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PubMedDate not supplied

The travesty of choosing after positive prenatal diagnosis.

OBJECTIVE: To integrate the findings of qualitative studies of expectant parents receiving positive prenatal diagnosis. DATA SOURCES: Seventeen published and unpublished reports appearing between 1984 and 2001 and retrieved between December of 2002 and March of 2003. The electronic databases searched include Academic Search Elite, AIDS Information Online (AIDSLINE), Anthropological Index Online, Anthropological Literature, Black Studies, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Digital Dissertations, Dissertation Abstracts Index (DAI), Educational Resource Information Center (ERIC), MEDLINE, PsycInfo, Public Affairs Information Service (PAIS), PubMed, Social Science Abstracts (SocSci Abstracts), Social Science Citation Index, Social Work Abstracts, Sociological Abstracts (Sociofile), Women's Resources International, and Women's Studies. STUDY SELECTION: Qualitative studies involving expectant parents living in the United States of any race, ethnicity, nationality, or class who learned during any time in pregnancy of any fetal impairment by any means of diagnosis were eligible for inclusion. DATA EXTRACTION: Metasummary techniques, including the calculation of frequency effect sizes, were used to aggregate the findings. Metasynthesis techniques, including constant comparison analysis and the reciprocal translation of concepts, were used to interpret the findings. DATA SYNTHESIS: The topical emphasis in the findings is on the termination of pregnancy following positive diagnosis. The thematic emphasis is on the dilemmas of choice and decision making. Positive prenatal diagnosis was for couples an experience of chosen losses and lost choices. Couples managed information to minimize stigmatization and cognitive dissonance. CONCLUSIONS: Existing guidelines for caring for couples after perinatal losses must accommodate the chosen loss experientially defining positive prenatal diagnosis.

Abortion, Induced↗
PubMed1988

Chemical Abstracts Service Chemical Registry System. 10. Registration of substances from pre-1965 indexes of Chemical Abstracts.

The Chemical Abstracts Service Chemical Registry System, operating since 1965, uniquely identifies chemical substances on the basis of molecular structure. Chemical Abstracts Service is now registering chemical substances cited in indexes to Chemical Abstracts prior to 1965. This effort will result in several hundred thousand additional chemical structures, along with their names, being available for online searching in the Registry File. Both the newly registered substances and those already on file are being linked to their pre-1965 citations in Chemical Abstracts in a new file called CAOLD. In this effort the printed Formula Index entries are converted to computer-readable form by using optical character recognition with the data subsequently processed with existing computer programs.

Abstracting and Indexing↗
PubMed1994

Full publication of results initially presented in abstracts. A meta-analysis.

OBJECTIVES: To estimate the rate of full publication of the results of randomized clinical trials initially presented as abstracts at national ophthalmology meetings in 1988 and 1989; and to combine data from this study with data from similar studies to determine the rate at which abstracts are subsequently published in full and the association between selected study characteristics and full publication. DATA SOURCES: Ophthalmology abstracts were identified by review of 1988 and 1989 meeting abstracts for the Association for Research in Vision and Ophthalmology and the American Academy of Ophthalmology. Similar studies were identified either from reports contained in our files or through a MEDLINE search, which combined the textword "abstract" with "or" statements to the Medical Subject Headings ABSTRACTING & INDEXING, CLINICAL TRIALS, PEER REVIEW, PERIODICALS, MEDICAL SOCIETIES, PUBLISHING, MEDLINE, INFORMATION SERVICES, and REGISTRIES. STUDY SELECTION: Ophthalmology abstracts were selected from the meeting proceedings if they reported results from a randomized controlled trial. For the summary study, similar studies were eligible for inclusion if they described followup and subsequent full publication for a cohort of abstracts describing the results of any type of research study. All studies had to have followed up abstracts for at least 24 months to be included. DATA EXTRACTION: Authors of ophthalmology abstracts were contacted by letter to ascertain whether there was subsequent full publication. Other information, including characteristics of the study design possibly related to publication, was taken from the abstract. For the summary study, rates of full publication were taken directly from reported results, as were associations between study factors (ie, "significant" results and sample size) and full publication. DATA SYNTHESIS: Sixty-six percent (61/93) of ophthalmology abstracts were published in full. Combined results from 11 studies showed that 51% (1198/2391) of all abstracts were subsequently published in full. Full publication was weakly associated with "significant" results and sample size above the median. CONCLUSIONS: Approximately one half of all studies initially presented in abstract form are subsequently published as full-length reports. Most are published in full within 2 years of appearance as abstracts. Full publication may be associated with "significant" results and sample size.

Abstracting and Indexing↗
PubMed2006

Laxatives for the management of constipation in palliative care patients.

BACKGROUND: Constipation is a common problem for palliative care patients which can generate considerable suffering for patients due to both the unpleasant physical symptoms and psychological preoccupations that can arise. There is uncertainty about the 'best' management of constipation in palliative care patients and variation in practice between palliative care settings. OBJECTIVES: To determine the effectiveness of laxative administration for the management of constipation in palliative care patients, and the differential efficacy of the laxatives used to manage constipation. SEARCH STRATEGY: We searched The Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue four, 2005), MEDLINE (1966 to January 2005), EMBASE (1980 to January 2005), CANCERLIT, PUBMED, Science Citation Index, CINAHL, The Cochrane Library, SIGLE, NTIS, DHSS-DATA, Dissertation Abstracts, Index to Scientific and Technical Proceedings and NHS-NRR and reference lists of articles. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing laxatives for constipation in palliative care patients. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted patient-reported data measuring changes in stool frequency and ease of passing stools, using objective and validated scales. Tolerance or adverse effects of laxatives used were also sought. The appropriateness of synthesizing data from the controlled trials depended upon the clinical and statistical homogeneity of studies identified. If the controlled trials were homogeneous, a meta-analysis would be attempted. MAIN RESULTS: Four trials involving 280 people were included. Between these trials, the laxatives lactulose; senna; danthron combined with poloxamer (Co-danthramer); Misrakasneham; magnesium hydroxide combined with liquid paraffin (Milpar) were evaluated. All four trials included number and frequency of bowel movements and relative ease of defecation as part of the assessment of laxative efficacy. All of the laxatives demonstrated a limited level of efficacy, although a significant number of participants required rescue laxatives in each of the studies. The only significantly different treatments were in the trial where lactulose plus senna were more effective than danthron combined with poloxamer. Patient preference did not favour either treatment option. Other related systematic reviews have similarly identified that there is a lack of evidence to support the use of one laxative, or combination of laxatives, over another. AUTHORS' CONCLUSIONS: The treatment of constipation in palliative care is based on inadequate experimental evidence, such that there are insufficient RCT data. Recommendations for laxative use can be related to costs as much as to efficacy. There have been few comparative studies, equally there have been few direct comparisons between different classes of laxative and between different combinations of laxatives. There persists an uncertainty about the 'best' management of constipation in this group of patients.

Cathartics↗
PubMed1995

The quality and impact of MEDLINE searches performed by end users.

Evidence suggests that MEDLINE is becoming an important clinical tool that can improve the care and health of patients. Efforts to improve the quality and impact of end-user searching are needed and ongoing. End users are completing many MEDLINE searches. They appreciate and value training along with feedback on their searching techniques. Practice, is however, the biggest single factor in improving the quality of searching. Key roles for the library in end-user searching include, providing the most effective MEDLINE access possible to the maximum number of users, and providing training that includes feedback and practice opportunities. System-wide advances in structured abstracts, indexing, system design, informatics research and the literature itself will make searching easier and more effective in the future. More important than the quality of search results per se is the impact that end-user searches have on patient care and patient outcomes. Growing evidence shows that both patient care and patient outcomes are improved by end-user searches.

Abstracting and Indexing↗
PubMed1967

Citation indexing and evaluation of scientific papers.

Evaluation by means of citation patterns can be successful only insofar as published papers and their bibliographies reflect scientific activity and nothing else. Such an innocent descrip tion is becoming less and less tenable. The present scientific explosion gave rise to more than a proportional pub lication explosion, which not only re flects the scientific explosion but has its own dynamics and vicious circles. Publication of results is probably the main means of accomplishing the al most impossible task of accounting for time and money spent on research. Inevitably, this puts a premium on quantity at the expense of quality, and, as with any other type of inflation, the problem worsens: the more papers are written, the less they count for and the greater is the pressure to publish more. What makes matters worse is the fact that the sheer volume of the"litera ture" makes it increasingly difficult to separate what is worthwhile from the rest. Critical reviews have become somewhat of a rarity, and editorial judgment is usually relegated to ref erees, who are contemporaries and, per haps, competitors of the authors-a situation which has its own undesirable implications (11, 18). It requires little imagination to discover other vicious circles, all arising from distortion of the primary reasons for publishing the results of scientific inquiry. There are, it is true, signs of ad justment to this crisis, partly due to some easing of the pressure to pub lish at all costs, and partly due to the readers' changing attitudes toward the flood of publications. An increasing amount of research is now being car ried out in the form of collective proj ects in large institutions where publica tion is no longer the standard method of accounting for individual work. At the same time there is apparent an in creasing tendency for scientific journals to polarize into the relatively few leading ones which carry important informa tion and the many subsidiary journals which serve as vehicles for interim lo cal accounting and, in a way, sub stitute for detailed intradepartmental re ports. This division is a result not of some arbitrary decree but of normal competition between journals, as a re sult of which, however, the strong usual ly get stronger and the weak get weaker. Were it not for these changes and also for a striking improvement in abstracting, indexing, and alerting serv ices, most research workers would have found long ago that, even in their own specialized fields, new information is accumulating faster than it can be sorted out. These developments can pro vide only a temporary reprieve, so long as there remains a strong incentive to publish the greatest possible number of papers. A new scale of values based on citations is by no means infallible or, in many cases, even fair, but at least it provides an alternative to the existing one, which is at the root of the crisis. It might, of course, be asked whether wide acceptance of such new stand ards would not lead to deliberate abuses. A little reflection shows that the system is less open to manipula tion than might appear. First, the ref erees are expected to see to it that the submitted papers cite work which is pertinent to the subject. An increased awareness of the usefulness of citation indexing as a tool for retrieval and evaluation will make this aspect of refereeing more important, and what now passes for minor carelessness or discourtesy could easily come to be regarded as serious malpractice. Sec ond, as noted above, careful selection of references is in the author's own interest, because it helps him to reach his readers. There is, therefore, some room for hope that healthy feedback in the system will tend to keep it viable. At the basis of this hope lies the supposition that, in the long run, only good work can ensure recognition. As Martyn (2) has pointed out, as an information-retrieval method, cita tion indexing is rather "noisy." The word noisy may apply even more to the problem of evaluation. Whereas in information retrieval much of the unwanted information can be filtered out by suitable search strategy (2, 6), this is not so easy to do for the pur pose of evaluation, because a simple descendence relationship between papers is still an ideal far removed from actuality (7). The situation would be much better if we could at will exclude all citations which do not indi cate real indebtedness. A scheme of citation relationship indicators, first men tioned by Garfield (12) and elaborated by Lipetz (17), would be a help, but, even if it were technically feasible, to provide such indicators would greatly add to the production costs of the Index. Another possible way to minimize the effects of "noise" is to increase the size of the samples on which the reckon ing is based. Now that research has be come a rather popular occupation, it seems that a kind of public vote may have to be accepted as a factor in evaluation. Since this is the case, there is something to be said for extending the "franchise" to minimize acciden tal effects. An index which attempted to process all scientific publications would be several times the size of the present Index, and, what is more, it would not necessarily be an improve ment as a tool for information retrieval because most of the significant work is already concentrated in the present Index. Whether this attempt will ever be considered worthwhile remains pri marily a matter of policy and eco nomics. In the meantime there is an urgent need for more experience with the existing services. It is not the purpose of this article to advocate evaluation of scientific work by some kind of public opinion poll; its purpose is to recognize a pos sible trend in this direction. Any judg ment by public acclaim is subject to obvious fallacies, but we must not be carried away by the analogy to the Stock Exchange or to electoral prac tices. The fact that, in this case, the "public" consists of authors whose con tributions are generally linked creates quite a new pattern of organization. In this discussion some of the aspects of this pattern have been explored through analogy to idealized genetic or mechani cal network models, but the very uniqueness of the system, with its many self-organizing ramifications, makes it a new field which deserves close study, since these developments may have pro found effects on the future of scientific communication.

Abstracting and Indexing↗
PubMed1996

[Control of Aedes aegypti in Martinique. Contribution of entomology studies].

The dengue prevention activities in Martinique are based on: Entomological surveillance (including the use of insecticide in all parts of the Island). Epidemiological (clinical, serological and virological) surveillance. Health Education (radio, TV, exhibitions, talks in primaries and secondaries schools, in associations,...). The main breeding sites of Aedes aegypti are maintained by human practices: flowers vases, containers, used tyres, waste... The role of those human practices in the standing of Aedes aegypti populations at high level in Martinique have lead us to emphasize entomological observations and Health education. The calculation of classical Breteau Index abstracts the nature and the productivity of the breeding sites (f.e.: no difference between a flower vase and a drum). In operational way, we have introduced a new approach for calculating the Breteau index value which includes the breeding sites nature and productivity. This approach permit us to adapt the Health education message in each geographical sector.

Aedes↗
PubMed1995

Effect on plaque removal and gingivitis of a triclosan-copolymer pre-brush rinse: a six-month clinical study in Canada.

The effect on plaque removal and gingivitis of using a pre-brush rinse containing 0.03 per cent triclosan (Irgacare MP, Ciba-Geigy Corp.) and 0.125 per cent of a copolymer of polyvinylmethyl ether and maleic acid over a six-month period, versus using a matching placebo pre-brush rinse, was assessed in this clinical study. Subjects were instructed to rinse their mouths for one minute, twice daily (morning and evening), with 15 mL of their assigned pre-brush rinse. Immediately after rinsing, subjects brushed their teeth for 30 seconds using the dentifrice and toothbrush supplied to them at the outset. Subjects were instructed to refrain from any other oral hygiene procedures throughout the duration of the study. Plaque and gingivitis examinations were conducted after three months and again after six months. At the conclusion of the study (six months), the triclosan/copolymer pre-brush rinse demonstrated an advantage of 24.8 per cent for plaque removal and a 22.1 per cent reduction in gingivitis, when compared to the matching placebo pre-brush rinse. These advantages in plaque removal and gingivitis reduction were statistically significant. The six-month effect of the triclosan/copolymer pre-brush rinse was even greater on "the more difficult to brush" surfaces of the teeth, as determined by the use of the Plaque Severity Index and the Gingivitis Severity Index.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Radial artery compliance in young, obese, normotensive subjects.

Obesity is characterized by a number of cardiovascular alterations, and whether these alterations involve arterial compliance is unknown. In 12 young, obese, normotensive subjects (age, 23.9 +/- 1.3 years; mean +/- SEM) and 12 age- and sex-matched lean control subjects we measured blood pressure, radial artery diameter, and radial artery compliance continuously over the systodiastolic pressure range with a Finapres device and recently developed echo-tracking device. Measurements were obtained at baseline and after prolonged ischemia, that is, when diameter and compliance are increased. Blood pressure values were normal in both groups (obese subjects: 109.2 +/- 4.9/68.2 +/- 2.7 mm Hg; lean control subjects: 108.2 +/- 4.1/60.7 +/- 3.8 mm Hg), but in addition to a marked increase in body mass index (38.5 +/- 0.8 versus 23.1 +/- 0.9 kg/m2, P < .01), obese subjects showed a slight and nonsignificant increase in heart rate (71.1 +/- 3.2 versus 66.7 +/- 3.3 beats per minute, P = NS), increases in left ventricular wall thickness and left ventricular mass index (121.5 +/- 4.8 versus 103.4 +/- 3.3 kg/m2, P < .01), no changes in plasma renin activity and plasma norepinephrine (compared with normal values), and a marked reduction in total body glucose uptake (glucose clamp technique). Obese subjects showed radial artery diameter and compliance values that were greater than those seen in control subjects throughout the systodiastolic pressure range. The differences were 13% (P < .05) and 96% (P < .01), respectively, and both diameter and compliance remained higher in obese than lean subjects after forearm ischemia. In obese and lean subjects baseline radial artery diameter values correlated highly with body weight, body surface area, and body mass index.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

PCNA immunopositivity index as a substitute to 3H-thymidine pulse-labeling index (TLI) in methanol-fixed human lymphocytes.

PHA-stimulated human lymphocytes or myelogenous leukemia cells (strain K-562) were pulse labeled with 3H-thymidine and submitted to various fixation-permeabilization procedures. They were then immunostained with the 19A2, 19F4 or PC10 monoclonal antibody against the proliferating cell nuclear antigen (PCNA). The preparations were finally scored for the proportion of unlabeled, double-labeled and single PCNA or 3H-thymidine-labeled nuclei. Unstimulated lymphocytes were immunonegative in all the conditions tested, as also were stimulated lymphocytes checked with an isotype of the primary antibody. A specificity (Sp) and a sensitivity (Se) score was calculated to evaluate the recognition by PCNA staining of the S-phase cells, as defined by the 3H-labeling. The data show that in most instances the three antibodies recognized the 3H-labeled cells with high sensitivity, ie with few false negative, but with low specificity, ie with PCNA positivity extending to variable proportions of non-S-phase cells. By contrast, methanol fixation followed by a brief treatment with the detergent Triton X-100 and immunostaining with either 19F4 or PC10 (but not with 19A2) combined a high sensitivity and specificity scores of the recognition of the 3H-thymidine-labeled cells: PC10 gave a more intense and, hence, more readable reaction. PHA-stimulated lymphocytes that had been preserved at -20 degrees C as cytocentrifuged smears failed to show any immunopositivity for PCNA if not submitted to further fixation prior to the immunocytochemical assay. When methanol-Triton was used for this step, only PC10 gave positive immunoreaction, yet with a lower specificity score (Sp = 76%) than in cells submitted to this fixation-permeabilization procedure without prior cryopreservation (Sp = 91.7%). The PCNA index was measured in cryopreserved, methanol-fixed smears of lymphocytes from patients with various hematological diseases and was compared to the Ki-67 index established independently on a serial sample. A good correlation was found between the two indices (r = 0.79; P < 0.0001) with the PCNA index generally lower than or close to the Ki-67 index. This warrants a note of caution about the use of total (ie stable and labile) PCNA immunostaining to measure the growth fraction (GF), classically defined as the proportion of proliferating cells in a population. However, in the absence of an absolute reference marker for G0 cells, there is no reason to assume that the PCNA index would necessarily be a worse estimate of GF than the Ki-67 index.(ABSTRACT TRUNCATED AT 400 WORDS)

Autoradiography↗