SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
This article is intended to serve as a guide to sources of information on avians. College and university libraries, abstract and index services, bookstores, journals, and veterinary literature are listed. Avian conferences, computer search services, natural history libraries and museums, and places to obtain video and audio tapes and slides are included.
OBJECTIVE: The main objective of this study was to systematically review the existing evidence for the effectiveness of farm injury prevention interventions. SEARCH STRATEGY: We used a systematic approach to search the following electronic databases: MEDLINE, EMBASE, ERIC, PsycInfo, Sociofile, NTIS, Agricola, Expanded Academic Index, Dissertation Abstracts, and Occupational Safety and Health (NIOSHTIC). Proceedings and technical papers of the National Institute for Farm Safety were reviewed. We also checked the references of potentially eligible studies and consulted with experts in the field to identify other relevant information sources. SELECTION CRITERIA: Papers had to involve a farm safety intervention to be included in the review. To best characterize the current state of farm safety research, all study designs were accepted, including those without comparison groups and those with absent or inadequate evaluation methods. RESULTS: We identified 25 studies for the review. Eleven of the studies involved farm safety education programs, five consisted of multifaceted interventions that included environmental revisions, a farm visit, or both; nine papers described farm safety interventions but did not report results from an evaluation. Farm safety education interventions included safety fairs, day camps; certification programs; workshops; and courses for farm families, youth, and agricultural workers. Multifaceted interventions were targeted to farm operators and generally involved farm safety audits, followed by environmental or equipment changes and/or safety education. Program evaluations assessed changes in safety attitudes, knowledge, and/or behaviors and generally involved pre- and post-test methodology. Only three studies examined changes in the incidence of farm injuries. Of the studies evaluated, most reported positive changes following the interventions. However, limitations in the design of evaluations make the results of many of the studies difficult to interpret. CONCLUSIONS: There is a need for more rigorous evaluations of farm safety intervention programs. Suggested study design improvements include randomization of study subjects when appropriate, use of control groups and the objective measurement of outcomes such as behavior change and injury incidence.
To determine the usefulness of echocardiographic indexes of left ventricular (LV) function as possible predictors of cardiac rejection, 12 transplant recipients (ages 3 to 17 years) underwent a total of 52 serial echocardiographic examinations and cardiac biopsies. The results were compared to those of 12 normal children (ages 2 to 17 years). Biopsies were graded as no rejection (n = 23), mild rejection (cellular infiltrate, n = 13), and moderate rejection (myocyte necrosis, n = 16). LV dimensions, percent shortening fraction, indexed LV mass, and ejection fraction were measured from M-mode and two-dimensional echocardiography. From the mitral valve Doppler tracing, the following measurements were made: isovolumic relaxation time, peak E and peak A velocities, and the fraction of filling under the E and A waves as well as in the first third of diastole. Compared with normal subjects, transplant recipients with no rejection had higher heart rates (95 +/- 15 vs 80 +/- 17 beats/min), longer isovolumic relaxation time (68.8 +/- 11.2 vs 51.5 +/- 13.6 msec), decreased first third area fraction (0.48 +/- 0.10 vs 0.57 +/- 0.10), and similar shortening fraction, LV mass, and peak E and A velocities (p less than 0.03). Compared with transplant recipients with no rejection, patients in whom mild rejection developed also had decreased shortening fraction (31% +/- 10% vs 37% +/- 8%) and decreased peak E velocity (0.68 +/- 0.19 vs 0.88 +/- 0.15 m/s) (p less than 0.03). From mild to moderate rejection, no further changes were noted in any echocardiographic indexes measured.(ABSTRACT TRUNCATED AT 250 WORDS)
The objective of this study is to compare the results of randomized trials and observational studies of interventions to prevent adolescent pregnancy. We identified published and unpublished reports through computerized searches of CATLINE, CINAHL, CONFERENCE PAPERS INDEX, DISSERTATION ABSTRACTS ONLINE, EMBASE, ERIC, MEDLINE, NTIS, POPLINE, PsycINFO, and SOCIOLOGICAL ABSTRACTS; manual searches of eight relevant journals; reference lists from primary articles; and contact with content experts. We included randomized trials and observational studies that evaluated the impact of primary prevention interventions including sex education classes, school-based clinics, free-standing clinics, physician/nurse practitioner practice-based service, improved access, and community-based programs on four outcomes: sexual intercourse, birth control use, responsible sexual behavior, or pregnancy in adolescents. One investigator abstracted the data and a second conducted a detailed review of the abstraction. We identified 13 randomized trials and 17 observational studies. We generated estimates of the impact of the interventions separately for males and females for all four outcomes for both observational studies and randomized trials. For six of the eight outcomes the summary odds ratios for the observational studies showed a significant intervention benefit (P<0.05) while the randomized trials did not show a benefit for any outcome in either females or males. The difference between the results of the observational studies and randomized trials was statistically significant in two of the eight outcomes (P<0.05 for initiation of intercourse and pregnancy in females). Observational studies yield systematically greater estimates of treatment effects than randomized trials of adolescent pregnancy prevention interventions. Public policy or individual patient treatment decisions should be based on observational studies only when randomized trials are unavailable and only with careful consideration of possible biases.
INTRODUCTION: Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a possible alternative to electroconvulsive therapy for the treatment of selected patients with depression, bipolar affective disorder and schizophrenia. The aim of this study was to evaluate the evidence for the effectiveness of rTMS in mood disorders and schizophrenia. METHODS: Studies were identified using MEDLINE (1966 to January 2000), EMBASE/Excerpta Medica (1980 to January 2000), Biological Abstracts and Index to Scientific and Technical Proceedings. A number of biomedical and TMS related websites were also searched. We estimated the number needed to treat to show beneficial effect of rTMS when compared with the placebo controlled group. RESULTS: Seven controlled trials of rTMS depression were identified. Five of these were suitable for meta-analysis and show a beneficial effect of rTMS compared to placebo, with a number needed to treat of 2-3 with a 95 % confidence interval 1.6 to 4.0, total; 81 patients. A single trial of rTMS has also been performed in mania, which shows a beneficial effect of right hemisphere stimulation when compared with left hemisphere stimulation. A controlled trial in schizophrenia failed to show any benefit of rTMS. DISCUSSION: rTMS has demonstrable beneficial effects in depression. The extent and the duration of the anti-depressant effect of rTMS has yet to be defined. There now needs to be randomized controlled trials to compare rTMS directly with standardized electroconvulsive therapy in order to take this subject forward. With regard to the treatment of other mood disorders and schizophrenia, we are at an early stage in the assessment of further studies that are needed to examine any potential role for rTMS.
BACKGROUND: Advances in medical technology and nursing care have enabled children who rely on long-term medical and technical support to reunite with their families and community. The impact of discharging these children into the community involves a number of unprecedented social implications that warrant policy consideration. To begin with, an effort must be made to understand the phenomenon of caring for technology-dependent children living at home. AIM: The aim of this paper is to provide a comprehensive literature review on caring for technology-dependent children living at home. METHODS: The review was conducted via keyword searches using various electronic databases. These included CINAHL, MEDLINE, Social Science Index, Sociological Abstracts, Australian Family and Society Abstracts, and the Australian Bureau of Statistics. The articles and books found were examined for commonality and difference, significant themes were extracted, and the strength of the research methods and subsequent evidence were critiqued. FINDINGS: In this paper, themes relating to home care for technology-dependent children and their families are elucidated and summarized. These are: chronic illness and children; the impact of paediatric home care on children; the uniqueness of technology-dependent children and their families; and parents' experience of paediatric home care. DISCUSSION: Contentious issues, relevant to the social life of these children and their families, are raised and are discussed with the intention of extending awareness and provoking further debate among key stakeholders. These issues include: the changed meaning of home; family dynamics; social isolation; saving costs for whom?; shifts in responsibility; and parent-professional relationships. CONCLUSION: More research is needed in the arena of paediatric home care, to facilitate relevant policy formation and implementation.
Gynaecological examinations were done for the first time in 32 girls, between age 13 and age 18 damaged by thalidomide. 11 of the girls had primary amenorrhoea at the time of examination. 9 of these cases showed genital malformations. 7 cases showed aplasia of the uterus. A rudimentary uterus and a hypo-plastic uterus were found in one patient each. In 8 girls these changes were combined with abnormalities of the vagina, 3 cases had vaginal aplasia. 4 cases had a blind vaginal sac. 1 case had a urogenital sinus. Two patients had primary amenorrhoea without genital malformations. In the girls who had started menstrual periods none of the 21 cases showed genital malformations. Supplementary endocrinological investigations were done to answer the question whether functional disturbances were caused by thalidomide in addition to organic changes. The development of puberty can be diagnosed from secondary sexual markers. Our patients had almost all advanced puberty with more mammary development than pubic development. The menarche between age 11 and age 16 showed no deviation from the normal in our patients. 11 girls had regular cycles. The hormonal vaginal cytology in 28 patients showed no sign of deficient estrogen. Neuro-endocrine maturation is responsible for the development of puberty. The basal secretions of FSH and LH increase. The dynamic functional test with LHRH shows the LH reserve of the pituitary which rises in a typical pattern. 14 patients had a LHRH test and nine of these showed a mature LH reserve corresponding to the index R2.(ABSTRACT TRUNCATED AT 250 WORDS)
The longitudinal case histories of 32 female-assigned male hermaphrodites aged 18 or older were indexed and abstracted for evidence of variables related to gender transposition, i.e., bisexualism, lesbianism, or sex reassignment to live as male. The prevalence of transposition was biased because of the referral of cases selected for reassignment. Childhood stigmatization, either subtle or blatant, because of the birth defect of the sex organs correlated with gender transposition (p less than .001) and was related to the age of feminizing surgery (p less than .05), which often coincided with the age of gonadectomy. Variables not significantly correlated with gender transposition were: neonatal ambivalence regarding the sex of announcement; feminizing or masculinizing puberty; presence or absence of mullerian organs; and gross family pathology. Physicians encountered no moral problem with sex reassignment as the chromosomal and gonadal sex were male.
The longitudinal case histories of 24 male-assigned male hermaphrodites aged 18 or older were indexed and abstracted for the presence or absence of variables related to gender transposition, namely, bisexualism, homosexuality, or sex reassignment to live as a female. The sample was biased in favor of cases (N = 20) not showing signs of gender transposition. In these cases, there was no gender transposition even if the following variables were in evidence; neonatal ambivalence in announcing the sex; cosmetic inadequacy of masculine genital appearance; sitting posture for urination; and feminizing (N = 9) instead of virilizing (N = 11) puberty. Despite the small size of the minority subsample (N = 4), it showed a trend toward an association between gender transposition and sitting to urinate, and being stigmatized in childhood. This trend is consistent with the association between stigmatization and gender transposition found in a counterpart study of male hermaphrodites announced and reared as girls. Freedom from gender transposition did not prevent suicidal depression, drug or alcohol addiction, marital failure, or death from testicular cancer.
The need for a central source of information regarding the availability, suitability, and quality of educational materials has led to the development of AVLINE. AVLINE is a computer information service available through the MEDLARS system of the National Library of Medicine. The Association of American Medical Colleges is gathering information from faculty members concerning useful materials and is bringing together content specialists, instructional designers, and technical specialists to review these materials. Information on materials that are recommended is provided to the National Library of Medicine to be cataloged, indexed, and abstracted for ultimate listing in AVLINE. Twenty-eight percent of the material has not been recommended; the many reasons for low ratings are categorized under content quality, instructional design, and technical quality.
Researchers in physical medicine and rehabilitation require access to information regarding possible interventions and programs, available services and technology, research (published, unpublished and in progress), statistics on incidence, prevalence and expected recovery, and funding sources. This paper provides an overview to the most readily available sources of information, including 16 abstracts and indexes, 6 sources of review articles, 9 population statistical databases and 84 journals specifically devoted to rehabilitation. Of these journals, 29 may be accessed through Medline and 32 through other sources. An additional 58 journals indexed in Medline publish more than 16 rehabilitation articles per year. The journals within Medline that publish the most rehabilitation articles are listed by topic area: geriatric rehabilitation, cardiac rehabilitation, pediatric rehabilitation, rehabilitation research, self-help devices, sports medicine and rheumatologic rehabilitation. Specific search strategies that may be used for any computer assisted search of Medline are given to locate articles in these topic areas and also the following areas: amputee rehabilitation, spinal cord injury rehabilitation, traumatic brain injury rehabilitation, cerebral palsy rehabilitation, stroke rehabilitation, decubitus care, electrodiagnosis, rehabilitation engineering, pain rehabilitation, pulmonary rehabilitation, sexual rehabilitation and urologic rehabilitation. The user friendly Grateful Med software is introduced for simplified online Medline searching. Exercises are provided for starting a journal club with the retrieved articles.
OBJECTIVE: To review the past 10 years of clinical and research reports on learning disorders. METHOD: The most common and best-researched type of learning disorder is reading disability, which is the focus of this review. A selective review of the literature from Psychological Abstracts and Index Medicus from 1985 to the present was conducted. This review focused on conceptual and methodological issues, current assessment practices, epidemiology, correlates of brain function, biological factors, predictors of reading achievement, core deficits, comorbidity reading development and instructional approaches, treatment, and outcome. RESULTS: Definitional issues, still unresolved, bedevil the field with the debate between those for and those against discrepancy definitions of reading disabilities. Nevertheless considerable progress has been made. Phonological processing problems are now considered the main core deficit responsible for reading disabilities. Correlates of brain function and possible genetic factors are noted. Comorbidity with externalizing and internalizing disorders is described, and some theories for the overlap are identified. Studies on the comorbidity with internalizing disorders are lacking. Good assessment practice and promising approaches to remediation are identified. Unless a concurrent disorder is present, the use of medication for the treatment of reading disabilities should be considered experimental. Favorable outcomes are dependent on initial severity and a supportive home and school environment. CONCLUSIONS: Much progress has been made in our understanding of learning disabilities, especially in reading disabilities. Resolution of definitional and conceptual issues will greatly assist research into assessment, treatment, and long-term outcome of learning disabilities with and without concurrent psychiatric disorders. Further research into the nature, extent, and correlates of comorbid learning disabilities and their treatment is much needed.
AIM: The aim of this paper is to review the evidence for the necessity and sufficiency of therapeutic relationships when working with people with enduring mental health problems, such as schizophrenia. BACKGROUND: The value of therapeutic relationships in mental health nursing has been the subject of some debate within the profession. This debate has centred on the spectrum of beliefs about therapeutic relationships, ranging from the position that the relationship is both necessary and sufficient to enable change, to more technical approaches, to therapeutic intervention which de-emphasises the influence of the relationship. METHODS: Searches for published material in English between 1986 and 2003 were carried out using the following databases: Cumulative Index of Nursing and Allied Health Literature; MEDLINE; Applied Social Sciences Index and Abstracts; Sociological abstracts; and social service abstracts. The search terms were: therapeutic alliance; therapeutic relationship; working alliance; and nurse-patient relationships. Papers chosen for inclusion in the review were those with a research focus on the elements and potential benefits/costs of therapeutic relationships in nursing. RESULTS: People who experience a relationship as being therapeutic appear to have better outcomes. A consistent finding of a number of meta-analyses is that therapeutic relationships characterized by facilitative and positive interpersonal relationships with the helper have in-built benefits, and that this is an important element of advanced techniques. In order for cognitive behavioural therapy to be successful, people need to feel understood and involved in the therapeutic relationship. CONCLUSION: Therapeutic relationships are necessary but not sufficient to enable change when working with people with schizophrenia.
AIM: This paper presents an evaluation of the effectiveness of three search strategies to identify research for a qualitative synthesis of patient experiences of living with a leg ulcer. BACKGROUND: Systematic reviews of research are increasingly the form of evidence used for evaluation of health care. There are well-established methods for conducting systematic reviews of effectiveness incorporating randomized controlled trials. Methods have been developed for the synthesis of qualitative research, but these are not widely used or evaluated. Searching for qualitative research is one of the least developed and tested areas in systematic reviewing of qualitative research. METHOD: The replication of three search strategies (free text, thesaurus and broad-based terms) developed for identification of qualitative research papers within electronic databases is described. Each strategy was run in seven electronic databases: MEDLINE, CINAHL, EMBASE, British Nursing Index, Social Science Citation Index, Applied Social Sciences Index and Abstracts, PsychInfo. The effectiveness of these strategies for identifying qualitative research for a synthesis of patients' experiences of living with a leg ulcer is discussed. FINDINGS: Each of the three search strategies produced similar numbers of potentially and actually relevant papers from each of the seven databases. These results were most striking for CINAHL, when all of the papers ultimately included in the review were identified by each search strategy. No other database identified all included papers. CONCLUSION: A simple search strategy using broad-based terms was as effective as a complex one (free text) in locating qualitative research examining patients' experiences of living with a leg ulcer. For a question with a clear nursing focus, it may be sufficient to search only CINAHL in order to locate qualitative research. This result needs replicating with other nursing topics.
The effect of dietary education incorporating information about the glycaemic index of carbohydrate was tested against standard dietary advice in a randomized controlled study in 51 newly diagnosed patients with Type 2 diabetes treated as out-patients with diet only over a 12-week study period. Outcome was assessed by dietary analysis of 3-day diet diaries, fasting blood glucose, fructosamine, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. Dietary analysis indicated that the group who received low glycaemic advice not only had a significantly lower calculated mean diet glycaemic index intake (77 +/- 1.1 (SEM) vs 82 +/- 1%, p < 0.01) but also had a lower fat intake (25 +/- 1 vs 32 +/- 2% of total energy day-1, p < 0.001), a higher carbohydrate intake (49 +/- 2% vs 44 +/- 1% of total energy day-1, p < 0.05) and non-starch polysaccharide intake (21 +/- 1.5 vs 14 +/- 1 g, p < 0.01). There was a significantly greater within-group fall in fructosamine (3.8 +/- 0.2 to 3.2 +/- 0.2 mmol-1 vs 3.6 +/- 0.2 to 3.6 +/- 0.3 mmol-1, p < 0.05) and cholesterol (6.1 +/- 0.3 to 5.4 +/- 0.3 mmol-1 vs. 5.6 +/- 0.2 to 5.3 +/- 0.1 mmol-1, p < 0.05) in the low glycaemic index group.(ABSTRACT TRUNCATED AT 250 WORDS)
OBJECTIVES: Are behavioural interventions effective in reducing the rate of sexually transmitted infections (STIs) among genitourinary medicine (GUM) clinic patients? DESIGN: Systematic review and meta-analysis of published articles. DATA SOURCES: Medline, CINAHL, Embase, PsychINFO, Applied Social Sciences Index and Abstracts, Cochrane Library Controlled Clinical Trials Register, National Research Register (1966 to January 2004). REVIEW METHODS: Randomised controlled trials of behavioural interventions in sexual health clinic patients were included if they reported change to STI rates or self reported sexual behaviour. Trial quality was assessed using the Jadad score and results pooled using random effects meta-analyses where outcomes were consistent across studies. RESULTS: 14 trials were included; 12 based in the United States. Experimental interventions were heterogeneous and most control interventions were more structured than typical UK care. Eight trials reported data on laboratory confirmed infections, of which four observed a greater reduction in their intervention groups (in two cases this result was statistically significant, p < 0.05). Seven trials reported consistent condom use, of which six observed a greater increase among their intervention subjects. Results for other measures of sexual behaviour were inconsistent. Success in reducing STIs was related to trial quality, use of social cognition models, and formative research in the target population. However, effectiveness was not related to intervention format or length. CONCLUSIONS: While results were heterogeneous, several trials observed reductions in STI rates. The most effective interventions were developed through extensive formative research. These findings should encourage further research in the United Kingdom where new approaches to preventing STIs are urgently required.
Data from cardiac catheterization at rest and during exercise in 57 patients with dilated cardiomyopathy (DCM) were analyzed to evaluate the bearing of mitral regurgitation (MR) detected by color Doppler echocardiography (CDE) on prognostically important invasive hemodynamic parameters and survival. The etiology of DCM was coronary artery disease in 21 patients and unproven ('idiopathic') in 36 patients. MR was detected by CDE in 34 patients (60%) with an agreement of 93% compared to left ventriculography. Mean age, etiology of DCM and duration of symptoms were similar in patients with and without MR, while patients with MR were in a higher NYHA class, had lower ejection fraction (LVEF) (25 +/- 13 vs. 35 +/- 17%; p < 0.02), larger left ventricular volumes (356 +/- 138 vs. 268 +/- 61 ml; p < 0.01) and higher left ventricular end-diastolic pressure (LVEDP) (21 +/- 9 vs. 13 +/- 7 mm Hg; p < 0.01). At rest, right-sided pressures were higher in patients with MR compared to patients without MR (pulmonary wedge pressure 20 +/- 9 vs. 10 +/- 3 mm Hg, mean pulmonary arterial pressure 30 +/- 11 vs. 20 +/- 8 mm Hg, mean right atrial pressure 9 +/- 4 vs. 4 +/- 2 mm Hg, all p < 0.001), but no significant differences were found in cardiac index (CI) or stroke index (SI).(ABSTRACT TRUNCATED AT 250 WORDS)
In the Second Mt. Sinai-New York University Reperfusion Trial, in which change of ejection fraction was the primary end point, the following secondary end points were prospectively assessed by serial coronary angiography: patency of the infarct artery both before intervention and 10-14 days later, acute and delayed recanalization rates, presence or absence of collateral flow, and complication rates of acute interventional catheterization. We assigned 393 patients randomly to groups receiving acute cardiac catheterization and a double-blind intracoronary infusion of streptokinase (SK arm), both streptokinase and nitroglycerin (SK-NTG arm), nitroglycerin alone (NTG arm), or conventional therapy without acute catheterization (control arm). Prospective stratification was based on duration of infarct pain before randomization: group A, less than 2 hours; Group B, 2-12 hours. Baseline patency rates were comparable in patients studied within 6 hours (30%, 40 of 135) and those studied later (24%, 32 of 133). This finding refutes the hypothesis that spontaneous recanalization occurs frequently after 6 hours. The acute recanalization rates of the SK arm (60%, 40 of 67) and the SK-NTG arm (63%, 29 of 62) did not differ. During streptokinase infusion, more vessels recanalized in group A (81%, 22 of 27) than in group B (56%, 57 of 102) (p less than 0.01); this was due to a significant reduction of recanalization rates from 75% (48 of 64) to 45% (26 of 62) with treatment after 6 hours (p less than 0.01). Delayed recanalization, that is, patency at end point but not postintervention, was seen in 17% (17 of 100) of total occlusions treated with streptokinase. In group A, all total occlusions treated with streptokinase recanalized either acutely (20 of 22) or delayed (two of 22), whereas in group B, 23% (18 of 78) remained obstructed. The reocclusion rate in the SK arms was 17% (11 of 65). In the NTG arm, recanalization occurred during intervention in 4% (two of 47) and delayed in 45% (21 of 47). At end-point angiography, the patency rates of the NTG arm (62%, 41 of 66) and the control arm (58%, 36 of 62) were comparable; those of the SK arms were higher (75%, 105 of 140) (p less than 0.01). Total occlusion was associated with collateral flow in 33% (66 of 199) at baseline; the prevalence of collaterals did not increase with time to angiography, which indicates that they had developed before the index event.(ABSTRACT TRUNCATED AT 400 WORDS)