Procedures of recruiting, obtaining informed consent, and compensating research participants in Qatar: findings from a qualitative investigation

Abstract Background Very few researchers have reported on procedures of recruiting, obtaining informed consent, and compensating participants in health research in the Arabian Gulf Region. Empirical research can inform the debate about whether to adjust these procedures for culturally diverse settings. Our objective was to delineate procedures related to recruiting, obtaining informed consent, and compensating health research participants in the extremely high-density multicultural setting of Qatar. Methods During a multistage mixed methods project, field observations and qualitative interviews were conducted in a general medicine clinic of a major medical center in Qatar. Participants were chosen based on gender, age, literacy, and preferred language, i.e., Arabic, English, Hindi and Urdu. Qualitative analysis identified themes about recruitment, informed consent, compensation, and other research procedures. Results A total of 153 individuals were approached and 84 enrolled; the latter showed a diverse age range (18 to 75 years); varied language representation: Arabic (n = 24), English (n = 20), Hindi (n = 20), and Urdu (n = 20); and balanced gender distribution: women (n = 43) and men (n = 41). Primary reasons for 30 declinations included concern about interview length and recording. The study achieved a 74% participation rate. Qualitative analytics revealed key themes about hesitation to participate, decisions about participation with family members as well as discussions with them as “incidental research participants”, the informed consent process, privacy and gender rules of the interview environment, reactions to member checking and compensation, and motivation for participating. Vulnerability emerged as a recurring issue throughout the process among a minority of participants. Conclusions This study from Qatar is the first to provide empirical data on recruitment, informed consent, compensation and other research procedures in a general adult population in the Middle East and Arabian Gulf. This investigation illustrates how potential research participants perceive research participation. Fundamentally, Western ethical research principles were applicable, but required flexibility and culturally informed adaptations.http://deepblue.lib.umich.edu/bitstream/2027.42/109514/1/12910_2013_Article_251.pd

The Usefulness of Nap Sleep Recording During Routine Electroencephalography: An Audit Study

Objectives: A measure to increase the electroencephalogram (EEG) outcome includes a short period of nap sleep during a routine standard EEG with the aim of increasing its sensitivity to interictal abnormalities or provoking seizures. As part of an ongoing auditing of our EEG data, we aimed to investigate the contribution of nap sleep during routine outpatient department based EEGs requested for a variety of reasons. Methods: EEG data at the Department of Clinical Physiology at Sultan Qaboos University Hospital, Oman, from July 2006 to December 2007 and from January 2009 to December 2010 (total 42 months) were reviewed. The EEGs were for patients older than 13-years referred for possible epilepsy, blackouts, headache, head trauma, and other non-specified attacks. The recording period was between 20 to 40 minutes. Abnormalities were identified during waking and nap sleep periods. Results: A total of 2 547 EEGs were reviewed and 744 were abnormal (29.2%). Of those abnormal EEGs, nap sleep was obtained in 258 (34.7%) EEGs, and 39 (15.1%) showed abnormalities during nap sleep. Nineteen out of the 39 (48.7%) EEGs were abnormal during awake and nap sleep; and 20 (51.3%) were abnormal during nap sleep, which represented only 2.7% of the total abnormal EEGs (n = 744). Conclusions: The contribution of the short nap sleep to the pickup rate of interictal abnormalities in EEG was minimal. We recommend the EEG service to include one cycle of spontaneous sleep EEG directed at patients with a history suggestive of epilepsy if their awake EEGs are normal

Patient responses to research recruitment and follow-up surveys: findings from a diverse multicultural health care setting in Qatar

Abstract Background Health care researchers working in the Arabian Gulf need information on how to optimize recruitment and retention of study participants in extremely culturally diverse settings. Implemented in Doha, Qatar in 2012 with 4 language groups, namely Arabic, English, Hindi, and Urdu, this research documents persons’ responses to recruitment, consent, follow-up, and reminder procedures during psychometric testing of the Multicultural Assessment Instrument (MAI), a novel self- or interviewer-administered survey. Methods Bilingual research assistants recruited adults in outpatient clinics by approaching persons in particular who appeared to be from a target language group. Participants completed the MAI, a second acculturation instrument used for content-validity assessment, and a demographics questionnaire. Participants were asked to take the MAI again in 2–3 weeks, in person or by post, to assess test-retest reliability. Recruitment data were analyzed by using nonparametric statistics. Results Of 1503 persons approached during recruitment, 400 enrolled (27 %)—100 per language group. The enrollment rates in the language groups were: Arabic-32 %; English-33 %; Hindi-18 %; Urdu-30 %. The groups varied somewhat in their preferences regarding consent procedure, follow-up survey administration, contact mode for follow-up reminders, and disclosure of personal mailing address (for postal follow-up). Over all, telephone was the preferred medium for follow-up reminders. Of 64 persons who accepted a research assistant’s invitation for in-person follow-up, 40 participants completed the interview (follow-up rate, 63 %); among 126 persons in the postal group with a deliverable address, 29 participants mailed back a completed follow-up survey (response rate, 23 %). Conclusions Researchers in the Arabian Gulf face challenges to successfully identify, enroll, and retain eligible study participants. Although bilingual assistants—often from the persons’ own culture—recruited face-to-face, and our questionnaire contained no health care-related content, many persons were reluctant to participate. This occurrence was observed especially at follow-up, particularly among participants who had agreed to follow-up by post

Additional file 1: of Traditional Arabic & Islamic medicine: validation and empirical assessment of a conceptual model in Qatar

Sample Interview Guide. (DOC 40 kb

What Do Pediatric Subinterns Say About Their Learning and Assessment? A Qualitative Analysis of Individual Learning Plans.

OBJECTIVE: To perform a qualitative content analysis of learning and assessment strategies that pediatric sub-interns describe in Individualized Learning Plans (ILPs) and to explore barriers and facilitators to their learning. METHODS: We analyzed ILPs from medical students enrolled in pediatric sub-internships at 10 U.S. medical schools that utilized a standardized curriculum and were recruited to reflect diversity in geographic location, funding, and enrollment. Students used an ILP to record three or more selected learning objectives, rationale for selection, and reflection on learning and assessment strategies. Investigators used the constant comparative method to perform a content analysis of the ILPs, grouping codes into themes, and verifying relationships between codes within themes. RESULTS: 204 ILPs that included student reflections on 850 learning objectives were analyzed. Content was analyzed in five categories: rationale for selecting objectives, learning strategies, assessment strategies, challenges to learning, and facilitators of learning. Students showed strong commitment to individualized, self-directed learning, developed a wide range of creative learning strategies, and relied heavily on self-reflection to assess their progress. The learning environment both helped and hindered students\u27 ability to make and assess progress on their selected learning objectives. CONCLUSIONS: Through ILP-guided reflection and a formal curriculum, students can choose well-justified learning objectives and demonstrate resourcefulness and independence in developing self-directed learning and assessments strategies. The strategies that students identified in this study provide a menu of learning and assessment options for sub-interns. Identified challenges and facilitators of learning provide guidance for educators who seek to enhance the clinical learning environment

Synthesis and evaluation of pyridine-3-carboxamide analogs as effective agents against bacterial wilt in tomatoes

Abstract This study focused on developing novel pyridine-3-carboxamide analogs to treat bacterial wilt in tomatoes caused by Ralstonia solanacearum. The analogs were synthesized through a multistep process and their structures confirmed using spectroscopy. Molecular docking studies identified the most potent analog from the series. A specific analog, compound 4a, was found to significantly enhance disease resistance in tomato plants infected with R. solanacearum. The structure–activity relationship analysis showed the positions and types of substituents on the aromatic rings of compounds 4a–i strongly influenced their biological activity. Compound 4a, with a chloro group at the para position on ring C and hydroxyl group at the ortho position on ring A, was exceptionally effective against R. solanacearum. When used to treat seeds, the analogs displayed remarkable efficacy, especially compound 4a which had specific activity against bacterial wilt pathogens. Compound 4a also promoted vegetative and reproductive growth of tomato plants, increasing seed germination and seedling vigor. In plants mechanically infected with bacteria, compound 4a substantially reduced the percentage of infection, pathogen quantity in young tissue, and disease progression. The analogs were highly potent due to their amide linkage. Molecular docking identified the best compounds with strong binding affinities. Overall, the strategic design and synthesis of these pyridine-3-carboxamide analogs offers an effective approach to targeting and controlling R. solanacearum and bacterial wilt in tomatoes