Case studies from morning report: librarians' role in helping residents find evidence-based clinical information

In primary care specialties, Morning Report is a traditional vehicle for expanding medical residents' training in diagnosis and treatment. At one academic medical center, residents and faculty in the Department of Family and Community Medicine use case-based teaching, centered around planning and reviewing patient management, to review intriguing cases from patient encounters in the department's hospital service. Seeking to improve the level of evidence-based information exchanged at Morning Report, department leaders invited reference librarians from the health sciences library to attend weekly Morning Report. The librarians saw this as an opportunity not only to improve residents' information-seeking skills, but also to improve librarians' teaching skills and understanding of the needs of users in clinical settings. This paper describes the evolution of librarians' involvement in Morning Report, examples of the kinds of contributions librarians have made in this setting, and changes made in Morning Report sessions to facilitate this activity.     

Information Retrieval with a Hybrid Automatic Query Expansion and Data Fusion Procedure

We propose a hybrid information retrieval (IR) procedure that builds on two well-known IR approaches: data fusion and query expansion via relevance feedback. This IR procedure is designed to exploit the strengths of data fusion and relevance feedback and to avoid some weaknesses of these approaches. We show that our IR procedure is built on postulates that can be justified analytically and empirically. Additionally, we offer an empirical investigation of the procedure, showing that it is superior to relevance feedback on some dimensions and comparable on other dimensions. The empirical investigation also verifies the conditions under which the use of our IR procedure could be beneficial.     

A distributional analysis of the effect of physical exercise on a choice reaction time task

The aim of this study was to examine the facilitating effects of physical exercise on the reaction process. Eleven participants with specific expertise in decision-making sports performed a choice reaction time task during moderate sub-maximal exercise (90% of their ventilatory threshold power). Participants were tested at rest and while cycling. During exercise, the participants were faster, without being more variable. We suggest that the effect of exercise on cognitive performance was due to a major generalized improvement of the whole distribution of response time and, although the benefit effect was small, it was consistent throughout the entire range of reaction times.     

The Central Dogma of molecular biology

The Central Dogma of molecular biology was enunciated more than 50 years ago by Francis Crick to define the relations between the main informational macromolecules: DNA, RNA and proteins. Since that time, many disciplines have mimicked biology, and introduced their own ‘Central Dogma’. This article is an attempt to review the status of the Central Dogma in the context of the new discoveries that were made during the past fifty years.     

Delayed diagnosis and treatment of extreme hypertriglyceridemia due to rejection of a lipemic sample

IntroductionMost laboratories routinely determine haemolysis, icterus and lipemia indices to identify lipemic samples and reject potentially affected results. Hypertriglyceridemia is the most common cause of lipemia and severe hypertriglyceridemia (≥ 11.3 mmol/L) is a major risk factor of acute pancreatitis.Laboratory analysisA 56-year-old woman attended the outpatient clinic for a follow-up visit 1 month after a kidney transplantation. Her immunosuppressive therapy consisted of corticosteroids, cyclosporine, and mycophenolic acid. The routine clinical chemistry sample was rejected due to extreme lipemia. The comment “extreme lipemic sample” was added on the report, but the requesting physician could not be reached. The Cobas 8000 gave a technical error (absorption > 3.3) for the HIL-indices (L-index: 38.6 mmol/L) which persisted after high-speed centrifugation. The patient was given a new appointment 2 days later. The new sample was also grossly lipemic and gave the same technical error (L-index: 35.9 mmol/L).What happenedThe second sample was manually diluted 20-fold after centrifugation to obtain a result for triglycerides within the measuring range (0.10–50.0 mmol/L). Triglycerides were 169.1 mmol/L, corresponding to very severe hypertriglyceridemia. This result was communicated to the nephrologist and the patient immediately recalled to the hospital. She received therapeutic plasma exchange the next day and did not develop acute pancreatitis.Main lessonThis case illustrates the delicate balance between avoiding the release of unreliable results due to lipemia and the risk of delayed diagnosis when results are rejected. Providing an estimate of the degree of hypertriglyceridemia might be preferable to rejecting the result.     

Effective learning activities in observation taks when learning to write and read argumentative texts

On repeated occasions, observational learning has proved itself to be an effective instruction method. Experimental studies have shown to be effective for complex tasks such as reading and writing for both teachers and students as models. The problem when interpreting the results of such research is that, in observation tasks, several mental activities play a simultaneous role. In this study we therefore set out to identify the effective elements of observation tasks. We focused on two elements of the observation tasks, both aimed at stimulating monitoring activities: evaluation of the model’s performance and elaboration on this evaluation. We have also distinguished between elaboration on the observed products (the models’ written answers), and elaboration on the observed processes (the models’ verbalisations of their mental activities). The data were subjected to a LISREL analysis. First of all, it was observed that subjects who performed “evaluation” and “productelaboration” better, and “process-elaboration” more often in one lesson, also performed these activities better or more often in the subsequent lesson. Next, we observed an effect of aptitude on the learning activities: pre skill scores influence “evaluation” and “product-elaboration”. The most important finding is that “evaluation” and “product-elaboration” contribute positively to argumentative writing skills. It is discussed that these findings confirm the importance of the monitoring, evaluative and reflective activities when learning complex tasks as writing.     

Challenging the feminisation of the workforce: rethinking the mind–body dualism in Early Childhood Education and Care

Despite the political and academic debate on the demands for more male workers in Early Childhood Education and Care (ECEC), no European country has reached the benchmark set for 2006 to have 20% male early childhood workers. This has predominantly been countered by challenging the idea that care for the youngest implies an activity ‘that women naturally do’ and by consequently arguing for a higher status and better working conditions for caring jobs. In this article, we analyse the recent ‘schoolification’ of ECEC, and in so doing, we argue that the traditional explanations of the feminisation of the early years workforce do not suffice. In addition, we dwell upon contemporary feminism to challenge the mind–body dualism in discourses and practices of care and explore the concepts of embodied subjectivity and corporeality to further explore pathways to a more equally gendered workforce in early childhood provision.