Publications by authors named "Sophie McAllister"

4 Publications

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Lessons From Learners: Adapting Medical Student Education During and Post-COVID-19.

Acad Med 2021 May 4. Epub 2021 May 4.

M.R.H. Castro is a third-year medical student, University of California San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0002-2085-4893. L.M. Calthorpe is a third-year medical student, University of California San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0002-0496-9471. S.E. Fogh is associate professor, Department of Radiation Oncology, University of California San Francisco School of Medicine, San Francisco, California. S. McAllister is a third-year medical student, University of California San Francisco School of Medicine, San Francisco, California. C.L Johnson is a third-year medical student, University of California San Francisco School of Medicine, San Francisco, California. E.D. Isaacs is professor of emergency medicine, Department of Emergency Medicine, University of California San Francisco, San Francisco, California. A. Ishizaki is manager, Clinical Microsystems Clerkship, University of California San Francisco School of Medicine, San Francisco, California. A. Kozas is curriculum coordinator, Clinical Microsystems Clerkship, University of California San Francisco School of Medicine, San Francisco, California. D. Lo is assistant professor of medicine, Division of Geriatrics, Department of Medicine, University of California San Francisco School of Medicine; and Department of Geriatrics and Extended Care, San Francisco Veterans Affairs Health Care System, San Francisco, California. S. Rennke is professor of medicine, Division of Hospital Medicine, Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California. J. Davis is professor of medicine and associate dean for curriculum, University of California San Francisco School of Medicine, San Francisco, California. A. Chang is professor of medicine, Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California.

In response to the COVID-19 pandemic, many medical schools suspended clinical clerkships and implemented newly adapted curricula to facilitate continued educational progress. While the implementation of these new curricula has been described, an understanding of the impact on student learning outcomes is lacking. In 2020, the authors followed Kern's 6-step approach to curricular development to create and evaluate a novel COVID-19 curriculum for medical students at the University of California San Francisco School of Medicine and evaluate its learning outcomes. The primary goal of the curriculum was to provide third- and fourth-year medical students an opportunity for workplace learning in the absence of clinical clerkships, specifically for students to develop clerkship-level milestones in the competency domains of practice-based learning and improvement, professionalism, and systems-based practice. The curriculum was designed to match students with faculty-mentored projects occurring primarily in virtual formats. A total of 126 students enrolled in the curriculum and completed a survey about their learning outcomes (100% response rate). Of 35 possible clerkship-level milestones, there were 12 milestones for which over half of students reported development, in competency domains including practice-based learning and improvement, professionalism, and interpersonal and communication skills. Thematic analysis of students' qualitative survey responses demonstrated 2 central motivations for participating in the curriculum: identity as physicians-in-training, and patient engagement. Six central learning areas were developed during the curriculum: interprofessional teamwork, community resources, technology in medicine, skill-building, quality improvement, and specialty-specific learning. This analysis demonstrates that students can develop competencies and achieve rich workplace learning through project-based experiential learning, even in virtual clinical workplaces. Furthermore, knowledge of community resources, technology in medicine, and quality improvement were developed through the curriculum more readily than in traditional clerkships, and could be considered as integral learning objectives in future curricular design.
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http://dx.doi.org/10.1097/ACM.0000000000004148DOI Listing
May 2021

Circadian regulation of mitochondrial uncoupling and lifespan.

Nat Commun 2020 04 21;11(1):1927. Epub 2020 Apr 21.

Department of Genetics and Development, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, 10032, USA.

Because old age is associated with defects in circadian rhythm, loss of circadian regulation is thought to be pathogenic and contribute to mortality. We show instead that loss of specific circadian clock components Period (Per) and Timeless (Tim) in male Drosophila significantly extends lifespan. This lifespan extension is not mediated by canonical diet-restriction longevity pathways but is due to altered cellular respiration via increased mitochondrial uncoupling. Lifespan extension of per mutants depends on mitochondrial uncoupling in the intestine. Moreover, upregulated uncoupling protein UCP4C in intestinal stem cells and enteroblasts is sufficient to extend lifespan and preserve proliferative homeostasis in the gut with age. Consistent with inducing a metabolic state that prevents overproliferation, mitochondrial uncoupling drugs also extend lifespan and inhibit intestinal stem cell overproliferation due to aging or even tumorigenesis. These results demonstrate that circadian-regulated intestinal mitochondrial uncoupling controls longevity in Drosophila and suggest a new potential anti-aging therapeutic target.
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http://dx.doi.org/10.1038/s41467-020-15617-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174288PMC
April 2020

A model of Fragile X syndrome exhibits defects in phagocytosis by innate immune cells.

J Cell Biol 2017 03 21;216(3):595-605. Epub 2017 Feb 21.

Department of Genetics and Development, Columbia University Medical Center, New York, NY 10032

Fragile X syndrome, the most common known monogenic cause of autism, results from the loss of FMR1, a conserved, ubiquitously expressed RNA-binding protein. Recent evidence suggests that Fragile X syndrome and other types of autism are associated with immune system defects. We found that mutants exhibit increased sensitivity to bacterial infection and decreased phagocytosis of bacteria by systemic immune cells. Using tissue-specific RNAi-mediated knockdown, we showed that Fmr1 plays a cell-autonomous role in the phagocytosis of bacteria. mutants also exhibit delays in two processes that require phagocytosis by glial cells, the immune cells in the brain: neuronal clearance after injury in adults and the development of the mushroom body, a brain structure required for learning and memory. Delayed neuronal clearance is associated with reduced recruitment of activated glia to the site of injury. These results suggest a previously unrecognized role for Fmr1 in regulating the activation of phagocytic immune cells both in the body and the brain.
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http://dx.doi.org/10.1083/jcb.201607093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350515PMC
March 2017

Healthcare professionals' attitudes, knowledge and self-efficacy levels regarding the use of self-hypnosis in childbirth: A prospective questionnaire survey.

Midwifery 2017 Apr 2;47:8-14. Epub 2017 Feb 2.

Division of Women's Health, Faculty of Life Sciences & Medicine, King's College London, Women's Health Academic Centre, St. Thomas' Hospital, London SE1 7EH, United Kingdom.

Objective: to examine healthcare professionals' attitudes, knowledge and levels of self-efficacy regarding the use of self-hypnosis in childbirth.

Design: a prospective survey.

Setting: two large maternity units in London, England.

Participants: healthcare professionals (n=129) involved in the care of childbearing women (anaesthetists, midwives and obstetricians).

Methods: online questionnaire assessing healthcare professionals' experience, knowledge, attitudes and self-efficacy relating to self-hypnosis in childbirth.

Main Outcome Measures: attitude, self-efficacy and knowledge.

Findings: over half of the participants surveyed (56%) reported they had minimal or no knowledge of hypnosis. Higher levels of knowledge were associated with higher levels of self-efficacy (p<0.001) and also with more positive attitudes (p<.001). Midwives reported significantly higher levels of knowledge, more positive attitudes (7.25, 95% CI: 4.60-9.89) and higher levels of self-efficacy (3.48, 95% CI: 1.46-5.51) than doctors. Midwives also reported more exposure to/experience of hypnosis than doctors, and more exposure was significantly associated with higher levels of self-efficacy (midwives p<.001; doctors p=.001). Professionals who would plan to use self-hypnosis in their own or partners' births had significantly higher self-efficacy scores (p<.001).

Key Conclusions: if healthcare professionals are to effectively support women using self-hypnosis in childbirth, they need to be confident in their ability to facilitate this method. Previous research has established that self-efficacy is a strong indicator of performance.

Implications For Practice: Professionals with more knowledge of self-hypnosis are also more confident in supporting women using this technique in childbirth. Multi-disciplinary staff training which aims to increase knowledge, and which includes exposure to hypnosis in labour, may be beneficial in assisting staff to support women choosing to use self-hypnosis in labour.
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http://dx.doi.org/10.1016/j.midw.2017.01.017DOI Listing
April 2017