Physician Executive Leadership: Assessing a Student-Led Approach to Healthcare Leadership Education in Medical School

Poster presented at: 14th Annual AMA Research Symposium in Orlando, Fl Objective: To investigate the effectiveness of Physican Leadership, an open access, student-led healthcare leadership program at Sidney Kimmel Medical College, in preparing to face five key emerging topics in medical practice: healthcare economics, health policy, care and quality and safety, law and medicine, and patient experience. The Problem: Gaps in Medical Education Healthcare in the US continues to evolve, and topics such as health policy, health finance, and patient experience are not central to the practice of medicine. However, the sheer volume of material students are required to learn in the preclinical years makes it challenging to introduce new subjects into traditional medical school curricula. As a result, these topics in healthcare leadership are often left out. Indeed, only 40-50% of medical student report appropriate training in the practice of medicine, including subjects as medical economics, healthcare systems, and managed care.https://jdc.jefferson.edu/pel/1002/thumbnail.jp

Development of a Short Trauma Screening Tool (STST) to Measure Child Trauma Symptoms: Establishing Content Validity

Purpose: The purpose of the study was to identify major symptom domain variables common to child trauma and create a prototype short trauma symptom screening tool (STST) intended for use in pediatric medical settings. Methods: This manuscript describes the first two phases of an on-going prospective mixed-method instrument development study. Phase 1 exploratory factor analysis was conducted with an archived LONGSCAN CBCL dataset to: (1) identify behavioral symptoms endorsed by children with known trauma exposure; and (2) generate a preliminary STST item pool. During Phase 2, researchers convened an expert panel (N = 10) and conducted Content Validity Index (CVI) procedures with the 20-item preliminary STST item pool, to further inform item retention, elimination and modification for an updated prototype STST. Findings: Expert quantitative scores yielded a CVI of 0.90 for the overall preliminary STST. The first two phases of this study assisted researchers with identifying 12 items that represent nine child trauma symptom domain variables, which include: (1) aggression/anger; (2) anxiety/fear; (3) sexual concerns; (4) elimination concerns; (5) somatic concerns; (6) depression; (7) dissociation; (8) physical acting out; and (9) dysregulation. Conclusions: The first two phases of STST development resulted in development of a brief, empirically-derived prototype screening tool that features 12 items operationalizing nine domains of child trauma symptoms. Developers can now advance to the next phase of STST development; feasibility assessment and psychometric testing

Design and Optimization of a Mycoplasma Detection Assay

Mycoplasma are among the smallest free living microorganisms. These bacteria grow slowly, lack a rigid cell wall and are not eliminated by filter sterilization methods used in tissue culture. Mycoplasma infection affects biochemical and genetic aspects of cultured cells, resulting in experimental inconsistency. Therefore, it is necessary to establish routine testing for mycoplasma contamination in tissue culture laboratories. Our goal is to develop a reliable and cost-effective test for mycoplasma in cell culture based on established methods found in literature. We first cloned and sequenced a PCR product from a commercial mycoplasma detection kit. Sequencing revealed the 16s rRNA as the target for mycoplasma detection; we confirmed this target by conducting a literature search. PCR primers were designed using 16s rRNA gene as a target. We set-up reactions and optimized conditions for the real-time PCR assay to detect the target and confirmed amplicon size with agarose gel electrophoresis. We identified that 56oC was the best temperature for the PCR and found that agarose gel electrophoresis was a better detection method because it identified the size to confirm the proper product. The primers we ordered to develop this assay produce the proper band; however, results of several assays have been inconsistent as sometimes a known positive sample fails to amplify. As well, in several PCR reactions the negative showed a signal. The overall reaction needs improvements to have greater reliability and to eliminate all sources of contamination. Research is continuing results are not final

Rapamycin induces transactivation of the EGFR and increases cell survival.

The mammalian target of rapamycin (mTOR) signaling network regulates cell growth, proliferation and cell survival. Deregulated activation of this pathway is a common event in diverse human diseases such as cancers, cardiac hypertrophy, vascular restenosis and nephrotic hypertrophy. Although mTOR inhibitor, rapamycin, has been widely used to inhibit the aberrant signaling due to mTOR activation that plays a major role in hyperproliferative diseases, in some cases rapamycin does not attenuate the cell proliferation and survival. Thus, we studied the mechanism(s) by which cells may confer resistance to rapamycin. Our data show that in a variety of cell types the mTOR inhibitor rapamycin activates extracellularly regulated kinases (Erk1/2) signaling. Rapamycin-mediated activation of the Erk1/2 signaling requires (a) the epidermal growth factor receptor (EGFR), (b) its tyrosine kinase activity and (c) intact autophosphorylation sites on the receptor. Rapamycin treatment increases tyrosine phosphorylation of EGFR without the addition of growth factor and this transactivation of receptor involves activation of c-Src. We also show that rapamycin treatment triggers activation of cell survival signaling pathway by activating the prosurvival kinases Erk1/2 and p90RSK. These studies provide a novel paradigm by which cells escape the apoptotic actions of rapamycin and its derivatives that inhibit the mTOR pathway

Replacement for the 10 page paper? A pilot project using blogs and wikis for a collaborative EBM assignment in a 3rd year internal medical clerkship

Objective Pilot a group assignment using blogs and wikis to develop evidence-based medicine skills in third year medical students on an internal medicine clerkship. Instead of the clerkship’s previous individual ten-page paper assignment, the students were divided into four groups of sixteen. During the clerkship, students are on geographically dispersed rotations. The earlier ten-page paper had required the students to complete a patient history and physical write-up. With the pilot project, each group was assigned a librarian and a physician faculty mentor. Each student recorded on the blog a clinical scenario and question they encountered. They were encouraged to communicate with the librarian to construct a well formed clinical question. Each student group then came to consensus on which question to pursue and collaborated on a wiki including a list of citations to the best available evidence, a critique of the studies, and implications for the patient

Elm Farm Organic Research Centre Bulletin 83 April 2006

Regular bulleting with technical updates from Organic Advisory Service Issue contains: Testing for Tolerance - a pragmatic view GM Debate Vaccination nation - to jab or not to jab Future shape of OCIS Evolutionary wheat makes the grade? NIAB tracks health of organic cereal seed Stopping erosion of soil quality - the organic way Care needed to halt butterfly collapse Aspects of poultry behaviour: How free range is free range? On choosing an organic wheat A local education challenge New Wakelyns Science Building Organic vegetable market growt

A 125 GeV SM-like Higgs in the MSSM and the γγ\gamma \gamma rate

We consider the possibility of a Standard Model (SM)-like Higgs in the context of the Minimal Supersymmetric Standard Model (MSSM), with a mass of about 125 GeV and with a production times decay rate into two photons which is similar or somewhat larger than the SM one. The relatively large value of the SM-like Higgs mass demands stops in the several hundred GeV mass range with somewhat large mixing, or a large hierarchy between the two stop masses in the case that one of the two stops is light. We find that, in general, if the heaviest stop mass is smaller than a few TeV, the rate of gluon fusion production of Higgs bosons decaying into two photons tends to be somewhat suppressed with respect to the SM one in this region of parameters. However, we show that an enhancement of the photon decay rate may be obtained for light third generation sleptons with large mixing, which can be naturally obtained for large values of $\tan\beta$ and sizable values of the Higgsino mass parameter.Comment: 14 pages, 4 figures. Corrected small typos and added reference

The Response of Serum Cortisol and Leptin Levels to Academic Stress

Background: Medical students are subjected to various types of stress during the academic course and they react differently. This study is an attempt to establish a relationship between the coping abilities, serum cortisol and leptin levels in response to academic examination stress in first year medical students. Methods: Thirty four 1st year medical students between 18 to 21 yrs of age were randomly selected and their coping abilities were assessed using the State Trait Anxiety Inventory. Two fasting blood samples were drawn, one on the day of examination (Situation I) and the second after the completion of the examination (Situation II). Serum cortisol and leptin levels were estimated using a standardized RIA Kit and the levels obtained were correlated with the psychometric data. Results: The results showed increased levels of cortisol prior to examination in the poor adjusters in comparison to the good adjusters. The levels of cortisol decreased after examination in both good and poor adjusters with the poor adjusters showing higher levels. On the other hand, leptin levels increased in good adjusters in comparison with poor adjusters in Situation I and in Situation II the good adjusters showed a marginal decrease and poor adjusters maintained the same levels of leptin. Conclusion: Cortisol and leptin respond inversely to academic stress. Cortisol levels sharply decline from stressful to post-stressful situation indicating the wane of stress