[Nursing research by clinical nurses: recommendation of 6 reference books].
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OBJECTIVES: While evaluating the effect of a community-wide informational intervention, this study explored access, health, and demographic factors related to the use of medical reference books, telephone advice nurses, and computers for health information. METHODS: A random sample of households in the intervention city (Boise, Idaho) and two control cities were surveyed about their use of health information in 1996. Shortly thereafter, the Healthwise Communities Project (HCP) distributed health information to all Boise residents. A follow-up survey was conducted in 1998. Overall, 5,909 surveys were completed for a 54% response rate. RESULTS: The HCP intervention was associated with statistically significant increases in the use of medical reference books and telephone advice nurses. The increased use of computers for health information was marginally significant. Few access, health, or demographic factors were consistently associated with using the different resources, except that people with depression used more of all three information resources, and income was not a significant predictor. CONCLUSION: Providing free health information led to an increase in use, but access, health, and demographic factors were also important determinants. In particular, poor health status and presence of a chronic illness were associated with health information use. These results suggest that healthy consumers are less interested in health information, and it may take other incentives to motivate them to learn about prevention and healthy behaviors.
Using data from an evaluation of a community-wide informational intervention, we modeled the demand for medical reference books, telephone advice nurses, and computers for health information. Data were gathered from random household surveys in Boise, ID (experimental site), Billings, MT, and Eugene, OR (control sites). Conditional difference-in-differences show that the intervention increased the use of medical reference books, advice nurses, and computers for health information by approximately 15, 6, and 4%. respectively. The results also suggest that the intervention was associated with a decreased reliance on health professionals for information.
A national telephone survey of 1,104 adults who had recently obtained a new prescription was undertaken to determine the nature and amount of drug information obtained. Sixty percent stated that physicians provided directions for use information with the pharmacy reported as about half as active. Only 3 to 6 per cent said they asked the physician or pharmacist for information. However, one in six respondents said they looked up the prescription in a drug reference book such as the Physicians Desk Reference.
This review is a summary of three reference books and of the final report of a European concerted action. The data have been updated by an analysis of recent publications, according to the same methodological criteria as those used in the reference books: sample size, quality of questionnaire and statistical methods. Mechanistic hypothesis are considered for each microcompounds, the effect of which is situated along the natural history of cancer. Few studies have considered folates effect on breast cancer, and they observed an interaction with the risk related to alcohol consumption, which is decreased with a high intake of folates. Many studies considered the effect of vitamin C and E, and carotenoids, but results are inconsistent. Conflicting results were also observed in studies on fibre and breast cancer. However, although only half of the studies showed a protective effect, the strength of the biological mechanisms give support to the hypothesis of a protection provided by fibre. The situation is comparable with phyto-estrogens: epidemiological studies are scarce and few of them show significant protection, but several plausible biological mechanisms are proposed, either related to the negative modulation of estrogen receptor by phyto-estrogen, or to the inhibition of proliferation by action on various enzymes. At the present time, caution in the interpretation of the results and in the use of plant microcompounds in prevention or therapy is strongly recommended.
PURPOSE: Discrepancies in the quoted prednisone dosages in the regimens reported as the only standard CHOP regimen stimulated our interest in reviewing the medical literature regarding this issue and to assess whether practicing hematologists and oncologists in the U.S. are aware of the different dose schedules of prednisone in the published CHOP programs. METHODS: Sixteen textbooks and chemotherapy reference books were reviewed. A MEDLINE search of English-language articles published between January 1970 and December 1998 was performed. An eight-point questionnaire was sent via e-mail with responses obtained from 421 hematology/oncology physicians in the U.S. RESULTS: Sixteen textbooks and chemotherapy reference books reviewed quoted only one prednisone dosage as part of the standard CHOP regimen; the prednisone dosages quoted as standard varied between publications. More than 4,000 eligible non-Hodgkin's lymphoma patients have been treated with the CHOP chemotherapy as part of 43 different clinical trials reviewed. The dosages of prednisone and prednisolone used varied among six different levels. Thirty percent (127/421) of practicing U.S. physicians were not aware of the existence of more than one prednisone dose schedule as part of the CHOP regimen. The three most frequently used dosages are 100 mg/days 1-5 (67%), 100 mg/m(2)/days 1-5 (17%), and 60 mg/m(2)/days 1-5 (13%). CONCLUSIONS: Discrepancies in steroid dosages used as part of the reported standard CHOP regimens are common and not well recognized in the medical literature nor by practicing U.S. hematologists/oncologists. Based on this study, a prednisone dose of 100 mg/day for five days should be considered the standard dose.
OBJECTIVE: To provide a rational strategy for the evaluation and long-term management of epilepsy. DATA SOURCES: Articles written between 1964 and 1993, obtained from a MEDLINE search on epilepsy-related topics as well as from the author's personal files, major reference books on antiepileptic drugs, and references identified from these books. STUDY SELECTION: Articles were selected if they contained well-documented information comparing anti-epileptic drugs, represented controlled clinical trials, or were considered "key" articles of clinical relevance. DATA SYNTHESIS: Epilepsy is a chronic condition requiring careful long-term management. The treatment is complex, involving classification and diagnosis, selection and monitoring of the appropriate antiepileptic agent, and evaluation of the chosen drug's side effects and drug interactions. Because these side effects increase when drugs are combined, monotherapy is recommended. Long-term management issues and optimal drug selection differ from patient to patient. If seizures are not controlled by medication, the patient may have been misdiagnosed or misclassified. Noncompliance, a major cause of apparent unresponsiveness to treatment, should also be ruled out. Recognizing that current therapy is not ideal for many patients, new pharmacologic and surgical therapies are briefly discussed. CONCLUSIONS: Physicians can pursue a rational strategy for the management of epilepsy if they understand the risks and benefits of various pharmacologic and therapeutic options and if they maintain open lines of communication with the patient.
The use and importance of specific decision-making tools, information sources, and drug-use management methods in determining drug availability and use in HMOs were studied. A questionnaire was sent to 303 randomly selected HMOs. Respondents were asked to rate their use of each of four formal decision-making tools and its relative importance, as well as the use and importance of eight information sources and 11 methods for managing drug availability and use, on a 5-point scale. The survey response rate was 28%. Approximately half of the respondents reported that their HMOs used decision analysis or multiattribute analysis in deciding on drug availability. If used, these tools were rated as very important. There were significant differences in levels of use by HMO type, membership size, and age. Journal articles and reference books were reported most often as information sources. Retrospective drug-use review was used very often and perceived to be very important in managing drug use. Other management methods were used only occasionally, but the importance placed on these tools when used ranged from moderately to very important. Older organizations used most of the management methods more often than did other HMOs. Decision analysis and multiattribute analysis were the most commonly used tools for deciding on which drugs to make available to HMO members, and reference books and journal articles were the most commonly used information sources. Retrospective and prospective drug-use reviews were the most commonly applied methods for managing HMO members' access to drugs.
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The NCBI (National Center for Biotechnology Information) at the National Institutes of Health collects a wide range of molecular biological data, and develops tools and databases to analyse and disseminate this information. Many life scientists are familiar with the website maintained by the NCBI (http://www.ncbi.nlm.nih.gov), because they use it to search GenBank for homologues of their genes of interest or to search the PubMed database for scientific literature of interest. There is also a database called the Bookshelf that includes searchable popular life science textbooks, medical and research reference books and NCBI reference materials. The Bookshelf can be useful for researchers and educators to find basic biological information. This article includes a representative list of the resources currently available on the Bookshelf, as well as instructions on how to access the information in these resources.
OBJECTIVE: To analyze the errors present in references cited in papers submitted for peer review for possible publication. METHODS: Nineteen consecutive manuscripts submitted for peer review were assessed. They contained a total of 261 references. Manuscripts were submitted to 1 of 5 major radiology journals. Journal references were compared with either the original articles or abstracts obtained through MEDLINE. Book references were checked against the original book. In total, 259 of 261 references were obtained. The remaining 2 references were both out-of-print books that were not available. Each reference was checked and errors were identified as either major or minor, depending on the gravity of the error. Errors were analyzed to see whether they could be attributed to not adhering to journal guidelines or to other reasons. RESULTS: Of a total of 259 references, 56% (n = 145) contained at least 1 error, 53% (n = 137) contained minor errors and 15% (n = 39) contained major errors. Five per cent (n = 13) of references had more than 3 errors, and 79% (n = 274) of all errors were the direct result of authors not following journal instructions. CONCLUSION: Over half of all references included in manuscripts submitted to radiology journals contain at least 1 error. The majority are avoidable, resulting from failure to follow the journal's instructions to authors.
Reference monographs in the Health Sciences Library of the College of Medicine and Dentistry of New Jersey were reorganized recently according to form, in order to enable both librarians and patrons to utilize these materials more efficiently. This reorganization reflects the unique characteristics of reference books as differentiated from the regular monographic collection, since reference materials are frequently consulted for quick "look-ups." A reference category scheme was developed and implemented, based on observations of and comparisons with reference collections of eight medical libraries in the New York metropolitan area. The reorganization enhances the retrievability of materials from this collection.
STATEMENT OF PURPOSE: Budget pressures, combined with the growing availability of resources, dictate careful examination of reference use. Two studies were conducted at the University of Maryland Health Sciences Library to examine this issue. A twelve-month reshelving study determined use by title and discipline; a simultaneous study analyzed print abstract and index use in an electronic environment. METHODOLOGY: Staff electronically recorded statistics for unshelved reference books, coded the collection by discipline, and tracked use by school. Oral surveys administered to reference room abstract and index users focused on title usage, user demographics, and stated reason for use. RESULTS: Sixty-five and a half percent of reference collection titles were used. Medical titles received the most use, but, in the context of collection size, dentistry and nursing titles used the greatest percentage of their collections. At an individual title level, medical textbooks and drug handbooks were most used. Users of abstracts and indexes were primarily campus nursing and medical students who preferred print resources. CONCLUSION: The monograph data will guide reference expenditures in canceling little-used standing orders, expanding most-used portions of the collection, and analyzing underused sections. The abstract and index survey identified the following needs: targeting instruction, contacting faculty who assign print resources, increasing the number of computer workstations, and installing signs linking databases to print equivalents.
OBJECTIVE: To describe the usefulness of some of the most common tertiary references that healthcare professionals employ to answer requests about herbal and dietary supplements. METHODS: All requests for information on herbal and dietary supplements received by the drug information service between April and September 2000 were evaluated. Each question was independently reviewed by 4 clinicians using a 4-point scale; 14 references were searched for appropriate answers. The percent of responses for each of the possible scores for each reference overall and by category of question was reported to determine the most helpful references for answering the broadest range of questions. RESULTS: Fifty questions regarding herbal and dietary supplements were analyzed. The electronic databases (Natural Medicine Comprehensive Database, Micromedex) and the Internet site (The Natural Pharmacist) were determined to be overall the most helpful references for providing information on herbal and dietary supplements. The Natural Therapeutics Pocket Guide was the most helpful book reference. CONCLUSIONS: These results will facilitate the retrieval of useful information on herbal and dietary supplements and enable healthcare professionals to determine appropriate allocation of resources as they build a drug information library for handling requests about these products.