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PubMed2006

Physician use of the curbside consultation to address information needs: report on a collective case study.

PURPOSE: The author reports key findings from a doctoral dissertation investigating what the curbside consultation is, how and why physicians use it, and what the implications for health sciences library services might be. SETTINGS/INFORMANTS: Primary informants included sixteen primary care physicians at six sites in one Midwestern state. Additional informants included twenty-eight specialists and subspecialists identified by the primary informants as colleagues who provided curbside consultations. METHODS: Qualitative research methods were used, including field observations, formal and informal interviews, and conversations with peer review physicians. RESULTS: Despite a lack of consensus about what constitutes a "good" curbside consultation, physician informants reported that curbside consultations were part of their medical education and that they continued to take part in them for a number of reasons. Tacit rules govern curbside consultation interactions, and negative consequences result when the rules are misunderstood or not observed. DISCUSSION/CONCLUSION: Acknowledging and understanding physicians' use of the curbside consultation to obtain and construct knowledge may suggest new ways for health sciences librarians to work with physicians in locating, diffusing, and disseminating clinical information.

Education, Medical, Continuing↗
PubMed2005

The new nutrition science: sustainability and development.

OBJECTIVE: To show that nutrition science is anchored in food systems and is influenced by the social, through the environmental to the cosmological, life's connections and rhythms. To indicate that an integrative approach is now becoming possible with advances in food technology, in the understanding of food choice and of human behaviour, and in a preparedness to recognise nutritional inputs in the full sweep of life-long well-being and health outcomes. METHOD: An analysis of the much broader understanding of nutritionally related diseases from an ecological perspective, with attention to economic development, beginning with poverty alleviation. Recognition that the biological dimension of nutrition science is undergoing a profound reappraisal; that technologies will allow us to change the course of nutritionally related diseases for the better; and that nutrition science will find partners in information technology and telecommunications, food technology and energy technology. CONCLUSION: A new generation of nutrition scientists can help build a new economy that supports development amongst communities, whether close or distant from each other. The opportunities for this kind of development to be realised between Asia, Latin America and Africa are considerable. At all times, however, nutrition scientists must uphold the paramount importance of good governance, conflict resolution and maternal literacy if their work is to achieve its growing potential.

Developing Countries↗
PubMed2005

Selection of information resources for education in medical pharmacology.

Pharmacology is the foundation science of medical pharmacotherapy. Education in medical pharmacology (EP) requires the use of information resources (IR) to meet the challenge of the continuous introduction of new drugs and new educational, didactic and pedagogical theories to enhance knowledge. Hence criteria for selecting bibliographic material for EP should be clearly outlined and implemented. In this work we present a method to select IR for EP based on systems theory and focusing on the factors determining: (a) the integration of a list of recommended IR for EP; (b) the design of the acquisition list for faculty and students work; (c) the overall organization of the resources available for its optimal use and benefit in the educational process; and (d) a general strategy for assessing the impact of the bibliographic infrastructure. The proposal is based on information from: (i) lists of recommended readings in the academic program of the Pharmacology course given at the School of Medicine of UNAM in the last 30 years; (ii) the extent of discipline development measured by two indexes derived from the contents of Goodman and Gilman's "Pharmacological Basis of Therapeutics" (G & G); (iii) the number of texts currently found in the collection of FM-UNAM which are classified in the section of Pharmacology using the Library of Congress Classification System (LCCS); and (iv) the comparison of academic versus standardized classification of pharmacology topics, such as Medical Subject Heading (MESH) and LCCS The importance of this proposal relates to its usefulness for EP and for other medical disciplines.

Books↗
PubMed2005

Nursing leadership in genomics for health and society.

PURPOSE: This article is part of the series regarding genomics and nursing practice, science, education, and policy. Issues in genetic testing, genetic information and the lessons learned through applications of genetic and genomic science are analyzed and discussed. FRAMEWORK: Scientists, scholars, and members of the public have articulated a vision to guide genomics research and scholarship. The three overarching themes of this conceptual framework are genomes to biology, genomes to health, and genomes to society. CONCLUSIONS: Nurses can promote the use of genomic research technologies and information in the context of health, biology, and society, as well as in nursing research, practice, education, and policy.

Attitude of Health Personnel↗
PubMed2002

Reducing tobacco harm: research challenges and issues.

The emergence of potential reduced-exposure tobacco and cigarette-like products and the reduction of smoking as a treatment approach, have recently been forcing the debate and discussion about the science that is necessary to inform policies, regulation, and programs. To deal effectively with the issues evolving around tobacco harm reduction, a comprehensive and strategic research agenda must be forged, and a multi-disciplinary, collaborative approach must be taken. The goal of this article is to describe research challenges and issues related to tobacco exposure and harm reduction. Scientists from multiple disciplines and individuals from government agencies, nonprofit organizations, and tobacco control advocacy groups as well as the pharmaceutical and tobacco industries attended a two-day meeting that focused on addressing the current knowledge regarding tobacco harm reduction, identifying gaps in knowledge, and recommending research directions. Workgroups, comprising a subset of attendees, met after the conference to synthesize, discuss, and prioritize the important research frontiers. The resulting document provides guidance for scientists, grant funding agencies, industry and policy makers by identifying areas in which to invest research effort and funds to develop a science base to ensure the future health of this nation and world.

Communication↗
PubMed1998

Using ethnography to investigate life scientists' information needs.

Designing information resources that actually meet the information needs of individuals requires detailed knowledge of these needs. This poses a challenge for developers. Because the meaning of particular terms can vary by field, professional knowledge differs to some extent in different disciplines, and the questions that people ask assume a certain amount of unarticulated background knowledge, understanding the information needs of life scientists is not a trivial undertaking. One source of help in meeting this challenge is ethnography, a set of research methods and an associated conceptual stance developed and used by anthropologists for investigating uncontrolled real-world settings. Drawing on the author's experience in using ethnographic techniques to study clinicians' information needs, this paper describes why such research is necessary, why it requires particular research methods, what an ethnographic perspective has added to the study of information needs, and what this broader approach has revealed about the types of information sought by clinicians in the course of their daily practice.

Anthropology, Cultural↗
PubMed2006

Nutrigenomics: feeding the genes for improved fertility.

The post genomic era will result in many new molecular tools for evaluating the factors influencing fertility and reproductive performance in domestic livestock and poultry. There is currently considerable interest and practical merit in examining the regulatory steps involved in the process of gene transcription. Currently, oligo-based and cDNA microarray techniques make it possible to understand many of the factors controlling the regulation of gene transcription and globally evaluate gene expression profiles by looking at the relative abundance of gene-specific mRNA in tissues. These techniques provide an unprecedented amount of information and are only now being used to examine key reproductive, developmental, and performance characteristics in cattle. They also promise to provide a tremendous amount of new information that can be used to understand and diagnose key issues that limit reproductive performance. The science of nutrigenomics has begun to use information obtained from basic studies of the genome to evaluate the effects of diet and nutrient management schemes on gene expression. Preliminary studies have shown the value of such techniques and suggest that it will be possible to use specific gene expression patterns to evaluate the effects of nutrition on key metabolic processes relating to reproductive performance. While the effects of nutrition on fertility are only partially understood, modern nutrigenomics will undoubtedly play a key role in developing strategies for addressing some of the limitations in reproductive performance.

Animal Nutritional Physiological Phenomena↗
PubMed1998

The Nucleic Acid Database: A resource for nucleic acid science.

The Nucleic Acid Database (NDB) distributes information about nucleic acid-containing structures. Here the information content of the database as well as the query capabilities are described. A summary of how the technology developed by this project has been used to develop other macromolecular databases is given.

Database Management Systems↗
PubMed1994

Analysis of the use of reference services in an academic health sciences library.

In 1991, the Reference and Information Services staff of the Alfred Taubman Medical Library at the University of Michigan gathered data on the use of the reference desk, including the frequency and types of assistance requested by different user groups throughout the year. Recommendations based on the results of this study led to improved service as well as more efficient use of staff resources.

Community Participation↗
PubMed1988

The arguments against a national health program: science or ideology?

This article provides empirical information that questions some of the major arguments put forward against the establishment of a comprehensive and universal health program in the United State. The positions that (1) "Americans do not want a further expansion of government roles in their lives," (2) "a National Health Program would further increase the rate of growth of health expenditures," (3) "the federal deficit is too large and needs to be reduced before establishing a National Health Program," and (4) "people do not want to pay higher taxes," are shown to be ideological rather than scientific. The author presents evidence that questions each of these assumptions.

Budgets↗
PubMed2001

Structural biology and its applications to the health sciences.

Part of the decipherment of genomic information lies in understanding the structure and function of the protein products of these genes. Protein structure is of further importance because of the molecular basis of many diseases. Structural biology is the field of research focusing on the experimental determination of the structure of biological molecules. We review the field of structural biology and its application to medical research and drug discovery, and describe the structural results recently obtained in our laboratory for the detoxifying enzyme glutathione S-transferase from the Asian mosquito Anopheles dirus species B, an important malaria vector. These enzymes have detoxifying activity toward pesticides and thus contribute to pesticide resistance in insects.

Amino Acid Sequence↗
PubMed1999

[The path from science to the practicing surgeon. Engagement of documentation of the Swiss Academy of Medical Sciences for providing evidence-based medicine].

The flood of information that comes along with the rise of electronic media has changed the expectations towards the Documentation Service of the Swiss Academy of Medical Sciences (DOKDI): Evidence Based Medicine (EMB) in particular not only demands procurement of information, but also a selection regarding quality and relevance: The question arising out of the clinical situation requires an answer correct in its content and helpful in the specific situation. Getting an idea of what evidence exists about the correctness of a certain procedure through critical lecture is an ideal often obstructed by lack of time and methodical problems in the practice; therefore, one often has to rely on evidence acquired through others and consult e.g. the Cochrane Library. DOKDI commits itself to the development of systematic reviews as well as to the dissemination of evidence found by using its experience in the documentation with electronic media and by providing the corresponding infrastructure. In addition to these activities, the Academy has spoken a grant for the training of EBM-Tutors. During a weekly workshop held in Oxford, clinicians will be trained as EBM-Tutors. This will allow an increasing number of EBM-Workshops held in Switzerland in the future.

Academies and Institutes↗
PubMed2005

[Physicians and professionalism. Patients and information].

In the present time, the advances in sciences brought by technology are worshiped. This contributes to dehumanize human relationships. Medical profession is a commitment to oneself, society and social justice. Scientific and humanist formation must coexist during the training of new physicians. The main objective of medical profession is the relationship with patients. Patients have acquired increasing autonomy and a deliberative relationship is the closest to the ideal medical action. The relationship must be based in autonomy, beneficence, lack of maleficence and justice. The patient must receive all the information about his ailment and the diagnostic and therapeutic alternatives in a clear and intelligible language. This will allow to obtain a fully conscious informed consent from the patient. Asking for this consent, gives the patient the opportunity to practice his responsibility and to decide the best for him in a friendly and confident environment. In the middle of science and technology, a close contact with ethics and humanism will allow a better understanding of the integrity of subjects, specially when they are ill.

Education, Medical↗
PubMed1999

Interactive computer technology, behavioral science, and family practice.

In this paper we discuss conceptual and practical uses for interactive computer applications (ICAs) for family practice, with an emphasis on implications for patient self-management, physician-patient relationships, primary care research, and health care systems quality improvement. We discuss recent behavioral science advances in patient self-management and the advantages and potential limitations of ICAs for medicine. We describe the benefits and risks of using ICAs for providing information, coping-skills training, and social support for patients and for improving the consistency and quality of care given by physicians. There are currently many effective ICAs, and they will play a central role in future health care. There is also the risk of inappropriate use of ICAs. We provide a summary of the empirical literature examining the use of ICAs to aid patients and providers in behavioral change and guidelines adherence efforts. We advise those people researching and applying ICAs in health care to be bold in what they attempt, but cautious in what they claim. Rigorous scientific evaluation and standardized reporting criteria can help quicken this advance, and there are important policy and ethical issues to consider. We conclude with a list of issues for family practices to consider when selecting and using ICAs.

Ambulatory Care Information Systems↗
PubMed1994

Nuclear analytical methods in the life sciences.

A survey is given of various nuclear analytical methods. The type of analytical information obtainable and advantageous features for application in the life sciences are briefly indicated. These features are: physically different basis of the analytical method, isotopic rather than elemental determination, no interfering effect of electrons and molecular structure, and penetrating character of nuclear radiation. Suggestions are given for exploitation of the sometimes unique potentials of nuclear analytical methods, particularly when requiring considerable investment for equipment, supporting facilities, and specialized staff.

Biology↗
PubMed2006

Information sources for developing the nursing literature.

BACKGROUND: Journals are an important method for disseminating research findings and other evidence for practice to nurses. Bibliometric analyses of nursing journals can reveal information about authorship, types of documents cited, and how information is communicated in nursing, among other characteristics. OBJECTIVES: The purposes of our study were to describe the types of documents used to develop the clinical and research literature in nursing, and extent of gray literature cited in those publications. DESIGN: This was a descriptive study of 18,901 citations of articles in clinical specialty and research journals in nursing published between January 2004 and June 2005. METHODS: The research team reviewed each citation to assess if the cited document was a journal article, book chapter or book, or document falling into the category of gray literature. Frequency counts for each type of cited document were recorded. RESULTS: Most of the citations were to journal articles (n=14,392, 76.1%) and among those, to articles in medical journals (n=7719, 40.8% of all the citations). This was true for the literature as a whole and for the clinical specialty and research literature separately. Although citations to medical journals were most common, in the clinical nursing literature there was a significantly higher proportion of citations to medical journal articles (n=6332, 44.5%) than in the nursing research literature (n=1387, 29.7%) (LR(X)(2)=326.7, p<0.0001). Nearly 10% of the citations were to gray literature. There was an increase in citations to websites (5.7%) compared to a study done only a few years earlier. CONCLUSIONS: Our study documented that journal literature was the primary source of information for communication within nursing. This is consistent with other biomedical and hard sciences where the transfer, assimilation, and use of information occur mainly within the scientific community. With a reliance on journal articles for dissemination of research and evidence for clinical practice, improved methods will be needed for integrating this knowledge and presenting it in a usable form to clinicians. As journals proliferate, it will become increasingly difficult for clinicians to keep current with research findings to guide their practice. The development and testing of new methods for integrating and disseminating research evidence to busy clinicians will be increasingly important in nursing. Gray literature was nearly 10% of the citations. The study also revealed an increase in citations to websites, which is anticipated to continue in the future. Further study is needed on the indexing of gray literature relevant to research use and evidence-based practice in nursing and on how to make this literature easily available to clinicians.

Bibliometrics↗