Standardized global evaluation template used in undergraduate medical education across the four-year curriculum. / This is a universal evaluation tool that is used in UGME for students to evaluate different aspects of the curriculum. It is meant to standardize evaluation practices as well as limit survey fatigue for students.

The capsaicin receptor (vanilloid receptor I, transient receptor potential vanilloid 1 or TRPV I) is a member of the transient receptor potential (TRP) family of proteins. This cation channel is sensitive to a range of inflammatory mediators such as some lipoxygenase products, as well as the tussive agents capsaicin, resiniferatoxin and protons. It has been proposed that TRPV I is a cough receptor and may be important in airways inflammation. Rat TRPVI (rTRPVI) and human TRPVI (hTRPVl) permanently expressing cell lines were generated and successfully characterised by agonist triggered changes in intracellular calcium levels. Thapsigargin and/or removal of extracellular calcium revealed that, both rTRPVI and hTRPVI are not only expressed on the cell surface but on thapsigargin sensitive and insensitive intracellular stores respectively. Citric acid, an agent routinely used in the clinic for inhalation cough challenges, was investigated for its ability to activate TRPVl permanently expressed in a cell line. rTRPV I was activated by citric acid in a concentration and pH dependent manner. Citric acid activation of TRPVI was inhibited by iodoresiniferatoxin but not capsazepine. Mutation of the TRPVI putative proton binding site (E648 to A648) abolished citric acid activation of the channel without reducing the capsaicin evoked response. Thus, citric acid activates rTRPV I by a proton dependent mechanism. The role of N-linked glycosylation and sialylation on rTRPVI and hTRPVI was investigated. Treatment of rTRPVl with neuraminidase or tunicamycin dramatically reduced the channels' maximal responses to capsaicin. In addition mutation of the rTRPVI N-linked glycosylation site (N604 to Q604) or expression ofrTRPVI in the glycosylation mutant cell line, Lec2, also resulted in a striking reduction in the receptors' maximal calcium response to capsaicin. Flow cytometry data indicated that these differences in TRPVI function were unlikely to be linked to differences in receptor cell surface expression. Human TRPV I also displayed significant reductions in responsiveness to capsaicin following either neuraminidase or tunicamycin treatment. Thus, receptor sialylation regulates TRPVI activation by capsaicin. Finally, TRPVI expression on human primary bronchial fibroblasts (HPBF) was investigated. Negligible endogenous TRPVI expression was detected in HPBF. Interestingly, the inflammatory mediators tumour necrosis factor (TNF-a), lipopolysaccharide (LPS) and interleukin Ia (IL-Ia) all induced TRPVI expression in HPBF, as assessed by RT-PCR, flow cytometry and calcium signalling. TRPVI functional expression was observed as early as 6 hrs (for TNF-a) post challenge and remained elevated upto the final time point tested (96 hrs for IL-Ia). Thus, TRPVI may play an important role in the inflammatory process. In conclusion, TRPV I may play an important role in conditions where cough and inflammation have been implicated.

Thesis (M.B.)--Harvard University, 1789. / Signatures: [1]⁸. Not in Blake. NLM copy: closely trimmed along fore-edges, affecting text. Film 633 reel 72 is part of Research Publications Early American Medical Imprints collection (RP reel 72, no. 1470). DNLM DNLM Microform version available in the Readex Early American Imprints series.

Making decisions about whom to admit to medical school and how to create diversity in the process has come under increased scrutiny. An additional layer of complexity is introduced when committees utilize the AAMC's prescribed holistic review in addition to their institutional diversity policies. This comparative case study explores how two medical schools (one public and one private) are charged with implementing holistic review when challenged by the institutional culture which may resist a holistic approach. Through interviews, meeting observations, and document analysis, the study examines how and when diversity is introduced into the admissions process, and how diversity policies function in the overall medical school environment. Applying a framework of institutional isomorphism (DiMaggio & Powell, 1983), the study found that medical schools are highly concerned about a decrease in MCAT scores and coursework grades, which could negatively impact medical school rankings. It could also contribute to institutional inertia when introducing a new review process, causing resistance by admissions committee members. Additionally, admissions committees and leadership may differ regarding philosophical and historical factors that create bias within the process resulting in isomorphic change. Isomorphic change is a result of the ambiguity and the lack of institutional buy-in on various levels (DiMaggio & Powell, 1983). Virtual adoption (Birnbaum, 2000) is a result of an increased focus emulating processes of peer medical schools that misalign the school's priorities, creating confusion about how to address the national shortage of diverse physicians. Future research needs to account for additional influences on admissions decisions, including the impact of the current Fisher v. University of Texas case that may redefine how diversity is measured in medical school admissions.

Within fifty years of its foundation in 1726 the Edinburgh Medical School had become the pre-emjnent centre of medical education in the English speaking world. This pre-eminence was part of the cultural movement known as the Scottish Enlightenment. What is attempted here is an elucidation of the intellectual content of the medicine taught at Edinburgh during the period 1726-1776 and the relation of its specific features to the changing Scottish social and philosophical context. When the School was founded its comprehensive curriculum was virtually a copy of that created by Hermann Boerhaave at Leyden. The professors at Edinburgh taught that medicine was a systematic body of knowledge which was to be learned synthetically, beginning with Newtonian natural philosophy. The establishment of Boerhaave's medical system in Edinburgh signified the increasing power in the city of pro-union,improvement minded Scots committed to the values of the Enlightenment. The Edinburgh medical courses on offer in the 1770s had overall similarity with those of the earlier period. The professors still taught that medicine was a systematic discipline which should be based on natural philosophy. However the foreign, Boerhaavian system had been rejected by all of them in favour of idiosyncratic medical systems which had many features in common with each other. Surgery, pathological anatomy, nosology, nosography, and a nervous physiology had all become more prominent in the teaching. Scepticism as the predominant attitude to medical knowledge. Besides relating these elements to intellectual changes in European medicine generally, I have tried to shov how they were shaped by particular local considerations. Further I also attempt to display how specific systematic differences, such as that between John Gregory and William Cullen, indicate differing allegiances to different Scottish philosophical and social groups.

The University of Arizona catalogs contain information regarding curricula, fees, university policies, and procedures.

The University of Arizona catalogs contain information regarding curricula, fees, university policies, and procedures.

The University of Arizona catalogs contain information regarding curricula, fees, university policies, and procedures.

The University of Arizona catalogs contain information regarding curricula, fees, university policies, and procedures.

INTRODUCTION: Transgender individuals experience distress due to the persistent feeling that their gender identity is incongruent with their assigned sex. This distress is associated with depression, a high suicide rate, and increased mortality. The best solution for transgender patients is cross-sex hormone therapy, a treatment that changes the physical sex of the patient to be more congruent with their gender identity. This treatment has been proven to reduce depression and suicide rates, as well as increase overall quality of life. Unfortunately transgender patients face unacceptable barriers to accessing this treatment, due in most part to the lack of willing and knowledgeable transgender care providers. Many physicians share the misconceptions that gender identity is malleable, making transgender identity a psychiatric problem, and that cross-sex hormone therapy may not be effective and carries too great a risk. However, the literature supports the notion that gender identity is a rigid biological phenomenon and that cross-sex hormone therapy is safe and effective. Studies reporting failed attempts to assign female sex to XY patients with disorders of sexual development provide evidence that gender identity is not malleable. Other studies reporting elevated gender identity disorder rates in XX individuals with excess prenatal androgen suggest that gender identity is a biological phenomenon influenced by hormones during prenatal development. Neuroanatomical studies of transgender cadavers report that some sexually dimorphic areas of the transgender brain are more similar to the opposite sex than the natal sex, suggesting that gender identity is a rigid biological phenomenon originating in the structure of the brain. A review of the side effects and risks associated with cross-sex hormone therapy concluded that treatment is safe provided the physician is familiar with the recommended treatment and monitoring regimens. The lack of transgender care providers is perpetuated by the fact that transgender medicine is not a standard part of the medical school curriculum. Few physicians, therefore, have experience or training in transgender medicine, which is why, to combat this problem, this study has focused on the medical school education system. Previous studies have demonstrated that the addition of transgender medicine to the medical school curriculum increases student comfort and willingness to provide transgender care. Building upon these findings the present study aims to demonstrate that the addition of transgender medicine to the medical school curriculum is an effective means to increase knowledge and change attitudes towards transgender medicine. METHODS: A single lecture on gender identity and transgender medicine was added to the mandatory first-year biochemistry course and the mandatory second-year pathophysiology course at Boston University School of Medicine. An audience response survey was conducted immediately before and after the first- year lecture to assess the change in students opinions regarding of the etiology of gender identity. An elective online survey consisting of two exam style questions was also sent to the first-year students prior to exposure to the curricular content. The same questions were also added to the first-year biochemistry and second-year pathophysiology exams following exposure to the content. The exam-style questions were designed to assess student knowledge of the rigidity of gender identity and transgender medicine. Results: Following exposure to the curricular content there was an increase in the number of students who believe that the origin of gender identity is in the neuroanatomical structure of the brain (p<0.001). The relative number of correct responses to the exam-style questions significantly improved between the online survey and the first-year exam (p<0.001). On one of the exam questions there was no significant difference between the relative number of correct responses given first-year students the second-year students. On the other exam question the second-year students performed significantly worse (p<0.001). CONCLUSION: Here we demonstrate that the addition of transgender medicine to a medical school curriculum can increase students' knowledge and change their attitudes towards transgender medicine. Following the curricular content students were convinced that gender identity is a rigid biological phenomenon and that cross-sex hormone therapy is a medically justified treatment. These findings suggest that a simple curricular content change is an effective means of training knowledgeable physicians who are willing to provide transgender care.