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PubMedDate not supplied

Increasing the pool of qualified minority medical school applicants: premedical training at historically black colleges and universities.

Historically black colleges and universities have educated significant numbers of black students preparing for careers in medicine. These institutions have the potential to make even greater contributions to the pool of black medical school applicants and ultimately to the supply of black physicians. The Division of Disadvantaged Assistance, Bureau of Health Professions, Health Resources and Services Administration within the Public Health Service, commissioned a study of the curriculums and other factors related to premedical education. The study was conducted at the historically black colleges and universities that graduate a large number of students who gain admission to medical school, and the historically black colleges and universities whose students are less successful in gaining admission to medical school. Nine historically black colleges and universities participated in a self-assessment of their undergraduate premedical curriculums. The findings from schools with higher acceptance rates were compared with those of schools with lower acceptance rates to identify factors contributing to the production of significant numbers of successful medical school applicants. Comparisons of data on these schools revealed several important factors that may be related to differences in acceptance rates: Those schools that devoted greater effort to premedical training (for example, advising students about how to prepare for medical school, curriculum development, maintaining premedical or pre-health professions offices and clubs--the staff of these offices provide students with information on medical or other health professions schools--to identify and recruit students) tended to have higher acceptance rates. * Schools with higher acceptance rates had larger proportions of biology and chemistry majors aspiring to medical and dental careers and stronger affiliations with medical schools than schools with lower acceptance rates.* Institutions with higher acceptance rates offered a broader range of externally sponsored enrichment programs; the highest medical school acceptance rates were found among those schools with continuing Health Careers Opportunity Program projects that served significant percentages of students interested in careers in medicine.* Mean Medical College Admission Test scores were somewhat lower for applicants from schools with lower acceptance rates, but the great variation in acceptance rates for these schools is not reflected in a comparable variation in the Medical College Admission Test scores.

Black or African American↗
PubMed1993

Universal precautions in the operating department.

Those operating theatre personnel who aim to keep up to date by reading the professional journals may well be confused and feel uninformed about the concept of universal precautions. While some authors focus on universal precautions, they do not mention operating theatres. Others continue to discuss the Human Immunodeficiency Virus (HIV), the Hepatitis B Virus (HBV) and high risk patient's. Furthermore the practical aspects of the implementation of universal precautions have not, to date, been thoroughly documented, other than the vague advice of 'treat every patient the same'. This article aims to clarify the concept of universal precautions, consider why they are needed, and suggest a possible pathway for their implementation. The three main changes in practice will also be discussed.

Humans↗
PubMed1987

[Science and the university. Both need more attention].

Scientific output in Chile was studied examining the publications indexed by the Institute for Scientific Information during 1985 and 1986. Meeting abstracts were not considered. The articles were classified in different areas and tabulated according to the institution from which they originated. As in previous years, more than 80% of the papers were published by universities. The most productive subjects in these institutions were biology (33.2%), medical sciences (23.4%), and chemistry (16.9%). Outside universities the following fields were the most productive: medical sciences, astronomy, social sciences, biology and physics. To compare the overall output of chilean universities, in addition to their scientific publications, the number of degrees granted at the undergraduate and graduate levels was also evaluated. The proportion of governmental funds that each university received was used to standardize the indicators. Significant differences were observed which revealed that the chilean higher educational system is very heterogeneous. The indicators presented herein objective the overall output of each of the 24 chilean institutions of higher education funded by the government and provide the necessary insight to compare their contribution, and to respond to their urgent needs.

Bibliometrics↗
PubMedDate not supplied

[Tutors and assistants for apprenticeship for students in the university diploma course in nursing science].

The article presents the results of a work carried out by a group of nurses dealing with nursing education, both graduate (Hospital School and then University) and post graduate, since about ten years. The Authors have defined role, functions, spheres of activity, hierarchic and functional relationships, qualifications and abilities of the two new professional figures quoted in the document agreed between Lombardia Region and Lombardia Universities about the new university diploma courses in Nursing Sciences: the tutor and the clinical instructor. In order to do such a work the Authors started from the literature review. They also tried to use the didactic and teaching experience gained by the nursing School of Varese since 1956 and the contemporary beginning of the University course since 1992.

Education, Nursing, Diploma Programs↗
PubMedDate not supplied

[Study of nursing teachers of university diploma courses in nursing science].

The aim of the present investigation is to focus on the role of nurse teachers at the basic nursing university programme (DUSI), especially to describe their social and professional characteristics as well as aspects of their positions. The results from the present study show a weak role and position and great variations in the nursing programme between universities. It's therefore recommended and urgent to review the nursing courses at university level, the role of nurse teachers within the university as well as their need of further education.

Education, Nursing, Diploma Programs↗
PubMed1996

[Medical and natrual scientists behind the museum which became the University of Bergen].

The University of Bergen celebrated its 50th anniversary in 1996. The University was built on an earlier institution, the Bergen Museum, founded in 1825. From 1880 until the beginning of this century the Museum gradually developed into an institution for research and higher education. The article describes work done by some of the key persons involved in this process, mainly medical and natural scientists. In particular, their international relations and ability to cooperative with other scientists were crucial factors in establishing the pillars of the later University of Bergen. Today, the University of Bergen has nearly 18,000 students and seven faculties, and is a highly internationalised institution.

History, 19th Century↗
PubMed1998

Alcohol consumption and sexually transmitted disease risk behavior: partner mix among male Korean university students.

BACKGROUND: This study examined alcohol consumption and sexually transmitted disease risk behavior as related to prostitute visits and sex partner mix among male Korean university students in 1993 to 1994. METHODS: Questionnaires were completed by a representative sample of 1103 university students in Seoul. Lifetime sexually transmitted disease risk behavior was categorized as none, only one, and multiple sexual experiences with prostitutes, whereas risk according to partner mix was classified as no sexual experience with prostitutes, sexual experience with prostitutes only, and with both prostitutes and girlfriends. The proportional odds model was applied to the data. RESULTS: A total of 25.8% of the university students had visited prostitutes--17.6% visited twice or more, and 12.9% had sexual experiences with both prostitutes and girlfriends. Heavier alcohol consumption was significantly related to multiple visits to prostitutes (odds ratio = 1.71) and to sexual experiences with both prostitutes and girlfriends (odds ratio = 2.30). CONCLUSIONS: In this first systematic study of the association between alcohol consumption and sexual experiences among Korean male university students, alcohol use was associated with risky sexual behaviors, and with first and most recent sexual experience with prostitutes, supporting our hypotheses.

Adolescent↗
PubMed1998

[Illegal professional conflict of interest from the viewpoint of university research].

The problem of illegal donations in favour of a medical faculty is complex since there exists a multi-layered network between the sponsors (public, private, industrial etc.) and the recipients (institutions, private persons, groups). The fields of interests are of course heterogeneous. The university needs the donation to perform research, the industry supports medicine to co-operate on the new development of drugs, techniques etc., the country needs both since otherwise there will be no innovative new products and thus no modern new jobs etc. to regulate these interactions, there are many regulations and decrees which may contradict each other. Transparency is the matter of cure, at least for medical universities. This means that all donations should be processed by accounts of the university or associated foundations. This should be open to the public that no inappropriate advantage can be taken personally. The University Hospital Charité for example has announced clear regulations for the scientists which they can follow easily to avoid unintended mistakes. It must be clarified to for the sponsors and the public that the financial support is clearly directed to stimulate and improve science--only this justifies our research work.

Conflict of Interest↗
PubMed1996

Consent form readability in university-sponsored research.

BACKGROUND: Consent forms are required in most biomedical research involving human subjects. In recent years, a number of studies from different disciplines have reported problems related to consent form readability. METHODS: We analyzed 284 consent forms submitted to and approved by five institutional review boards (IRBs) (schools of Medicine, Nursing, Academic Affairs, Dentistry, and Public Health) at one university and one IRB at another. We examined consent form readability scores and factors that might relate to readability. RESULTS: The average reading level of all consent forms was high: 12.2, which corresponds roughly to a 12th-grade reading level. Less than 10% of all consent forms were written at a 10th grade reading level or below. Thirty-two percent of all consent forms had no evidence of revisions, and less than 2% of consent forms were revised more than once. Readability scores were not related to consent form revisions, the type of IRB, the year of study, or the university where the research was conducted. CONCLUSIONS: Poor readability of consent forms probably occurs in all university-related research. We recommend that IRBs require readability checks for research consent forms before researchers submit their proposals to an IRB.

Comprehension↗
PubMed1993

Comparative costs of urgent care services in university-based clinical sites.

OBJECTIVE: To identify the most cost-effective utilization of resources for urgent care for a managed care Medicaid population at a university medical center. The null hypothesis was that there are no significant differences between the costs and types of services for patients with comparable urgent care problems who are seen in outpatient clinical settings compared with those seen in the central emergency department of a university medical center. DESIGN: Retrospective case study comparing patient visits and charges for three clinical urgent care locales by diagnosis, severity of illness, age group, time period in which seen, and reason for referral. SETTING: Ambulatory care and hospital emergency department facilities at a university medical center. PATIENTS: 1096 Medicaid patients who were enrolled in the university physicians' managed care plan. MAIN OUTCOME MEASURES: Diagnosis-specific comparisons of types of services and charges for patient visits. RESULTS: There were significantly higher charges for all urgent care diagnoses of patients treated in the emergency department compared with urgent care facilities; these costs were higher in all categories of charges. CONCLUSIONS: A variety of alternatives to use of the full emergency department are more cost-effective in providing urgent care services for Medicaid clients in a managed care setting.

Academic Medical Centers↗
PubMed1987

A preliminary report on the Universal Implant.

Extrusion and time-consuming surgical techniques required of implantation have been the major criticisms of quasi-integrated implants such as the Iowa Implant. With these concerns in mind, the Universal Implant (Oculo-Plastik, Montreal) has been designed to offer the motility advantages seen with quasi-integrated implants and the ease of placement of a sphere. The Universal Implant incorporates most of the advantages seen in the Iowa Implant and other quasi-integrated implants. In addition, the Universal Implant (1) utilizes a faster surgical technique for implantation; (2) avoids cleaning the muscles; (3) has lower, more rounded, smaller mounds that should decrease the late extrusion rate; (4) can be used as an enucleation implant, evisceration implant, or secondary implant; and (5) has a greater girth and larger radius of the posterior surface that helps support orbital fat and tissues, resulting in a more natural superior sulcus. Considering that the Iowa Implant is presently not available, the Universal Implant should be used by those surgeons who were pleased with the former implant and should be considered as a reasonable alternative to other enucleation implants.

Equipment Design↗
PubMed1997

Impaired endothelium-dependent relaxation of human hepatic arteries after preservation with the University of Wisconsin solution.

OBJECTIVE: To evaluate the effect of University of Wisconsin solution on endothelium-dependent relaxation and contraction of human hepatic arteries in vitro. DESIGN: Human hepatic arteries were harvested from 24 patients with hepatocellular carcinoma who had undergone hepatectomy. SETTING: A tertiary care center. INTERVENTIONS: Human hepatic arteries (n = 6 in each group) were harvested during resection for hepatocellular carcinoma. The arteries in group 1 (i.e., the control group) were immediately studied without preservation. The arteries in group 2 were preserved in cold (4 degrees C) physiological solution for 1 hour, while the arteries in groups 3 and 4 were preserved in University of Wisconsin solution for 1 and 16 hours, respectively. Segments of control and preserved hepatic arteries with or without endothelium were then suspended in organ chambers to measure the isometric force. RESULTS: The relaxation of segments of the hepatic arteries with endothelium in response to acetylcholine and adenosine diphosphate was significantly (P < .05) greater than that of segments without endothelium. The maximal relaxation of hepatic arterial segments with endothelium in groups 3 and 4 in response to acetylcholine was notably different from that of segments in groups 1 and 2. The maximal relaxation of hepatic arterial segments with endothelium in groups 3 and 4 in response to adenosine diphosphate was notably different from that of segments in groups 1 and 2. Perfusate hypoxia (mean +/- SD PO2, 30 +/- 5 mm Hg) caused the endothelium-dependent contraction of the arteries (the median initial tension in groups 1, 2, 3, and 4 was 251%, 233%, 276%, and 260%, respectively; P > .05). CONCLUSIONS: The endothelium-dependent relaxation of human hepatic arteries in response to acetylcholine and adenosine diphosphate was notably attenuated by University of Wisconsin solution. The impaired endothelium-dependent relaxation by University of Wisconsin solution and the prominent endothelium-dependent contraction of human hepatic arteries would favor vasospasm and thrombosis after hepatic transplantation.

Adenosine↗
PubMed2003

Clinical outcomes following institution of the Canadian universal leukoreduction program for red blood cell transfusions.

CONTEXT: A number of countries have implemented a policy of universal leukoreduction of their blood supply, but the potential role of leukoreduction in decreasing postoperative mortality and infection is unclear. OBJECTIVE: To evaluate clinical outcomes following adoption of a national universal prestorage leukoreduction program for blood transfusions. DESIGN, SETTING, AND POPULATION: Retrospective before-and-after cohort study conducted from August 1998 to August 2000 in 23 academic and community hospitals throughout Canada, enrolling 14 786 patients who received red blood cell transfusions following cardiac surgery or repair of hip fracture, or who required intensive care following a surgical intervention or multiple trauma. INTERVENTION: Universal prestorage leukoreduction program introduced by 2 Canadian blood agencies. A total of 6982 patients were enrolled during the control period and 7804 patients were enrolled following prestorage leukoreduction. MAIN OUTCOME MEASURES: All-cause in-hospital mortality and serious nosocomial infections (pneumonia, bacteremia, septic shock, all surgical site infections) occurring after first transfusion and at least 2 days after index procedure or intensive care unit admission. Secondary outcomes included rates of posttransfusion fever and antibiotic use. RESULTS: Unadjusted in-hospital mortality rates were significantly lower following the introduction of leukoreduction compared with the control period (6.19% vs 7.03%, respectively; P =.04). Compared with the control period, the adjusted odds of death following leukoreduction were reduced (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.75-0.99), but serious nosocomial infections did not decrease (adjusted OR, 0.97; 95% CI, 0.87-1.09). The frequency of posttransfusion fevers decreased significantly following leukoreduction (adjusted OR, 0.86; 95% CI, 0.79-0.94), as did antibiotic use (adjusted OR, 0.90; 95% CI, 0.82-0.99). CONCLUSION: A national universal leukoreduction program is potentially associated with decreased mortality as well as decreased fever episodes and antibiotic use after red blood cell transfusion in high-risk patients.

Adult↗
PubMed2005

Universal neonatal hearing screening versus selective screening as part of the management of childhood deafness.

BACKGROUND: The principal factors that decide how deafness affects a child's development are the degree of hearing impairment and the age at which it is diagnosed. A number of factors are thought to increase the risk of hearing impairment: low birth weight, prematurity, perinatal hypoxia and jaundice, among others. The high incidence of deafness in children without risk factors and the introduction of simple new screening tests of high sensitivity and specificity has led many prestigious bodies to recommend universal early detection programmes for deafness rather than screening targeted only at high-risk groups. OBJECTIVES: To compare the long-term effectiveness of a universal neonatal screening and early treatment programme for hearing impairment with: a) screening and treatment only of high-risk neonates and b) opportunistic screening and treatment. SEARCH STRATEGY: Databases searched were MEDLINE (1966 to 2003), EMBASE (1974 to 2003), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2004) and registers of health technology assessment agencies as well as registers of clinical guidelines. SELECTION CRITERIA: Randomised controlled trials comparing universal neonatal screening with either high-risk screening or opportunistic screening for hearing impairment. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the search results to identify suitable trials. MAIN RESULTS: No studies were identified which fulfilled the inclusion criteria. AUTHORS' CONCLUSIONS: The long-term effectiveness of universal newborn hearing screening programmes has not been established to date. There is a need for controlled trials and before and after studies to address this issue further.

Deafness↗
PubMed2002

Trends in long-term management of survivors of acute myocardial infarction by cardiologists in a government university-affiliated teaching hospital.

BACKGROUND: Despite prospective randomized control trials showing that beta blockers, aspirin, angiotensin-converting enzyme (ACE) inhibitors, and lipid-lowering agents improve survival rates after myocardial infarction (MI), these agents are routinely underutilized. HYPOTHESIS: Our aim was to determine the frequency with which cardiologists at a government, university-affiliated teaching hospital prescribe aspirin, beta blockers, ACE inhibitors, calcium-channel blocking agents (CCBs), and lipid-lowering agents in patients post MI. The patients were followed by their primary care physicians in this hospital after discharge. We evaluated changes in patients' medical management at an average of 24 months after discharge from the acute event. METHODS: Clinical data relative to long-term use of life-saving drugs in 156 survivors of definite MI (WHO criteria) at a government, university-affiliated teaching hospital were analyzed over a 24-month follow-up period. RESULTS: Over 90% of patients with acute MI were given aspirin and beta blockers at discharge. About 50% of these patients were given ACE inhibitors, only 25% were prescribed CCBs, and 21% were given lipid-lowering agents. At 24 months of follow-up, the percentage of patients receiving aspirin, beta blockers, and ACE inhibitors had fallen to 88% (p = 0.0408), 71% (p < 0.0001), and 43% (p = 0.1122), respectively, whereas use of lipid-lowering agents slightly increased (p = 0.4277). Use of CCBs had also fallen (p = 0.0001). Nonetheless, the use of aspirin, beta blockers, and ACE inhibitors was higher than that in the National Registry of similar patients at discharge (p < 0.0001). CONCLUSIONS: Patients at a government, university-affiliated teaching hospital are likely to receive life-saving therapy at discharge, in accordance with the American College of Cardiology/American Heart Association (ACC/AHA) guidelines. There is a modest decrease in intake of these life-saving drugs during the follow-up period. As documented earlier, cardiologists in a teaching institution are more likely to prescribe established life-saving drugs than do primary care physicians. However, full-time primary care physicians at a university-affiliated teaching hospital continue to use these therapies at a higher rate than do those outside academic medicine.

Adrenergic beta-Antagonists↗
PubMed2006

New universal primers facilitate Pyrosequencing.

A cost-driving factor in Pyrosequencing is the need for single-stranded PCR products that are usually obtained by biotin-labeling of one primer. We designed new universal primers that allow the introduction of biotin during the specific PCR at either the forward or the reverse primer in a single reaction. When converting five human single nucleotide polymorphism assays from the standard format into the universal format, we obtained pyrograms of similar good quality. Although the universal nonhuman sequences are unlikely to form loop structures, we mostly failed to establish assays without using the proprietary software from Biotage AB. Nevertheless, our universal primer pair adds flexibility to the process of assay design due to optional strand selection and contributes to the reduction of genotyping costs.

Apolipoproteins↗
PubMed2006

Universal newborn screening and adverse medical outcomes: a historical note.

Universal newborn screening programs for metabolic disorders are typically described as a triumph of medicine and public policy in the US over the last 50 years. Advances in science and technology, including the Human Genome Project, offer the opportunity to expand universal newborn screening programs to include many additional metabolic and genetic conditions. Although the benefits of such screening programs appear to outweigh their costs, some critics have claimed that historical examples of inadvertent harm ensuing from false-positive screening results and subsequent inappropriate medical treatment should make us wary of expanding universal newborn screening. In this essay, we report the results of a review of the published literature to assess whether the extension of screening from at risk populations to all newborns led to substantial morbidity and mortality from misguided medical treatment. We provide a historical overview of universal newborn screening programs in the United States, and then focus on six early NBS programs: congenital hypothyroidism, phenylketonuria, congenital adrenal hyperplasia, galactosemia, sickle cell disease, and maple syrup urine disease. Our comprehensive search of published sources did not reveal a widespread problem of harm ensuing from medical treatment of children with false positive screening test results.

Diagnostic Errors↗
PubMed2000

Biochemical changes in transplanted rat liver stored in University of Wisconsin and Euro-Collins solutions.

BACKGROUND: Liver ischemia/reperfusion injury is a severe problem in transplantation, and preservation solutions could be critical for liver viability. The aim of our study was to evaluate the cytosolic and mitochondrial glutathione levels, the glyoxalase II activity, and the mitochondrial hydroperoxide contents of livers stored in different preservation solutions for 7 or 24 h and after transplantation. MATERIALS AND METHODS: Orthotopic liver transplantation was performed without reconstruction of the hepatic artery. The livers were stored at 4 degrees C for 7 or 24 h in University of Wisconsin or Euro-Collins solutions. Portions of livers before and after transplantation were homogenized and mitochondria isolated. RESULTS: Cytosolic glutathione levels were decreased in all stored livers and after transplantation. In livers stored with University of Wisconsin solution, mitochondrial glutathione was unchanged during cold storage and no significant decrease has been found after reperfusion, whereas in livers stored in Euro-Collins solution, mitochondrial glutathione was decreased and a further significant decrease was found 30 min after reperfusion. Mitochondrial hydroperoxides were higher in livers stored in Euro-Collins solution than in University of Wisconsin solution after 30 min of reperfusion. Mitochondrial glyoxalase II did not show any change by reperfusion. CONCLUSION: We have demonstrated that rat liver stored in Euro-Collins solution suffered a severe depletion of mitochondrial GSH and a concomitant increase of hydroperoxides. The data obtained suggested that the livers stored with University of Wisconsin solution were probably less prone to ischemia/reperfusion injury after liver transplantation.

Adenosine↗