Understanding How Vulnerable Populations Use Common Information and Communications Technologies (ICTs) to Access Health Care Information

The goal of this study is to investigate patterns of internet access via computers and cellular telephones among the population being served by the Drexel University Eleventh (11th) Street Health Center (Here after, the Center) and to determine which Information and Communications Technologies (ICTs) will be most appropriate for delivering health care information to this population. This two-part study examines 2 concepts: 1). Which ICTs do patients at the11th Street center use to connect to the internet; 2) How these patients use the internet through the identified ICTs. Results of the project will be used to improve the ways the Center communicates with its patients by developing new approaches for using ICTs that better reflect the existing patterns of use in the population. The study will also provide researchers with a better understanding of the barriers and facilitators to internet access in this vulnerable population

CD-ROM MEDLINE use and users: information transfer in the clinical setting

Effective delivery of biomedical information to health professionals depends on the availability of systems that are compatible with the information-seeking patterns of health professionals. MEDLINE is a major source of biomedical information, but has been available primarily through libraries via telecommunications networks. The recent availability of MEDLINE on CD-ROM has made it possible to provide MEDLINE directly to clinicians without the associated problems of telecommunications and online use charges. The MEDLINE on CD-ROM Evaluation Forum sponsored by the National Library of Medicine reported on clinicians' use of CD-ROM MEDLINE at seven different clinical settings. This article summarizes the findings from these sites and places them in the context of current understanding of information-seeking behaviors of health professionals. Key issues in the design and development of information technologies in the clinical setting are also articulated

Understanding Accreditation: The Librarian's Role in Educational Evaluation

This article will describe the practice of accreditation in general, and will identify several issues and trends that occurred as a result of changes in political and social structures. It will also discuss some of the challenges facing accreditation today, and how the changes in higher education may affect both libraries and accreditation

Tools for improvement: a systematic analysis and guide to accreditation by the JCAHO

By viewing the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) standards in the context of current accreditation practice, hospital librarians can understand and clarify their role in realizing their organization's mission, goals, and objectives. By broadening their view of the information function as described in the accreditation standards, health sciences librarians can enhance their position in the hospital's management team, improve health information practice, and contribute to the overall performance of the health care organization. The role of the librarian and the library throughout the entire set of standards and interrelationships with other professionals and units are described. Examples of ways to demonstrate conformity to the standards are provided. Special emphasis is placed on Standard 9, Management of Information, to provide guidance to the librarian undergoing JCAHO accreditation

Tools for improvement: a systematic analysis and guide to accreditation by the JCAHO

By viewing the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) standards in the context of current accreditation practice, hospital librarians can understand and clarify their role in realizing their organization's mission, goals, and objectives. By broadening their view of the information function as described in the accreditation standards, health sciences librarians can enhance their position in the hospital's management team, improve health information practice, and contribute to the overall performance of the health care organization. The role of the librarian and the library throughout the entire set of standards and interrelationships with other professionals and units are described. Examples of ways to demonstrate conformity to the standards are provided. Special emphasis is placed on Standard 9, Management of Information, to provide guidance to the librarian undergoing JCAHO accreditation

Factors influencing research productivity among health sciences librarians

Secondary analysis was performed of data collected in 1989 from a random sample of members of the Medical Library Association. Results show that about half the sample had at least one publication; academic health sciences librarians were much more likely than hospital librarians to have published. Almost half the sample had taken formal courses in research, but only a small percentage had taken continuing education (CE) courses in research. Institutional support services for research were most available in academic settings. The combination of institutional support, CE training, and research courses explained 31.1% of the variation in research productivity among academic librarians; these factors were less important in hospitals and other institutional settings. The authors suggest that health sciences librarians working outside academia should seek support for research from sources outside the employing institution

Working Paper on the Relationship between Subject Indexing Principles and Online Subject Searching Strategies

Abstract not clea

Imperatives for continuing research education: results of a Medical Library Association survey

This paper reports the results of a survey assessing the interest of Medical Library Association (MLA) members in acquiring or improving research skills through continuing education (CE). It describes respondents' educational preparation for research and selected research activities, reviews MLA's experiences with offering CE courses on research topics, and discusses MLA's role in providing education to prepare members for research. The paper includes recommendations for improving research skills through CE and other professional activities. Topics of greatest interest to MLA members were survey development, problem identification, evaluation and cost studies, survey methodology, and methods of data collection. Many respondents preferred local courses. Academic health sciences librarians, as a group, were found to be more productive publishers than hospital librarians. Many respondents reported the availability of free or subsidized research-support services, but more than half did not. More than 90% of respondents indicated that MLA should actively encourage, require, or offer research education. A comprehensive plan for obtaining research skills through CE, along with individual self-assessment and counseling, is recommended

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

User-centered evaluation of information retrieval

This paper briefly summarizes the history of evaluation in information retrieval and describes both the strengths and limitations of traditional criteria for retrieval effectiveness such as precision, recall, cost, novelty, and satisfaction. It presents a continuum of approaches to studying the user in information retrieval, and suggests that because the situations in which information is sought and used are social situations, objective measures such as retrieval sets and transaction log data may have limited usefulness in determining retrieval effectiveness. Information retrieval evaluation has been locked into a rationalistic, empirical framework which is no longer adequate. A different framework of analysis, design, and evaluation that is contextual in nature is needed. User-centered criteria employing affective measures such as user satisfaction and situational information retrieval must be incorporated into evaluation and design of new information retrieval systems. Qualitative methods such as case studies, focus groups, or in-depth interviews can be combined with objective measures to produce more effective information retrieval research and evaluation.published or submitted for publicatio