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PubMed1976

The PHILSOM system--one user's experience.

The University of Texas Health Science Center at San Antonio joined the PHILSOM system, a comprehensive serials control network, in 1971. The experiences of the library in using the system are described. The major benefit of the system has been multiple copies of the holdings list which have made the serial records publicly accessible and significantly increased their value. Tallies of these lists' use indicate that more than half of serials-related questions are now answered directly by the users. The effects of PHILSOM on the procedures of the serials department--processing, claiming, bindery, and personnel are described. Costs to the network and the UTHSCSA Library are briefly summarized.

Catalogs, Library↗
PubMed2003

[Postnatal care in a cross-cultural and historical perspective].

BACKGROUND: In most societies, birth and the immediate postpartum period are considered a time of vulnerability for mother and child. Rituals for major changes in the life cycle are common in most societies. The aim of this study was to present some examples of postpartum customs in a cross-cultural and historical perspective. We also present research on associations between postnatal care and mental health. MATERIAL AND METHODS: A systematic search was performed in Medline and the Science Citation Index Expanded (ISI) from 1966 until March 2003. Reference lists in books about pregnancy and birth from the library of the University of Oslo were used to get additional information. RESULTS: The postnatal period is defined as approximately 40 days in most cultures; most societies have special postnatal customs that include special diet, isolation, rest and help in the household. The resemblance between different cultures is striking. Many postnatal customs from rural societies that were common before 1950 have disappeared. The focus on rest and help in the household for the mother after delivery has been reduced. INTERPRETATION: We need more knowledge about the impact of different kinds of postnatal care on the mother's wellbeing.

Anthropology↗
PubMed2004

[Scientific communication at the beginning of the 21st century--Hungarian survey and international outlook in medicine and the life sciences].

INTRODUCTION: Rapid developments take place in communication technology. It is a hard task to keep pace with them, but unavoidable. The scene of electronic communication and publication, the Internet has originally been constructed for scientific communication and publication of scientists. Nowadays, the electronic communication has spread all over the world. Though the share of sciences has been diminished, the progress in the scientific electronic communication has not been broken. AIM: The authors delineate the present situation in electronic communication in general and in Hungary. METHODS: The authors asked by questionnaire survey the medical scientists and professionals about their knowledge and usage of modern publication possibilities. For comparison's sake, the authors referred to some foreign surveys as well. RESULTS: In Hungary, the communication possibilities on the Internet--and the electronically accessible publications--are at the readers' disposal at the universities and academic institutions. The opinions about the popularity and effects of electronic publication are generally positive. Concerns were expressed in connection with the possible weaker professional control in case of certain types of publication. In the opinion of the majority of questioned people the electronic form of publication will never replace the traditional one completely, it will be, however, dominant.

Biological Science Disciplines↗
PubMed1992

Meta-analysis: a tool for medical and scientific discoveries.

Medicine has made increasing use of meta-analysis, largely as a quantitative procedure for combining results of clinical trials. Meta-analysis begins with a comprehensive review of the literature. The next step is a systematic analysis of the quality and content of each study. Finally, results are combined statistically and conclusions are drawn from this new overview of the data. This paper presents a brief historical perspective on the use of meta-analysis in medicine with emphasis on the medical library. The authors conclude that in the future, medical librarians will play a significant role in the application of this useful technique.

History, 20th Century↗
PubMed1994

Absence of symmetry in superior articular facets on the first cervical vertebra in humans: implications for diagnosis and treatment.

OBJECTIVE: Little attention has been given to the craniovertebral articulations. Specifically, gross observations of variations of the superior articular facets on the atlas have not been described with respect to static and motion palpation findings. This study describes the anatomical variations of these facets and the clinical implications associated with asymmetrical structure. DESIGN: The superior articular facets of thirty human first cervical vertebrae were chosen for this study because the atlas constitutes the middle of the upper cervical complex and the atlanto-occipital joint contributes greatly to head movements. SETTING: The basic science research department of Logan College of Chiropractic, St. Louis, Missouri. SPECIMEN POPULATION: All available previously dissected anatomy laboratory and library specimens (30) were used in this study. All of the specimens were dry with intact facet surfaces and no regard was given to age, gender, or race. INTERVENTIONS: The atlases were studied out of situ and all soft tissue was removed so that the bony articular surfaces could be clearly viewed and photographed. MAIN OUTCOME MEASURES: Palpation and unaided visual examination were performed on 30 atlases. The shape, size, angle, texture, border, and number of superior articular facets on each atlas were recorded to determine symmetry. RESULTS: The classically described kidney-shaped facet was in fact an infrequent finding. Upon comparison of right and left sides, none (0%) of the facets were mirror images of symmetry, while 19 of the atlases (63%) had grossly asymmetrical facets, and 11 of 30 atlases (37%) had facets which were only slightly asymmetrical in regard to shape, border, depth and angle. Furthermore, 7 of the 19 grossly asymmetrical atlases (37%) had three or four separate superior articular facets. Three atlases had two facets on the left and one on the right, while two atlases had two facets on the right with a single facet on the left, and two atlases had four superior facets (two on each side). CONCLUSION: The validity of vertebral joint assessment based on the assumption of facet symmetry is challenged, impugning certain chiropractic theories and/or techniques which rely on symmetry as being "normal." To achieve symmetrical function, the anatomical structure must be symmetrical. Since true structural symmetry does not exist, true symmetry of segmental movement may not be possible.

Atlanto-Axial Joint↗
PubMedDate not supplied

[The computerized clinical record: merely an academic discussion or an essential technology?].

The publication of the results of a study on improving patient records, recently completed by the Institute of Medicine of the National Academy of Sciences, in the United States, where it was concluded that the Computer-Based Patient Record (CPR) was an essential technology for health care, witnesses the importance and expectations that patients, physicians and other health care professionals, hospital administrators and health systems managers, place on forms of management of clinical information that are more accurate, complete and efficient than what is possible with current methods. A large amount of work is in order, to develop standards for sharing clinical data between clinical information systems and for representing medical terminology and knowledge, to create legislation regarding data protection in CPR, and for the preparation of health care professionals for the information and technological demands of the future. Recent developments in database integration, and the experience of several CPR systems developed at academic institutions, have led to the progressive delineation of the architecture of modern CPR systems.

Computer Security↗
PubMedDate not supplied

Cyclic perimenstrual pain and discomfort: the scientific basis for practice.

OBJECTIVE: To review and organize the science related to cyclic perimenstrual pain and discomfort for the fifth research-based practice project of the Association of Women's Health, Obstetric and Neonatal Nurses. DATA SOURCES: Computerized searches in CINAHL, MEDLINE, and the Cochrane Library, as well as hand searches of cited references. Keywords included cyclic pelvic pain, comfort, pain guidelines, and dysmenorrhea. DATA EXTRACTION: All relevant articles prior to 1999 were considered. Thirty-three research-based articles (1992-1999) were reviewed for relevance by the science team as part of the fifth research-based practice project of the Association of Women's Health, Obstetric and Neonatal Nurses. DATA SYNTHESIS: The literature review and synthesis resulted in a cogent description of cyclic perimenstrual pain and discomfort and the development of three nursing diagnoses: perimenstrual cyclic pelvic pain, perimenstrual discomfort, and perimenstrual negative affect. Cyclic pelvic pain is a new concept, developed by the science team during the project. Perimenstrual cyclic pelvic pain is an acute, subjective experience defined by pelvic pain that presents in a repeating time frame associated with the menstrual cycle. It is usually clustered with other discomforts and appreciably affects a woman's quality of life. Because the science about interventions is complex and extensive, data synthesis led to organization of the interventions within seven categories. CONCLUSIONS: Translation of research into practice is essential. Cyclic perimenstrual pain and discomfort is an important clinical issue, yet the science had not previously been comprehensively reviewed with the mission to translate it for nursing practice. Translation of this complex literature was accomplished though an innovative clinical practice guideline and subsequently evaluated in nursing practice through the research-based practice project.

Dysmenorrhea↗
PubMed1998

Gastroenterology research in the United Kingdom: funding sources and impact.

AIMS: To determine the sources of founding for UK gastroenterology research papers and the relative impact of papers funded by different groups and of unfunded ones. METHODS: UK gastroenterology papers from 1988-94 were selectively retrieved from the Science Citation Index by means of a specially constructed filter based on their title keywords and journal names. They were looked up in libraries to determine their funding sources and these, together with their numbers of authors, numbers of addresses, and research category (clinical/basic) were considered as input parameters to the research. Output parameters analysed were mean journal impact category, citation counts by papers, and the frequency of citation by a US patient. RESULTS: Gastroenterology papers comprise about 7% of all UK biomedical research and 46% of them have no acknowledged funding source. One quarter of the papers acknowledged government support, and a similar fraction a private, non-profit source; 11% were funded by the pharmaceutical industry. The papers acknowledging funding had significantly more impact than the others on all three measures. The citing patents had six times more UK inventors than the average for all US Patent and Trademark Office patents in the relevant classes and were mostly generic in application. CONCLUSION: The variation in impact of papers funded by different sources can mostly be explained by a simple model based on the input factors (numbers of funding bodies, numbers of authors, numbers of addresses, and research type). The national science base in gastroenterology is important for the underpinning of UK invented patents citing to it.

Financing, Organized↗
PubMed2006

The costs and effectiveness of information-skills training and mediated searching: quantitative results from the EMPIRIC project.

OBJECTIVES: To compare the effectiveness and costs of providing information for patient care via librarian-mediated searches and information-skills training. METHODS: A questionnaire survey to library staff and health professionals in the North West. Data was collected on perceptions of services, satisfaction and service usage, allowing a cost analysis to be undertaken. Statistical data was analysed using Statistical Package for the Social Sciences (spss). RESULTS: Using satisfaction and use of skills as outcome measures, both mediated searches and information skills training are effective. A breakdown of costs per type of training session and literature search is provided. Cost-effectiveness is dependent on whether costs are viewed from a library or trust point of view. Providing information skills training does not reduce the volume of mediated-search requests. CONCLUSIONS: No one method of providing information for health professionals is more effective or cost-effective than another. A decision about which services to provide cannot be made on the basis of effectiveness or costs alone; the views of library staff and the health professionals they serve should also be taken into account. A proactive approach and targeting training towards those who are most likely to benefit may be an appropriate way forward.

Cost-Benefit Analysis↗
PubMed1992

Cloning and sequence determination of a cDNA encoding Aspergillus nidulans calmodulin-dependent multifunctional protein kinase.

A partial cDNA encoding Aspergillus nidulans calmodulin-dependent multifunctional protein kinase (ACMPK) was isolated from a lambda ZAP expression library by immunoselection using monospecific polyclonal antibodies to the enzyme. The sequence of both strands of the cDNA (CMKa) was determined. The deduced amino acid (aa) sequence contained all eleven consensus domains found in serine/threonine protein kinases [Hanks et al., Science 241 (1988) 42-52], as well as a putative calmodulin-binding domain. The cDNA contained an intron, lacked an in-frame start codon, and was not polyadenylated. A full-length copy of CMKa was subsequently isolated from a lambda gt10 library of A. nidulans cDNA using a restriction fragment of the first clone as a probe. It contained an in-frame start codon, an open reading frame (ORF) of 1242 bp and was polyadenylated. The ORF encoded a protein of 414 aa residues with an M(r) of 46,895 and an isoelectric point pI = 6.4. These values are in good agreement with that observed for the native enzyme [Bartelt et al., Proc. Natl. Acad. Sci. USA 85 (1988) 3279-3283]. When aligned to optimize homology, 29% of the predicted aa sequence of ACMPK is identical to that of the alpha-subunit of rat brain calmodulin-dependent protein kinase II. ACMPK shares 40 and 44% identity in aa sequence with YCMK1 and YCMK2, respectively, two Ca2+/calmodulin-dependent protein kinases recently cloned from Saccharomyces cerevisiae [Pausch et al., EMBO J. 10 (1991) 1511-1522]. Results of Southern analysis of restriction digests of genomic DNA indicate that ACMPK is encoded by a single-copy gene.

Amino Acid Sequence↗
PubMed2005

Plant metabolomics: potential for practical operation.

In the postgenomic era, metabolomics is expected to be the newest useful omics science for functional genomics. However, in plant science, the present metabolomics technology cannot be considered a universal tool to perfectly elucidate perturbations imposed on sample plants although this is desired by plant physiologists. Despite it being an immature technology, metabolomics has already been used as a powerful tool for precise phenotyping, particularly for industrial application. Metabolomics is the best technology for the analysis of large mutant or transgenic libraries of model experimental plants, such as Arabidopsis, rice, etc. Here, we review the applications and technical problems of metabolomics. We also suggest the potential of metabolomics for plant post-genomic science.

Computational Biology↗
PubMed2001

Beta2-agonists for acute bronchitis.

BACKGROUND: The optimal treatment for acute bronchitis is not clear. Because many patients with acute bronchitis have airflow limitation as well as cough, beta2-agonists may be useful. OBJECTIVES: To determine whether beta2-agonists improve the symptoms of acute bronchitis in patients who do not have underlying pulmonary disease. SEARCH STRATEGY: Cochrane Library, MEDLINE, EMBASE, and Conference Proceedings using "bronchodilator (exp)", "adrenergic beta-agonist (exp)", or "sympathomimetics (exp)" and "bronchitis" or "cough"; Science Citation Index for referenced publications; and letters to manufacturers of beta2-agonists. SELECTION CRITERIA: Trials in which patients (adults or children age > 2 years) without known pulmonary disease who were diagnosed with acute bronchitis or acute cough without other cause were randomized to beta2-agonist vs. placebo, no treatment, or alternative treatment. DATA COLLECTION AND ANALYSIS: Three reviewers independently first selected outcomes and evaluated trial quality while blinded to study results, and then extracted data. Trials in children and in adults were analyzed separately. MAIN RESULTS: Two trials in children with acute cough and no evidence of airway obstruction did not find any benefits from beta2-agonists. Five trials in adults with acute cough or acute bronchitis had mixed results, but overall summary statistics did not reveal any significant benefits from beta2-agonists. Subgroups of patients with evidence of airflow limitation had lower symptom scores if given beta2-agonists in one trial; and the trials that did note quicker resolution of cough in patients given beta2-agonists were those that had a higher proportion of patients with wheezing at baseline. Patients given beta2-agonists (whether oral or inhaled) were more likely to report tremor, shakiness, or nervousness than patients in the control groups (NNH for children 9, 95% CI 5 to 100; NNH for adults 2.3, 95% CI 2 to 3). REVIEWER'S CONCLUSIONS: There is no evidence to support using beta2-agonists in children with acute cough who do not have evidence of airflow obstruction. There is also little evidence that the routine use of beta2-agonists for adults with acute cough is helpful. These agents may reduce symptoms, including cough, in patients with evidence of airflow obstruction; but this potential benefit is not well-supported by the available data and must be weighed against the adverse effects associated with beta2-agonists.

Acute Disease↗
PubMed2004

In-hospital care pathways for stroke.

BACKGROUND: Stroke care pathways have the potential to promote organised and efficient patient care that is based on best evidence and guidelines, but evidence to support their use is unclear. OBJECTIVES: We aimed to assess the effects of care pathways, compared with standard medical care, among patients with acute stroke who had been admitted to hospital. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched in June 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2003), MEDLINE (1975 to June 2003), EMBASE (1980 to June 2003), CINAHL (1982 to June 2003), ISI Proceedings: Science & Technology (1990 to November 2003), and HealthSTAR (1994 to May 2001). We also handsearched the Journal of Integrated Care Pathways (2001 to 2003), formerly Journal of Managed Care (1997 to 1998) and Journal of Integrated Care (1998 to 2001). Reference lists of articles were searched. SELECTION CRITERIA: We considered randomised controlled trials and non-randomised studies that compared care pathway care with standard medical care. DATA COLLECTION AND ANALYSIS: One reviewer selected studies for inclusion and the other independently checked the decisions. Two reviewers independently assessed the methodological quality of the studies. One reviewer extracted the data and the other checked the extracted data. MAIN RESULTS: Three randomised controlled trials (340 patients) and 12 non-randomised studies (4081 patients) were included. There was significant statistical heterogeneity in the analysis of many of the outcomes. We found no significant difference between care pathway and control groups in terms of death or discharge destination. Patients managed with a care pathway were: (a) more dependent at discharge (P = 0.04); (b) less likely to suffer a urinary tract infection (Odds Ratio (OR) 0.51, 95% Confidence Interval (CI) 0.34 to 0.79); (c) less likely to be readmitted (OR 0.11, 95% CI 0.03 to 0.39); and (d) more likely to have neuroimaging (OR 2.42, 95% CI 1.12 to 5.25). Evidence from randomised trials suggested that patient satisfaction and quality of life were significantly lower in the care pathway group (P = 0.02 and P < 0.005 respectively). REVIEWERS' CONCLUSIONS: Use of stroke care pathways may be associated with positive and negative effects. Since most of the results have been derived from non-randomised studies, they are likely to be influenced by potential biases and confounding factors. There is currently insufficient supporting evidence to justify the routine implementation of care pathways for acute stroke management or stroke rehabilitation.

Critical Pathways↗
PubMed2005

Interventions for rosacea.

BACKGROUND: Rosacea is a common chronic skin condition affecting the face, characterised by flushing, redness, pimples, pustules, and dilated blood vessels. The eyes are often involved. Frequently it can be controlled, but it is not clear which treatments are most effective. OBJECTIVES: To assess the evidence for the efficacy and safety of treatments for rosacea. SEARCH STRATEGY: We searched the Skin Group Specialised Register (February 2005), Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to February 2005), EMBASE (1980 to February 2005), BIOSIS (1970 to March 2002) and the Science Citation Index (1988 to February 2005). Reference lists of trials and key review articles were searched. Relevant manufacturers and experts were contacted. SELECTION CRITERIA: Randomised controlled trials in people with moderate to severe rosacea were included. Studies judged by the authors to have seriously flawed methodology were excluded. DATA COLLECTION AND ANALYSIS: Study selection, assessment of methodological quality, data extraction and analysis were carried out by two independent authors. Disagreements were resolved by discussion and consensus. MAIN RESULTS: The evidence provided by twenty-nine included studies was generally weak because of poor methodology and reporting. One of our primary outcome measures, 'quality of life', was not assessed in any of the studies. Only two studies of ocular rosacea were included. Pooled data from two trials involving 174 participants indicated that according to the participants, topical metronidazole is more effective than placebo (odds ratio (OR) 5.96, 95% confidence interval (CI) 2.95 to 12.06). Data pooled from three between-patient trials showed a clear improvement in the azelaic acid group; the rates of treatment success were approximately 70 to 80% versus 50% to 55% (OR 2.45, 95% CI 1.82 to 3.28). A within-patient trial of azelaic cream versus placebo could not be pooled with the other three studies, but also showed good evidence of efficacy. Data pooled from three studies of oral tetracycline versus placebo involving 152 participants showed that, according to physicians, tetracycline was effective (OR 6.06, 95% CI 2.96 to 12.42). Some evidence of efficacy of oral metronidazole was provided by one small study. AUTHORS' CONCLUSIONS: The quality of studies evaluating rosacea treatments was generally poor. There is evidence that topical metronidazole and azelaic acid are effective. There is some evidence that oral metronidazole and tetracycline are effective. There is insufficient evidence concerning the effectiveness of other treatments. Good RCTs looking at these treatments are urgently needed.

Dermatologic Agents↗
PubMed2004

Needling for encapsulated trabeculectomy filtering blebs.

BACKGROUND: Encapsulation of a filtering bleb following trabeculectomy may lead to elevation of intraocular pressure, prompting further medical or surgical intervention. It has been suggested that needling of an encapsulated bleb may be effective in re-establishing drainage and lowering intraocular pressure. OBJECTIVES: The objective of this review is to assess the effects of needling encapsulated blebs on intraocular pressure. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which contains the Cochrane Eyes and Vision Group trials register) on The Cochrane Library (Issue 2 2003), MEDLINE (1966 to March 2003), EMBASE (1980 to May 2003) and LILACS (Latin American and Caribbean Health Sciences ) (June 2003). There were no language or date restrictions in the searches. SELECTION CRITERIA: We included randomised and quasi-randomised in which bleb needling was compared with any form of antiglaucoma medication in people with encapsulated trabeculectomy blebs. The primary outcome was mean intraocular pressure measured in millimetres of mercury at day one, one week, one month and at last available follow-up. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS: One trial, which randomised 25 eyes to either needling or medical treatment, met the inclusion criteria. At one day post-treatment, mean intraocular pressure was lower in the needling group (16.28 mm Hg, standard deviation 5.9) than the medical group (19.45 mm Hg, standard deviation 3.75). The difference was not statistically significant. At all other follow-up points, mean intraocular pressure was consistently higher in the needling group than the medical group, although the differences were not statistically significant. However, only one needled bleb remained successful at the end of follow-up compared to 10 out of the 11 blebs managed conservatively. This difference was statistically highly significant. REVIEWERS' CONCLUSIONS: Evidence from one small trial suggests that needling of encapsulated trabeculectomy blebs is not better than medical treatment in reducing intraocular pressure.

Blister↗