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PubMed1979

Searching the MEDLARS file on NLM and BRS a comparative study.

A comparison of the MEDLARS data base as it is currently available from the National Library of Medicine and Bibliographic Retrieval Services (BRS), Inc., is presented in chart format, and some major capability differences between the two systems are highlighted. The information inlcuded justifies the dual availability of the data base in health sciences libraries. This paper is intended for searchers and others familiar with one or both systems. Administrators considering the acquisition of the BRS system may find the study useful.

MEDLARS↗

PubMed2000

Interlibrary loan in primary access libraries: challenging the traditional view.

INTRODUCTION: Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. OBJECTIVE: This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. HYPOTHESES: Three hypotheses were developed. HI: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. METHODS: The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. RESULTS: CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the state resource library and other DOCLINE libraries higher up in the ILL hierarchy and highlighting the contribution made by CCML primary access libraries (H2). CCML primary access libraries borrow and lend in amounts that are proportional to their collection size, rather than overtaxing libraries at higher levels in the ILL hierarchy with large numbers of requests (H3). LIMITATIONS: The main limitations of this study were the small sample size and the use of data collected for another purpose, the CCML ILL survey. CONCLUSIONS: The findings suggest that there is little evidence to support several commonly held beliefs regarding ILL system use by primary access libraries. In addition to validating the important contributions made by primary access libraries to the national ILL system, baseline data that can be used to benchmark current practice performance are provided.

Benchmarking↗

PubMed1999

Measurements of journal use: an analysis of the correlations between three methods.

Rapid journal price increases have made essential that libraries have reliable and efficient measures of the importance of individual journals to local clientele. Three key measures are in-house use, circulation, and citation by faculty. This paper examines the correlations between these three measures at an academic health sciences library. Data were gathered from 1992 to 1994 using each of the three methods. Each set of data was compared with the other two, and for each pair of data sets both Spearman Rank Order and Pearson Product-Moment correlation coefficients were calculated to examine the degree of correlation between the two sets. All of the correlation coefficients were positive and statistically significant (P < 0.0001). This information suggests that if gathering many types of use data is impractical, one method may be used with the confidence that it correlates with other types of use. Visual inspection of the data confirms this with one exception: many clinical review titles tend to have a low local citation rate but high in-house use and circulation rates, suggesting that these are being used for educational and clinical purposes but not for research.

Budgets↗

PubMed1988

Monograph support provided by the National Library of Medicine and its regional medical libraries in the medical behavioral sciences.

The National Library of Medicine's (NLM) monographic resources in the medical behavioral sciences (MBS) were examined to assess NLM's ability to support the needs of researchers writing in this area. A sample of 239 representative monographs derived from citations in MBS-related articles published in 61 journals in 1981 were evaluated. These monographs were limited to works published between 1978 and 1981, inclusive. The subject distribution of the sample included fourteen of the twenty-one main classes in the LC classification, although BF (psychology), H (social sciences), and R (medicine) constituted 80.3% of the sample. The study revealed that NLM held 48.5% of the sample. The holdings of ten research medical libraries, including six of the seven regional medical libraries, were also evaluated in order to gauge NLM's ability to support that element of the medical library network. The holding rates of these libraries ranged widely (9.6% to 36%), although NLM was found to have far more extensive holdings overall, and when assessed against classes BF, H, and R. Overall, NLM could have supplied from 28.8% to 44.5% of the monographs not held by the medical libraries. In only a few cases were the ten medical libraries able to provide access to monographs not held by NLM. The findings of the study indicate that, regardless of NLM's indication of support to the MBS area, the holdings of more general research and academic libraries are essential to support the monograph needs of MBS researchers.

Behavioral Sciences↗

PubMed1995

Physical therapists in private practice: information sources and information needs.

Increasing numbers of physical therapists are providing evaluation and therapy in their own private-practice clinics. Their move out of the hospital setting has reduced their access to the sources of information designed to support clinical and practice-management decision making. The author designed a survey to determine how often physical therapists in private practice in Vermont use seven sources of information for clinical and practice-management decision making. Survey respondents also were asked to rate the anticipated usefulness of a variety of health sciences library information and research services not currently available to them and to rank access paths to information according to their preferences. The therapists' responses show frequent reliance on personal and office collections of professional literature for clinical decision making but virtually no use of bibliographic databases. Respondents ranked document-delivery services and mediated searches as having the greatest anticipated usefulness for clinical decision making. The limitations of their current information-seeking behavior and their high level of interest in increased access to a wide range of information and research services make physical therapists in private practice of special interest to health sciences librarians who are planning outreach programs.

Information Services↗

PubMedDate not supplied

The Ontario Northern Outreach Program in physical therapy.

The Northern Outreach Program (NOP) in Ontario, Canada was initiated in 1980 by the Health Sciences Faculties at The University of Western Ontario and the Ontario Ministry of Health. Objectives of the NOP are to contribute to development of health services and health manpower in Northern Ontario and to develop supportive research programs. NOP Coordinators are appointed to their respective faculties from each of the following disciplines: Communicative Disorders, Library Science, Nursing, Occupational Therapy, and Physical Therapy (PT). PT coordinators identify needs and opportunities for development of PT service and manpower in the North, collaborating with District Health Councils and health professionals. Programs are developed considering the areas of service, manpower, education, and research. Programs include workshops, consultations, student clinical placements, and access to library resources. An external evaluation of the NOP was carried out and ongoing evaluation of the PT program is based on feedback from program participants. The NOP has been effective in supporting development of PT services in Northern Ontario, decreasing professional isolation and also serves as a model for other programs. Alternatives for recruitment and retention of manpower and research opportunities must continue to be developed to ensure optimal delivery of health care to underserviced areas.

Academic Medical Centers↗

PubMed1989

Preservation of the biomedical literature: an overview.

The National Library of Medicine began to preserve its collection many years ago. This article presents a brief review of NLM's early conservation and microfilming programs, and describes the current activities of the library's new Preservation Section. Also mentioned are the complementary efforts of NLM staff who are involved in research into electronic imaging and the campaign to increase the use of alkaline paper in medical and scientific publishing. Goals of the National Preservation Plan for the Biomedical Literature are summarized and a report on progress in implementing the plan is provided. Results of the preservation needs assessment described in the accompanying article by Kirkpatrick are briefly analyzed. Recent efforts of the Commission on Preservation and Access, the National Endowment for the Humanities, the Research Libraries Group, and several international associations are described in terms of their potential benefit to preservation of the biomedical literature. The need to monitor new preservation technologies and preserve materials in audiovisual and electronic formats is emphasized. It is argued that with enough coordination, cooperation, and willingness among health sciences libraries to share the costs, the goal of preserving all of the important biomedical literature can be accomplished.

Books↗

PubMed2005

An evolution of experts: MEDLINE in the library school.

QUESTION: What is the real value that medical librarians bring to the health care environment? How have library science educators, frequently former practitioners themselves, responded to the challenge of expert searching? METHODS: In this paper, I give an historical introduction to the landscape of medical information retrieval through the development of MEDLINE. I then look at the evolution of training in online searching and its place in the context of library school education and particularly the effect of generalist education on future specialists. Finally, I acknowledge the new role of the informationist as another assertion of our professional expertise. CONCLUSIONS: The three interdependent subsystems of our professional machine-our schools, our association, and our professional peers- must all respond to this challenge by asserting our expertise in our curricula, in our continuing education, and in our dialogues with each other. Only by acknowledging the interaction of these subsystems will real and positive changes be effected to benefit our profession and our constituencies.

Education, Continuing↗

PubMed1993

Ethics and the role of the medical librarian: health care information and the new consumer.

Because medical libraries increasingly serve nonprofessionals, medical librarians may need to reconsider their role. In addition, as clients alter their expectations about librarians and begin to think of them as participants in health care delivery, librarians face new ethical challenges. This paper compares the values and goals of the library and medical professions in the provision of health care information. In examining the factors that health care professionals consider when deciding what information to share with patients, the author challenges medical librarians to reconsider their duties toward their nonprofessional clients, whether patients, patients' families, or other laypersons, and to clarify the goals of the health science library profession regarding the provision of information.

Adult↗

PubMed2005

Extending the reference desk experience: Information Resources for the Nursing Care Plan.

Both nursing and library science literature discuss the information needs and information-seeking behavior of nurses. Some research has focused on information needs of nursing students, but little research is available regarding information-seeking behavior of nursing students, specifically baccalaureate nursing students. Only a few key references were identified addressing nursing students' information seeking with regard to nurse care planning. At the University of Medicine and Dentistry of New Jersey, George F. Smith Library, a wide range of nursing students from those in traditional BSN programs, to students in accelerated BSN programs, to masters' nursing students of all types visit the reference desk asking direct and indirect questions involving the nursing care plan. This article highlights repeated categories of information sought by nursing students at the University of Medicine and Dentistry of New Jersey, George F. Smith Library via both formal and informal reference interviews. Information sought most frequently was categorized and formed the basis for a new library workshop entitled "Information Resources for the Nursing Care Plan."

Education, Nursing, Baccalaureate↗

PubMed1996

NLM extramural program: frequently asked questions.

New and aspiring investigators often ask the same questions of experts as proposals are formulated, written, and submitted to the National Library of Medicine (NLM) for peer review. The NLM's Division of Extramural Programs (EP) provides support to medical libraries, academic medical centers, individuals, and industry through numerous types of grants and contracts. A complex set of processes and procedures is in place and is familiar to established and funded researchers, but to few others. A collection of frequently asked questions (FAQ) and their answers on these issues has been prepared by the Biomedical Library Review Committee (BLRC), a standing advisory group to the NLM that meets three times a year to review and score proposals. The BLRC and two experts on National Institutes of Health (NIH) grants and contracts compiled their advice in an electronic FAQ that has been edited and abridged as an introduction to NLM EP for investigators from medical library science, informatics, and biotechnology. The BLRC expects that if new investigators are able to avoid common mistakes and misconceptions, their proposals will improve in quality and they will be able to spend their time more effectively in proposal preparation.

Biotechnology↗

PubMed1995

Benchmarking reference services: an introduction.

Benchmarking is based on the common sense idea that someone else, either inside or outside of libraries, has found a better way of doing certain things and that your own library's performance can be improved by finding out how others do things and adopting the best practices you find. Benchmarking is one of the tools used for achieving continuous improvement in Total Quality Management (TQM) programs. Although benchmarking can be done on an informal basis, TQM puts considerable emphasis on formal data collection and performance measurement. Used to its full potential, benchmarking can provide a common measuring stick to evaluate process performance. This article introduces the general concept of benchmarking, linking it whenever possible to reference services in health sciences libraries. Data collection instruments that have potential application in benchmarking studies are discussed and the need to develop common measurement tools to facilitate benchmarking is emphasized.

Efficiency, Organizational↗

PubMed1988

Tying it all together: The Integrated Academic Information Management System being implemented at Maryland.

With the National Library of Medicine serving as the catalyst, the University of Maryland at Baltimore, Campus for the Professions, entered into a major initiative to integrate information management systems in support of the campus missions of education, research, and clinical care. Strategic planning initiated the integration process and continues in an iterative mode. In support of integration, changes were made in the campus organizational structure and in its technological infrastructure. Implementation involves transforming the Information Resources Management Division into an information utility on a phased and incremental basis. Collaboration with the Health Sciences Library is key to this transformation, as are numerous outreach activities.

Computers↗

PubMed1998

International cooperation and the European Association for Health Information and Libraries.

This paper describes cooperation between European libraries: what EAHIL hopes to achieve, and how it may be done. Since its founding in 1987, EAHIL has been working for professional development and to improve cooperation and exchange of experience amongst its members. In 1995 a working programme entitled 'EAHIL--Aims towards year 2000' was approved, and it consolidates some of the most important aims of EAHIL. In this paper, only three of the six aims are referred to: conferences and workshops arranged by EAHIL, the development of an efficient network system in order to increase communication and information among members, and the establishment of agreements for cooperation with medical and health science libraries in Eastern and Central Europe in particular.

Communication↗

PubMed2006

Physician use of the curbside consultation to address information needs: report on a collective case study.

PURPOSE: The author reports key findings from a doctoral dissertation investigating what the curbside consultation is, how and why physicians use it, and what the implications for health sciences library services might be. SETTINGS/INFORMANTS: Primary informants included sixteen primary care physicians at six sites in one Midwestern state. Additional informants included twenty-eight specialists and subspecialists identified by the primary informants as colleagues who provided curbside consultations. METHODS: Qualitative research methods were used, including field observations, formal and informal interviews, and conversations with peer review physicians. RESULTS: Despite a lack of consensus about what constitutes a "good" curbside consultation, physician informants reported that curbside consultations were part of their medical education and that they continued to take part in them for a number of reasons. Tacit rules govern curbside consultation interactions, and negative consequences result when the rules are misunderstood or not observed. DISCUSSION/CONCLUSION: Acknowledging and understanding physicians' use of the curbside consultation to obtain and construct knowledge may suggest new ways for health sciences librarians to work with physicians in locating, diffusing, and disseminating clinical information.

Education, Medical, Continuing↗

PubMed2006

Neo-adjuvant and adjuvant hormone therapy for localised and locally advanced prostate cancer.

BACKGROUND: Hormone therapy for early prostate cancer has demonstrated an improvement in clinical and pathological variables, but not always an improvement in overall survival. We performed a systematic review of both adjuvant and neo-adjuvant hormone therapy combined with surgery or radiotherapy in localised or locally advanced prostate cancer. OBJECTIVES: The objective of this review was to undertake a systematic review and, if possible, a meta-analysis of neo-adjuvant and adjuvant hormone therapy in localised or locally advanced prostate cancer. SEARCH STRATEGY: We searched MEDLINE (1966-2006), EMBASE, The Cochrane Library, Science Citation Index, LILACS, and SIGLE for relevant randomised trials. Handsearching of appropriate publications was also undertaken. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials of patients with localised or locally advanced prostate cancer, that is, stages T1-T4, any N, M0, comparing neo-adjuvant or adjuvant hormonal deprivation in combination with primary therapy (radical radiotherapy or radical prostatectomy) versus primary therapy alone were included in this review. DATA COLLECTION AND ANALYSIS: Data were extracted from eligible studies and assessed for quality, and included information on study design, participants, interventions, and outcomes. Comparable data were pooled together for meta-analysis with intention-to treat principle. MAIN RESULTS: Men with prostate cancer have different clinical outcomes based on their risk (T1-T2, T3-T4, PSA levels and Gleason score). However, the majority of studies included in this review did not report results by risk groups; therefore, it was not possible to perform sub-group analysis. Neo-adjuvant hormonal therapy prior to prostatectomy did not improve overall survival (OR 1.11, 95% CI 0.67 to 1.85, P = 0.69). However, there was a significant reduction in the positive surgical margin rate (OR 0.34, 95% CI 0.27 to 0.42, P < 0.00001) and a significant improvement in other pathological variables such as lymph node involvement, pathological staging and organ confined rates. There was a borderline significant reduction of disease recurrence rates (OR 0.74, 95% CI 0.55 to 1.0, P = 0.05), in favour of treatment. The use of longer duration of neo-adjuvant hormones, that is either 6 or 8 months prior to prostatectomy, was associated with a significant reduction in positive surgical margins (OR 0.56, 95% CI 0.39 to 0.80, P = 0.002). In one study, neo-adjuvant hormones prior to radiotherapy significantly improved overall survival for Gleason 2 to 6 patients; although, in two studies, there was no improvement in disease-specific survival (OR 0.99, 95% CI 0.75 to 1.32, P = 0.97). However, there was a significant improvement in both clinical disease-free survival (OR 1.86, 95% CI 1.93 to 2.40, P < 0.00001) and biochemical disease-free survival (OR 1.93, 95% CI 1.45 to 2.56, P < 0.00001). Adjuvant androgen deprivation following prostatectomy did not significantly improve overall survival at 5 years (OR 1.50, 95% CI 0.79 to 2.85, P = 0.2); although one study reported a significant disease-specific survival advantage with adjuvant therapy (P = 0.001). In addition, there was a significant improvement in disease-free survival at both 5 years (OR 3.73, 95%CI 2.30 to 6.03, P < 0.00001) and 10 years (OR 2.06, 95% CI 1.34 to 3.15, P = 0.0009). Adjuvant therapy following radiotherapy resulted in a significant overall survival gain apparent at 5 (OR 1.46, 95% CI 1.17 to 1.83, P = 0.0009) and 10 years (OR 1.44, 95% CI 1.13 to 1.84, P = 0.003); although there was significant heterogeneity (P = 0.09 and P = 0.07, respectively). There was also a significant improvement in disease-specific survival (OR 2.10, 95% CI 1.53 to 2.88, P = 0.00001) and disease-free survival (OR 2.53, 95% CI 2.05 to 3.12, P < 0.00001) at 5 years. AUTHORS' CONCLUSIONS: Hormone therapy combined with either prostatectomy or radiotherapy is associated with significant clinical benefits in patients with local or locally advanced prostate cancer. Significant local control may be achieved when given prior to prostatectomy or radiotherapy, which may improve patient's quality of life. When given adjuvant to these primary therapies, hormone therapy, not only provides a method for local control, but there is also evidence for a significant survival advantage. However, hormone therapy is associated with significant side effects, such as hot flushes and gynaecomastia, as well as cost implications. The decision to use hormone therapy should, therefore, be taken at a local level, between the patient, clinician and policy maker, taking into account the clinical benefits, toxicity and cost. More research is needed to guide the choice, the duration, and the schedule of hormonal deprivation therapy, and the impact of long-term hormone therapy with regard to toxicity and the patient's quality of life.

Androgen Antagonists↗

PubMed2005

Variant Creutzfeldt-Jakob disease: a cause for concern. Review of the evidence for risk of transmission through abdominal lymphoreticular tissue surgery.

BACKGROUND: Concern has long existed regarding the possible iatrogenic spread of variant Creutzfeldt-Jakob disease (v-CJD) through surgery. This had been fueled by recent reports of bovine spongiform encephalopathy in U.S. cattle and the first probable case of blood transmission of v-CJD in the UK. METHODS: Systematic review of experimental and nonexperimental studies. Studies identified from searches of Medline, Embase, Cochrane Library, Science Citation Index medical databases, searching bibliographies of retrieved papers, and personal communication with international experts in the field. RESULTS: Six articles satisfied our search criteria. Evidence stems from case reports, case series, and cross-sectional studies. There are no published cases of surgically transmitted v-CJD. CONCLUSION: We found evidence of v-CJD prion agents in the spleen, appendix, rectum, and adrenal glands of affected patients and evidence of v-CJD prion in the appendix of patients in the preclinical stage of the disease. The risk of transmission of v-CJD prion during abdominal surgery is currently unquantifiable.

Abdomen↗

PubMed1994

Building the library/information center of the future.

Changes in the mission, roles, and infrastructure of academic health sciences libraries pose an enormous challenge to those designing and planning new library buildings. The library will be judged by its ability to respond to changing information dissemination patterns, changing missions, technologies not yet contemplated, and curricular trends, notably the rise of informatics and problem-based learning. Key questions are posed; the answers will shape library building now and in the future.

Architecture↗