READING     

Mary C. Wilson 《The Educational forum》2013,77(1)

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The deceit continues: an updated literature review of Munchausen Syndrome by Proxy     

Sheridan MS 《Child abuse & neglect》2003,27(4):431-451

OBJECTIVE: This article presents an updated review of the literature of Munchausen Syndrome by Proxy (Factitious Disorder by Proxy, MBP). METHOD: Four hundred fifty-one cases of MBP were analyzed from 154 medical and psychosocial journal articles. RESULTS: Typical victims may be either males or females, usually 4 years of age or under. Victims averaged 21.8 months from onset of symptoms to diagnosis. Six percent of victims were dead, and 7.3% were judged to have suffered long-term or permanent injury. Twenty-five percent of victims' known siblings are dead, and 61.3% of siblings had illnesses similar to those of the victim or which raised suspicions of MBP. Mothers were perpetrators in 76.5% of cases, but as knowledge of MBP grows a wider range of perpetrators is identified. In a small number of cases, MBP was found to co-exist with secondary gain or other inflicted injury. CONCLUSION: Although published cases form a non-random sample, they add to knowledge about MBP and validate claims that it occurs. More knowledge about non-medical aspects of MBP, and more pooling of data, is desirable.  相似文献   

The influence of a 6.5% carbohydrate-electrolyte solution on performance of prolonged intermittent high-intensity running at 30 degrees C     

Morris JG  Nevill ME  Thompson D  Collie J  Williams C 《Journal of sports sciences》2003,21(5):371-381

Nine male student games players consumed either flavoured water (0.1 g carbohydrate, Na+ 6 mmol x l(-1)), a solution containing 6.5% carbohydrate-electrolytes (6.5 g carbohydrate, Na+ 21 mmol x l(-1)) or a taste placebo (Na+ 2 mmol x l(-1)) during an intermittent shuttle test performed on three separate occasions at an ambient temperature of 30 degrees C (dry bulb). The test involved five 15-min sets of repeated cycles of walking and variable speed running, each separated by a 4-min rest (part A of the test), followed by 60 s run/60 s rest until exhaustion (part B of the test). The participants drank 6.5 ml x kg(-1) of fluid as a bolus just before exercise and thereafter 4.5 ml x kg(-1) during every exercise set and rest period (19 min). There was a trial order effect. The total distance completed by the participants was greater in trial 3 (8441 +/- 873 m) than in trial 1 (6839 +/- 512, P < 0.05). This represented a 19% improvement in exercise capacity. However, the trials were performed in a random counterbalanced order and the participants completed 8634 +/- 653 m, 7786 +/- 741 m and 7099 +/- 647 m in the flavoured water (FW), placebo (P) and carbohydrate-electrolyte (CE) trials, respectively (P = 0.08). Sprint performance was not different between the trials but was impaired over time (FW vs P vs CE: set 1, 2.41 +/- 0.02 vs 2.39 +/- 0.03 vs 2.39 +/- 0.03 s; end set, 2.46 +/- 0.03 vs 2.47 +/- 0.03 vs 2.47 +/- 0.02 s; main effect time, P < 0.01). The rate of rise in rectal temperature was greater in the carbohydrate-electrolyte trial (rise in rectal temperature/duration of trial, degrees C x h(-1); FW vs CE, P < 0.05; P vs CE, N.S.). Blood glucose concentrations were higher in the carbohydrate-electrolyte than in the other two trials (FW vs P vs CE:rest, 4.4 +/- 0.1 vs 4.3 +/- 0.1 vs 4.2 +/- 0.1 mmol x l(-1); end of exercise, 5.4 +/- 0.3 vs 6.4 +/- 0.6 vs 7.2 +/- 0.5 mmol x l(-1); main effect trial, P < 0.05; main effect time, P < 0.01). Plasma free fatty acid concentrations at the end of exercise were lower in the carbohydrate-electrolyte trial than in the other two trials (FW vs P vs CE: 0.57 +/- 0.08 vs 0.53 +/- 0.11 vs 0.29 +/- 0.04 mmol x l(-1); interaction, P < 0.01). The correlation between the rate of rise in rectal temperature (degrees C x h(-1)) and the distance completed was -0.91, -0.92 and -0.96 in the flavoured water, placebo and carbohydrate-electrolyte conditions, respectively (P < 0.01). Heart rate, blood pressure, plasma ammonia, blood lactate, plasma volume and rate of perceived exertion were not different between the three fluid trials. Although drinking the carbohydrate-electrolyte solution induced greater metabolic changes than the flavoured water and placebo solutions, it is unlikely that in these unacclimated males carbohydrate availability was a limiting factor in the performance of intermittent running in hot environmental conditions.  相似文献   

Case studies from morning report: librarians' role in helping residents find evidence-based clinical information     

Atlas MC  Smigielski EM  Wulff JL  Coleman MT 《Medical reference services quarterly》2003,22(3):1-14

In primary care specialties, Morning Report is a traditional vehicle for expanding medical residents' training in diagnosis and treatment. At one academic medical center, residents and faculty in the Department of Family and Community Medicine use case-based teaching, centered around planning and reviewing patient management, to review intriguing cases from patient encounters in the department's hospital service. Seeking to improve the level of evidence-based information exchanged at Morning Report, department leaders invited reference librarians from the health sciences library to attend weekly Morning Report. The librarians saw this as an opportunity not only to improve residents' information-seeking skills, but also to improve librarians' teaching skills and understanding of the needs of users in clinical settings. This paper describes the evolution of librarians' involvement in Morning Report, examples of the kinds of contributions librarians have made in this setting, and changes made in Morning Report sessions to facilitate this activity.  相似文献   

Personal digital assistant-based drug information sources: potential to improve medication safety.     

Kimberly A Galt  Ann M Rule  Bruce Houghton  Daniel O Young  Gina Remington 《Journal of the Medical Library Association》2005,93(2):229-236

OBJECTIVES: This study compared the potential for personal digital assistant (PDA)-based drug information sources to minimize potential medication errors dependent on accurate and complete drug information at the point of care. METHODS: A quality and safety framework for drug information resources was developed to evaluate 11 PDA-based drug information sources. Three drug information sources met the criteria of the framework: Eprocrates Rx Pro, Lexi-Drugs, and mobileMICROMEDEX. Medication error types related to drug information at the point of care were then determined. Forty-seven questions were developed to test the potential of the sources to prevent these error types. Pharmacists and physician experts from Creighton University created these questions based on the most common types of questions asked by primary care providers. Three physicians evaluated the drug information sources, rating the source for each question: 1=no information available, 2=some information available, or 3 = adequate amount of information available. RESULTS: The mean ratings for the drug information sources were: 2.0 (Eprocrates Rx Pro), 2.5 (Lexi-Drugs), and 2.03 (mobileMICROMEDEX). Lexi-Drugs was significantly better (mobileMICROMEDEX t test; P=0.05; Eprocrates Rx Pro t test; P=0.01). CONCLUSION: Lexi-Drugs was found to be the most specific and complete PDA resource available to optimize medication safety by reducing potential errors associated with drug information. No resource was sufficient to address the patient safety information needs for all cases.  相似文献   

Book reviews     

P N Hirschmann  Mary Fox 《Learned Publishing》1998,11(1):77-80

Journal Publishing By Gillian Page, Robert Campbell and Jack Meadows, Cambridge: Cambridge University Press, 1997, 420 pp £35.00, ISBN: 0 521 44137 4 Small Publishers A–Z: The guide to good publishing By Daphne Macara, West Molesey: Pandor House Publications, 1997, 44pp £6.50, ISBN: 1 871248 03 5  相似文献   

The Robert Honeyman Jr. Collection Digital Archive: EAD and the Use of Library and Museum Descriptive Standards     

Mary W. Elings  Eva Garcelon 《Archives and Museum Informatics》1998,12(3-4):205-219

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Side-by-side,but from different worlds: service and resource provision by academic health sciences libraries to their affiliated hospitals     

Heather L. Brown  Ann M. Kaste 《Journal of the Medical Library Association》2009,97(4):315-317

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Community secondary schools: A case-study of a Nigerian innovation in self-help     

Mary Okoye 《International Journal of Educational Development》1986,6(4)

Changing patterns of economic, political and social development tend to produce innovations in the educational field, as the system seeks to adjust to the needs of the current situation. When Eastern Nigeria faced the aftermath of civil war, new political and educational policies contributed to produce an overwhelming demand for secondary education. This paper presents a case-study of the innovation that resulted in Anambra State, where local communities worked with the Government, providing schools for the Government to run. The success of this policy over the past decade is analysed and evaluated, indicating how educational standards were controlled.  相似文献   

Supply and demand of doctorates in economics     

Jean D. Gibbons  Mary Fish 《Research in higher education》1986,25(4):355-364

Little is known about the changes in supply and demand for economists. American universities and colleges report the awarding of 12,513 doctoral degrees in economics between 1969 and 1984, with the number randomly varying by over 500 per year. New job listings give an indication that market demand for economists between 1975 and 1984 led the supply and was far more volatile than the number of doctoral degrees awarded. Although the graduate economic specialties over the last 16 years have been relatively stable and the specialties ranked by employers have remained relatively constant, they show no comparative agreement. Graduate students may not be choosing fields of specialization that reflect the market, and institutions may not be responding to market changes.  相似文献