Complacent and conflicting scientific expertise in British and American drug regulation: clinical risk assessment of triazolam

This paper presents a case study in the production and interpretation of regulatory science, focusing on the conflicting British and American clinical risk assessments of triazolam (Halcion) - the most controversial sleeping pill in the world. The regulation of triazolam is shown to be more permissive in the USA than in the UK. Six principal socio-political factors are put forward to explain this; differential regulatory trust; regulators' socio-technical data selections; medico-scientific disciplinary influences; organizational and professional interests; conflicts of interest of expert advisers; and the growth of the neo-liberal regulatory state. The risk assessments of both the British and American regulatory agencies are shown to be complacent relative to technical standards which the agencies themselves later accepted. It is suggested that, when the interests of pharmaceutical manufacturers and patients diverge, regulatory assessments are crucially affected by whether regulators are predisposed to award the benefit of the scientific doubts to the manufacturers or patients, and by the balance of such predispositions both within and between regulatory institutions of scientific expertise. The triazolam case indicates that the amount of trust placed in the pharmaceutical industry by the British American regulatory systems may hamper detection of flaws in manufacturers' medical data in a timely manner and, as a consequence, compromise patients' interests. Some policy implications for drug regulation are sketched.     

Four-year changes in college athletes' ethical value choices in sports situations.

Positive values for fairness in competition are supposed to undergird the behavior of athletes engaged in sport. Whether athletes' values actually develop over 4 years in a college that emphasizes character development is the focus of this study. Athletes' (N = 631) use of deontological ethics (Hahm, Beller & Stoll, 1989) in 21 sports value dilemmas were evaluated. At entrance, as well as near graduation, intercollegiate athletes' value scores were lower than intramural athletes' scores. Both groups' scores declined while they were in college. Individual-sport athletes had higher scores than team-sport athletes but manifested a greater decline over 4 years. The findings are consistent with other studies that show decreases in "sportsmanship orientation" and an increase in "professional" attitudes associated with participation in sport.     

GaIN (Georgia Interactive Network for Medical Information) study on health professionals' search requests and continuing education needs

Health sciences librarians are being called upon to be more proactive in their institutions' continuing education efforts. In an effort to identify whether search requests indicated CE needs, a study was conducted by a group of members of GaIN (Georgia Interactive Network for Medical Information). MEDLINE requests from health care professionals for subject specific clinical topics were collected during a six-month period via a standard search request form created for the study. Copies of all completed requests were collected and broad ICD-9 codes assigned to the search topics. Institutional reports were generated for each participating library to share with hospital CE coordinators. They were also compiled for the group as a whole, and reflected the "hottest" topics requested during the study period for physicians and for non-physicians (nurses, allied health, administrators). A survey to hospital librarians and CE educators showed some value in the reports, but greater potential for further collaboration between librarians and CE coordinators.     

Digital information evolution: the AIDS Library experience

The AIDS Library evolved out of consumer health activism in response to the need for the latest HIV information, materials, and technology. In 1998, staff implemented a microcomputer-based integrated automated library system with Web publishing capability to link catalogs, databases of Philadelphia regional services, online publications, and fact sheets. The Web site, , became "live" December 1, 1998. History leading to its development and future plans are presented.     

The comparative importance of books: clinical psychology in the health sciences library

Clinical psychology has received little attention as a subject in health sciences library collections. This study seeks to demonstrate the relative importance of the monographic literature to clinical psychology through the examination of citations in graduate student theses and dissertations at the Fordham Health Sciences Library, Wright State University. Dissertations and theses were sampled randomly; citations were classified by format, counted, and subjected to statistical analysis. Books and book chapters together account for 35% of the citations in clinical psychology dissertations, 25% in nursing theses, and 8% in biomedical sciences theses and dissertations. Analysis of variance indicates that the citations in dissertations and theses in the three areas differ significantly (F = 162.2 with 2 and 253 degrees of freedom, P = 0.0001). Dissertations and theses in biomedical sciences and nursing theses both cite significantly more journals per book than the dissertations in clinical psychology. These results support the hypothesis that users of clinical psychology literature rely more heavily on books than many other users of a health sciences library. Problems with using citation analyses in a single subject to determine a serials to monographs ratio for a health sciences library are pointed out.     

Tracing the evolution of critical evaluation skills in students' use of the Internet

This paper documents the evolving uses of the Internet made by public health graduate students and traces the development of their search methods and critical evaluative criteria. Early in the first semester and again six months later, twenty-four graduate students in a problem-based learning curriculum, which emphasizes evidence-based critical thinking skills, were required to describe their most helpful resources and to evaluate these resources critically. The answers were coded for the types of resources the students used, how frequently they were used, and why they were used. Student perception of the usefulness of resources, especially the Internet, and ability to evaluate these resources critically changed greatly. Initially, 96% of the students stated that the Internet was their most helpful resource. Six months later, these students continued to use the Internet; however, it was not their most useful source. At the later point, students had very specific uses for the Internet. Their most frequently used evaluation criterion was the reliability and objectivity of the source of the information. By the end of the first year of study, the majority of the students demonstrated an understanding of the principles of evidence-based practice and applied them to their research and analysis of information resources.