Lack Of Exposure Research Articles

Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school.

Rural residents of the United States (US) and Canada face problems in accessing healthcare. International medical graduates (IMGs) play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care. Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD) course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation. The study was conducted among premedical and preclinical undergraduate medical (MD) students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied. Ninety nine of the 108 students (91.7%) participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth. Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues. About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been mentioned above. Graduates from Caribbean medical schools have a role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce.

Heritage Language Maintenance and Language Attitude of Korean Immigrant Families in the United States

This study examined language maintenance and language attitude of Korean immigrant families in the United States. The researcher conducted a qualitative of eight Korean parents. Data were collected from interviews and classroom observation. Findings showed that Korean American children faced conflicts with their Korean speaking friends due to different linguistic and cultural backgrounds. Their parents also had difficulties in maintaining their children’s Korean proficiency without a Korean language school. However, despite the urgent concerns about children’s Korean language loss due to the lack of exposure to practicing Korean, the Korean immigrant parents underestimated upcoming communication gap between generations in the future. Thus, Korean parents need to reconsider their role as a primary source to foster their children"s heritage language practice.

The Effect of Science Process Skills Teaching Approach on Secondary School Students’ Achievement in Chemistry in Nyando District, Kenya

Science process skills are central to the acquisition of scientific knowledge which is useful in solving problems in society. In Kenya, students’ achievement in chemistry in the Kenya Certificate of Secondary Education (KCSE) is generally low. The low performance could probably be attributed to lack of exposure to science process skills. This study investigated the effect of science process skills teaching approach (SPSTA) on students’ achievement in chemistry. Solomon Four Group Quasi-experimental design was employed. Purposive sampling was used in selecting four district secondary schools having equal number of boys and girls. The sample size was 153 Form Three students. The Form Three classes were randomly assigned to two experimental and two control groups. The study covered two topics selected from the KCSE Chemistry syllabus namely, Volumetric analysis (Titration) and Qualitative analysis. Chemistry Achievement Test (CAT) consisting of simple calculations, True and False items, and Fill in blanks were used as a pre-test. After the administration of treatment, which lasted five weeks, the same test was administered to the four groups as a post-test. The reliability coefficient of the CAT estimated using Kuder-Richardson (K-R21) formula was equal to 0.88. The data were analyzed using descriptive statistics, t-test, ANOVA and ANCOVA. Hypotheses were tested at α = 0.05 level of significance. The results revealed that SPSTA had a significant effect on students’ achievement in Chemistry. The outcome of this study may provide an insight for designing instructional strategies that aim to enhance students’ performance and contribute to the improvement of teaching and learning of chemistry in secondary schools. DOI: 10.5901/jesr.2014.v4n6p359

G144(P) Is it a time to consider introducing simulation training for ‘Child Safeguarding’?

BackgroundChild protection medical examination is an essential competency for any trainee to progress through CCT. Often trainees are apprehensive when asked to perform Child Protection medicals. Inadequate training may lead...

Modeling Malaria Infection and Immunity against Variant Surface Antigens in Príncipe Island, West Africa

After remarkable success of vector control campaigns worldwide, concerns about loss of immunity against Plasmodium falciparum due to lack of exposure to the parasite are relevant since an increase of severe cases in less immune individuals is expected. We present a mathematical model to investigate the impact of reducing exposure to the parasite on the immune repertoire against P. falciparum erythrocyte membrane protein 1 (PfEMP1) variants. The model was parameterized with data from Príncipe Island, West Africa, and applied to simulate two alternative transmission scenarios: one where control measures are continued to eventually drive the system to elimination; and another where the effort is interrupted after 6 years of its initiation and the system returns to the initial transmission potential. Population dynamics of parasite prevalence predict that in a few years infection levels return to the pre-control values, while the re-acquisition of the immune repertoire against PfEMP1 is slower, creating a window for increased severity. The model illustrates the consequences of loss of immune repertoire against PfEMP1 in a given setting and can be applied to other regions where similar data may be available.

Looking at the Overexposed: Visuality and Race in Harnett’s Attention Company!

Looking at the OverexposedVisuality and Race in Harnett’s Attention Company! Christopher J. Lukasik (bio) The last twenty years has seen a number of cultural critics investigating the relationship between race and visuality.1 Michelle Wallace, for example, closed the 1992 Black Popular Culture collection by addressing “the problem of visuality in African American culture” (335). Wallace attributes this problem—what she calls “the history of a mostly invisible black visuality” (335)—to the institutional limitations of a white-dominated art world that restrict or prohibit both the production of and discourse on black visuality. She finds it difficult, for instance, to imagine an African American’s relation to visual practice either as an artist or as a critic, if nearly all the depictions are negative. The historical legacy of negative images (African Americans as objects) plus the historical absence of positive images (African Americans as subjects), contributes to an absence of visual producers which, in turn, produces an absence of critical discourse on the visual.2 Thus, the existence of a mostly invisible black visuality, ironically enough, has little to do with a lack of exposure. In fact, Wallace finds the negative image of the black to be thoroughly overexposed.3 Consequently, she believes that one of the goals of contemporary cultural criticism should be to “begin to understand how regimes of visuality enforce racism, how they literally hold it in place” (Wallace, “Afterword” 344). Like Wallace, Henry Louis Gates also discusses the problem of African American visuality in his introductions to two recent museum exhibition catalogues (“The Face” 11–14). But for Gates, the problem of African American visuality is more about the past than the present. Gates contends that “the hegemony of racist images that dominated the popular arts and infiltrated the fine arts” during the nineteenth century prompted the New Negro movement to use words, and “not the tactics of visual representation, as the tools … used to assert their self-image” (“The Face” xliv). Here, the negative visual representations of African Americans have not only stifled visual production, but they have literally generated textual bodies to take their place. In his introduction to the Black Male catalogue, Gates maintains that “tragically, every African American male who walks down any street in America carries with him the hidden heritage of this negative cultural and psychological legacy, the burden of being perceived through what … Barbara Johnson calls a stereotype—’an already-read text’—the already read text of debasedness and animality” (Preface 13). Like Wallace, Gates draws virtually the same conclusion: African American visuality is problematic largely because of the historical legacy of centuries of negative images. Where Wallace locates “the problem” in the cultural institutions that regulate and maintain the production of visual practice, Gates locates “the problem” in [End Page 723] the historical effects of a cultural conflation between the stereotyped images and the actual people they seek to reductively display. Yet, as both Wallace and Gates discuss the enduring legacy of the production of negative images, and the vexed status that it has subsequently created for the relationship between African American discourse and visuality, there is scarcely any attention paid to how these images themselves might actually participate in the problem outside of their status as an already-read text. In fact, it remains unclear if the representational modalities of images have any bearing whatsoever on what Wallace claims as a “vital” problem for African American discourse. While Wallace hopes to address this problem, her notion of visuality seems confined to “who produces and reproduces vision,” and oddly leaves out interrogating the very material condition for the production of vision in the first place: the image. Similarly, Gates reduces almost the entire history of the relationship between race and representation in American art (1710–1940) to the steady production of images that by and large always exist as “already-read” texts. Although the iconoclasm implicit within such criticism is understandable given the vast corpus of stereotypical images of African Americans within American culture, the implications and limitations of this iconoclasm on African American cultural criticism’s relationship to the problem it seeks to understand warrants further thought as to how African American visuality might...

Exploring obstacles to success for early careerists in healthcare leadership.

INTRODUCTIONA young man of Caribbean descent from a two-parent home attended a top-tier pre-med program, majoring in science and language. After graduation, he worked for a year and was quickly promoted into a leadership position. Discovering his natural leadership abilities, he began to explore a career in healthcare management.He was surprised to learn that his alma mater offered a master of health administration (MHA) program and enrolled immediately-no one on campus had spoken with him about healthcare administration when he was an undergraduate there.During his time as an MHA student, the young man was accepted to a 10-week internship through the Institute for Diversity in Health Management's Summer Enrichment Program-it was his first experience working in a hospital setting. As a result of his limited exposure to prior healthcare leadership roles, he was later denied acceptance to paid administrative fellowships at two top medical centers.Compare this young man's experience with that of a minority administrative fellow candidate who had attended a top-ranked graduate school, aced her health system fellowship interviews, completed her fellowship program early, and accepted an impressive position at the health system. The difference between the two is that she comes from a well-educated, influential family that boasts multiple generations of physicians and CEOs. From an early age, she was exposed to healthcare topics in conversations around the dinner table and in social and civic gatherings, with her parents' friends and associates-all this enculturation prepared her to understand the context of healthcare delivery and access. The young man, on the other hand, lacks influential family and friends who could have introduced him to the healthcare leadership context early on.Considering that the U.S. population is shifting from a white majority to a minority makeup, healthcare leaders from diverse backgrounds will be essential to delivering culturally appropriate care to the chronically ill and the burgeoning elderly population and addressing the shifting health needs of our population. Yet the lack of exposure to the healthcare environment is but one-albeit a crucialobstacle that many early careerists face as they launch their careers. Will we have enough diverse, qualified leadership talent in the pipeline to run our complex, dynamic organizations?ISSUES SURROUNDING STUDENT PREPAREDNESSThe good news is that the healthcare management field is attracting online, evening, and part-time students in addition to those in traditional, full-time master's programs, which are expected to yield an increasingly diverse talent pool. But my 20-plus years of experience as the head of a search firm known for specializing in, and committing to, mentoring, coaching, recruiting, and placing diverse talent has shown me that obstacles remain for students from diverse backgrounds. For several years, my firm helped recruit minority postgraduates into a competitive, two-year, paid administrative fellowship program for a large health system in the Midwest. We found that selecting even a cohort of seven fellows was challenging. Of the more than 50 postgraduates and early careerists who were vetted, nine were invited to participate in onsite interviews and complete a competency inventory assessment. Unexpectedly for many of the candidates, the overall evaluation scores revealed deficits in communication, analytical, and critical thinking skills-all areas that are vital to effective leadership. The candidates, having performed well in graduate school, were disappointed with the outcome and questioned the validity of the scores. It further confirmed my previous observation that there exists a disconnect between some graduate program requirements and curricula and those of today's health system.Quality of Unaccredited Health Administration ProgramsThe recent proliferation of health management programs includes many that lack Commission on Accreditation of Healthcare Management Education accreditation, graduating students who are inadequately prepared. …

ACR Appropriateness Criteria Imaging for Transcatheter Aortic Valve Replacement

Although aortic valve replacement is the definitive therapy for severe aortic stenosis, almost half of patients with severe aortic stenosis are unable to undergo conventional aortic valve replacement because of advanced age, comorbidities, or prohibitive surgical risk. Treatment options have been recently expanded with the introduction of catheter-based implantation of a bioprosthetic aortic valve, referred to as transcatheter aortic valve replacement. Because this procedure is characterized by lack of exposure of the operative field, image guidance plays a critical role in preprocedural planning. This guideline document evaluates several preintervention imaging examinations that focus on both imaging at the aortic valve plane and planning in the supravalvular aorta and iliofemoral system. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Use of Prognostic Tools in the Hospital, Assessment of Factors Behind Their Use or lack Thereof Through a Physician-Oriented Survey

Physician's use of prognostic tools may help to decide on the intensity of therapies provided and communicate with patients and their caregivers in a timely fashion. However, literature that describes knowledge, perceived limitations and overall use of these tools by doctors is lacking. By way of a physician survey, we attempted to look at the use of prognostic tools in our community of doctors in our department of internal medicine. Our results showed that overall physicians have superficial knowledge of prognostic tools. We also discovered that physicians believe these tools to be helpful, yet their availability is compromised by lack of exposure during formative years, their cumbersome structure and the impracticalities of remembering them at bedside.

The image of the teacher held by learners from 10 different countries: A new perspective on the causes of problems with learner discipline

The article reports on research that investigated the image of teachers held by school learners. Based on a conceptual-theoretical distinction between the ideal teacher, the totally effective teacher and the typically excellent teacher, it was assumed that learners would focus on the first, which is a mental construct, and not on the third, which refers to a flesh-and-blood person actually found working in classrooms. They would not be aware of the discrepancy existing between the ideal teacher and the actual typically excellent teacher. A hundred learners in each of England, Latvia, Greece, Serbia, Slovenia, Bulgaria, Turkey, Pakistan, South Africa and Mexico were asked to write a one-page essay on the following topic: ‘What does a typical teacher look like?’ The investigation confirmed the correctness of the assumption. Despite clear instructions to describe a typical teacher, many respondents from all 10 countries described what they regarded as the ideal teacher. There seems to be a discrepancy between what learners want in a teacher (the ideal teacher) and what they actually have (the typical teacher). It is also possible that the lack of exposure to truly transformative teachers may in many instances lead to ineffective education. This may be one of the causes of problems with learner discipline in school that has thus far been overlooked in the scholarly pursuit to get to the root of problems with learner discipline, possibly because it does not fit neatly into the widely used model of categorising the causes of problems with learner discipline in schools.

AB1409 Confidence levels of internal medicine trainees in rheumatological skills and diagnosis: A singapore perspective

BackgroundMusculoskeletal (MSK) disease is one of the most common problems encountered in primary care and specialist consultations. Clinical assessment is essential to approaching MSK complaints and central to management. However...

Is uterine serous carcinoma a part of hereditary breast cancer syndrome?

5587 Background: Whilst the association between breast cancer and uterine serous carcinoma (USC) is attributed to tamoxifen treatment, few studies have reported that this increased risk is independent of tamoxifen. Methods: To further investigate the relationship between breast cancer and USC, we retrospectively studied 216 patients from 5 hospital trusts in Birmingham, UK who were diagnosed with USC between 1993 and 2012. We collected personal history of cancer in these cases before or after USC diagnosis. In addition FIGO staging, clinical and survival data were collected from our local cancer registry and patients’ clinical records. Results: In this case series, 56 patients (25.9%) had personal history of at least one cancer before and 18 patients (8.3%) had history of at least one cancer after the diagnosis of USC. Within the group of patients with the history of cancer before the USC, 38 patients (68%, 17.5% of all cases) had personal history of breast cancer prior to the development of USC, higher than the UK expected age standardised relative incidence of breast cancer (350 in 100,000, CRUK 2006-2008). Although 27/38 cases (71%) had endocrine treatment for their primary breast cancer, 11/38 patients (29%) did not have any tamoxifen treatment due to hormone receptor negative breast cancer. Additionally the median age of breast cancer diagnosis for the hormone receptor negative group was significantly lower than those patients who had hormonal treatment for their breast cancer (56 vs. 64 years, p :0.036) compatible with the younger age at diagnosis expected of the familial (BRCA mutated) or triple negative breast cancer. Of 18 patients with a second cancer after diagnosis of USC, 6 patients (33%) were diagnosed with breast/ovarian cancer. This group also had no treatment with tamoxifen. Conclusions: Lack of exposure to tamoxifen and younger age at diagnosis in this subgroup suggest that other factors such as a common underlying genetic predisposition may be responsible for the development of both malignancies. We propose that at least a subgroup of USC may be a part of hereditary breast cancer syndrome. This may have implications in prevention (prophylactic hysterectomy) or trials of targeted treatments (PARP inhibitors) for a subgroup of USC patients.

Current attitudes of Turkish anesthesiologists to radiation exposure

The aim of this study was to investigate the attitudes of anesthesiologists to radiation exposure and current safety practice in Turkey. The study enrolled anesthesiologists from all over Turkey, including all levels of academic degrees and all types of different institutions. Questionnaire forms were sent via e-mail to 505 anesthesiologists. The survey collected demographic data such as age, gender, position, and the institution at which the participant worked, and data about the frequency of radiation exposure during procedures and the participant's attitudes concerning radiation safety measures during these procedures. The questionnaire forms were delivered to 491 anesthesiologists, and 301 (61.3 %) of these were returned. Of these, 9 had not completed the questionnaire because of a lack of exposure to radiation. Among the remaining 292 personnel, the weekly frequencies of radiation exposure were more than five times (36.7 %), one to five times (50.3 %), and less than once (13 %) per week, respectively. Only a few anesthesiologists regularly wore a lead apron (30.11 %) and a thyroid shield (11.3 %) during procedures involving radiation exposure. This study demonstrated that nearly all anesthesiologists are regularly exposed to radiation and that few anesthesiologists in Turkey wear protective clothing, which is essential for radiation protection. Therefore, if it is not, increasing awareness about radiation protection should be an integral part of medical training and education.

Learning from the Tradition: The Religious Lives of Children

My six-year-old son and his friend—whom I will call Samuel—have grown up together since infancy. Between my husband’s vocation as a pastor in the Lutheran tradition and my own determination to forge a connection with my Catholic roots, our son receives perhaps a steadier diet than he would like of Christian liturgy and Christian education. It seems natural that he ventures opinions on who and where God is and how God feels and that Bible stories rate almost equally with Charlie and the Great Glass Elevator as bedtime reading. More surprising, given his almost complete lack of exposure to liturgy and religious stories, is Samuel’s theological interest quotient. Over the past year or so, carpool and backyard conversations with my son (usually at Samuel’s initiation) have occasionally but persistently turned to theology and spirituality: the connection between God and Jesus (separate beings, they concluded, God residing in heaven somewhere in the sky and Jesus inhabiting the earth), God’s feelings about homelessness, theories about how God manages to listen to everyone’s prayers. With varying degrees of independence from their families’ religious patterning, these two young children have been articulating their spiritual lives and

Effect of Body Mass Index on In Vitro Maturation Treatment Outcomes in Women without Polycystic Ovarian Syndrome

Purpose: Previous studies have suggested that obesity can affect the oocyte yield, embryo quality and pregnancy rates following IVF. In vitro maturation differs from IVF in several ways including lack of controlled ovarian stimulation, oocyte retrieval when majority are expected to be still immature, and possibly different endometrial environment due to short secretory phase and the lack of exposure to supraphysiologic estrogen levels. Therefore female obesity can affect IVM and IVF cycles differentially. This study aims to assess the effect of female obesity on IVM outcomes in women without polycystic ovarian syndrome. Methods: Retrospective chart review of 125 women who underwent an IVM cycle during a 5 year period. Women were divided to four categories based on Body Mass Index (BMI) according to the World Health Organization classification. Procedural and clinical outcomes were compared across different BMI categories. Independent effect of BMI on the odds of achieving a live birth was assessed using a multivariate logistic regression model. Results: The numbers of cumulus corona complexes, in vivo matured and immature oocytes collected, metaphase two oocytes available for fertilization, good quality embryos available for transfer and embryos transferred were not statistically significantly different across BMI categories. Likewise, in vitro maturation rate of immature oocytes, fertilization rate, embryo implantation, clinical pregnancy and live birth rates were similar across the groups. BMI category did not have an independent effect after adjusting for possible confounders in the regression model. Conclusions: BMI does not seem to affect IVM outcomes

Factors Influencing Domestic Violence Against Married Women in Bangladesh : Evidence From Bangladesh Demographic and Health Survey

Violence against women is a common and menacing phenomenon in Bangladesh-and domestic violence is the most common form which includes pushing, shaking or throwing of any objects, slapping, punching with fist or something harmful, kicking or dragging, trying of choke or burn, threatening with knife/gun or other weapon, twisting arm or pulling hair. In the study mean age of the respondents were 30.66 (±8.904) and 62.5% respondents lived in Rural areas where higher prevalence of abuse has been observed. The reasons mentioned through out the country for abuse were inconsequential and included failure to perform household work and care of children, economic problems, food crisis, refusal to bring dowry, disobeying husband/elder, unemployment status of husband, suspected case of infidelity etc. Factors influencing domestic violence were lack of education both in respondents or their spouse, lack of exposure to magazine or source of information, current married, large number of children ever born etc. The majority of abused women remained silent about their experience because of the high acceptance of violence within society, only a few shared the matter with neighbor, father/mother or other relatives. A very small proportion of women approached institutional sources for help. Interestingly, violence increased with membership of women in any non government organization or mother club or relating to any income generating process. It is furthermore disgraceful to find that the women with lower body mass index are the higher group of population who are the high-flying victims of violence. In rural or urban Bangladesh, women's physical, mental, social and economic circumstances may influence their risk of domestic violence in multifaceted and paradoxical ways. Therefore findings suggest discussing policy propositions to overcome current realities.

Reply to Krueger et al.

We thank Krueger et al. for their interest in our paper [1, 2]. The Lausanne group uses the Pairolero’s modification of the Clagett’s procedure [3, 4]—only with vacuum assisted closure VAC in lieu of repeated dressing changes [3]. In the past, we have used and still use this time-honoured approach for critically ill patients. However, we wanted to verify the possibility of managing stable (i.e. >1 month after primary surgery) post-pneumonectomy patients in an outpatient setting, and we opted for the openwindow thoracostomy (OWT) as per our previous experience published in 2006 [5]. Contrary to Dr Krueger’s interpretation, we did not suggest OWT and vacuum assisted closure (VAC) in an outpatient setting for the ‘critically ill’ [3]. In addition, in the Lausanne group’s series, there were only eight post-resectional empyemas [3]. Of these, only two occurred after primary pneumonectomy performed for mesothelioma and extended thymoma [3]. We suspect that applying VAC after primary pneumonectomy may be different from using VAC for somewhat smaller, contained, chronic areas of infection [5]. As to the OWT issue, contrary to Dr Krueger’s interpretation, OWT is obtained by refashioning the original thoracotomy without the need for additional incisions and repeated general anaesthesia [5]. If a broncho-pleural fistula (BPF) is identified, it is sutured and reinforced with a muscle flap [5]. In fact, we were successful in 1 patient despite several techniques used for bronchial closure (Table 1) [2]. The closure of the thoracostomy is done by an approximation of the myocutaneous edges after obliteration by granulation tissue and Clagett solution or additional intrathoracic viable tissue transposition [5]. Accordingly, to include, among the advantages of VAC therapy via thoracotomy, the ‘preserved integrity of the chest wall’ is at least questionable. We do not think that VAC should not be considered an alternative to OWT [5]. We believe that OWT is, rather, an alternative approach to redo thoracotomy under general anaesthesia [5]. Possibly, both could be considered in different stages of the management of postpneumonectomy empyema (PPE). Nevertheless, VAC can be used through the OWT despite the adverse effects observed in our patients [2]. We feel that soaking the foams with local anaesthetic, avoidance of the vagus nerve and the interposition of gauzes on the mediastinum may easily improve our learning curve [3]. Similarly to our experience, the lack of exposure upon removal or the application of the VAC foam directly on the mammary vein may have caused a similar incident in the series from Lausanne [2, 3]. In conclusion, we think that two different categories of patients and two—not necessarily alternative— approaches are compared to manage PPE [2, 3]. In fact, OWT and VAC can speed up recovery in stable pneumonectomy patients, thus avoiding psychologically burdensome and costly prolonged hospitalizations. However, the jury is still out as to the role of VAC in the closure of BPF. Conversely, for critically ill PPE patients whose condition obviously mandates a high level of care, the use of VAC instead of repeated dressing changes via the Pairolero-Clagett’s procedure may be a reasonable alternative to accelerated treatment of PPE [6].

Muslim attitude and awareness towards Istihalah

PurposeThe purpose of this study is to investigate the attitude and awareness towards Istihalah of Muslim Malaysian students in Universiti Sains Malaysia, Penang. This study aims to indicate the alertness of Muslim students about Istihalah in their daily life.Design/methodology/approachA total of 450 students from the university were selected using a stratified random sampling technique. The self‐administered questionnaire focused on attitude and awareness towards Istihalah and their interest to learn more about Istihalah.FindingsA total of 99.1 percent of respondents agreed that the Muslim community lack of exposure about the Istihalah concept. Male students are more agreeable than female students (100.0 percent vs 98.2 percent). More than 94.7 percent of the respondents believe that Istihalah concept is very important to Muslim consumers. A total of 100.0 percent of the respondents are interested to know more about Istihalah.Research limitations/implicationsThe respondents in this research were Muslim students in Universiti Sains Malaysia. The results of this research are only applicable to the subjected community. Therefore, any generalization of the findings on the whole or other Muslim communities should be avoided.Originality/valueThis paper is the first paper produced to investigate the attitude and awareness towards Istihalah among Muslim students, not only in Universiti Sains Malaysia, Penang but also the Muslim community as a whole. This paper will provide new information on the attitude and awareness of students towards Istihalah and the product of Istihalah as there no records on the matter prior to this. It will also be the pioneer to future research on this matter.

Different biological activity of CD154-SIVgp41 fusion protein vaccine component in naïve or pre-immune individuals

Background Trimeric gp41 might be an important target for neutralizing antibodies; however, the poor immunogenicity of this region may be due to its lack of exposure on native virus. CD154 (CD40L) is a trimeric glycoprotein found on activated CD4 T-cells that binds to CD40 on APCs and leads to B-cell activation and differentiation to plasma cells. We designed a novel immunogen with the potential for inducing neutralizing antibodies to gp41 and for stimulating activity on APC and B-cells.

Medical Student Career Survey—Vascular Surgery Awareness Initiative

The objectives of this survey were to identify medical students' general knowledge of vascular surgery as a career choice on entrance to medical school, and how student perspectives change during their exposure to clinical disciplines. Furthermore, we sought to determine which factors may influence the choice of a particular career path, and to apply this knowledge to improve the recruitment process of medical students into the specialty of vascular surgery. A one-time anonymous questionnaire consisting of 21 open and multiple-choice questions was distributed to first- (MS1), second- (MS2), and third-year (MS3) medical students at a large single-campus medical school. Responses were collected and subjected to analysis. Three hundred thirty-eight medical students responded to the survey (110 MS1, 126 MS2, and 102 MS3). Two hundred thirty-six MS1 and MS2 students had no clinical exposure to vascular surgery. Of 102 MS3 students having completed a general surgery rotation, 38 had exposure to vascular surgery. Of MS1 and MS2 students, 49% would consider vascular surgery. An additional 19% were willing to consider vascular surgery if the length of training was reduced. Twenty-six percent of the clinical students rotated on a vascular surgery service during their clinical general surgery rotation, of which 78% reported a positive experience. Only 26% (10 of 38) still considered vascular surgery as a career at the MS3 level. Thirty-four percent of students would consider vascular surgery if the training was reduced from 7 to 5 years. However, only 5% of MS1 and MS2 (11 of 236) and 9% of MS3 (9 of 102) students were aware of the 0 + 5 training program. As students advanced in medical school, lifestyle (31% MS1 vs. 63% MS3, P < 0.001) and length of training (19% MS1 and 2 vs. 34% MS3, P < 0.001) became a more critical factor in their career choice decision making. Medical students have minimal knowledge of vascular surgery on entry to medical school; however, many are willing to consider vascular surgery as a career. Lack of exposure in the first 2 years of medical school and lifestyle considerations may be deterrents for students to choosing vascular surgery as a career. To improve the recruitment process, focused education and interaction with preclinical medical students are needed.