Tehreem A. Khan

Undergraduate research: An innovative student-centered committee from the Kingdom of Saudi Arabia

Abstract Introduction: Concern has been expressed in recent times whether medical schools have adapted sufficiently to cater for the increasing demand of physician–scientists. Studies have shown that research involvement at the undergraduate level is vital to accommodate this growing need. Enhanced communication skills, improved problem-solving abilities and better future employment opportunities are among the other many benefits of undergraduate research (UR). Herein, we report projects run by a unique student driven undergraduate research committee (URC) at Alfaisal University, Riyadh, Saudi Arabia aimed at providing the future generation of physicians training opportunities for pursuing a research intensive career. Methods: The article describes the unique structure of the URC and provides an in-depth description of the various programs and activities used in promoting students’ research activities. We analyzed students’ perception of URC activities via a questionnaire and analyzed research-output of the first graduating batches through their publication record. Results: Overall, more than 60% of the graduating students were involved in the various research programs offered by the URC and around 50% published in peer-reviewed journals with an average impact factor of 2.4. Conclusions: Research involvement by medical students is an essential need of the twenty-first century and models like URC could provide crucial platform for research training to the new generation of physician–scientists.

Malnutrition in Yemen: an invisible crisis

www.thelancet.com Published online December 20, 2016 http://dx.doi.org/10.1016/S0140-6736(16)32592-2 1 4 UNICEF. Yemen Humanitarian Situation Report. http://www.unicef.org/mena/UNICEF_ Yemen_Crisis_SitRep_-_8_July_to_21_ July_2015.pdf (accessed Oct 28, 2016). 5 Zeyad A. Yemen’s coast struggles with severe malnutrition as confl ict drags. Sep 16, 2016. http://www.cbsnews.com/news/yemenscoast-struggles-with-severe-malnutrition-asconfl ict-drags-on/ (accessed Oct 29, 2016). 6 UNICEF. Yemen Cholera Report #2. http://www.unicef.org/appeals/fi les/UNICEF_ Yemen_Cholera_Outbreak_Situation_ Report_24_Oct_2016.pdf (accessed Oct 29, 2016). Malnutrition in Yemen: an invisible crisis

Self-reported breast feeding practices and the Baby Friendly Hospital Initiative in Riyadh, Saudi Arabia: prospective cohort study

Background The Baby Friendly Hospital Initiative (BFHI) is a practice guideline for healthcare providers to promote breastfeeding and increase breastfeeding rates. Objective This study aimed to examine reported experiences and views on breastfeeding of women using prenatal and postnatal services, and opinions of staff, in the context of the BFHI programme in Riyadh, Saudi Arabia. Design Prospective cohort study. Setting This prospective, longitudinal study was conducted from December 2013 to September 2015 at two healthcare facilities (BFHI and non-BFHI) in Riyadh Saudi Arabia. Methods Women 36–40 weeks gestation receiving antenatal care at the hospitals were enrolled. Questionnaires were administered prenatally, at 1, 3 and 6 months postnatal and to the administrator and maternity staff. Results We recruited 277 women with an estimated 80% response rate. 156 (BFHI=78/139, non-BFHI=78/138, 56%) participants completed all questionnaires. Most BFHI-hospital participants (77.9%, n=8 for this question) acknowledged seeing the breast feeding policy compared to 23.5% (n=23) at the non-BFHI-hospital (p<0.01). Breast feeding education and encouragement was higher at the BFHI-hospital (93.3%) compared to the non-BFHI-hospital (48.2%; p<0.01). At postpartum discharge, 51% (n=53) of mothers in the BFHI-hospital were breast feeding exclusively versus 29.6% (n=29) at the non-BFHI-hospital. Where formula feed was introduced, women in the BFHI-hospital more often practiced mixed feeding rather than exclusive formula feeding with some switching from mixed feeding to exclusive breast feeding between 3 and 6 months postpartum. Exclusive breast feeding rates declined in both hospitals at 3 and 6 months postpartum with lack of community services for lactation being a major reason. Although BFHI-hospital staff (n=9) were more conversant with BFHI principles, defects in adherence to the BFHI 10 Steps were identified. Conclusions This is the first study assessing the effectiveness of BFHI implementation in Saudi Arabia. Although women reported increased breast feeding rates, we identified important weaknesses that could be improved through strict compliance with BFHI practices.

Assessing declarative and procedural knowledge using multiple-choice questions

Assessment is an indispensable aspect of academic life a natural partner to curriculum and a central component in medical education (1). Aside from its core objective of gauging student performance, assessment is also crucial for documenting the attainment of learning outcomes, verifying medical competence and, ultimately, minimizing risks to patients arising from an unsatisfactory knowledge base (2). (Published: 22 May 2013) Citation: Med Educ Online 2013, 18 : 21132 - http://dx.doi.org/10.3402/meo.v18i0.21132

Comparative analysis of quantity and quality of biomedical publications in Gulf Cooperation Council countries from 2011-2013

Objectives: To compare the research productivity of different Gulf Cooperation Council (GCC) countries in the field of biomedical sciences from 2011-2013. Methods: This is a retrospective study conducted in the College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Data on the biomedical publications originating from GCC countries published between January 2011 to December 2013 was searched via MEDLINE using PubMed. The total number of publications emanating from each country was normalized with the country’s population. The mean impact factor (IF) of all the publications in a year was calculated for comparative analysis. Results: A total of 11,000 publications were retrieved via MEDLINE using PubMed, out of which, 9222 were selected for analysis. A successive increase in the number of publications by every country was observed. The most striking increase in the number of publications was from Saudi Arabia. However, after normalization with population, the performance of Oman, Qatar, and Kuwait looks far better than Saudi Arabia in terms of research productivity. Data on mean IF showed that the overall mean IF of all GCC countries has remained largely unchanged except Oman. Although Oman had a comparatively low mean IF value in 2011, they recorded a tremendous improvement in successive years. Conclusion: All GCC countries underwent an increase in quantitative research productivity over the last 3 years. However, no increase in quality of research publications was noted based on the proxy reports of mean journal IF.

Research-oriented series: a portal into the culture of biomedical research for junior medical students at Alfaisal University in Saudi Arabia

Student contributions to research have been shown to effectively reflect on their communication and critical thinking skills. Short-term research courses offer opportunities for medical students to advance their research experience in subsequent high-demanding long-term research opportunities. The purpose of the present study was to describe the development, implementation, and evaluation of a research-oriented series (ROS) on undergraduate students at Alfaisal University in Saudi Arabia. The ROS was designed to comprise eight sessions. Each session addressed core principles and the practice of research concepts and was based on theoretical morning sessions supplemented by afternoon practical sessions delivered by experienced senior medical students and faculty members. Students were assessed comprehensively by the end of the ROS. The series was conducted twice, and 35 students were involved each time. A total of 70 enrolled students (35 men and 35 women) with grade point averages of >3.5 and <3.5 were asked to fill out an anonymous, online, self-administered questionnaire assessing their perception of knowledge, skills, and confidence after attending the ROS and evaluating their senior peers. Ninety percent of the medical students responded to the online survey and rated the ROS highly in improving their research knowledge, skills, and confidence. Male students reported significant gains compared with their female peers (P<0.05). Grade point averages did not play a role in student gains after attending the ROS. Qualitative responses were in support of three recurring themes favoring the unique learning environment in the ROS. In conclusion, the ROS offers a short-term systematic approach to fundamental steps and concepts of biomedical research.

Women's health and empowerment in Yemen

Yemen’s health-care system has witnessed improvements since 1990; however, these improvements are disappointing when compared with successes achieved by neighbouring Gulf countries. Women and child health is a chief concern requiring advance ment and effective intervention. Recent initiatives have been de veloped to target Millennium Developmental Goals 4 and 5, which buttress reduction in child mortality rates and improvement of maternal health. Among these initiatives, the National Midwifery Strategy led by the Ministry of Public Health and Population, the National Reproductive Health Strategy, and the CATALYST Consortium in partnership with USAID aimed at improving training of midwives, staff retention, and methods used in family planning and reproductive-health service delivery. However, present data show that these projects exhibit some challenges and have had limited success. Yemen has an infant death rate of 51 deaths per 1000 livebirths and a maternal mortality rate of 365 per 100 000 livebirths. At present, 22 women die every year because of poor maternal health facilities in Yemen, and 1 in 39 women die during childbirth. According to the UN Population Fund (UNFPA), although there has been a 61% decline in maternal mortality rate since 1990, maternal mortality is expected to rise in the future. This is, partly, due to the recent political and economic crises, which have affected mobility and resources, further hindering access to health care—particularly for women. It seems unlikely that Yemen will achieve the UN Millennium Development Goal with regard to the empowerment of women by 2015. The sociocultural and educational structure of Yemeni society seems to play an important part in hindering progress towards the above-mentioned goals. For example, the average cut off age for women’s education stands at a disturbing 7 years, and women’s literacy rate is an alarming 59·1%. Moreover, from child marriages to unequal rights for divorce, custody, and inheritance within marriages, Yemeni society suff ers from marked discrimination against women. The future of Yemen’s women depends heavily on greater public awareness about wellbeing, increased and diverse access to health care, and equal educational and socioeconomic rights. Lawmakers and governmental organisations must recognise the threat posed by child marriages and unequal marital status not only for women and children’s health, but also at sociopsychological levels, and amend legal policies to combat these issues. Furthermore, it is crucial that projects targeting women’s empowerment and health care are placed under regular and rigorous surveillance and adjusted on the basis of analysis of gains and benefi ts to the community. International col laboration with neighbouring Gulf countries, in particular, is necessary to solve existing and impending concerns regarding women’s health in Yemen.