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PubMed2000

NCBI genetic resources supporting immunogenetic research.

The NCBI creates and maintains a set of integrated bibliographic, sequence, map, structure and other database resources to promote the efficient retrieval of information and the discovery of novel relationships. The connections made between elements of these resources permit researchers to start a search from a wide spectrum of entry points. These multiple dimensions of data can be roughly categorized by primary content as text or bibliographic (PubMed, PubMedCentral, OMIM, LocusLink), sequence (GenBank, Reference Sequence Project (RefSeq), dbSNP, MMDB), protein structure (MMDB) or map position (MapView). They can also becategorized by level of expert curation, which may range from validation of submissions from external groups (GenBank, PubMed, PubMedCentral,), to automatic computation (HomoloGene, UniGene), and to highly reviewed and corrected (LocusLink, MMDB, OMIM, RefSeq). Searches can be made by words (in an article title, key words, sequence annotation, database value, author) by sequence (BLAST or e-PCR against multiple sequence databases), or by map coordinates. By computing or curating bi-directional links between related objects, NCBI can represent content on the genetics, molecular biology, and clinical considerations of interest to immunogeneticists. There is also an emerging resource developed by the NCBI in collaboration with the IHWG devoted to the presentation of MHC data (dbMHC). How dbMHC will augment existing resources at the NCBI is described.

Computational Biology↗

PubMed2002

Resource selection for an interdisciplinary field: a methodology.

The Health Sciences and Human Services Library of the University of Maryland developed and implemented a methodology to evaluate print and digital resources for social work. Although this methodology was devised for the interdisciplinary field of social work, the authors believe it may lend itself to resource selection in other interdisciplinary fields. The methodology was developed in response to the results of two separate surveys conducted in late 1999, which indicated improvement was needed in the library's graduate-level social work collections. Library liaisons evaluated the print collection by identifying forty-five locally relevant Library of Congress subject headings and then using these subjects or synonymous terms to compare the library's titles to collections of peer institutions, publisher catalogs, and Amazon.com. The collection also was compared to social work association bibliographies, ISI Journal Citation Reports, and major social work citation databases. An approval plan for social work books was set up to assist in identifying newly published titles. The library acquired new print and digital social work resources as a result of the evaluation, thus improving both print and digital collections for its social work constituents. Visibility of digital resources was increased by cataloging individual titles in aggregated electronic journal packages and listing each title on the library Web page.

Books↗

PubMed2003

Use of on-line evidence-based resources at the point of care.

BACKGROUND AND OBJECTIVES: The utility of on-line evidence-based summary databases for answering clinical questions at the point of care is not well understood. Our objectives were to determine if family physician faculty could answer their questions using on-line resources and the proportion of answers that influenced patient care. METHODS: This was a prospective study in which clinical faculty in an urban residency training office recorded their clinical questions and their search results. RESULTS: Faculty asked 92 questions. Therapy, prognosis, and epidemiology questions were the most common types of inquiries. Fifty-four percent of the questions were fully or partially answered by use of an on-line resource; obtaining an answer required 5-10 minutes of searching. Physicians reported that 62% of the obtained answers modified their opinion, influenced the care of the current patient 56% of the time, and would affect the care of future patients 70% of the time. Slow Internet connection and interruptions were the most frequent barriers reported. DISCUSSION: Practicing physicians inexperienced in the use of on-line evidence-based resources answered a proportion of their clinical questions that was comparable to reports of more-experienced searchers; however, the time required to find answers limits the practical use of these databases during patient care time. On-line summary databases such as those used in this study show promise in providing answers that influence care during the patient's visit. With faster Internet connection (or handheld devices) and improved navigability, such resources have the potential to optimize health care in the primary care setting.

Clinical Competence↗

PubMed2003

[Outcomes of prevention and treatment of adolescent psychiatric disorders in Turkish immigrants with reference to resources and risks].

Semi-structured bilingual interviews were conducted with 223 adolescents from Turkey and their parents in 77 volunteering immigrant families (field group) and in 40 outpatient families attending the adolescent service (CAP treatment group). Risks and resources for mental health were assessed in a qualitative approach based on contextual family theory, cohesion and adaptability according to Olson's Clinical Rating Scale. While adolescent psychiatric morbidity in the field group equalled an expected rate of 24%, families with psychologically healthy offspring significantly excelled in parental and child resources. Yet, resources did not separate symptomatic and non-symptomatic families (referring to child symptoms) as well as risks did. A parent without work constituted a risk factor of its own. Differentiating CRS from 3 to 4 steps of adequacy for child health (introducing a range of high cohesion or high rigidity alone as another step between normal and dysfunctional) led to classify 80% of non-symptomatic families as functional. Following our results, a resource oriented family therapy seems to be the most promising therapeutic approach. Social case management should be provided for at the same time.

Adolescent↗

PubMed2003

Evaluating a health information resource in a health system.

In an effort to offer the broadest scope of quality information resources, libraries are often faced with decisions related to the sources they provide based on the quality and cost of each resource. However, there lacks a framework to evaluate these resources to maximize the value of services offered to library users. The Claude Moore Health Sciences Library collaborated with the Department of Health Evaluation Sciences to undertake a comprehensive evaluation project to begin to establish such a framework. The long term goals are to: 1) determine cost effectiveness of services provided on an ongoing basis to provide objective basis for pursuing or renewing licenses, 2) evaluate licensed health care information services/databases under consideration and 3) create a process for ongoing evaluation. This abstract reports the results of the first demonstration evaluation of an information resource, MDConsult, as a model for future evaluation studies in a library setting.

Cost-Benefit Analysis↗

PubMed1992

Attentional resource demands of stimulus encoding for persons with and without mental retardation.

Speed of encoding differences between individuals with and without mental retardation were examined to determine whether they stem from an automatically executed cognitive process or from encoding processes that require attentional resources. In Experiment 1, encoding functions were generated for physical identity and name identity encoding while subjects retained a full memory load or half memory load. Size of memory load influenced encoding times for all subjects. However, the pattern of group differences suggested that subjects with mental retardation allocated fewer attentional resources to encoding, even though encoding may require more of their resources for efficient execution. These conclusions were supported in Experiment 2, in which resource allocation was assessed using response times to auditory probes placed at various locations in the semantic encoding and decision task.

Adolescent↗

PubMed2004

[Health care resources and mortality as assessed by the "empirical Bayes estimate of standardized mortality ratio": results for Fukuoka Prefecture].

BACKGROUND AND OBJECTIVE: The standardized mortality ratio (SMR) is frequently used to compare health status among different populations. However, it may be biased when based upon communities with small population sizes such as towns, cities, and wards. Thus, comparison of SMRs among such small communities is not appropriate. But the "empirical Bayes estimate of standardized mortality ratio" (EBSMR) is, in contrast, a useful index. The objective of the present study was to use the EBSMR to clarify the relationships between health care resources and mortalities in 109 communities in Fukuoka Prefecture. MATERIALS AND METHODS: Data for health care resources (number of physicians, number of general clinics, number of general sickbeds in hospitals, number of emergency hospitals, and proportion of elderly outpatients within their resident' community) and socioeconomic factors (birth rate, inflow or outflow population, aged households, marital status, taxable income per individual under taxes duty, unemployment, primary, secondary, tertiary industrial employment and criminal offense records) were obtained from officially published reports. EBSMRs for all causes, cerebrovascular disease, heart disease, malignant neoplasms, and acute myocardial infarction were calculated from the 1993-1997 vital statistic records. Multiple regression analysis with stepwise variable selection was used to examine the relationships between EBSMRs and the five variables representing health care resources, considering the eleven socioeconomic factors as covariates. Some of the variables were log-transformed to normalize the distribution. RESULTS: Some of the EBSMRs were inversely related to the numbers of physicians per person (acute myocardial infarction in males (P=0.047) and females (P=0.012)), emergency hospitals per person (acute myocardial infarction in females: P=0.001), and general sickbeds per person (all causes in females: P<0.001, cerebrovascular disease in females: P=0.007, heart disease in females: P<0.001, malignant neoplasms in females: P=0.049). In contrast, when the higher the number of clinics per person, the higher the EBSMR in females for all causes (P=0.025), as well as acute myocardial infarction (P=0.006). CONCLUSION: The results suggest that an appropriate distribution of hospital care resources such as physicians, general sickbeds, and emergency hospitals is an important factor related to mortality in a community.

Aged↗

PubMed2005

Learning to use learning resources during medical school and residency.

OBJECTIVES: This study (1) examined the natural history of learning to use learning resources by medical students and residents and (2) considered whether that history is consistent with the ways in which physicians approach their learning tasks. METHODS: The authors conducted and analyzed thirty-two open-ended interviews of first-year and third-year medical students and first-year and senior residents in internal medicine, family medicine, or pediatrics. RESULTS AND DISCUSSION: Learning to use learning resources occurs at the same time as learning done to address instructional and clinical problems that physicians-in-training face, with all kinds of learning following well-documented stages. Skills for using resources are developed gradually and by overcoming barriers such as time constraints and existing habits. CONCLUSIONS: Implications of the natural history of learning to use learning resources can be employed by librarians and medical teachers to facilitate self-directed learning for physicians-in-training. Specific recommendations are provided.

Adult↗

PubMed2005

[Study on relationship between coping resources and strain in mental workers].

OBJECTIVE: To study the effects of mental workers' coping resources on their strain. METHODS: Strain (vocational strain, psychological strain, interpersonal strain, physical strain) and coping resources (recreation, self-care, social support, rational coping) were measured on 3379 mental workers with personal strain questionnaire (PSQ) and personal resources questionnaire (PRQ). RESULTS: There existed significantly negative correlations between PRQ and PSQ (P < 0.01). In PRQ, social support (SS) and rational coping (RC) had the closest relationships with PSQ. In the items of SS, those related to feeling support had more remission on strain. In the items of RC, those related to reasonable arrangement of time and anti-interference had more remission on strain. In the items of recreation (RE), those related to self-determination had more effects on the remission of strain, while indulging in watching TV could cause the strength of strain, and there was a positive correlation between watching TV and strain (P < 0.01). In the items of self-care (SC), sufficient sleeping had the most effects on the remission of strain in the all 40 items of PRQ, while not being immersed in contemplation had a positive correlation with strain (P < 0.01). CONCLUSION: Enhancing coping resources, especially sufficient sleeping, feeling support and reasonable arrangement of time, were the important measures for the remission of mental worker' strain.

Adaptation, Psychological↗

PubMed2005

Effectiveness of tegaserod therapy on GI-related resource utilization in a managed care population.

This study sought to determine the real-world effectiveness of tegaserod therapy on gastrointestinal (GI)-related resource utilization in a managed care population with a retrospective, longitudinal pre-/post-parallel cohort study of tegaserod users and a matched reference cohort of tegaserod nonusers through medical and pharmacy claims data from a large, geographically diverse, managed care organization. Continuously enrolled benefit-eligible patients newly initiated on tegaserod therapy (index prescription) were identified between August 1, 2002, and June 30, 2003, and were categorized (using International Statistical Classification of Diseases, 9th Revision, Clinical Modification codes) as having irritable bowel syndrome (IBS) or another GI-related disorder (e.g., gastroesophageal reflux disease). GI-related resource utilization (office visits, hospitalizations, emergency department visits, endoscopic and nonendoscopic procedures, and GI drug prescriptions) was determined for the 6-month period before and after the index prescription date for tegaserod users and nonusers. The study population consisted of 3365 tegaserod users and 3364 matched nonusers. Within-cohort differences before and after therapy were tested using the Wilcoxon signed rank test. The mean age of 3365 tegaserod users and 3364 matched nonusers was 47 years (+/-15 years); 92% were women, 47% had an index diagnosis of IBS, and 53% had an index diagnosis of another GI-related disorder. Within-cohort GI resource utilization comparisons before and after therapy initiation showed significant decreases (P < .01) in all utilization categories, except GI drug prescriptions, for tegaserod users; these decreases were not consistently observed for matched nonusers. Tegaserod use appeared to be associated with consistent decreases in GI-related resource utilization after 6 months of therapy; similarly consistent reductions were not observed in tegaserod nonusers. These early findings suggest that tegaserod may provide important clinical and economic benefits.

Adult↗

PubMed2005

[Allelopathy and resources competition of rice under different nitrogen supplies].

In order to explore the bio-interference of allelopathic rice with barnyardgrass under different nitrogen supplies, a new bioassay method, i.e., allelopathy-competition separation based (ACS) approach was recommended in this study. The results indicated that ACS could be successfully used to distinguish the rice allelopathy from its resources competition in rice-weed co-culture system, and to evaluate its response characteristics under different N supplies. The test rice accession PI312777 had a higher ability in interfering target weed barnyardgrass (BYD), represented by its stable and higher ability in resources competition, as well as its increasing allelopathic potential in suppressing companion weed BYD when the N supply decreased in the co-cultured system. The reverse was true in the case of rice accession Lemont, which had a lower allelopathic potential under all N supply levels, and a lower ability in resources competition under normal or rich N supply. But, Lemont had an obviously increased ability in resources competition under lower N supply, which was considered as the result of econiche competition in rice-weed system.

Echinochloa↗

PubMed2005

A comparative study of six European databases of medically oriented Web resources.

OBJECTIVES: The paper describes six European medically oriented databases of Web resources, pertaining to five quality-controlled subject gateways, and compares their performance. METHOD: The characteristics, coverage, procedure for selecting Web resources, record structure, searching possibilities, and existence of user assistance were described for each database. Performance indicators for each database were obtained by means of searches carried out using the key words, "myocardial infarction." RESULTS: Most of the databases originated in the 1990s in an academic or library context and include all types of Web resources of an international nature. Five databases use Medical Subject Headings. The number of fields per record varies between three and nineteen. The language of the search interfaces is mostly English, and some of them allow searches in other languages. In some databases, the search can be extended to Pubmed. Organizing Medical Networked Information, Catalogue et Index des Sites Médicaux Francophones, and Diseases, Disorders and Related Topics produced the best results. CONCLUSIONS: The usefulness of these databases as quick reference resources is clear. In addition, their lack of content overlap means that, for the user, they complement each other. Their continued survival faces three challenges: the instability of the Internet, maintenance costs, and lack of use in spite of their potential usefulness.

Databases, Bibliographic↗

PubMed2006

GeneTests: an online genetic information resource for health care providers.

OBJECTIVE: This paper describes the GeneTests genetic testing information resource with a focus on the GeneReviews component. METHODS AND FINDINGS: The need for authoritative genetic testing information and issues in the development and maintenance of GeneReviews are discussed: Hampered by lack of currency and content deficits, traditional medical information resources such as textbooks and the published literature are generally inadequate sources of genetic testing information. Problems encountered in developing GeneReviews include the evolution of new authorship models and academic and genetics professionals' skepticism about the quality of Web-based publications. CONCLUSIONS: GeneTests is an authoritative, highly used, and well-regarded resource in the international medical community that is intended for health care providers. Future development issues to address include ways to (1) manage the increasing editing and updating load as content grows and (2) address technical and content issues that need to be considered in displaying GeneReviews as a "just in time" resource in the electronic medical record to achieve the project goal of integrating appropriate use of genetic testing into patient care.

Authorship↗

PubMed2006

Criteria for prioritising access to healthcare resources in New Zealand during an influenza pandemic or at other times of overwhelming demand.

During overwhelming demand for resources, such as during an influenza pandemic, clinicians may be required to deny some patients access to a resource (for example ventilation, or hospital admission). However, no pragmatic guidance exists to help clinicians do this. This paper presents criteria for the prioritisation of access to resources during overwhelming demand. The criteria are in the form of eight questions related to the resource and the patients competing for it and are intended to be sufficiently comprehensive and sufficiently succinct to be useful to clinicians who might be required to make such decisions.

Disease Outbreaks↗

PubMed2006

The development of NRMIS (Nursing Resources Management Information System)--Focused on patient classification.

Information system can be useful to effective and flexible decision making of nursing resource administration. A Nurse Resources Management Information Model and a Nurse Resources Management Information System (NRMIS) were developed in this study. The NRMIS consisted of a nursing staff scheduling system (NRS), a patient classification system (PCS), and an optimal nursing manpower estimating system (ONMES). The patient classification system was developed according to nursing intensity. The system was evaluated through user interface satisfaction and usefulness in the clinical settings. The main challenge is how we realize this information model to support evidence-based nursing resource administration.

Hospital Information Systems↗

PubMed2006

Specific classification of elibrary resources says more about users' preferences.

BACKGROUND: Medical Subject Headings (MeSH) are a hierarchical taxonomy of over 42,000 descriptors designed to classify scientific literature; it is hierarchical with generic high order headings and specific low order headings. Over 1,000 resources in the Primary Care Electronic Library (PCEL - www.pcel.info) were classified with MeSH. METHODS: Each of the entries or resources in the primary care digital library was assigned up to five MeSH terms. We compared whether the most generic or specific MeSH term ascribed to each resource best predicted user preferences. RESULTS: over the four month period analysed statistically significant differences were found for resources according to specific key MeSH terms they were classified by. This result was not repeated for generic key MeSH terms. CONCLUSIONS: Analysis of the use of specific MeSH terms reveals user preferences that would have otherwise remained obscured. These preferences are not found if more generic MeSH terms are analysed.

Consumer Behavior↗

PubMed2007

Family medicine curriculum resource project: overview.

In 2000, the Health Resources and Services Administration, in the interest of fostering curriculum reform in medical schools, awarded a 4-year contract to the Society of Teachers of Family Medicine to develop a curricular resource. The contract directed development of a multi-part resource aimed at (1) preclerkship prerequisites for third-year clerkships in collaboration with internal medicine and pediatrics, (2) the family medicine clerkship, (3) post-clerkship preparation for residency training, and (4) specific special topic areas of importance to the government. The Family Medicine Curriculum Resource (FMCR) was produced by primary care educators, with day-to-day direction from an executive committee and overall oversight by an advisory committee. The FMCR was built around a theoretical framework to link medical student competencies with the Accreditation Council for Graduate Medical Education (ACGME) competencies for residency training. Considerable energy throughout development of the FMCR was devoted to obtaining input from potential end-user audiences through an active dissemination effort.

Curriculum↗

PubMed2007

Family Medicine Curriculum Resource Project: the future.

Under contract to the Health Resources and Services Administration (HRSA), the Society of Teachers of Family Medicine (STFM) created an undergraduate medical education curricular resource designed to train physicians to practice in the 21st century. An interdisciplinary group of more than 35 educators worked for 4 years to create the Family Medicine Curriculum Resource (FMCR). By consensus, the Accreditation Council for Graduate Medical Education (ACGME) competencies were adopted as the theoretical framework for this project. The FMCR provides materials for the preclerkship years, the third-year family medicine clerkship, the postclerkship year, and faculty development, as well as guidance for integrating topics of special interest to the federal government (such as, geriatrics, Healthy People 2010, genetics, informatics) into a 4-year continuum of medical education. There are challenges inherent in implementing each component of the FMCR. For example, can the ACGME competency-based approach be adapted to undergraduate medical education? Can the densely packed preclerkship years be adapted to include more focused effort on developing these competencies, and whose job is it anyway? What is "core" to being a competent clinician, and what information can be obtained when needed from medical informatics sources? Will family medicine educators embrace the FMCR recommendations for their third-year clerkships? Will exit assessment of the competency levels of graduating medical students be achieved, and can it make them more capable residents? Can faculty in different clinical and educational settings integrate the teaching of "how to learn" into their repertoire? How will faculty development innovation progress in a time of increasing emphasis on clinical productivity? Developing a common language and adoption of core competencies for all levels of medical education is imperative in a society that is focusing on improving health care quality and outcomes. The FMCR Project has developed a curricular resource to assist medical educators in this task. The challenge for the future is to measure how the FMCR is used and to ascertain if it has an influence on better patient and system outcomes.

Curriculum↗