Monday, April 20, 2015

Pull My Finger

On April 15, a new scientific paper hit worldwide with a major impact. My friend and colleague, Greg Kawchuk of the University of Edmonton, had done what no one before him had ever been able to do. He found out what happened when you crack your knuckle. And on that fateful day, Greg had more than 45 media interviews, including with the New York Times, the BBC and other major newspapers. Greg is a top scientist, and to this day I remember his presentation at an ACC-RAC conference with pleasure- he recreated a famous Olympic iice-dancing routine as part of his presentation, only he used two chiropractors to do the dance. It remains the funnies thing I have ever seen at any conference, ever. But I digress.

In his paper, which has become known as the “Pull my finger” study, he placed the fingers of a chiropractor into a device that literally pulled the finger to the point where a knuckle crack occurred. Even better, the reason he used that chiropractor’s finger was because the chiropractor possessed the unusual ability of being able to have his knuckle crack on demand- no refractory period, etc. Greg was able to use this on all 10 fingers of the participant. With his team, he then took cine-MRI images of the knuckle as it cracked, and was able to visualize the changes taking place. He found not that there was a bubble collapse (the prevailing theory) but that a cavity was formed. You can now see why this garneed such worldwide attention (in a Facebook post of a few moments ago, Greg noted that his aunt said that “it went virus.”).
The actual paper, which is titled “Real-time visualization of joint cavitation,”  is available free for download on the Public Library of Science, or PLoS. It can be found at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0119470. From Greg’s work, we need to know a new term: tribonucleation. Here is the abstract of this most interesting paper.

Cracking sounds emitted from human synovial joints have been attributed historically to the sudden collapse of a cavitation bubble formed as articular surfaces are separated. Unfortunately, bubble collapse as the source of joint cracking is inconsistent with many physical phenomena that define the joint cracking phenomenon. Here we present direct evidence from real-time magnetic resonance imaging that the mechanism of joint cracking is related to cavity formation rather than bubble collapse. In this study, ten metacarpophalangeal joints were studied by inserting the finger of interest into a flexible tube tightened around a length of cable used to provide long-axis traction. Before and after traction, static 3D T1-weighted magnetic resonance images were acquired. During traction, rapid cine magnetic resonance images were obtained from the joint midline at a rate of 3.2 frames per second until the cracking event occurred. As traction forces increased, real-time cine magnetic resonance imaging demonstrated rapid cavity inception at the time of joint separation and sound production after which the resulting cavity remained visible. Our results offer direct experimental evidence that joint cracking is associated with cavity inception rather than collapse of a pre-existing bubble. These observations are consistent with tribonucleation, a known process where opposing surfaces resist separation until a critical point where they then separate rapidly creating sustained gas cavities. Observed previously in vitro, this is the first in-vivo macroscopic demonstration of tribonucleation and as such, provides a new theoretical framework to investigate health outcomes associated with joint cracking.

Monday, April 13, 2015

Reviewing Manuscripts

On the current home page for BioMed Central blog is an article about peer review. I have had an opportunity to provide hundreds of peer reviews for submitted manuscripts over the course of my career, and I enjoy providing them, while understanding that they take time and a certain amount of skill. But I also know that it is a human process, so it is imperfect and subject to idiosyncrasy.  The blog post here (http://blogs.biomedcentral.com/bmcblog/2015/04/09/peer-review-throw-early-career-researchers-deep-end/)  rises a number of critical issues.

The first issue relates to training. Should those who provide peer review have some sort of training to do so? This is important, because the quality and depth of peer review ranges a great deal. Consider that at ACC-RAC there may be 200 reviewers involved in vetting the papers that have been submitted. None have any training whatsoever. Certainly, some reviewers will be scientists who have themselves undergone peer review, and may also offer same to various journals, but they will provide their reviews based on the own perceptions about how in-depth they should be, etc. And many others have never done reviewing at all. It does seem that it would be beneficial to provide a base level of training so that individuals would know about how deep to go into their review, would understand they do not need to comment on or correct editing errors (after all, that is what an editor is for), and would be trained to keep comments impersonal. The use of a mentor might help here.
Second, journals could provide checklists for reviewers to use.  And journals could offer some sort of accreditation process for those who review. They could open up the review process (that is, they could publish the reviewers’ comments along with the paper).

And reviewers should be acknowledged for the work they do. I would publish an annual thank you to reviewers, when I edited JMPT. It takes time and is done free, and it is a valuable service. I hope that you will find such opportunities to provide such a service.

Monday, March 30, 2015

The Muddiest Point Exercise

During my recent visit to Las Vegas for ACC-RAC, I was able to attend numerous educational sessions. One was taught by Dr. Joseph Guagliardo, a NUHS graduate teaching at Life University. His presentation addressed ways to engage students in classroom settings while also working to assess learning outcomes. In his presentation, he made mention of a couple of quick “devices” one can do in the classroom. I found this fascinating.

One activity was called “The Muddiest Point.” This is simplicity itself.  When you complete a teaching unit, you can ask your students to anonymously report what idea or concept from that unit was most confusing (“muddy”) to them. You then collate the answers and use that to help your students better understand those areas that seemed to give them the most trouble. Using this information, you can, for example, return to the classroom the very next sessions and go over that information; you can expand upon it if you want to; or you can provide resources to your students by whatever means you feel most appropriate (i.e. via your webpage, or by a podcast or video clip, or by sending out a pdf of a paper).
A flip to this approach is use what some refer to as a “one-minute paper.” Using this tool, at the end of your class session you ask your students to write down what they feel was the most important concept from that session; you can also ask them to write down any questions they have related to that session.  These are not graded and should also be done anonymously. From this, you can judge whether your students are capturing what you believe are the important aspects of that topic area. Again, if you use this exercise, you should provide close to immediate feedback (i.e. next session) feedback.

Information on these are other methods can be found in a short paper entitled “description of several common methods for assessing expected learning outcomes,” which is located at https://www.tltc.ttu.edu/content/asp/assessment/pages/pg14.pdf.

Monday, March 23, 2015

ACC-RAC Representation


Last week I provided a list of papers and presentations Palmer faculty, administration and staff were involved with at ACC-RAC. This week I wish to acknowledge everyone who had something ready for the program.

Michelle Barber

Judy Bhatti

Ron Boesch

James Boysen

Thomas Brozovich

Alana Callender

Shane Carter

Robert Cooperstein

Dustin Derby

James DeVocht

Catherine Eberhart

Rod Floyd

Karen Goodell

Stephen Grand

Maruti Ram Gudavalli

Andrea Haan

Julie Hartman

Xiaohua He

LaKeisha Holloway

Janice Hubbard

Todd Hubbard

Rachelle Hynes

Roger Hynes

Julie Johnson

Lisa Killinger

Dana Lawrence

Dennis Marchiori

Stacie Martel

Craig Mencl

Bill Meeker

Amy Minkalis

Kenice Morehouse

Lia Nightingale

Kevin Paustian

Ali Rabatsky

Dewan Raja

Robert Rowell

Stacie Salsbury

Kathy Shaw

Sheyan Shebani

William Sherrier

Bahar Sultana

Chabha Hocine Tepe

Michael Tunning

Elissa Twist

Michael VanNatta

Robert Vining

Dan Weinert

Morgan Young

Niu Zhang

Monday, March 16, 2015

Palmer College at ACC-RAC 2015

Once again, we are representing ourselves very well. Congratulations to all!

Plenary

Enhancing spinal manipulation skills with evidence based innovation
David Starmer, Glori Hinck, Stephen Grande

Risks and rewards: Will interprofessional collaboration save or destroy the chiropractic profession?
Dennis Marchiori

 Workshops

Collaborative Learning Strategies to Develop Interprofessional Collaboration: Process and Product
Ayla Azad, Lisa Z. Killinger, Loretta Howard

Active learning and meaningful assessment with large class sizes
Andrea Haan, Michelle Barber, Kevin Paustian

Critical Appraisal of Research Information and the Literature: Enabling the Reader
Anthony L. Rosner, Dana Lawrence, Michael Schneider

Revitalizing the North American Chiropractic Research Agenda: Planning for 2020
Bill Meeker, Claire Johnson, Greg Cramer, John Mrozek, Mitch Haas, Robert Mootz

Platform

Ambiguity in the onset of EMG response to a visual prompt
James DeVocht


Student perceptions of test effectiveness following a simulated objective structured clinical exam (OSCE)
Michael Tunning, Robert Rowell, Thomas Brozovich, Michael VanNatta

Distance education online intervention for evidence based practice literacy
Michael Schneider, Roni Evans, Mitchell Haas, Cynthia Long, Cheryl Hawk, Matthew Leach, Greg Cramer, Corrie Vihstadt, Oakland Walters, Lauren Terhorst

The reliability of lumbar motion palpation using continuous analysis and confidence ratings
Robert Cooperstein, Morgan Young

Criterion validity of static spinal palpation compared to a reference standard
Robert Cooperstein, Morgan Young, Michael Haneline

Measurements of innominate vertical length in assessing leg length discrepancy in idiopathic scoliosis patients
Xiaohua He, HanSuk Jung, JooHyun Ham, KyeongAh Min

Force-time characteristics of double thenar posterior to anterior thoracic spinal manipulations
Maruti Ram Gudavalli

Transformation to confident clinician: A focus group study of chiropractic students following an international service learning experience
James Boysen, Stacie Salsbury, Dustin Derby, Dana Lawrence

The efficacy of collaborative instruction and its implications on interprofessional development
William Sherrier

Preferred instructional strategies for various learning styles in Cell Physiology: A pilot study
Lia Nightingale

Use of video to teach a biochemical concept in the doctor of chiropractic program
Kathy Shaw, Ali Rabatsky

Effects of peer instruction enhanced lectures on student recall and comprehension
Niu Zhang, Charles Henderson

A review of organizational structure when developing a practice-based research network
Janice Hubbard, Dana Lawrence

What are the current structures and practices of IRBs of chiropractic institutions? A descriptive survey of IRB chairs
Elissa Twist, Dana Lawrence, Stacie Salsbury, Cheryl Hawk

A collaborative project examining faculty and intern attitudes and behaviors towards smoking cessation interventions in a chiropractic-teaching clinic: A qualitative analysis
Kenice Morehouse-Grand, Bahar Sultana

Survey of students' perception of the palmer college of chiropractic preceptor program
Roger Hynes, Alana Callender, Rachelle Hynes

Complementary and alternative medicine techniques for breech correction
Julie Hartman

Posters

Overcoming barriers to publication: a case report of a chiropractic researcher
Barclay Bakkum, Robert Cooperstein, Cynthia Chapman

Assessing the change in Chiropractic student scores in a review course for Part 1 NBCE examination provided as a required course by an accredited chiropractic college
Judy Bhatti, Elissa Twist

The return of color vision secondary to macular degeneration after chiropractic care
Thomas Brozovich

A cross-sectional study to determine current basic public health markers of faculty clinicians at a chiropractic teaching institution
Rod Floyd, Kenice Morehouse, Stephen Grand, Shane Carter, Craig Mencl

Chiropractic Intern attitudes, beliefs, and intentions with regard to health promotion, wellness, and preventive services - phase 2
Stephen Grand, Kenice Morehouse-Grand, Shane Carter, Rod Floyd

Changes in state regulation pertaining to chiropractic staff
LaKeisha Holloway, Catherine Eberhart, Stacie Martel

Cervical herniated disc with cervical radiculopathy symptoms improved under conservative chiropractic care: a case report
Todd Hubbard, Brian Hall, Janice Hubbard


Implementation of a chiropractic care program for soldiers, veterans and their families in a chiropractic college clinic system
Julie Johnson, Shayan Sheybani, Ron Boesch LaKeisha Holloway, Catherine Eberhart, Stacie Martel

Students’ perceived confidence in specific elements of the physical examination one year post training: a survey and focus groups of three student cohorts
Lisa Killinger

Where is the pain source? A patient with low back pain and bilateral avascular necrosis of the hips
Amy Minkalis, Robert Vining

Post-concussion symptom reduction and return to play following chiropractic intervention: a case report
Harold Olson, Michael Tunning, Ron Boesch

Ankylosing Spondylitis mimicking spasmodic torticollis - a case report
Lynn Pownall, Stephen Grande, Elizabeth Rokitka

An association between low-back Pain and cigarette smoking
Dewan Raja, Bahar Sultana


Chiropractic in the age of Ebola: A systematic review of infectious disease prevention and recommendations for chiropractors
Robert Rowell, Josefina Torres, Karen Goodell

Collaborative care for a patient with complex low back pain and long-term tobacco use: a case report
Michael Seidman, Robert Vining, Stacie Salsbury

The deserted library: students' perceptions of the library as supporting their academic achievement: interpretive case study
Chabha Hocine Tepe

Transient quadriplegia in a high school athlete
Michael VanNatta

Impact of justice on organizational and supervisor trust at chiropractic colleges
Dan Weinert, Dustin Derby

Monday, March 9, 2015

Desire2Learn Brightspace Learning Platform

As you are likely aware, the College has committed to implementing a learning management system known as Desire2Learn. This decision involved many people across all campuses and from many walks of college life: faculty, information technology and administration. Many issues needed to be confronted and after all is said and done, the College is in process of working out integration between Desire2Learn (or, as it is more correctly called, The Brightspace Learning Platform) and our existing Student Information System (SIS), which is PowerCampus. Because we have multiple campuses and programs (3 DCS programs, a BS program, an AAS program and an MS program), there are some challenges in making this all work. This will all be resolved in the near future; it is coding issue relating to how we can access course rosters correctly from PowerCampus.

The Brightspace platform looks somewhat similar to the portal system we currently use, but it has much more flexibility, ease of use and capacity. It also can integrate with other programs such as turnitin.com and Atomic Learning. It has a built-in Capture system, too.
As we move closer to implementation, we will be offering training in the use of the system. It works somewhat similar to what you are all accustomed to; you can upload files or announcements to your course home area. But it is very easy to use; you can “drag and drop” multiple files at once and have them populate your course, and once your course is created, there are ways with just a couple clicks or so to create a new course in the following term and have all your material copied over.

There is also a community of users and resources you can easily tap. For those of you who like to have access, the initial link is at https://community.brightspace.com. From there you can access blogs about the system, message boards, articles and most important training videos.
Please take a look at this site: https://community.brightspace.com/resources/videos

From there you can maneuver to the “G” list and find a series of “Getting Started” clips that will give you some insight into the system. We are going to attempt to create “sandboxes” for you to play in, and will let you know what that happens.

This is exciting, and I am hoping you will engage in the use of the system to a greater degree than you have in the past.

Monday, March 2, 2015

US Law on Copyright and Fair Use

There is always confusion over what constitutes fair use of copyrighted material. To that end, I thought I would directly quote the United States Copyright Office- using material that is in the common domain- for their insight (http://www.copyright.gov/fls/fl102.html, accessed February 25, 2015).

“One of the rights accorded to the owner of copyright is the right to reproduce or to authorize others to reproduce the work in copies or phonorecords. This right is subject to certain limitations found in sections 107 through 118 of the copyright law (title 17, U. S. Code). One of the more important limitations is the doctrine of “fair use.” The doctrine of fair use has developed through a substantial number of court decisions over the years and has been codified in section 107 of the copyright law.

Section 107 contains a list of the various purposes for which the reproduction of a particular work may be considered fair, such as criticism, comment, news reporting, teaching, scholarship, and research. Section 107 also sets out four factors to be considered in determining whether or not a particular use is fair.

1.      The purpose and character of the use, including whether such use is of commercial nature or is for nonprofit educational purposes

2.      The nature of the copyrighted work

3.      The amount and substantiality of the portion used in relation to the copyrighted work as a whole

4.      The effect of the use upon the potential market for, or value of, the copyrighted work
The distinction between what is fair use and what is infringement in a particular case will not always be clear or easily defined. There is no specific number of words, lines, or notes that may safely be taken without permission. Acknowledging the source of the copyrighted material does not substitute for obtaining permission.

The 1961 Report of the Register of Copyrights on the General Revision of the U.S. Copyright Law cites examples of activities that courts have regarded as fair use: “quotation of excerpts in a review or criticism for purposes of illustration or comment; quotation of short passages in a scholarly or technical work, for illustration or clarification of the author’s observations; use in a parody of some of the content of the work parodied; summary of an address or article, with brief quotations, in a news report; reproduction by a library of a portion of a work to replace part of a damaged copy; reproduction by a teacher or student of a small part of a work to illustrate a lesson; reproduction of a work in legislative or judicial proceedings or reports; incidental and fortuitous reproduction, in a newsreel or broadcast, of a work located in the scene of an event being reported.”
Copyright protects the particular way authors have expressed themselves. It does not extend to any ideas, systems, or factual information conveyed in a work.

The safest course is to get permission from the copyright owner before using copyrighted material. The Copyright Office cannot give this permission.
When it is impracticable to obtain permission, you should consider avoiding the use of copyrighted material unless you are confident that the doctrine of fair use would apply to the situation. The Copyright Office can neither determine whether a particular use may be considered fair nor advise on possible copyright violations. If there is any doubt, it is advisable to consult an attorney.”