A preliminary survey of professionalism teaching practices in anatomy education among Indian Medical Colleges

Professionalism and ethics have gained widespread recognition as competencies to be fulfilled, taught, and assessed within medical education. The role of the anatomy course in developed nations has evolved over time and now encompasses multiple domains, including knowledge, skills, and the inculcation of professionalism and ethics. The Medical Council of India recently recommended the integration of professionalism teaching in undergraduate medical curricula. The authors investigated whether the initial orientation lectures and instructions given by faculty at the outset of undergraduate medical anatomy courses throughout India served a “hidden curriculum” regarding professionalism practices, and whether these orientation messages could serve as an early exposure to medical professionalism and ethics for medical students. An online survey was carried out among 102 anatomy faculty members across India requesting details about specific professionalism protocols and instructions regarding behavior in the dissection hall that are routinely given to preclinical students, as well as the importance that they placed on professional behavior. It was found that most faculty members regularly instruct students regarding expected behavior during the anatomy course, including dissection practices. These instructions stress attributes of professionalism like humanism, accountability, and honesty. However, there needs to be a more concentrated effort by educators to prohibit such unprofessional practices like dissection hall photography, and better information is required regarding biomedical waste disposal. Despite the absence of clear guidelines for professionalism teaching in medical education in India, the existing framework of anatomy education provides an opportunity to introduce the concept of professionalism to the first‐year medical student. This opportunity may provide an early foundation for designing a professionalism‐integrated curriculum. Anat Sci Educ 10: 433–443. © 2017 American Association of Anatomists.     

Maternal mind-mindedness and attachment security as predictors of theory of mind understanding

This study investigated relations between social interaction during infancy and children's subsequent theory of mind (ToM). Infant-mother pairs (N = 57) were observed in a free-play context at 6 months. Interactions were coded for (a) mothers' use of mental state language that commented appropriately on the infants' mental states, and (b) mothers' use of mental state language that did not appropriately reflect their infants' minds. A third variable was (c) security of attachment, which was assessed using the Strange Situation procedure at 12 months. Performance on a battery of ToM tasks at 45 and 48 months was positively correlated with (a), but was not related to (b) or (c). A regression analysis showed that mothers' use of appropriate mental state comments independently predicted overall ToM performance, accounting for 11% of the variance. Children's verbal ability was the only other independent predictor of ToM performance, accounting for 16% of the variance. These findings represent the earliest known social predictor of individual differences in ToM.     

Attitudes of academic staff towards their own work and towards external evaluation,from the perspective of self-determination theory: Estonian case

The purpose of this study was to ascertain the attitudes of academic staff towards their own work as well as towards external evaluations. The study was based on (1) an analysis of assessment reports of institutional accreditations conducted by the Estonian Quality Agency for Higher and Vocational Education and (2) self-determination theory on intrinsic and extrinsic motivation. The satisfaction of academic staff with their own teaching and research competencies was measured and links among the following attitudes were analysed: sense of competence, intrinsic motivation for research, attitudes towards assessment of students and towards external evaluations. The results indicate that a correlation between attitudes towards work and towards external evaluation exists and that the attitudes of academic staff at universities and professional higher education institutions differ. The study involved 252 academic staff members and showed that competent and intrinsically motivated people perceive external evaluation more positively, thus supporting self-determination theory.     

Silence of the genes

The 2006 Nobel Prize in Physiology or Medicine was awarded to Andrew Fire and Craig Mello for discovering “RNA interference—genesilencing by double-stranded RNA”. The Nobel Committee at the Karolinska Institute in Sweden selected them for the award for unraveling “a fundamental mechanism for controlling the flow of genetic information” that is “already being widely used in basic science as a method to study the function of genes and may lead to novel therapies in the future”. This has been one of the fastest Nobel Prizes conferred in physiology or medicine, considering that Fire and Mello published their path-breaking article in the journal Nature in 1998, less than ten years ago. Utpal Nath is an Assistant Professor in the Department of Microbiology and Cell Biology, IISc. His laboratory is studying the genetic mechanisms of plant development. Saumitra Das is an Associate Professor in the Department of Microbiology and Cell Biology, IISc. His laboratory is interested in the translational control of cellular and viral RNA.     

Enumeration of lymphocyte subsets using flow cytometry: Effect of storage before and after staining in a developing country setting

Lymphocyte subset estimations by flow cytometry in population-based studies require transportation of samples from the field site to the laboratory. As samples arrive late in the day they have to wait overnight before being processed. The effect of two possible approaches, sample storage for 24 h before staining and immediate staining with analysis after 24 h and 48 h were evaluated. Two sets of experiments were performed with EDTA (ethylenediamine tetra-acetate) anticoagulated peripheral blood. In the first experiment, after collection, each sample was divided into two portions. One portion was stained at the time of blood collection and the other 24 h later after keeping it at room temperature (38–45°C). In the second experiment, blood samples were stained within 1–2 h. Each sample was analyzed immediately upon completion of staining process and subsequently after 24 h and 48 h of storage at 4°C. Results suggest that blood collected in EDTA can be processed using whole blood lysis method, after storage at room temperature (38–45°C) for 24 h with some but not significant alteration in T-cell subsets. Storage at 4°C after staining for 24 h results in a lesser and insignificant loss of cells or alteration of T-cell subsets and may be the method of choice.     

Biochemical markers for alcohol consumption

A variety of laboratory tests are available to assist in the diagnosis of alcohol consumption and related disorders. The levels of intake at which laboratory results become abnormal vary from person to person. Laboratory tests are particularly useful in settings where cooperativeness is suspected or when a history is not available. Several biochemical and hematological tests, such as γ-glutamyltransferase (GGT) activity, aspartate aminotransferase (AST) activity, high-density lipoprotein cholesterol (HDL-C) content of serum, and erythrocyte mean corpuscular volume (MCV) are established markers of alcohol intake. Their validity as markers is based largely on correlations with recent intake at a single time point and on decreases in elevated values when heavy drinkers abstain from alcohol. These readily available laboratory tests provide important prognostic information and should be integral part of the assessment of persons with hazardous alcohol consumption. There are several other markers with considerable potential for more accurate reflection of recent alcohol intake. These include carbohydrate deficient transferrin, β-hexosaminidase, acetaldehyde adducts and the urinary ratio of serotonin metabolites, 5-hydroxytryptophol and 5-hydroxyindoleacetic acid. These markers provide hope for more sensitive and specific aids to diagnosis and improved monitoring for intake.     

Should we use carbohydrate deficient transferrin as a marker for alcohol abusers?

Carbohydrate deficient transferrin (CDT) is one of the conventional markers for chronic alcohol consumption, is used by researchers and clinicians. A number of enzymes are affected by ethanol intake. The induction or inhibition of sialyl transferase and plasma sialidase may be involved in the CDT level elevation. An alteration of protein transport during post-translational modification could be a primary mechanism in the impairment of protein metabolism associated with chronic alcohol abuse. Transferrin being a steroid responsive protein, sex-based hormonal variations might contribute to the lower sensitivity of CDT. Varying hormonal statuses such as pregnancy, use of contraceptives, menopause/ menstrual cycle can alter iron homeostasis in women. CDT levels are markedly affected by iron homeostasis. Several CDT assay methods appeared promising, but it is not readily apparent which technique is the most accurate. Moreover, false-positive results of CDT have been reported in non-alcohol related hepatic failure and in rare conditions. Therefore clinical interpretation of CDT needs careful assessment in patients with alcohol-related or non-alcohol-related health disorders.     

Role of ethanol on aluminum induced biochemical changes on rat brain

Aluminum and alcohol, both are well-accepted neurotoxin. The plausible mechanisms for their neurotoxicity are also common. Therefore, the effect of ethanol on aluminum induced biochemical changes in rat brain is being studied. In the present study, ethanol exposure significantly affected the aluminum and protein content of brain. The activities of acid phosphatase and alkaline phosphatase were also changed. Aluminum exposure, on the other hand, contributed significantly in the alterations of aluminum content, acid phosphatase acivity and aspartate aminotransferase activity. Though ethanol co-exposure significantly influenced the aluminum load of brain, the interactions of these two neurotoxins were found to be significant only in case of acid phosphatase activity of brain. Therefore, it can be suggested that general neurotoxicity produced by aluminum is not modified by ethanol. However, the aluminum load caused by aluminum exposure, may be influenced by ethanol co-exposure.