What research tools do historians of Canadian medicine currently use? what do they need and want for the future? report and analysis of a survey, 1995-96.
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Creation of an online collection of emergency medicine literature.
Residents and medical students are challenged to incorporate the latest medical literature into their clinical practice. However, retrieving influential articles in a timely manner can be difficult. To address this, the authors created a collection of influential primary research literature relevant to the practice of emergency medicine. The authors surveyed local experts as to the most influential articles in their area of expertise and then linked articles in the literature collection to full-text versions available through the medical school's digital library. A total of 154 articles were included in the literature collection. These were organized into 23 subject headings and 23 subheadings. Fifty-two residents were surveyed one month after the collection became available; 18 residents (35%) had used the literature collection at that time. An online collection has several advantages: it makes the most relevant literature immediately available during clinical care and allows residents to elaborate on their own knowledge when clinical problems arise. It also can be easily updated and password protected. Similar collections may be developed for use in other educational settings.
Bibliometrics↗
A survey of the Mycoplasma genitalium genome by using random sequencing.
A total of 508 random clones from five Mycoplasma genitalium genomic libraries were partially sequenced and analyzed. This resulted in the identification of 291 unique contigs. Sequence information from these clones (100,993 nucleotides), representing approximately 17% of this pathogen's genome, was analyzed by comparison to the DNA and protein sequence data bases. The frequency with which clones could be identified, by virtue of possessing homology to another data base entry, was 46%. Sequence analysis indicated the following. (i) The M. genitalium genome contains many genes involved in various metabolic processes. (ii) Repetitive DNA may comprise as much as 4% of this genome. (iii) The MgPa adhesin gene may be the result of horizontal transfer from an unknown origin. (iv) Not all dinucleotide pairs are present in this genome at the expected frequency. (v) This genome potentially encodes approximately 390 proteins and makes very efficient use of its limited amount of DNA. In addition, this study allowed us to estimate the number of genes involved with various cellular functions.
Amino Acid Sequence↗
Issues surrounding the administration of a credit course for medical students: survey of US academic health sciences librarians.
OBJECTIVES: For librarians developing a credit course for medical students, the process often involves trial and error. This project identified issues surrounding the administration of a credit course, so that librarians nationally can rely more upon shared knowledge of common practices and less upon trial and error. METHODS: A questionnaire was sent to the education services librarian at each medical school listed in the 2000 AAMC Data Book. A second questionnaire was sent to those librarians who did not return the first one. RESULTS: Of the 125 librarians surveyed, 82 returned the questionnaire. Of those 82, only 11 offered a credit course for medical students, though 19 more were in the process of developing one. Data were gathered on the following aspects of course administration: credit course offerings, course listing, information learned to administer the course, costs associated with the course, relationships with other departments on campus, preparation for teaching and grading, and evaluation of the course. CONCLUSIONS: Because of small number of respondents offering a credit course and institutional variations, making generalizations about issues surrounding the administration of a credit course is difficult. The article closes with a list of recommendations for librarians planning to develop a course.
Curriculum↗
Free MEDLINE and implications for library operations.
The widespread availability of free MEDLINE systems on the Internet raises issues about the continued need to allocate library funds for commercial, fee-for-service MEDLINE vendors. This paper explores the evolution and acceptance of free MEDLINE, looking in particular at NLM's PubMed system. Results of a survey on librarian perceptions of PubMed are discussed. The new generation of PubMed software is evaluated in the context of end-user needs and educational goals of medical libraries.
Fee-for-Service Plans↗
Picture archiving and communication system and its impact on image viewing in physical therapy practice.
Imaging plays an increasing role in physical therapy (PT) practice. We sought to determine if picture archiving and communication system (PACS) deployment would increase the proportion of imaging studies viewed by physical therapists (PTs) at the point of care and to assess PTs' perception of the value of access to imaging information. The study was performed in a 720-bed urban teaching hospital where an average of 2,000 rehabilitation visits per month are performed by 12 PTs. We compared the proportion of imaging studies viewed by PTs before and after PACS implementation. We surveyed PTs to assess their perception on the value of access to imaging studies. Film library records pre-PACS and web server audit trail post-PACS implementation were reviewed to measure access. Chi-square was used to compare proportions and trends. During the 3-month period before PACS usage, PTs viewed 1% (6/505) of imaging studies, citing time as the primary barrier. Post-PACS, the proportion of imaging studies viewed rose from 28% (95/344, second month) to 84% (163/192, fifth month) (p < 0.0001, chi-square). Most PTs believed that access to imaging studies has high value and has a positive impact on clinical practice. Physical therapists rarely viewed imaging studies before PACS due to time barriers. They viewed more imaging studies (84%) post-PACS and felt that access to imaging studies has a positive impact on clinical practice. Further studies are needed to assess whether PACS enhances PTs' clinical decision making and improves patient outcomes.
Attitude of Health Personnel↗
Profiling the malaria genome: a gene survey of three species of malaria parasite with comparison to other apicomplexan species.
We have undertaken the first comparative pilot gene discovery analysis of approximately 25,000 random genomic and expressed sequence tags (ESTs) from three species of Plasmodium, the infectious agent that causes malaria. A total of 5482 genome survey sequences (GSSs) and 5582 ESTs were generated from mung bean nuclease (MBN) and cDNA libraries, respectively, of the ANKA line of the rodent malaria parasite Plasmodium berghei, and 10,874 GSSs generated from MBN libraries of the Salvador I and Belem lines of Plasmodium vivax, the most geographically wide-spread human malaria pathogen. These tags, together with 2438 Plasmodium falciparum sequences present in GenBank, were used to perform first-pass assembly and transcript reconstruction, and non-redundant consensus sequence datasets created. The datasets were compared against public protein databases and more than 1000 putative new Plasmodium proteins identified based on sequence similarity. Homologs of previously characterized Plasmodium genes were also identified, increasing the number of P. vivax and P. berghei sequences in public databases at least 10-fold. Comparative studies with other species of Apicomplexa identified interesting homologs of possible therapeutic or diagnostic value. A gene prediction program, Phat, was used to predict probable open reading frames for proteins in all three datasets. Predicted and non-redundant BLAST-matched proteins were submitted to InterPro, an integrated database of protein domains, signatures and families, for functional classification. Thus a partial predicted proteome was created for each species. This first comparative analysis of Plasmodium protein coding sequences represents a valuable resource for further studies on the biology of this important pathogen.
Animals↗
Age differences in response accuracy for factual survey questions.
The correspondence between survey responses to a number of factual questions and information from independent verification sources (i.e., concurrent validity) was examined by age of respondents. The relevant data were drawn from four different surveys that included questions referring to issues of physical health, voting behavior, transportation, charitable contributions, library patronage, and age. Generally, there was little evidence that older respondents report factual information less validly than younger respondents; only chronological age was reported somewhat less validly by older respondents.
Adult↗
The British quasi-market in health care: a balance sheet of the evidence.
OBJECTIVES: To summarise the findings from a comprehensive review of research on the effects of the three main elements of the quasi-market reforms of the UK National Health Service (NHS) introduced in 1991/92: General practices becoming fundholders by volunteering to purchase elective care for their patients; Health authorities becoming purchasers of emergency, unplanned and elective services, together with a range of alternatives to fundholding operating under their auspices; The conversion of providers of hospital and community health services to NHS trusts separate from their local health authorities. METHODS: Published and unpublished studies which included any data on the impact of the three main planks of the quasi-market changes, produced between 1991 and late 1998, were identified using a combination of electronic databases, library catalogues at the King's Fund, London, bibliographies, reference lists of individual studies, a survey of NHS directors of public health and consultations with subject area experts. Each main element of the quasi-market was assessed in relation to its impact on: efficiency (primarily productivity); equity; quality; choice and responsiveness; and accountability. RESULTS: There was relatively little measurable change that could be related unequivocally to the core mechanisms of the quasi-market. CONCLUSIONS: The incentives were generally too weak and the constraints too strong to generate the consequences predicted by either proponents or critics of the quasi-market. On the other hand, the way in which the NHS operates was changed irrevocably by the reforms.
Budgets↗
User attitudes toward end-user literature searching.
A survey to determine attitudes toward end-user searching was made at Loyola University's Medical Center Library using MEDIS, an online full-text and bibliographic medical retrieval system. One hundred forty-one completed questionnaires were analyzed for this report. Information was collected on user familiarity with computers, end-user training, system use, mechanics of searching, and attitudes toward future use. Computer familiarity was highest among the faculty users. Ninety percent of the respondents saw librarians as a crucial agent in training and in providing end-user assistance. Respondents identified five major reasons for using the system: helpfulness, convenience, time savings, rapid feedback, and presentation of needed information. Searching the MEDLINE database rather than the full-text database was the search method of choice. Continued use of both mediated and end-user searching was intended by most of the respondents. Survey results support a perceived need for end-user searching and confirmed recommendations of the Association of American Medical Colleges on medical information science skills.
Attitude of Health Personnel↗
Contents of the Cochrane library on the organisation of stroke services.
BACKGROUND: The Cochrane Collaboration is an international organisation that aims to help people make well-informed decisions about healthcare by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of healthcare interventions. This paper briefly summarises the output of the Cochrane Stroke Group in relation to evaluating different forms of the organisation of services for patients with stroke. METHODS: A survey of randomised controlled trials and systematic reviews (and meta-analyses) of randomised controlled trials. RESULTS: Issue 2 of the Cochrane Library 2002 includes 1,377 completed systematic reviews and 1,055 protocols for reviews in progress. The Cochrane Controlled Trials Register included 343,270 reports of randomised or controlled clinical trials. The Cochrane Stroke Review Group had contributed 63 completed systematic reviews, 29 protocols of reviews in progress, and 4,396 reports of stroke trials. The main published reviews relevant to entire services related to: stroke units; services for helping acute stroke patients avoid hospital admission; services for reducing duration of hospital care for acute stroke patients; care pathways for stroke. MAIN CONCLUSIONS: There has been a rapid recent growth in the evidence base on stroke care. Systematic reviews of several aspects of stroke services are now published and other reviews are in progress. For areas where no reviews have been completed, the Cochrane Library includes a substantial number of individual randomised trials evaluating the effects of specific services and components of services.
Databases as Topic↗
Academic research on solid waste in Sweden 1994-2003.
A small desk survey was conducted in the spring of 2004 to get an overview on the development of waste research. The survey targeted the last 10 years of waste research at Swedish academic institutions trying to identify the total amount of research and trends over time with regard to issues, volume and distribution over academic disciplines. In the survey, only the theses written at major Swedish universities were considered. All post-graduate theses from major Swedish universities were reviewed. Data were obtained from the homepages and search engines of the various libraries as of May 13 2004. Altogether 90 theses were identified from nine universities, i.e., an average of 1 thesis per University per year. The results of the survey indicate that: (1) the academic waste research is very small in comparison to the R&D performed by the industry; there seems to be a lack of interaction between industry and academia; (2) waste research is slowly getting into established academic environments and gains in quantity and diversion over time; (3) in addition to being driven by environmental protection legislation, there also seems to be emerging more industry interest from a production perspective.
Academic Dissertations as Topic↗
Monitoring patron use of CD-ROM databases using SignIn-Stat.
SignIn-Stat, a PC-based, menu-driven program, collects information from users of the library's public access computer systems. It was used to collect patron use data for the library's four CD-ROM workstations for the period September 1987 to April 1988 and to survey users for the period December 1987 to March 1988. During the sample period, 5,909 CD-ROM uses were recorded. MEDLINE was the most heavily used database, followed by PsycLIT and Micromedex CCIS. Students accounted for 61% of the use, while faculty, residents, and staff were responsible for 31%. Graduate students had the highest rate of use per student. Nineteen percent of use was by patrons who had never used CD-ROMs before, while 37% was by patrons who had used CD-ROMs ten or more times. Residents were the least experienced user group, while graduate students and faculty were the most experienced.
Faculty↗
Resident versus program director perceptions about PM&R research training.
A survey of all residents and residency program directors in Physical Medicine and Rehabilitation (PM&R) was done to assess perspectives of residents and directors regarding research training, resources, mentorship, and encouragement available to residents. A response rate of 55% was obtained from 1188 resident mailings, and 83% of 77 program directors responded. A number of discrepancies in perceptions of residents v program directors responded. A number of discrepancies in perceptions of residents v program directors were identified. In general, residents perceived that they had less research support and training than directors felt their departments were offering. Only 24% of residents felt that they got adequate training in statistics, 40% for research design, and 26% for writing research papers. The corresponding numbers for residency program directors were 47%, 73%, and 61%. There were similar discrepancies in the perception of the quality of research training. On a 1 to 5 scale, residents registered a mean score of 2.8 (SD 1.0) to the question of how qualified their faculty was to teach principles of research. Program directors' mean response was 3.2 (SD 1.0). Residents were also often not aware of resources available for research in their departments. Only 19% of residents knew of access to a research coordinator/grant writer, 36% for statistical support, and 67% for library assistance. The corresponding numbers for program directors were 31%, 69%, and 97%. Additional results of the survey are summarized, and suggestions for further study to improve the resident research training experience are given.
Attitude of Health Personnel↗
Cloning of the immunological repertoire in Escherichia coli for generation of monoclonal catalytic antibodies: construction of a heavy chain variable region-specific cDNA library.
Efficient generation of catalytic antibodies is uniquely dependent on the exact nature of the binding interactions in the antigen-antibody complex. Current methods for generation of monoclonal antibodies do not efficiently survey the immunological repertoire and, therefore, they limit the number of catalysts that can be obtained. We are exploring methods to clone and express the immunological repertoire in Escherichia coli. As the essential first step, we present here a method for the establishment of a highly diverse heavy chain variable region library. Consequently, it should now be possible to express and recombine the heavy and light chain variable region fragments to generate a large array of functional combining portions of the antibody molecule. This technology may provide an alternative to the hybridoma methodology for accessing the monoclonal antibody specificity of the immune system.
Animals↗
Information on wheels--library outreach.
Information on Wheels is an outreach service of the Medical College of Wisconsin Libraries. A mobile cart loaded with professional books and journals is taken weekly to the hospital unit and outpatient clinic of the Milwaukee County Hospital and Froedtert Hospital. The targeted audience is primarily nurses since their job demands usually allow little time flexibility, and they make up the largest percentage of hospital health care professionals. After one year of service, a survey was undertaken to determine the usefulness of the service. The results were very positive. One comment repeated was, "This is an excellent service because it provides easy access to pertinent information to people who are sometimes too busy or don't think to go to the library."
Evaluation Studies as Topic↗
The study of untreated syphilis in the negro male.
PURPOSE: The participation of minorities in clinical studies is the subject of much discussion and has even become the subject of Federal law. The project known as the Tuskegee Syphilis Study and officially titled "The Tuskegee Study of Untreated Syphilis in the Negro Male," is one of the great debacles of American medicine and a national shame. Despite the fact that its existence is well known, many do not know the historical facts of the study nor the context of the study. My purpose here is to recount the facts of the study and its historical context. METHODS: The history recounted here is taken from documents gathered during a U.S. Senate investigation of the study, original papers located in National Library of Medicine, and books about the trial. RESULTS: The trial began in 1931 as a survey of the natural history of untreated tertiary syphilis in Black men. This study enrolled 399 men with syphilis and 201 uninfected men to serve as controls. All were at least 25 years old at enrollment. The men were told they were in a study, but never educated about the implications. Later, men were not informed that there was a treatment for effective treatment for their disease--a treatment that was being withheld from them. This trial continued till 1972. CONCLUSION: Many of the issues that led to the study and caused it to continue for 40 years still exist. The lessons of the Public Health Study of Untreated Syphilis in the Untreated Negro include the dangers of paternalism, arrogance, blind loyalty, and misuse of science. "Those who do not appreciate history are condemned to repeat it" (Alfred North Whitehead).
Alabama↗
e-FOLIO: using e-learning to learn about e-learning.
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Curriculum↗