Can the Delta stop singing the blues?

This article was written to describe a collaborative effort between the University of Mississippi Medical Center and the Delta Health Alliance to increase primary care providers in the 18 counties designated as the Mississippi Delta. Journals compiled by trainees were analyzed to reveal issues significant to practicing in a rural area from the perspective of medical students and residents who participated in the program. Patient noncompliance, provider sensitivity to cost, continuity of care, and quality of the doctor-patient relationship were all identified as significant issues by the trainees.     

An algorithm for identifying physical activity patterns from motion data

An algorithm was developed to describe how physical activity (PA) patterns relate to overall motion counts. Thirty-five children wore an accelerometer (7-days). Each motion count was compared with the mean of surrounding counts within 21 min. Counts per minute similar to the mean were grouped into bouts. Counts that differed by more than 20% of the coefficient of variations (based on the mean and SD of the 21 min period) indicated transitions between bouts. Children with more daily motion had more and longer moderate (MPA) and vigorous (VPA) bouts, higher counts during MPA bouts, and more transitions from VPA to VPA bouts. In addition to differences in PA levels, highly active and less active children perform PA differently.     

Mucinous cyst of the sural nerve

Mucinous cysts are rare neural lesions. There has been no documentation of this lesion affecting the sural nerve. The lesion is referred to by a number of confusing names. The authors present a case history, and propose a new name based on consistent histologic characteristics.     

Chiropractic interns' perceptions of stress and confidence

Objective:

Psychological stress has been shown to influence learning and performance among medical and graduate students. Few studies have examined psychological stress in chiropractic students and interns. This preliminary study explored interns'' perceptions around stress and confidence at the midpoint of professional training.

Methods:

This pilot study used a mixed-methods approach, combining rating scales and modified qualitative methods, to explore interns'' lived experience. Eighty-eight interns provided ratings of stress and confidence and narrative responses to broad questions.

Results:

Participants reported multiple sources of stress; stress and confidence ratings were inversely related. Interns described stress as forced priorities, inadequate time, and perceptions of weak performance. Two themes, “convey respect” and “guide real-world learning,” describe faculty actions that minimized stress and promoted confidence.

Conclusion:

Chiropractic interns experience varying degrees of stress, which is managed with diverse strategies. The development of confidence appears to be influenced by the consistency and manner in which feedback is provided. Although faculty cannot control the amount or sources of stress, awareness of interns'' perceptions can strengthen our effectiveness as educators.Key Indexing Terms: education, professional, mixed methods, qualitative studies, stress, psychological     

Epstein-Barr virus infection in renal transplant recipients. Effects of antithymocyte globulin and interferon

We studied Epstein-Barr (EB) virus excretion and antibody in 41 renal transplant recipients enrolled in a placebo-controlled trial of human leukocyte interferon. Half the patients were also treated with antithymocyte globulin. Epstein-Barr virus excretion occurred more often in recipients of cadaver kidneys (P = 0.03) and those receiving antithymocyte globulin (P = 0.04) and less often in patients given interferon (P = 0.08). Antibody to viral capsid antigen increased fourfold or more in 12 of 22 patients treated with antithymocyte globulin and in none of the non-antithymocyte globulin-treated group (P = 0.0002). Antibody to the restricted component of early antigen rose fourfold or more in eight patients and appeared related to the occurrence of syndromes similar to those attributed to cytomegalovirus in transplant recipients. We conclude that increasing immunosuppression augments the rate of EB virus reactivation and that EB virus may be an important pathogen in heretofore ill-defined syndromes.