Known Knowns and Known Unknowns

Abstract

Health care professionals often request information delivered stat. Patient treatment is urgent. Any hospital library, large or small, that uses Internet document delivery (IDD) systems can place information in the hands of the health professional faster. Libraries that use Internet document delivery technologies can provide health care professionals with information more quickly. Ultimately, it could reduce the length of a hospital stay and reduce health care costs. However, hospital libraries are faced with significant barriers that prevent them from utilizing electronic document delivery systems. docMD successfully overcame barriers and allowed small and/or rural hospital libraries to take advantage of the benefits of electronic document delivery that larger libraries have enjoyed for over a decade. It provides health professionals affiliated with smaller hospitals an equal opportunity to access professional literature quickly in order to make quicker, well-informed patient care decisions. The docMD pilot project investigated, eliminated the barriers and provided IDD services to eleven small and rural hospital libraries using a centralized document mediation center. This paper provides background information, describes the creation of the docMD service delivery model and discusses possible future project outcomes.     

Collaborating with Information Technology: Implementing Web Search at the University of New Mexico

The University of New Mexico (UNM) has used the Google Search Appliance (GSA) to provide search for the University's Web content. When the GSA license expired, the campus Information Technologies (IT) department and the University Libraries (UL) took the opportunity to collaborate on a re-launch of the service as a joint project. By collaborating closely with IT, the UL personnel gained insight and first-hand information on how to optimize the Libraries’ Web presence. Outcomes were positive, both in the resulting product and in building bridges between the work cultures.     

Midsession reversals with pigeons: visual versus spatial discriminations and the intertrial interval

Discrimination reversal learning has been used as a measure of species flexibility in dealing with changes in reinforcement contingency. In the simultaneous-discrimination, midsession-reversal task, one stimulus (S1) is correct for the first half of the session, and the other stimulus (S2) is correct for the second half. After training, pigeons show a curious pattern of choices: They begin to respond to S2 well before the reversal point (i.e., they make anticipatory errors), and they continue to respond to S1 well after the reversal (i.e., they make perseverative errors). That is, pigeons appear to be using the passage of time or the number of trials into the session as a cue to reverse, and are less sensitive to the feedback at the point of reversal. To determine whether the nature of the discrimination or a failure of memory for the stimulus chosen on the preceding trial contributed to the pigeons’ less-than-optimal performance, we manipulated the nature of the discrimination (spatial or visual) and the duration of the intertrial interval (5.0 or 1.5 s), in order to determine the conditions under which pigeons would show efficient reversal learning. The major finding was that only when the discrimination was spatial and the intertrial interval was short did the pigeons perform optimally.     

Comparison of computed tomography and chest radiography in the detection of rib fractures in abused infants

PURPOSE: Chest radiographs (CXR) are the standard method for evaluating rib fractures in abused infants. Computed tomography (CT) is a sensitive method to detect rib fractures. The purpose of this study was to compare CT and CXR in the evaluation of rib fractures in abused infants. METHODS: This retrospective study included all 12 abused infants identified from 1999 to 2004 who had rib fractures and both CXR and CT (8 abdomen CTs, 4 chest CTs). CT exams had been performed for clinical indications, and were obtained within one day of the CXR. Studies were reviewed by two pediatric radiologists to determine the number, locations, and approximate ages of the rib fractures. A total of 225 ribs were completely (192) or partially (33) seen by CT, and the matched ribs on CXR were used for the analysis. RESULTS: The mean patient age was 2.5 months (1.2-5.6), with seven females and five males. While 131 fractures were visualized by CT, only 79 were seen by CXR (p<.001). One patient had fractures only seen by CT. There were significantly (p<.05) more early subacute (24 vs. 4), subacute (47 vs. 26), and old fractures (4 vs. 0) seen by CT than by CXR. Anterior (42 vs. 11), anterolateral (21 vs. 12), posterolateral (9 vs. 3) and posterior (39 vs. 24) fractures were better seen by CT than by CXR (p<.01). Bilateral fractures were detected more often by CT (11) than by CXR (6). CONCLUSIONS: While this study group is small, these findings suggest that CT is better than CXR in visualizing rib fractures in abused infants.     

Diarrhea Management Training in Early Childhood Settings

This study addresses the health of young children and how to safely and effectively care for children with diarrhea in the home and in early child care settings. A baseline survey showed the prevalence of oral rehydration solution (ORS) usage at last diarrhea bout to be low. An educational workshop was developed to train parents and child care professionals on how to properly manage young children with diarrhea and reduce the risk of diarrhea spread at home and in early childhood settings. Specific intervention activities are discussed and program activities, including specially designed materials for mixing homemade ORS are described. A comparison of pre- and postintervention data indicates substantial gains in knowledge among both urban and rural populations. Implications of research findings are discussed along with suggestions for future research.