A Theoretical Review of Developing Faculty Leadership to Enhance Classroom Setting Using the “Boyer Model of Scholarship”

Purpose: This study aims to investigate the position of faculty leadership in promoting the four components of Boyer's Model of Scholarship are discovery, integration, application, and instruction, and its impact on educational establishments.   Theoretical framework: The study emphasizes the significance of faculty leadership in promoting a culture of learning and advancement in educational institutions.   Design/methodology/approach: Using a content analysis method, a descriptive research approach is used to identify common themes and patterns related to faculty leadership and the four components of Boyer's model.   Findings: The results reveal that faculty leadership is critical in promoting the four components of Boyer's model and can positively affect educational institutions' overall effectiveness. The findings also emphasize the need for professional development programs and recognition of faculty leadership to enhance educational outcomes.   Research, Practical and Social Implications: The study's findings have implications for educational leaders and policymakers, accentuating the essence of investing in faculty leadership development to boost a culture of learning and advancement in educational institutions.   Originality/value: This study contributes to the existing literature on faculty leadership and Boyer's Model of Scholarship by highlighting the critical role faculty leadership plays in promoting a culture of learning and advancement in educational institutions. It also provides practical solutions for improving faculty leadership efficacy and overall educational outcomes

Pharmacists’ prescribing in Saudi Arabia : cross-sectional study describing current practices and future perspectives

Pharmacist prescribing is being increasingly undertaken to better use their skills and reduce the workload of existing prescribers such as doctors, often using formal processes to legitimate these activities. In developing countries like Saudi Arabia, however, pharmacists’ prescribing remains informal with no legislation or formal training and there is a lack of research and understanding into such practices. Therefore, we aimed to describe current pharmacist prescribing practices in Saudi Arabia and explore pharmacists’ views about pharmacists’ prescribing. This is a cross-sectional survey study using an online questionnaire of hospital pharmacists in Saudi Arabia about pharmacists’ prescribing, and associated views about prescribing legislation and barriers to implementing pharmacist prescribing. Over a quarter (28.5%) of pharmacists reported themselves as prescribers, 49% were following a collaborative prescribing model, 18% independent prescribing, and 33% were doing both. Ninety percent of prescribers reported confidence in prescribing the appropriate treatment and 92.3% perceived they will benefit from more prescribing training. Healthcare practice culture and pharmacist’s competency were identified as barriers. There is an overall support for pharmacists’ prescribing in Saudi Arabia among this sample of hospital pharmacists, with limitations in resources and the absence of standardized prescribing training being perceived as key barriers to pharmacists’ prescribing

The role of dietary fat and adipose tissues in the aetiopathogenesis and treatment of Crohn’s disease

Treatment of Crohn's disease (CD) is challenging. The use of enteral nutrition (EN) as primary therapy in adult patients with CD is not yet supported by high quality evidence. The fat composition of EN has been suggested to be a key factor in controlling the inflammation in CD. Moreover, deep understanding of disease pathogenesis is lacking. In CD, the mesentery attached to the inflamed intestine is often focally thickened: the phenomenon known as “fat-wrapping”, but the reasons for this are unknown. Additionally, the alteration in tissue remodelling of intestinal epithelium by high fat intake is a newly suggested cellular mechanism for intestinal diseases. It is predicted that improved patient outcomes will come from novel nutritional therapies resulting from an improved understanding of the disease pathogenesis. The aims of my PhD research were to investigate novel mechanisms of action of dietary fatty acids in CD patients’ mesenteric pre-adipocytes and epithelial cells which could benefit the development of optimized lipid formulation of enteral feeds. Here, in a systematic review of previous clinical trials in CD, we demonstrated that high remission rate is significantly associated with the intake of exclusive enteral nutrition (EEN) feeds that have a high n-6:n-3 ratio. The amount of medium chain triglyceride (MCT) in the feeds was also positively correlated with the remission rate but without statistical significance. lower remission rates were non-significantly associated with higher intakes of feeds enriched with long chain triglycerides (LCTs) or monounsaturated fatty acids (MUFA). In CD mesenteric adipose tissue (MAT) I have identified several abnormalities in their gene expression profile. Unlike typical adipose tissue, MAT in CD was associated with defective adipogenesis via reduced expression of leptin and CEBPa, and was associated with a low anti-inflammatory profile via decreased expression of M2 macrophage markers. Moreover, in in-vitro study I showed that mesenteric preadipocytes have an increased adipogenic response to oleic acid, linoleic acid, and alinolenic acid, which was predominantly modulated via CEBPa. Finally, in cell culture study I have shown that low concentration of lipids can modulate the physiology of the gut epithelium by reducing colonic crypt proliferation. In conclusion, my data indicate that the fatty acid composition of EEN can play a key role in improving clinical outcomes in CD. According to my findings, the mechanism of this action can be mediated via MAT function and possibly through intestinal stem cell function. Overall, the findings of this PhD research provide important insights into a new mechanism of action which can be exploited to target future therapeutic approaches in CD and to help optimize the lipid formulation of enteral feeds used in its treatment

Dietary polyunsaturated fat for prevention and treatment of inflammatory bowel disease:Protocol

Published in PROSPERO international prospective register of systematic review

Oral anticoagulant prescribing among patients with cancer and atrial fibrillation in England, 2009–2019:OAC prescribing in AF patients with cancer

BACKGROUND: Anticoagulation of patients with atrial fibrillation (AF) and cancer is challenging because of their high risk for stroke and bleeding. Little is known of the variations of oral anticoagulant (OAC) prescribing in patients with AF with and without cancer.METHODS: Patients with first-time AF during 2009-2019 from the Clinical Practice Research Datalink were included. Cancer diagnosis was defined as a history of breast, prostate, colorectal, lung, or hematological cancer. Competing-risk analysis was used to assess the risk of OAC prescribing in patients with AF and cancer adjusted for clinical and sociodemographic factors.RESULTS: Of 177,065 patients with AF, 11.7% had cancer. Compared to patients without cancer, patients with cancer were less likely to receive OAC: prostate cancer (subhazard ratio [SHR], 0.95; 95% CI, 0.91-0.99), breast cancer (SHR, 0.93; 95% CI, 0.89-0.98), colorectal cancer (SHR, 0.93; 95% CI, 0.88-0.99), hematological cancer (SHR, 0.70; 95% CI, 0.65-0.75), and lung cancer (SHR, 0.44; 95% CI, 0.38-0.50). The cumulative incidence function (CIF) of OAC prescribing was lowest for patients with lung cancer and hematological cancer compared with patients without cancer. The difference between the CIF of OAC prescribing in patients with and without cancer becomes narrower in the most deprived areas. Elderly patients (aged ≥85 years) overall had the lowest CIF of OAC prescribing regardless of cancer status.CONCLUSIONS: In patients with AF, underprescribing of OAC is independently associated with certain cancer types. Patients with hematological and lung cancer are the least likely to receive anticoagulation therapy compared with patients without cancer. Underprescribing of OAC in cancer is linked to old age. Further studies of patients with AF and cancer are warranted to assess the net clinical benefit of anticoagulation in certain cancer types.</p

Dysglycemia risk score in Saudi Arabia: A tool to identify people at high future risk of developing type 2 diabetes

Abstract Aims/Introduction To develop a non-invasive risk score to identify Saudis having prediabetes or undiagnosed type 2 diabetes. Methods Adult Saudis without diabetes were recruited randomly using a stratified two-stage cluster sampling method. Demographic, dietary, lifestyle variables, personal and family medical history were collected using a questionnaire. Blood pressure and anthropometric measurements were taken. Body mass index was calculated. The 1-h oral glucose tolerance test was carried out. Glycated hemoglobin, fasting and 1-h plasma glucose were measured, and obtained values were used to define prediabetes and type 2 diabetes (dysglycemia). Logistic regression models were used for assessing the association between various factors and dysglycemia, and Hosmer?Lemeshow summary statistics were used to assess the goodness-of-fit. Results A total of 791 men and 612 women were included, of whom 69 were found to have diabetes, and 259 had prediabetes. The prevalence of dysglycemia was 23%, increasing with age, reaching 71% in adults aged ≥65 years. In univariate analysis age, body mass index, waist circumference, use of antihypertensive medication, history of hyperglycemia, low physical activity, short sleep and family history of diabetes were statistically significant. The final model for the Saudi Diabetes Risk Score constituted sex, age, waist circumference, history of hyperglycemia and family history of diabetes, with the score ranging from 0 to 15. Its fit based on assessment using the receiver operating characteristic curve was good, with an area under the curve of 0.76 (95% confidence interval 0.73?0.79). The proposed cut-point for dysglycemia is 5 or 6, with sensitivity and specificity being approximately 0.7. Conclusion The Saudi Diabetes Risk Score is a simple tool that can effectively distinguish Saudis at high risk of dysglycemia.Peer reviewe

Long-term effects of increasing omega-3, omega-6 and total polyunsaturated fats on inflammatory bowel disease and markers of inflammation: A systematic review and meta-analysis of randomized controlled trials

Background & Aims: Effects of long-chain omega-3 (LCn3) and omega-6 fatty acids on prevention and treatment of inflammatory bowel diseases (IBD, including Crohn’s Disease, CD and ulcerative colitis, UC), and inflammation are unclear. We systematically reviewed long-term effects of omega-3, omega-6 and total polyunsaturated fats (PUFA) on IBD diagnosis, relapse, severity, pharmacotherapy, quality of life and key inflammatory markers.  Methods: We searched Medline, Embase, Cochrane CENTRAL, and trials registries, including RCTs in adults with or without IBD comparing higher with lower omega-3, omega-6 and/or total PUFA intake for ≥24 weeks that assessed IBD-specific outcomes or inflammatory biomarkers.  Results: We included 83 RCTs (41,751 participants), of which 13 recruited participants with IBD. Increasing LCn3 may reduce risk of IBD relapse (RR 0.85, 95% CI 0.72 to 1.01) and IBD worsening (RR 0.85, 95% CI 0.71 to 1.03), and reduce erythrocyte sedimentation rate (ESR, SMD -0.23, 95% CI -0.44 to -0.01), but may increase IBD diagnosis risk (RR 1.10, 95% CI 0.63 to 1.92), and faecal calprotectin, a specific inflammatory marker for IBD (MD 16.1μg/g, 95% CI -37.6 to 69.8, all low-quality evidence). Outcomes for alpha-linolenic acid, omega-6 and total PUFA were sparse, but suggested little or no effect where data were available.  Conclusion: This is the most comprehensive meta-analysis of RCTs investigating long-term effects of omega-3, omega-6 and total PUFA on IBD and inflammatory markers. Our findings suggest that supplementation with PUFAs has little or no effect on prevention or treatment of IBD and provides little support for modification of long-term inflammatory status

Association Between Anthropometric Indices and Nonanthropometric Components of Metabolic Syndrome in Saudi Adults

Context: Waist circumference (WC) is used in screening for metabolic syndrome (MetS) based on its association with cardiometabolic risk.This might apply differently in ethnically different populations. Associations with other measures are also unclear. Objective: This work aimed to investigate the association between neck circumference (NC), WC, WC:hip circumference, WC:height (VVC:Ht), NC:Ht, fat percentage, body mass index (BMI), conicity index, abdominal volume index, and weight-adjusted waist index with nonanthropometric components of MetS in nondiabetic Saudi adults. Methods: This cross-sectional study took place in public health centers in Jeddah, comprising 1365 Saudi adults (772 men and 593 women) aged 18 years or older not previously diagnosed with diabetes. Main outcome measures included the presence of 2 or more nonanthropometric components of the MetS were used to define clinical metabolic abnormality (CMA). The predictive ability of studied anthropometric indices for CMA was determined using the area under receiver operating characteristics (AUC) curve and binary logistic regression. Results: A total of 157 men and 83 women had CMA. NC and NC:Ht had the highest predictive ability for CMA in men (odds ratio [OR](NC) = 1.79, P < .001 and ORNC:Ht = 1.68, P < .001; AUC(NC) = 0.69 [95% CI, 0.64-0.74] and ALS, = 0.69 [95% CI, 0.64-0.73]). In women, WC had the highest predictive ability ORWC = 1.81, P< .001; AUC(WC) = 0.75 [95% CI, 0.69-0.80]). Conclusion: Upper-body anthropometric indicators that were associated with subcutaneous fat had the highest predictive ability for CMA in men whereas abdominal obesity indictors had the best predictive ability in women, suggesting that fat distribution might contribute to CMA in a sex-specific manner.Peer reviewe

The association between hypertension and other cardiovascular risk factors among non-diabetic Saudis adults-A cross sectional study

Population specific associations between cardiovascular disease with various risk factors including pre-hypertension and hypertension were reported. We aimed to investigate the association of higher than optimal blood pressure with measures of dysglycemia, dyslipidemia, and markers of inflammation in non-diabetic Saudi adults hoping to improve current Saudi guidelines to prevent cardiovascular disease. Volunteers were recruited randomly from public healthcare centers in Jeddah. Demographic information, blood pressure (BP), and anthropometric measurements were taken. Fasting blood samples were drawn, then again following 1-hour oral glucose tolerance test. Glycated hemoglobin, fasting plasma glucose (FPG), lipid profile, highly sensitive C- reactive protein, gamma glutamyl transferase, and 1-hour plasma glucose were measured. Complete data was found for 742 men and 592 women. Pre-hypertension was found in 47.2% of men, and 24.7% of women, while 15.1% of men, and 14.6% of women were hypertensive. Means of measured variables differed significantly between normotensive, pre-hypertensive, and hypertensive groups of men and women in gender specific manner. Association between measured variables and elevated BP, and hypertension were assessed using logistic regression models. After adjustment for age, body mass index and waist circumference, elevated blood pressure was associated with elevated triglycerides in men, while hypertension was significantly associated with elevated fasting plasma glucose, total cholesterol, triglycerides, low density lipoprotein- cholesterol, and low high density lipoprotein- cholesterol in men, and elevated triglycerides, and total cholesterol in women. Therefore, it is strongly recommended to measure lipid profile, specifically TG, for all diagnosed pre-hypertensive and hypertensive patients in addition to FPG for men.Peer reviewe