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It is questionable whether the Evidence-Based Health Care model, whereby end users appraise all potentially pertinent information, is sustainable. A shift to an Evidence-Based Practice model, featuring a new medical knowledge base infrastructure facilitating rapid translation of clinical research into practice should be embraced. This shift would offer new opportunities for health sciences librarians. In this article, the authors: (1) review milestones in the evolution of the health sciences knowledge base; (2) review the evolution of the Evidence- Based Health Care/Practice model of health information utilization; and (3) discuss the significance and implications for health sciences librarians of trends towards an increasingly digital health information environment. The authors suggest new roles for health sciences librarians: partnering to integrate advanced information management technologies into the clinical enterprise and integration into the processes for developing these technologies.  相似文献   
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The incidence of orthopedic problems was examined in 5,582 men and women who attended the Cooper Clinic in Dallas, Texas between 1974 and 1982. The effects of age, physical activity, physical fitness, and body mass index (BMI) on the occurrence of these problems were examined using a proportional hazards approach. The expected risk of orthopedic problems per person-year was 0.045 for men and 0.046 for women. For men, physical fitness, BMI, and physical activity were associated with orthopedic problems, while for women, physical activity was the main predictor. Age was not a factor for either gender. The effect of change in physical fitness, physical activity, and BMI was examined in a subset of 2,325 persons with more than one visit to the clinic. For women, physical activity and a decrease in BMI were associated with orthopedic problems, while for men none of those factors were significant. Again, age was not a factor in either group. The absence of any age effect on the occurrence of problems suggests that with regard to orthopedic problems, moderate amounts of physical activity in generally healthy persons may be recommended without special consideration as to age.  相似文献   
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