Sami Shaban

Physician participation in clinical research and trials: issues and approaches

The rapid development of new drugs, therapies, and devices has created a dramatic increase in the number of clinical research studies that highlights the need for greater participation in research by physicians as well as patients. Furthermore, the potential of clinical research is unlikely to be reached without greater participation of physicians in research. Physicians face a variety of barriers with regard to participation in clinical research. These barriers are system-or organization-related as well as research-and physician-related. To encourage physician participation, appropriate organizational and operational infrastructures are needed in health care institutes to support research planning and management. All physicians should receive education and training in the fundamentals of research design and methodology, which need to be incorporated into undergraduate medical education and postgraduate training curricula and then reinforced through continuing medical education. Medical schools need to analyze current practices of teaching–learning and research, and reflect upon possible changes needed to develop a ‘student-focused teaching–learning and research culture’. This article examines the barriers to and benefits of physician participation in clinical research as well as interventions needed to increase their participation, including the specific role of undergraduate medical education. The main challenge is the unwillingness of many physicians and patients to participate in clinical trials. Barriers to participation include lack of time, lack of resources, trial-specific issues, communication difficulties, conflicts between the role of clinician and scientist, inadequate research experience and training for physicians, lack of rewards and recognition for physicians, and sometimes a scientifically uninteresting research question, among others. Strategies to encourage physician participation in clinical research include financial and nonfinancial incentives, adequate training, research questions that are in line with physician interests and have clear potential to improve patient care, and regular feedback. Finally, encouraging research culture and fostering the development of inquiry and research-based learning among medical students is now a high priority in order to develop more and better clinician-researchers.

Biocompatibility of calcined mesoporous silica particles with cellular bioenergetics in murine tissues.

A novel in vitro system was developed to investigate the effects of two forms of calcined mesoporous silica particles (MCM41-cal and SBA15-cal) on cellular respiration of mouse tissues. O(2) consumption by lung, liver, kidney, spleen, and pancreatic tissues was unaffected by exposure to 200 μg/mL MCM41-cal or SBA15-cal for several hours. Normal tissue histology was confirmed by light microscopy. Intracellular accumulation of the particles in the studied tissues was evident by electron microscopy. The results show reasonable in vitro biocompatibility of the mesoporous silicas with murine tissue bioenergetics.

Towards a national trauma registry for the United Arab Emirates

BackgroundTrauma is a major health problem in the United Arab Emirates (UAE) as well as worldwide. Trauma registries provide large longitudinal databases for analysis and policy improvement. We aim in this paper to report on the development and evolution of a national trauma registry using a staged approach by developing a single-center registry, a two-center registry, and then a multi-center registry. The three registries were established by developing suitable data collection forms, databases, and interfaces to these databases. The first two registries collected data for a finite period of time and the third is underway. The steps taken to establish these registries depend on whether the registry is intended as a single-center or multi-center registry.FindingsSeveral issues arose and were resolved during the development of these registries such as the relational design of the database, whether to use a standalone database management system or a web-based system, and the usability and security of the system. The inclusion of preventive medicine data elements is important in a trauma registry and the focus on road traffic collision data elements is essential in a country such as the UAE. The first two registries provided valuable data which has been analyzed and published.ConclusionsThe main factors leading to the successful establishment of a multi-center trauma registry are the development of a concise data entry form, development of a user-friendly secure web-based database system, the availability of a computer and Internet connection in each data collection center, funded data entry personnel well trained in extracting medical data from the medical record and entering it into the computer, and experienced personnel in trauma injuries and data analysis to continuously maintain and analyze the registry.

A heuristic approach to simultaneous course/student timetabling

Abstract Many approaches have been taken in academic environments to address the problem of student and course timetabling. Typically, student scheduling and course scheduling have been treated as separate tasks. Our approach is to build the schedule and place the students into classes simultaneously. That is, to collect all constraints and requirements, quantify them, and build a schedule based on heuristic functions, as we populate it with students. Heuristic functions are also used to order the processing of students. After the schedule is built, we endeavour to further optimise it using additional heuristic-based operations. An initial parallel implementation of the system was performed alongside the manual system followed by live runs in recent semesters. The system has been successfully adopted by the United Arab Emirates Universitys University General Requirements Unit since the semester starting February 2001. The schedules created have been well accepted by the students and the administration as they have made good use of the students’ time while making near-optimal use of the Universitys physical and human resources. The scheduling system is written in Visual Basic with embedded SQL.

Oxygen measurements via phosphorescence

Accurate measurements of dissolved O(2) as a function of time have numerous chemical and biological applications. The Pd (II) complex of meso-tetra-(4-sulfonatophenyl)-tetrabenzoporphyrin (Pd phosphor) was used for this purpose. Detection is based on the principle that the phosphorescence of this oxygen probe is inversely related to dissolved O(2) (O(2) quenches the phosphorescence). Biologic samples containing the Pd phosphor were flashed (10/s) with a peak output of 625nm; emitted light was detected at 800nm. Amplified pulses of phosphorescence were digitized at 1-2MHz using an analog/digital converter (PCI-DAS 4020/12 I/O Board) with outputs ranging from 1 to 20MHz. Assessment revealed a customized program was necessary. Pulses were captured using a developed software at 0.1-4MHz, depending on the speed of the computer. O(2) concentration was calculated by fitting to an exponential the decay of the phosphorescence. Twelve tasks were identified, which allowed full control and customization of the data acquisition, storage and analysis. The program used Microsoft Visual Basic 6 (VB6), Microsoft Access Database 2007, and a Universal Library component that allowed direct reading from the PCI-DAS 4020/12 I/O Board. It involved a relational database design to store experiments, pulses and pulse metadata, including phosphorescence decay rates. The method permitted reliable measurements of cellular O(2) consumption over several hours.

The long term effects of early analysis of a trauma registry

BackgroundWe established a trauma registry in 2003 to collect data on trauma patients, which is a major cause of death in the United Arab Emirates (UAE). The aim of this paper is to report on the long term effects of our early analysis of this registry.MethodsData in the early stages of this trauma registry were collected for 503 patients during a period of 6 months in 2003. Data was collected on a paper form and then entered into the trauma registry using a self-developed Access database. Descriptive analysis was performed.ResultsMost were males (87%), the mean age (SD) was 30.5 (14.9). UAE citizens formed 18.5%. Road traffic collisions caused an overwhelming 34.2% of injuries with 29.7% of those involving UAE citizens while work-related injuries were 26.2%. The early analysis of this registry had two major impacts. Firstly, the alarmingly high rate of UAE nationals in road traffic collisions standardized to the population led to major concerns and to the development of a specialized road traffic collision registry three years later. Second, the equally alarming high rate of work-related injuries led to collaboration with a Preventive Medicine team who helped with refining data elements of the trauma registry to include data important for research in trauma prevention.ConclusionAnalysis of a trauma registry as early as six months can lead to useful information which has long term effects on the progress of trauma research and prevention.

Trend towards multiple authorship in occupational medicine journals

BackgroundThere is an established trend towards an increasing number of authors per article in prestigious journals for medicine and health sciences. It is uncertain whether a similar trend occurs to the same extent in journals for specific medical specialties.MethodsJournals focusing on occupational medicine were selected for analysis with regard to single or multiple-authorship per peer-reviewed paper. Data were collected from PubMed for publications between 1970 and 2007. These were analysed to calculate the average number of authors per multiple-author article per year and the percentage of single-author articles per year. The slope and average of these journals were then compared with that of previously studied non-occupational medicine journals.ResultsThe results confirm a trend towards a linear increase in the average number of authors per article and a linear decrease in the percentage of single-author articles. The slope for the average number of authors for multiple-author articles was significantly higher in the Journal of Occupational and Environmental Medicine than in the other occupational medicine journals. Computational analysis of all articles published showed that Occupational Medicine (Oxford) had a significantly higher percentage of single-author articles than the other occupational medicine journals as well as major journals previously studied.ConclusionThe same trend towards multiple authorship can be observed in medical specialty journals as in major journals for medicine and health sciences. There is a direct relationship between occupational journals with higher impact factors and a higher average number of authors per article in those journals.

Superficial and deep learning approaches among medical students in an interdisciplinary integrated curriculum

Introduction: Students′ learning approaches have a significant impact on the success of the educational experience, and a mismatch between instructional methods and the learning approach is very likely to create an obstacle to learning. Educational institutes′ understanding of students′ learning approaches allows those institutes to introduce changes in their curriculum content, instructional format, and assessment methods that will allow students to adopt deep learning techniques and critical thinking. The objective of this study was to determine and compare learning approaches among medical students following an interdisciplinary integrated curriculum. Methods: This was a cross-sectional study in which an electronic questionnaire using the Biggs two-factor Study Process Questionnaire (SPQ) with 20 questions was administered. Results: Of a total of 402 students at the medical school, 214 (53.2%) completed the questionnaire. There was a significant difference in the mean score of superficial approach, motive and strategy between students in the six medical school years. However, no significant difference was observed in the mean score of deep approach, motive and strategy. The mean score for years 1 and 2 showed a significantly higher surface approach, surface motive and surface strategy when compared with students in years 4-6 in medical school. Discussion: The superficial approach to learning was mostly preferred among first and second year medical students, and the least preferred among students in the final clinical years. These results may be useful in creating future teaching, learning and assessment strategies aiming to enhance a deep learning approach among medical students. Future studies are needed to investigate the reason for the preferred superficial approach among medical students in their early years of study.

Predicting performance at medical school: Can we identify at-risk students?

Background The purpose of this study was to examine the predictive potential of multiple indicators (eg, preadmission scores, unit, module and clerkship grades, course and examination scores) on academic performance at medical school, with a view to identifying students at risk. Methods An analysis was undertaken of medical student grades in a 6-year medical school program at the Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates, over the past 14 years. Results While high school scores were significantly (P < 0.001) correlated with the final integrated examination, predictability was only 6.8%. Scores for the United Arab Emirates university placement assessment (Common Educational Proficiency Assessment) were only slightly more promising as predictors with 14.9% predictability for the final integrated examination. Each unit or module in the first four years was highly correlated with the next unit or module, with 25%–60% predictability. Course examination scores (end of years 2, 4, and 6) were significantly correlated (P < 0.001) with the average scores in that 2-year period (59.3%, 64.8%, and 55.8% predictability, respectively). Final integrated examination scores were significantly correlated (P < 0.001) with National Board of Medical Examiners scores (35% predictability). Multivariate linear regression identified key grades with the greatest predictability of the final integrated examination score at three stages in the program. Conclusion This study has demonstrated that it may be possible to identify “at-risk” students relatively early in their studies through continuous data archiving and regular analysis. The data analysis techniques used in this study are not unique to this institution.

Multiple Authorship and Article Type in Journals of Urology across the Atlantic: Trends over the Past Six Decades

Objective: The aim of this research was to study the trends in authorship and type of article in European and North American journals of urology over the past 6 decades. Materials and Methods: Using a self-developed Visual Basic program, the number of authors per article and the type of article in four European journals (BJU International, Current Opinion in Urology, European Urology and Urologia Internationalis) and four North American journals (Journal of Urology, Urologic Clinics of North America, Urology and World Journal of Urology) were extracted from the PubMed website from January 1946 to October 2010, and the number of authors per article in each year was calculated in all the journals. Results: The average number of authors per article has increased and the percentage of single-author articles has decreased in both European and American journals. An increase in the number of authors per article was observed mainly in original articles and case reports. Since the early 1980s, there has also been a decreasing percentage of published case reports and a general increase in the percentage of letters to the editor and editorials. Conclusions: The multiple-authorship trends observed in both European and North American urology journals were similar and appeared to be mainly due to changes in original articles and case reports.