Oncology research in Saudi Arabia over a 10-year period: A synopsis

Objectives:To assess the quality and quantity of Saudi publications in oncology over a 10-year period.Methods:A systematic PubMed search was conducted between January 2008 and December 2017 to retrieve all Saudi oncology publications. Data about the articles was collected. The level of evidence (LOE) was independently assessed by 2 authors. Two 5-year periods (2008-2012 and 2013-2017) were compared using the relevant parameters. Clinicaltrials.gov was also searched for all oncology trials registered in Saudi Arabia.Results:A total of 839 publications met our inclusion criteria. The most common type of research was case series, totaling 32% of all publications. Clinical trials formed less than 2% of the total. The LOE was I, II, III, and IV in 0.3%, 2.1%, 58.4%, and 39.3% of the included publications, respectively. The LOE was the same in the 2 periods. There were more publications in international journals (p=0.004), more international collaborations (p=0.001), and higher journal impact factors (p=0.037) in 2013-2017 than in 2008-2012. Only 76 registered clinical trials were found in the Clinicaltrials.gov registry.Conclusion:Despite an increase in the number of Saudi publications in the field of oncology over time, the LOE did not change. There were, however, some improvements in the international collaboration and journal impact factor, as well as an increase in the number of studies published in international journals. These observations call for a national strategy to improve oncology research in Saudi Arabia.     

The Effects of Evidence,Coherence and Credentials on Jury Decision-Making in Child Sexual Abuse Trials

Expert testimony is being used increasingly in child sexual assault cases. This study extended a prior study that examined factors related to expert testimony (evidence strength, coherence and credentials of the expert) on ratings of guilt and overall verdict. Specifically, we replicated our prior study but with two modifications: we used community samples as opposed to university students, and participants made their decisions in groups of 12 (as in the case of juries where one decision represents the overall group) rather than having participants decide and submit their verdicts and guilt ratings individually. Consistent with the prior (less ecologically valid) study, credentials of the expert had negligible impact. Evidence that was high in strength elicited a relatively high guilt rating even when the testimony was low in coherence. Further, it appears that when participants deliberate in a group (as in the case of juries) they are more conservative in their judgements (i.e., they are less likely to give a guilty verdict) compared to individual jurors who make their decisions alone. These findings suggest that caution must be exercised when drawing conclusions about the generalisability of prior research findings where participants did not engage in group deliberation.     

The Cogency of Risk Assessments

Preventive detention schemes rely on assessments of risk carried out by forensic practitioners. Corrective services departments and other organs of the state inevitably present the approaches they adopt and the tools they employ in this endeavour as being “best practice” and “evidence based”. Typically these assessments are conducted according to a bureaucratic template and are based on a selected suite of tests that are heavily biased towards actuarial assessment. The validity of this approach is gravely suspect as is the failure of many forensic professionals to properly identify the diagnostic accuracy/inaccuracy of the tests and methods they rely upon in conducting risk assessments. This article iterates the methodological and evidentiary problems with risk assessment of sexual offenders. It is concluded that common extant approaches lack scientific objectivity and fail to provide the courts with cogent evidence. As a result of these errors in investigatory processes miscarriages of justice are inevitable.     

Evidence,Policies and Practices: Continuities and Discontinuities in Mental Health Promotion in a Developing Country

The relationship between research evidence, policy and implementation is complex throughout the world, but where resources are scarce (especially in developing countries) there is a need to ensure rational implementation. With reference to a study on which we work, we show how the simple act of conducting research where resources are lacking affects implementability. We discuss five key issues with which researchers must engage if they wish to affect policy and implementation: evidence is not the only criterion by which implementation decisions are made, implementation decisions are often political rather than health-oriented in the narrow sense, there is often a difference in time scale between research enterprises and policy implementation, moving from research to the ‘real world’ requires engagement with existing organisational systems, and we need to be able to tell the difference between changes in rhetoric and changes in the real world. The broad international context of funding and the scientific community also affect how researchers work in developing countries. We suggest that engagement with these apparently ‘non-scientific’ concerns is essential to the work of researchers.     

Bella and the white water rapids

Abstract

This article is an exploration of the feeling state engendered in the art psychotherapist when working with a child who had been emotionally and sexually abused. It attempts to discover the meaning of what happened in a therapy when no verbal or thinking interaction could initially take place. It describes the difficulty of finding a way to articulate the fragmented information available, both to bring to consciousness the snippets of memory presented, and to structure them into an organised story.

Thinking appeared to be what the child was desperate to avoid. It was far too painful for her, so anger and abuse were used as a defence. Noise was produced during therapy, so that the artwork, the games and in particular the experience of projective identification could not be thought about. The noise often led to the art psychotherapist being silenced and also unable to think.

Countertransference feelings were communicated, including shame, hatred, love and fear. These were explored to help find meaning, which led to understanding that the child needed to experience attachment to a constant and non-retaliatory Other. This made the experience of both merging and separation from the therapist an enabling space in which to find symbol and thought.     

Report on the European Association of Body Psychotherapy: Bodies of Knowledge: Resources for a World in Crisis

The heterogeneous field of body oriented psychotherapy (BOP) provides a range of unique contributions for the treatment of mental disorders. Practice based clinical evidence and a few empirical studies point towards good efficacy of these non-verbal intervention strategies. This is particularly relevant for those disorders with body image aberration and other body-related psychopathology, but also for mental disorders with limited treatment response to traditional talking therapies, e.g. somatoform disorders/medically unexplained syndromes, PTSD, anorexia nervosa or chronic schizophrenia. However, the evidence base is not yet sufficiently developed in order to get BOP recognised as suitable mainstream treatment by national health services and their commissioning bodies. Strong academic links are urgently required in order to support practitioners in their efforts to evaluate the clinical work in systematic research. The field would greatly benefit from the development of international higher education training in integrated clinical body psychotherapy, enabling practitioners to obtain a master's degree. From a scientific perspective, projects on the interface between neuroscience and psychotherapy research should be conducted in order to understand more fully the therapeutic processes in BOP, particularly with regard to emotional processing, movement behaviour and body/self perception. Qualitative research is needed to further investigate the specific interactive therapeutic relationship, the dynamics of touch in psychotherapy and the additional self-helping potential of creative/arts therapy components. Provided that these requirements will be fulfilled, BOP could be established as one of the main psychotherapeutic modalities in clinical care, alongside other mainstream schools such as psychodynamic, cognitive-behavioural and systemic.     

Improving oral healthcare using academic detailing – design of the ADVOCATE Field Studies

Background: Academic detailing (AD) is a defined form of educational outreach that can be deployed to intrinsically motivate practitioners towards improving quality of care. This paper describes the design of the ADVOCATE Field Studies. This proof of concept study aims to evaluate the feasibility, acceptability and usefulness of AD, reinforced with feedback information to promote prevention-oriented, patient-centred and evidence-based oral healthcare delivery by general dental practitioners (GDPs).

Methods: Six groups of GDPs will be recruited; two groups of six to eight GDPs in each of three countries – the Netherlands, Germany and Denmark. GDPs will meet for four Academic Detailing Group (ADG) meetings for open discussions using comparative feedback data to stimulate debate about their dental practice performance and care delivery. Group meetings will be moderated using the AD methodology. Qualitative data will be collected through focus group interviews, an online discussion forum, field notes and debriefs of ADG meetings and analysed by conventional content analysis using MaxQDA software.

Discussion: The results of the study will provide novel information on the feasibility, perceived acceptability and usefulness of AD and feedback data for GDPs to improve oral healthcare delivery.     

Task Group for Orthodontics Report.

Abstract

The UK Specialist Review Group of the General Dental Council's Education Committee has been charged with taking forward the recommendations in the Chief Dental Officer's report 'UK Specialist Dental Training'. The Specialist Review Group has, in turn, established a number of specialty task groups. This report is from the Task Group for Orthodontics. It was submitted in May 1996.