Monday, September 24, 2012

A Few Basic Tricks for Excel

Excel is an excellent program for more than analyzing numbers. It can be used to track information in many different ways; for example, you can use it for attendance purposes, as a grading system, to track steps in a process, etc. But many of us have no more than a rudimentary knowledge of how it works and what it can do. Here are some basic maneuvers the program uses.

Freezing Panes or Top Row or Columns: you know that there are times when you have a long list of information in a spreadsheet, and as you begin to move to the lower parts of that sheet, you lose the column headings identifying what kind of information is in each column. You can “freeze” the top row so that it is always present. This is easy to do. Go the “View” tab in the top ribbon bar. When you click that tab, you will see a menu selection titled “Freeze Panes.” Click that and it opens a drop-down menu with 3 choices: Freeze Pane, Freeze Top Row, or Freeze First Column. If you click on “Freeze Top Row.” That top row will now have a dark line under it and will remain present as you scroll up and down the information in your spreadsheet. Similarly, if you click on “Freeze First Column,” that will remain present as you move back and forth across many columns of data.

Wrapping Text: Sometimes you need to enter a lot of verbal information into a cell on Excel, but when you do the text either cannot be seen in the text box (because the box is likely too small to display it and you have not formatted it to wrap the text) or it extends well beyond and outside the text box. This is easily fixed. Once you enter the text, click on the text box into which that text was entered. You can now “wrap the text,” that is present it so that you can easily read it, by either going to the “Home” tab and clicking the box entitled “Wrap Text,” or by right clicking the box, select “Format Cells” from the drop-down menu that appears, click the “Alignment” tab, and then clicking “Wrap Text.” Either way will do the trick.

A Border for a Cell: Say that you have a spreadsheet in which you have entered a significant amount of information and every now and again there is one cell in particular that catches your eye, because it has some finding that you feel is interesting or worth returning to. But you have information in hundreds of cells. How can easily identify the ones that you wish to return to? There are several ways to do this. One is quite simple: highlight the cell in color. To do that, be on the “Home” tab and in that tab look for the “font” panel. In it you will see a small graphic of a pallet, which is next the “A” insignia used for changing the color of text. If you click on that button, you will be able to choose a color in which to highlight that cell. If later you need to remove the color, simply return to the button and choose the “no fill” command. You could also put a border around the cell> The Border control button looks like a small box and is situated in the “font” panel next to the fill command. When you click it, you will get a drop-down menu offering you many choices of how to place a border around that cell. You can play with the options to see how they display. Other options are to change text color for the cell or to alter the font in some way (i.e. boldface, italic, etc.).

These are a few basic Excel tricks which can help you organize information. Microsoft offers many additional tricks on its website, which can be a useful reference for you.

Monday, September 17, 2012

New from Biomed Central

Bradley R, Sherman KJ, Catz S, Calabrese C, Oberg EB, Jordan L, Grothous L, Cherkin D. Adjunctive naturopathic care for type 2 diabetes: patient-reported and clinical outcomes after one year. BMC Complementary and Alternative Medicine 2012, 12:44 doi:10.1186/1472-6882-12-44


Background: Several small, uncontrolled studies have found improvements in self-care behaviors and reductions in clinical risk in persons with type 2 diabetes who received care from licensed naturopathic physicians. To extend these findings and determine the feasibility and promise of a randomized clinical trial, we conducted a prospective study to measure the effects of adjunctive naturopathic care (ANC) in primary care patients with inadequately controlled type 2 diabetes.

Methods: Forty patients with type 2 diabetes were invited from a large integrated health care system to receive up to eight ANC visits for up to one year. Participants were required to have hemoglobin A1c (HbA1c) values between 7.5-9.5 % and at least one additional cardiovascular risk factor (i.e., hypertension, hyperlipidemia or overweight). Standardized instruments were administered by telephone to collect outcome data on self-care, self-efficacy, diabetes problem areas, perceived stress, motivation, and mood. Changes from baseline scores were calculated at 6- and 12-months after entry into the study. Six and 12-month changes in clinical risk factors (i.e., HbA1c, lipid and blood pressure) were calculated for the ANC cohort, and compared to changes in a cohort of 329 eligible, non-participating patients constructed using electronic medical records data. Between-cohort comparisons were adjusted for age, gender, baseline HbA1c, and diabetes medications. Six months was pre-specified as the primary endpoint for outcome assessment.

Results: Participants made 3.9 ANC visits on average during the year, 78 % of which occurred within six months of entry into the study. At 6-months, significant improvements were found in most patient-reported measures, including glucose testing (P = 0.001), diet (P = 0.001), physical activity (P = 0.02), mood (P = 0.001), self-efficacy (P = 0.0001) and motivation to change lifestyle (P = 0.003). Improvements in glucose testing, mood, self-efficacy and motivation to change lifestyle persisted at 12-months (all P < 0.005). For clinical outcomes, mean HbA1c decreased by −0.90 % (P = 0.02) in the ANC cohort at 6-months, a −0.51 % mean difference compared to usual care (P = 0.07). Reductions at 12-months were not statistically significant (−0.34 % in the ANC cohort, P = 0.14; -0.37 % difference compared to the usual care cohort, P = 0.12).

Conclusions: Improvements were noted in self-monitoring of glucose, diet, self-efficacy, motivation and mood following initiation of ANC for patients with inadequately controlled type 2 diabetes. Study participants also experienced reductions in blood glucose that exceeded those for similar patients who did not receive ANC. Randomized clinical trials will be necessary to determine if ANC was responsible for these benefits.

Nkenke E, Vairaktaris E, Bauersachs A, Eitner S, Budach A, Knipfer C, Stelzle F. Acceptance of technology-enhanced learning for a theoretical radiological science course: a randomized controlled trial. BMC Medical Education 2012, 12:18 doi:10.1186/1472-6920-12-18


Background: Technology-enhanced learning (TEL) gives a view to improved education. However, there is a need to clarify how TEL can be used effectively. The study compared students' attitudes and opinions towards a traditional face-to-face course on theoretical radiological science and a TEL course where students could combine face-to-face lectures and e-learning modules at their best convenience.

Methods: 42 third-year dental students were randomly assigned to the traditional face-to-face group and the TEL group. Both groups completed questionnaires before the beginning and after completion of the course on attitudes and opinions towards a traditional face-to-face lectures and technology-enhanced learning. After completion of the course both groups also filled in the validated German-language TRIL (Trierer Inventar zur Lehrevaluation) questionnaire for the evaluation of courses given at universities.

Results: Both groups had a positive attitude towards e-learning that did not change over time. The TEL group attended significantly less face-to-face lectures than the traditional group. However, both groups stated that face-to-face lectures were the basis for education in a theoretical radiological science course.The members of the TEL group rated e-mail reminders significantly more important when they filled in the questionnaire on attitudes and opinions towards a traditional face-to-face lectures and technology-enhanced learning for the second time after completion of the course.The members of the technology-enhanced learning group were significantly less confident in passing the exam compared to the members of the traditional group. However, examination results did not differ significantly for traditional and the TEL group.

Conclusions: It seems that technology-enhanced learning in a theoretical radiological science course has the potential to reduce the need for face-to-face lectures. At the same time examination results are not impaired. However, technology-enhanced learning cannot completely replace traditional face-to-face lectures, because students indicate that they consider traditional teaching as the basis of their education.

Kiguba R, Kutyaabami P, Kiwuwa S, Katabira E, Sewankambo NK. Assessing the quality of informed consent in a resource-limited setting: A cross-sectional study. BMC Medical Ethics 2012, 13:21 doi:10.1186/1472-6939-13-21


Background: The process of obtaining informed consent continues to be a contentious issue in clinical and public health research carried out in resource-limited settings. We sought to evaluate this process among human research participants in randomly selected active research studies approved by the School of Medicine Research and Ethics Committee at the College of Health Sciences, Makerere University.

Methods: Data were collected using semi-structured interviewer-administered questionnaires on clinic days after initial or repeat informed consent procedures for the respective clinical studies had been administered to each study participant.

Results: Of the 600 participants interviewed, two thirds (64.2 %, 385/600) were female. Overall mean age of study participants was 37.6 (SD = 7.7) years. Amongst all participants, less than a tenth (5.9 %, 35/598) reported that they were not given enough information before making a decision to participate. A similar proportion (5.7 %, 34/597) reported that they had not signed a consent form prior to making a decision to participate in the study. A third (33.7 %, 201/596) of the participants were not aware that they could, at any time, voluntarily withdraw participation from these studies. Participants in clinical trials were 50 % less likely than those in observational studies [clinical trial vs. observational; (odds ratio, OR = 0.5; 95 % CI: 0.35-0.78)] to perceive that refusal to participate in the parent research project would affect their regular medical care.

Conclusions: Most of the participants signed informed consent forms and a vast majority felt that they received enough information before deciding to participate. On the contrary, several were not aware that they could voluntarily withdraw their participation. Participants in observational studies were more likely than those in clinical trials to perceive that refusal to participate in the parent study would affect their regular medical care.




Monday, September 10, 2012


For the past few weeks I have been acting as the interim director for the Palmer College library system. I am not, like everyone else who works in the library, trained as a librarian, and these past weeks have been filled with significant educational adventures. I have a much higher respect for the work our librarians do, and I already held them in high respect before.  There are intricacies in the library that users may never consider. But I will ask you to.

So, consider. There you are, at your desk, looking for some piece of information that you think you can find with a good literature search. You log onto the Library website, click on the link to information resources, and then click on PubMed. You type in a few key words (words that if you are unsure what to use, our resource librarians can certainly help you find), and voila!, there is a paper you can use. You click on the link to the paper, and PubMed then gives you the abstract. You decide you want the full paper. And so you look at the upper right of your screen, seeing a button there that provides the direct link to the full paper. You click it, and a pdf opens, which you then save for later use.

Pretty easy! Well, for you it is pretty easy. That link did not occur by magic, though. It had to be put there, and a librarian put it there for you to use. An entire series of steps took place, all invisible and behind the scenes, that made it possible for you to both find and save that paper. It started with Collection Management, for example, working on the site licenses and subscriptions that allow us to have those links. Palmer spends a great deal of money to obtain access to journals. Links have to be made so that you can obtain papers internally in the institution, and externally from your home or mobile device. Proxy servers are used. Everything is logged in. The website has to be managed, so that you can use it to find links. That is done via Access Services.

When you don’t even know what you need to find, you seek help from an Information Librarian, who in the case of Palmer College also has expertise in evidence-based medicine. If the piece of information you need is archival or older, you might also avail yourself of Special Collections, where for example we hold papers dating back to the early history of our profession.
The library of today is not the same brick and mortar operation we grew up with. Information technology has completely revolutionized libraries, and specialized computer systems allow us to locate information. You may not know what Sirsi-Dynix is, but it is the framework on which our library operates. We have a great library, and I hope you can take time to send a quick note of thanks to everyone working in it. They are usually behind the curtain, so to say, but all them make our life immeasurably easier.

Tuesday, September 4, 2012

A Cautionary Tale

A couple of weeks ago you might have seen me limping around the campus. While I have had back problems in the past, this was the result of a crash I experienced while riding my bicycle. I thought I would talk about it here with the goal of providing a guide to sharing space. It is not the usual kind of post for this blog, but it has been on my mind. 

While I was out riding on the Duck Creek pathway, which I do every day after work, I saw ahead of me a man walking his dog. The dog was on a long leash, and was actively running back and forth across the path. As I approached the man, he began to reel the dog back in on his retractable leash; as a result, I kept riding, but moved to the right side of the path. However, I think he failed to lock the leash and the dog unexpectedly ran across the path right into my ride path. In order to prevent hitting him, I turned by handlebars sharply to the left and threw on my brakes. This stopped the bike but threw it and me up and forward at 17mph, my riding speed. Since I was clipped into my pedals I could not stop the fall and I hit the ground very hard on my left side, my head hitting the ground hard as well. I was stunned and left lying on the ground.

A man walking behind me happened to be a male nurse who had the local ER wired into his cell phone. An ambulance was dispatched and assessed me at the site. After an hour with them I was released, fixed my bike and rode home. This was an accident, and accidents happen. That night I began to stiffen up and experience real pain; I count that night as among the worse I have ever had. I ended up bruised from my left knee to my left hip, and I had neck pain as well from hitting my head. Fortunately, I always wear a helmet. I am now recovered for the most part and up and riding comfortably.

But it got me to thinking. Can’t we all get along on the path? The path is a multi-user pathway. There are bicyclists, walkers, dog walkers, kids, and running teams. If all pay attention to the rules, accidents will occur less frequently. Mine happened because a dog was on a long leash. But here is my thinking.

Riders: You know the rules. Ride on the right of the path. Tell people and other riders when you pass them; if you do not, they are often shocked when you go by and that makes them unpredictable. Do not ride two or more abreast. Stop at stop signs and lights. 

Walkers: Stay right when you walk. Do not walk two or more abreast. You should not wear headphones, because you then cannot hear a rider telling you that he or she is passing. When riders come up behind you and let you know, move to the right. If you have children with you, tell them what to do. Small kids do not understand the conventions we use. Hold onto them. If you are walking a dog, use a short leash and control your pet. Too many dogs are running free on the path, and they are very unpredictable.

Runners- If you run with a club you need to pay attention to the rules. Often when I ride I come across a local running club. When I see them, I usually turn around. I do because they often run in a pack, may have 3 or 4 runners across the path blocking traffic in both directions, and wear headphones so that you cannot get them to move even when you tell them. I remember once being behind a runner who was running in the same direction I was riding, but was on the left side of the path, next to 3 runners on the right and who failed to move when I signaled her because she had headphones on. This puts riders at risk, especially those whose pedals are clipped in and cannot be released when the unexpected happens. 

If we know the rules (stay right, don’t run or walk or ride 2 abreast, control your dog, or your kids, and move right when told that you are being passed), we can ride in more safety. Let’s all be careful out there.