Functional outcomes in Rett syndrome.

Aim: To relate functional outcomes to mutation type and age at evaluation in patients with Rett syndrome (RTT).

Method: We identified 96 RTT patients with mutations in the MECP2 (methyl-CpG-binding protein 2) gene. Chart analysis, clinical evaluation, and functional measures were completed.

Changes in medical students' exposure to and attitudes about drug company interactions from 2003 to 2012: a multi-institutional follow-up survey.

Purpose: To ascertain whether changes occurred in medical student exposure to and attitudes about drug company interactions from 2003-2012, which factors influence exposure and attitudes, and whether exposure and attitudes influence future plans to interact with drug companies.

Method: In 2012, the authors surveyed 1,269 third-year students at eight U.S.

Adolescent health care maintenance in a teen-friendly clinic.

Adolescence is marked by complex physical, cognitive, social, and emotional development, which can be stressful for families and adolescents. Before the onset of puberty, providers should clearly lay the groundwork for clinical care and office visits during the adolescent years. This article addresses the guidelines and current legal standards for confidentiality in adolescent care, the most frequently used psychosocial screening tools, and current recommendations for preventive health services and immunizations.

Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs.

Understanding the needs and concerns of senior faculty in academic medicine: building strategies to maintain this critical resource.

Purpose: The average age of medical school faculty is increasing, with 30% over age 55 in 2007. In 2012, 56% of Society of Teachers of Family Medicine (STFM) members were at least 50 years old. The authors sought to identify the transition and faculty development needs of this group of senior faculty.

Analysis of clerkship student-patient interviews in underserved clinics.

Background And Objectives: Third-year family medicine clerkship students at our urban medical school are assigned to clinics in diverse settings, where they are required to video record one patient interview. Our research goals were to describe student communication behaviors and compare the frequency of these behaviors at clinics serving primarily uninsured patients to clinics with primarily insured patients.

Methods: Eighty-seven student-patient recordings were reviewed and analyzed.

Exercise following burn injury.

Fatigue is a major barrier to recovery for burned individuals. Studies indicate that a slow return to normal or near-normal muscle strength is the natural course of recovery. With no special interventions, other than the "usual care" tailored to the needs of the individual, postburn patients will make gradual improvement in strength and aerobic capacity.

Development of a longitudinal integrated clerkship at an academic medical center.

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member.

A pilot study of functional electrical stimulation cycling in progressive multiple sclerosis.

Background: Functional electrical stimulation (FES) cycling is used by spinal cord injury patients to facilitate neurologic recovery and may also be useful for progressive MS patients.

Objective: To evaluate the safety and preliminary efficacy of home FES cycling in progressive MS and to explore how it changes cerebrospinal fluid (CSF) cytokine levels.

Methods: Five patients with primary or secondary progressive MS were given an FES cycle for six months.

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.

Doing well: a SEM analysis of the relationships between various activities of daily living and geriatric well-being.

An existing large data set, the Health and Retirement Study (HRS) with the subsequent addition of the Consumption and Activities Mail Survey (CAMS) data, provides a rich data set for the examination of the activities of older adults. In this study HRS and CAMS data are used to examine relationships between various activities of daily living (ADLs) and well-being in older adults. Using structural equation modeling, influences of direct and indirect factors that affect older individuals' cognitive and emotional well-being are analyzed.

What it's really like: the complex role of medical students in end-of-life care.

Background: Medical student end-of-life care training provides insight into the hidden curriculum and physician professional development.

Description: Second-year medical students at a university medical center listen to a panel discussion of 4th-year students and residents describing their end-of-life care experiences during clerkships. This discussion is intended to provide "anticipatory guidance" to 2nd-year students about challenging situations they might encounter on the wards.

Objective assessment of gait in normal-pressure hydrocephalus.

Objectives: Gait abnormalities are an early clinical symptom in normal pressure hydrocephalus (NPH), and subjective improvement in gait after temporary removal of CSF is often used to decide to perform shunt surgery. We investigated objective measures to compare gait before and after CSF drainage and shunt surgery.

Design: Twenty patients and nine controls were studied.

Prevention and treatment of frailty in the postmenopausal woman.

Frailty is a complex subject, and all aspects of frailty are intertwined. This article identifies and discusses the individual aspects of frailty. These aspects, including sarcopenia, nutrition, obesity, relative strength, inflammatory markers, osteopenia and osteoporosis, aerobic capacity, absolute strength, balance, and prevention of frailty, must be reunited, albeit in varying combinations, if the effects of frailty on women are to be understood and treated.

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.

Partial knowledge of word meanings: thematic and taxonomic representations.

The type of information (taxonomic or thematic) available at different levels of knowledge was investigated. Following extensive norming to identify taxonomic and thematic associates of low-frequency nouns, participants determined if taxonomic or thematic associates were meaningfully related to target words at three levels of knowledge: target words they correctly defined (known), recognized as familiar (frontier), or mistakenly denied as part of the language (unknown). In another experiment, participants reported which type of relationship (taxonomic or thematic) was preferred.

A narwhal is an animal: partial word knowledge biases adults' decisions.

Adults' accuracy on a sentence verification task was measured to assess reliable biases in their responses as a function of their level of knowledge about the target words, as well as adults' ability to reject incorrect ontological category membership for their partially known words. Three levels of word knowledge (known, frontier, and unknown) were assessed in two experiments. Results indicated that participants were conservative decision-makers about sentences using the vocabulary words and that the conservative bias increased in strength as their level of knowledge about the target word increased.

Do required preclinical courses with family physicians encourage interest in family medicine?

Background: Many medical schools, including the University of California, San Francisco (UCSF), added required preclinical course work with family physicians in the 1990s. We examined whether current UCSF students interested in family medicine noted more contact with family physicians and more faculty support of their interest than current Stanford students and 1993 UCSF students, neither of whom had required preclinical course work with family physicians.

Methods: A questionnaire was administered to students interested in family medicine at UCSF and Stanford in February 2001, with response rates of 84% and 90%, respectively.