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PubMed1993

Paraprofessional staff: a review and report on current duty assignment in academic health sciences libraries in North America.

This paper reviews paraprofessional employment in libraries and examines the trend toward assigning increasingly complex duties to academic library paraprofessionals. During the spring of 1989, directors of academic health sciences libraries in the United States and Canada were surveyed to determine the duties assigned to paraprofessionals. The results show that paraprofessionals are assigned a wide range of duties, including supervising functional areas, such as circulation and interlibrary loan, and some tasks often considered professional, such as original cataloging and in-depth reference work. The findings illustrate the importance of the paraprofessional to librarianship.

Academic Medical Centers↗
PubMed1993

[Current drug problems].

From the multifaceted and complex catalog of problems in drug abuse those are selected that are relevant for medical practise. After a short introduction the situation of drug abuse in the canton of Zürich is described, based on estimates about users, descriptions of consumed amounts, market prices of heroine and cocaine and a summary of some epidemiologic data and the sequelae of drug-dependence. In a second part substitution by methadone is described in detail. In a third part cocaine with its effects and adverse effects is presented in more detail.

Cocaine↗
PubMed1993

Functional voiding disorders of childhood.

Voiding problems in children are common and lead to symptoms of incontinence, urinary tract infections, urinary frequency, and urgency. Most voiding disorders occur in children with relatively normal neurologic and urinary systems and are believed to be functional in nature. Functional voiding disorders have a complex etiology involving faulty decision making and toilet habits. These disorders present with various combinations of symptoms and may be difficult for the physician and the parents to recognize. A catalog of the most common voiding disorders and their treatment is outlined. The close relationship between voiding and stooling dysfunction and their treatment is also presented.

Child↗
PubMed1995

Multilevel library instruction for emerging nursing roles.

As new nursing roles emerge that involve greater decision making than in the past, added responsibility for outcomes and cost control, and increased emphasis on primary care, the information-seeking skills needed by nurses change. A search of library and nursing literature indicates that there is little comprehensive library instruction covering all levels of nursing programs: undergraduate, returning registered nurses, and graduate students. The University of Florida is one of the few places that has such a multilevel, course-integrated curriculum in place for all entrants into the nursing program. Objectives have been developed for each stage of learning. The courses include instruction in the use of the online public access catalog, printed resources, and electronic databases. A library classroom equipped with the latest technology enables student interaction with electronic databases. This paper discusses the program and several methods used to evaluate it.

Adult↗
PubMed1995

[Schindler disease/Kanzaki disease].

Schindler disease and Kanzaki disease are caused by a deficient lysosomal enzyme, alpha-N-acetylgalactosaminidase (E.C.3.2.1.49). Two German children were first reported in 1987 and other two Dutch children were recently reported in 1993. These children were very similar clinically and characterized by maked neuroaxonal dystrophy of an infantile onset. This disease (type 1) was named Schindler disease. On the other hand, an adult patient with profuse angiokeratoma corporis diffusum but minimum involvement in nervous system was reported in 1987 from Japan. This disease (type 2) was named Kanzaki disease (Mckusick catalog No. 104170). Molecular analyses of these diseases revealed one each point mutation in the encoding gene. Clinical, ultrastructural and molecular studies of these disease were described.

Adult↗
PubMed1995

Menstrually related disorders: what we do know, what we only believe that we know, and what we know that we do not know.

Menstrually related disorders (MRD) are quite prevalent. Attention is mostly focused upon the premenstrual syndromes (PMS), which are a subject of controversy tinted by opinions, beliefs, and biases. Recently, substantial progress has occurred in the diagnosis, evaluation, and treatment of MRD, but their etiology and pathophysiology are still unknown and are a matter for several hypotheses. Data on MRDs were recently extensively cataloged and reviewed elsewhere. Here the emphasis is on some opinions from the departure point that: (1) The existence of MRD is undoubtful if beliefs and biases are put aside, and (2) symptoms of MRD are diversified and the dysphoric ones are associated with other dysphoric disorders and states. The biology of MRDs should be elucidated by emphasizing the multidimensional interactional processes involving the hypothalamic-pituitary-gonadal (HPG) system, neurotransmitters, and other hormonal axes, as well as other biological systems and circuits. The biological systems are interwoven with environmental and psychological inputs. Much of the available data can be understood within a model of dynamically evolving, diversified vulnerabilities, which may be expressed as symptoms when a trigger is applied. That trigger is probably related to ovulation and/or the HPG system but might also be related to another stress- or state-related mechanism. Treatment of MRD might be targeted at the symptoms or vulnerability variables (as is the case with antidepressants) or at the ovulation-related trigger (as is the case with ovulation suppressors). Knowledge about MRD will be enhanced by studies of the mechanisms of interaction between environment and hormonal and brain systems, by studies of processes of homeostasis and its dysregulation, and by an in-depth evaluation of the mechanisms of treatment response and nonresponse.

Female↗
PubMed1995

Retrieval from a large, integrated HIS-database through formal descriptions and SQL.

This paper outlines the realization of rich retrieval facilities and comprehensive data administration in an existing, large, integrated Hospital Information System (HIS) using SQL as a query-language and using a large collection of formal data descriptions stored in the Data Dictionary and Directory System (DD/DS). It is emphasized that the approach to enhance the access to the database is more important than the technology. Nevertheless, the facilities are presented that support non-routine retrieval. The Data Dictionary and Directory System functions as a catalog of the information system. The vehicle that facilitates the communication with the database is an implementation of SQL-in a number of appearances. It is stressed that only full benefit can be gained through a combined action of a large integrated HIS, a complete and correct DD/DS, and strong retrieval functions.

Hospital Information Systems↗
PubMed1995

An interactive histology image-barcode manual for a videodisc image library.

UNLABELLED: Cell Biology and HISTOLOGY (alias Microanatomy, alias Microscopic Anatomy) is a required course for first-year medical and dental students in most health science centers. The traditional approach used in teaching this discipline is to present photomicrographic images of structures to students in lecture using 35 mm slides of fields seen through the microscope. The students then spend many hours viewing and studying specimens of tissues using a light microscope in a laboratory setting. Students in traditional courses of histology spend an inordinate amount of time learning the component structures by attempting to find and identify them in tissue sections using a microscope, where the structure being sought is surrounded by a multitude of other structures with which they are also not familiar. With the recent availability of videodisc stored image libraries of histological samples, it is now possible to study histological principles without the use of the microscope as the primary learning tool. A videodisc entitled " HISTOLOGY: A Photographic Atlas" by S. Downing (published by Image Premastering Services Limited, Minneapolis, MN, 1991) has been incorporated into our histology course. Fifteen videodisc player stations are provided for 150 students. Images are retrieved by students using a bar code scanner attached to a videodisc player (Pioneer CLD-2400). Using this kind of image library, students can now learn basic histological structure, such as cell and tissue types, without the use of a microscope or as a tool for facilitating microscopy. The use of a videodisc library of randomly accessible images simplifies learning the basic components which all organs are composed of by presenting the learner with clear-cut examples to avoid confusion with other structures. However, videodisc players and TV monitors are still not appropriately priced for every student to own. This presents a problem in that the same images studied in class are not available to study and review outside of class. There is a need for resources for additional study outside of the institutional setting, for students to have and interact with to reinforce the learning experience in the teaching laboratory. A hard copy manual was created and is being used in our course; it incorporates photos captured from the videodisc. The images displayed in the manual are chosen to give the student one example of each histological component. Additional labeling is added to the images, and each image is accompanied by a bar code that may be used at a videodisc player with a bar code reader to retrieve the same color image from the disc displayed in larger format on a TV monitor. Each topic in the manual is accompanied by learning objectives and a statement of clinical relevance. Following the presentation of the images in each section of the manual, the students are encouraged to practice by viewing multiple examples of each structural component presented in the lesson. They can do this by using the bar-coded catalog supplied with each disc. The presentation of each topic concludes with a quiz composed of questions about images that the student can retrieve from the videodisc using barcodes in the text of the manual. Some of the images on the quiz are printed in miniature in the manual to provide the student with an opportunity for personal review at home when hardware to obtain and display images from a video disc is not available. This manual provides an answer to the dilemma faced by the learner when access to hardware is not available; reinforcement is therefore facilitated outside the teaching laboratory. This allows learning to continue outside of the classroom, using the same materials. (abstract truncated)

Computer-Assisted Instruction↗
PubMed1995

Computer-based information collection and feedback for Norwegian municipal health and social services.

Norway is governed by a three-tier parliamentary system where each tier is governed by a popularly selected body: the national parliament, the county councils, and the municipality councils. This three-tier system is in many ways also reflected in the organization, management, and financing of health and social services. A large amount of information (e.g.,statistics and annual reports) flows between the three levels of management. In order to have a proper and efficient information flow, The Norwegian Ministry of Health and Social Affairs has, since 1992, been conducting a nation-wide project for information collection from and feedback to municipal health and social services (see Figure 1). In this presentation, we will present the basic idea behind The Wheel. We will also discuss some of the major activities in and experiences from the project of using Information Technology to implement an electronic Wheel. The following are basic issues to consider in implementing such a system, related to the following basic issues in implementing such a system [1]: Obtaining a unified information basis to: increase the data quality, and compile "definition catalogs" that contain commonly agreed-upon definitions of central concepts and data sets that are used in the municipal health and social services [2]. Achieving electronic data collection, both in terms of the automatic selection and aggregation of relevant data from operational systems in the municipalities and in terms of using Electronic Forms. Experiments with various ways of electronically feeding back the statistics and other comparative data to the municipalities. Providing the municipal users with appropriate tools for using the statistics that are fed back.

Data Collection↗
PubMed1996

[Traveling on the data highway--online information for urologists].

Global exchange of information is one of the major sources of scientific progress in medicine. Electronic media have recently supplemented the standard methods of scientific communication such as congresses, books and journals. Currently, 30 million computers are part of the world-wide, exponentially growing network, the ""information superhighway''. Numerous resources offered by the network are becoming increasingly useful in clinical medicine. In Germany, three major networks are currently available: T-Online/Datex-J, Compuserve and Internet. The majority of information relevant to urologists can be found in the Internet. This information includes medical journals that can either partly or completely be read online, online library catalogs, scientific images (pathology and radiology), and databases on urologic oncology and basic research in urology. Even outside academic institutions access to the "information superhighway" is easily available. Currently, the "information superhighway" constitutes a new source of database-type information; in the near future, medical education, clinical consultation and worldwide cooperation in clinical studies will be new fields of scientific communication employing worldwide computer networks.

Forecasting↗
PubMed1996

[A comparison of the morphology of mammalian and bird ear ossicles and reflections on the asymmetrical form of the human stapes arch].

BACKGROUND: The human middle ear presents some anatomical detail which can not be explained exclusively by sound transmission (joints, muscles). These details can be interpreted as an adaptation to environmental atmospheric pressure loads. In order to further investigate the influence of these non-acoustic loads on the geometry of the middle ear structures, the ossicles of animals from different environments were examined. METHODS: In the first half of our century, the zoologist C. F. Werner collected the ossicles of 175 species, mostly mammals and birds. This collection was now cataloged and analysed with light and x-ray microscopy. RESULTS AND DISCUSSION: The diversity in size and design of the ossicles seems to be influenced not only by the acoustic environment of the animal--the ossicles of mammals living in the desert are relatively large, reflecting the better sensitivity of their middle ear for the far traveling low frequencies--but especially the bony structure of the ossicles can be related to the static loads of the environment of the animal. Ossicles of aquatic mammals are more solid and denser than in terrestrial forms. The bony structure aligns to the static load. This structural principle forms the basis of the skeleton and muscles and can also be found in the human stapes: the asymmetry of the stapedial arch can be explained as adaptation of the bony structure to the pull of the stapedius muscle. CONCLUSIONS: The anatomical structure of the ossicles of human and animal origin is not only influenced by its function as sound transmitter, but it is also shaped by nonacoustic forces and static loads of the environment.

Animals↗
PubMedDate not supplied

[French language pharmaceutical publications in 1995. I. Assessment and analysis of French language pharmaceutical periodicals].

Periodicals constitute a vital source of information and an invaluable continuing education medium to pharmacists. The aim of the present study was to compile the list of the 83 pharmacy-related periodicals published in French as at 1995 with a view to establishing their main characteristics. The first part focuses on the definition of the concept of "French language pharmaceutical periodicals" selected for the survey needed a) to be in circulation in 1995 and published at least two times a year, b) published by pharmacists or non-pharmacists but must carry articles intended to help, inform, or retrain pharmacists irrespective of their specialties (community, hospital, biological or industrial pharmacy) as well as their closest collaborators (assistants, technicians, etc.) and c) published in French. The second section presents the methodology of the survey, which consisted essentially in consulting publisher and library catalogs and direct interviews with embassies and Pharmacy Associations in French-speaking countries. Questionnaires were also sent out to editors of periodicals and the information gathered was analysed by computer. The following section reproduces the results of the the survey: These were classified into three categories: scientific, professional, and continuing education periodicals. The last section concentrates on their readership (national, international), frequency, modalities of publication, date of creation, indexing in bibliographic databases.

Language↗
PubMed1996

Library instruction in the medical school curriculum: a survey of medical college libraries.

Future physicians must learn to cope with continuing changes in access to medical information. New instructional techniques, such as problem-based learning, emphasize the importance of research skills to medical students. To investigate the feasibility of establishing library instruction as a required part of the East Tennessee State University College of Medicine curriculum for undergraduates, the university's medical library surveyed 123 medical school libraries to determine the level of instruction offered by other academic medical libraries. The survey asked whether formal instruction was offered or required, and which courses were taught at each level of undergraduate training. Analysis of the fifty-five responses revealed that 75% offered formal library instruction, and that 49% of these respondents (36% of the total sample) required all students to take such courses. The courses offered most often were library tours, online catalog instruction, and MEDLINE-on-CD-ROM classes. Overall, thirty-three different course titles were offered by responding libraries. The majority of classes involved second- and third-year students. The survey responses reveal the prevalence of required library instruction in medical school curricula, and a broad-scale commitment to the development of lifelong learning skills among future health professionals.

CD-ROM↗
PubMed1995

[Diseases due to instability of DNA].

The catalog of genetic diseases whose mutational mechanisms are based on the expansion of nucleotide triplets includes 8 disorders classified in terms of type of triplet sequence and the mechanism by which the mutation manifests clinically. To date there are 3 groups. The first is made up of several mental retardation syndromes linked to fragility in the X chromosome (FRAXA, FRAXE, FRAXF, FRA16), with CGG type triplets and large growth expansions located close to a CpG island whose methylation determines degree of chromosome fragility as well as the size of expansion. The second group encompasses diseases arising from CAG triplets. Examples are spinal bulbar atrophy, Huntington's chorea (HC), type 1 dominant cerebellar ataxia (DCA1), dentatorubral-pallidoluysian atrophy (DRPLA) and Machado-Joseph's disease. In this group the expansion codes a polyglutamate residue that gives rise to clinical manifestations by way of functional gain. Myotonic dystrophy (MD) remains in a separate group, with large-size expansion but no chromosomal fragility, and clinical manifestations in multiple systems. All entities encompass phenotypic variation or tendency to inter-generational growth of the expanded fragment that triggers the anticipation phenomenon to varying degrees--greater for some diseases (MD) in cases of maternal transmission and for others (DCA1, HC and DRPLA) when transmission is paternal. The mechanisms by which expansions occur is unknown but the decisive element in some entities may be failure to correct errors in DNA duplication and errors in the integrity of the repeated sequence. We review the difficulties inherent in establishing correlations between genotype and phenotype and in providing genetic counseling.

Chromosome Aberrations↗
PubMed1996

Musculoskeletal injury review in the U.S. space program.

Astronauts in NASA's space program are expected to remain fit to complete their on-orbit tasks and to function effectively in the event of contingency operations. Due to the generally self-directed exercise program and reliance on competitive sports and running for conditioning, plus limited emphasis on training techniques and rehabilitation, there have been a surprising number of orthopedic injuries and surgeries in this small adult population. This article examines the orthopedic injury history of U.S. astronauts during the period from 1987-95. The type of injury, activity involved, and subsequent surgical interventions are cataloged. There were a total of 26 fractures, 36 serious ligament, cartilage, or soft tissue injuries, and 28 orthopedic surgical procedures in this adult group with a mean astronaut corps size of only 94. Women accounted for 16% of the study population but accounted for only 1 of 28 surgical procedures. Knee injuries required surgical intervention 19 times. Running, skiing, and basketball were most frequently associated with injuries. The descriptive data regarding frequency of adverse events and activity associated with injuries is presented. These injury patterns are analyzed and suggestions made for future improvement, including decreased reliance on running and competitive athletics for conditioning, improved personal fitness training preflight, and coordinated rehabilitation postflight. Also recommended is the use of a lap pool for preflight total body fitness training, since swimming provides conditioning to those muscle groups used during spaceflight, and for variably weighted gravity rehabilitation postflight.

Adult↗
PubMedDate not supplied

Medical information on the Internet.

Connecting to the Internet allows health care professionals to access medical information at computer sites worldwide, to search databases, communicate with peers, obtain continuing education, retrieve images and software, obtain drug information and access statistical data. Users can access sites with "virtual patients," search library catalogs, locate jobs and post resumes, and explore conference sites and topics. Rural health care professionals can have access to medical information equivalent to their urban peers. Information is usually available over the Internet much more rapidly than through traditional print methods.

Computer Communication Networks↗
PubMed1996

Library services for people with disabilities: results of a survey.

The Americans with Disabilities Act (ADA), enacted in 1990, has had a significant impact on the way many institutions, including libraries, do business. The Association of Research Libraries surveyed its members in 1991 to determine the effect of this legislation, and the author conducted a similar survey in 1995 to learn what progress academic health sciences libraries have made in serving the needs of people with disablities. A questionnaire was mailed to 131 members of the Association of Academic Health Sciences Library Directors. Nearly three-quarters of respondents reported elimination of physical barriers. The most common services provided are retrieval of materials from the stacks and photocopy assistance. Much less attention has been paid to the use of adaptive technology that allows disabled users to search a library's online catalog and databases; special technology is often provided by another unit on campus but there seems to be little coordination with library services Few libraries have assigned responsibility for disability services to a specific staff member and even fewer have done a formal assessment of the need for special services. The issues identified by the survey should challenge academic health sciences libraries to examine their status regarding compliance with ADA legislation.

Architectural Accessibility↗
PubMed1995

Equipment records for modular analytical systems.

The dominant technology in the BAS analytical chemistry laboratory is high-performance liquid chromatography (HPLC). Logbooks have been too cumbersome and unworkable for recording maintenance and repair of HPLC systems. Liquid chromatographs can have 10 or more components that can all move independently of one another as systems are reconfigured for different types of analyses. One solution to the problem of keeping accurate, easily retrievable records of equipment maintenance and repair is to use a card to record the information and a database to catalog the cards. The card contains all of the required information for routine or nonroutine maintenance and for remedial action and/or repair. The document is controlled by providing each card with a unique number and maintaining a duplicate in a bound book. The cards are filed by equipment ID number, producing an historical record of the maintenance and repair of a piece of equipment. The information on each card is also summarized in a database. Using the database, regular schedules of routine maintenance can be produced, the inclusion of all cards can be verified, and the records of a particular piece of equipment can be displayed.

Chromatography, High Pressure Liquid↗