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PubMed2000

[A study on evolution of the term impotence and its classification and diagnosis].

Called "bu qi" (unable to erect) in the pre-Qin period, it was called "yin wei" (yin flabbiness) during Qin-Han to Jin-yuan dynasties, and called "yang wei" (yang flabbiness) since the Ming dynasty, though a few books called it Yin-flabbiness, but both Yang- and Yin- flabbiness didn't appear simultaneously in the same work. It was categorized under seven-injuries, kidney disorders, consumptive diseases, five non-masculine and sexual diseases before the Tang dynasty, and categorized under miscellaneous diseases since Jin dynasty. It was typed into bu ju (non erected), bu jian (non hardened) and bu jiu (non persistent). Some classified on the basis of etiology. It was pointed out that this disorder refers to inability to errect though the patient has a desire to erect, instead of unwilling to erect. The changes of the idea reflect the different levels of recognition in different historical periods.

China↗
PubMedDate not supplied

A teaching booklet for patients receiving mantle field irradiation.

PURPOSE/OBJECTIVES: To design a booklet for use in educating patients with Hodgkin's disease about mantle field irradiation. DATA SOURCES: Published articles, book chapters, and clinical experience. DATA SYNTHESIS: Information about the actual mantle field irradiation treatment and its acute side effects, self-care measures, and late effects are included in the booklet, along with a self quiz. CONCLUSIONS: Feedback from patients and staff is positive. Early detection of and intervention for herpes zoster infection has improved. IMPLICATIONS FOR NURSING PRACTICE: The booklet can be used in conjunction with other teaching tools for radiation therapy and skin care and as a written reference for patients and staff.

Hodgkin Disease↗
PubMed1993

A study of prescribing patterns with special reference to drug use indicators in Dar es Salaam Region, Tanzania.

Drug prescribing patterns were studied in 720 retrospective and 779 prospective outpatient prescriptions from 20 dispensaries in Dar es Salaam region, and these revealed a mean drug exposure of 2.0 and 2.3, respectively. The percentage of patients leaving the dispensaries with no prescribed drugs was 1.3% and 0.7%, respectively. Prescriptions containing antibiotics were 36.8% (retrospective) and 39.8% (prospective), while injections accounted for 24.6% and 34% of the total encounters, respectively. Over 70% of prescriptions conformed to the Tanzania essential drug list (EDP) and/or standard treatment guidelines and consisted of 83.9% and 79.1% generic prescriptions, respectively. Interestingly, only 15% of the surveyed dispensaries had an EDP book and/or calendar. Despite the consulting and dispensing times being short (2.98 min and 77.7 s, respectively), 70% of the patients could remember the dosing instructions. Only 64% of the patients had a minimum physical examination.

Ambulatory Care Facilities↗
PubMed2005

An online interactive simulation system for medical imaging education.

This report presents a recently developed web-based medical imaging simulation system for teaching students or other trainees who plan to work in the medical imaging field. The increased importance of computer and information technology widely applied to different imaging techniques in clinics and medical research necessitates a comprehensive medical imaging education program. A complete tutorial of simulations introducing popular imaging modalities, such as X-ray, MRI, CT, ultrasound and PET, forms an essential component of such an education. Internet technologies provide a vehicle to carry medical imaging education online. There exist a number of internet-based medical imaging hyper-books or online documentations. However, there are few providing interactive computational simulations. We focus on delivering knowledge of the physical principles and engineering implementation of medical imaging techniques through an interactive website environment. The online medical imaging simulation system presented in this report outlines basic principles underlying different imaging techniques and image processing algorithms and offers trainees an interactive virtual laboratory. For education purposes, this system aims to provide general understanding of each imaging modality with comprehensive explanations, ample illustrations and copious references as its thrust, rather than complex physics or detailed math. This report specifically describes the development of the tutorial for commonly used medical imaging modalities. An internet-accessible interface is used to simulate various imaging algorithms with user-adjustable parameters. The tutorial is under the MATLAB Web Server environment. Macromedia Director MX is used to develop interactive animations integrating theory with graphic-oriented simulations. HTML and JavaScript are used to enable a user to explore these modules online in a web browser. Numerous multiple choice questions, links and references for advanced study are provided in the tutorial for trainees to verify their understanding of each unit. It is expected that this tutorial will enhance medical imaging education, help trainees in subsequent analysis of image data, and form the basis for the development of more advanced technologies in the future.

Computer Simulation↗
PubMed1995

[The Galton whistle and discovery of presbycusis. Images from the history of otorhinolaryngology, exemplified by equipment from the collection of the Ingolstadt German Medical History Museum].

One of the many interests of Sir Francis Galton (1822-1911), a singularly versatile English research worker, was anthropometry, i.e. measuring and comparing physical attributes in men. Here he introduced the concept of eugenics. He thought that the upper hearing threshold for high-pitched tones might be an attribute specific to each species, and in order to prove this he devised a whistle which was later named after him. Using this instrument he found that the upper hearing threshold in animals actually differs very much with the species and that in humans it is regularly depressed with age. The relevant passages of his book Inquiries into Human Faculty of 1883 are quoted in translation. Burckhardt-Merian from Basel, Switzerland, introduced Galton's whistle into otology in 1885. Appropriate instruments were soon developed by König in Paris and Edelmann in Munich and became commercially available. Zwaardemaker in Utrecht, the Netherlands, was the first to systematically investigate hearing in the elderly using Galton's whistle, and he derived from these studies what he called the "prebyacusial law." Technical details of Galton's whistle are described with reference to Edelmann's final refined version of the instrument of 1900. During the first 30 years of this century, Galton's whistle was in wide use, but due to unavoidable inherent flaws it later gave way to the monochord and eventually to tone audiometry.

Aged↗
PubMed2003

Social class, ethnicity and attendance for antenatal care in the United Kingdom: a systematic review.

BACKGROUND: Evidence from outside the United Kingdom points to several socio-demographic factors associated with late initiation of antenatal care or fewer antenatal visits, but it is not clear how generalizable these studies are to the UK context. This systematic review addresses the question of whether there are social or ethnic inequalities in attendance for antenatal care in the United Kingdom. METHODS: We identified and reviewed UK studies assessing attendance for antenatal care according to any measure of social class, social deprivation or ethnicity. A wide range of electronic databases was searched for published and unpublished studies. Further studies were identified from reference lists, citation searches and key organizations. RESULTS: From over 1300 identified papers, 20 were potentially relevant. Nine were included in the review. Most studies were of poor quality, with only one study controlling for the effect of potential confounders such as age, parity and clinical risk factors. All but one were based on data collected around 20 years ago. Three of the five studies looking at antenatal attendance and social class found that women from manual classes were more likely to book late for antenatal care and/or make fewer antenatal visits than other women. All four studies reporting on antenatal attendance and ethnicity found that women of Asian origin were more likely to book late for antenatal care than white British women. CONCLUSIONS: There is little good quality evidence on social and ethnic inequalities in attendance for antenatal care in the United Kingdom. Recommendations for further research are suggested.

Female↗
PubMed1994

An incident case-referent study of stillbirths at Harare Maternity Hospital: socio-economic and obstetric risk factors.

This incident case-referent study was conducted at Harare Maternity Hospital in 1989-1990 on 104 consecutive cases of stillbirth with unknown aetiology and 96 age- and parity-matched referents. Information was collected by interviewing the women following a standardized form and by review of antenatal cards. None of the women refused to participate. The most significant obstetric risk factors were prevalence of earlier stillbirths (odds ratio, OR = 6.1) and miscarriages (OR = 4.8). Low height and body mass index also increased the risk of having a stillborn baby significantly as well as a history of flue-like illness during pregnancy (OR = 4.6). The latter may have stimulated the women to book early causing the unexpectedly high OR for early booking among these cases. The pattern for the socio-economic risk factors was not easy to interpret. The most striking finding was the U-shaped relationship between socio-economic status and stillbirths with a higher risk among those with low and high status.

Adolescent↗
PubMed2006

Outbreak of Burkholderia cepacia bacteremia in immunocompetent children caused by contaminated nebulized sulbutamol in Saudi Arabia.

BACKGROUND: An outbreak of 5 inpatient and otherwise healthy children admitted for respiratory problems developed dry fever and cough after a few days of hospitalization. Burkhuldaria cepacia was isolated from their blood culture. The Infection Control Department (ICD) in the King Fahad Medical City (KFMC) detected and investigated the outbreak to identify the source of the organism and mode of transmission. METHODS: After the initial review of all the existing records in the KFMC, log book of the laboratory, and direct questioning of all physicians and revising the method of B cepacia identification in our laboratory, an observational study to identify any violation of infection control policy and a case-control study were designed to identify possible risk factors associated with the occurrence and transmission of the disease. RESULTS: A total of 7 healthy patients were reported to have B cepacia-positive blood culture, with 5 patients infected in the KFMC and 2 patients in their referring hospitals. We could isolate the same organism from sulbutamol solution 0.5% manufactured locally (Vintec). Among the risk factors studied, concomitant use of nebulized budesonide with sulbutamol (OR, 26; 95% CI: 1.31-1,187) was found to be 26 times more likely to be associated with infection and to be statistically significant; concomitant use of systemic hydrocortisone increased the risk of infection 4 times but, statistically, was not significant. No significant association was found with concomitant syncitial respiratory virus (RSV) infections or having chronic diseases. None of the affected patients were found to be immunocompromised. CONCLUSION: B cepacia can affect healthy children. Contaminated nebulized sulbutamol with B cepacia was the source of infection, and inhalation was the mode of transmission. Concomitant use of nebulized budesonide solution is a significant risk factor. The KFMC was the first health institution to diagnose this national outbreak.

Albuterol↗
PubMed1997

Contact dermatitis.

LEARNING OBJECTIVES: Reading this article will reinforce the reader's knowledge of the definition, pathophysiology, differential diagnosis, evaluation, and management of the most common of all the "eczemas," contact dermatitis, which can have an allergic and/or an irritant pathogenesis. DATA SOURCES: Relevant articles and current texts on contact dermatitis were referenced and reviewed. The personal experiences of the authors in an Environmental Medicine Clinic, their private practices, and their teaching of residents and other physicians were evaluated. A MEDLINE database using subject keywords was searched from 1986 to date. STUDY SELECTION: Book chapters, pertinent articles, data source abstracts, guidelines for the management of contact dermatitis set by the American Academy of Dermatology, and the American Contact Dermatitis Society were critiqued. RESULTS: The recent elucidation of the pathoimmunology of contact dermatitis is concisely reviewed, highlighting its clinical implications. The protean clinical presentations of contact dermatitis, both "allergic" and "irritant" type are cited. The signs and symptoms warranting the search for a contactant are outlined. The most likely regional contactants are listed, but the need to reference a more complete textbook is often required. That patch testing is the gold standard to identify an allergenic agent causing allergic contact dermatitis is stressed. While the "who" and "when" to patch test is amply described, a cookbook "how" to patch test has been omitted in order to emphasize the importance of "hands on" experience for such testing. The advantages and limitations of the commercially available standard patch tests (Hermal, and T.R.U.E.) are described, plus the sources for "nonstandard" patch tests is made available. Therapeutic modalities, topical and systemic, for management of the uncomfortable patient are outlined. CONCLUSION: The physician who manages a patient with an "eczematous" rash must be aware of the complete differential diagnosis of that clinical presentation. Suspicion that a "contactant" is the cause must have high priority, especially when the rash is persistent, and fails to respond to "appropriate" therapy. The value of a skin biopsy is limited to confirming its eczematous (spongiotic) nature and ruling out other diseases. Appreciating the paradox of patch testing, namely the deceptive simplicity of application versus the required expertise for interpretation and recognition of clinical significance, is the key to the proper management of the patient with contact dermatitis.

Allergens↗
PubMed1991

ras proteins and the ras-related signal transduction pathway.

Mammalian ras genes may naturally acquire oncogenic transformation potential through some point mutations which result in the impairment of the normal ras protein functions, and which are localised in codons 12, 13 or 61. Mutationally activated ras alleles were found in a wide variety of human and carcinogen (including radiation)-induced animal malignancies. In man, myeloid leukemias are often associated with the presence of a mutationally activated ras gene (for review, see Bos JL (1989), Cancer Res 49:4682-4689). However, we failed till now in our attempts to detect oncogenic ras mutations in radiation-induced mouse myeloid leukemias. We thus have the feeling that ras might perhaps participate to tumorigenesis through another mechanism provoking a deregulation of the ras protein functions. In order to help evaluate such a possibility, we give here a very concise overview of the properties of the ras proteins and of their regulation by a variety of still hypothetical molecular switches. This overview does not include bibliographic references. Indeed, we gathered much of the information described below at the Cold Spring Harbor Symposium on "Function and Evolution of ras Proteins", May 9-13, 1990. Communications presented at Cold Spring Harbor Symposia may contain preliminary data and should not be cited in bibliographies. Another voluntary omission in this overview is that, for the sake of simplicity, we do not mention whether the data were obtained from experiments performed on H-, K- or N-ras. Details can be found in the published book of abstracts.

Animals↗
PubMed2006

Capacity planning for cardiac catheterization: a case study.

BACKGROUND: Excessive waiting for procedures such as cardiac catheterization is an important issue for health care systems. Delays are generally attributed to a mismatch between demand and available capacity. Furthermore, due to the dynamic nature of short-term referral rates, procedure times, and patients' medical urgency, all of which are important contributors to the problem of excessive waiting time, it has been difficult to predict capacity needs accurately. The objective of our paper is to demonstrate how such calculations could be performed. METHODS: After constructing a patient flow model and populating it with appropriate data from 16 consecutive months of operations (n=6215 referrals) of a regional cardiac centre in Ontario, we used computer simulation to simulate the operations of catheterization laboratories in several "what-if" scenarios. We divided the patients into three urgency categories: U1--hospitalized patients, U2--urgent outpatients, U3--elective outpatients. We tested the accuracy of the model by comparing a 1-year sample of computer simulation with actual data which resulted in a highly significant correlation of 0.94. RESULTS: We observed from the referral cohort that waiting times were long, both overall and within each urgency category. We observed from the simulation models that: (1) a one-time infusion of capacity to clear the backlog failed to reduce the waiting times; (2) targeting extra capacity to highest urgency categories reduced waiting times overall and also benefited low urgency patients for whom specific increased capacity was not earmarked; (3) there were no significant effects on waiting times if in some cases patients or referring physicians were able to choose their cath physician; and (4) in situations where the arrival rates increased overall or within specific urgency categories, waiting times increased dramatically and failed to return to baseline for several months to years for the low urgency patients. Efficiency of the labs within the existing capacity could be improved by: (1) reducing changeover time between cases (2) externalizing and standardizing many of the pre- and post-procedural management of the patients, and (3) more carefully balancing the booking to reduce both slack and overtime. INTERPRETATION: Capacity determination is a complex and dynamic process. A combination of available clinical and administrative data, along with a computer simulation model, helps predict capacity needs and is the most appropriate strategy to minimize waiting of patients for procedures. This approach is generalizable and can lead to more effective management of waiting lists for a variety of procedures.

Cardiac Catheterization↗
PubMed2001

[Investigation on relation between Yang Shangshan and the classified compilation of Tai su (Comprehensive Notes)].

Taisu, a book complied by Yang Shangshan by imperial decree is the earliest complete commentary and classified complation of Neijing (The Yellow Emperor's Canon of Internal Medicine) now extant. Recently, some scholars argued about the classified compilation of Taisu performed by Yang Shangshan. However, by analyzing and researching into the text and commentary of Taisu, conclusion can be drawn that the classified compilation of Taisu was indeed complied by Yang Shangshan himself. First, "youben" (certain edition) and "yiben" (an edition) in the commentary are not referring to the other editions of Taisu. Second, quotations cited from Su wen (Plain Questions) and Jiu juan (Nine Volumes) in the commentary are not used to collate Taisu. Thire, analysis made on the compilation and commentary by Yang Shangshan. Fourth, analyzing "taisu jing lun (Classical Discourses of Taisu)", the commentary of Taisu Shui lun (On water in Comprehensive Notes).

China↗
PubMed1993

[Full computerization of a radiology service. A 5 years' experience at a centralized system].

Even though the problem of collecting and processing information is of paramount importance in any radiology department, the choice of the best information system--as for organization and effectiveness--largely depends on specific and different local situations and is therefore still largely debated. In the ULSS 18 in Veneto (Dolo, Venezia), all patients are referred to the only existing hospital radiology. Therefore, a central computer system has been be realized and used also by the radiology department, for completely computed procedures, since January 1, 1988. We describe the computer configuration of both the ULSS and the radiology department and report on our 5-year experience with full computerization within a central information system. As for department organization, any information system--with appropriate hardware and software--can be equivalent to others, since it largely contributes to both management (programming, booking, filing, accounting) and reporting (automatic reporting with memorized texts and/or voice recognition; reprinting; immediate correction at the video-terminal). Thanks to more rational exploitation of human and technological resources, any information system makes a radiology department more functional and efficient. However, some peculiarities of the central computer system must be stressed, as they allow: 1) to use pre-existing and updated patients files (unequivocal identification in the whole ULSS); 2) to gain access to the databanks of different specialties and to patients' clinical histories (complete data collected from many sources); 3) to intervene in booking and ticket collection centers with none of the relative loads; 4) to have no limits of memory, storage or speed for complex programs (automatic reporting also with the recognition of the dictating voice, accounting and statistical analyses, ecc.); 5) to profit by continually updated and fitted hardware and software, with the relative expenses and benefits shared by the whole ULSS. Within the possibilities given by a double role-ruled password, all different menus and programs are accessible from any video-terminal, even while other programs are running, thus allowing cost-effective hardware to be available in the radiology department.

Computers↗
PubMed2006

Effect of a therapeutic maximum allowable cost (MAC) program on the cost and utilization of proton pump inhibitors in an employer-sponsored drug plan in Canada.

BACKGROUND: Therapeutic maximum allowable cost (MAC) is a managed care intervention that uses reference pricing in a therapeutic class or category of drugs or an indication (e.g., heartburn). Therapeutic MAC has not been studied in Canada or the United States. The proton pump inhibitor (PPI) rabeprazole was used as the reference drug in this therapeutic MAC program based on prices for PPIs in the province of Ontario. No PPI is available over the counter in Canada. OBJECTIVE: To evaluate the utilization and anticipated drug cost savings for PPIs in an employer-sponsored drug plan in Canada that implemented a therapeutic MAC program for PPIs. METHODS: An employer group with an average of 6,300 covered members, which adopted the MAC program for PPIs in June 2003, was compared with a comparison group comprising the book of business throughout Canada (approximately 5 million lives) without a PPI MAC program (non-MAC group). Pharmacy claims for PPIs were identified using the first 6 characters of the generic product identifier (GPI 492700) for a 36-month period from June 1, 2002, through May 31, 2005. The primary comparison was the year prior to the intervention (from June 1, 2002, through May 31, 2003) and the first full year following the intervention (June 1, 2004, through May 31, 2005). Drug utilization was evaluated by comparing the market share of each of the PPIs for the 2 time periods and by the days of PPI therapy per patient per year (PPPY) and days of therapy per prescription (Rx). Drug cost was defined as the cost of the drug (ingredient cost), including allowable provincial pharmacy markup but excluding pharmacy dispense fee. Cost savings were calculated from the allowed drug cost per claim, allowed cost per day, and allowed cost PPPY. RESULTS: (All amounts are in Canadian dollars.) The MAC intervention group experienced an 11.7% reduction in the average cost per day of PPI drug therapy, from 2.14 US dollars in the preperiod to 1.89 US dollars in the postperiod, compared with a 3.7% reduction in the comparison group (2.16 US dollars vs. 2.08 US dollars). Utilization dropped by 11.9% in the intervention group, from 166.7 days of PPI drug therapy PPPY to 146.9 days PPPY, compared with an increase of 7.9% in the comparison group, from 136.1 days to 146.8 days PPPY. The combined effect of the decrease in drug cost per day and utilization was a 22.1% reduction in allowed drug cost PPPY in the intervention (MAC) group (from 357 US dollars to 278 US dollars PPPY) versus a 4.1% increase in the comparison group (from 293 US dollars to 305 US dollars PPPY). CONCLUSION: A MAC program for PPIs for one employer in Canada was associated with savings for the drug plan sponsor of approximately 8% in actual drug cost per day of therapy compared with the comparison group. Total savings after consideration of utilization was approximately 26% for the intervention group versus the comparison group.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2000

[Gerard van Swieten (1700-1772). A celebrated and faithful disciple of Boerhaave].

This article provides an overview of the life and work of the Dutchman Gerard van Swieten respectively at Leyden and Vienna. He is still well known as the founder of the first Vienna medical school and reformer of the Viennese medical faculty. During the eighteenth century his five volumes containing Commentaries upon the aphorisms of Herman Boerhaave were considered to be the best medical reference work. In his organizational work Van Swieten can be characterized as a medical manager avant la lettre and at the same time as a (brilliant) epigone of his master Boerhaave and the Leyden clinic. In his writings too he closely followed the ideas and papers of Boerhaave and others, and also here he was an epigone, be it a great one. His Commentaria are at the present time still valuable to inform us about the state of the art in eighteenth century medicine. These books really deserve a timely overall study.

Aphorisms and Proverbs as Topic↗
PubMedDate not supplied

Neurobehavioral testing of chemicals: impact on recommended standards.

Historically, the American Conference of Governmental Industrial Hygienists (ACGIH) has served as a major source of information on recommended safe exposure limits (Threshold Limit Values or TLV's) for chemicals most frequently encountered in U. S. industry and of known toxicologic significance. A review of the ACGIH Documentation book, which details the basis for their judgements, has indicated that 167 of the 588 chemicals for which they assigned recommended standards have, as one of their bases, direct nervous system effects. In order to increase the impact of future behavioral toxicology research on recommended standards, the neurotoxicologist can utilize certain strategies: (a) Focus on established mixtures in the environment of interest or select exposures of particular chemical classes, considering population size and severity of effect; (b) Ensure that the results of the study are referable to the expected route of exposure in the environment of interest; and (c) Select tests with face validity for non-psychologists, using reference substances. Finally, the neurotoxicologist is urged to consider effects related to safety as well as health in developing his/her research.

Air Pollutants, Occupational↗
PubMed2006

Seventeenth century concepts of "apoplexy" as reflected in Bonet's "Sepulchretum".

The term "apoplexy," which has been in use since antiquity, referred to a catastrophic illness with an abrupt loss of consciousness and a frequently fatal outcome. During the sixteenth and seventeenth centuries scholastic approaches that relied on authorities were merging with an observational approach to medicine and Galen's speculation that apoplexy was due to an accumulation of phlegm or black bile in the cerebral ventricles began to be seriously challenged. The most extensive collection of case reports with autopsies published in the seventeenth century was Theophile Bonet's Sepulchretum sive Anatomia Practica. Section 2 of Book I of the Sepulchretum contains 70 case reports of patients that died with the diagnosis of apoplexy. The scholia in this section provide an idea for the modern reader of the notions physicians had of apoplexy in the seventeenth century. The Sepulchretum was an important book for physicians of the late seventeenth and eighteenth centuries. It played an important role in the development of modern medicine and it was an important foundation for Morgagni's De Sedibus et Causis Morborum. This essay reviews the pathological findings reported in victims of apoplexy and examines the views concerning the symptomatology, pathogenesis, etiology, and treatment of this condition that were prevalent at that time.

Cerebrovascular Disorders↗
PubMed2006

Development and validation of MIX: comprehensive free software for meta-analysis of causal research data.

BACKGROUND: Meta-analysis has become a well-known method for synthesis of quantitative data from previously conducted research in applied health sciences. So far, meta-analysis has been particularly useful in evaluating and comparing therapies and in assessing causes of disease. Consequently, the number of software packages that can perform meta-analysis has increased over the years. Unfortunately, it can take a substantial amount of time to get acquainted with some of these programs and most contain little or no interactive educational material. We set out to create and validate an easy-to-use and comprehensive meta-analysis package that would be simple enough programming-wise to remain available as a free download. We specifically aimed at students and researchers who are new to meta-analysis, with important parts of the development oriented towards creating internal interactive tutoring tools and designing features that would facilitate usage of the software as a companion to existing books on meta-analysis. RESULTS: We took an unconventional approach and created a program that uses Excel as a calculation and programming platform. The main programming language was Visual Basic, as implemented in Visual Basic 6 and Visual Basic for Applications in Excel 2000 and higher. The development took approximately two years and resulted in the 'MIX' program, which can be downloaded from the program's website free of charge. Next, we set out to validate the MIX output with two major software packages as reference standards, namely STATA (metan, metabias, and metatrim) and Comprehensive Meta-Analysis Version 2. Eight meta-analyses that had been published in major journals were used as data sources. All numerical and graphical results from analyses with MIX were identical to their counterparts in STATA and CMA. The MIX program distinguishes itself from most other programs by the extensive graphical output, the click-and-go (Excel) interface, and the educational features. CONCLUSION: The MIX program is a valid tool for performing meta-analysis and may be particularly useful in educational environments. It can be downloaded free of charge via http://www.mix-for-meta-analysis.info or http://sourceforge.net/projects/meta-analysis.

Causality↗