Development and validation of the Anaesthetic Theatre Educational Environment Measure (ATEEM).

The Anaesthetic Trainee Theatre Educational Environment Measure (ATEEM) was developed to measure the educational environment for trainee anaesthetists in the theatre setting using similar methodology to that of other existing tools. The ATEEM was administered to 271 anaesthetic trainees three months into their post of whom 218 (80%) responded. The ATEEM showed that trainees' perceptions of their educational environments do vary and that this inventory is capable of identifying problem areas that can be remediated by training managers.

From task force to statute: establishing health sciences libraries in state law as a component of the health care system.

This paper describes how Montana librarians successfully incorporated health sciences libraries into the statewide health care resource management plan being developed under 1993 state law. First, a broad-based Montana Task Force for Biomedical Information was formed with funds from the National Network of Libraries of Medicine/Pacific Northwest Region and the Montana Area Health Education Center. The resulting report reviewed findings from national studies and trends to current state developments and deficiencies. The report was presented to the governor and state legislators in the context of cost-containment measures being considered in the state's health care reform bill. Now Montana law provides that "it is further the policy of the state of Montana that the health care system should ... facilitate universal access to current health sciences information," and "The management plan must include ... identification of the current supply and distribution of ... health sciences library resources and services." This experience highlights the need for health sciences librarians to develop skills in advocacy, lobbying, and networking with other components of the health care industry.

Health impacts of AT&T's Total Life Concept (TLC) program after five years.

For study group participants who returned for measurement in 1988, the health promotion program appeared to have a limited effect on health risk indicators and a positive effect on health-related attitudes. The data suggest that decreases in smoking and alcohol consumption may be attributed to the program. The combined evidence after 5 years of improved health behaviors, better health attitudes, and self-reports of lifestyle improvements suggests that the program has a positive impact on habit and attitude changes.

Community hospitals and the Internet: lessons from pilot connections.

Community hospitals in rural and isolated areas have had little access to the Internet. In 1992, the National Library of Medicine funded a pilot project to be conducted by the University of Washington and seven community hospitals in the northwestern United States. The goals of the project were to connect the hospitals to the Internet and study the uses made of this resource. A number of administrative, technical, financial, and organizational problems were dealt with in the attempt to establish the Internet connections and introduce this resource to these health care settings. This paper examines these issues and presents conclusions drawn from the experiences of the project team.

Microcephaly: general considerations and aids to nosology.

Microcephaly is defined as an occipito-frontal head circumference (OFC) 2 or more standard deviations below the mean for age and sex using the new Roche et al. [Pediatrics 1987;79:706-712] charts, and corrected for parental OFC by the method of Weaver and Christian [J Pediatr 1980;96:990-994]. "Relative" microcephaly, i.e., a small head on a small child, may be associated with a much better intellectual prognosis than absolute microcephaly, although the average IQ of children with absolute microcephaly ascertained in a normal school system is normal when compared with that of appropriate control children. "Primary" microcephaly means an abnormal OFC at birth (corrected for gestational age and length), and "secondary" microcephaly a normal birth OFC with later, acquired microcephaly due to deceleration of brain growth reflecting infection, trauma, intoxication, metabolic disease, the Rett syndrome, or a true CNS degenerative disease. Some cases of syndromal microcephaly may be associated with normal intelligence including some "primordial dwarfs," children with Dubowitz syndrome, FAS, mild SC-Roberts syndrome, and an occasional Brachmann-de Lange individual. The nosology of (syndromal) microcephaly is extraordinarily complex and requires the assistance of special library resources and information retrieval expertise. At a minimum, it requires McKusick's Catalog of Mendelian Inheritance in Man (MIM); however, we find that our work is greatly enhanced by recently developed electronic databases such as MIM-online (OMIM), POSSUM, SYNDROME, and MEDLINE, as well. Three groups of syndromal and non-syndromal microcephaly are discussed selectively in order to illustrate the marvels of pleiotropy in human development and its abnormalities and the difficulties encountered in splitting and lumping entities with overlapping manifestations.