The Maternal Infant Health Outreach Worker program in low-income families.

Vanderbilt University Medical Center's Maternal Infant Health Outreach Worker program (MIHOW) is a community-based intervention dedicated to enhancing birth outcomes and healthy child development. Trained neighborhood women provide home and group services to underserved families in rural and inner city communities. This report describes MIHOW's history and work in Tennessee, Kentucky, West Virginia, Mississippi, and Louisiana.

The Emphasis Program: a scholarly concentrations program at Vanderbilt University School of Medicine.

In 1999, a faculty committee at Vanderbilt University School of Medicine reviewed the mission and goals of the school and determined that graduates should receive initial preparation to develop scholarly careers in medicine. The authors describe the design of a scholarly projects course, the Emphasis Program, which is required of all students in the first two years of medical school. Each student undertakes a mentored project in one of nine areas of scholarship related to medicine.

A program to enhance competence in clinical transaction skills.

The ability to take a comprehensive and accurate clinical history, perform a thorough and nuanced physical examination, engage in sequential clinical reasoning using all relevant clinical and laboratory data, and communicate clearly and compassionately with patients and other providers--the skills of the clinical transaction--are critical to a successful therapeutic outcome. Yet few medical schools' curricula include an explicit focus on developing these skills beyond the introductory level. Vanderbilt Medical School has developed a structured curriculum, integrated into the traditional clerkships of the third and fourth years, that ensures that each student receives specific instruction in clinical transaction skills.

The relationship between academic performance and severity of depressed mood during medical school.

We employ a structural equation model to examine the relationship between academic performance and depressed mood over 4 years for a single medical school class. Academic performance measures included undergraduate gradepoint average, first- and second-year medical school gradepoint average, full Medical College Admissions Test (MCAT) and total National Boards Part I (NB) scores. Severity of depressed mood was assessed by administering the Beck Depression Inventory two times per year during the first 2 years, and once per year during the last 2 years.

Medical student counseling: the Rush Medical College Adviser Program.

An adviser program has been instituted at Rush Medical College which utilizes specially selected and trained faculty members and provides comprehensive counseling with continuity of contact between adviser and student through the four years of medical school. In this paper, the authors describe the development of the program and the evaluations used to determine its efficacy. The authors conclude that the personal characteristics and time commitment of the advisers are of primary importance rather than their training discipline, that continuity of contact between student and adviser fosters the development of the most beneficial relationships, that advisers require special training during the entire time of their service as advisers, and that the program and the advisers require continual monitoring so that deficient performance and changing needs can be promptly identified.

Effect of nicotinic acid on cholera-induced fluid movement and unidirectional sodium fluxes in rabbit jejunum.

Cholera toxin produces intestinal secretion and elevation of intestinal cyclic AMP. Nicotinic acid has been shown to prevent these responses. The effect of nicotinic acid on cholera toxin-induced secretion could be caused by decreased plasma-to-lumen flux, increased lumen-to-plasma flux, or a combination of both.

Prevention and reversal of cholera enterotoxin effects in rabbit jejunum by nicotinic acid.

The cholera enterotoxin produces intestinal secretion associated with an elevation of tissue levels of cyclic adenosine 3',5'-monophosphate levels of cyclic adenosine 3',5'-monosphosphate (cAMP). The objectives of this study were to determine whether intestinal secretion and cAMP elevation induced by cholera toxin could be prevented, or once initiated, reversed by nicotinic acid, an agent known to lower tissue levels of cAMP. In rabbits, four jejunal loops were constructed as alternating control (3-ml isotonic electrolyte solution) and cholera toxin (same solution containing 50 mug purified cholera toxin) loops.

Effect of intestinal distention on levels of cyclic AMP and fluid secretion.

The effect of distention on levels of intestinal cyclic AMP has been examined in rabbit jejunal loops under conditions of distention causing fluid secretion. Cyclic AMP levels were not significantly changed when compared with control loops. Histologic examination of the distended loops showed no significant changes from normal.

Effect of indomethacin on cholera-induced fluid movement, unidirectional sodium fluxes, and intestinal cAMP.

Cholera enterotoxin (CT) produces intestinal secretion associated with an elevation of intestinal cyclic AMP (cAMP). Indomethacin, a potent inhibitor of prostaglandin (PG) synthesis, decreases CT-induced secretion, although a role for PG in this process has not been demonstrated. The purpose of this study was to measure the effects of indomethacin on net fluid movement and unidirectional Na fluxes in rabbit jejunal loops exposed to CT and to correlate these findings with intestinal cAMP levels.

In vitro uptake and metabolism of pteroylpolyglutamate by rat small intestine.

The digestion and cellular uptake of 14C-pteroylheptaglutamate (14C-PG-7) was studied using an isolated cell preparation from rat small intestine and by assay of folate conjugase (EC 3.4.23.

ANGULAR LIGHT-SCATTERING STUDIES ON ISOLATED MITOCHONDRIA.

Angular light-scattering studies have been carried out on suspensions of isolated rat liver mitochondria. The angular scatter pattern has a large forward component, typical of large particles. Changes in dissymmetry and in the intensity of light scattered at 90 degrees have been correlated with changes in optical density during the course of mitochondrial swelling and contraction.