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PubMed2001

The demand for consumer health information.

Using data from an evaluation of a community-wide informational intervention, we modeled the demand for medical reference books, telephone advice nurses, and computers for health information. Data were gathered from random household surveys in Boise, ID (experimental site), Billings, MT, and Eugene, OR (control sites). Conditional difference-in-differences show that the intervention increased the use of medical reference books, advice nurses, and computers for health information by approximately 15, 6, and 4%. respectively. The results also suggest that the intervention was associated with a decreased reliance on health professionals for information.

Adolescent↗
PubMed1984

A survey of patient sources of prescription drug information.

A national telephone survey of 1,104 adults who had recently obtained a new prescription was undertaken to determine the nature and amount of drug information obtained. Sixty percent stated that physicians provided directions for use information with the pharmacy reported as about half as active. Only 3 to 6 per cent said they asked the physician or pharmacist for information. However, one in six respondents said they looked up the prescription in a drug reference book such as the Physicians Desk Reference.

Adolescent↗
PubMed2001

[Protective vegetal micronutrients and microcomponents for breast cancer].

This review is a summary of three reference books and of the final report of a European concerted action. The data have been updated by an analysis of recent publications, according to the same methodological criteria as those used in the reference books: sample size, quality of questionnaire and statistical methods. Mechanistic hypothesis are considered for each microcompounds, the effect of which is situated along the natural history of cancer. Few studies have considered folates effect on breast cancer, and they observed an interaction with the risk related to alcohol consumption, which is decreased with a high intake of folates. Many studies considered the effect of vitamin C and E, and carotenoids, but results are inconsistent. Conflicting results were also observed in studies on fibre and breast cancer. However, although only half of the studies showed a protective effect, the strength of the biological mechanisms give support to the hypothesis of a protection provided by fibre. The situation is comparable with phyto-estrogens: epidemiological studies are scarce and few of them show significant protection, but several plausible biological mechanisms are proposed, either related to the negative modulation of estrogen receptor by phyto-estrogen, or to the inhibition of proliferation by action on various enzymes. At the present time, caution in the interpretation of the results and in the use of plant microcompounds in prevention or therapy is strongly recommended.

Antioxidants↗
PubMed2000

The prednisone dosage in the CHOP chemotherapy regimen for non-Hodgkin's lymphomas (NHL): is there a standard?

PURPOSE: Discrepancies in the quoted prednisone dosages in the regimens reported as the only standard CHOP regimen stimulated our interest in reviewing the medical literature regarding this issue and to assess whether practicing hematologists and oncologists in the U.S. are aware of the different dose schedules of prednisone in the published CHOP programs. METHODS: Sixteen textbooks and chemotherapy reference books were reviewed. A MEDLINE search of English-language articles published between January 1970 and December 1998 was performed. An eight-point questionnaire was sent via e-mail with responses obtained from 421 hematology/oncology physicians in the U.S. RESULTS: Sixteen textbooks and chemotherapy reference books reviewed quoted only one prednisone dosage as part of the standard CHOP regimen; the prednisone dosages quoted as standard varied between publications. More than 4,000 eligible non-Hodgkin's lymphoma patients have been treated with the CHOP chemotherapy as part of 43 different clinical trials reviewed. The dosages of prednisone and prednisolone used varied among six different levels. Thirty percent (127/421) of practicing U.S. physicians were not aware of the existence of more than one prednisone dose schedule as part of the CHOP regimen. The three most frequently used dosages are 100 mg/days 1-5 (67%), 100 mg/m(2)/days 1-5 (17%), and 60 mg/m(2)/days 1-5 (13%). CONCLUSIONS: Discrepancies in steroid dosages used as part of the reported standard CHOP regimens are common and not well recognized in the medical literature nor by practicing U.S. hematologists/oncologists. Based on this study, a prednisone dose of 100 mg/day for five days should be considered the standard dose.

Antineoplastic Agents, Hormonal↗
PubMed1994

The long-term therapeutic management of epilepsy.

OBJECTIVE: To provide a rational strategy for the evaluation and long-term management of epilepsy. DATA SOURCES: Articles written between 1964 and 1993, obtained from a MEDLINE search on epilepsy-related topics as well as from the author's personal files, major reference books on antiepileptic drugs, and references identified from these books. STUDY SELECTION: Articles were selected if they contained well-documented information comparing anti-epileptic drugs, represented controlled clinical trials, or were considered "key" articles of clinical relevance. DATA SYNTHESIS: Epilepsy is a chronic condition requiring careful long-term management. The treatment is complex, involving classification and diagnosis, selection and monitoring of the appropriate antiepileptic agent, and evaluation of the chosen drug's side effects and drug interactions. Because these side effects increase when drugs are combined, monotherapy is recommended. Long-term management issues and optimal drug selection differ from patient to patient. If seizures are not controlled by medication, the patient may have been misdiagnosed or misclassified. Noncompliance, a major cause of apparent unresponsiveness to treatment, should also be ruled out. Recognizing that current therapy is not ideal for many patients, new pharmacologic and surgical therapies are briefly discussed. CONCLUSIONS: Physicians can pursue a rational strategy for the management of epilepsy if they understand the risks and benefits of various pharmacologic and therapeutic options and if they maintain open lines of communication with the patient.

Anticonvulsants↗
PubMed1998

Tools, information sources, and methods used in deciding on drug availability in HMOs.

The use and importance of specific decision-making tools, information sources, and drug-use management methods in determining drug availability and use in HMOs were studied. A questionnaire was sent to 303 randomly selected HMOs. Respondents were asked to rate their use of each of four formal decision-making tools and its relative importance, as well as the use and importance of eight information sources and 11 methods for managing drug availability and use, on a 5-point scale. The survey response rate was 28%. Approximately half of the respondents reported that their HMOs used decision analysis or multiattribute analysis in deciding on drug availability. If used, these tools were rated as very important. There were significant differences in levels of use by HMO type, membership size, and age. Journal articles and reference books were reported most often as information sources. Retrospective drug-use review was used very often and perceived to be very important in managing drug use. Other management methods were used only occasionally, but the importance placed on these tools when used ranged from moderately to very important. Older organizations used most of the management methods more often than did other HMOs. Decision analysis and multiattribute analysis were the most commonly used tools for deciding on which drugs to make available to HMO members, and reference books and journal articles were the most commonly used information sources. Retrospective and prospective drug-use reviews were the most commonly applied methods for managing HMO members' access to drugs.

Data Collection↗
PubMed1976

The reorganization of a monographic reference collection.

Reference monographs in the Health Sciences Library of the College of Medicine and Dentistry of New Jersey were reorganized recently according to form, in order to enable both librarians and patrons to utilize these materials more efficiently. This reorganization reflects the unique characteristics of reference books as differentiated from the regular monographic collection, since reference materials are frequently consulted for quick "look-ups." A reference category scheme was developed and implemented, based on observations of and comparisons with reference collections of eight medical libraries in the New York metropolitan area. The reorganization enhances the retrievability of materials from this collection.

Book Classification↗
PubMed1998

Rich in resources/deficient in dollars! Which titles do reference departments really need?

STATEMENT OF PURPOSE: Budget pressures, combined with the growing availability of resources, dictate careful examination of reference use. Two studies were conducted at the University of Maryland Health Sciences Library to examine this issue. A twelve-month reshelving study determined use by title and discipline; a simultaneous study analyzed print abstract and index use in an electronic environment. METHODOLOGY: Staff electronically recorded statistics for unshelved reference books, coded the collection by discipline, and tracked use by school. Oral surveys administered to reference room abstract and index users focused on title usage, user demographics, and stated reason for use. RESULTS: Sixty-five and a half percent of reference collection titles were used. Medical titles received the most use, but, in the context of collection size, dentistry and nursing titles used the greatest percentage of their collections. At an individual title level, medical textbooks and drug handbooks were most used. Users of abstracts and indexes were primarily campus nursing and medical students who preferred print resources. CONCLUSION: The monograph data will guide reference expenditures in canceling little-used standing orders, expanding most-used portions of the collection, and analyzing underused sections. The abstract and index survey identified the following needs: targeting instruction, contacting faculty who assign print resources, increasing the number of computer workstations, and installing signs linking databases to print equivalents.

Abstracting and Indexing↗
PubMed1997

University hospital-based drug information service in a developing country.

In 1994, a clinically oriented drug information unit was established at the Tribhuvan University Teaching hospital in Nepal, with a view to providing objective and independent information through a question-answer service and bulletin production. During the first 2 years of its service, the unit received a total of 674 encounters, with an average of 28 inquiries a month (range 13-42): about three-quarters (74.5%) of all the inquiries were from prescribing doctors, including 38.0% from specialist clinicians: about a quarter (24.6%) were related to patient problems. Most (86.8%) of the responses were provided within 24 h of the inquiry. Frequently encountered queries related to: pharmacotherapy of a disease or drug indication(s), adverse drug reactions, drug doses, availability, drug use in pregnancy, ingredient(s) of a proprietary product, precautions for use and drug interactions. Details of the inquiries received and the responses provided by the unit are documented in a standard question-answer form. The unit also carries out proactive dissemination of information through the publication and free distribution of a bimonthly bulletin which includes brief referenced reviews on drug- and therapeutics-related topics. Nepal- or the local situation-related write-ups are now being increasingly included in the bulletin. A users' survey carried out at the end of 1-year service indicated that the question-answer and bulletin production activities of the unit were well-perceived by its target audiences, i.e. the prescribing doctors and postgraduate medical students. Although Medline on CD-ROM and original journal articles available in the hospital library were consulted for answering a few of the questions, the vast majority of them could be adequately handled by consulting a limited number of well-known drug information books. Our experience indicates that in developing countries such as Nepal, where funds are often severely limited, a small-scale drug information centre, serving a local area, can be usefully initiated by a few motivated staff with a modest collection of about a dozen key reference books.

Adult↗
PubMedDate not supplied

[Experience in creating a card file of reference publications on foreign institutions working in the field of the science of nutrition].

Work on detecting reference publications on foreign scientific institutions active in the domain of nutritional science is summed up. Information on reference books and guides embracing scientific and research establishments of the whole world, individual countries and also on the guides containing information on international bodies and prominent figures in nutritional science is offered.

Academies and Institutes↗
PubMed1999

[A quality reference manual for radiology].

The purpose of this article is to introduce a quality manual for radiology departments. A radiology department has implemented a quality improvement program since 1996. This manual was developed as a tool for quality improvement program. This manuscript, was based on foreign accreditation manuals as well as from French experiences and summarized. In addition, new criteria were added, especially in the field of interventional radiology. This reference book is first dedicated to the self-assessment of radiology departments. It can also be used for an external audit.

Accreditation↗
PubMed1985

The Eck-Pavlov connection.

In 1877, N. V. Eck described the surgical creation of a fistula between the inferior vena cava and the portal vein in a dog. At the same time he suggested that this operation might be of use in humans for the treatment of ascites. But it was not until more than 50 years later that A. O. Whipple's report of his experience with Eck's operation ushered in the so-called modern era of the portacaval shunt. While there has been sporadic reports about various phases of Eck's life, most reference books do not even give the date of his death, and some references disagree as to the date of his birth. He has been mistakenly placed among the physiologists rather than the surgeons of Russia, and while quoted as a "brilliant student," he has been accused of being "ill-suited" to his profession by the same source. For his intense interest in other areas such as mining and geology, he is depicted as an erratic man who sought something he probably never found. It is said that for 13 years he was divorced from medicine and surgery, when in fact it was during this period that he performed the only clinical portocaval shunt of his career (and it was successful). Unable to find answers to many questions concerning the 59 years of this man's life in the Western world, a recent trip to Leningrad by the author was informative, interesting, and even surprising. Eck's rarely quoted connection with I. P. Pavlov was more than just an acquaintance, and the famed "Eck-fistula" of the Western world is known as the "Eck-Pavlov shunt" in Leningrad.

Animals↗
PubMed1997

[Value of automated medical indexing of an image database and a digital radiological library].

We indexed the contents of a radiology server on the web to facilitate access to research documents and to link reference texts to images contained in radiology databases. Indexation also allows case reports to be transformed with no supplementary work into formats compatible with computer-assisted training. Indexation was performed automatically by ADM-Index, the aim being to identify the medical concepts expressed within each medical text. Two types of texts were indexed: medical imaging reference books (Edicerf) and case reports with illustrations and captions (Iconocerf). These documents are now available on a web server with HTML format for Edicerf and on an Oracle database for Iconocerf. When the user consults a chapter of a book or a case report, the indexed terms are displayed in the heading; all reference texts and case reports containing the indexed terms can then be called up instantaneously. The user can express his search in natural language. Indexation follows the same process allowing instantaneous recall of all reference texts and case reports where the same concept appears in the diagnosis or clinical context. By using the context of the case reports as the search index, all case reports involving a common medical concept can be found. The context is interpreted as a question. When the user responds to this question, ADM-Index compares this response with the answer furnished by the reference texts and case reports. Correct or erroneous responses can thus be identified, converting the system into a computer-assisted training tool.

Abstracting and Indexing↗
PubMed2001

Induction of labour and scheduled cesarean deliveries in twin pregnancies at the Port-Royal Maternity Hospital in Paris France.

The study is a critical analysis of the decisions to induce labour or schedule cesareans in the practice of a third level referral centre, with as outcome criterion the reduction of fetal death. 783 women pregnant with twins were included from 1.1.1993 to 31.12.1998, in three groups: originally booked, referred for care during pregnancy, or transferred from another institution. The results show that an important proportion of preterm deliveries result from a medical decision to induce labour or from a scheduled cesarean in the originally booked group with even higher proportions in groups of referred and transferred women. These results are discussed in relation to fetal death rates and causes. Deaths related to fetal growth restriction were not observed in women originally booked for care. The hospital bias has been discussed. The conclusion is that decisions to minimize fetal deaths in twin pregnancies increased preterm deliveries by medical decision.

Cesarean Section↗
PubMed1987

A segmentational analysis of prescription drug information seeking.

Drug information-seeking proclivities were examined using data from a telephone survey of 835 individuals who had obtained new outpatient prescriptions within the previous 4 weeks. Factor analytic and clustering techniques were used to segment patients based on the source and nature of drug information received in conjunction with the prescription. A four-cluster solution appeared to represent the most stable, distinct, yet homogeneous solution for the data. The groups were named "physician reliant" (40%), "pharmacist reliant" (19%), "questioners" (7%), and "uniformed" (34%). The four groups were compared for demographic, situational, and attitudinal differences. The physician-reliant group appeared most satisfied with the direct counseling of the doctor. Although this group may have sought additional information, the information appeared to reinforce the physician's directions. The pharmacist-reliant group often obtained prescriptions at independent pharmacies and tended not to rely on magazines or reference books for additional information. The questioners were often taking multiple medications. This group tended to seek out reference information from nonprofessional sources and reported several barriers to seeking information from professionals. The uninformed group was the oldest, tended to receive little information, and was more likely than the other groups to agree that one need not ask questions if one trusts the doctor. Different types of patient education programs were recommended as appropriate for each of the four groups. Motivational messages directed to the uninformed segment appeared to be the largest unmet need in patient-oriented prescription drug education.

Adult↗
PubMed2002

Dietary supplements.

The amount of published information on dietary supplements mushroomed in the 1990s. In fewer than 5 years, publications increased at least 100-fold in the medical literature alone. Dietary supplements are an uncharted territory that warrants complete and accurate exploration. One should not be surprised that disease and illness may respond to dietary supplements. Nutrition is the foundation to good health, and dietary supplements may prove to be some of the most powerful medicines ever discovered. An especially exciting discovery is that dietary supplements may enhance the effects of specific drugs. This discovery may lead to more effective and safer protocols for the treatment of cancer, heart and lung disease, and a host of chronic medical conditions. Information about dietary supplements is becoming more common in the popular medical literature and is creating increased curiosity and an increased awareness. The explosion of the dietary supplement market is compelling physicians to become aware of dietary supplements. Whether or not they are used in clinical practice is a decision for the individual physician. Given the increasing number of patients who are using dietary supplements, however, it is imperative that physicians have a good understanding of this topic. Considering the increasing complexity and magnitude of this topic, physician specialization may be essential. There are many good reference books, review articles, and internet sites on specific supplements that probably should be part of every physician's reference library. The accompanying box provides a brief list of such sources.

Dietary Supplements↗
PubMed1985

A recommended core book list for public health libraries.

Public health is a multidisciplinary field ranging broadly across the health care spectrum. In light of this diversity the selection of basic reference books and textbooks in the field is a complex task. This paper first defines the components of what is public health and then presents such a list to serve as a guide to the librarian faced with this task.

Bibliographies as Topic↗