Monday, November 25, 2013

Holiday Week

This week is a short one, due to our Thanksgiving break. Please accept my best wishes for this holiday season, and I hope you have a chance to relax, spend time with family and eat hearty. I will have various and sundry kids and spouses/significant others in, as well as one grandchild. Rest may not be in the picture… J

Monday, November 18, 2013

New from Biomed Central

Lyness JE, Lurie SJ, Ward DS, Mooney CJ, Lambert DR. Engaging students and faculty:
implications of self-determination theory for teachers and leaders in academic medicine
BMC Medical Education 2013, 13:151 doi:10.1186/1472-6920-13-151

Background: Much of the work of teachers and leaders at academic health centers involves engaging learners and faculty members in shared goals. Strategies to do so, however, are seldom informed by empirically-supported theories of human motivation.
Discussion: This article summarizes a substantial body of motivational research that yields insights and approaches of importance to academic faculty leaders. After identification of key limitations of traditional rewards-based (i.e., incentives, or 'carrots and sticks’) approaches, key findings are summarized from the science of self-determination theory. These findings demonstrate the importance of fostering autonomous motivation by supporting the fundamental human needs for autonomy, competence, and relatedness. In turn, these considerations lead to specific recommendations about approaches to engaging autonomous motivation, using examples in academic health centers.
Summary: Since supporting autonomous motivation maximizes both functioning and well-being (i.e., people are both happier and more productive), the approaches recommended will help academic health centers recruit, retain, and foster the success of learners and faculty members. Such goals are particularly important to address the multiple challenges confronting these institutions.

Sim TF, Sherriff J, Hattingh L, Parsons R, Tee LBG. The use of herbal medicines during breastfeeding: a population-based survey in Western Australia
BMC Complementary and Alternative Medicine 2013, 13:317 doi:10.1186/1472-6882-13-317

Background: Main concerns for lactating women about medications include the safety of their breastfed infants and the potential effects of medication on quantity and quality of breast milk. While medicine treatments include conventional and complementary medicines, most studies to date have focused on evaluating the safety aspect of conventional medicines. Despite increasing popularity of herbal medicines, there are currently limited data available on the pattern of use and safety of these medicines during breastfeeding. This study aimed to identify the pattern of use of herbal medicines during breastfeeding in Perth, Western Australia, and to identify aspects which require further clinical research.
Methods: This study was conducted using a self-administered questionnaire validated through two pilot studies. Participants were 18 years or older, breastfeeding or had breastfed in the past 12 months. Participants were recruited from various community and health centres, and through advertising in newspapers. Simple descriptive statistics were used to summarise the demographic profile and attitudes of respondents, using the SPSS statistical software.
Results: A total of 304 questionnaires from eligible participants were returned (27.2% response rate) and analysed. Amongst the respondents, 59.9% took at least one herb for medicinal purposes during breastfeeding, whilst 24.3% reported the use of at least one herb to increase breast milk supply. Most commonly used herbs were fenugreek (18.4%), ginger (11.8%), dong quai (7.9%), chamomile (7.2%), garlic (6.6%) and blessed thistle (5.9%). The majority of participants (70.1%) believed that there was a lack of information resources, whilst 43.4% perceived herbal medicines to be safer than conventional medicines. Only 28.6% of users notified their doctor of their decision to use herbal medicine(s) during breastfeeding; 71.6% had previously refused or avoided conventional medicine treatments due to concerns regarding safety of their breastfed infants.
Conclusions: The use of herbal medicines is common amongst breastfeeding women, while information supporting their safety and efficacy is lacking. This study has demonstrated the need for further research into commonly used herbal medicines. Evidence-based information should be available to breastfeeding women who wish to consider use of all medicines, including complementary medicines, to avoid unnecessary cessation of breastfeeding or compromising of pharmacotherapy.
Triano JJ, Budgell B, Bagnulo A, Roffey B, Bergmann T, Cooperstein R, Gleberzon B, Good C, Perron J, Tepe R. Review of methods used by chiropractors to determine the site for applying manipulation

Chiropractic & Manual Therapies 2013, 21:36 doi:10.1186/2045-709X-21-36

Background: With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation.
Methods: Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation.
Results: A total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement.
Conclusions: A considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care– methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine–such as skin conductance or thermography–tend not to be supported by the available evidence.


Monday, November 11, 2013

New Content on Atomic Learning

I thought I would let you know of new training programs recently added to our Atomic Learning website. Please feel free to play around.

Blackboard 9.1 Service Pack 8 – Instructor Training

Blackboard 9.1 Service Pack 9 – Instructor Training

Blackboard 9.1 Service Pack 10 – Instructor Training

Blackboard 9.1 Service Pack 11 – Instructor Training

Blackboard 9.1 Service Pack 12 – Instructor Training

Blackboard 9.1 Service Pack 13 – Instructor Training

Rapid Web Development Using Bootstrap


Monday, November 4, 2013

American Society for Bioethics and Humanities 2013 Conference

At the end of the break week, I was able to attend the annual meeting of the American Society for Bioethics and Humanities. This is a conference I always eagerly look forward to going to. Just to give you a flavor of the scope of material the conference covers, here are the sessions I attended:

  • Delivering Research Ethics Education: Strategies for Training Community Research Partner
  • The Moral Courage of Paracelsus: Medical, Religious, and Social Refor
  • Unfit for the Future: The Need for Moral Bioenhancement
  • A Tribute to Edmund Pellegrino and His Work 
  • Student Paper Award Selections
  •      Bioethics, Human Rights, and Maternal Mortality
  •      More than Informed Consent: Why Research Ethics Needs Religion
  •      Toward a More Patient-Centered Advance Directive for Surgical Patients
  • A Conversation with Amy Gutmann, Chair, Presidential Commission for the Study of Bioethical Issues
  • Student-Led Research Review Panel: An Alternative to IRB Review of Medical Student Projects
  • IRBs in Existential Crisis: Proposals for Evaluating the Efficacy of IRB Oversigh
  • How to Get Fired in Bioethics: A User’s Guide to Succes
  • Difference, Representation, and Inclusion in Bioethics and Humanitie
  • Thinking Through the Ethics of Pregnancy Reduction
  • The Best-Laid Schemes: Do Bioethicists Corrupt Public Policy
  • Climate Change: A Neglected Topic in Bioethic
  • Ethical Issues Surrounding the Use of Social Media Platforms in Disease Surveillance and Epidemiological Researc
  • Gun Control, Ethics, and Public Health
  • Disability Gai
  • Has Bioethics Undermined Medical Ethics
  • Legal Update 2013: Top 10 Legal Developments in Bioethic
  • A Seat at the Table or a Voice in the Void: A Pilot Study of the Factors That Shape Community Members’ Roles on Research Review Board
  • Pay-to-Participate Research: A Worthwhile Innovation
  • Subversive Subjects: Rule-Breaking and Deception in Clinical Trial
  • From Unification, Registration: The Genesis of Research Subject Registrie
  • Randomized Clinical Trials in Maternal-Fetal Surgery: Who Is the Patient and Why It Matter
  • Exploiting Altruism in Human Subjects Research