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PubMed2002

Dietary interventions for recurrent abdominal pain (RAP) in childhood.

BACKGROUND: Between 4% and 25% of school-age children complain of recurrent abdominal pain (RAP) of sufficient severity to interfere with daily activities. It is unclear whether the diagnosis of RAP includes children with different aetiologies for their pain. For the majority of such children, no organic cause for their pain can be found on physical examination or investigation. Although most children are likely managed by reassurance and simple measures, a large range of interventions have been recommended. OBJECTIVES: To determine the effectiveness of dietary interventions for recurrent abdominal pain in school-age children. SEARCH STRATEGY: The Cochrane Library (CENTRAL), MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, LILACS and JICST were searched using a strategy combining (Recurrent OR synonyms) AND (Abdomen OR synonyms) AND (Pain OR synonyms). Where appropriate, search filters were employed. In addition, researchers working in this area were asked to identify relevant studies. SELECTION CRITERIA: Any study in which the majority of participants were school-age children fulfilling standard criteria for RAP, and who were allocated by random or quasi-random methods to any dietary treatment compared with a placebo or no treatment, were selected. DATA COLLECTION AND ANALYSIS: References identified by the searches were screened against the inclusion criteria by two independent reviewers. MAIN RESULTS: Four trials were included in the review overall. Two comparing fibre supplements with placebo (Christensen 1982, Feldman 1985) were included, with data from one study reported in two papers (Christensen 1982, Christensen 1986). A total of 92 school-aged children participated in the two trials. The pooled odds ratio for improvement in the frequency of abdominal pain was 1.16 (95% CI 0.45-2.87). Two trials (Lebenthal 1981, Dearlove 1983) comparing lactose-containing with lactose-free diets were included. A total of 90 school-aged children participated in these two trials; however, neither trial reported data in a form which could be used in the meta-analysis and the former trial had a loss to follow-up of 45%. We are continuing to try to contact the authors of the Lebenthal 1981 trial for more data. The authors of Dearlove 1983 reported that raw data from their trial is not available. REVIEWER'S CONCLUSIONS: There is a lack of high quality evidence on the effectiveness or otherwise of dietary interventions. This review suggests that fibre supplements are not effective in the management of RAP, although the trials are small and of variable quality. The trials from lactose-restricting diets are as yet wholly inclusive. There is a need for well-designed trials (which include compliance measures) of all recommended dietary interventions for children with RAP.

Abdominal Pain↗
PubMed1972

The Mount Sinai Hospital Library, 1883 to 1970.

A history of the Mount Sinai Hospital Library in New York City from its inception in 1883 to 1970 is presented. From its modest beginnings the growth and development of the library is reviewed through eight decades. The paper reports the library's expanded role in the Mount Sinai School of Medicine of the City University of New York.

History, 19th Century↗
PubMed1999

Health information resources: tradition and innovation in a medical school curriculum.

Changes in LCME accreditation for medical colleges fostered the development of Health Information Resources, a required, for-credit course created by the Saint Louis University Health Sciences Center Library Reference Department for the first-year medical school curriculum. Six content areas were developed for inclusion in the syllabus: "Electronic Resources Survival Kit"; "Introduction to Problem Based Resources"; "Introduction to Literature Searching"; "MEDLINE Searching Hands-On/Publishing Pearls & Pitfalls"; "The World Wide Web and Patient Information"; and "Introduction to Electronic Mail." A combination of lectures, hands-on instruction, and active learning techniques were employed in the teaching of this class. Submission of a Health Information Resource Guide and a two-part final exam were required.

Academic Medical Centers↗
PubMed2002

[The ancient Alexandria school of medicine].

A famous medical school was established in old Alexandria during the third century BC. Although mainly Greek in essence, and following the Hippocratic teachings, it was heavily tainted by the medical practices of ancient Egypt. Anatomy was particularly advanced due to the possibility of dissecting the human body. The most important Alexandrian physicians were Herophilus and Erasistratus. Many graduates of this medical school traveled and practiced throughout the Mediterranean basin. Galen, the famous Roman physician studied in Alexandria before practicing in Rome. His teachings and writings survived well into the sixteenth century and formed the basis of more modern medical practices during the renaissance. These writings were conserved partly by Christian monks and partly by Arab and Jewish scholars of the middle ages. The medical school of Alexandria was still active until late in the 3rd century AD. However, it slipped slowly into oblivion after the fire of 389 AD, which also devastated its famous library.

Anatomy↗
PubMed2000

Urban girls, internet use, and accessing health information

Background: With the burgeoning growth of the Internet, many have raised concerns over whether and how underserved populations might be included in the Information Revolution. This study examines how urban adolescent girls access the Internet and whether it is a viable source for health information.Methods: During Fall 1999 in New York City, 176 girls completed an anonymous survey where half were from a private high school (N = 86) and the other half were patients at a health clinic serving ethnically diverse and disadvantaged youth (N = 90). Data were analyzed to provide information on how urban girls use the Internet.Results: Internet use was widespread; 99% of the high school and 83% of the clinic girls said they used this medium (p <.001). On frequency, 32% of high school girls compared to 13% of the clinic girls used the Internet 6-7 days/wk (p <.001). Among the high school girls, 30% indicated that they used the Internet less than 30 min/wk and another 18% reported using the Internet more than 5 hrs/wk. Among clinic girls, 51% used the Internet less than 30 min/wk while 9% reported more than 5 hrs/wk. Comfort levels differed with 20% of the high school compared to 10% of the clinic girls reporting "extreme" comfort using the Internet (p <.001).Urban girls accessed the Web from multiple locales. Almost all (98%) of the high school girls compared to 45% of the clinic girls reported that they used the Internet from home (p <.001). Most high school girls (82%) used the Internet at school compared to 63% of the clinic girls currently in school (p <.05). More clinic girls used the Internet at another family member's house (28% vs. 14%, p <.05). Similar percentages of high school and clinic girls used the Internet at a friend's house (46%), the library (31%), or a community center (3%).With similar rates among high school and clinic girls, 44% reported that they had tried to get health information from the Web. Of these (N = 74), 50% said that they got information on different diseases, 43% on diet/nutrition, 34% on fitness/exercise, 26% on sex, 24% on alcohol/drug abuse, 20% on mental health, 14% on medicines, 12% on violence among peers, 10% on parenting, 8% on violence among dating partners, 7% on tobacco and smoking, 7% on emotional or physical abuse, 3% on sexual abuse, and 1% on illness support groups. Clinic girls were more likely to have tried to get information on sex (p <. 001) and parenting (p <.001) from the Web. Many girls (59%) indicated that it was "very" or "extremely" worthwhile to have general health information on the Web, with no significant differences between high school and clinic girls. As well, 71% and 62% said it was "very" or "extremely" worthwhile to have access to contraceptive and diet/nutrition information, respectively. Conclusions. High school girls, as anticipated, were technologically savvy. Somewhat surprising, however, were the clinic girls' high levels of Internet use and access. Significant differences revealed that the high school girls were more on-line than clinic girls, but clinic girls were still using the Web frequently. A considerable number or urban girls had tried to get a range of health information from the Internet. This study offers promising statistics on how urban adolescent girls are accessing and using the Internet, especially for health information.

Journal Article↗
PubMed1974

Introduction to library services for allied health personnel.

Experience with a non-credit course, given by the staff of the University of Western Ontario Health Sciences Library, within the framework of the University's Summer School and Extension Program, to allied health personnel is presented. The purpose of this course was to acquaint allied health personnel with the library and its services and how to use the services to the best advantage.

Allied Health Personnel↗
PubMed1993

A problem-based learning curriculum in transition: the emerging role of the library.

This case study describes library education programs that serve the University of New Mexico School of Medicine, known for its innovative problem-based learning (PBL) curricular track. The paper outlines the specific library instruction techniques that are integrated into the curriculum. The adaptation of library instruction to a PBL mode of medical education, including the use of case studies, is discussed in detail. Also addressed are the planning processes for the new PBL curriculum scheduled for implementation in 1993, including the activities of library faculty and staff and the probable new role of the library in the new curriculum.

Computer-Assisted Instruction↗
PubMed2000

[School injuries among 7 to 15 years old children].

This study had two purposes: first, to describe the incidence and characteristics of school injuries among 7 to 15 year old pupils in Norway; second, to identify effective preventive measures. Data on school injuries were taken from the Norwegian National Injury Register (National Institute of Public Health) for the 1995-97 period, n = 2,975. The incidence of school injuries was 29 per 1,000 children-years. Over the nine-year age span, boys had a higher cumulative incidence (292 injuries per 1,000 boys) than girls (239 injuries per 1,000 girls); 1% of the injuries was categorized as severe. Among pupils aged 7-12, 34% of injuries occurred during sports activities; among the 13-15 age group, 60% were related to sports. A literature review was conducted in order to identify preventive measures shown to be effective in reducing school injuries. The databases used were Cochrane Library (issue 4, 1998), Medline (1966-98) and Embase (1980-98). However, no studies found in the literature had evaluated preventive measures. On the basis of our findings, we suggest that preventive measures should emphasise non-sport injuries among the younger pupils and sport injuries among the older pupils. Preventive measures should be evaluated.

Accident Prevention↗
PubMed2004

[Evolution of a quality assurance programme for physiotherapy schools - results of the first quality inspections].

In cooperation with the Hochrhein-Institute for Research in Rehabilitation (HRI), the Association for Assuring the Quality of Education in Physiotherapy Schools in Germany (ISQ) has developed a quality assurance programme for physiotherapy schools. It aims at assessing the quality of physiotherapy schools in Germany, and to award a quality seal based on compliance with defined criteria. First, a catalogue of quality features and criteria relevant for education in physiotherapy was developed. It is based on the analysis of questionnaires that had been sent to all German physiotherapy schools, to selected physiotherapists and leading physiotherapists in hospitals, to competent federal authorities, and to three school-classes with group discussions. The persons addressed named 360 different quality features. They were collected in a catalogue, revised in a multi-stage Delphi procedure, and approved consensually. The final criteria were transformed into basic quality requirements, and formulated as a check-list. Assessment of the quality features is carried out by trained visitors. In addition, the satisfaction of students is assessed with a questionnaire. The results of the interviews and the questionnaires are fed back to the schools in a quality report. Schools meeting all basic quality requirements are awarded the seal of quality. The seal is valid for three years. Since January 2003, this procedure is available for all schools in Germany. Until September 2002, a pretest of visitations and student questionnaires had been carried out with 31 member schools of the ISQ; according to the resulting quality reports, none of these schools would instantly be awarded the quality seal. In all, more than half of the schools do not meet 10 of the 42 basic criteria. Fundamental deficiencies have been found in the documentation pertaining to supervision of practical training. In terms of training, further training and professional development of their teachers and associated professors, needs for improvement could be shown in more than 66 % of all visited schools. Only 9 of 31 schools could produce a written syllabus. Additionally, the requirements of teachers conferences and equipment of libraries were not met by the majority. A general problem among the schools is inadequate documentation in many fields.

Clinical Competence↗
PubMedDate not supplied

[The evaluation of effectiveness of scholastic programs in the prevention of consumption of tobacco, alcohol and cannabis: what do meta-analyses tell us?].

Consumption of tobacco, alcohol and illegal drugs is a major public health problem in developed countries. The aim of the study is to describe the impact and associated characteristics of preventive programs addressed at those problems in the school setting. Meta-analysis focusing on evaluations of programs focusing on smoking, alcohol and/or cannabis at the school setting are reviewed. The search was done at Cochrane Library and Medline databases of articles published between 1993 and 1999, and including as keywords programs, education, drugs prevention, prevention, smoking, alcohol, school, adolescence, teenagers, young people, evaluation, health education, effectiveness, review, meta-analysis. We found 5 meta-analysis of programs summarizing the effect of preventive programs, most of them dealing with legal and illegal drugs. However, most of the interventions reporting changes in behavior measured only smoking. More effective interventions addressed social influences, used active methodology and were implemented by teachers or peers. The importance of booster sessions, the quality of implementation and thorough evaluation is stressed. Overall, meta-analysis of evaluated programs shows a small effect, although the population impact may be relevant. Some limitations point to new areas of interest for future research.

Adolescent↗
PubMed2001

A review of the chemistry, biological action, and clinical applications of anabolic-androgenic steroids.

BACKGROUND: Since its discovery in 1935, numerous derivatives of testosterone have been synthesized, with the goals of prolonging its biological activity in vivo, producing orally active androgens, and developing products, commonly referred to as anabolic-androgenic steroids (AAS), that are more anabolic and less androgenic than the parent molecule. OBJECTIVE: This article reviews the structure, biotransformation, and mechanism of action of testosterone and some of the most commonly used AAS. Clinical applications of the AAS are discussed, and guidelines and therapeutic maneuvers for minimizing their side effects are outlined. METHODS: Literature for inclusion in this review was identified using the libraries of the University of Wisconsin Medical School and School of Pharmacy, the author's files, and searches of MEDLINE, Science Citation Index, Biological Abstracts, and Chemical Abstracts. RESULTS: The myotrophic action of testosterone and its derivatives and their stimulatory effects on the brain have led to widespread use of AAS by athletes and "recreational" drug users. Consequently, all AAS were classified as class III controlled substances in 1991. Nonetheless, AAS have shown benefit in a variety of human disorders, including HIV-related muscle wasting and other catabolic conditions such as chronic obstructive pulmonary disease, severe burn injuries, and alcoholic hepatitis. Because of their diverse biological actions, AAS have been used to treat a variety of other conditions, including bone marrow failure syndromes, constitutional growth retardation in children, and hereditary angioedema. AAS therapy is associated with various side effects that are generally dose related; therefore, illicit use of megadoses of AAS for the purpose of bodybuilding and enhancement of athletic performance can lead to serious and irreversible organ damage. The most common side effects of AAS are some degree of masculinization in women and children, behavioral changes (eg, aggression), hepatotoxicity, and alteration of blood lipid levels and coagulation factors. CONCLUSIONS: To minimize or avoid serious toxicities with AAS therapy, close medical supervision and periodic monitoring are important, with dose adjustment as appropriate to achieve the minimum effective dose. Given the biological effects and potential adverse effects of AAS, administration of these agents should be avoided in pregnant women, women with breast cancer or hypercalcemia, men with carcinoma of the prostate or breast, and patients with nephrotic syndromes or significant liver dysfunction.

Anabolic Agents↗
PubMedDate not supplied

Resident education in transfusion medicine: a multi-institutional needs assessment.

A survey was conducted among resident physicians at nine academic medical centers to assess their perceptions of their knowledge of transfusion medicine (TM), their confidence in using various blood bank resources, and their ratings of the contribution of various learning resources to their knowledge of TM. A total of 320 residents completed the survey; nearly 90 percent were in an internal medicine, surgery, or anesthesiology residency. Respondents placed a high value on the relevance of TM to patient care, although they rated their knowledge and learning opportunities as only moderate. They rated senior residents as the most useful educational resource, with undergraduate medical school education, formal conferences, and journals and library resources being the three next most useful. Residents had the greatest confidence in using packed red cells, platelets, and fresh-frozen plasma. Surgery and anesthesiology residents generally had greater confidence in using blood bank resources than internal medicine residents. The findings of the survey can be used, along with the results of medical care evaluations of transfusion practice and opinions of education experts, to create an optimally relevant and effective curriculum for resident education in transfusion medicine.

Academic Medical Centers↗
PubMed1989

Introducing NurseSearch into an academic setting.

NurseSearch is a floppy-disk, abridged version of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), covering about sixty journals. The program is a menu-driven software package designed to allow end users with no prior searching experience to perform their own searches. It is available in annual editions from 1985 to the present. This paper describes the introduction of NurseSearch within the Libraries at Kent State University and its School of Nursing. Reactions of new users to selected program operations are identified. Conclusions from a trial period are set forth.

Information Systems↗
PubMed1990

Drug information skills for pharmacy students: curriculum integration.

For pharmacy students to provide optimal and complete pharmaceutical care, it is vital that they develop drug information skills. At the University of Southern California, the School of Pharmacy and the Norris Medical Library have established an interactive educational program. Library programs support an increasingly complex progression of information retrieval, evaluation, organization, application, and communication. Librarians are systematically involved in all four years of coursework for the doctor of pharmacy degree. Training and experience in computer literacy and online database searching are included in the library components. Description of the educational program covers its beginning a decade ago, current status, and future in an environment of rapidly advancing technology.

California↗
PubMed2005

Defining and assessing medical informatics competencies.

As academic health sciences libraries assume larger roles in informatics instruction within medical school curricula, librarians are challenged to develop useful and accurate measures for assessing the effectiveness of instructional approaches. The need for this evaluation has intensified as medical schools increase their emphasis on integration of curriculum content and shift to competency-based education and assessment of medical students. This paper reports on a pilot project developed at Dahlgren Memorial Library, Georgetown University Medical Center, for two courses using an instructional intervention and tailored assignment for assessing student competencies.

Competency-Based Education↗