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From EBM to EBL: two steps forward or one step back?

The author employs his vantage point as a contributor to Evidence-based Medicine (EBM) and Evidence-based Librarianship (EBL) in the United Kingdom to anticipate obstacles to be overcome by the emerging EBL paradigm. After reviewing and synthesizing three proto-definitions of EBL, he discusses issues around the potential domains to be populated by research findings. He then briefly considers the contribution that critical appraisal skills can make to an evidence-based profession. In concluding that "evidence-based librarianship" is a self-limiting "label," he encourages health information professionals instead to promote the contribution of librarianship to evidence-based practice, a role for which they are uniquely qualified.

Databases, Bibliographic↗

Beyond the literature: bioinformatics training for medical librarians.

As genetics and molecular biology progressively impact on society and the practice of medicine, medical librarians must prepare themselves to deal with this new arena of information. The Eskind Biomedical Library at Vanderbilt University Medical Center has developed a bioinformatics training program for its librarians involving subject knowledge, literature evaluation, and database searching techniques. This program can serve as a model for other libraries.

Computational Biology↗

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↗

The PLoS community journals.

2005 will see the launch of three new open access journals from the Public Library of Science - PLoS Computational Biology, PLoS Genetics, and PLoS Pathogens.

Computational Biology↗

[Revista de Saúde Pública: forty years of Brazilian scientific production].

OBJECTIVE: To recognize the characteristics and path taken by the through analysis of the scientific production it has published over the period from 1967 to 2005. METHODS: Scientometric methods were used to analyze reference data on the articles published in the Revista, retrieved from the databases ISI/Thomson Scientific (Web of Science), National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO). RESULTS: The Revista is the only Brazilian publication in the field of public health that is indexed by ISI/Thomson Scientific. It is prominent as a medium for publishing Brazilian scientific production in public health and is displaying a geometric increase in publication and citation, with annual rates of 4.4% and 12.7%, respectively. The mean number of authors per paper has risen from 2 to 3.5 over recent years. Although original research articles predominate, the numbers of reviews, multicenter studies, clinical trials and validation studies have been increasing. The number of articles published in foreign languages has also increased, accounting for 13% of the total, and the leading countries originating these are the UK, USA, Argentina and Mexico. The number and diversity of journals citing the Journal has been increasing, many of which are non-Brazilian. Authorship per author shows good fit to Lotka's Law, but the parameters suggest greater concentration and less dispersion than would be expected. Among the fields of interest of published papers, the following topics account for more than 50% of the total volume: infectious-parasitic diseases and vectors; health promotion, policies and administration; and epidemiology, surveillance and disease control. CONCLUSIONS: The Revista shows great dynamism, without signs of abating or reaching a plateau any time soon. There are signs of progressively increasing complexity in the studies published, and more multidisciplinary work. The Revista seems to be widening its outreach and recognition, while remaining faithful to the field of public health in Brazil.

Abstracting and Indexing↗

Effect of Physical Exercise on Telomere Length: Umbrella Review and Meta-Analysis.

BACKGROUND: Telomere length (TL) is a marker of cellular health and aging. Physical exercise has been associated with longer telomeres and, therefore, healthier aging. However, results supporting such effects vary across studies. Our aim was to synthesize existing evidence on the effect of different modalities and durations of physical exercise on TL. OBJECTIVE: The aim of this study was to explore the needs and expectations of individuals with physical disabilities and their interventionists for the use of a virtual reality physical activity platform in a community organization. METHODS: We performed an umbrella review and meta-analysis. Data sources included PubMed, Embase, Web of Science, Cochrane Library, and Scopus. We selected systematic reviews and meta-analyses of randomized and nonrandomized controlled clinical trials evaluating the effect of physical exercise on TL. RESULTS: Our literature search retrieved 12 eligible systematic reviews, 5 of which included meta-analyses. We identified 22 distinct primary studies to estimate the overall effect size of physical exercise on TL. The overall effect size was 0.28 (95% CI 0.118-0.439), with a heterogeneity test value Q of 43.08 (P=.003) and I² coefficient of 51%. The number of weeks of intervention explained part of this heterogeneity (Q_B=8.25; P=.004), with higher effect sizes found in studies with an intervention of less than 30 weeks. Exercise modality explained additional heterogeneity within this subgroup (Q_B=10.28, P=.02). The effect sizes were small for aerobic exercise and endurance training, and moderate for high-intensity interval training. CONCLUSIONS: Our umbrella review and meta-analysis detected a small-moderate positive effect of physical exercise on TL, which seems to be influenced by the duration and type of physical exercise. High quality studies looking into the impact of standardized, evidence-based physical exercise programs on TL are still warranted.

Humans↗

Insulin sensitizers in treatment of nonalcoholic fatty liver disease: Systematic review.

AIM: To summarize the evidence available for the clinical effectiveness of insulin sensitizers in the treatment of nonalcoholic fatty liver disease (NAFLD) systematically. METHODS: Relevant articles were located using computer-assisted searches of Medline (1966-March 2006), EMBASE (1988-March 2006), CINAHL (1982-March 2003), Educational Resource Information Center (1966-March 2006), Library, Information Science and Technology Abstracts (1967-March 2006), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (1994-2006), dissertations in ProQuest and FirstSearch databases. Manual searches were made in the abstracts from meetings of the American Gastroenterological Association (1999-2006), and the American Association for the Study of Liver Diseases (2003-2005). Studies were retrieved using the following selection criteria: (1) clinical trials using insulin sensitizers in subjects with NAFLD, (2) adult patients, (3) published as full manuscripts or abstracts, and (4) English, Spanish, German, and French languages only. Data were abstracted independently by two reviewers following standardized procedures. A face-to-face comparison of data was conducted to ensure the completeness and reliability of the abstraction process. RESULTS: Nine studies were included, six using metformin and three using thiazolidinediones. Only two studies were placebo-controlled trials. The median sample size for all studies was 18 subjects. In the placebo-controlled trials, metformin improved insulin resistance markers and liver function tests, but not histological scores. In the single-arm trials, metformin and thiazolidinediones improved insulin resistance markers and liver function tests, and beneficial histological changes were reported. There is limited high-quality information available from which to draw categorical conclusions about the clinical use of insulin sensitizers in NAFLD. CONCLUSION: Current information indicates that the use of insulin sensitizers in NAFLD improves insulin resistance and liver function. Histological changes must be corroborated in randomized controlled trials.

Controlled Clinical Trials as Topic↗

Reviewing the literature: a guide for students.

This article aims to help students develop the skills of searching, analysing and critiquing the literature so that they can make sense of the vast amount of written material they will have to read, both while they are studying and throughout their careers.

Databases, Factual↗