Spontaneous pneumomediastinum (SPM) is a fairly rare condition, caused by increased intrathoracic pressure, leading to free air in the mediastinal structures. Underlying lung conditions are associated with increased incidence of SPM, including asthma, interstitial lung disease, pneumonia, bullous lung, and radiation therapy for lung cancer. It is often preceded by Valsalva maneuvers, vomiting, coughing, asthma exacerbation, sneezing, childbirth, or intense physical activity. A case of SPM is presented in a 15-year-old male, who complained of throat pain and dyspnea while running sprints at football practice. Workup revealed SPM, and he was subsequently admitted and treated conservatively. His symptoms resolved in 2 days and he was discharged and suffered no further recurrences. In contrast to secondary pneumomediastinum, SPM is usually a benign condition although life-threatening conditions can rarely arise. Differentiating between these two conditions has important prognostic indications. There is a paucity of prospectively collected data regarding SPM, and considerable variation in recommendations concerning the extent of workup.

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Objectives: Student evaluation of courses is an important component of overall course evaluation. The extent of student participation in the evaluation may be related to the ease of the evaluation process. The standard evaluation format is a paper form. This study examines medical students preference of utilizing Audience Response System compared to a paper method. Methods: Following several medical school lectures, students were queried if they preferred Audience Response System versus a paper method, and if they would prefer using Audience Response System more for future course evaluations. Results: 391 students were queried. Overall response rate was 94%. Using a five point Likert scale, 299 out of 361 (82%) responded they agreed, or strongly agreed with the statement “We should use ARS more. . .” When asked which format they preferred to use for evaluation, 299/367 (81%) responded Audience Response System, 31 (8%) preferred paper, and 37 (10%) were not sure, or had no opinion (chi squared = 378.936, df2, p<0.0001). Conclusion: The medical students surveyed showed a strong preference for utilizing Audience Response System as a course evaluation modality, and desired its continued use in medical school. Audience Response System should be pursued as a lecture evaluation modality, and its use in medical school education should be encouraged

Although most responders consider use of live defibrillation important and believe formal defibrillator safety training should be conducted before use, only about one third of the centers had a training policy in effect. It remains to be determined whether safety training before the use of live defibrillation during simulation-based education increases user safety.

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Objective:Opioid replacement therapy (ORT) is the recommended treatment for opioid dependency. Relapse rates after release from incarceration are high. Treatment should be a component of the transition from incarceration to release. The attitudes of parole officers may prevent appropriate patients from seeking care in ORT. Can an informational discussion help convince Parole Officers ORT is advantageous for appropriate patients? Methods:An informative talk was given to 37 State and Federal Parole and Predetention Officers. Prior to the talk, the officers were surveyed using an anonymous device regarding their agreement with various statements concerning some common misconceptions about opioid addiction and methadone treatment. Their answers were scored on a 7-point Likert scale (agree, disagree). A 48-slide PowerPoint presentation was given to the officers, espousing the benefits of ORT. After the talk, the officers were then resurveyed with the same questions, and their prepresentation and postpresentation answers were compared.Overall Results:A paired samples t test was conducted to compare preresponses and postresponses for all parole officers. Preresponses (M = 4.54, SD = 1.34) were significantly lower than postresponses (M = 5.48, SD = 1.41), t(34) = -5.98, P<0.001, d = -0.68. Thus, the talk seemed to have a positive effect on the officer' answers. Effect sizes (Cohen d) were also calculated to determine the practical significance of the differences (where 0.2 is small, 0.5 is medium, and 0.8 is large). Overall, there was a statistically significant difference with a medium effect size when comparing the preresponses and postresponses from all parole officers. Conclusions:The results indicate that an informative talk about the benefits of ORT had a significant change in the parole officers' attitudes in this study.

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