tag:blogger.com,1999:blog-307549022024-02-19T02:44:57.352-08:00JMLA Case Studies in Health Sciences Librarianshipjmlaeditorhttp://www.blogger.com/profile/16078744974636042409noreply@blogger.comBlogger135125tag:blogger.com,1999:blog-30754902.post-52332248253461060762009-01-26T07:47:00.000-08:002009-01-26T07:53:51.645-08:00TV shows prompting bioethics discussionsIn this week's AMNews: <a href="http://www.ama-assn.org/amednews/2009/01/26/prl20126.htm">TV doctors' flaws become bioethics teaching moments</a> -- comments on a recent study examining medical students' TV viewing habits.<br /><blockquote>Dr. House is the fictional protagonist of Fox TV's "House," a medical mystery drama that last year drew an average 16.2 million viewers weekly. The bad-boy antics that made the master diagnostician a hit with American viewers also have made him popular among medical students, according to a December 2008 study in The American Journal of Bioethics.<br /><br />The survey of nearly 400 medical and nursing students at Johns Hopkins University in Maryland found that 76% of doctors in training watch "House" and 73% watch ABC's hospital soap opera "Grey's Anatomy." Nearly 40% watch NBC's "ER" and one in five tunes in "Nip/Tuck," which airs on the FX cable network. Eighty-five percent of medical students said they watched a medical drama in the prior year.</blockquote>The AJOB paper itself: Matthew Czarny, Edwin Bodensiek, Ruth R. Faden, Marie T. Nolan, Jeremy Sugarman. <a href="http://www.bioethics.net/journal/j_articles.php?aid=1709&display=abstract">Medical and Nursing Students' Television Viewing Habits: Potential Implications for Bioethics</a> 2008. The Am J Bioethics 2008 Dec; 8(12):1.Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-89170147043250006792009-01-20T07:54:00.000-08:002009-01-20T07:55:28.735-08:00Personalized genetic predictionCommentary on the current state of genetic testing for personalized medicine, including promise as well as challenges that still need to be tackled..<br /><br />Personalized Genetic Prediction: Too Limited, Too Expensive, or Too Soon?<br />John P.A. Ioannidis<br />Ann Intern Med 2009;150 139-141<br /><a href="http://www.annals.org/cgi/content/full/150/2/139?etoc">http://www.annals.org/cgi/content/full/150/2/139?etoc</a><br /><blockquote>“Genetic epidemiology has identified many common genetic variants that are associated with common diseases, and the list is growing monthly (1, 2). This success has boosted expectations for personalized genetic prediction. According to these expectations, genetic information can tell people about their risk for various diseases and which medications they should use or avoid. However, 2 articles in this issue (3, 4) suggest that this promise may be exaggerated and premature.”</blockquote>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-27431971744270155982009-01-06T14:34:00.000-08:002009-01-20T13:30:36.653-08:00New JAMA users' guide articleIn today's JAMA -- John Attia; John P. A. Ioannidis; Ammarin Thakkinstian; Mark McEvoy; Rodney J. Scott; Cosetta Minelli; John Thompson; Claire Infante-Rivard; Gordon Guyatt. <a href="http://jama.ama-assn.org/cgi/content/abstract/301/1/74?etoc">How to Use an Article About Genetic Association: A: Background Concepts</a>. JAMA 2009;301 74-81.<br /><br />The start of a 3-article series about how to read a genetic association study.<br /><br />Update: the 2nd and 3rd articles are now available too.<br /><br />- Attia J, Ioannidis JPA, Thakkinstian A; et al. <a href="http://jama.ama-assn.org/cgi/content/abstract/301/2/191">How to use an article about genetic association: B: are the results of the study valid?</a> JAMA. 2009;301(2):191-197. <br /><br />- John Attia; John P. A. Ioannidis; Ammarin Thakkinstian; Mark McEvoy; Rodney J. Scott; Cosetta Minelli; John Thompson; Claire Infante-Rivard; Gordon Guyatt. <a href="http://jama.ama-assn.org/cgi/content/abstract/301/3/304?etoc">How to Use an Article About Genetic Association: C: What Are the Results and Will They Help Me in Caring for My Patients?</a> JAMA 2009;301 304-308.Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-46587049078922628662008-12-19T08:34:00.000-08:002008-12-19T08:38:31.189-08:00Limited usefulness of private-sector medication informationFrom the FDA: "<a href="http://www.fda.gov/bbs/topics/NEWS/2008/NEW01926.html">Study Finds Much of Private-Sector Consumer Medication Information Not Consistently Useful</a>" (12/16/2008)<br /><blockquote>A study released today by the U.S. Food and Drug Administration found that the printed consumer medication information (CMI) voluntarily provided with new prescriptions by retail pharmacies does not consistently provide easy-to-read, understandable information about the use and risks of medications.<br /><br />The study, Expert and Consumer Evaluation of Consumer Medication Information, showed that while most consumers (94 percent) received CMI with new prescriptions, only about 75 percent of this information met the minimum criteria for usefulness as defined by a panel of stakeholders. In 1996, Congress called for 95 percent of all new prescriptions to be accompanied by useful CMI by 2006. </blockquote>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-39487601943409977352008-12-19T08:21:00.000-08:002008-12-19T08:24:40.151-08:00CyberchondriaOne more from the WSJ's Health blog -- summary of a recent Microsoft study about how people search for health information: <a href="http://blogs.wsj.com/health/2008/11/25/cyberchondria-its-not-just-in-your-head/">Cyberchondria: it's not just in your head</a>.<br /><blockquote>Is that burning feeling heartburn or a heart attack? Quick, your brain says to the hand not clutching your chest, type “chest pain” into Google and let’s get to the bottom of this.<br /><br />What happens next, for many people, is a descent into worst-case scenarios, fueled by the ready availability of information on the Web about medical conditions both rare and common. Obscure or serious medical problems can bubble up to the first page of search results, where anxious searchers can quickly conclude their symptoms result from scary but unlikely causes. Before you can say, “Google,” there’s another case of cyberchondria on the loose.</blockquote>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-66991797322509997602008-12-19T08:17:00.000-08:002008-12-19T08:19:37.135-08:00Negative studies going unpublishedBrief item on the Wall Street Journal Health blog -- "<a href="http://blogs.wsj.com/health/2008/12/12/how-many-negative-drug-studies-still-go-unpublished/">How many negative drug studies still go unpublished?</a>" -- includes highlights from the last year's studies on publication bias and news items about pharma potentially suppressing release of some results.Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-40160583140525681162008-12-04T08:07:00.000-08:002008-12-04T08:10:47.232-08:00Latest JMLA caseIn case you haven't seen it yet, check out the latest installment in the JMLA case study series -- <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2568840">The role of the medical librarian in the basic biological sciences: a case study in virology and evolution</a> by Michele Tennant and Michael Miyamoto. <br /><br />This case challenges us to apply our medical knowledge building and searching skills to the field of virology, touring us through basic virology concepts and considering the implicit nature of the answer for the question featured in the case.<br /><br />The next case will tackle a selection of veterinary and zoological medicine topics and will appear later next year.Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-82039954188900339522008-12-04T07:41:00.000-08:002008-12-04T07:47:35.881-08:00New IOM report on resident work hoursThe <a href="http://www.iom.edu">Institute of Medicine</a> has released new recommendations for resident work hours, including protected time for sleep intervals during call and longer shifts, off-time, and other issues. The full-text of the report is online <a href="http://www.iom.edu/CMS/3809/48553/60449.aspx">here</a> and links to a few commentary pieces below:<br /><br />- <a href="http://content.nejm.org/cgi/content/full/NEJMp0808736?query=TOC">NEJM article</a>, including table comparing new recommendations to the existing ACGME recs<br />- <a href="http://www.nytimes.com/2008/12/03/health/03doctors.html?partner=permalink&exprod=permalink">New York Times article</a><br />- <a href="http://www.acgme.org/acWebsite/newsReleases/newsRel_12_2_08.asp">ACGME press release about the report</a>, including mention of a pending March 2009 conference on work hoursBeckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-912960205603916082008-11-25T14:20:00.000-08:002008-11-25T14:41:31.450-08:00Wikipedia for Drug Information<a href="http://jmlacasestudies.blogspot.com/search?q=wikipedia">Several posts on this blog</a> have looked at the varying ways Wikipedia can be used for addressing medical concepts. <a href="http://www.ihealthbeat.org/articles/2008/11/25/wikipedia-drug-entries-often-omit-important-safety-information.aspx">Reuters Health reports today</a> on a study from researchers at Nova Southeastern University that compares the scope, completeness, and accuracy of drug information in Wikipedia when comparted to Medscape Drug Reference (MDR). <div><br />Using assessments in 8 categories of drug information, the study authors report that Wikipedia answered fewer drug questions than MDR (40% vs. 82.5%, p<0.001) <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=DetailsSearch&Term=19017825[uid]">see PubMed abstract</a>.<div><br /></div><div>Interesting article. Did you know to date there are over <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=DetailsSearch&Term=wikipedia[All+Fields]">30 articles</a> in Pubmed referencing Wikipedia? <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=DetailsSearch&Term="wiki*"[All+Fields]">More than 50</a> mention wikis in general? </div></div>Taneyahttp://www.blogger.com/profile/01499972028109463250noreply@blogger.com2tag:blogger.com,1999:blog-30754902.post-33362121954941818172008-09-19T08:52:00.000-07:002008-09-19T08:54:54.315-07:00Understanding cancerA few of our search challenges have focused on a cancer-related topic - for those interested in understanding more about how cancer develops, etc., check out these two posts from <a href="http://scienceblogs.com/denialism">denialism blog</a> at <a href="http://scienceblogs.com/">ScienceBlogs</a>:<br /><a href="http://scienceblogs.com/denialism/2008/09/cancer_101.php">Cancer 101</a><br /><a href="http://scienceblogs.com/denialism/2008/09/cancer_102.php">Cancer 102</a>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com1tag:blogger.com,1999:blog-30754902.post-39044329984020710072008-09-17T07:44:00.000-07:002008-09-17T07:48:01.599-07:00C. diff in the news againOur <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17252060">second JMLA case</a> discussed <span style="font-style: italic;">Clostridium difficile</span> infection, and this type of healthcare-acquired infection continues to gain notoriety, now being billed by some as "the new MRSA" -- see <a href="http://blogs.wsj.com/health/2008/09/17/clostridium-difficile-is-the-new-mrsa/">this brief item in the WSJ Health blog </a>and <a href="http://online.wsj.com/article/SB122160848756745487.html">this longer piece in the </a><span style="font-style: italic;"><a href="http://online.wsj.com/article/SB122160848756745487.html">Wall Street Journal</a> </span>itself.Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com1tag:blogger.com,1999:blog-30754902.post-42391129228694619022008-08-27T11:16:00.001-07:002008-08-27T11:18:27.234-07:00Medication errorsA <a href="http://www.npr.org/templates/story/story.php?storyId=94019645&ft=1&f=1024">nice brief piece from NPR's Day to Day today</a>, discussing outpatient medication errors--touches particularly on patient education and doctor/patient communication as key to addressing the issue.<br /><blockquote>Painkillers, sleeping pills and anti-anxiety drugs are being prescribed to out-patients in high doses, without the oversight of a doctor. A new study found that in the last 20 years there has been a 500 percent increase in the death rate from medication errors made at home. Medical contributor Dr. Sydney Spiesel discusses the data with Alex Chadwick.<br /></blockquote>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-77282659337265686832008-08-11T09:44:00.000-07:002008-08-11T09:47:25.998-07:00July JMLA caseThe latest JMLA case, <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2479049">Addressing Hemolysis in an Infant Due to Mother–Infant ABO Blood Incompatibility</a>, is available in the <a href="http://www.pubmedcentral.nih.gov/tocrender.fcgi?iid=169414">July issue of the journal</a>.<br /><br />The question that this case focuses on: Is [intravenous immunoglobulin G] a safe and effective alternative to exchange transfusion in a premature infant with hemolysis and hyperbilirubinemia secondary to ABO incompatibility, who has failed phototherapy?<br /><br />See the <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2479049">full-text of the case</a> for definition of the medical terms, discussion of the search, and an analysis of the literature on this topic!Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-68220913033118183332008-08-11T09:39:00.000-07:002008-08-11T09:42:56.873-07:00Adoption of electronic medical recordsThis week's <a href="http://www.nlm.nih.gov/medlineplus/directorscomments.html">MedlinePlus podcast from the National Library of Medicine</a> covers data about provider and patient perceptions and adoption of EMRs; Rob Logan PhD is filling in for Dr Lindberg this week. The transcript of the podcast is <a href="http://www.nlm.nih.gov/medlineplus/podcast/transcript081108.html">here</a> and the MedlinePlus topic page on EMRs is <a href="http://www.nlm.nih.gov/medlineplus/personalmedicalrecords.html">here</a>.Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com2tag:blogger.com,1999:blog-30754902.post-82930022228138941682008-08-08T08:50:00.000-07:002008-08-08T08:57:22.163-07:00Learning about qualitative research in today's BMJThis week's <a href="http://www.bmj.com"><span style="font-style:italic;">British Medical Journal</span></a> includes several great overview/tutorial pieces about aspects of qualitative research:<br /><br />- Ayelet Kuper, Scott Reeves, and Wendy Levinson. <a href="http://www.bmj.com/cgi/content/extract/337/aug07_3/a288">An introduction to reading and appraising qualitative research</a>. BMJ 2008;337:a288<br /><br />- Ayelet Kuper, Lorelei Lingard, and Wendy Levinson. <a href="http://www.bmj.com/cgi/content/extract/337/aug07_3/a1035">Critically appraising qualitative research</a>. BMJ 2008;337:a1035<br /><br />- Scott Reeves, Ayelet Kuper, and Brian David Hodges. <a href="http://www.bmj.com/cgi/content/extract/337/aug07_3/a1020">Qualitative research methodologies: ethnography</a>. BMJ 2008;337:a1020<br /><br />- Scott Reeves, Mathieu Albert, Ayelet Kuper, and Brian David Hodges. <a href="http://www.bmj.com/cgi/content/extract/337/aug07_3/a949">Why use theories in qualitative research?</a> BMJ 2008;337:a949<br /><br />- Brian David Hodges, Ayelet Kuper, and Scott Reeves. <a href="http://www.bmj.com/cgi/content/extract/337/aug07_3/a879">Discourse analysis</a>. BMJ 2008;337:a879<br /><br />- Lorelei Lingard, Mathieu Albert, and Wendy Levinson. <a href="http://www.bmj.com/cgi/content/extract/337/aug07_3/a567">Grounded theory, mixed methods, and action research</a>. BMJ 2008;337:a567Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-10685893889423404512008-08-04T14:14:00.000-07:002008-08-04T14:18:34.589-07:00Search challenge 11This month's topic: What information (online or print) and support resources are available for children with wheat allergy and their parents?<br /><br />Post your suggestions in the comments and come back on Tuesday Sept. 2 for more discussion!Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com1tag:blogger.com,1999:blog-30754902.post-76767777760312487012008-08-04T07:59:00.000-07:002008-08-04T14:14:15.890-07:00Search challenge 10: strategies<a href="http://jmlacasestudies.blogspot.com/2008/07/search-challenge-10.html">Search challenge 10</a> examines the issue of how to decide on appropriate screening practices for breast cancer in a young woman whose grandmother developed breast cancer at a relatively young age.<br /><br />A search that incorporates the main "components" of the question might look something like:<br />("Breast Neoplasms/diagnosis"[Majr] OR breast neoplasms/genetics[majr]) AND (inherited[tiab] OR familial[tiab] OR high risk[tiab] OR family history[tiab] OR grandmother[tiab] OR pedigree[tiab] OR second degree[tiab] OR heredity[tiab] OR hereditary[tiab]) AND (age factors[mh] OR risk[mh] OR predictive value of tests[mh] OR sensitivity and specificity[mh]) AND (diagnostic imaging[majr] OR mass screening[majr]) AND english[la] AND humans[mh] NOT (case reports[pt] OR letter[pt] OR comment[pt] OR editorial[pt])<br /><span style="font-style: italic; font-weight: bold;"><br />A few good articles on the topics, drawn from PubMed and a Google search: <span></span></span><br />Claus EB, Risch N, Thompson WD. Autosomal dominant inheritance of early-onset breast cancer. Implications for risk prediction. Cancer. 1994 Feb 1;73(3):643-51. PMID: 8299086<br /><br />Kriege M, Brekelmans CT, Obdeijn IM, Boetes C, Zonderland HM, Muller SH, Kok T, Manoliu RA, Besnard AP, Tilanus-Linthorst MM, Seynaeve C, Bartels CC, Kaas R, Meijer S, Oosterwijk JC, Hoogerbrugge N, Tollenaar RA, Rutgers EJ, de Koning HJ, Klijn JG. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer. Breast Cancer Res Treat. 2006 Nov;100(1):109-19. Epub 2006 Jun 22. PMID: 16791481<br /><br />Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM, Manoliu RA, Kok T, Peterse H, Tilanus-Linthorst MM, Muller SH, Meijer S, Oosterwijk JC, Beex LV, Tollenaar RA, de Koning HJ, Rutgers EJ, Klijn JG; Magnetic Resonance Imaging Screening Study Group. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med. 2004 Jul 29;351(5):427-37. PMID: 15282350<br /><br />NCCN practice guidelines in oncology: Breast cancer risk reduction, 2008. Vol. 1, http://www.nccn.org/professionals/physician_gls/PDF/breast_risk.pdf<br /><br />NCCN practice guidelines in oncology: Breast cancer screening and diagnosis, 2008. Vol. 1, http://www.nccn.org/professionals/physician_gls/PDF/breast-screening.pdf<br /><br />NCCN practice guidelines in oncology: Genetic/familial high risk assessment: Breast and ovarian, 2008. Vol. 1, http://www.nccn.org/professionals/physician_gls/PDF/genetics_screening.pdf<br /><br />Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, Morris E, Pisano E, Schnall M, Sener S, Smith RA, Warner E, Yaffe M, Andrews KS, Russell CA; American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89. Erratum in: CA Cancer J Clin. 2007 May-Jun;57(3):185. PMID: 17392385<br /><br />Smith RA, Saslow D, Sawyer KA, Burke W, Costanza ME, Evans WP 3rd, Foster RS Jr, Hendrick E, Eyre HJ, Sener S; American Cancer Society High-Risk Work Group;American Cancer Society Screening Older Women Work Group; American Cancer Society Mammography Work Group; American Cancer Society Physical Examination Work Group; American Cancer Society New Technologies Work Group; American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast cancer screening: update 2003.CA Cancer J Clin. 2003 May-Jun;53(3):141-69.PMID: 12809408<br /><br />Yu J, Park A, Morris E, Liberman L, Borgen PI, King TA. MRI screening in a clinic population with a family history of breast cancer. Ann Surg Oncol. 2008 Feb;15(2):452-61. Epub 2007 Nov 17. PMID: 18026801Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-45194971937586700462008-07-14T09:45:00.000-07:002008-07-14T10:00:20.153-07:00Health literacy and the emergency roomA multicenter, cross-sectional study in last month's Academic Emergency Medicine administered a short health literacy assessment questionnaire to 300 patients in 3 Boston emergency rooms. In addition to examining raw scores, investigators also looked at correlations with other sociodemographic variables.<br /><br />Older age, less education, and lower income were all associated with reduced functional health literacy. Associations with ethnicity, race, and language were not statistically significant in the multivariate analysis (i.e. after correcting for other variables).<br /><br />The authors note "In this sample, one-quarter of ED patients would be expected to have difficulty understanding health materials and following prescribed treatment regimens. Advanced age and low socioeconomic status were independently associated with limited health literacy. The ability of a significant subgroup of ED patients to understand health information, especially during illness or injury, requires further study."<br /><br />One potential limitation that comes to mind - a cross-sectional study gives just a snapshot, rather than a longitudinal assessment -- the questionnaire results reflect each individual's completion of a brief test during their stay in the ED setting, which is a fairly difficult environment given the complexity of this kind of healthcare encounter (stress of the health condition, urgency, family issues, financial considerations, etc.). The competing concerns of the environment may shift individual test results downward. If you tested the same person while they were going to a routine visit at their doctor, their results may be different. <br /><br />On the other hand, the methods of the current study would seem to give an accurate picture of functional health literacy at the moment of crisis, which speaks more to how people may (or may not) be able to handle, process, and retain information in that particular setting.<br /><br />So, having a librarian stationed in the ED might not, then, be a good idea, but do other strategies come to mind for aiding individuals with lower health literacy in this setting?<br /><br />Reference: Ginde AA, Weiner SG, Pallin DJ, Camargo CA Jr. Multicenter study of limited health literacy in emergency department patients. Acad Emerg Med. 2008 Jun;15(6):577-80. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18616448">PubMed abstract</a>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com1tag:blogger.com,1999:blog-30754902.post-91139456214758310692008-07-10T07:11:00.000-07:002008-07-10T07:19:34.788-07:00Change in drugmaker swagvia WSJ's Health blog -- <a href="http://blogs.wsj.com/health/2008/07/10/drugmakers-pulling-plug-on-free-pens-mugs-pads/?mod=WSJBlog">Drugmakers pulling plug on free pens, mugs, and pads</a> -- talks about <a href="http://www.phrma.org/news_room/press_releases/phrma_code_reinforces_commitment_to_responsible_interactions_with_healthcare_professionals/">this revision to the PhRMA Code</a> (voluntary guidelines for pharma marketing activities), authored by the pharmaceutical industry's trade group, which is calling for more responsible marketing by eliminating some of the freebie gifts. It doesn't, however, set explicit limits on spending for physician consulting and speaking engagements, but recommends internal limits and tracking procedures be put in place.<br /><br />The full PhRMA marketing code is <a href="http://www.phrma.org/files/PhRMA%20Marketing%20Code%202008.pdf">here</a>; more in the <a href="http://online.wsj.com/article/SB121568650743242315.html">WSJ</a> and the <a href="http://www.nytimes.com/2008/07/10/business/10code.html?ex=1373428800&en=344e999790b6717d&ei=5124&partner=permalink&exprod=permalink">New York Times</a>.Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-72170185223640070052008-07-09T08:41:00.000-07:002008-07-09T08:49:33.501-07:00Violence against nursesIt seems like we get a search request on this topic every couple of years or so and yesterday's <em>New York Times</em> has a great piece by David Tuller summarizing recent stats about violence against nurses and workplace prevention strategies -- "<a href="http://www.nytimes.com/2008/07/08/health/08nurses.html?8dpc=&_r=1&adxnnl=1&oref=slogin&adxnnlx=1215604880-6Nd+R565dZXw+YX+41Gp9A">Nurses Step Up Efforts to Protect Against Attacks</a>" (via <a href="http://thepumphandle.wordpress.com/">The Pump Handle</a>)<br /><br />For more info, a quick PubMed search - <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=DetailsSearch&Term=%22nurse-patient+relations%22%5BMeSH+Major+Topic%5D+AND+%22violence%22%5BMeSH+Major+Topic%5D">nurse-patient relations[majr] AND violence[majr]</a> (does include some false drops about screening for abuse, domestic violence, elder abuse, etc.)Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-29047829466276878402008-07-08T12:20:00.000-07:002008-07-08T12:23:16.897-07:00PubMed as a verbDrugMonkey ponders the changing role of PubMed with increasing focus on open access -- "<a href="http://scienceblogs.com/drugmonkey/2008/07/ill_pubmed_it_and_find_out.php">I'll PubMed it and find out</a>"<br /><blockquote>Most of the audience for this blog will be familiar with the use of "Google" as a verb to describe searching the World Wide Web for information on a given topic. "I googled a half-dozen mojito recipes which we tried out on the Fourth". "Did you google your blind date/new postdoc to make sure he isn't a psycho?". "You got dinner plans after the conference sessions end for the day? No? Lemme google up some restaurants." <p>...</p> Lagging well behind this transformation of our information-age lives, but assuredly steaming right along behind, is the verb-ification of PubMed. For some of us, it is here already. This is the area where I am sympathetic to the antics of the Open Access Acolytes™.</blockquote>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-7498760932166770452008-07-08T09:04:00.000-07:002008-07-08T09:07:29.768-07:00Search challenge 10<p>For this month's search challenge, a question from a primary care physician: A woman's maternal grandmother had breast cancer at the age of 36. As a result, her ob/gyn is recommending screening to begin at 31. What is the evidence for determining when to begin screening patients who have second degree relatives with breast cancer? Is imaging other than mammogram (e.g. MRI) preferred? Does the presence/absence of BRCA 1/2 mutations affect these recommendations?</p><p>Post your suggestions in the comments! I'll pull our thoughts together for a follow-up post on the first Monday of August.<br /></p>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-64339288758402465222008-07-08T08:36:00.000-07:002008-07-11T08:11:54.510-07:00Search challenge 9: strategiesSearch challenge 9 was "<a href="http://jmlacasestudies.blogspot.com/2008/06/search-challenge-9.html">Can you find literature that discusses physician/nurse collaboration and communication, and assessments of associated effects on nurse retention?</a>"<br /><br />One commenter posted a CINAHL strategy and found some dissertations that may be useful in aiding a literature review, also noting that a PubMed on the search might be more difficult since some of the most relevant indexing terms are unique to CINAHL.<br /><br />From a few quick searches, the main term that seems to be useful in PubMed is the MeSH term "Physician-Nurse Relations" -- restricting to "major" and a few other things brings it down to about 500 hits, including ~180 in the last two years<br /><blockquote>"Physician-Nurse Relations"[Majr] AND eng[la] NOT (case reports[pt] OR letter[pt] OR comment[pt] OR editorial[pt] OR news[pt] OR newspaper article[pt])</blockquote><br />ANDing a string like (job satisfaction[mh] OR personnel turnover[mh] OR retention[tiab] OR retaining[tiab] OR retain[tiab] OR retained[tiab] OR turnover[tiab]) was fairly effective in finding a few studies that looked at the retention/turnover issue. Other MeSH terms also seemed to pop up in the indexing of the more relevant items -- "communication," "attitudes of health personnel," "cooperative behavior," "burnout, professional," and the "psychology" subheading (attached to various MeSH terms).Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-82254343692387873842008-07-07T08:29:00.000-07:002008-07-07T08:32:23.171-07:00EMRs in ambulatory careLast week's NEJM has a large survey of opinion and usage of EMRs by ambulatory care physicians (n=2758):<br /><br />DesRoches CM, Campbell EG, Rao SR, Donelan K, Ferris TG, Jha A, Kaushal R, Levy DE, Rosenbaum S, Shields AE, Blumenthal D. <a href="http://content.nejm.org/cgi/content/abstract/359/1/50">Electronic health records in ambulatory care--a national survey of physicians</a>. N Engl J Med. 2008 Jul 3;359(1):50-60.<br /><br />excerpt from the abstract:<br /><blockquote>Results: Four percent of physicians reported having an extensive, fully functional electronic-records system, and 13% reported having a basic system. In multivariate analyses, primary care physicians and those practicing in large groups, in hospitals or medical centers, and in the western region of the United States were more likely to use electronic health records. Physicians reported positive effects of these systems on several dimensions of quality of care and high levels of satisfaction. Financial barriers were viewed as having the greatest effect on decisions about the adoption of electronic health records.<br /><br />Conclusions: Physicians who use electronic health records believe such systems improve the quality of care and are generally satisfied with the systems. However, as of early 2008, electronic systems had been adopted by only a small minority of U.S. physicians, who may differ from later adopters of these systems.</blockquote>Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0tag:blogger.com,1999:blog-30754902.post-35723584701804816062008-06-26T07:45:00.000-07:002008-06-26T07:49:38.304-07:00Health privacy framework for Google and Microsoftvia the WSJ Health Blog: <a href="http://blogs.wsj.com/health/2008/06/26/google-microsoft-agree-to-health-privacy-standards/">Google, Microsoft Agree to Health Privacy Standards</a> (<a href="http://www.connectingforhealth.org/news/pressrelease_062508.html">endorsed by AAFP and AARP, among others</a>)<br /><br />The 8MB full framework document is available for downloading <a href="http://www.connectingforhealth.org/phti/#guide">here</a> (along with a Flash presentation of key issues and points).Beckyhttp://www.blogger.com/profile/08694809393245889248noreply@blogger.com0