Environmental factors promoting the effective use of a computer-assisted clinical case for second-year osteopathic medical students

We report a 38-year-old female of Puerto Rican descent with Hermansky-Pudlak syndrome and decreased levels of von Willebrand factor. Histologic and ultrastructural findings of non-sunexposed skin showed melanocytes with short dendritic processes and decreased numbers of melanosomes. Ultrastructural examination of platelets revealed greatly reduced numbers of delta granules. Recognition of this syndrome is important because skin neoplasms, ceroid deposition and hemorrhagic manifestations can be causes of morbidity and of potential death in patients affected with this syndrome.     

Cheating in medical school: a survey of second-year students at 31 schools

This study examined mechanisms by which fluoxetine may reduce energy consumption and body weight. Women with binge-eating disorder (BED; n = 38) and age- and weight-matched women without BED (n = 32) monitored their dietary intake and concurrently recorded mood variables on a hand-held computer for 6 d of baseline and for 6 d after being randomly assigned to receive placebo or fluoxetine (60 mg). Fluoxetine reduced eating more than did the placebo on days 4-6 of treatment. The frequency of episodes was not affected, suggesting that fluoxetine affects satiety, not hunger. Fluoxetine did not preferentially reduce carbohydrate intake, did not affect snack consumption as compared with meal consumption, and did not affect negative-mood eating more than positive-mood eating, nor did fluoxetine affect subjects' mood ratings. Benefits of fluoxetine were of approximately equal magnitude for women with and without BED. However, women who reported higher energy consumption at baseline were more responsive to fluoxetine than were women who reported lower energy consumption at baseline, and binge-eating status was associated with greater energy consumption at all time points, including baseline. Fluoxetine affects dietary intake within 4 d of its consumption, and if future research shows that this remains true on repeated applications, this drug may be useful for short periods when difficulty with overeating is anticipated, such as during vacations.     

Modeling concepts in medicine for medical language understanding

Over the past two decades, the construction of models for medical concept representation and for understanding of the deep meaning of medical narrative texts have been challenging areas of medical informatics research. This review highlights how these two inter-related domains have evolved, emphasizing aspects of medical modeling as a tool for medical language understanding. A representation schema, which balances partially but accurately with complete but complex representations of domain-specific knowledge, must be developed to facilitate language understanding. Representative examples are drawn from two major independent efforts undertaken by the authors: the elaboration and the subsequent adjustment of the RECIT multilingual analyzer to include a robust medical concept model, and the recasting of a frame-based interlingua system, originally developed to map equivalent concepts between controlled clinical vocabularies, to invoke a similar concept model.     

Computer-based neuroanatomy laboratory for medical students

Bone is one of the most common sites of metastasis in melanoma and breast cancer cells. Human melanoma (A375M) and human breast cancer (MDA-MB-231) cells form osteolytic bone metastasis in vivo when these tumor cells are injected into the left ventricles of BALB/c nude mice. These tumor cells promote bone resorption in the in vitro neonatal murine calvaria organ culture system by indirectly stimulating the production of a bone resorption-inducing factor (or factors) from human osteoblast-like cells. This secreted factor was identified as interleukin-11 (IL-11). Although many cytokines and hormones were associated with IL-11 production from osteoblasts, transforming growth factor-beta (TGF-beta) was found to be involved in the promotion of IL-11 production from osteoblasts, because the addition of a neutralizing anti-TGF-beta antibody decreased the production of IL-11. However, these tumor cells did not produce TGF-beta by themselves. We found that they enhanced IL-11 production by activating latent TGF-beta produced from osteoblast-like cells. Our results indicate that metastatic tumor cells induce osteolysis by activating TGF-beta, which leads IL-11 production from osteoblasts to promote bone resorption.     

Stress in medical students

The object of this study was to examine the main stressors experienced by students in an Irish medical school and their effects on the attitude of the students towards their training. It also determined the students' knowledge of how they could receive help and their attitudes towards seeking such help. Data was collected by an anonymous self-report questionnaire distributed to a fifth year medical school class in the Hilary Term of the academic year. These 63 students had chosen medicine as a career mainly because of vocational and academic factors and almost two thirds of them had always wanted to do medicine. However four were no longer happy with that choice. Fifty-four percent of them had felt like making a complaint on at least one occasion, but did not do so. The perceived problems were mainly verbal in nature. 41% said that this had affected their attendance. The main source of perceived mistreatment was consultant staff. Rates of perceived racial and sexual discrimination were low. Other stressors included examinations, financial issues and family issues. 52% of students did not know the process by which they could make a complaint and 30% felt that seeking help or advice from staff would be damaging to their future career. This study analyses these issues and suggests ways of addressing them.     

Ambulatory blood pressure and risk factors for coronary heart disease in black and Indian medical students

BACKGROUND: Coronary heart disease (CHD) has reached 'epidemic' proportions in South Africa. CHD is uncommon in the black population of South Africa, yet the prevalence of hypertension in the adult black population is high. DESIGN: This study compared the blood pressure profile in 154 medical students of which 83 were Indians (1), 71 were black (B), 87 were male (50 I, 37 B), and 67 were female (33 I, 34 B) age 21 (SD+/-1.6), using the cuff method and 24 h ambulatory blood pressure monitoring (ABPM). METHODS: All students underwent ABPM. Biochemical studies for CHD risk factors were done. Electrocardiography (ECG) was performed in all participants and echocardiography in 90. RESULTS: ABPM showed that black students had higher systolic and diastolic blood pressure throughout the day, night and critical time periods compared with the Indian students. Blood pressure load was higher in black (40.8%) than in Indian participants (29.6%; P<0.05) and there was less dipping at night Left ventricular mass was significantly higher in black than in Indian participants (29.6%; P<0.05) and there was less dipping at night. Left ventricular mass was significantly higher in black than in Indian participants. Risk factors leading to CHD were more common in Indian than in black participants. Those with borderline hypertension (blood pressure > or = 130/85 and < or = 140/90 mmHg) had statistically higher serum triglyceride and left ventricular mass than normotensives. CONCLUSIONS: Young black people had higher blood pressure readings than young Indian participants in the absence of metabolic abnormalities and had greater cardiac involvement Borderline hypertension is not innocuous. Metabolic risk factors for CHD in Indian people are apparent at an early age. This study emphasizes the need for prevention of risk factors leading to CHD at an early age.     

Elective experiences in family medicine for medical students

A new technique to insert acupuncture needles into the tissue without touching the needle with the fingers of the acupuncturist was developed by the authors. It is easy to perform and completely eliminates the problem of contamination. The bending of the needle is less frequent and the pain sensation of the patient is also minimized.     

Black students in medical schools

This paper presents an assessment and comparison of two groups of black medical students and the problems they confronted in medical school. Data were obtained from a sample of blacks who attended medical school during the years 1971 to 1974 and from black physicians who graduated from medical school in 1970 or before. A comparison of the two groups revealed statistically significant differences in the impact of others on the decision to enter medicine and in the sources of financial support; also the data suggest differences in perceived discrimination and in the time at which the individual decided to become a physician. The information from the 1971-1974 group illuminates the type and intensity of problems they encountered and the importance of various programs designed to aid black medical students. Overall, the findings of this study indicate a need for new efforts to recruit and to retain black students in medical schools.     

A case-based emergency medicine curriculum for senior medical students

OBJECTIVE: To determine the effects of a case-based, core content-oriented emergency medicine (EM) curriculum on the basic EM knowledge of senior medical students. METHODS: All senior medical students rotating through the Milwaukee County EM elective during the 1992-1993 academic year were assigned specific chapter readings from a case-oriented EM textbook. A course curriculum consisting of goals and objectives for each chapter and two to three representative cases for the discussion topic also was distributed to each student. Interspersed with the cases was a series of questions directed at pathophysiology, diagnosis, management, and disposition. The EM faculty and residents conducted case discussions three times per week. All students completing the rotation were given a pretest at the beginning and a final examination at the end of the rotation. In addition, the students rated the textbook, coursebook, and lecture series at the end of the rotation using a five-point Likert scale. RESULTS: Seventy-five students rotated through the elective. The students showed a significant improvement in their EM knowledge base as judged by improvement in final examination scores compared with pretest scores (pretest score 62.2 +/- 7.1%; final examination score 76.2 +/- 6.3%; p < 0.0001). The mean change in scores was 14.8%, with a range of -1.6% to 34%. The students also rated the textbook, coursebook, and lecture series as effective, as shown by high median scores on a Likert scale. CONCLUSIONS: A case-based EM curriculum coupled with ED clinical experience improves basic EM diagnostic and management knowledge of senior medical students.     

Evaluation of a breaking bad news course for medical students

This paper presents the evaluation of a Breaking Bad News course run for three groups of medical students (fourth and fifth year from the London Hospital Medical College and fourth year from St Bartholomew's Hospital Medical College). The course, which is student centred, uses group discussion, videotape presentations and role-play including actors. All teachers, clinicians and human science tutors, had been through a staff training programme on teaching methods. At the end of the course, students' knowledge of important principles in giving bad news had increased, particularly in relation to interpersonal communication; they were more confident in their ability to break bad news well; and the course learning methods were highly rated. The course was just as well received by fourth year as by fifth year students and several said they would like more of this training. The evaluation shows that if reservations about role-play can be overcome then this experiential learning is highly valued by students.     

How groups co-ordinate their concepts and terminology: implications for medical informatics

Conceptual and terminological systems are established and maintained by the communities who use them. This paper reports experiments which investigate the role of communication and interaction in the process. The experiments show that isolated pairs of communicators and virtual communities of interacting pairs naturally converge on their own conceptual and terminological systems when confronted with a common task. The results also indicate that the system converged on is optimal for that particular group engaged in that particular task. These findings are discussed in relation to the increasing use of tightly coordinated medical teams and its implications for getting them to adopt standardized medical terminologies.     

Korean concepts of giftedness and the self-perceived characteristics of students selected for gifted programs.

Fostering creativity among gifted students has become forefront as an important element in Korea’s future economic prosperity. Since the passage of a gifted education act in 2002, all K-12 schools have been developing gifted programs. The first of two studies examines Koreans’ concept of giftedness based on the implicit theory. Three hundred twenty-eight Koreans including scientists, parents, teachers, and college students described their concept of giftedness, which includes intelligence, task commitment, creativity, interpersonal relationship, moral sense, and artistic talent. The second study explores self-reported characteristics of Korean students identified as gifted and whether identification criteria for giftedness miss creative students by emphasizing IQ and achievement scores. One thousand one hundred fifty-four students (469 gifted in sciences, 285 gifted in humanities, and 400 regular students) answered a questionnaire developed from the first study. The results indicate that students identified as gifted tend to have higher intelligence and task commitment than regular students, but tend not to differ from regular students in creativity when compared to Renzulli’s three rings concept of giftedness—above average ability, task commitment, and creativity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)