1447 on chicken bone a presumptive Gla fraction was isolated by ion exchange chromatography from alkaline hydrolysates of the chicken bone and identified as Gla on the basis of both its conversion to glutamic acid upon heating in acid and its coelution with a similar putative Gla fraction in alkaline hydrolysates of prothrombin (7). In the present study we have used Gla synthesized by the procedure of Morris et al. (9) to show further that the mass spectra of the presumptive Gla from bovine bone and synthetic Gla are identical. Studies with synthetic Gla have also enabled us to show that Gla is indeed completely stable under the conditions of alkaline protein hydrolysis, and to establish its ninhydrin color factor for quantitative estimation of Gla content in proteins.In the present work we report the chemical composition of the bovine Gla protein and the sequence of its first 15 residues, which establish that the bovine Gla protein is not a fragment of the bovine blood clotting factors. We also present evidence of a similar Gla-containing protein in most other bovine calcified tissues and in a variety of other vertebrates. The low molecular weight and high electrophoretic mobility of the main Gla protein in chicken bone (7) indicate that it is probably another member of this class of proteins. We find that the bovine Gla protein binds strongly to the mineral phase of bone, with an average stoichiometry of one Gla protein per crystal, and that the bovine Gla protein is a potent inhibitor of hydroxyapatite crystallization. MATERIALS AND METHODSCortical bone was obtained from the central section of the femur of freshly slaughtered calves or cows. Bone samples were freed of marrow and connective tissue, ground to a particle size that passed through a 210-,gm sieve, and washed with several changes of water for 24 hr at 4°. The bone was then dialyzed against several changes of 0.5 M EDTA, pH 8, at 40 for 8-10 days. The soluble fraction inside the dialysis sack was collected by centrifugation, dialyzed exhaustively against 5 mM NH4HCO3, and lyophilized. After gel filtration on Sephadex G-100 (Fig. 1), peak fractions containing the Gla protein were lyophilized and then chromatographed on a 2 X 50 cm column of DEAE-Sephadex A25 at 25°with a linear gradient in 0.1 M Tris-HCI, pH 8.0, from 0 to 0.75 M NaCl. The procedure for the isolation of Gla protein from swordfish and human bone and bovine dentine was altered only in the use of 50 mM rather than 5 mM NH4HCO3 to suppress Gla protein precipitation. Hydroxyapatite crystals were made by mixing calcium chloride and sodium phosphate solutions at 5 mM concentrations, pH 7.4, and 250. Hydroxyapatite also was purchased from Clarkson Chemical Co. Amorphous calcium phosphate was prepared by mixing saturated solutions of calcium chloride and sodium phosphate at pH 7.4 and 250.

A case-based interprofessional education (IPE) ethics activity between pharmacy and dental students was developed and evaluated. Eighty-two third-year pharmacy and 51 first-year dental students were divided into teams for two sessions. The IPE activity involved the student teams analyzing two cases at each session utilizing an ethical decision-making process followed by debriefing of each case. Assessments included pre-/post-Readiness for Interprofessional Learning Scale (RIPLS), pre-/post-individual ethics knowledge quiz, pre-team ethics knowledge quiz and post-student perception survey. The results indicated no significant differences in RIPLS scores although scores indicated a high readiness for interprofessional learning including teamwork and collaboration among pharmacy and dental students. When comparing pre-/post-ethics knowledge quiz scores a significant difference was found between individual and team scores as well as between professions. Perception survey results were highly favorable toward the value of interprofessional learning activities. The sessions resulted in enhanced knowledge about ethical decision-making.

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The aim of this study was to validate a health professions ethics rubric by an interprofessional team. The rubric was used by two pharmacy and two dental faculty members to score ethics cases submitted by 16 teams comprised of 80 pharmacy and 50 dental students. A debrieing session for each case was moderated by a non-rater faculty member to arrive at a consensus score for the cases. Interrater reliability was calculated for the four raters and the debrieing scores as well as the four raters without the debrieing scores. The overall interrater correlations were in the range of 0.790 to 0.906 for the four raters. Issues ranged from 0.320 to 0.758. Principles ranged from 0.610 to 0.838. Options ranged from 0.655 to 0.843. Analysis ranged from 0.667 to 0.918. Solution ranged from 0.739 to 0.886. With the inclusion of the consensus scores, the interrater correlations were even higher. The best correlations were for the overall score and solution components of the rubric. With further edits in the rubric and enhanced training by faculty raters and changes in the ethics learning session, the revised rubric could be evaluated again for grading. Further training for faculty using the rubric for grading student cases should enhance its reliability. Demonstrating to students the ethical decision making process using the rubric should enhance the validation process.

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