA to manage public health emergencies.
This chapter examines the implications of Saudi Arabia’s net zero by 2060 goal for domestic politics and on the kingdom’s stature in the international community. The gargantuan task of decarbonizing Saudi Arabia is evident in its disproportionate oil use: The kingdom is the world’s No. 4 consumer of oil, despite overseeing the world’s 20th biggest economy and its 41st largest population. There are legitimate doubts about the credibility of Saudi commitment to net zero, given the regime’s track record of noncompliance with prior clean energy goals. A realistic net-zero undertaking would require an overhaul of a fossil fuel-driven society and economy in less than four decades. Sweeping changes would affect the consumption of energies and services, resulting in enormous shifts in ingrained behaviour and in consuming technologies. Difficulties aside, Saudi Arabia holds major advantages in decarbonization. These include unused land with copious solar radiation, as well as geological storage near carbon emissions clusters. Since the global transition could not happen without the kingdom’s cooperation, a documented achievement of decarbonization milestones would increase global goodwill and provide added credibility required to shape the energy transition in ways that could ensure long-term roles for hydrocarbons.
Cognitive behavioural therapy (CBT) is one of the best-evidenced psychosocial interventions for psychosis and is recommended by the National Institute for Health and Care Excellence and the American Psychiatric Association. CBT was developed and derived from Western cultural values, which may not be appropriate for non-Western cultures. Trials of CBT in Western countries have indicated that participants from ethnic minority groups demonstrate low rates of engagement, retention, and recruitment. This indicates that the principles underlying CBT may conflict with individual beliefs and cultural values in non-Western countries. Therefore, we interviewed 15 people diagnosed with schizophrenia and 15 with their family members to explore the beliefs and attitudes of people diagnosed with schizophrenia and their family members concerning the proposed CBT intervention for psychosis in the Saudi context. The findings revealed that most participants accepted the proposed intervention. Important factors that influenced participants’ engagement and motivation in the CBT intervention were related to the therapist’s qualities (sex, empathy, and competence), family involvement, religion, and the number and format of CBT sessions for psychosis.
Key learning aims
(1) To explore the beliefs and attitudes of people diagnosed with schizophrenia concerning the proposed CBT intervention for psychosis and how to improve it to make it more appropriate for their needs and cultures.
(2) To explore the beliefs and attitudes of family members of people diagnosed with schizophrenia concerning the proposed CBT intervention for psychosis and how to improve it to make it more appropriate to their needs and culture.
Ticks are important vectors and reservoirs of pathogens causing zoonotic diseases in camels and other livestock, rodents and other small mammals, birds and humans. Hyalomma dromedarii is the most abundant tick species in Saudi Arabia and United Arab Emirates (UAE) affecting primarily camels, and to a lesser extent, other livestock. Species presence data, land use/landcover, elevation, slope and 19 bioclimatic variables were used to model current and future distribution of H. dromedarii ticks using maximum entropy species distribution modelling (MaxEnt.). The model highlighted areas in the northern, eastern and southwestern parts of the study area as highly suitable for ticks. Several variables including land use/land cover (LULC) (53.1%), precipitation of coldest quarter (Bio19) (21.8%), elevation (20.6%), isothermality (Bio3) (1.9%), mean diurnal range [mean of monthly (max temp – min temp)] (Bio2) (1.8%), slope (0.5%), precipitation, seasonality (Bio15) (0.2%) influenced habitat suitability of ticks, predicting high tick density or abundance. Middle of the road scenario (ssp2-4.5) where CO2 levels remain similar to current levels, did not indicate a major change in the tick distributions. This tick distribution model could be used for targeting surveillance efforts and increasing the efficiency and accuracy of public health investigations and vector control strategies.
Disasters pose significant challenges globally, affecting millions of people annually. In Saudi Arabia, floods constitute a prevalent natural disaster, underscoring the necessity for effective disaster preparedness among Emergency Medical Services (EMS) workers. Despite their critical role in disaster response, research on disaster preparedness among EMS workers in Saudi Arabia is limited.
Study Objective/Methods:
The study aimed to explore the disaster preparedness among EMS workers in Saudi Arabia. This study applied an explanatory sequential mixed-methods design to explore disaster preparedness among EMS workers in Saudi Arabia, focusing on the qualitative phase. Semi-structured interviews were conducted with 15 EMS workers from National Guard Health Affairs (NGHA) and Ministry of Health (MOH) facilities in Riyadh, Dammam, and Jeddah. Thematic analysis was conducted following Braun and Clarke’s six-step process, ensuring data rigor through Schwandt, et al’s criteria for trustworthiness.
Findings:
The demographic characteristics of participants revealed a predominantly young, male workforce with varying levels of experience and educational backgrounds. Thematic analysis identified three key themes: (1) Newly/developed profession, highlighting the challenges faced by young EMS workers in acquiring disaster preparedness; (2) Access to opportunities and workplace resources (government versus military), indicating discrepancies in disaster preparedness support between government and military hospitals; and (3) Workplace policies and procedures, highlighting the need for clearer disaster policies, training opportunities, and role clarity among EMS workers.
Conclusion:
The study underscores the importance of addressing the unique challenges faced by EMS workers in Saudi Arabia to enhance disaster preparedness. Recommendations include targeted support for young EMS professionals, standardization of disaster training across health care facilities, and improved communication of disaster policies and procedures. These findings have implications for policy and practice in disaster management and EMS training in Saudi Arabia.
Emergency Medical Services (EMS) workers are critical to effective disaster response. Therefore, it is important to understand their knowledge, skills, and preparedness for disasters. This study investigated factors influencing EMS workers’ disaster knowledge, skills, and preparedness in the Saudi Arabian context. The study also sought to identify challenges to disaster preparedness among Saudi Arabian EMS workers.
Methods
A descriptive cross-sectional survey using The Disaster Preparedness Evaluation Tool was distributed to EMS workers in military and government hospitals across 3 Saudi Arabian cities. Responses were recorded on a 6-point Likert scale where higher scores indicated higher knowledge, skills, or preparedness. The results were analysed using descriptive and inferential statistical analysis.
Results
272EMS workers participated in this study. EMS workers reported a moderate level of knowledge (3.56), skills (3.44), and preparedness (3.73) for disasters. Despite this, EMS workers reported a high level of involvement in regular disaster drills (M = 4.24, SD = 1.274) and a strong interest in further disaster education opportunities (M = 5.43, SD = 1.121). Participants also reported a high skill level with the triage principles used in their workplace during a disaster (M = 4.06, SD = 1.218). The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in.
Conclusions
EMS workers have moderate disaster knowledge, skills, and preparedness levels. Knowledge, skill, and preparedness have a significant relationship on the EMS workers’ demographics. These findings demonstrate the need to invest in preparing Saudi Arabian EMS workers to effectively respond to bioterrorism disasters.
Before World War I, the Ottoman Empire ruled the southwestern region of the Arabian Peninsula. However, unlike other Ottoman territories in Eastern Europe and the Middle East, the fate of this region was not decided during the Paris Peace Conference. This created a vacuum of power that allowed the local elites of Arabia to engage in a lengthy process of conflict, negotiations, peace talks, and the exchange of ideas to resolve issues of legitimacy, sovereignty, borders, and cultural differences. This article argues that these local elites of Arabia developed an alternative model of statehood and sovereignty that persisted until the outbreak of the Gulf War in 1990. The immediate result of this new model was the separation of al-Mikhlāf al-Sulaimānī region and the transformation of the people of the Najrān region into a sectarian group.
This retrospective study compared central line-associated bloodstream infection (CLABSI) rates per 1 000 central line days, and overall mortality before and during the COVID-19 pandemic in adult, paediatric, and neonatal ICU patients at King Abdul-Aziz Medical City-Riyadh who had a central line and were diagnosed with CLABSI according to the National Healthcare Safety Network standard definition. The study spanned between January 2018 and December 2019 (pre-pandemic), and January 2020 and December 2021 (pandemic). SARS-CoV-2 was confirmed by positive RT-PCR testing. The study included 156 CLABSI events and 46 406 central line days; 52 and 22 447 (respectively) in pre-pandemic, and 104 and 23 959 (respectively) during the pandemic. CLABSI rates increased by 2.02 per 1 000 central line days during the pandemic period (from 2.32 to 4.34, p < 0.001). Likewise, overall mortality rates increased by 0.86 per 1 000 patient days (from 0.93 to 1.79, p = 0.003). Both CLABSI rates (6.18 vs. 3.7, p = 0.006) and overall mortality (2.72 vs. 1.47, p = 0.014) were higher among COVID-19 patients compared to non-COVID-19 patients. The pandemic was associated with a substantial increase in CLABSI-associated morbidity and mortality.
The occurrence of palygorskite in some Tertiary sediments in eastern Saudi Arabia was studied. Mineralogical and chemical analyses were made of samples from two sections several meters thick from the Umm er Radhuma and Dammam Formations of Paleocene and Eocene periods, respectively. Layers of shales were observed within the sections of the dolomitic-calcitic limestone of the Umm er Radhuma Formation and of the dolomitic limestone of the Dammam Formation. After treatment for carbonate removal the shales consisted of more than 95% clay-size particles, most of which were <0.2-μm in size. Palygorskite was the main constituent of some of the shales, with minor amounts of gypsum, soluble salts, and carbonates. The association of gypsum and other salts with palygorskite in the shale suggests that palygorskite formed in closed-basin environments. The presence of palygorskite and the absence of other minerals in the clay fraction of the limestones also suggests that the palygorskite formed under marine conditions.
Clay mineralogy and petrography of the Early to Middle Eocene succession of the Dammam dome, Saudi Arabia, comprising the Rus and Dammam Formations, were studied using X-ray powder diffraction, light microscopy, and scanning electron microscopy. These formations consist of alternations of dolomite, dolomitic marl, claystone, and shale. The rocks were deposited and subjected to early diagenetic dolomitization in a shallow, coastal marginal basin characterized by rapid changes in salinity. Palygorskite occurs as interwoven fibrous mats forming fine laminae in shales and as coatings and pore-filling and pore-bridging cements in dolomitic marls. This textural evidence suggests a direct chemical precipitation, mostly post-dating dolomitization. Magnesium concentrations in presence of dolomite was sufficient for palygorskite precipitation; the necessary Si and Al were derived by dissolution of silicates under alkaline conditions. The maximum development of palygorskite was near the top of the Dammam Formation, which was deposited during a marine transgression in the Lutetian. The formation of palygorskite in marginal restricted basins in eastern Saudi Arabia took place during Paleocene-Middle Eocene time and was contemporaneous with similar occurrences in the Tertiary basins of West Africa.
This chapter examines current philanthropic trends in emerging economies, exploring the extent to which philanthropists in these settings are investing in resilience and how they are doing so. Three dimensions are considered: what philanthropists invest in, how they invest, and with whom they invest. The state of emerging economy philanthropy, both pre-COVID and in the wake of the pandemic, is discussed, and frameworks and considerations for understanding resilience in philanthropy are set forth. Resilience is understood as having sufficient stability within a system to protect communities – particularly the most vulnerable – and services from deep shocks. The COVID-19 pandemic has sent deep shockwaves through global and local economies, health-care and education systems, and into personal homes and lives. While the shock was universal, the impact and its long-term implications have been felt and will linger much longer for the most vulnerable countries, communities, and individuals. In emerging economies around the world, the pandemic has set back hard-fought progress in economic development and social equity. This system encompasses not only government, but also civil society, including philanthropy. The chapter presents case studies of philanthropic organisations in Brazil, India, and Saudi Arabia whose investments reflect dimensions of resilience, and makes the case for investing in resilience in emerging economies, discussing both challenges and opportunities for doing so.
The great discoveries of the past two and a half centuries – the steam engine, electromagnetic induction, the electric power grid, the internal combustion engine, the transistor, personal computers, the internet – change not just the way we live, but an entire global economy. Nothing, however, created more change or made more millionaires than one discovery. By the early 1900s, the iron carriage had made its appearance on the streets of our booming cities, but a new kind of engine and a new kind of fuel would be needed to make a “gasmobile” run. Oil.
Despite the many advances, however, since the start of the petroleum era, ecosystems are failing because of increased industrialization, combustion pollution, and greenhouse gases. Are we seeing the beginning of the end, the twilight of our most gleaming idol? Is the next great global energy transition being forced upon us? In the words of Ahmed Zaki Yamani, Saudi oil minister from 1962 to 1986, “the Stone Age did not end for lack of stone and the Oil Age will end long before the world runs out of oil.” Alas, short-term profits and share price is still being valued over environmental degradation and global warming.
Between the end of World War I and the Mecca World Muslim Congress of 1926, Soviet officials and Indian Muslim thinkers imagined the possibilities of a post-imperial world through the Hijaz. The All-India Khilafat Committee (AIKC; established 1919), an organization led by prominent Indian Muslim thinkers, and the Soviet Union promoted competing projects to protect the Hijaz, home to some of Islam’s holiest shrines, against European imperialism. Yet, far from limiting themselves to the question of who should rule the Hijaz, the AIKC and the Soviet state engaged in broader debates about religious and social difference, sovereignty, and minority rights. Whereas the AIKC imagined the Hijaz as an international Muslim republic and a place of refuge for Muslims worldwide, Soviet officials contended that the political future of Muslims should only be settled within the framework of ethno-territorial nation-states. Ironically, the programs of both the AIKC and the Soviet state denied the right of self-determination to Hijazis themselves, leaving the region’s inhabitants to choose between two forms of external oversight: a Soviet-supported Saudi ethno-territorialism or limited domestic autonomy under the management and inspection of an international Muslim Council. With very few exceptions, past scholarship on the Hijaz in this period has analyzed the region’s political fortunes through Saudi statecraft or European colonial influence. However, Soviet and Indian Muslim experimental engagement with the Hijaz ultimately proved just as crucial to the consolidation of Saudi governance over the region. The article arrives at these novel insights by bringing rare Soviet archival documents together with the Urdu proceedings of the AIKC’s delegation to the Hijaz, as well as Arabic sources from the period in question.
The Cold War, oil, and new borders intensified the fight for hegemony in the Middle East. The shah maneuvered around thorny international issues by keeping intact his ties to different US administrations. Iran watched the Vietnam War with concern but maintained a balanced stance. Elsewhere, the creation of the Organization of the Petroleum Exporting Countries (OPEC) brought some regional cooperation. However, in the Persian Gulf, Iran became isolated and faced competition from the Arabian Peninsula and the newly Arab states of the south. Its conflict with Iraq escalated until a short-lived truce was concluded in 1975. Iran also flexed its muscles by supporting the Sultanate in Oman during the conflict in Dhofar, but the shah’s interventions only fueled the domestic unrest against his rule. Student groups and artists increasingly decried the shah’s dictatorial ways.
Chemical, biological, radiological, and nuclear (CBRN) incidents are those that involve chemical or biological warfare agents or toxic radiological or nuclear materials. These agents can cause disasters intentionally or accidentally. Hospitals play a crucial role in handling CBRN disasters. This study aimed to assess the CBRN preparedness of government hospitals in Riyadh.
Methods:
A descriptive cross-sectional study was conducted across government hospitals in Riyadh. All government hospitals with more than 100 inpatient beds and an emergency department met the inclusion criteria. Hospital preparedness was assessed using an adaptation of the CBRNE (chemical, biological, radiological, nuclear, or explosive event) Plan Checklist. This adaptation was chosen due to the inclusion of explosive events in hospital disaster readiness, and its structural composition of key clinical guidelines necessary for a comprehensive disaster and readiness plan. Results were described in frequencies across several domains such as foundational considerations and planning which are used to assess plan preparedness using readiness tools, training, and awareness among staff members in accordance to a pre-established emergency plan, placed procedures and their implementation, and modules for preparing for a biological incident, a chemical incident, and a radiological or nuclear incident.
Results:
Of the 11 eligible hospitals, 10 participated in the study. Furthermore, CBRN considerations were included in the disaster plans of 7 hospitals. Drills had been conducted in collaboration with local agencies in only 2 hospitals. The staff had been trained to recognize the signs and symptoms of exposure to class (A) biological agents in less than half of the hospitals. Eight of the hospitals had antidotes and prophylactics to manage chemical incidents, but only half of them had radiation detection instruments. Personal protective equipment was available in all hospitals, but rapid access to stockpiles of medications was available in only half of them.
Conclusions:
Government hospitals in Riyadh demonstrated insufficient CBRN preparedness as per the CBRNE Plan Checklist. Overall, there was a lack of preemptive planning, application of pre-established policies and procedures, and adequate staff training. Furthermore, several hospitals had insufficient stockpiles of medications and in concrete plans on accessing government stockpiles in the case of an emergency. Therefore, their staffs should be trained to manage CBRN emergencies, and local drills should be conducted to improve their preparedness.
Mecca is often conceptualized as a destination for the ḥajj or a source of leverage for both western and Ottoman imperial states, and in the twentieth century, for Saudi national foreign policy and Islamist movements. While building on such transnational angles, this article views the city as a convergence point for diaspora populations, an intermediary site that has received and redirected the mobilities of sojourners, refugees, and exiles from different parts of Asia throughout the manifold turnovers of the twentieth century. The article focuses on a community of first- to third-generation settlers in the Hejaz who trace their other homes to different places in China proper. Using archival documents, travelogues, and ethnographic interviews, the article argues that the routes to Mecca, coupled with imaginaries of the city as a home place for Muslims worldwide, served as a rare constant orienting force that sustained two-directional mobilities of Chinese Muslim diasporas through the wars and revolutions of modern times.