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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.

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PubMed2005

The biomechanical and clinical significance of the lumbar erector spinae flexion-relaxation phenomenon: a review of literature.

OBJECTIVES: The aim of this study was to review the biomedical literature to ascertain the biomechanical and clinical significance of the lumbar erector spinae flexion-relaxation phenomenon (FRP). DATA SOURCES: Index Medicus via PubMed, the Noble Science Library's e-journal archives, and the Manual Alternative and Natural Therapy Index System databases were searched using the same search terms. DISCUSSION: The presence of the FRP during trunk flexion represents myoelectric silence consistent with increased load sharing of the posterior discoligamentous passive structures. Passive contributions from erector spinae stretching during the flexion posture and active contributions from other muscles (quadratus lumborum and deep erector spinae among others) further assist in load sharing in the trunk flexion posture. A number of studies have shown differences in the FRP between patients with chronic low back pain and healthy individuals, and the reliability of the assessment. Persistent activation of the lumbar erector spinae musculature among patients with back pain may represent the body's attempt to stabilize injured or diseased spinal structures via reflexogenic ligamentomuscular activation thereby protecting them from further injury and avoiding pain. CONCLUSIONS: The myoelectric silencing of the erector spinae muscles in the trunk flexion posture is indicative of increased load sharing on passive structures, which tissues have been found to fail under excessive loading conditions and shown to be a source of low back pain. The studies that show differences in the presence of the FRP among patients and control subjects are encouraging for this type of clinical assessment and suggest that assessment of the FRP is a valuable objective clinical tool to aid in the diagnosis and treatment of patients with low back pain.

Biomechanical Phenomena↗
PubMedDate not supplied

Clinical teaching and learning in midwifery and women's health.

Although there is an abundance of literature about clinical teaching in the health professions, a much smaller body of information focuses on the art and science of clinical teaching in midwifery and women's health. We reviewed preceptor handbooks, training manuals, and Web sites created by nursing and nurse-midwifery education programs, medical and pharmacy schools, and national associations of health professionals. Using the search terms "clinical teaching, clinical learning, preceptor, clerkship, residency training, and midwifery education", we searched the MEDLINE and CINAHL databases and health sciences libraries for relevant articles and books. The information and practical strategies about clinical teaching that we found are synthesized and presented in this article. It includes a discussion of challenges in clinical teaching; an overview of expectations and responsibilities of the education program, students, and preceptors; suggestions about orienting students to clinical sites; clinical teaching strategies and skills; suggestions for incorporating critical thinking and evidence-based care into clinical teaching; guidelines for giving constructive feedback and evaluation; characteristics of excellent clinical teachers; and suggestions about how education programs and professional associations can support and develop clinical sites and preceptors. The Appendix contains manuals, books, and Web sites devoted to clinical teaching.

Clinical Competence↗
PubMed1993

The conceptual validity of a taxonomy of nursing interventions.

The purpose of this paper is to report validity evidence for the nursing intervention taxonomy developed as part of the Nursing Intervention Lexicon and Taxonomy (NILT) Study. Using eclectic classification methods of library science, cognitive science, nursing science and computational linguistics, a taxonomy of nursing interventions consisting of seven categories was developed. These categories which incorporate care as a central concept are described and defined, and prototypical examples of each category are presented. Brinberg & McGrath's validity schema provides the framework within which evidence for validity as value, validity as correspondence and validity as generalizability were examined. Comparison of the NILT categories with previously published categorizations of nursing functions and interventions provides strong support for the validity of this classification. Additionally, comparison of the NILT categories with two internationally derived categorizations of nursing functions supports the robustness or generalizability of the NILT classification.

Job Description↗
PubMed2002

Mirage or reality?

Explore the source record for details and available documents.

Evidence-Based Medicine↗
PubMed2003

Patterns and costs of printed and online journal usage.

This study in an academic medical sciences library setting examines the correlation of usage of a matched set of print and online titles, the validity of e-journals usage statistics and the impact of online journals on print journal usage. The print and online usage was determined for 270 journals, both versions of which were available. Print usage was determined annually since 1997 using the reshelving and the error-copies method. Online usage statistics were delivered by five publishers and corrected for redundant multiple accesses. Print journal usage decreased by 22.3 and 30.2% respectively over each of 2 years after the introduction of online journals. Journals published both in print and online lost 30.4% of their print usage within 2 years. The total loss of usage of print-only titles in the same period was somewhat higher, at 45.8%. The average correlation between online and print usage is 0.60 and 0.67 respectively. For the examined titles, users accessed the online versions ten times as often as the print version. Two clearly distinguishable groupings emerged: while with Academic Press and Elsevier, e-journal usage exceeded print usage by a factor of 3 or 4, the e-journals of Blackwell, HighWire and Springer were used on average 14.6 times as frequently as the corresponding print journals. Each usage of a print article cost 2.79-50.82 Euro, each usage of an online article 0.31-15.10 Euro, depending on the publisher. On average, the usage of an online article was 5.4 times cheaper. Within 2-3 years the usage of online journals has outstripped that of print titles by a factor of ten, but the specific spectrum of usage remains much the same as when only print journals alone existed. Print titles not available online suffer a greater decline in usage compared with print/online journals. This confirms that what is read or purchased is determined primarily by ease of access and that there is a steady tendency to reduce the multiplicity of access modes to a manageable few. The availability of journals online seems to have created a new clientele, at least in the case of the German-language Springer journals. The connection between supplier and supply is much less clear with e-journals than it is with print titles. Therefore it is very important to stress and encourage the role of the library as the supplier of this sort of information in the university environment. Collection building issues are discussed in the light of the results.

Costs and Cost Analysis↗
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↗
PubMed1981

A randomized trial of librarian educational participation in clinical settings.

In order to evaluate the librarian's educational role in patient care settings, an information service was provided for health professionals, patients, and families by two part-time clinical librarians. Eight clinical areas were randomly selected from a pool of settings which met predetermined entry criteria. Four of these settings were randomly allocated to the experimental maneuver (that is, the clinical librarian service), and four were control settings. Results showed that the clinical librarians were accepted by health professionals and that services to all groups were viewed as successful. Significant differences in information-seeking patterns were found between study and control groups of health professionals. In particular, the study group was more likely to use the library for direct patient care and rated the librarian and library resources more highly as sources of information. This time-limited and education-oriented model would be useful for settings in which a full-time librarian program is not feasible.

Attitude↗
PubMedDate not supplied

The potential use of "blogs" in nursing education.

Web logs, also known as "blogs," are an emerging writing tool that are easy to use, are Internet-based, and can enhance health professionals' writing, communication, collaboration, reading, and information-gathering skills. Students from different disciplines, such as medicine, public health, business, library science, and journalism, garner knowledge from blogs as innovative educational tools. Healthcare professionals are expected to be competent in the use of information technology to be able to effectively communicate, manage information, diminish medical error, and support decision making. However, the use of blogs, as an interactive and effective educational method, has not been well documented by nurse educators.

Education, Distance↗
PubMed2005

Impact of librarians in first-year medical and dental student problem-based learning (PBL) groups: a controlled study.

BACKGROUND: Librarians at the University of Alberta have been involved with teaching undergraduate medical and dental education for several years. After 1 year of increased librarian involvement at the problem-based learning (PBL), small-group level, informal feedback from faculty and students suggested that librarians' participation in PBL groups was beneficial. There was, however, no real evidence to support this claim or justify the high demand on librarians' time. OBJECTIVES: The study aimed to determine whether having a librarian present in the small-group, problem-based learning modules for first-year medical and dental students results in an improved understanding of evidence-based medicine concepts, the nature of medical literature, and information access skills. METHODS: One hundred and sixty-four first-year medical and dental students participated in the study. There were a total of 18 PBL groups, each with approximately nine students and one faculty tutor. Six librarians participated and were assigned randomly to the six intervention groups. Students were given pre- and post-tests at the outset and upon completion of the 6-week course. RESULTS: Post-test scores showed that there was a small positive librarian impact, but final exam scores showed no impact. There was also no difference in attitudes or comfort levels between students who had a librarian in their group and those who did not. CONCLUSIONS: Impact was not sufficient to warrant continued participation of librarians in PBL. In future instruction, librarians at the John W. Scott Health Sciences Library will continue to teach at the larger group level.

Adult↗
PubMed2003

AHEC in West Virginia: a case study. Area health education centers.

This case study describes the area health education centers (AHEC) program in West Virginia, spanning 30 years from a first-generation project at Charleston in 1972 (AHEC 1) to a newly funded statewide program (AHEC 2). The outcome is an evolving university-community partnership designed to meet changing work-force and community health needs in the heart of rural Appalachia. West Virginia University's (WVU's) application of the original Carnegie Commission AHEC recommendations (1970) resulted in the Charleston AHEC, now part of the Robert C. Byrd Health Sciences Center of WVU. AHEC today trains more than 135 residents and interns, and one-third of the third-year and fourth-year WVU medical students. Charleston offers clinical and continuing education for nurses, dentists, pharmacists, and allied health professionals. A health sciences library, distance learning, and a network of primary care clinics help define Charleston's unique AHEC role. This AHEC hub continues to meet the classic Carnegie goals of recruiting and retaining health professionals, and providing access to care in the original service area and statewide. Based on the Charleston experience, four new federally funded AHECs are being developed to link rural primary care residencies with the state-funded West Virginia rural health education partnerships. These rural consortia AHECs are applying the concept of community competency, a performance-based methodology, to integrate learning while achieving the goals of Healthy People 2010.

Academic Medical Centers↗
PubMed1983

Establishing a psychiatric library.

The amount of information in the psychiatric field has increased to such an extent that a specialized library is an essential part of the mental health facility. Guidelines are presented for establishing a psychiatric library, including staffing, budgeting, physical layout, and selection and handling of books, reference materials, journals and annuals, microfilm and microfiche, and audiovisuals. The expertise of the librarian is the single most important factor in determining the quality of the collection and the services provided, the author believes. Because of escalating costs, developing a cooperative library network of small, specialized mental health collections may be the most productive course for the future.

Humans↗
PubMed2006

Technology mediator: a new role for the reference librarian?

The Arizona Health Sciences Library has collaborated with clinical faculty to develop a federated search engine that is useful for meeting real-time clinical information needs. This article proposes a technology mediation role for the reference librarian that was inspired by the project, and describes the collaborative model used for developing technology-mediated services for targeted users.

Journal Article↗
PubMed2006

The transformation of spinal curvature into spinal deformity: pathological processes and implications for treatment.

BACKGROUND: This review summarizes what is known about the pathological processes (e.g. structural and functional changes), by which spinal curvatures develop and evolve into spinal deformities. METHODS: Comprehensive review of articles (English language only) published on 'scoliosis,' whose content yielded data on the pathological changes associated with spinal curvatures. Medline, Science Citation Index and other searches yielded > 10,000 titles each of which was surveyed for content related to 'pathology' and related terms such as 'etiology,' 'inheritance,' 'pathomechanism,' 'signs and symptoms.' Additional resources included all books published on 'scoliosis' and available through the Arizona Health Sciences Library, Interlibrary Loan, or through direct contact with the authors or publishers. RESULTS: A lateral curvature of the spine-'scoliosis'-can develop in association with postural imbalance due to genetic defects and injury as well as pain and scarring from trauma or surgery. Irrespective of the factor that triggers its appearance, a sustained postural imbalance can result, over time, in establishment of a state of continuous asymmetric loading relative to the spinal axis. Recent studies support the longstanding hypothesis that spinal deformity results directly from such postural imbalance, irrespective of the primary trigger, because the dynamics of growth within vertebrae are altered by continuous asymmetric mechanical loading. These data suggest that, as long as growth potential remains, evolution of a spinal curvature into a spinal deformity can be prevented by reversing the state of continuous asymmetric loading. CONCLUSION: Spinal curvatures can routinely be diagnosed in early stages, before pathological deformity of the vertebral elements is induced in response to asymmetric loading. Current clinical approaches involve 'watching and waiting' while mild reversible spinal curvatures develop into spinal deformities with potential to cause symptoms throughout life. Research to define patient-specific mechanics of spinal loading may allow quantification of a critical threshold at which curvature establishment and progression become inevitable, and thereby yield strategies to prevent development of spinal deformity.Even within the normal spine there is considerable flexibility with the possibility of producing many types of curves that can be altered during the course of normal movements. To create these curves during normal movement simply requires an imbalance of forces along the spine and, extending this concept a little further, a scoliotic curve is produced simply by a small but sustained imbalance of forces along the spine. In fact I would argue that no matter what you believe to be the cause of AIS, ultimately the problem can be reduced to the production of an imbalance of forces along the spine 1.

Journal Article↗
PubMed2004

Teaching evidence-based medicine to medical students.

Evidence-based medicine (EBM) is the rubric for an approach to learning and practicing medicine that applies skills from clinical epidemiology, library science, and information management to clinical practice. Teaching EBM effectively requires a longitudinal approach throughout medical education. This presents many opportunities for academic emergency physicians, especially in the setting of an emergency medicine clerkship. EBM is best taught at the bedside, although this depends on a skilled and interested faculty. Bedside teaching of EBM also requires ready access to modern information resources. Other venues for teaching EBM include morning report, teaching conferences, and journal clubs. Many tools can be used to aid the process, including Web-based sources such as UpToDate, textbooks, and Web-based tutorials, educational prescriptions, and critically appraised topics.

Clinical Clerkship↗
PubMedDate not supplied

Access to the internet in an acute care area: experiences of nurses.

The internet is expected to play a key role in delivering evidence-based practice (Department of Health (DoH), 1997, 1998a; Beyea, 2000). In the UK, poor access to the internet and a lack of knowledge and confidence have been identified as barriers to nurses accessing evidence via the internet. The study described here aimed to evaluate how open access to the internet in an acute ward area had an impact upon the evidence-based practice of nurse and allied health professionals. The study was funded by the Department of Health. It incorporated a survey of over 200 staff, semi-structured interviews and monitoring of internet use. The results indicate that the ward-based internet facilities were valued and used by nurses. However, time, support and training are required for nurse to realize the full potential of the internet. Future partnerships between health science libraries and the NHS are recommended to help staff to access and use the internet in order to answer clinically derived questions.

Access to Information↗
PubMed1988

BRS Colleague MEDLINE end user training follow-up survey.

The amount of recent literature describing end user training programs is substantial, yet there are few reports evaluating the effectiveness of such training. This article reports on a follow-up survey of the first seventy-five trainees of a four-hour BRS Colleague MEDLINE training program at the Health Sciences Library of East Carolina University. The 90.7 percent response rate to the questionnaire provided information about both those who performed searches and those who had not. It indicated how trainees felt about their training, their ability to perform searches or reason for not performing searches, and types of additional training the trainees desired. Survey results are discussed in terms of effectiveness of the training for the end user with infrequent search needs, possible modifications to improve the effectiveness of the training, and possible alternatives to BRS Colleague MEDLINE.

Attitude of Health Personnel↗