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Public library consumer health information pilot project: results of a National Library of Medicine evaluation.

In October 1998, the National Library of Medicine (NLM) launched a pilot project to learn about the role of public libraries in providing health information to the public and to generate information that would assist NLM and the National Network of Libraries of Medicine (NN/LM) in learning how best to work with public libraries in the future. Three regional medical libraries (RMLs), eight resource libraries, and forty-one public libraries or library systems from nine states and the District of Columbia were selected for participation. The pilot project included an evaluation component that was carried out in parallel with project implementation. The evaluation ran through September 1999. The results of the evaluation indicated that participating public librarians were enthusiastic about the training and information materials provided as part of the project and that many public libraries used the materials and conducted their own outreach to local communities and groups. Most libraries applied the modest funds to purchase additional Internet-accessible computers and/or upgrade their health-reference materials. However, few of the participating public libraries had health information centers (although health information was perceived as a top-ten or top-five topic of interest to patrons). Also, the project generated only minimal usage of NLM's consumer health database, known as MEDLINEplus, from the premises of the monitored libraries (patron usage from home or office locations was not tracked). The evaluation results suggested a balanced follow-up by NLM and the NN/LM, with a few carefully selected national activities, complemented by a package of targeted activities that, as of January 2000, are being planned, developed, or implemented. The results also highlighted the importance of building an evaluation component into projects like this one from the outset, to assure that objectives were met and that evaluative information was available on a timely basis, as was the case here.

Computers↗

Bringing a virtual library to a small group classroom.

A small group case discussion class would seem to be the ideal setting for a virtual library. Two courses at the Albert Einstein College of Medicine were observed. One hour of observation was of groups with no computer available, one hour of groups with a computer available "incidentally", and two hours of groups with computer integrated case material. Across all groups, at least one student was using a reference source (paper or computer) 55% of the time. In a room with no computer, paper references were used 59% of the time. In a room with a computer, references were used 53% of the time (18% computer only, 13% paper only, 22% both). While the amount of data is insufficient for detecting statistically significant difference, this study does provide important baseline data not previously available concerning reference use behavior for electronic and paper sources.

Databases as Topic↗

Web-based provision of information on infectious diseases: a systems study.

The National electronic Library for Health (NeLH) is an Internet medical information resources portal, principally for healthcare professionals, within which the National electronic Library of Infection (NeLI) is one of NeLH Specialist Libraries providing evidence on infectious diseases. In this article, we describe a systems-based evaluation of NeLI based on a soft systems methodology. User feedback and other data for the analysis were obtained using online questionnaires. This evaluation, which is a pilot study aimed at demonstrating proof of concept, provided evidence for improving three systems that are crucial to effective NeLI provision. These are navigation of the site, quality and tagging of information provided by NeLI, and information regarding users and their usage of the system. On the basis of a soft systems analysis, an action plan was formulated identifying areas where improvement is needed. Actions for consideration included simplifying terminologies to improve the navigation, enhancing the provision of research assessments, quality tagging NeLI documents, provided by experts in the field, and attracting a broader cross-section of healthcare professional user.

Communicable Diseases↗

Application of the office or home computer to searching the medical literature.

Search of the medical literature has, until recently, most often been conducted by medical librarians. The recent development of "user friendly" systems and competition among an increasing number of commercial and non-commercial vendors now provide the opportunity to personally conduct literature searches using a home or office computer without enormous investment in time, training or equipment. Hardware requirements and general principles of computerized literature searching are described, and the various services available for individual subscription are summarized, including National Library of Medicine (NLM) MEDLINE; Bibliographic Retrieval Services (BRS) and BRS/Saunders Colleague; PaperChase; Dialog/Knowledge Index; American Medical Association (AMA) Minet; and MEDIS.

Computers↗

Government documents and the online catalog.

Prior to planning for implementing the NOTIS system, the Vanderbilt Medical Center Library had not fully cataloged its government publications, and records for these materials were not in machine-readable format. A decision was made that patrons should need to look in only one place for all library materials, including the Health and Human Services Department publications received each year from the central library's Government Documents Unit. Beginning in 1985, these publications were added to the library's database, and the entire 7,200-piece collection is now in the online catalog. Working with these publications has taught the library much about the advantages and disadvantages of cataloging government documents in an online environment. It was found that OCLC cataloging copy is eventually available for most titles, although only about 10% of the records have MeSH headings. Staff time is the major expenditure; problems are caused by documents' irregular nature, frequent format changes, and difficult authority work. Since their addition to the online catalog, documents are used more and the library has better control.

Cataloging↗

A study of hospital and medical libraries in Riyadh, Kingdom of Saudi Arabia.

The study reported examined the status of hospital libraries, their sponsoring organizations, their staff, the academic qualifications of the head of the library, collection size, available space, buildings, and services. The study was limited to the hospitals with libraries for staff in Riyadh, the capital of Saudi Arabia. The data were collected through questionnaires sent to a sample of fifteen hospitals with medical libraries. Twelve libraries responded. This is the first study of its kind in Saudi Arabia, and it is hoped that similar surveys will be done covering the whole kingdom.

CD-ROM↗

MEDLINE: the options for health professionals.

The bibliographic database MEDLINE, produced by the National Library of Medicine (NLM), is a computerized index to the world's biomedical literature. The database can be searched back to 1966 and contains 6.8 million records. The various means of access are divided, for the purposes of this article, into three categories: logging onto a remote host computer by telephone and modem or by the Internet; subscribing to part or all of the database on compact disc (CD-ROM); and leasing the data on a transport medium such as magnetic tape or CDs for loading on a local host computer. Decisions about which method is preferable in a given situation depend on cost, availability of hardware and software, local expertise, and the size of the intended user population. Trends include increased access to the Internet by health professionals, increased network speed, links from MEDLINE records to full-text databases or online journals, and integration of MEDLINE into wider health information systems.

CD-ROM↗

What clinical information resources are available in family physicians' offices?

BACKGROUND: When faced with questions about patient care, family physicians usually turn to books in their personal libraries for the answers. The resources in these libraries have not been adequately characterized. METHODS: We recorded the titles of all medical books in the personal libraries of 103 randomly selected family physicians in eastern Iowa. We also noted all clinical information that was posted on walls, bulletin boards, refrigerators, and so forth. Participants were asked to describe their use of other resources such as computers, MEDLINE, reprint files, and "peripheral brains" (personal notebooks of clinical information). For each physician, we recorded how often the resources were used to answer clinical questions during 2 half-day observation periods. RESULTS: The 103 participants owned a total of 5794 medical books, with 2836 different titles. Each physician kept an average of 56 books in the office. Prescribing references (especially the Physicians' Desk Reference) were most common (owned by 100% of the participants), followed by books on general internal medicine (99%), adult infectious disease (89%), and general pediatrics (83%). Books used to answer clinical questions were more likely to be up to date (copyright date within 5 years) than unused books (74% vs 27%, P <.001). Items posted on walls included drug dosage charts and pediatric immunization schedules. Only 26% of the physicians had computers in their offices. CONCLUSIONS: Drug-prescribing textbooks were the most common type of book in family physicians' offices, followed by books on general internal medicine and adult infectious diseases. Although many books were relatively old, those used to answer clinical questions were generally current.

Adult↗

Health InfoNet of Jefferson County: collaboration in consumer health information service.

Health InfoNet of Jefferson County is a new collaborative consumer health information service of the Jefferson County public libraries and the UAB Lister Hill Library of the Health Sciences. Working with the input and cooperation of local voluntary health agencies, health care professionals and other health information providers, the intent is to improve the efficiency with which consumers might access such information while avoiding duplication of effort on the part of the information providers. Various considerations in InfoNet's mission include providing service not only to established library and Internet users, but also those on the other side of the "digital divide" as well as those with low literacy skills or English as a second language. The role of health care professionals in guiding their patients to the best consumer health information resources is emphasized.

Alabama↗

Lamination of fragile documents as preliminary intervention to aqueous mass deacidification. A study on reversibility effects.

Paper lamination is a widely known method to consolidate fragile and brittle documents. Since the loss of mechanical strength of paper documents is almost completely due to their acidity, the procedure generally adopted by restorers consists of an aqueous treatment of deacidification followed by consolidation. The drawback of this method is due to the loss of paper fragments during the deacidification step, that must be therefore accurately controlled. Some preliminary experiments showed that a better and faster practice would be the lamination of paper documents with a water-resistant sheet before their immersion in the deacidification bath. The aim of this work is to evaluate the permeability, chemical stability and reversibility of the lamination sheets coated with two commercially available acrylic resins. From both gravimetric and FTIR analyses it appeared that slight modifications of the acrylic monomers led to different properties, and this behaviour can be exploited to improve the properties of lamination sheets in order to set up a reliable method of aqueous mass deacidification.

Acids↗

On-line serials collection analysis.

A design for an on-line serials decision-making and collection analysis system is proposed. It is composed of four basic components: citation data, conventional serial records data, utility/cost ratio compilation and journal ranking techniques, and user interface software. The system would have the ability to respond specifically to user interest profiles and to integrate locally generated data. It is postulated that such a system is capable of satisfactorily resolving the major criticisms of the use of citation data for selection purposes: that libraries are diverse in their interests and that no aggregate list can be more than generally relevant; that the inclusion of cost data is essential and that citation ranking without regard to cost can be misleading; and that other relevant data should be considered as well.

Decision Making↗

Education and training for computer-based reference services: review of training efforts to date.

This article raises several questions regarding training for computer-based reference services, including who is to be trained and who is responsible for training. It discusses these issues and then provides a summary of the training provided to date by search service suppliers, database suppliers, library schools and extension programs, library cooperatives, and professional organizations. The available training materials are also discussed. Some projections are made of likely future activities.

Information Systems↗

Information medicine and its primary functions of exploitation of medical resources.

The aim of this paper is to continue the discussion on the defects of the structures of medical resources and their applicability at the present time, and then to design the qualitative networklike subsystem of the new research Quantitatively Medicine Simulating and Operating by Computer (QMSOC) and a five-library model of the new knowledge-base of QMSOC. Finally, a set of results from the primary functions of exploitation of pancreas-glucagon-insulin information by QMSOC are presented.

Databases, Factual↗

[Effective literature searching. Focusing the question and using PubMed queries].

Apart from clinical and social expertise, the availability of contemporary knowledge is a key component in organisations within the health system that aim for excellence and competitiveness. Efficient literature searching is within this context a core business of evidence-based medicine. In addition to the need for valid data, the retrieval of information based on published literature has so far constituted a critical hurdle. Based on these requirements, two core issues for success with respect to literature searching are described: First, the generation of a structured question to form the basis of the most promising search terms. Second, a new feature of the web service of the national library of medicine, called "clinical queries", that allows the application of predefined filters to allocate clinically relevant data in terms of published clinical trials and systematic reviews.

Evidence-Based Medicine↗

Neurotrophic factors and the pathophysiology of schizophrenic psychoses.

The aim of this review is to summarize the present state of findings on altered neurotrophic factor levels in schizophrenic psychoses, on variations in genes coding for neurotrophic factors, and on the effect of antipsychotic drugs on the expression level of neurotrophic factors. This is a conceptual paper that aims to establish the link between the neuromaldevelopment theory of schizophrenia and neurotrophic factors. An extensive literature review has been done using the Pub Med database, a service of the National Library of Medicine, which includes over 14 million citations for biomedical articles back to the 1950s. The majority of studies discussed in this review support the notion of alterations of neurotrophic factors at the protein and gene level, respectively, and support the hypothesis that these alterations could, at least partially, explain some of the morphological, cytoarchitectural and neurobiochemical abnormalities found in the brain of schizophrenic patients. However, the results are not always conclusive and the clinical significance of these alterations is not fully understood. It is, thus, important to further neurotrophic factor research in order to better understand the etiopathogenesis of schizophrenic psychoses and, thus, potentially develop new treatment strategies urgently needed for patients suffering from these devastating disorders.

Animals↗

Neuromodulatory therapy to improve erectile function recovery outcomes after pelvic surgery.

PURPOSE: Erectile dysfunction is a recognized, common adverse consequence of radical prostatectomy as well as various other pelvic surgeries. While a host of management options have been considered to decrease this complication, neuromodulatory therapy has recently been advanced as an intervention that may be applied for this purpose. We evaluated concepts regarding the neuropathic basis for erectile dysfunction following pelvic surgery, principles for establishing neuromodulatory therapy in this clinical context, evidence from preclinical studies supporting neuromodulatory approaches as a therapeutic strategy and the progress of early clinical developments in this field. MATERIALS AND METHODS: The exercise principally consisted of a current literature search using the National Library of Medicine PubMed Services, a survey of recent abstract proceedings from national meetings relevant to the topic and an Internet online search for current information on federally and privately supported clinical trials specific to this topic. References were made to such key words as neuroprotection, nerve regeneration, nerve growth factors, neurotrophic factors, cavernous nerves, nerve guides and penile erection. RESULTS: Basic science research and clinical studies support the concept that erectile loss after pelvic surgery is frequently related to neuropathic effects, resulting in penile vascular impairment. An assortment of neurobiological studies using rodent models of cavernous nerve injury have shown nerve reconstitutive actions for a host of neurotrophic substances, including classic neurotrophins, growth hormone, cytokines and atypical neurotrophic mediators. Clinical trials of several proposed neuroprotective and neurotrophic applications have been done or are in progress. CONCLUSIONS: Erectile dysfunction is a well recognized and yet ineffectively averted complication of pelvic surgery. Neuromodulatory therapy offers a therapeutic approach for addressing the neuropathic changes of the penis that occurs in this context with the goal of maximally preserving erectile function postoperatively. While several specific neuromodulatory applications have gained interest for their potential benefit with pelvic surgery, determining their actual roles awaits the completion of controlled clinical trials.

Erectile Dysfunction↗

Using internet search engines and library catalogs to locate toxicology information.

The increasing importance of the Internet demands that toxicologists become aquainted with its resources. To find information, researchers must be able to effectively use Internet search engines, directories, subject-oriented websites, and library catalogs. The article will explain these resources, explore their benefits and weaknesses, and identify skills that help the researcher to improve search results and critically evaluate sources for their relevancy, validity, accuracy, and timeliness.

Catalogs, Library↗

[Acute poisoning by chemical warfare agent: sulfur mustard].

OBJECTIVE: To review story, mechanism of action, clinical and therapeutic bases of a sulfur mustard poisoning, by accidental, terrorism or war exposure. DATA SOURCES: References were obtained from computerised bibliographic research (Medline), from personnel data (academic memoir, documents under approbation of the National Defense Office) and from the Library of Military Medical Service. DATA SYNTHESIS: Sulfur mustard is a chemical warfare agent with peace time results: leak, accidental handling, acts of terrorism. Sulfur mustard is a vesicant agent, an organochlorine agent, who alkylate DNA. Under liquid or gas form its main target are skin and lungs. Clinical effects are like burns with loss of immunity, with respiratory failure, ophthalmic, gastrointestinal and haematological signs. The last studies have improved knowledge about the mechanism of action, detection, protection and treatment. Methods for determination of sulfur mustard are based on gas chromatographic method and mass spectrometry. During sulfur mustard contamination the first priorities of treatment are to remove victims from the contaminated place and to initiate decontamination. Emergency workers and materials must take protection to avoid secondary contamination of emergency unit. With treatment of vital functions and respiratory failure, the new ways of treatment are about N-acetyl cysteine for lung injury, poly (ADP-ribose) polymerase inhibitors, calmodulin antagonists and Ca(++) chelators. Interactions between sulfur mustard and anaesthetic agents are not well known and are based on clinical observations. CONCLUSION: Emergency care unit can be confronted with sulfur mustard during accidental contamination or acts of terrorism. First and most efficacy priorities of treatment are to remove and to decontaminate victims. New means of detection and treatment are studied since several years but are not still appropriate to human victims or mass treatment.

Alkylating Agents↗