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PubMedDate not supplied

An evidence-based evaluation of EMS protocols.

OBJECTIVE: To determine the extent to which prehospital patient care protocols incorporate the findings of the peer-reviewed scientific EMS literature. METHODS: Using a computerized literature search, articles published from eight institutions known to be active in prehospital care research were identified and obtained from the local health sciences library. Animal or bench research, analysis of administrative practices, evaluation of educational or quality assurance techniques, collective reviews, and air medical articles were excluded. We compared the findings of each article with the guidelines contained in 12 sets of prehospital care protocols, ranking them as: 1) consistent; 2) partially consistent; 3) not discussed; or 4) not consistent. The rankings for the article-protocol comparisons for each EMS system were compared using the Kruskal-Wallis test. RESULTS: Forty-nine papers were compared with 12 sets of protocols, resulting in 588 comparisons. More than half (53.1%, n = 312) of the comparisons were ranked as "consistent." Only 28 (4.8%) of the comparisons were found to be "not consistent." There was no significant difference in the rankings assigned to the comparisons for protocols from each individual system, nor in the rankings for protocols from the EMS system associated with the source of the article, from other systems with academic affiliations, and from systems without academic affiliations. CONCLUSION: Most EMS protocols are consistent with the published peer-reviewed research. There is no difference in the level of consistency when comparing protocols from EMS systems associated with the source of the articles, those associated with other academic institutions, and those without strong academic affiliations.

Clinical Protocols↗
PubMed2004

Analysis of human reticulocyte genes reveals altered erythropoiesis: potential use to detect recombinant human erythropoietin doping.

BACKGROUND AND OBJECTIVES: Enhancement of oxygen delivery to tissues is associated with improved sporting performance. One way of enhancing oxygen delivery is to take recombinant human erythropoietin (rHuEpo), which is an unethical and potentially dangerous practice. However, detection of the use of rHuEpo remains difficult in situations such as: i) several days after the end of treatment ii) when a treatment with low doses is conducted iii) if the rHuEpo effect is increased by other substances. In an attempt to detect rHuEpo abuse, we selected erythroid gene markers from a SAGE library and analyzed the effects of rHuEpo administration on expression of the HBB, FTL and OAZ genes. DESIGN AND METHODS: Ten athletes were assigned to the rHuEpo or placebo group. The rHuEpo group received subcutaneous injections of rHuEpo (50 UI/kg three times a week, 4 weeks; 20 UI/kg three times a week, 2 weeks). HBB, FTL and OAZ gene profiles were monitored by real time-polymerase chain reaction (PCR) quantification during and for 3 weeks after drug administration. RESULTS: The global analysis of these targeted genes detected in whole blood samples showed a characteristic profile of subjects misusing rHuEpo with a increase above the threshold levels. The individual analysis of OAZ mRNA seemed indicative of rHuEpo treatment. INTERPRETATION AND CONCLUSIONS: The performance-enhancing effect of rHuEpo treatment is greater than the duration of hematologic changes associated with rHuEpo misuse. Although direct electrophoretic methods to detect rHuEpo have been developed, recombinant isoforms of rHuEpo are not detectable some days after the last subcutaneous injection. To overcome these limitations indirect OFF models have been developed. Our data suggest that, in the near future, it will be possible to consolidate results achievable with the OFF models by analyzing selected erythroid gene markers as a supplement to indirect methods.

Adolescent↗
PubMed1994

The activity of the Istituto Superiore di Sanità in the field of existing chemicals.

The Istituto Superiore di Sanità (Italian National Health Institute, ISS) is one of the main Italian research institutes and a scientific body of the Italian National Health Service. At present, the ISS includes twenty laboratories, six technical services, an administrative division for personnel affairs and a library. The staff includes about 1400 people, plus over 600 external collaborators. The ISS international activities in the field of existing chemicals includes the participation in a wide number of programmes of the World Health Organization, the European Union, the International Agency for Research on Cancer, the Organisation for Economic Co-operation and Development and other organizations. At a national level, the ISS is particularly active in the field of risks connected with chemicals in the environment and in food, and constantly provides advice to the Ministry of Health and often to other ministries in the definition of laws and regulations which include technical-scientific aspects related to the existing chemicals. The ISS research activity in the field of chemical substances represents a significant part of the Environment research project, which includes more than one hundred research lines, and also of other research projects.

Academies and Institutes↗
PubMed2006

Mapping the literature of nursing administration.

OBJECTIVES: As part of Phase I of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association, this study identifies the core literature cited in nursing administration and the indexing services that provide access to the core journals. The results of this study will assist librarians and end users searching for information related to this nursing discipline, as well as database producers who might consider adding specific titles to their indexing services. METHODS: Using the common methodology described in the overview article, five source journals for nursing administration were identified and selected for citation analysis over a three-year period, 1996 to 1998, to identify the most frequently cited titles according to Bradford's Law of Scattering. From this core of most productive journal titles, the bibliographic databases that provide the best access to these titles were identified. RESULTS: Results reveal that nursing administration literature relies most heavily on journal articles and on those titles identified as core nursing administrative titles. When the indexing coverage of nine services is compared, PubMed/MEDLINE and CINAHL provide the most comprehensive coverage of this nursing discipline. CONCLUSIONS: No one indexing service adequately covers this nursing discipline. Researchers needing comprehensive coverage in this area must search more than one database to effectively research their projects. While PubMed/MEDLINE and CINAHL provide more coverage for this discipline than the other indexing services, none is sufficiently broad in scope to provide indexing of nursing, health care management, and medical literature in a single file. Nurse administrators using the literature to research current work issues need to review not only the nursing titles covered by CINAHL but should also include the major weekly medical titles, core titles in health care administration, and general business sources if they wish to adequately cover the many aspects of nursing administration.

Abstracting and Indexing↗
PubMed2006

The Medical Library Association Benchmarking Network: development and implementation.

OBJECTIVE: This article explores the development and implementation of the Medical Library Association (MLA) Benchmarking Network from the initial idea and test survey, to the implementation of a national survey in 2002, to the establishment of a continuing program in 2004. Started as a program for hospital libraries, it has expanded to include other nonacademic health sciences libraries. METHODS: The activities and timelines of MLA's Benchmarking Network task forces and editorial board from 1998 to 2004 are described. RESULTS: The Benchmarking Network task forces successfully developed an extensive questionnaire with parameters of size and measures of library activity and published a report of the data collected by September 2002. The data were available to all MLA members in the form of aggregate tables. Utilization of Web-based technologies proved feasible for data intake and interactive display. A companion article analyzes and presents some of the data. MLA has continued to develop the Benchmarking Network with the completion of a second survey in 2004. CONCLUSIONS: The Benchmarking Network has provided many small libraries with comparative data to present to their administrators. It is a challenge for the future to convince all MLA members to participate in this valuable program.

Advisory Committees↗
PubMed1995

From apartheid to integration: the role of the Witwatersrand Medical library in health care services in Johannesburg, South Africa.

Adapting to change is always difficult; all the more so when changes in the administrative structure of health care are part of a national political transformation toward democracy. As South Africa moves from apartheid to integration in its health services, the Witwatersrand Medical Library (WML) will have to adopt innovative strategies to cope with increasing demands on its resources by sub-Saharan African medical libraries and with expected decreases in state funding for health and education. WML also will have to address the lack of hospital library services in the Johannesburg region by expanding its academic branches at University of the Witwatersrand Medical School's teaching hospitals to serve both hospital and academic health care staff. This article discusses these challenges in the context of rapidly changing academic health care services in Johannesburg.

Health Policy↗
PubMedDate not supplied

AHRA survey: film library practices.

Presented here are the highlights of the Film Library Practices Report, taken from the 92-page report published by the AHRA in November 1996. Administrators may find information useful for improving their departments, which function most efficiently with smooth running libraries. The survey of AHRA members covers such topics as staffing, storage, copy policies, PACS and problem areas.

Data Collection↗
PubMed1968

Developing of methodologic tools for planning and managing library services: 3. Standardized inventories of library services.

A standardized procedure was developed for eliciting those details of a library's service policies that are important to its users and for recording the data by checking appropriate categories on a form. This inventory procedure covers the entire spectrum of user services and accommodates a wide range of policies. The inventory was originally designed for use by trained interviewers in largescale surveys of academic medical libraries. However, it is also suitable for other kinds of libraries, and the Interview Guide and Checklist can be used for a self-survey by library staff. In addition to survey use, the inventory has a variety of educational, administrative, managerial, and research applications. A method for weighting the categorical inventory data to reflect the relative desirability of different policies makes it possible to calculate scores indicating how a library's policies compare with those of an "optimal" library. An analogous inventory of the services a library provides to other libraries was developed for surveying major backup resources in the medical library system.

Consumer Behavior↗
PubMed2002

Standards for hospital libraries 2002.

The Medical Library Association's "Standards for Hospital Libraries 2002" have been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified librarian who functions as a department head and is a member of the Academy of Health Information Professionals. The standards define the role of the medical librarian and the links between knowledge-based information and other functions such as patient care, patient education, performance improvement, and education. In addition, the standards address the development and implementation of the knowledge-based information needs assessment and plans, the promotion and publicity of the knowledge-based information services, and the physical space and staffing requirements. The role, qualifications, and functions of a hospital library consultant are outlined. The health sciences library is positioned to play a key role in the hospital. The increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs; patients; and the community require new strategies, strategic planning, allocation of adequate resources, and selection and evaluation of appropriate information resources and technologies. The Hospital Library Standards Committee has developed this document as a guideline to be used in facing these challenges.

Consultants↗
PubMed2005

Standards for Hospital Libraries 2002 with 2004 revisions.

The Medical Library Association's Standards for Hospital Libraries 2002 has been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified librarian who functions as a department head and is a member of the Academy of Health Information Professionals. The standards define the role of the medical librarian and the links between knowledge-based information and other functions such as patient care, patient education, performance improvement, and education. In addition, the standards address the development and implementation of the knowledge-based information needs assessment and plan, the promotion and publicity of the KBI services, and the physical space and staffing requirements. The role, qualifications, and functions of a hospital library consultant are outlined. The health sciences library is positioned to play a key role in the hospital. The increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs, patients and the community require new strategies, strategic planning, allocation of adequate resources, and selection and evaluation of appropriate information resources and technologies. The Hospital Library Standards Committee has developed this document as a guideline to be used in facing these challenges together.

Guidelines as Topic↗
PubMed2004

Serial analysis of gene expression in methamphetamine- and phencyclidine-treated rodent cerebral cortices: are there common mechanisms?

Pharmacological actions of methamphetamine (METH) and phencyclidine (PCP) are different, but both of them can induce similar psychiatric disorders including abuse, intoxication, withdrawal, and psychotic symptoms like those of schizophrenia. These mental disorders are caused not only by their direct pharmacological effects, but also by secondary brain damage containing gene expression changes. In order to broadly grasp these alterations, we used serial analysis of gene expression (SAGE), a transcriptome analysis. We analyzed three cDNA libraries from cerebral cortices of saline (1 mL/kg)-, METH (4 mg/kg)-, or PCP (10 mg/kg)-treated Wistar rats (one hour after i.p. administration). The numbers of total tags were about 50,000 in each library, and approximately 18,000 kinds of tags were identified respectively. From the comparisons of three groups, we found both METH- and PCP-reactive genes. Upregulated genes contained calmodulin 2, stromal cell-derived factor receptor 1, brain-specific angiogenesis inhibitor 1-associated protein 2, ras homologue enriched in brain, basigin and thyrotropin-releasing hormone receptor. Downregulated genes contained lipocalin 2, aldolase A, importin 13, fatty acid binding protein 3, and glycine receptor alpha2 subunit. These data suggest important clues of common molecular basis in METH- and PCP-related psychiatric disorders.

Animals↗
PubMed2000

Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues.

OBJECTIVE: To identify all financial incentives that had been proposed, described, or used regardless of their initial objective and, when possible, to assess the results of these incentives on costs, process or outcomes of care. MATERIAL AND METHODS: Systematic review of the literature. Databases searched were: Medline, Embase, Health Planning and Administration, Pascal, International Pharmaceutical Abstracts and the Cochrane Library. Search terms were: health professionals and tape of practice, type of incentive, methodology, languages English or French, January 1993 to May 1999. RESULTS: Financial incentives concerned the modalities of physician payment and financing of the health care system. Confounding factors included: age of the doctor, training, speciality, place and type of medical practice, previous sanctions for over-prescribing, type and severity of disease, type of insurance. Risks of financial incentives were: limited access to certain types of care, lack of continuity of care, conflict of interests between the physician and the patient. Any form of fund-holding or capitation decreased the total volume of prescriptions by 0-24%, and hospital days by up to 80% compared with fee-for-service. Annual cap on doctors' incomes resulted in referrals to colleagues when target income is reached. DISCUSSION: Financial incentives can be used to reduce the use of health care resources, improve compliance with practice guidelines or achieve a general health target. It may be effective to use incentives in combination depending on the target set for a given health care programme.

Capitation Fee↗