Student perspectives on a course on medical ethics in Saudi Arabia

Medical students face ethical issues as early as the first year of medical school. Teaching bioethics is challenging because medical students and some teachers make a distinction between hard science and so-called 'soft' ones like bioethics. Courses in ethics were taught in the first and third years at the College of Medicine at King Saud University, Riyadh, Saudi Arabia, at the time this study was conducted. The objective of this study was to determine the students' perspectives of the courses and their attitudes towards teaching ethics. Apredesigned, self-administered, piloted questionnairewas administered to all students in the third year. The questions covered the curriculum, themethods of instruction and the content of the course. The response rate to 327 questionnaires distributed was 77%. Most students were satisfied with the course and its timing [84%], but more than 85% considered that the method of instruction should be changed to case-based teaching. A majority [89%] agreed that ethical issues based on Islamic fiqh [jurisprudence] should continue to be discussed, and they wished to discuss issues related to the doctor-patient relationship and professionalism. The students' preferences for the topics to be covered were: brain death [76.8%], organ transplantation [72.4%], cosmetic surgery [68.8%], abortion [66.8%], terminal care [61.6%], reproduction [59.6%], doctors' rights [56.4%], end-of-life issues [56%] and medical errors [45%].The medical students were satisfied with the course and its content but were dissatisfied with the method of instruction. This was taken into consideration in subsequent years.

Seroprevalence of toxoplasmosis, leptospirosis and brucellosis in sugarcane fieldworkers in Trinidad and Tobago / Seroprevalencia de la toxoplasmosis, la leptospirosis y la brucelosis en los trabajadores de las plantaciones de caña de azúcar en Trinidad y Tobago

Sugarcane field-workers, like rice field-workers, livestock farmers and abattoir workers are known to be occupationally exposed to zoonotic agents. The study determined the seroprevalence of immunoglobulins to Toxoplasma gondii (IgM), Leptospira spp (IgM) and Brucella abortus (IgG) in sugarcane field-workers across weighing stations in the island of Trinidad. In addition, the association of risk factors to infections by the three zoonoses was investigated. Blood samples were collected from consenting apparently healthy sugarcane field-workers across the island of Trinidad. Current/acute infection in individuals was determined in the sera of individuals using the enzyme immunoassay (EIA) for T gondii IgM antibodies, enzyme-linked immunosorbent assay (ELISA) for Leptospira spp IgM immunoglobulins and both buffered plate agglutination test (BPAT) and competitive ELISA for B abortus IgG antibodies. The seroprevalence of IgM immunoglobulins to T gondii was 15.7% (64 of 407) and to Leptospira spp was 0.7% (5 of 704) and the difference was statistically significant (p 0 < 0.05; χ2). All 704 samples tested for B abortus IgG immunoglobulins were negative. All risk factors (age, gender, race and type of work done) were not statistically significantly (p > 0.05; χ2) associated with infections by T gondii and Leptospira spp. It was concluded that sugarcane field-workers in Trinidad were at high risk of acute toxoplasmosis and, to a lesser extent, to leptospirosis. The fact that the four risk factors studied were not significantly associated with T gondiiand Leptospira spp infections suggests that they may not be important in the epidemiology of both diseases in the population studied.

Se sabe que los trabajadores de las plantaciones de caña de azúcar - al igual que los trabajadores de los campos de arroz, la ganadería y los mataderos - se hallan expuestos a agentes zoonóticos debido a su ocupación. El estudio determinó la seroprevalencia de las inmunoglobulinas en relación con Toxoplasma gondii (IgM), Leptospira spp (IgM) y Brucella abortus (IgG) en los trabajadores cañeros a lo largo de las estaciones de pesaje en la isla de Trinidad. Además, se investigó la asociación de factores de riesgo de infecciones por las tres formas de zoonosis. Se obtuvieron muestras de sangre a lo largo de la isla de Trinidad, tomadas de trabajadores cañeros de apariencia saludable, que dieron su consentimiento. La infección aguda presente en los individuos, fue determinada en sus sueros mediante el inmunoensayo enzimático (IEE) para anticuerpos de T gondii IgM, el ensayo inmunosorbente vinculado a enzimas (ELISA) para inmunoglobulinas frente a Leptospira spp IgM, y la prueba de aglutinación tamponada en placa (BPAT) así como el ELISA competitivo para anticuerpos de B abortus IgG. Palabras claves: toxoplasmosis, leptospirosis, brucelosis, trabajadores cañeros, Trinidad. La seroprevalencia de inmunoglobulinas IgM para T gondii fue de 15,7% (64 de 407) en tanto que para la Leptospira spp fue 0,7% (5 de 704). La diferencia fue estadísticamente significativa (p 0 < 0.05; c²). Las 704 muestras sometidas a la prueba de inmunoglobulinas para B abortus IgG, fueron negativas. Los factores de riesgo (edad, género, raza y tipo de trabajo realizado) no estuvieron significativamente asociados (p > 0.05; c²) de manera estadística con las infecciones por T gondii y Leptospira spp Se llegó a la conclusión de que los trabajadores cañeros de Trinidad presentaban un alto riesgo de toxoplasmosis aguda y, en menor medida, de leptospirosis. El hecho de que los cuatro factores de riesgo estudiados no estaban significativamente asociadas con T gondiiy a infecciones de Leptospira spp, sugiere que puede que no sean importantes en la epidemiología de ambas enfermedades en la población estudiada.