Relationships Matter: Enhancing Trainee Development with a (Simple) Clerkship Curriculum Reform.

Problem: The traditional clerkship model of brief encounters between faculty and students results in reduced meaningful learning opportunities due to the lack of a relationship that enables repeated observation, supervisor feedback, trust formation, and growth.

Intervention: Clinical clerkships at our institution were restructured to decrease fragmentation of supervision and foster an educational alliance between faculty and student. A mixed-methods approach was used to study the impact of this curriculum reform on the student experience in the obstetrics and gynecology clerkship.

Social Cognitive Constructs Did Not Mediate the BEAT Cancer Intervention Effects on Objective Physical Activity Behavior Based on Multivariable Path Analysis.

Background: Most breast cancer survivors do not meet physical activity recommendations. Understanding mediators of physical activity behavior change can improve interventions designed to increase physical activity in this at-risk population.

Purpose: Study aims were to determine the 3-month Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) behavior change intervention effects on social cognitive theory constructs and the mediating role of any changes on the increase in accelerometer-measured physical activity previously reported.

Effects of a multicomponent physical activity behavior change intervention on breast cancer survivor health status outcomes in a randomized controlled trial.

Little is known about the effects of physical activity behavior change interventions on health outcomes such as lower extremity dysfunction and SF-36 physical health (predictor of mortality) in breast cancer survivors. Furthermore, effect moderators are rarely reported. Therefore, we report the effects of the 3-month BEAT Cancer physical activity behavior change intervention on global health status and health indicators along with moderators of intervention outcomes.

Effects of a multicomponent physical activity behavior change intervention on fatigue, anxiety, and depressive symptomatology in breast cancer survivors: randomized trial.

Objectives: To determine the effects of the 3-month multicomponent Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) physical activity behavior change intervention on fatigue, depressive symptomatology, and anxiety.

Methods: Postprimary treatment breast cancer survivors (n = 222) were randomized to BEAT Cancer or usual care. Fatigue Symptom Inventory and Hospital Anxiety and Depression Scale were assessed at baseline, postintervention (month 3; M3), and follow-up (month 6; M6).

AKR1B10 promotes breast cancer metastasis through integrin α5/δ-catenin mediated FAK/Src/Rac1 signaling pathway.

Aldo-keto reductase 1B10 (AKR1B10) is not expressed in normal breast, but upregulated in primary and metastatic breast cancers, being a negative prognostic factor. This study characterized the molecular mechanisms of AKR1B10-promoted breast cancer metastasis. Ectopic expression of AKR1B10 in breast cancer cells MCF-7 and MDA-MB-231 or siRNA-mediated silencing in BT-20 cells affected cell adhesion, migration and invasion in cell culture, and metastasis to the lung in the nude mice through upregulation of integrin α5 and δ-catenin.

D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs.

Objective: Test D-methionine (D-met) as an otoprotectant from kanamycin-induced ototoxicity and determine the lowest maximally protective D-met dose.

Design: Auditory brainstem responses (ABR) were measured at 4, 8, 14, and 20 kHz at baseline and two, four, and six weeks after kanamycin and D-met administration initiation. ABR threshold shifts assessed auditory function.

Is a Single-Item Operative Performance Rating Sufficient?

Objective: A valid measure of resident operative performance ability requires direct observation and accurate rating of multiple resident performances under the normal range of operating conditions. The challenge is to create an operative performance rating (OPR) system that: is easy to use, encourages completion of many ratings immediately after performances and minimally disrupts supervising surgeons' work days. The purpose of this study was to determine whether a score based on a single-item overall OPR provides a valid and stable appraisal of resident operative performances.

Refining Measurement of Social Cognitive Theory Factors Associated with Exercise Adherence in Head and Neck Cancer Patients.

Social cognitive theory (SCT) measures related to exercise adherence in head and neck cancer (HNCa) patients were developed. Enrolling 101 HNCa patients, psychometric properties and associations with exercise behavior were examined for barriers self-efficacy, perceived barriers interference, outcome expectations, enjoyment, and goal setting. Cronbach's alpha ranged from.

d-Methionine reduces tobramycin-induced ototoxicity without antimicrobial interference in animal models.

Background: Tobramycin is a critical cystic fibrosis treatment however it causes ototoxicity. This study tested d-methionine protection from tobramycin-induced ototoxicity and potential antimicrobial interference.

Methods: Auditory brainstem responses (ABRs) and outer hair cell (OHC) quantifications measured protection in guinea pigs treated with tobramycin and a range of d-methionine doses.

Effects of the BEAT Cancer physical activity behavior change intervention on physical activity, aerobic fitness, and quality of life in breast cancer survivors: a multicenter randomized controlled trial.

Most breast cancer survivors (BCS) are not meeting recommended physical activity guidelines. Here, we report the effects of the Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) behavior change intervention on physical activity, aerobic fitness, and quality of life (QoL). We randomized 222 post-primary treatment BCS to the 3-month intervention (BEAT Cancer) or usual care (UC).

Meeting physical activity guidelines in rural breast cancer survivors.

Objectives: To examine the contribution of social cognitive constructs to meeting physical activity (PA) recommendations in rural breast cancer survivors (BCS).

Methods: Rural BCS (N = 483) completed a mail-based survey. PA, fatigue, barriers and exercise self-efficacy, environment, social support, and perceived barriers to PA were assessed.

Inflammation and psychosocial factors mediate exercise effects on sleep quality in breast cancer survivors: pilot randomized controlled trial.

Objective: To improve mechanistic understanding, this pilot randomized controlled trial examined mediators of an exercise intervention effects on sleep in breast cancer survivors (BCS).

Methods: Forty-six postmenopausal BCS (≤Stage II, off primary treatment) were randomized to a 3-month exercise intervention or control group. Intervention included 160 min/week of moderate intensity aerobic walking, twice weekly resistance training (resistance bands), and six discussion groups (to improve adherence).

Variations in senior medical student diagnostic justification ability.

Purpose: To determine the diagnostic justification proficiency of senior medical students across a broad spectrum of cases with common chief complaints and diagnoses.

Method: The authors gathered diagnostic justification exercise data from the Senior Clinical Comprehensive Examination taken by Southern Illinois University School of Medicine's students from the classes of 2011 (n = 67), 2012 (n = 66), and 2013 (n = 79). After interviewing and examining standardized patients, students listed their key findings and diagnostic possibilities considered, and provided a written explanation of how they used key findings to move from their initial differential diagnoses to their final diagnosis.

CSF neurofilament light chain is elevated in OMS (decreasing with immunotherapy) and other pediatric neuroinflammatory disorders.

Using a panel of seven brain cell-specific biomarkers in cerebrospinal fluid (CSF), pediatric opsoclonus-myoclonus syndrome (OMS) (n=234) was compared to pediatric non-inflammatory neurological controls (n=84) and other inflammatory neurological disorders (OIND) (n=44). Only CSF NFL was elevated in untreated OMS versus controls (+83%). It was 87% higher in OIND than in OMS.

Biobehavioral factors mediate exercise effects on fatigue in breast cancer survivors.

Purpose: This study aimed to examine mediators of fatigue response to an exercise intervention for breast cancer survivors in a pilot randomized controlled trial.

Methods: Postmenopausal breast cancer survivors (n = 46; ≤stage 2), off primary treatment, and reporting fatigue and/or sleep dysfunction were randomized to a 3-month exercise intervention (160 min·wk of moderate-intensity aerobic walking, twice weekly resistance training with resistance bands) or control group. Six discussion group sessions provided behavioral support to improve adherence.

D-methionine pre-loading reduces both noise-induced permanent threshold shift and outer hair cell loss in the chinchilla.

Objective: This study tested multiple dosing epochs of pre-loaded D-methionine (D-met) for otoprotection from noise-induced hearing loss (NIHL).

Design: Auditory brainstem response (ABR) thresholds were measured at baseline, 1 day, and 21 days following a 6-hour 105 dB sound pressure level (SPL) octave band noise (OBN) exposure. Outer hair cell (OHC) counts were measured after day 21 sacrifice.

Vitamin D insufficiency in psychiatric inpatients.

Objective: The extraskeletal effects of vitamin D have gained increasing attention with the discovery of receptors in a variety of organ systems. Previous work has identified associations between vitamin D insufficiency and a variety of mental illnesses, including affective, cognitive, and psychotic spectrum disorders. We attempted to determine the point prevalence of vitamin D insufficiency among psychiatric inpatients and determine if there was a relationship between vitamin D insufficiency and specific diagnoses and pharmacological treatments.

Effect of normal saline and half normal saline on serum electrolytes during recovery phase of diabetic ketoacidosis.

Objective: This study aims to describe the effect of 0.9% saline (NS) versus 0.45% saline (half NS) when used during recovery phase of diabetic ketoacidosis (DKA) in children.

A template for reliable assessment of resident operative performance: assessment intervals, numbers of cases and raters.

Background: Operative performance rating (OPR) instruments have been developed to assess operative performance (OP). To guide program implementation, this study determined: 1) Appropriate intervals for OP progress decisions, 2) Number of OPRs and raters required per interval to achieve reproducible results.

Methods: 21 surgeons rated 897 OPs (3 procedures) by 36 residents.

Pilot, randomized trial of resistance exercise during radiation therapy for head and neck cancer.

Background: The purpose of this study was to determine the feasibility of a randomized trial of resistance exercise in patients with head and neck cancer receiving radiation.

Methods: Fifteen patients with head and neck cancer receiving radiation were randomized to resistance exercise (using resistance bands) or control group. Resistance exercise occurred at the radiation therapy site (weeks 1-6) and home (weeks 7-12).

Effects of a physical activity behavior change intervention on inflammation and related health outcomes in breast cancer survivors: pilot randomized trial.

Background: The goal of this pilot study was to determine the magnitude and direction of intervention effect sizes for inflammatory-related serum markers and relevant health outcomes among breast cancer survivors (BCSs) receiving a physical activity behavior change intervention compared with usual care.

Methods: This randomized controlled trial enrolled 28 stage I, II, or IIIA BCSs who were post-primary treatment and not regular exercisers. Participants were assigned to either a 3-month physical activity behavior change intervention group (ING) or usual care group (UCG).

From test validity to construct validity … and back?

Context:   Major changes in thinking about validity have occurred during the past century, shifting the focus in thinking from the validity of the test to the validity of test score interpretations. These changes have resulted from the 'new' thinking about validity in which construct validity has emerged as the central or unifying idea of validity today. Construct validity was introduced by Cronbach and Meehl in the mid-1950s in an attempt to address the validity of those many psychological concepts that have no clear referent in reality.