Impact of UK academic foundation programmes on aspirations to pursue a career in academia

Medical Education 2010: 44: 996–1005 Objectives This study aimed to determine the role played by academic foundation programmes in influencing junior doctors’ desire to pursue a career in academic medicine. Methods We conducted an online questionnaire‐based study of doctors who were enrolled on or had completed academic foundation programmes in the UK. There were 92 respondents (44 men, 48 women). Of these, 32 (35%) possessed a higher degree and 73 (79%) had undertaken a 4‐month academic placement during Foundation Year 2. Outcomes were measured using Likert scale‐based ordinal response data. Results From a cohort of 115 academic foundation trainees directly contacted, 46 replies were obtained (40% response rate). A further 46 responses were obtained via indirect notification through local programme directors. From the combined responses, the majority (77%) wished to pursue a career in academia at the end of the academic Foundation Year (acFY) programme. Feeling well informed about academic careers (odds ratio [OR] 16.9, p = 0.005) and possessing a higher degree (OR 31.1, p = 0.013) were independently associated with an increased desire to continue in academia. Concern about reduced clinical experience whilst in academic training dissuaded from continuing in academia (OR 0.15, p = 0.026). Many respondents expressed concerns about autonomy, the organisation of the programme and the quantity and quality of academic teaching received. However, choice of work carried out during the academic block was the only variable independently associated with increasing the desire of respondents to pursue a career in academia following their experiences in the acFY programme (OR 6.3, p = 0.007). Conclusions The results support the provision of well‐organised academic training programmes that assist junior clinical academics in achieving clinical competencies whilst providing protected academic time, information about further academic training pathways and autonomy in their choice of academic work.     

Cytotoxicity Evaluation and Isolation of a Chroman Derivative from Phyllanthus amarus. Aerial Part Extract

Abstract

Chemical and cytotoxicity examinations of the crude methanol extract of the aerial parts of Phyllanthus amarus. Schum. et Thonn. (Euphorbiaceae) were investigated. The cytotoxicity property of the P. amarus. was evaluated in vitro., using the human ovarian A2780 cancer cell. Bioassay-guided fraction of the crude extract (IC₅₀ value of 31.2 µg/mL) showed that the dichloromethane fraction was most toxic with an IC₅₀ value of 22.7 µg/mL, whereas the polar methanol fraction was least cytotoxic with an IC₅₀ value of 31.2 µg/mL. This led to the isolation of a new chroman derivative from the dichloromethane fraction. On the basis of nuclear magnetic resonance and mass spectral data, the structure of the chroman was established as 4,4,8-trimethoxy chroman. The compound exhibited very little or no in vitro. cytotoxicity with an IC₅₀ of 16.2 µg/mL, relative to actinomycin, the reference compound, with an IC₅₀ of 2.0 ng/mL. It can therefore be concluded that the aerial parts of P. amarus., an extensively used plant remedy in various African and Asian Pacific ethnomedicines, is relatively nontoxic.     

Antiplasmodial activity of compounds from Sloanea rhodantha (Baker) Capuron var. rhodantha from the Madagascar rain forest

Bioassay-directed separation of the butanol-soluble portion of an extract of Sloanea rhodantha (Baker) Capuron var. Rhodantha (Elaeocarpaceae) active against the drug-sensitive HB3 strain of Plasmodium falciparum led to the isolation of seven phenolic compounds, gallic acid (1), 3,5-di-O-galloylquinic acid (2), 1,6-di-O-galloyl glucopyranoside (3), 3,4,5-tri-O-galloylquinic acid (4), 1-O-eudesmoylquinic acid (5), 1,2,3,6-tetra-O-galloyl glucopyranoside (6), and 3,4,5-trimethoxyphenyl-(6'-O-galloyl)-O-b-D-glucopyranoside (7). The structure of the new compound 5 was established on the basis of interpretation of its 1D and 2D NMR spectroscopic data. Compounds 2, 3, 4, 6, and 7 showed weak inhibitory activity against the drug-sensitive HB3 and the drug-resistant FCM29 strains of P. falciparum, with IC (50) values ranging from 8.0 - 43.0 and 16.1 - 93.0 microg/mL, respectively.     

A novel cytotoxic guttiferone analogue from Garcinia macrophylla from the Suriname rainforest

Bioassay-guided fractionation of the EtOAc extract of the twigs of Garcinia macrophylla from Suriname produced the known benzophenone, guttiferone A (1), and a new guttiferone analogue, guttiferone G (2). Friedelin was also isolated. The structures of compounds 1 and 2 were elucidated using 1D and 2D NMR spectroscopy. Compounds 1 and 2 were weakly cytotoxic in the A2780 human ovarian cell line, with IC (50) values of 6.8 and 8.0 microg/mL, respectively.     

Studies on di- and triterpenoids from Salvia staminea with cytotoxic activity

A new ursane-type triterpenoid, 3 beta,11 alpha,21 alpha-trihydroxyurs-12-ene, named salvistamineol (1), has been isolated from the methanol extract of Salvia staminea. In addition to 1, the methanol extract yielded four known compounds and the acetone extract yielded twelve known compounds consisting of two sesquiterpenes, six diterpenoids, a triterpenoid, two steroids and one flavone. DNA damaging properties of the extracts and some isolated diterpenes were investigated against three yeasts and only taxodione gave a positive response and also showed the highest cytotoxic activity against a panel of cell lines among the investigated compounds in this study.     

谷氨酸脱羧酶抑制剂L-苹果酸对小鼠学习记忆的影响

跳台法和Y迷宫法试验表明,小鼠po L-苹果酸600mg·kg^-1连续5d后对记忆的获得、巩固和再现均有明显的改善作用,并能促进空间辨别学习能力;L-苹果酸改善记忆的作用能被NMDA受体拮抗剂氯胺酮所拮抗。脑内游离氨基酸测定显示,L-苹果酸可明显降低小鼠脑内GABA水平,提高Glu/GABA比值。实验结果表明,脑内GABA水平下降,Glu/GABA比值升高对学习记忆有正性调节作用。     

Isolation and synthesis of antiproliferative eupolauridine alkaloids of Ambavia gerrardii from the Madagascar Dry Forest

Investigation of the Madagascan endemic plant Ambavia gerrardii for antiproliferative activity against the A2780 ovarian cancer cell line led to the isolation of the three new alkaloids 8-hydroxyeupolauridine (1), 9-methoxyeupolauridine 1-oxide (2), and 11-methoxysampangine (3) and the three known alkaloids 4-6. The structures of 1 and 2 were confirmed by synthesis. Compounds 3, 4, and 6 showed moderate to good antiproliferative activities, with IC50 values of 10.3, 3.5, and 0.60 μM, respectively, against the A2780 human ovarian cancer cell line and with IC50 values of 0.57, 1.77, and 0.58 μM, respectively, against the H460 human lung cancer cell line.     

Echocardiogram Utilization Among Rural and Urban Veterans

Purpose: To compare echocardiography use among urban and rural veterans and whether differences could be accounted for by distance. Methods: We used Veterans Administration (VA) administrative data from 1999 to 2007 to identify regular users of the VA Healthcare System (VA users) who did and did not receive echocardiography. Each veteran was categorized as residing in urban, rural or highly rural areas using RUCA codes. Poisson regression was used to compare echocardiography utilization rates among veterans residing in each area after adjusting for demographics, comorbidities, clustering of patients within VA networks and distance to the nearest VA medical center offering echocardiography. Findings: Our study included 22.7 million veterans of whom 1.3 million (5.7%) received at least 1 echocardiogram. Of echocardiography recipients, 69.2% lived in urban, 22.0% in rural and 8.8% in highly rural areas. In analyses adjusting for patient demographics, comorbidities, and clustering, utilization of echocardiography was modestly lower for highly rural and rural veterans compared with urban veterans (42.0 vs 40.1 vs 43.1 echocardiograms per 1,000 VA users per year for highly rural, rural and urban, respectively; P < .001). After further adjusting for distance, echocardiography utilization was somewhat higher for veterans in highly rural and rural areas than it was for urban areas (44.9 vs 41.8 vs 40.8 for highly rural, rural and urban, respectively; P < .001). Conclusions: Echocardiography utilization among rural and highly rural veterans was marginally lower than for urban veterans, but these differences can be accounted for by the greater distance of more rural veterans from facilities offering echocardiograms.     

Mothers' perceptions of children's quality of life following early diagnosis and treatment for retinoblastoma (Rb)

We describe the Quality of Life (QoL) and IQ of survivors of retinoblastoma (Rb), both in relation to the normal population and between subgroups of Rb patients differing in relative risk (i.e. unilateral vs. bilateral disease). The sample included 54 children (28 males, age-range 8-16 years) and their mothers. Mothers completed standardized questionnaires to report their own QoL and that of their child. Children completed a brief IQ test. Compared with population norms, mothers reported lower levels of QoL for their child on total QoL and for sub-scales measuring Physical and Psychosocial function. Mothers reported their own QoL to be comparable or higher than norms on all but one of eight sub-scales (energy/vitality). Compared with population norms, children with no visual impairment scored in the normal range for tasks measuring Verbal IQ, but below the mean on tasks measuring Performance IQ. According to their mothers, survivors of Rb have excellent school attendance and take part in most school activities. However, based on standardized questionnaire, they show compromised QoL. We consider that excellent survival rates in Rb are matched with good QoL according to mothers' report.