How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review.

BACKGROUND: Teaching of evidence-based medicine (EBM) has become widespread in medical education. Teaching the teachers (TTT) courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM TTT courses.To summarise and appraise existing assessment methods for teaching the teachers courses in EBM by a systematic review. METHODS: We searched PubMed, BioMed, EmBase, Cochrane and Eric databases without language restrictions and included articles that assessed its participants. Study selection and data extraction were conducted independently by two reviewers. RESULTS: Of 1230 potentially relevant studies, five papers met the selection criteria. There were no specific assessment tools for evaluating effectiveness of EBM TTT courses. Some of the material available might be useful in initiating the development of such an assessment tool. CONCLUSION: There is a need for the development of educationally sound assessment tools for teaching the teachers courses in EBM, without which it would be impossible to ascertain if such courses have the desired effect.

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Evidence of altered antioxidant systems and signs of elevated oxidative stress are reported in peripheral tissue and brain of schizophrenic patients, including low levels of glutathione (GSH), a major thiol antioxidant and redox buffer. Functional and genetic data indicate that an impaired regulation of GSH synthesis is a vulnerability factor for the disease. Impaired GSH synthesis from a genetic origin combined with environmental risk factors generating oxidative stress (e.g., malnutrition, exposure to toxins, maternai infection and diabetes, obstetrical complications, and psychological stress) could lead to redox dysregulation. This could subsequently perturb normal brain development and maturation with delayed functional consequences emerging in early adulthood. Depending on the nature and the time of occurrence of the environmental insults, the structural and functional delayed consequences could vary, giving rise to various endophenotypes. The use of animal models of GSH deficit represents a valuable approach to investigate how interactions between genetic and environmental factors lead to the emergence of pathologies found in the disease. Moreover, these models of GSH can be useful to investigate links between schizophrenia and comorbid somatic disorders, as dysregulation of the GSH system and elevated oxidative stress are also found in cardiovascular diseases and diabetes. This chapter reviews pharmacological and genetic rodent models of GSH synthesis dysregulation used to address some of the aforementioned issues. Up to date, these models revealed that GSH deficits lead to morphological, physiological, and behavioral alterations that are quite analogous to pathologies observed in patients. This includes hypofunction of NMDA receptors, alteration of dopamine neurotransmission, anomalies in parvalbumin-immunoreactive fast-spiking interneurons, and reduced myelination. In addition, a GSH deficit affects the brain in a region-specific manner, the anterior cingulate cortex and the ventral hippocampus being the most vulnerable regions investigated. Interestingly, a GSH deficit during a limited period of postnatal development is sufficient to have long-lasting consequences on the integrity of PV-IR interneurons in the anterior cingulate cortex and impairs cognitive functions in adulthood. Finally, these animal models of GSH deficit display behavioral impairments that could be related to schizophrenia. Altogether, current data strongly support a contributing role of a redox dysregulation on the development of pathologies associated with the illness and demonstrate the usefulness of these models to better understand the biological mechanisms leading to schizophrenia.

Iowa Commission on the Status of African Americans Annual Report, Fiscal Year 2006

A Public Intellectual recently suggested that I read the book Life Out Of Context by the very productive writer Walter Mosley. In this book, Mosley began to summarize a speech that was given by Harry Belafonte. Belafonte made a comparison between a particular Olympic relay race and the Civil Rights Movement. In the race, an experienced runner stumbled a little while passing the baton, and the race was lost. For Belafonte, this momentary slip was a metaphor for the failure of the Civil Rights Movement to “pass the baton” to the younger generation as “it moved past its original phase and into the latter part of the century.” Regardless of your views of the strengths and weaknesses of the Civil Rights Movement, I think all of us would agree that the current issues facing Black Iowa today--e.g., the need for economic development, increased educational achievement and more political involvement in our communities--demand our immediate attention and action. This urgency requires that we cross generational, class, and territorial boundaries within the state to collaborate among ourselves and with others to deal constructively with these issues. We cannot afford to have another “momentary slip.” Serving as the Administrator for ICSAA allows me to serve Black Iowa in a significant way, and Kimberly Cheeks and I in this Division look forward to the work ahead over the next several months and years. Working closely with Walter Reed, Director of the Department of Human Rights, along with so many others across this state, we are keenly aware that we are provided with a great opportunity to positively impact the quality of life for African-Americans in Iowa.

Glyphosate behavior in a Rhodic Oxisol under no-till and conventional agricultural systems

The behavior of glyphosate in a Rhodic Oxisol, collected from fields under no-till and conventional management systems in Ponta Grossa, Parana state (Brazil) was investigated. Both agricultural systems had been in production for 23 years. Glyphosate mineralization, soil-bound forms, sorption and desorption kinetics, sorption/desorption batch experiments, and soil glyphosate phythoavailability (to Panicum maximum) were determined. The mineralization experiment was set up in a completely randomized design with a 2 x 2 factorial scheme (two management systems and two 14C radiolabelled positions in the glyphosate), with five replicates. 14CO2 evolution was measured in 7-day intervals during 63 days. The glyphosate sorption kinetics was investigated in a batch experiment, employing a glyphosate concentration of 0.84 mg L-1. The equilibration solution was 0.01 mol L-1 CaCl2 and the equilibration times were 0, 10, 30, 60, 120, 240, and 360 min. Sorption/desorption of glyphosate was also investigated using equilibrium batch experiments. Five different concentrations of the herbicide were used for sorption (0.42, 0.84, 1.68, 3.36, and 6.72 mg L-1) and one concentration for desorption. Glyphosate phytoavailability was analyzed in a 2 x 5 factorial scheme with two management systems and five glyphosate concentrations added to soil (0, 4.2, 8.4, 42.0, and 210.0 µg g-1) in a completely randomized design. Phytotoxicity symptoms in P. maximum were evaluated for different periods. The soil under both management systems showed high glyphosate sorption, which impeded its desorption and impaired the mineralization in the soil solution. Practically the total amount of the applied glyphosate was quickly sorbed (over 90 % sorbed within 10 min). Glyphosate bound to residues did not have adverse effects on P. maximum growth. The mineralization of glyphosate was faster under no-till and aminomethylphosphonic acid was the main glyphosate metabolite.

How can we teach EBM in clinical practice? : an analysis of barriers to implementation of on-the-job EBM teaching and learning.

Introduction: Evidence-based medicine (EBM) improves the quality of health care. Courses on how to teach EBM in practice are available, but knowledge does not automatically imply its application in teaching. We aimed to identify and compare barriers and facilitators for teaching EBM in clinical practice in various European countries. Methods: A questionnaire was constructed listing potential barriers and facilitators for EBM teaching in clinical practice. Answers were reported on a 7-point Likert scale ranging from not at all being a barrier to being an insurmountable barrier. Results: The questionnaire was completed by 120 clinical EBM teachers from 11 countries. Lack of time was the strongest barrier for teaching EBM in practice (median 5). Moderate barriers were the lack of requirements for EBM skills and a pyramid hierarchy in health care management structure (median 4). In Germany, Hungary and Poland, reading and understanding articles in English was a higher barrier than in the other countries. Conclusion: Incorporation of teaching EBM in practice faces several barriers to implementation. Teaching EBM in clinical settings is most successful where EBM principles are culturally embedded and form part and parcel of everyday clinical decisions and medical practice.

Rutas cinematográficas hacia la imagen platónica de la caverna

El objetivo de este artículo es demostrar la posibilidad de llegar también a la imagen platónica de l caverna desde el cine. En este sentido se puede hablar de referencias explícitas como en el caso de El conformista de B. Bertolucci o Shadowlands de R. Attenborough, si se tienen presentes las Crónicas de Narnia de C. S. Lewis- o The Picture of Dorian Gray -si se tiene presenta la novela de Oscar Wilde-, pero, en otras ocasiones, pese a que la influencia platónica no pueda ser demostrada, por ejemplo en The Truman Show, A Room with a View o Brideshead Revisited, podemos servirnos perfectamente de estas películas para guiar al público contemporáneo hacia aquella imagen platónica, ya que el mismo platón demuestra que se trata de una imagen aplicable y, en primer lugar, a su filosofía idealista.

Cinema Roads to the Platonic Image of the Cave

The aim of this article is to prove the real possibility of travelling intellectually to the Platonic image of the cave from different films. In this sense, one can speak of explicit references as in The Conformist by B. Bertolucci or in Shadowlands by R. Attenborough -if one bears in mind the Chronicles of Narnia by C. S. Lewis- or The Picture of Dorian Gray ¿if one bears in mind the well-known O. Wilde¿s novel-, but, on other occasions, although the Platonic influence cannot be proved, for instance in The Truman Show, A Room with a View or Brideshead Revisited, one can perfectly think of these films in order to guide the contemporary audiences to that Platonic image, since Plato himself affirms that it deals with an image which can be easily applied and, in first place, to his idealistic philosophy.