Flamingo Vol. III N 6

Ubersax. Cover. Picture. 0. Chaparral. Untitled. Prose. 1. Don Marquis. Love Sonnet of a Caveman. Poem. 4. Sun Dial. RIPPING, WE\u27D CALL IT. Prose. 4. Burr. Untitled. Prose. 4. Whirlwind. Untitled. Prose. 4. Octopus. Untitled. Prose. 4. Voo Doo. Untitled. Prose. 4. Log. Untitled. Prose. 4. Chaparral. Untitled. Prose. 4. E.S. Untitled. Picture. 5. OLD IRONSIDES. HER THUNDERS SHOOK THE MIGHTY DEEP, AND THERE SHOULD BE HER GRAVE. Picture. 6. A.I.C. AFTER CHAUCER. Poem. 7. Anonymous. Untitled. Prose. 7. Anonymous. ODE TO A CATFISH. Poem. 7. Anonymous. Untitled. Prose. 7. Anonymous. Untitled. Prose. 7. Anonymous. Untitled. Prose. 7. Anonymous. Untitled. Prose. 7. E.T. SCENE TWO. Picture. 7. Anonymous. Untitled. Prose. 7. Anonymous. WHAT EVERY COLLEGE MAN KNOWS. Poem. 7. Anonymous. LIKE KELLY DID. Poem. 7. Anonymous. TRAINED ANATOMY. Prose. 7. Taylor, Edna B. COUTEAU ET FOURCHETTE-A Farce in One Smack. Prose. 8. Anonymous. TWO CHARMS. Poem. 9. W.A.V. Untitled. Poem. 9. Anonymous. A Tribute to Genius. Poem. 9. Anonymous. Untitled. Picture. 9. Anonymous. Untitled. Poem. 9. A.E.R. INDIFFERENCE. Poem. 9. Anonymous. Untitled. Poem. 9. W.A.V. Untitled. Poem. 9. Anonymous. CIN— IN THAT DEATH SCENE OF MINE I MOVED THEM ALL TO TEARS. EMMA— YES. THEY KNEW YOU WERE ONLY PLAYING DEAD. Picture. 10. Anonymous. PIED PIKER. Prose. 10. Anonymous. IN A HISTRIONIC SCENTS. Picture/Poem. 10. XE. Lines. Poem. 10.; Anonymous. Untitled. Prose. 10. Anonymous. Untitled. Prose. 10. Anonymous. STAGE DIRECTIONS SAME SET THROUGHOUT THE PLAY. Picture. 11. W.M.P. TALES OF THE RAZZ AGE. Prose. 11. Anonymous. BENNY\u27S BLANK VERSE. Poem. 11. Anonymous. Untitled. Prose. 11. Anonymous. Untitled. Prose. 11. Grayce. YOU ALL KNOW THAT GUY WE LOVE SO MUCH— I SWEAR WE\u27LL HAVE TO CROWN HIM YET— WHO AFTER EVERY ACT, OR SCENE, OR SUCH, GOES OUT TO HAVE HIS CIGARETTE. Picture. 11. H.K. Untitled. Picture. 11. H.G.P. UH-UH. Prose. 11. W.G.M. THE VISION OF SIR LONGFALL. Prose. 12. Anonymous. -NIGH HALF UPON THY HORSE, A GRACEFUL SEMITE TRICK. Picture. 12. Anonymous. I\u27m Preserving That Lock of Hair... Picture. 13. Anonymous. Untitled. Prose. 13. Grayce. IT\u27S A LONG JANE THAT HAS NO CRUVES. Picture. 13. Anonymous. Relativity. Prose. 13. Anonymous. STOP THIEF! Prose. 14. Anonymous. FLAMINGO PINFEATHERS. Prose. 15. Anonymous. TO WHOM IT MAY CONCERN. Prose. 15. Bridge. Denison Comics. Picture. 16. Anonymous. A STUDY OF WILD LIFE. Picture. 18. Anonymous. Names. Poem. 18. Anonymous. YOU ARE THE FIRST MAN I EVER PERMITTED TO KISS ME. AND YOU ARE THE FIRST GIRL I EVER KISSED. WILL YOU MARRY ME? I WOULDN\u27T MARRY A LIAR. I WOULD. Picture. 18. Anonymous. TECHNICAL STUFF. Prose. 18. Anonymous. Untitled. Prose. 18. Anonymous. JACK, WHEN WE ARE MARRIED, I MUST HAVE THREE SERVANTS. YOU SHALL HAVE TWENTY, DEAR, BUT NOT ALL AT ONE TIME. Picture. 18. Anonymous. Untitled. Poem. 18. Anonymous. Untitled. Prose. 18. Anonymous. THEN THIS IS FINAL? ABSOLUTELY. SHALL I RETURN YOUR LETTERS? YES, THERE\u27S SOME GOOD MATERIAL IN THEM I CAN USE. Picture. 18. Anonymous. MY BUT YOU\u27RE CONTRADICTORY TO-NIGHT \u27\u27WHY, I AM NOT. Picture. 19. Anonymous. Untitled. Prose. 19. Anonymous. Untitled. Prose. 19. Anonymous. SPRING THIS AND RUN. Prose. 19. Anonymous. Untitled. Prose. 19. Anonymous. Untitled. Prose. 19. E.S. STOP THIEF! Prose. 19. Anonymous. Untitled. Poem. 19. Anonymous. Untitled. Prose. 19. Grayce. HER REASON. Picture/Poem. 19. Anonymous. Untitled. Prose. 19. Anonymous. LIKE KELLY DID. Prose. 19. N.H.G. FAVORITE FICTION. Poem. 19. Anonymous. HARD JUVENILE LEAD: D— THAT BALL!\u27 Picture. 19. E.B. THE END—. Picture. 20. Anonymous. Untitled. Prose. 20. Anonymous. NODE 2 A BLOCK HEAD. Prose. 20. Anonymous. Untitled. Prose. 20. Anonymous. Untitled. Prose. 20. E.B. OF A PERFECT DAY. Picture. 20. Wisconsin Octopus. Sweet Kisses. Prose. 22. Log. Untitled. Prose. 22. Bean Pot. Untitled. Prose. 22. Gargoyle. EXACTLY. Prose. 22. Froth. Untitled. Prose. 22. Phoenix. Untitled. Prose. 22. Anonymous. Untitled. Prose. 23. Chaparral. Famous Hands. Prose. 24. Chaparral. WASH OUT FOR THIS. Prose. 24. Gargoyle. Untitled. Prose. 24. Goblin. Untitled. Prose. 24. Octopus. A Tragedy. Poem. 24. Froth. Untitled. Prose. 24. Juggler. Untitled. Prose. 24. Lord Jeff. THE FROSH RETORT. Prose. 25. Goblin. Untitled. Prose. 25. Green Gander. Untitled. Prose. 25. Judge. AN EXPLANATION. Prose. 25. Green Gander. Untitled. Prose. 25. Spider Web. Untitled. Prose. 25. Chapparal. Untitled. Prose. 26. Williams Purple Cow. Untitled. Prose. 26. Froth. Untitled. Prose. 26. Gargoyle. SHERIFF, DO YOUR DUTY. Prose. 26. Beanpot. Untitled. Prose. 26. Sun Dial. A WELL BALANCED SENTENCE. Prose. 26. Chapparal. Untitled. Prose. 26. Scalper. Untitled. Prose. 26. Cracker. Untitled. Prose. 27. Scalper. Untitled. Prose. 27. Burr. Untitled. Prose. 27. Lemon Punch. Untitled. prose. 27. Schmitz. Untitled. Picture. 28. Puppet. Untitled. Prose. 28. Malteaser. Untitled. Prose. 28. Jester. SO IT GOES. Poem. 29. Brown Jug. CONTRIBUTORS ATTENTION! Prose. 29. Tiger. Untitled. Prose. 29. Scalper. QUALIFIED. Prose. 29. Purple Cow. Untitled. Prose. 29. E.B. D\u27JA EVER FEEL LIKE THIS? Picture. 29. Chaparral. Untitled. Prose. 30. Tiger. Untitled. Prose. 30. Malteaser. STOP THIEF! Prose. 30. Black and Blue Jay. Untitled. Prose. 30. Yellow Jacket. Untitled. Prose. 30. Tiger. Untitled. Prose. 30. Gargoyle. RIGHTO. Prose. 30. Yale Record. Untitled. Prose. 31. Puppet. Untitled. Prose. 31. Puppet. Untitled. Poem. 31. Virginia Reel. Untitled. Prose. 31. Puppet. Untitled. Prose. 31. Virginia Reel. Untitled. Prose. 31. Phoenix. Untitled. Prose. 31. Exchange. Untitled. Prose. 31. Stone Mill. Untitled. Prose. 31. Orange Peel. Untitled. Prose. 31. Stone Mill. Untitled. Prose. 32. Puppet. A SHORT TRAGEDY. Poem. 32. Stone Mill. Untitled. Prose. 32. Ex. Untitled. Prose. 32. Anonymous. Untitled. Prose. 32. Anonymous. Untitled. Prose. 32

Flamingo Vol. III N 6

Ubersax. Cover. Picture. 0. Chaparral. Untitled. Prose. 1. Don Marquis. Love Sonnet of a Caveman. Poem. 4. Sun Dial. RIPPING, WE\u27D CALL IT. Prose. 4. Burr. Untitled. Prose. 4. Whirlwind. Untitled. Prose. 4. Octopus. Untitled. Prose. 4. Voo Doo. Untitled. Prose. 4. Log. Untitled. Prose. 4. Chaparral. Untitled. Prose. 4. E.S. Untitled. Picture. 5. OLD IRONSIDES. HER THUNDERS SHOOK THE MIGHTY DEEP, AND THERE SHOULD BE HER GRAVE. Picture. 6. A.I.C. AFTER CHAUCER. Poem. 7. Anonymous. Untitled. Prose. 7. Anonymous. ODE TO A CATFISH. Poem. 7. Anonymous. Untitled. Prose. 7. Anonymous. Untitled. Prose. 7. Anonymous. Untitled. Prose. 7. Anonymous. Untitled. Prose. 7. E.T. SCENE TWO. Picture. 7. Anonymous. Untitled. Prose. 7. Anonymous. WHAT EVERY COLLEGE MAN KNOWS. Poem. 7. Anonymous. LIKE KELLY DID. Poem. 7. Anonymous. TRAINED ANATOMY. Prose. 7. Taylor, Edna B. COUTEAU ET FOURCHETTE-A Farce in One Smack. Prose. 8. Anonymous. TWO CHARMS. Poem. 9. W.A.V. Untitled. Poem. 9. Anonymous. A Tribute to Genius. Poem. 9. Anonymous. Untitled. Picture. 9. Anonymous. Untitled. Poem. 9. A.E.R. INDIFFERENCE. Poem. 9. Anonymous. Untitled. Poem. 9. W.A.V. Untitled. Poem. 9. Anonymous. CIN— IN THAT DEATH SCENE OF MINE I MOVED THEM ALL TO TEARS. EMMA— YES. THEY KNEW YOU WERE ONLY PLAYING DEAD. Picture. 10. Anonymous. PIED PIKER. Prose. 10. Anonymous. IN A HISTRIONIC SCENTS. Picture/Poem. 10. XE. Lines. Poem. 10.; Anonymous. Untitled. Prose. 10. Anonymous. Untitled. Prose. 10. Anonymous. STAGE DIRECTIONS SAME SET THROUGHOUT THE PLAY. Picture. 11. W.M.P. TALES OF THE RAZZ AGE. Prose. 11. Anonymous. BENNY\u27S BLANK VERSE. Poem. 11. Anonymous. Untitled. Prose. 11. Anonymous. Untitled. Prose. 11. Grayce. YOU ALL KNOW THAT GUY WE LOVE SO MUCH— I SWEAR WE\u27LL HAVE TO CROWN HIM YET— WHO AFTER EVERY ACT, OR SCENE, OR SUCH, GOES OUT TO HAVE HIS CIGARETTE. Picture. 11. H.K. Untitled. Picture. 11. H.G.P. UH-UH. Prose. 11. W.G.M. THE VISION OF SIR LONGFALL. Prose. 12. Anonymous. -NIGH HALF UPON THY HORSE, A GRACEFUL SEMITE TRICK. Picture. 12. Anonymous. I\u27m Preserving That Lock of Hair... Picture. 13. Anonymous. Untitled. Prose. 13. Grayce. IT\u27S A LONG JANE THAT HAS NO CRUVES. Picture. 13. Anonymous. Relativity. Prose. 13. Anonymous. STOP THIEF! Prose. 14. Anonymous. FLAMINGO PINFEATHERS. Prose. 15. Anonymous. TO WHOM IT MAY CONCERN. Prose. 15. Bridge. Denison Comics. Picture. 16. Anonymous. A STUDY OF WILD LIFE. Picture. 18. Anonymous. Names. Poem. 18. Anonymous. YOU ARE THE FIRST MAN I EVER PERMITTED TO KISS ME. AND YOU ARE THE FIRST GIRL I EVER KISSED. WILL YOU MARRY ME? I WOULDN\u27T MARRY A LIAR. I WOULD. Picture. 18. Anonymous. TECHNICAL STUFF. Prose. 18. Anonymous. Untitled. Prose. 18. Anonymous. JACK, WHEN WE ARE MARRIED, I MUST HAVE THREE SERVANTS. YOU SHALL HAVE TWENTY, DEAR, BUT NOT ALL AT ONE TIME. Picture. 18. Anonymous. Untitled. Poem. 18. Anonymous. Untitled. Prose. 18. Anonymous. THEN THIS IS FINAL? ABSOLUTELY. SHALL I RETURN YOUR LETTERS? YES, THERE\u27S SOME GOOD MATERIAL IN THEM I CAN USE. Picture. 18. Anonymous. MY BUT YOU\u27RE CONTRADICTORY TO-NIGHT \u27\u27WHY, I AM NOT. Picture. 19. Anonymous. Untitled. Prose. 19. Anonymous. Untitled. Prose. 19. Anonymous. SPRING THIS AND RUN. Prose. 19. Anonymous. Untitled. Prose. 19. Anonymous. Untitled. Prose. 19. E.S. STOP THIEF! Prose. 19. Anonymous. Untitled. Poem. 19. Anonymous. Untitled. Prose. 19. Grayce. HER REASON. Picture/Poem. 19. Anonymous. Untitled. Prose. 19. Anonymous. LIKE KELLY DID. Prose. 19. N.H.G. FAVORITE FICTION. Poem. 19. Anonymous. HARD JUVENILE LEAD: D— THAT BALL!\u27 Picture. 19. E.B. THE END—. Picture. 20. Anonymous. Untitled. Prose. 20. Anonymous. NODE 2 A BLOCK HEAD. Prose. 20. Anonymous. Untitled. Prose. 20. Anonymous. Untitled. Prose. 20. E.B. OF A PERFECT DAY. Picture. 20. Wisconsin Octopus. Sweet Kisses. Prose. 22. Log. Untitled. Prose. 22. Bean Pot. Untitled. Prose. 22. Gargoyle. EXACTLY. Prose. 22. Froth. Untitled. Prose. 22. Phoenix. Untitled. Prose. 22. Anonymous. Untitled. Prose. 23. Chaparral. Famous Hands. Prose. 24. Chaparral. WASH OUT FOR THIS. Prose. 24. Gargoyle. Untitled. Prose. 24. Goblin. Untitled. Prose. 24. Octopus. A Tragedy. Poem. 24. Froth. Untitled. Prose. 24. Juggler. Untitled. Prose. 24. Lord Jeff. THE FROSH RETORT. Prose. 25. Goblin. Untitled. Prose. 25. Green Gander. Untitled. Prose. 25. Judge. AN EXPLANATION. Prose. 25. Green Gander. Untitled. Prose. 25. Spider Web. Untitled. Prose. 25. Chapparal. Untitled. Prose. 26. Williams Purple Cow. Untitled. Prose. 26. Froth. Untitled. Prose. 26. Gargoyle. SHERIFF, DO YOUR DUTY. Prose. 26. Beanpot. Untitled. Prose. 26. Sun Dial. A WELL BALANCED SENTENCE. Prose. 26. Chapparal. Untitled. Prose. 26. Scalper. Untitled. Prose. 26. Cracker. Untitled. Prose. 27. Scalper. Untitled. Prose. 27. Burr. Untitled. Prose. 27. Lemon Punch. Untitled. prose. 27. Schmitz. Untitled. Picture. 28. Puppet. Untitled. Prose. 28. Malteaser. Untitled. Prose. 28. Jester. SO IT GOES. Poem. 29. Brown Jug. CONTRIBUTORS ATTENTION! Prose. 29. Tiger. Untitled. Prose. 29. Scalper. QUALIFIED. Prose. 29. Purple Cow. Untitled. Prose. 29. E.B. D\u27JA EVER FEEL LIKE THIS? Picture. 29. Chaparral. Untitled. Prose. 30. Tiger. Untitled. Prose. 30. Malteaser. STOP THIEF! Prose. 30. Black and Blue Jay. Untitled. Prose. 30. Yellow Jacket. Untitled. Prose. 30. Tiger. Untitled. Prose. 30. Gargoyle. RIGHTO. Prose. 30. Yale Record. Untitled. Prose. 31. Puppet. Untitled. Prose. 31. Puppet. Untitled. Poem. 31. Virginia Reel. Untitled. Prose. 31. Puppet. Untitled. Prose. 31. Virginia Reel. Untitled. Prose. 31. Phoenix. Untitled. Prose. 31. Exchange. Untitled. Prose. 31. Stone Mill. Untitled. Prose. 31. Orange Peel. Untitled. Prose. 31. Stone Mill. Untitled. Prose. 32. Puppet. A SHORT TRAGEDY. Poem. 32. Stone Mill. Untitled. Prose. 32. Ex. Untitled. Prose. 32. Anonymous. Untitled. Prose. 32. Anonymous. Untitled. Prose. 32

Zoledronate upregulates MMP-9 and -13 in rat vascular smooth muscle cells by inducing oxidative stress

WOS: 000374502300001PubMed ID: 27143852Background: Bisphosphonates, including zoledronate, target osteoclasts and are widely used in the treatment of osteoporosis and other bone resorption diseases, despite side effects that include damaging the stomach epithelium. Beneficial and adverse effects on other organ systems, including the cardiovascular system, have also been described and could impact on the use of bisphosphonates as therapeutic agents. Vascular smooth muscle cells (VSMCs) are major constituents of the normal vascular wall and have a key role in intimal thickening and atherosclerosis, in part by secreting MMPs that remodel the extracellular matrix and cleave cell surface proteins or secreted mediators. In this study, we investigated the effects of zoledronate on MMP expression. Methods: Rat VSMCs were stimulated by PDGF (50 ng/mL) plus TNF-alpha (10 ng/mL) or left unstimulated for a further 24 hours in serum-free medium. In other series of experiments, cells were pre-treated either with SC-514 (50 mu M) or with apocynin (20 nM) for 2 hours, then zoledronate (100 mu M) was added into 2% fetal calf serum containing medium for 24 hours. Results and discussion: Using isolated rat VSMCs in culture, zoledronate (100 mu M) increased MMP-9 and -13 mRNA expressions but inhibited MMP-2 expression. MMP-9 and MMP-13 up-regulation was shown to depend on the NF-kappa B pathway; and this was activated by zoledronate. Furthermore, zoledronate elevated the levels of reactive oxygen species detected by either dichlorofluorescein in isolated VSMCs or lucigenin enhanced chemiluminescence in rat aortic rings in vitro. Apocynin, an inhibitor of NADPH oxidase, reversed NF-kappa B activation and MMP-9 and MMP-13 up-regulation by zoledronate. Conclusion: We conclude that zoledronate increases MMP-9 and MMP-13 expressions in rat VSMCs dependent upon stimulation of the NF-kappa B pathway by reactive oxygen species. Effects on MMP expression may contribute to the pharmacologic profile of bisphosphonates.British Heart FoundationBritish Heart Foundation [CH95/001]; British Heart FoundationBritish Heart Foundation [RG/09/006/27918]The authors would like to thank Dr Goksel Gokce, Ege University Faculty of Pharmacy and Dr Steve White, University of Bristol for valuable help and expertise on oxidative stress measurements. MZA would also like to thank Prof Levent Ustunes for kind help and encouragement. This study was supported by the British Heart Foundation grant CH95/001

Contrasting Views of Physicians and Nurses about an Inpatient Computer-based Provider Order-entry System

Objective: Many hospitals are investing in computer-based provider order-entry (POE) systems, and providers’ evaluations have proved important for the success of the systems. The authors assessed how physicians and nurses viewed the effects of one modified commercial POE system on time spent patients, resource utilization, errors with orders, and overall quality of care. Design: Survey. Measurements: Opinions of 271 POE users on medicine wards of an urban teaching hospital: 96 medical house officers, 49 attending physicians, 19 clinical fellows with heavy inpatient loads, and 107 nurses. Results: Responses were received from 85 percent of the sample. Most physicians and nurses agreed that orders were executed faster under POE. About 30 percent of house officers and attendings or fellows, compared with 56 percent of nurses, reported improvement in overall quality of care with POE. Forty-four percent of house officers and 34 percent of attendings/fellows reported that their time with patients decreased, whereas 56 percent of nurses indicated that their time with patients increased (P \u3c 0.001). Sixty percent of house officers and 41 percent of attendings/fellows indicated that order errors increased, whereas 69 percent of nurses indicated a decrease or no change in errors. Although most nurses reported no change in the frequency of ordering tests and medications with POE, 61 percent of house officers reported an increased frequency. Conclusion: Physicians and nurses had markedly different views about effects of a POE system on patient care, highlighting the need to consider both perspectives when assessing the impact of POE. With this POE system, most nurses saw beneficial effects, whereas many physicians saw negative effects

An investigation to assess ankle mobility in healthy individuals from the application of multi-component compression bandages and compression hosiery

Background An investigation was undertaken to compare the effect of multi-component compression bandages and compression hosiery kits on individuals’ range of ankle motion whilst wearing typical and medical footwear, and barefoot. Methods A convenience sample of 30 healthy individuals recruited from the staff and student population at the University of Huddersfield, UK. Plantarflexion/dorsiflexion range of ankle motion (ROAM) was measured in participants over 6 steps in every combination of typical, medical and no footwear; and multi-component bandages, compression hosiery and no garments. Results Controlling for age, gender and garments, the use of typical footwear was associated with a mean increase in ROAM of 2.54° at best estimate compared with barefoot; the use of medical footwear was associated with a mean decrease in ROAM of 1.12° at best estimate compared with barefoot. Controlling for age, gender and footwear, the use of bandaging was associated with a mean decrease in ROAM of 2.51° at best estimate compared with no garments. Controlling for age, gender and footwear, the use of hosiery was not associated with a significant change in ROAM compared with no garments. Conclusions Bandages appear to restrict ROAM more than hosiery when used in conjunction with a variety of footwear types

Early Elevation of Matrix Metalloproteinase-8 and -9 in Pediatric ARDS Is Associated with an Increased Risk of Prolonged Mechanical Ventilation

BACKGROUND: Matrix metalloproteinases (MMP) -8 and -9 may play key roles in the modulation of neutrophilic lung inflammation seen in pediatric Acute Respiratory Distress Syndrome (ARDS). We aimed to perform a comprehensive analysis of MMP-8 and MMP-9 activity in tracheal aspirates of pediatric ARDS patients compared with non-ARDS controls, testing whether increased MMP-8 and -9 activities were associated with clinical outcomes. METHODS: Tracheal aspirates were collected from 33 pediatric ARDS patients and 21 non-ARDS controls at 48 hours of intubation, and serially for those who remained intubated greater than five days. MMPs, tissue inhibitor of metalloproteinases (TIMPs), human neutrophil elastase (HNE) and myeloperoxidase (MPO) activity were measured by ELISA, and correlated with clinical indicators of disease severity such as PRISM (Pediatric Risk of Mortality) scores, oxygen index (OI), multi-organ system failure (MOSF) and clinical outcome measures including length of intubation, ventilator-free days (VFDs) and mortality in the Pediatric Intensive Care Unit (PICU). RESULTS: Active MMP-9 was elevated early in pediatric ARDS subjects compared to non-ARDS controls. Higher MMP-8 and active MMP-9 levels at 48 hours correlated with a longer course of mechanical ventilation (r = 0.41, p = 0.018 and r = 0.75, p<0.001; respectively) and fewer number of VFDs (r = -0.43, p = 0.013 and r = -0.76, p<0.001; respectively), independent of age, gender and severity of illness. Patients with the highest number of ventilator days had the highest levels of active MMP-9. MMP-9 and to a lesser extent MMP-8 activities in tracheal aspirates from ARDS subjects were sensitive to blockade by small molecule inhibitors. CONCLUSIONS: Higher MMP-8 and active MMP-9 levels at 48 hours of disease onset are associated with a longer duration of mechanical ventilation and fewer ventilator-free days among pediatric patients with ARDS. Together, these results identify early biomarkers predictive of disease course and potential therapeutic targets for this life threatening disease

Narrative constructions of anorexia and abuse: An athlete's search for meaning in trauma

Interpretive approaches to the study of eating disorders are scarce. Narrative analysis provides an attractive means to address this shortfall and is applied to the life story of Beth, a former elite athlete with experience of anorexia nervosa and, as she revealed, sexual abuse. Six unstructured life history interviews took place yielding more than 9 hours of interview data. Throughout our conversations, Beth constructed multiple, fragile, and sometimes contrasting narrative coherences indicative of a fragmented and uncertain understanding of her life. It is argued that how Beth makes sense of her trauma is consequential for her future experiences

Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise

BACKGROUND: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. METHOD: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. RESULTS: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. CONCLUSIONS: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety

The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning

BACKGROUND: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). METHOD: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. RESULTS: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. DISCUSSION: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training