Cross-cultural comparison of the patient-centeredness of the hidden curriculum between a Saudi Arabian and 9 US medical schools

BACKGROUND: The implicit hidden curriculum strongly influences medical students\u27 perceptions of the importance of patient-centeredness. A new instrument, the Communication, Curriculum, and Culture Survey (C3), already used to assess this hard-to- access part of the curriculum in the US, has potential for use in cross-cultural comparisons. OBJECTIVE: To use the C3 to perform a pilot cross-cultural comparison of the patient-centeredness of the hidden curriculum between a Saudi medical school and 9 U.S. medical schools. DESIGN: Senior Saudi medical students completed the C3 and a second instrument, the Patient-Provider Orientation Scale (PPOS), which measured their attitudes toward patient-centered behavior. PARTICIPANTS: Senior Saudi medical students. RESULTS: 139/256 (54%) Saudis completed the C3; 122/256(48%) completed the PPOS. Means for 2 out of 3 of the C3\u27s domains (0-100 scale) were lower for the Saudis than those for the Americans (95% confidence intervals in parentheses): 47 (45, 50) vs. 55 (53, 58); 54 (50, 58) vs. 68 (67, 70); they overlapped in the third: 60 (57, 63) vs. 62 (60, 63). The mean Saudi PPOS score was 4.0 (3.9, 4.1); for the American medical schools, 4.8 (4.8-4.8) (1-6, least to most patient-centered). CONCLUSIONS: In this preliminary study the data suggest that the patient-centeredness of the hidden curriculum differs in Saudi and US medical schools in 2 out of 3 domains. Cross-cultural use of instruments such as the C3 can highlight such important differences and help educators evaluate their curriculum from an international, as well as a local perspective. Use of instruments across borders is a growing trend and an indicator of the increasing globalization of medical education

Novel and Emerging Therapies for Inflammatory Bowel Disease.

Inflammatory bowel diseases (IBD) such as ulcerative colitis and Crohn\u27s disease are chronic, relapsing and remitting disorders of intestinal inflammation with potential systemic manifestations. Despite the availability of current biologics, such as anti-tumor necrosis factor (anti-TNF), anti-integrins, anti-interleukins and small molecules such as tofacitinib, the rates of primary and secondary treatment failure remain high in IBD. This highlights the importance of continued development of new therapeutic targets and modifications of existing ones to improve the treatment response rates and to also improve the safety profile and tolerability of these medications. In this review we will discuss novel treatment target agents including selective janus kinase (JAK) inhibitors, anti-interleukin (IL) (IL-12/IL-23), leukocyte trafficking/migrating inhibitors (such as sphingosine-1-phosphate receptor modulator) and other small molecules currently in development

Emerging Therapies for Ulcerative Colitis: Updates from Recent Clinical Trials

Turki AlAmeel,1 Abdulelah AlMutairdi,2,3 Badr Al-Bawardy2– 4 1Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 2Department of Internal Medicine, Division of Gastroenterology and Hepatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 3College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; 4Department of Internal Medicine, Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, USACorrespondence: Badr Al-Bawardy, Department of Internal Medicine, Division of Gastroenterology and Hepatology, King Faisal Specialist Hospital and Research Center, P. O. Box 3354, Riyadh, 11121, Saudi Arabia, Email [email protected]: Ulcerative colitis (UC) is a chronic and progressive inflammatory disorder that affects the colon. The advent of advanced therapies such as biologic agents and small molecules has revolutionized the management of UC. Despite the expanding therapeutic armamentarium of advanced therapies to treat UC, the overall net remission rates and durability of currently available agents are relatively low. This highlights the need for further drug development and more innovative clinical trial design. There are currently multiple emerging agents in the pipeline for the management of UC. This includes agents with alternative routes of administration such as oral or subcutaneous tumor necrosis factor inhibitors or novel mechanisms of action such as toll-like receptor 9 (TLR9) agonist cobitolimod and phosphodiesterase 4 inhibitor apremilast. In this review, we will highlight novel and emerging advanced therapies currently in the pipeline for the management of UC.Keywords: inflammatory bowel disease, ulcerative colitis, small molecules, biologics, novel therap