In Case of Emergency: Implementing Disaster Clauses in Publisher Contracts

Joanne Romano, Licensing and Serials Librarian for The Texas Medical Center Library, presented “In Case of Emergency--Implementing Disaster Clauses in Publisher Contracts” to the National Network of Libraries of Medicine/Southeastern/Atlantic Region’s Emergency Response and Preparedness Advisory Committee, (NN/LM-SE/A ERAC) on November 17, 2010, in St. Petersburg, FLA at the Marriott Vinoy Renaissance Resort. Included were slides of the devastation after the 8.8 magnitude earthquake in the Maule region of Chile, how The TMC Library assisted, lessons learned, and advice for how to include disaster clauses in publisher licenses. The NN/LM-SE/A ERAC group invited Ms. Romano to present at their bi-meeting after learning of her library’s key role from other NLM officers. As a result, Ms. Romano was then invited as a guest speaker on for NN/LM-SE/A region’s annual webinar, “Beyond the Sea”, which also included speakers from John Wiley & Sons, Inc., the publisher who worked with The TMC Library in providing emergency access to researchers at the University de Talca, Talca, Chile.

Nutrition knowledge and attitudes of physician assistants in Texas

Physician Assistants (PAs) are increasingly assuming more responsibilities as "front-line" health providers due to emphasis on primary care and cost-containment in the rapidly changing health care environment. Nutrition plays an important role in health promotion and disease prevention. Primary care providers, including PAs, have enormous potential as nutrition counselors and advocates. There have been no studies to date that address the PAs' adequacy of nutrition education or their attitudes toward the value of nutrition. Therefore, it was the purpose of the study to determine the nutrition knowledge and attitudes of PAs in Texas.^ All certified physician assistants in Texas were eligible for the study. A mailed survey was sent to 1,482 PAs in Texas with a response rate of 54.2%. The sample utilized for data analysis was 764 PAs.^ The study compared the nutrition knowledge mean scores for PAs who graduated from a PA program greater than 11 years ago with those who graduated less than 11 years ago. The study also examined Texas PAs' attitudes about their nutrition education training, the value of nutrition counseling, and their perceived ability to provide such nutrition counseling. Demographic and practice information was collected from the PAs. Demographically, PAs in Texas were found to be comparable to the national population of PAs surveyed in 1996.^ The overall mean level of nutrition knowledge was 70% correct. The mean level of nutrition knowledge was significantly related to the type of PA program that the PA graduated from (i.e., Certificate only or Master's degree level). No significant relationships were found between the mean nutrition knowledge score and age, year of graduation, length of practice, or the type of nutrition education provided in PA program.^ The majority of the PAs surveyed felt that diet and nutrition has an important role in disease prevention and felt that PA programs should place a greater emphasis on nutrition education. Many PAs surveyed were not satisfied with the amount of nutrition education they had received in their PA education programs and were not confident in their ability to provide nutrition counseling to patients.^ Suggestions are offered for improvement in PA nutrition education in the areas of both nutrition knowledge and patient counseling skills. In addition, this study recommends developing and strengthening partnerships between PAs and nutrition organizations. ^

Factors associated with needle sharing among Black male injection drug users in Harris County, Texas

Background. Injection drug users (IDUs) are at increased risk for HIV transmission due to unique risk behaviors, such as sharing needles. In Houston, IDUs account for 18% of all HIV/AIDS cases among Black males. ^ Objectives. This analysis compared demographic, behavioral, and psychosocial characteristics of needle sharing and non-sharing IDUs in a population of Black males in Harris County, Texas. ^ Methods. Data used for this analysis were from the second IDU cycle of the National HIV Behavioral Surveillance System. This dataset included a sample of 288 Black male IDUs. Univariate and multivariate statistical analysis were performed to determine statistically significant associations of needle sharing in this population and to create a functional model to inform local HIV prevention programs. ^ Results. Half of the participants in this analysis shared needles in the past 12 months. Compared to non-sharers, sharers were more likely to be homeless (OR=3.70, p<0.01) or arrested in the past year (OR=2.31, p<0.01), inject cocaine (OR=2.07, p<0.01), report male-to-male sex in the past year (OR=6.97, p<0.01), and to exchange sex for money or drugs. Sharers were less likely than non-sharers to graduate high school (OR=0.36, p<0.01), earn $5,000 or more a year (OR=1.15, p=0.05), get needles from a medical source (OR=0.59, p=0.03), and ever test for HIV (OR=0.17, p<0.01). Sharers were more likely to report depressive symptoms (OR=3.49, p<0.01), lower scores on the family support scale (mean difference 0.41, p=0.01) and decision-making confidence scale (mean difference 0.38, p<0.01), and greater risk-taking (mean difference -0.49, p<0.01) than non-sharers. In a multivariable logistic regression, sharers were less likely to have graduated high school (OR=0.33, p<0.01) and have been tested for HIV (OR=0.12, p<0.01) and were more likely to have been arrested in the past year (OR=2.3, p<0.01), get needles from a street source (OR=3.87, p<0.01), report male-to-male sex (OR=7.01, p<0.01), and have depressive symptoms (OR=2.36, p=0.02) and increased risk-taking (OR=1.78, p=0.01). ^ Conclusions. IDUs that shared needles are different from those that did not, reporting lower socioeconomic status, increased sexual and risk behaviors, increased depressive symptoms and increased risk-taking. These findings suggest that intervention programs that also address these demographic, behavioral, and psychosocial factors may be more successful in decreasing needle sharing among this population.^

A look at parent-adolescent processes and adolescent sexual intentions among urban, minority, middle school youth

Background. The United States continues to have the highest rates in teenage pregnancy among industrialized nations and approximately 46% of high school students engaged in sex by the time they graduated. Various family adolescent processes (family connectedness, perceived parental beliefs about sex, parent-child communication about sex) have been linked to adolescent sexual behavior. However, the association between family adolescent and adolescent sexual intentions has not often been studied in middle school minority youth.^ Methods. Research hypotheses were tested using a secondary data analysis from a HIV, STI, and pregnancy prevention program for urban middle school students.^ Results. At baseline, 77% of students reported low intentions to engage in vaginal or oral sex within a year and 87% reported they would use a condom if having sex within the next 3 months. After adjusting for gender, age, and race/ethnicity, family connectedness and perceived parental beliefs about sex were significantly associated with vaginal and oral sex intentions. Only perceived parental beliefs was associated with condom use intentions. ^ Conclusions. Family adolescent processes appear to be associated with adolescents’ intentions regarding sex and condom use. Early interventions are needed that take into account the importance of healthy, supportive parent-adolescent relationships and encourage parents to share their beliefs about sex to adolescents before the onset of sexual activity. ^

April 25, 2012

Geneva Henry, Executive Director of the Center for Digital Scholarship, Rice University. Data rights and ownership of digital research data can impact how you use data, how others use data you've collected, and how rights are determined in collaborative research. Copyright rules governing data vary from one country to the next, making data ownership in international collaborations particularly murky. Licensing the use of data sets from the start is one way to address these issues early and provide a means for easily sharing datasets that can be cited and properly attributed. This talk with introduce issues associated with digital research data governance and how to protect your rights with data you work with.

Two Obstetrical Heresies

Dr. Silas F. Starley deplores what he considered errors generally taught and accepted in the late 19th century in Two Obstetrical Heresies . “The first is the part that membranes containing the amniotic fluid and the foetus play in effecting dilation of the os uteri in the first stage of labor.The second is the supposed necessity for waiting for their rupture and the escape of the waters before applying the forceps, in every case, without exception.” Silas F. Starley (1823-1887) was born in Alabama and moved to Texas with his family in 1837. He graduated from the University of Louisville School of Medicine in 1854 and spent his professional career in Texas, ending his career in Corsicana. He was President of the State Medical Association of Texas (Texas Medical Association) in 1883 and wrote articles in Texas medical journals on various topics including obstetrics, vascular tumor, and pneumonia. Texas State Historical Association, http://www.tshaonline.org/handbook/online/articles/sat05 , accessed 10/16/2012. Texas Physicians Historical Biographical Database, http://www4.utsouthwestern.edu/library/doctors/doctors.cfm?DoctorID=16809 , accessed 10/16/12.

On Bayesian seamless phase I-II designs

Early phase clinical trial designs have long been the focus of interest for clinicians and statisticians working in oncology field. There are several standard phse I and phase II designs that have been widely-implemented in medical practice. For phase I design, the most commonly used methods are 3+3 and CRM. A newly-developed Bayesian model-based mTPI design has now been used by an increasing number of hospitals and pharmaceutical companies. The advantages and disadvantages of these three top phase I designs have been discussed in my work here and their performances were compared using simulated data. It was shown that mTPI design exhibited superior performance in most scenarios in comparison with 3+3 and CRM designs. ^ The next major part of my work is proposing an innovative seamless phase I/II design that allows clinicians to conduct phase I and phase II clinical trials simultaneously. Bayesian framework was implemented throughout the whole design. The phase I portion of the design adopts mTPI method, with the addition of futility rule which monitors the efficacy performance of the tested drugs. Dose graduation rules were proposed in this design to allow doses move forward from phase I portion of the study to phase II portion without interrupting the ongoing phase I dose-finding schema. Once a dose graduated to phase II, adaptive randomization was used to randomly allocated patients into different treatment arms, with the intention of more patients being assigned to receive more promising dose(s). Again simulations were performed to compare the performance of this innovative phase I/II design with a recently published phase I/II design, together with the conventional phase I and phase II designs. The simulation results indicated that the seamless phase I/II design outperform the other two competing methods in most scenarios, with superior trial power and the fact that it requires smaller sample size. It also significantly reduces the overall study time. ^ Similar to other early phase clinical trial designs, the proposed seamless phase I/II design requires that the efficacy and safety outcomes being able to be observed in a short time frame. This limitation can be overcome by using validated surrogate marker for the efficacy and safety endpoints.^