Discontinuation syndrome in newborns whose mothers took antidepressants while pregnant or breastfeeding.

Objective: This study compared mothers' report of symptoms of discontinuation syndrome in infants exposed to antidepressants both in utero and during lactation to infants who were exposed only during lactation.

Study Design: This is a convenience sample of 930 women breastfeeding women who answered an online questionnaire about antidepressant use while pregnant and breastfeeding. All 930 women had taken antidepressants while breastfeeding, and 527 had also taken antidepressants during pregnancy.

Relationships between drug company representatives and medical students: medical school policies and attitudes of student affairs deans and third-year medical students.

Objectives: The authors sought to ascertain the details of medical school policies about relationships between drug companies and medical students as well as student affairs deans' attitudes about these interactions.

Methods: In 2005, the authors surveyed deans and student affairs deans at all U.S.

Clinical experience and examination performance: is there a correlation?

Context: The Liaison Committee on Medical Education (LCME) requires there to be: '...

Medical students' exposure to and attitudes about drug company interactions: a national survey.

Context: While exposure to and attitudes about drug company interactions among residents have been studied extensively, relatively little is known about relationships between drug companies and medical students.

Objective: To measure third-year medical students' exposure to and attitudes about drug company interactions.

Design, Setting, And Participants: In 2003, we distributed a 64-item anonymous survey to 1143 third-year students at 8 US medical schools, exploring their exposure and response to drug company interactions.

From library to discharge: a managing care student project.

Background And Objectives: The Patient Care Project (PCP) was a central component of the Undergraduate Medical Education for the 21st Century (UME-21) grant project at the University of Nebraska. With the primary goal of improving students' critical thinking skills, the PCP was directed more toward an understanding of managing care than the business aspects of managed care and emphasized written communication skills, clinical hypothesis testing, and exploring ways to solve medical and ethical questions.

Methods: All 239 students graduating in 2000 and 2001 were required to analyze the medical care received by one of their hospitalized patients.

Teaching quality measurement and improvement, cost-effectiveness, and patient satisfaction in undergraduate medical education: the UME-21 experience.

Background: The health care system in the United States is changing at an ever-increasing rate. Recent reports by the Institute of Medicine raising concerns regarding rates of medical errors and suggesting the need for reengineering of the health care delivery system have focused attention on the need for quality measurement and improvement.

Methods: We abstracted data from final written reports submitted by 18 Undergraduate Medical Education for the 21st Century (UME-21) schools, as well as other materials available from participating UME-21 schools.

The administrative colloquium: developing management and leadership skills for faculty.

Objective: Development of leadership competencies has become a priority for many academic health science centers. However, traditional faculty development has focused almost exclusively on improving teaching skills. The process and outcomes of developing leadership skills for academic health science center faculty has not been extensively studied.

Experience with a program of faculty development.

The authors describe the faculty development program at the University of Nebraska Medical Center. Faculty needs were identified in instructional skill development, academic socialization and mentoring. Committees with campus-wide representation designed the instructional activities.

Setting a personal career direction.

In summary, we believe that both you and your organization should have a set of core values, a well-defined mission (core purpose), and a vision of the future. Ideally, your projects and activities should be congruent with your mission and values, you should be pursuing your vision, and all of this should be congruent with the organization mission and values. Practically speaking, most individuals we have worked with over the years find themselves in two different groups at this point in the exercise.

A comparison of clinical pediatric patient encounters in university medical center and community private practice settings.

Background: Growing numbers of medical students complete clerkships in community private practice (CPP) settings instead of the more traditional university-based clinics, yet few empirical studies have evaluated how setting type impacts clinical experiences, skill development, and student satisfaction.

Objective: This study compared the pediatric patient encounters seen by third-year medical students in university medical center (UMC) and CPP settings.

Methods: Third-year medical students were required to keep a log of all patients seen during their 8-week pediatric clerkship.

Clerkship directors' perceptions of the effects of managed care on medical students' education.

Purpose: Little is known about the effect of managed care on medical students' education. Because clerkship directors (CDs) are especially well positioned to observe any changes, this study surveyed CDs from six medical specialties about their perceptions of the effects of managed care on medical students' education.

Method: Anonymous questionnaires were mailed to 808 CDs from departments of six medical specialties at 125 U.

Clerkship directors' perceptions of the impact of HCFA documentation guidelines.

Purpose: Chart notes are used to support billing codes under the evaluation and management guidelines of the Health Care Financing Administration (HCFA), in addition to serving as a record of the visit. To better understand the effect of the HCFA documentation guidelines, the authors collected data on how the guidelines affect participation by university- and community-based faculty in clinical education programs.

Method: In 2000, the authors sent six copies of their questionnaire to the associate deans of the 125 U.

Do clerkship experiences affect medical students' attitudes toward chronically ill patients?

Purpose: To measure changes in medical students' attitudes toward chronically ill patients, and to identify experiences, specifically during clerkships, that contributed to students' attitudes.

Method: A cohort of students from five U.S.

Third-year medical student survey of office preceptorships during the pediatric clerkship.

Objective: To assess medical students' interest in a career in pediatrics following their categorical pediatric clerkship.

Design: Satisfaction questionnaire to 704 third-year clerks in 5 university medical schools following the pediatric clerkship.

Methods: Analysis of the influence of the community office-based experience compared with the inpatient experience, and examination aspects of the office preceptorship most valued by the medical students.

The Interdisciplinary Generalist Project at the University of Nebraska Medical Center.

The Interdisciplinary Generalist Curriculum (IGC) Project at the University of Nebraska College of Medicine (Nebraska) had three goals: (1) to increase first- and second-year students' exposure to primary care practice in the community; (2) to develop specific educational programs introducing these students to the principles and practices of primary care medicine; and (3) to establish a generalist coordinating council to provide leadership and to nurture generalist educational initiatives in the College of MEDICINE: Students at Nebraska were already required to spend three half-days a semester in a longitudinal clinical experience (LCE) and to complete a three-week primary care block experience in the summer between the first and second years. IGC Project funds were used increase the number of required LCE visits to five a semester and to develop curricular enhancements that would maximize the educational potential of community-based clinical experiences for first- and second-year students. Curricular elements developed included a focus on faculty development for preceptors and development of the Primary Care Introduction to Medicine Curriculum, an eight-week, interdisciplinary module scheduled late in the first year to help prepare students for intensive summer rotations.

Pediatric clerkship experience and performance in the Nebraska Education Consortium: a community vs university comparison.

Objective: To compare the reported experiences and performance on end-of-course examinations of students completing their pediatric clerkship at the University of Nebraska Medical Center (UNMC), Omaha, with that of students completing their clerkship in a community pediatrician's practice (CPP) outside the Omaha metropolitan area.

Design: Cohort study.

Setting: Private and/or institutional practices with both ambulatory and hospital components.

Teaching newborn medicine to third-year medical students. Use of a checklist.

Objective: To determine if use of a checklist during the third-year medical student's newborn medicine rotation within the pediatric clerkship affected grades, end-of-course examination scores, or perceptions of the new-born clinical experience before and after use of this teaching aid.

Methods: The checklist contained 46 newborn medicine-related skills and concepts and required staff review. A postclerkship questionnaire was used to assess the student's perception of all components of the clinical clerkship.

Heptavax-B in pediatric dialysis patients: effect of systemic lupus erythematosus. Chesapeake Pediatric Nephrology Study Group.

Twenty-three pediatric dialysis patients [6 hemodialysis (HD) and 17 peritoneal dialysis (PD)], with a mean age of 13.9 years, were vaccinated against hepatitis B virus and their seroconversion rates were analyzed. There was no significant difference in the mean duration of dialysis between the HD and PD groups, or between responders and nonresponders to the vaccine.

Characterization of immune cells in kidneys from patients with Sjogren's syndrome.

The association of interstitial nephritis, the most common renal lesion in Sjogren's syndrome, to the other manifestations of the disease is unclear. To begin to address this issue, the infiltrating cells in frozen kidney tissues from two patients with interstitial nephritis secondary to Sjogren's syndrome were characterized by indirect immunofluorescence. T cells predominated, the majority of which were helper/inducer cells (OKT4+).

The familial occurrence of focal segmental glomerular sclerosis.

We have observed the occurrence of focal segmental glomerulosclerosis in all three siblings of a single Hispanic family. Each of the children had the onset of significant proteinuria on or before the age of 10. The two oldest children have had progression of their disease to end-stage with subsequent successful transplantation.

Imipramine poisoning in a child: lack of efficacy of resin hemoperfusion.

A three-year-old boy ingested up to 1,500 mg of the tricyclic antidepressant imipramine (Tofranil). He entered our facility within two hours of discovery, and multiple resuscitative efforts, which proved unsuccessful, followed. Resin hemoperfusion was used in an effort to remove imipramine from the systemic circulation.