Project Outreach: Organizations Unified to Reach Youth

Youths of today are forced to deal with the external pressures of alcohol and drug abuse on all levels-from the older youngsters across the street pressuring them to be "cool," to the "cute dog" enticing them with the glamour of being the original "party animal." Through today's mass communications, young people are exposed to negative, self-destructive attitudes. It is important, therefore, to expose them to a more positive influence and try to reach them through parental guidance, personal contact, and peer pressure. To achieve this, the University of Missouri's Kansas City Chapter of the American Pharmaceutical Association's Academy of Students of Pharmacy, in conjunction with the Metropolitan Kansas City Area Task Force on Alcohol and Other Drug Abuse, proposed the development of an annual drug abuse prevention program that specifically targets fifth graders in the greater Kansas City metropolitan area. A primary goal of Project Outreach (Organizations Unified to Reach Youth) is to unite drug abuse prevention programs in the greater Kansas City metropolitan area in their outreach efforts to give positive support to Kansas City's youth against alcohol and other drugs. Phase I of Project Outreach consisted of a series of programs for the parents in the community. Phase II entailed college students who spoke to fifth graders in their classrooms. These students also participated in poster and poem contents centered around drug abuse prevention. In Phase III, which featured an outstanding, motivated speaker, the sample group of 600 fifth graders in the area participated in a major event to give positive peer pressure to say no to drugs.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pyridinyl imidazoles inhibit IL-1 and TNF production at the protein level

The mechanism by which SK&F 86002 and other pyridinyl imidazoles inhibit the production of IL-1 and TNF from LPS-stimulated human monocytes was examined. Inhibition of IL-1 and TNF production was found to depend on the time of addition of SK&F 86002, with diminishing effect when added more than 2 h after LPS stimulation. Analysis of Western blots confirmed that both intracellular IL-1β and extracellular TNF were significantly reduced in response to SK&F 86002, but these reductions were not paralleled by changes in IL-1 and TNF mRNA.³⁵S methionine pulse and pulse-chase studies on IL-1 biosynthesis suggest that significant inhibition by SK&F 86002 and related compounds occurs at the translational level.

     

Effect of vitamin E on tamoxifen-treated breast cancer cells

BACKGROUND: Induction of apoptosis by tamoxifen has been postulated to involve oxidative stress. Tamoxifen (TAM) may act on estrogen receptors (ER) located in the plasma membrane. Our hypothesis that supplemental antioxidant vitamin E (alpha-tocopherol) acts at the plasma membrane to alter the effectiveness of tamoxifen was tested in ER-positive breast cancer cell lines, MCF-7 and T47D. METHODS: Cells were treated in vitro with 20-muM TAM alone and in combination with 10-muM alpha-tocopherol (AT). Estrogen growth signals were quantified by immunohistochemical staining for the mitogen-activated protein kinase p-ERK. Rapid changes in intracellular calcium were detected in TAM-treated MCF-7 and T-47D cells by fluorescence microscopy of cells loaded with the calcium-sensitive dye Fluo 4AM. Apoptosis was assayed by flow cytometry. RESULTS: Proliferating cells in normal medium exhibited strong p-ERK staining. Addition of TAM abolished p-ERK staining and caused cell rounding and death. The addition of AT led to the restoration of cell proliferation and p-ERK expression even in the presence of high-dose TAM. Intracellular calcium rapidly increased in MCF-7 and T47D cells upon exposure to TAM, followed by an increase in caspase activation and eventual apoptosis. The increase in intracellular calcium was abolished by the addition of 10muM AT to TAM, and pan-caspase staining decreased at 5 hours from 72% to 41%. CONCLUSIONS: These studies suggest that supplemental vitamin E decreases the inhibitory effect of TAM on the proliferation of ER+ breast cancer cells and eliminates the rapid rise in intracellular calcium that leads to apoptosis stimulated by TAM. The use of vitamin E acetate supplements may be inadvisable for women taking tamoxifen.     

Team training for surgical trainees

Healthcare professionals work in teams but are rarely trained together. Realizing the adverse impact of poor teamwork on patient care, the Accreditation Council for Graduate Medical Education requires surgical trainees to demonstrate a mastery of teamwork-related competencies. A number of team training curricula are available in the USA, the best known of which is TeamSTEPPS – developed by the U.S. Department of Defense Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality.     

Argon beam coagulator electrode tip mimicking a metallic foreign body

OBJECTIVE: Our purpose is to describe the appearance of an argon beam coagulator electrode tip that may become fractured and detached during surgery. CONCLUSION: Knowledge of the potential for fracture and detachment and recognition of the characteristic radiographic appearance of the argon beam coagulator electrode tip allows radiographic identification of this metallic foreign body.     

Development of physical examination skills in a third-year surgical clerkship.

BACKGROUND: Previous studies have revealed deficiencies in physical examination (PE) skills of third-year medical students. The purpose of this study was to determine if formal teaching of PE skills and more supervised experiences with clinical faculty would increase the competency of these skills. METHODS: Forty-nine third-year medical students were assigned to one of two groups: group A was given formal instruction on PE skills at the beginning of the clerkship, and group B received the same instruction at the midpoint of the clerkship. The two groups received an assessment of the PE skills before, in the middle, and at the end of clerkship, utilizing a physician-developed checklist. RESULTS: Group A had a pretest score of 57.7%. Group B scored 59.8% on the pretest. Independent groups t tests were used to compare the two groups. At the midterm examination, group A increased their score to 71.0%, while group B decreased their score to 55.6%. From beginning to final, both groups had significant improvements in all areas, with group A scoring an overall mean of 75.1% (P = 0.0001), and group B scoring 75.5% (P = 0.0001). CONCLUSION: These findings show the effectiveness of structured learning situations for improving third-year surgery students' PE skills. There is also an indication that usual clerkship activities may not enhance learning of PE skills.     

A comparison of the teaching effectiveness of the didactic lecture and the problem-oriented small group session: a prospective study

A prospective study was designed to assess the teaching effectiveness of active learning in problem-oriented small group sessions (POSGS) compared with passive learning in didactic lectures (DL). Third-year medical students participated in a POSGS on breast disease and a standardized DL on thyroid disease (N = 23) or participated in a POSGS on thyroid disease and a DL on breast disease (N = 19). Students were tested with a multiple-choice examination (MCQ) and a highly structured oral examination (OE) administered by faculty members blinded about student group. Results of a between-within analysis of variance performed separately for breast and thyroid disease yielded significant group differences because of instructional method for thyroid disease (p = 0.003) and approached significance for breast disease (p = 0.095). Although no significant interactions were detected with percentage scores, a significant interaction between group membership and test type was noted for thyroid disease when the percentage scores were transformed to Z scores. We conclude that regardless of topic or testing method, students in POSGS tended to perform better than students in a DL and that the POSGS offers significant advantages over the DL in teaching surgery to third-year medical students.     

Sex-linked feathering alleles (K, k+) in chickens of diverse genetic backgrounds

Chicks were produced for this experiment by mating males from a broiler parent stock that were heterozygous (K/k+) at the sex-linked feathering locus with early feathering (fc+/w) females. Dams were from three diverse lines - White Plymouth Rocks selected for high or low 8-week, body weight and White Leghorns selected for high antibody response to sheep erythrocytes. Escherichia coli (E. coli) were injected into the caudal air sac of some chickens and others were maintained as uninoculated controls. Body weights were obtained immediately before inoculation and at subsequent 24-hour periods until 5 days after inoculation, at which time air sac and heart lesions were scored. Chicks were less affected by E. coli if they were maintained in warmer environments, younger at time of inoculation, or from the low weight dam line. Lesion scores suggested that chicks with only allele fc+ were slightly more resistant to E. coli inoculation than those with the K allele.     

The New ACS/APDS Skills Curriculum: Moving the Learning Curve Out of the Operating Room

Surgical education has dramatically changed in response to numerous constraints placed on residency programs, but a substantial gap in uniform practices exist, especially in the area of skills laboratory availability and usage. Simulation-based training has gained significant momentum and will be a requirement for residencies in the near future. In response, the American College of Surgeons and the Association of Program Directors in Surgery have formed a Surgical Skills Curriculum Task Force with the aim of establishing a National Skills Curriculum. The first of three phases will undergo implementation in 2007, with subsequent phases scheduled for launch in 2008. The curriculum has been carefully structured and designed by content experts to enhance resident training through reproducible simulations, with verification of proficiency before operative experience. Free-of-charge distribution is planned through a web-based platform, and widespread adoption is encouraged. In the future, these simulation-based strategies may be useful in assuring the competency of practicing surgeons and for credentialing purposes. Oral presentation at the 48th Annual Meeting, Education Committee Panel (Dr. David I. Soybel, Moderator), The Society for Surgery of the Alimentary Tract (SSAT), May 23, 2007, Washington, DC. This paper was originally presented as part of the SSAT Education Committee Panel on Simulation in Gastrointestinal Surgery at the SSAT 48th Annual Meeting, May 2007, in Washington, DC. The other articles presented in the panel were Johnson KA, Sachdeva AK, Pellegrini, CA, The Critical Role of Accreditation in Establishing the ACS Education Institutes to Advance Patient Safety through Simulation; Fried GM, FLS Assessment of Competency Using Simulated Laparoscopic Tasks; and Rehrig ST, Powers KA, Jones DB, Integrating Simulation in Surgery as a Teaching Tool and Credentialing Standard.