[Experience on centers of biomedical information in Latin America].
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Central America↗
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Results for “Library Administration”
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The multiple services of a hospital library.
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Book Selection↗
Maternal oxygen administration for fetal distress.
BACKGROUND: Maternal oxygen administration has been used in an attempt to lessen fetal distress by increasing the available oxygen from the mother. OBJECTIVES: The objective of this review was to assess the effects of maternal oxygenation for fetal distress during labour and to assess the effects of prophylactic oxygen therapy during the second stage of labour on perinatal outcome. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: December 1997. SELECTION CRITERIA: Randomised trials comparing maternal oxygen therapy for fetal distress during labour and prophylactic oxygen therapy during the second stage of labour with a control group (dummy or no oxygen therapy). DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by the reviewer. MAIN RESULTS: No trials addressing maternal oxygen therapy for fetal distress could be located. One trial of 85 women which addressed prophylactic oxygen therapy during labour was included. Cord blood pH values of less than 7.2 were more frequently recorded in the oxygenation group than the control group (relative risk 4.83, 95% confidence interval 1.11 to 21.04). There were no other statistically significant differences between the groups. Within the oxygenation group, those receiving oxygenation for less than 10 minutes had higher umbilical artery pH values than those receiving oxygen for longer than 10 minutes. REVIEWER'S CONCLUSIONS: There is not enough evidence to support the use of prophylactic oxygen therapy for women in labour, nor to evaluate its effectiveness for fetal distress.
Female↗
Administrative costs in U.S. hospitals.
BACKGROUND: Previous estimates of administrative costs in U.S. hospitals have been based on figures for California, and nationwide extrapolation has been controversial. If the costs of bureaucracy are high, major policy reforms may yield substantial savings. METHODS: We obtained detailed data on hospital expenses for fiscal year 1990 from reports submitted to Medicare by 6400 hospitals. We calculated each hospital's administrative costs by summing expenses in the following Medicare cost-accounting categories: administrative and general, nursing administration, central services and supply (excluding the purchase cost of supplies), medical records and library, utilization review, and the salary costs of the employee benefits department. We classified costs in most other categories as clinical. Some small categories of expenses (e.g., gift shop) were excluded from both our clinical and administrative groupings, and for others (e.g., plant operations), a proportional share was allocated between the two groupings. RESULTS: Nationwide, administration accounted for an average of 24.8 percent of each hospital's spending in fiscal 1990. Average hospital administrative costs ranged from 20.5 percent in Minnesota to 30.6 percent in Hawaii. Administrative salaries accounted for 22.4 percent of the average hospital's salary costs. Administrative costs were similar in states with high and low rates of enrollment in health maintenance organizations (HMOs). CONCLUSIONS: Hospital administrative costs in the United States are higher than previous estimates and more than twice as high as those in Canada. Greater enrollment in HMOs, with more competitive bidding by hospitals for managed-care contracts, an important element of proposed managed-competition health care reforms, does not seem to lower hospital administrative costs.
Costs and Cost Analysis↗
National Library of Medicine programs--PHS. Notice of proposed rulemaking.
The Public Health Service, HHS, proposes to revise the regulations for the programs of the National Library of Medicine. The proposed revisions would: (1) Permit the Regional Medical Libraries to recover part or all of the costs of providing photocopies of biomedical materials, (2) improve readability of the regulations, (3) update references to statutory authorities and uniform administrative requirements, and (4) revoke Part 63 (Traineeships) which is obsolete.
Library Services↗
Isolation and characterization of all-trans-retinoic acid-responsive genes in the rat testis.
By way of differential screening of testis cDNA libraries from vitamin A-deficient (VAD) rats before and after administration of all-trans retinoic acid (ATRA), genes, the transcription of which was influenced by ATRA, were isolated. Most clones with an increased transcription encoded different subunits of the same mitochondrial protein complex, cytochrome c oxidase (COX). The mRNA expression of COX increased by a factor 3.9 +/- 1.5 (mean +/- SD, n = 4). This increased expression seems to reflect an increased energy demand in the ATRA-supplemented VAD testis. Also, one gene was isolated, the transcription of which was reduced to about 70% by ATRA. This gene, sulfated glycoprotein 2 (Sgp-2), is a major secretion product of Sertoli cells, the function of which is still unknown. The effect of ATRA on Sgp-2 expression may be direct, since the promoter of Sgp-2 contains a putative ATRA-responsive element (RARE).
Animals↗
Area health education centers and health science library services.
A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.
Area Health Education Centers↗
IVR and administrative operations in healthcare and hospitals.
IVR (Interactive Voice Response) systems are effectively used in healthcare and hospitals for drug and health library information, prescription refills, history records, medical transcripts, patient information services, automated pre-admissions, patient account records, appointment scheduling and reminder, lab results notification, food services, and many other applications. Among its benefits, IVR relieves administrative staff and physicians of routine customer interactions and helps healthcare organizations increase their efficiency, productivity, and profitability.
Appointments and Schedules↗
Leadership alert: methods for reaching out to administrators, Part II.
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Interprofessional Relations↗
Library outreach: addressing Utah's "Digital Divide".
A "Digital Divide" in information and technological literacy exists in Utah between small hospitals and clinics in rural areas and the larger health care institutions in the major urban area of the state. The goals of the outreach program of the Spencer S. Eccles Health Sciences Library at the University of Utah address solutions to this disparity in partnership with the National Network of Libraries of Medicine-- Midcontinental Region, the Utah Department of Health, and the Utah Area Health Education Centers. In a circuit-rider approach, an outreach librarian offers classes and demonstrations throughout the state that teach information-access skills to health professionals. Provision of traditional library services to unaffiliated health professionals is integrated into the library's daily workload as a component of the outreach program. The paper describes the history, methodology, administration, funding, impact, and results of the program.
Area Health Education Centers↗
Antibiotics for preterm premature rupture of membranes.
OBJECTIVES: The aim of the review was to evaluate the effectiveness and the immediate and long-term safety of the effects of administering antibiotics to women with preterm prelabour rupture of membranes on maternal infectious morbidity, fetal and neonatal morbidity and mortality, and longer term childhood development. SEARCH STRATEGY: All randomized trials identified using the search strategy described by the Cochrane Pregnancy and Childbirth Group. SELECTION CRITERIA: All trials which reported clinically relevant outcomes (as opposed to laboratory data) were included. DATA COLLECTION AND ANALYSIS: Data were extracted from each report without any blinding of either the results or the treatments which women received. Unpublished data were sought from a number of authors. MAIN RESULTS: Antibiotic treatment following pPROM is effective at prolonging pregnancy and reducing maternal and neonatal infectious morbidity. There is no statisically proven benefit that their use improves neonatal mortality and morbidity in the short or long term. REVIEWER'S CONCLUSIONS: There are insufficient data to recommend routine prescription of antibiotics in this clinical situation. Research into this area should continue.
Anti-Bacterial Agents↗
Data-banks: a comparative study of INSERM and NLM data-banks.
The two main types of computerized information systems at present available to users-bibliographic systems and data-banks-render different, though complementary services. While bibliographic systems retrieve citations, data-banks provide correct and precise items of information in reply to queries. The nature of these items can be numeric, alphanumeric, textual or factual. The object of this paper is to contribute to a definition of data-banks through a description and a comparison of two new banks: (a) BIR, the data-bank on research contracts financed by the French Ministry of the Environment, is a 'factual' bank designed by INSERM as both an information and a management tool for the use of researchers and administrators. (b) TDB, the Toxicology Data Bank developed by the National Library of Medicine, is a textual bank covering toxicological data taken from sources such as manuals and handbooks. It provides a summary of the state of knowledge on a given substance at a given time.
Humans↗
Librarians in the Woods Hole Biomedical Informatics course.
What has come to be known as the "Woods Hole course", Biomedical Informatics, is a week-long course sponsored by the National Library of Medicine which has been offered since 1992. Its participants include librarians, clinicians, educators, and administrators. This article discusses the content of the course and its applicability to medical librarians.
Librarians↗
Problems in plannning medical libraries.
In spite of many recent publications dealing with the methods of planning medical libraries, serious problems have been encountered in most of the proposals submitted under the Medical Library Assistance Act of 1965. Problems are viewed as falling into several major categories: administration, personnel, location, space allocation, structural, layout, and undue reliance on generalized formulas. Finally, the role of the librarian as the key integrating force in developing a sound building plan is emphasized.
Architecture↗
Efficient target-selected mutagenesis in zebrafish.
One of the most powerful methods available to assign function to a gene is to inactivate or knockout the gene. Recently,we described the first target-selected knockout in zebrafish. Here,we report on the further improvements of this procedure,resulting in a highly efficient and easy method to do target-selected mutagenesis in zebrafish. A library of 4608 ENU-mutagenized F1 animals was generated and kept as a living stock. The DNA of these animals was screened for mutations in 16 genes by use of CEL-I-mediated heteroduplex cleavage (TILLING) and subsequent resequencing. In total,255 mutations were identified,of which 14 resulted in a premature stop codon,7 in a splice donor/acceptor site mutation,and 119 in an amino acid change. By this method,we potentially knocked out 13 different genes in a few months time. Furthermore,we show that TILLING can be used to detect the full spectrum of ENU-induced mutations in a vertebrate genome with the presence of many naturally occurring polymorphisms.
Animals↗
Raising the bar: the importance of hospital library standards in the continuing medical education accreditation process.
The Connecticut State Medical Society (CSMS) reviews and accredits the continuing medical education (CME) programs offered by Connecticut's hospitals. As part of the survey process, the CSMS assesses the quality of the hospitals' libraries. In 1987, the CSMS adopted the Medical Library Association's (MLA's) "Minimum Standards for Health Sciences Libraries in Hospitals." In 1990, professional librarians were added to the survey team and, later, to the CSMS CME Committee. Librarians participating in this effort are recruited from the membership of the Connecticut Association of Health Sciences Librarians (CAHSL). The positive results of having a qualified librarian on the survey team and the invaluable impact of adherence to the MLA standards are outlined. As a direct result of this process, hospitals throughout the state have added staffing, increased space, and added funding for resources during an era of cutbacks. Some hospital libraries have been able to maintain a healthy status quo, while others have had proposed cuts reconsidered by administrators for fear of losing valuable CME accreditation status. Creating a relationship with an accrediting agency is one method by which hospital librarians elsewhere may strengthen their efforts to ensure adequate library resources in an era of downsizing. In addition, this collaboration has provided a new and important role for librarians to play on an accreditation team.
Accreditation↗
Depot versus daily administration of GnRH agonist protocols for pituitary desensitization in assisted reproduction cycles: a Cochrane Review.
UNLABELLED: This paper is based on a Cochrane review published in The Cochrane Library, issue 4, 2002 (see www.CochraneLibrary.net for information) with permission from The Cochrane Collaboration. Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and The Cochrane Library should be consulted for the most recent version of the review. BACKGROUND: GnRH agonists have been widely used in cycles of IVF. There are two types of GnRH agonist administration that can be used to lead to hypophysis desensitization in IVF cycles in the long protocol: one consisting of daily low doses of GnRH agonist and the other the administration of analogues in higher, long-acting doses (depot). The objective of this study is to compare the use of a single long-acting depot dose with that of daily GnRH agonist doses in IVF cycles. METHODS: Relevant randomized controlled trials were identified by electronic search of the following databases: MEDLINE, EMBASE, LILACS (Latin American and Caribbean Center on Health Sciences Information) and the Cochrane Controlled Trials Register. Six studies, with a total of 552 women, were included and analysed. RESULTS: The studies do not indicate that there is a statistically significant difference between the use of depot GnRH agonist and of daily GnRH agonist in the primary outcome, clinical pregnancy rates per woman [odds ratio (OR) 0.94, 95% confidence interval (CI) 0.65-1.37]. However, there was sufficient evidence showing that the use of depot GnRH agonist for pituitary desensitization in IVF cycles increased the number of gonadotrophin ampoules [weighted mean difference (WMD) 3.30, 95% CI 1.27-5.34] and the duration of the ovarian stimulation (WMD 0.56, 95% CI 0.31-0.81), as compared with the use of daily GnRH agonist. CONCLUSIONS: Although we recognize that the clinical pregnancy rates per woman are not the ideal primary outcome, we found no evidence of differences between the long protocols using depot or daily GnRH agonist for IVF cycles. However, the use of depot GnRH agonist is associated with increased requirements for gonadotrophins and a longer time needed for ovarian stimulation. If these differences could be shown to translate into economic benefit, depot GnRH agonist would increase the overall costs of IVF treatment.
Delayed-Action Preparations↗
Morbidity in hospitalized patients receiving human albumin: a meta-analysis of randomized, controlled trials.
OBJECTIVE: To determine the effect of albumin administration on morbidity in acutely ill hospitalized patients. DATA SOURCE: Computer searches of MEDLINE, EMBASE, and the Cochrane Library; hand searches of journals and Index Medicus; inquiries with investigators and fluid product suppliers; and examination of reference lists. No language or time period restrictions were adopted. STUDY SELECTION: Randomized, controlled trials comparing the administration of albumin with that of crystalloid, no albumin, or lower-dose albumin. DATA EXTRACTION: Two investigators independently extracted data. The primary endpoint for the meta-analysis was morbidity, defined as the incidence of complications, including death. Trial quality was evaluated by blinding, allocation concealment, presence of morbidity as a study endpoint, and individual patient crossover. DATA SYNTHESIS: Seventy-one trials were included in the categories of surgery or trauma, burns, hypoalbuminemia, high-risk neonates, ascites, and other indications. The 3,782 randomized patients in the included trials experienced a total of 3,287 complications, including 515 deaths and 2,772 cardiovascular, gastrointestinal, hepatic, infectious, renal, respiratory, and other complications. Albumin significantly reduced overall morbidity, with a risk ratio of 0.92 (confidence interval [CI], 0.86-0.98). Control group albumin dose significantly affected the incidence of complications (p = .002). In 32 trials with no albumin administered to the control group, the risk ratio was 0.77 (CI, 0.67-0.88) compared with 0.89 (CI, 0.80-1.00) in 20 trials with control patients receiving low-dose albumin and 1.07 (CI, 0.96-1.20) in 19 trials with moderate-dose control group albumin. CONCLUSIONS: Albumin reduces morbidity in acutely ill hospitalized patients. Concomitant administration of albumin in the control group can obscure the effects of albumin on clinical outcome in randomized trials.
Acute Disease↗