Interest and perceived barriers toward careers in academic medicine among medical students at Alfaisal University – College of Medicine: A Saudi Arabian perspective

Abstract

Aims: [1] Identify the percentage of undergraduate students who are interested in academic medicine (AM) careers, [2] Explore the relationship between students’ characteristics, previous experiences and interest in AM careers and [3] Determine students’ perceived barriers toward AM careers at Alfaisal University – College of Medicine.

Methods: An online, anonymous, random, self-rating survey was administered during spring 2013–2014 to second-year and third-year students (n?=?302). Chi-square test was used to correlate between interest in AM careers and students’ characteristics. Mann–Whitney U-test was used to compare the mean 5-point Likert scale responses between male and female students.

Results: A total of 231 students participated in the survey (response rate: 76.5%). A total of 32 students (13.9%) expressed interest in AM careers, and this percentage significantly differed by gender, academic year, interest in teaching and research and previous research experiences (p?<?0.05). The top three barriers were “lower income” (77.5%), “competing pressures to fulfill clinical-teaching-research duties” (73.6%) and “lack of career advising” (69.7%). As opposed to males, females achieved higher statistically significant differences of means regarding: “competing pressures to fulfill clinical-teaching-research duties” (p?<?0.001) and “lack of same-gender role models in AM careers” (p?<?0.000).

Conclusions: AM careers were unpopular by students. Curricular, extracurricular and institutional measures should be implemented to rectify this dilemma.     

The 3111 Clock gene polymorphism is not associated with sleep and circadian rhythmicity in phenotypically characterized human subjects

Mutations in clock genes are associated with abnormal circadian parameters, including sleep. An association has been reported previously between a polymorphism (3111C), situated in the 3'-untranslated region (3'-UTR) of the circadian gene Clock and evening preference. In the present study, this polymorphism was assessed in: (1) 105 control subjects with defined diurnal preference, (2) 26 blind subjects with free-running circadian rhythms and characterized with regard to circadian period (tau) and (3) 16 delayed sleep phase syndrome patients. The control group was chosen from a larger population (n = 484) by Horne-Ostberg questionnaire analysis, from which three subgroups were selected (evening, intermediate and morning preference). Data from sleep diaries completed by 90% of these subjects showed a strong correlation between preferred and estimated timings of sleep and wake. The mean timings of activities for the evening group were at least 2 h later than the morning group. Genetic analysis showed that, in contrast with the previously published finding, there was no association between 3111C and eveningness. Neither was there an association between 3111C and tau, nor a significant difference in 3111C frequency between the normal and delayed sleep phase syndrome groups. To assess the effect of this polymorphism on messenger RNA (mRNA) translatability, luciferase reporter gene constructs containing the two Clock polymorphic variants in their 3'-UTR were transfected into COS-1 cells and luciferase activity measured. No significant difference was observed between the two variants. These results do not support Clock 3111C as a marker for diurnal preference, tau, or delayed sleep phase syndrome in humans.     

Ischemic Colitis

Ischemic diseases of the gastrointestinal tract are some of the commonly encountered gastrointestinal diseases which are difficult to diagnose and still more difficult to treat. Presentation of colon ischemia is even more subtle, and this review article details about the various presentation patterns of ischemic colitis and their management.     

Metabolism Pharmacokinetics of Melatonin in the Ewe

The pineal hormone melatonin has been used to advance the onset of the breeding season in sheep and thus produce lambs earlier in the year. If this reproductive manipulation is to be used commercially, some knowledge of the route of metabolism and identity of possible metabolites is necessary. A major metabolite of melatonin in rodents and man is 6-hydroxymelatonin sulphate (acetyl-methoxytryptamine-6-sulphate [aMT6S]). No significant amounts of this metabolite could be found in the plasma of untreated ewes. After subcutaneous implantation of melatonin for 5 months, plasma levels of aMT6S were also insignificant. On the other hand, both a single oral dose of melatonin (3 mg) and daily oral dosing gave rise to circulating levels of aMT6S in the range of 150 to 1,500 pg/ml for at least 18 h. The profiles seen after 180 days treatment were similar to those seen after a single dose, indicating that this route of melatonin metabolism is not induced by chronic administration. Intravenous injection of melatonin (200 or 20 micrograms) gave rise to detectable levels of aMT6S in the plasma. These results indicate that the quantitative aspects of melatonin metabolism differ according to the route of administration.     

Referral outcomes from a vision screening program for school-aged children

ObjectiveTo assess ocular diagnoses and follow-up patterns of children referred for a comprehensive eye examination after a school-based vision screening program.DesignRetrospective chart review.ParticipantsStudents in grades K–5 from the School District of Philadelphia public schools screened by The Wills Eye Vision Screening Program for Children between January 2014 and June 2015.MethodsChildren with subnormal best-corrected visual acuity or other ocular conditions were referred to the Wills Eye pediatric ophthalmology service. A social worker assisted parents/guardians of referred children in scheduling an appointment and navigating insurance/payment issues. Measured outcomes included demographic information, ocular diagnoses, treatments, and follow-up patterns.ResultsOf 10 726 children screened, 509 (5%) were referred for a follow-up eye examination. Of these 509 children, only 127 (25%) completed a referral eye examination with parental consent. Most children (58%) were diagnosed with more than one eye condition, including refractive error (76%), amblyopia (43%), strabismus (16%), and anisometropia (13%). Other conditions included macular hypoplasia, ptosis, and other congenital anomalies.ConclusionsThis program discovered and addressed potentially vision-threatening conditions in underserved children susceptible to amblyopia by offering social worker services and financial support to enable referred children to complete an eye examination. Contact by the social worker required consent. Obtaining such consent proved to be a barrier to connecting children with the recommended consultation.     

Effectiveness of Nurse led structured teaching programme on knowledge and practice of postnatal mothers on low birth weight care

BackgroundLow birth weight (LBW) in infants is a critical issue worldwide. If the issue is not recognized early, it can lead to high mortality and morbidity rates. Mothers and caregivers of LBW newborns holds a great responsibility and need appropriate information and expertise in caring for the LBW newborns. This study aimed to evaluate the effectiveness of a Nurse led structured teaching program (NLSTP) on the knowledge and practice of mothers of LBW infants.MethodsA quantitative pre-experimental one group pre-test post-test research study was conducted. A sample of 30 postnatal mothers of LBW babies meeting the inclusion criteria were selected. The knowledge and practices of postnatal mothers on the care of LBW babies was tested using a structured interview schedule and a checklist before the administration of NLSTP. Thereafter, the NLSTP was conducted using an educational booklet. After the NLSTP, the knowledge and practice were assessed on the 7th day.ResultsThe findings of the study reflected poor knowledge and practice scores before the intervention in the pre-test. However, the mothers gained a good level of knowledge showing marked improvement in their practices after the NLSTP was implemented. The mean post-test knowledge score (17.6) was significantly higher than the mean pre-test knowledge score (10.8) with a SD of +1.33. Likewise, the mean post-test practice score (15.6) was significantly higher than the mean pre-test practice score (8.23) with a SD of +7.5. The paired ‘t’ test computed between pre-test and post-test knowledge scores (t = 67.6) and practice scores (t = 5.28) were highly significant at p ≤ 0.05 level. A significant association was found between the pre-test knowledge scores and monthly family income (p < 0.05 level).ConclusionThis study highlights that post-natal mothers have a lack of expertise in caring for their LBW babies. The NLSTP targeted at improving the knowledge and practices of post-natal mothers regarding the care of their LBW babies can help reduce the morbidity and mortality rates of LBW babies.