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Research was conducted to examine the feasibility of using the green fluorescent protein (GFP) of Aequorea victoria as a tag to follow the growth of Aspergillus flavus. One of the advantages of using GFP as an in vivo reporter for monitoring dynamic processes in cells or organisms is its ability to be measured directly without additional substrates, cofactors or proteins. Results indicate that the use of modified GFP in strains of A. flavus could facilitate the detection of the fungus in substrates.

A three-year study compared entry-level and junior-level clinically oriented reading and writing skills of 231 medical students. Entry-level skills were found to be the best predictors of clinical skills. Inclusion of communication skills training in admission criteria and/or medical curriculum are recommended. (Author/MSE)

Chronic fatigue syndrome is a disabling disorder that has been studied primarily in clinical settings. In the absence of an adequate epidemiological database, cultural stereotypes have influenced the characterization of chronic fatigue syndrome as 'the yuppie flu,' similar to the 19th century characterization of neurasthenia as a disease of the affluent. The limited epidemiological data available and the overall medical-sociological literature call this assumption into question. Only a community 'true' prevalence study that is unbiased by help seeking and access to health care can provide an accurate assessment of the risk factors for and the public health ramifications of this disease. (Am J Public, The prevalence of chronic fatigue syndrome in low-income populations has probably been underestimated. Most prevalence estimates have been derived from those who seek medical care. Low-income minorities are less likely to have health insurance and therefore less likely to have access to health care. One study estimated that between 15% and 23% of people in nine counties in Washington State do not have health insurance and so would be overlooked in an epidemiological study. Some research has indicated that low-income minorities may have higher levels of chronic illnesses and fatigue-related symptoms. These symptoms may be seen as indicators of illness in upper-class patients. Also, women are more likely to seek health care than men. This may account for the high number of women in estimates of disease prevalence. Definitions of chronic fatigue syndrome have varied between studies. This may have led to the exclusion of some cases in which patients forced themselves to function in spite of severe symptoms.

Medical students who deviate from the traditional norms of masculine or feminine behavior may be subjected to abusive situations more often than other students, and many may suffer psychological problems as a result. Of 137 medical students surveyed every year from their freshman year up to graduation, 71.8% reported at least one abusive experience with faculty, residents or staff. Being yelled at, being forced to listen to sexually suggestive jokes and being excluded from activities because of gender were the most commonly reported abuses. Women were more likely to report many of the abuses; 61.4% reported being uncomfortable listening to sexual jokes and 36.3% reported unwanted sexual advances from superiors. Men scoring low on masculinity tests and women scoring low on femininity tests were more likely to report abuse. These students were more likely to experience anxiety, depression, hostility and problem drinking., Objective.-To assess the prevalence, correlates, and mental health consequences of reported medical training-related abuses. Design.-A longitudinal cohort study of 137 students surveyed from medical school entrance (time 1) through the winter of the fourth training year (time 4). Setting.-A state college of medicine. Outcome Measures. - Reported training-related abuses (measured at time 4) and mental health status measured at times 1 and 4 (depressive and anxiety symptoms, hostility, problem drinking, escapist drinking, alcohol consumption levels, and gender role orientations). Results.-Seventy-two percent of students reported at least one abusive experience during medical training. Females were significantly more likely than males to report gender discrimination, exclusion from informal settings, discomfort from sexual humor, and unwanted sexual advances. Abuse was significantly related to most psychopathological outcomes, controlling for pre-existing psychopathology. Males low in masculinity and females low in femininity were most likely to report abuse. Conclusions.-The data provide further support for the assumption that a high proportion of medical students not only experience the training process as abusive in nature but also suffer measurable psychopathological consequences. Efforts should be made to reform medical education, with a prominent focus on gender role related issues. (JAMA. 1992;267:692-694)

A study is conducted to identify a candidate regulatory gene, ZFR1in an expressed sequence tag library enriched for transcripts during fumonisin B1 /(FB1) biosynthesis. The results of the study indicate that ZFR1 is a positive regulator of FB1 biosynthesis in F. verticilliodes and suggest that FCC1 is required for ZFR1 function.

Research has been conducted on Fusarium verticillioides. The authors describe the isolation and characterization of cloned PACC-like gene from this bacterium, and suggest that this gene is responsible for fumonisin biosynthesis under alkaline conditions.

Background. One of the major goals of home care is the prevention of hospitalization. The objective of this study was to examine the relation between medication use (number, type, and inappropriateness) and hospitalization among home care patients older than 65 years. Methods. A retrospective chart review of 833 discharged older home care patients was performed. These patients were consecutive discharges from a single home care agency who either (a) returned to independent self-care or care of the family (S/F Care group) or (b) were admitted to the hospital (Hospitalized group). Medication assessment within these two groups included total number of medications (prescription and nonprescription); degree of polypharmacy (percentage of patients taking 5 or more, 7 or more, and 10 or more medications); and prevalence for different types of medications, including different types of inappropriate medications. Inappropriate medications were designated according to a list that was previously developed through a modified Delphi consensus technique by a panel of 13 experts in geriatric pharmacology and has been utilized in other studies. Student's t test was used for continuous variables and chi-square test was used for categorical variables to evaluate for differences between the S/F Care group and the Hospitalized group (p [is less than] .05). For comparisons of types of medications, p [is less than] .01 was used for significant differences, because of the high number of comparisons made. Results. Of 833 discharges, 644 (77.3%) returned to self-care or care of the Family (S/F Care group) and 189 (22.7%) were hospitalized. The Hospitalized group, compared with the S/F Care group, was taking a higher number of medications (mean [+ or -] SD: 6.6 [+ or -] 3.9 vs 5.7 [+ or -] 3.4, p = .004), and had a higher percentage of patients taking 7 or more medications (46% vs 26%, p = .002) and 10 or more medications (21% vs 10%, p = .005), but not 5 or more medications. Only three types of medications were more commonly used among patients in the Hospitalized group than among patients in the S/F Care group: clonidine (4.2% vs 1.1%, p = .004); mineral supplements (23.8% vs 14.8%, p = .003); and metoclopramide (5.8% vs 2.0%, p = .006). The Hospitalized group had a lower percentage of patients taking inappropriate medications than did the S/F Care group (20% vs 27%, p = .040), but none of the types of inappropriate medications was used more often in either group. Conclusions. This study shows a relationship between high levels of polypharmacy and hospitalization. Although it cannot be determined from this study whether a higher number of medications was an indicator of sicker patients at risk for hospitalization, or whether a higher number of medications might have directly led to hospitalization, polypharmacy should still be considered a marker for older home care patients for whom prevention of hospitalization is the goal.

A course to teach students how to interview medical patients, to allow for discussion of student concerns about entering into clinical work, and to make students aware of the complex psychosocial factors related to medical illness is described. (MLW)