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ALS diagnostic criteria, El Escorial, and Philip II of Spain: a historical perspective.

El Escorial, a magnificent palace-monastery in central Spain, was the setting in 1990 for a meeting of ALS experts who developed a consensus document called the El Escorial ALS Diagnostic Criteria. El Escorial was originally conceived by the Spanish Habsburg monarch, Philip II (1527-1598), as an elaborate burial place for his parents, Emperor Charles V and Isabella. It soon became a symbol of the Spanish empire and Philip's Catholic leadership of the Counter-Reformation. El Escorial included a monastery, palace, basilica, mausoleum, seminary, library, and hospital. Nothing was spared by Philip in obtaining the finest examples of religious art, architecture, music, and books. Philip, as absolute monarch, inherited a vast empire which stretched over Europe, Asia, North Africa, and the New World. His style of personal micro-management and poor economic planning hampered his ability to manage both national and foreign affairs. Philip had a special interest in medicine, including royal hospitals, improved government standards for physicians, medicinal plants, and the health benefits of alchemy and sacred relics. El Escorial's grand scale has generated both illustrious praise and critical condemnation over the last four centuries. Its place in Spanish and world history is assured.

Amyotrophic Lateral Sclerosis↗

The information needs and information seeking behaviour of family doctors.

AIMS: To explore the information needs and information seeking behaviour of family doctors, identifying any differences in attitudes and behaviours deriving from membership of a training practice and investigating the impact of a practice librarian. METHODS: A case study of general practitioners (GPs) in Aylesbury Vale incorporated a quantitative study of use of the medical library, and two qualitative techniques, in-depth interviews and group discussions. RESULTS: A total of 58 GPs, almost three quarters of those in the Vale, participated; 19 via individual interviews and a further 39 via two group discussions. Family doctors are prompted to seek information by needs arising from a combination of professional responsibilities and personal characteristics. A need for problem-orientated information, related to the care of individual patients, was the predominant factor that prompted these GPs to seek information. Personal collections remain the preferred information resource; electronic sources rank second. The study demonstrated low use of the medical library. However, both vocational training and the employment of a practice librarian impacted on library use. CONCLUSIONS: The study illuminates the information needs and preferences of GPs and illustrates the contribution that librarians may make at practice level, indicating the importance of outreach work.

Attitude of Health Personnel↗

Clinical effectiveness of treatment with hyperbaric oxygen for neonatal hypoxic-ischaemic encephalopathy: systematic review of Chinese literature.

OBJECTIVES: To investigate the clinical effectiveness of treatment with hyperbaric oxygen for neonates with hypoxic-ischaemic encephalopathy. This treatment is frequently used in China but much less often in the West. DATA SOURCES: Western (Cochrane controlled trials register and database of systematic reviews, Medline, Embase, CINAHL, and HealthSTAR) and Chinese (China Hospital Digital Library, Chinese Medical Journal Network) databases and hand search of Chinese journals. No language restrictions. REVIEW METHODS: Randomised or quasi-randomised controlled trials of treatment with hyperbaric oxygen compared with "usual care" in term neonates with hypoxic-ischaemic encephalopathy. Outcomes included mortality and long term neurological sequelae. Standardised forms were used to extract and compare data. Criteria of York Centre for Reviews and Dissemination were used to assess quality. Analysis was mainly qualitative but included meta-analysis. RESULTS: 20 trials were found, mainly from Chinese sources. The reporting quality of trials was poor by Western (CONSORT) standards. Treatment with hyperbaric oxygen had better outcomes than the comparator in almost all trials. The odds ratios of the meta-analyses were 0.26 (95% confidence interval 0.14 to 0.46) for mortality and 0.41 (0.27 to 0.61) for neurological sequelae. CONCLUSION: Treatment with hyperbaric oxygen possibly reduces mortality and neurological sequelae in term neonates with hypoxic-ischaemic encephalopathy. Because of the poor quality of reporting in all trials and the possibility of publication bias, an adequately powered, high quality randomised controlled trial is needed to investigate these findings. The Chinese medical literature may be a rich source of evidence to inform clinical practice and other systematic reviews.

China↗

Evaluating IAIMS at Yale: information access.

OBJECTIVE: To evaluate use of information resources during the first year of IAIMS implementation at the Yale-New Haven Medical Center. The evaluation asked: (1) Which information resources are being used? (2) Who uses information resources? (3) Where are information resources used? (4) Are multiple sources of information being integrated? DESIGN: Measures included monthly usage data for resources delivered network-wide, in the Medical Library, and in the Hospital; online surveys of library workstation users; an annual survey of a random, stratified sample of Medical Center faculty, postdoctoral trainees, students, nurses, residents, and managerial and professional staff; and user comments. RESULTS: Eighty-three percent of the Medical Center community use networked information resources, and use of resources is increasing. Both status (faculty, student, nurse, etc.) and mission (teaching, research, patient care) affect use of individual resources. Eighty-eight percent of people use computers in more than one location, and increases in usage of traditional library resources such as MEDLINE are due to increased access from outside the Library. Both survey and usage data suggest that people are using multiple resources during the same information seeking session. CONCLUSIONS: Almost all of the Medical Center community is using networked information resources in more settings. It is necessary to support increased demand for information access from remote locations and to specific populations, such as nurses. People are integrating information from multiple sources, but true integration within information systems is just beginning. Other institutions are advised to incorporate pragmatic evaluation into their IAIMS activities and to share evaluation results with decision-makers.

Academic Medical Centers↗

Technical note: a radiological education system--organization of an image library.

A successful radiological library and teaching system should be easy to compile, user-friendly, dynamic and flexible. Nowadays it must be amenable to incorporation into digitally-based communication systems such as personal computers (pc) and picture archiving and communication systems (PACS). This article describes the structural organization and capabilities of such a digital radiological education system, and demonstrates how it fulfils these aims.

Computers↗

Full-text and bibliographic database searching in the health sciences: an exploratory study comparing CCML and MEDLINE.

An exploratory study to investigate perceived differences between searching full-text databases and bibliographic databases was undertaken. BRS's full-text database, Comprehensive Core Medical Library (CCML), and BRS's current MEDLINE file (MESH) were compared. Identical literature search topics were run in the two databases and the results evaluated regarding currency of search results, success in answering specific questions, uniqueness of information retrieved, and relevancy of retrieval. Additionally, connect time and costs were noted to aid in determining the feasibility of offering full-text database searching as a service for which the authors' institution would charge.

Data Collection↗

Cost recovery and usage tracking of CD-ROM databases with menuing software.

CD-ROM database products are in widespread use and offer potential cost savings over online products. Many libraries would find a cost-benefit analysis useful. Libraries often do not have sufficient funding simply to underwrite all costs related to CD-ROM workstations. Inexpensive menuing software permits usage tracking for data analysis and cost recovery of CD-ROM subscription, start-up, and operating costs. This article will explore the approach taken at the Fox Chase Cancer Center in Philadelphia to recover CD-ROM related expenses through user fees.

CD-ROM↗

Beyond online: primary research as a value-added service.

Information specialists should provide a value-added service by supplementing their online searches with primary research. Primary research results in more up-to-date information from a broader spectrum of sources. The requester benefits from primary research by receiving a cost-effective and more comprehensive information package. The information professional benefits by acquiring a more in-depth knowledge of the subject, increasing awareness of important projects within the organization, and achieving recognition as a key information analyst.

Commerce↗

Sources of information on postgraduate medical training programs--update.

This is an update of an earlier article listing directories, journal articles, and general books that aid the librarian, resident, or medical student in finding information on residency and fellowship programs. The article also gives suggestions for building a file of program catalogs related to residencies, fellowships, and clerkships and related materials.

Education, Medical↗

Promoting an awareness of retractions: the Louisiana State University Medical Center in Shreveport experience.

The current mission statement of the Medical Library Association states that it is "dedicated to improving health through professional excellence and leadership of its members in the ... provision of information services and educational programs ..." With this goal in mind, retractions offer medical librarians a professional challenge to become involved in the scientific process. Through results of a survey conducted among the consortium of South Central Academic Medical Libraries (SCAMeL), this paper reveals opinions on the importance of retraction awareness and who is responsible for disseminating this knowledge. The paper also reports what the Louisiana State University Medical Center at Shreveport Library and other SCAMeL member libraries are doing to promote awareness.

Academic Medical Centers↗