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This paper looks at libraries as a $10 billion industry and identifies ways in which libraries and businesses are similar.

Previous research has demonstrated that a hypnotic intervention can reduce hot flashes, a significant problem for some women. Based on the authors' previous research, the present study was developed to evaluate the feasibility of a guided self-hypnosis intervention for hot flashes. Thirteen postmenopausal women received 5 sessions of guided self-hypnosis in which all hypnotic inductions were recordings. Guidance regarding symptom monitoring, individualization of mental imagery, and practice of self-hypnosis were provided. Hot flashes were determined through diaries. Results indicated average frequency of hot flashes decreased by 72% (p < .001) and hot-flash scores decreased by 76% (p < .001) on average. Guided self-hypnosis reduced perceived hot flashes in the pilot study with postmenopausal women supporting the possible feasibility and potential benefit of the intervention.

Introduction Burn injuries are often considered to be one of the most physically and psychologically damaging experiences an individual may endure. Because of this, more treatment options for managing pain and distress during burn wound debridement are needed. When used in combination with traditional treatment, medical hypnosis may offer health-care professionals an option for meeting the needs of patients with burn wounds. This article offers a critical review of the literature currently available on the efficacy of medical hypnosis for managing pain and distress during wound debridement and offers suggestions for an improved methodology for future trials. Materials and Methods MEDLINE, PsycINFO, Psyc ARTICLES, HealthSource: Nursing Edition, PubMed and Google Scholar were searched using the keywords ‘hypnosis’, ‘burn wounds’, ‘pain’ and ‘debridement’. Additional articles were selected from the bibliographies of representative literature. All experimental and quasi- experimental studies investigating the efficacy of hypnosis for managing pain and psychological distress during wound debridement were included in our results. Results Six studies involving a total of 217 participants met our inclusion criteria. The results of these studies suggest that hypnosis may be more effective than structured attention for reducing patients’ pain and anxiety levels during wound debridement. However, results are inconclusive due to oversights in study design, and additional studies that correct these design flaws are needed. Conclusion The existing evidence suggests that medical hypnosis may be effective in managing pain and distress for burn victims who have difficulty coping during wound debridement. Further investigation is warranted.

The use of estrogen and progesterone to manage vasomotor symptoms (ie, hot flashes and night sweats) has declined because of concerns about their risks, and there is an increased interest in alternate, effective, and low-risk treatments. This study reports the results of a randomized controlled trial of clinical hypnosis for treating vasomotor symptoms among postmenopausal women.This is a randomized, single-blind, controlled, clinical trial involving 187 postmenopausal women reporting a minimum of seven hot flashes per day (or at least 50 hot flashes a week) at baseline between December 2008 and April 2012. Eligible participants received five weekly sessions of either clinical hypnosis or structured-attention control. Primary outcomes were hot flash frequency (subjectively and physiologically recorded) and hot flash score assessed by daily diaries on weeks 2 to 6 and week 12. Secondary outcomes included measures of hot flash-related daily interference, sleep quality, and treatment satisfaction.In a modified intent-to-treat analysis that included all randomized participants who provided data, reported subjective hot flash frequency from baseline to week 12 showed a mean reduction of 55.82 (74.16%) hot flashes for the clinical hypnosis intervention versus a mean reduction of 12.89 (17.13%) hot flashes for controls (P0.001; 95% CI, 36.15-49.67). The mean reduction in hot flash score was 18.83 (80.32%) for the clinical hypnosis intervention as compared with 3.53 (15.38%) for controls (P0.001; 95% CI, 12.60-17.54). At 12-week follow-up, the mean reduction in physiologically monitored hot flashes was 5.92 (56.86%) for clinical hypnosis and 0.88 (9.94%) for controls (P0.001; 95% CI, 2.00-5.46). Secondary outcomes were significantly improved compared with controls at 12-week follow-up: hot flash-related interference (P0.001; 95% CI, 2.74-4.02), sleep quality (P0.001; 95% CI, 3.65-5.84), and treatment satisfaction (P0.001; 95% CI, 7.79-8.59).Compared with structured-attention control, clinical hypnosis results in significant reductions in self-reported and physiologically measured hot flashes and hot flash scores in postmenopausal women.

This paper traces the development of management as a “science” and into the 1970s as one management “fad” replaces another. A sample of “fads” is discussed and some contrarian viewpoints expressed.

This paper looks at Total Quality Management (TQM) and how it fits into organizational change. TQM's emphasis on customer service and empowerment falls right in line with current thinking on organizational change. However, the commitment to TQM should be organization-wide, which is hard to obtain.

Psychological stress in cancer patients has been identified as a significant and ongoing problem in oncology. Non-pharmacological interventions have been increasingly employed to facilitate coping with stressful circumstances. Mind-body therapies, which approach healthcare holistically as an interaction between mind, body, and spirit, have been studied as adjunctive therapies to reduce stress, enhance relaxation, reduce anxiety, and improve health outcomes. Mind-body therapies, including mindfulness/meditation, biofeedback, hypnosis, relaxation therapy, art therapy, Qigong, Taichi, and yoga have demonstrated efficacies in their potential to mitigate stress and improve the quality of life of cancer patients and survivors. Though the mind-body literature shows overwhelmingly positive results, methodological deficits hinder adoption as evidence-based palliative care for cancer survivors. Although additional research is warranted, the body of evidence presented in this chapter suggests that clinicians should give serious consideration to mind-body therapies when advising cancer patients and survivors on adjunctive treatment options.

To review current knowledge about emergency contraception (EC), including available options, their modes of action, efficacy, safety, and the effective provision of EC within a practice setting.The combined estradiol-levonorgestrel (Yuzpe regimen) and the levonorgestrel-only regimen, as well as post-coital use of copper intrauterine devices, are reviewed.Efficacy in terms of reduction in risk of pregnancy, safety, and side effects of methods for EC and the effect of the means of access to EC on its appropriate use and the use of consistent contraception.Studies published in English between January 1998 and March 2010 were retrieved though searches of Medline and the Cochrane Database, using appropriate key words (emergency contraception, post-coital contraception, emergency contraceptive pills, post-coital copper IUD). Clinical guidelines and position papers developed by health or family planning organizations were also reviewed.The studies reviewed were classified according to criteria described by the Canadian Task Force on Preventive Health Care, and the recommendations for practice were ranked according to this classification (Table 1).These guidelines are intended to help reduce unintended pregnancies by increasing awareness and appropriate use of EC.The Society of Obstetricians and Gynaecologists of Canada. Summary Statements 1. Hormonal emergency contraception may be effective if used up to 5 days after unprotected intercourse. (II-2) 2. The earlier hormonal emergency contraception is used, the more effective it is. (II-2) 3. A copper IUD can be effective emergency contraception if used within 7 days after intercourse. (II-2) 4. Levonorgestrel emergency contraception regimens are more effective and cause fewer side effects than the Yuzpe regimen. (I) 5. Levonorgestrel emergency contraception single dose (1.5 mg) and the 2-dose levonorgestrel regimen (0.75 mg 12 hours apart) have similar efficacy with no difference in side effects. (I) 6. Of the hormonal emergency contraception regimens available in Canada, levonorgestrel-only is the drug of choice. (I) 7. A pregnancy that results from failure of emergency contraception need not be terminated (I) Recommendations 1. Emergency contraception should be used as soon as possible after unprotected sexual intercourse. (II-2A) 2. Emergency contraception should be offered to women if unprotected intercourse has occurred within the time it is known to be effective (5 days for hormonal methods and up to 7 days for a copper IUD). (II-2B) 3. Women should be evaluated for pregnancy if menses have not begun within 21 days following emergency contraception treatment. (III-A) 4. During physician visits for periodic health examinations or reproductive health concerns, any woman in the reproductive age group who has not been sterilized may be counselled about emergency contraception in advance with detailed information about how and when to use it. (III-C).

Purpose Hot flashes are a significant clinical problem for many women. Currently there are limited options to hormone replacement therapy as non-hormonal pharmacological agents are associated with only modest activity and many adverse side effects. Hypnosis is one mind-body therapy that seems particularly promising for treating hot flashes and was investigated in the present study. This study examined the efficacy of hypnosis in reducing both self-reported and physiologically determined hot flash frequency and severity among post-menopausal women.

Patients receiving chemotherapy for cancer are at increased risk for venous thromboembolism. Limited data support the clinical benefit of antithrombotic prophylaxis.In this double-blind, multicenter trial, we evaluated the efficacy and safety of the ultra-low-molecular-weight heparin semuloparin for prevention of venous thromboembolism in patients receiving chemotherapy for cancer. Patients with metastatic or locally advanced solid tumors who were beginning to receive a course of chemotherapy were randomly assigned to receive subcutaneous semuloparin, 20 mg once daily, or placebo until there was a change of chemotherapy regimen. The primary efficacy outcome was the composite of any symptomatic deep-vein thrombosis, any nonfatal pulmonary embolism, and death related to venous thromboembolism. Clinically relevant bleeding (major and nonmajor) was the main safety outcome.The median treatment duration was 3.5 months. Venous thromboembolism occurred in 20 of 1608 patients (1.2%) receiving semuloparin, as compared with 55 of 1604 (3.4%) receiving placebo (hazard ratio, 0.36; 95% confidence interval [CI], 0.21 to 0.60; P0.001), with consistent efficacy among subgroups defined according to the origin and stage of cancer and the baseline risk of venous thromboembolism. The incidence of clinically relevant bleeding was 2.8% and 2.0% in the semuloparin and placebo groups, respectively (hazard ratio, 1.40; 95% CI, 0.89 to 2.21). Major bleeding occurred in 19 of 1589 patients (1.2%) receiving semuloparin and 18 of 1583 (1.1%) receiving placebo (hazard ratio, 1.05; 95% CI, 0.55 to 1.99). Incidences of all other adverse events were similar in the two study groups.Semuloparin reduces the incidence of thromboembolic events in patients receiving chemotherapy for cancer, with no apparent increase in major bleeding. (Funded by Sanofi; ClinicalTrials.gov number, NCT00694382.).

The Epidemiological Catchment Area study found that 47% of individuals with schizophrenia have or have had an alcohol or illicit drug use disorder during their lifetime.

The role of the indigenous Kayapo in environmentalist movements that oppose large-scale development projects in the Amazon is described. The analytic focus is on the construction of environmentalism within the context of opposition to hydroelectric dams along the Xingu River. The changing pressures on the Kayapo and the effectiveness of their responses are shown to be related to successive changes in dominant political-economic relations within the Kayapo region comprised by the extractive period, the bureaucratic period, and the multinational period. Based on historical experiences, I contend that Kayapo successes have been tied to their ability to cause or threaten political disruptions. Their current adeptness in producing media images as natural ecologists is a rhetorical stance related to a specific moment in the history of development in which the ability of the Brazilian government to marshal international financing is central to economic prospects within the Amazon. How a relatively marginalized p...

This study examined Medicaid enrollment for all individuals arrested in Florida in fiscal year (FY) 2006.Florida Department of Law Enforcement arrest data were used to identify all individuals arrested in Florida in FY 2006. Arrest data were matched against Medicaid claims data to determine how many individuals had been enrolled in Medicaid in the 365 days before arrest, had used Medicaid-reimbursed behavioral health services during this period, and were enrolled in Medicaid at the time of arrest.In FY 2006, a total of 689,046 individuals were arrested in Florida. A total of 65,097 (9.5%) of those were enrolled in Medicaid before arrest, and 37,662 (5.5%) were still enrolled at the time of arrest.Because of the importance of Medicaid enrollment for service access after release from jail, the loss of enrollment among a large number of individuals has important policy implications.

Data on the impact of abnormal cervical smear results on health-related quality of life (HrQoL) are scarce. We aimed to (i) prospectively assess the HrQoL of women who were informed of an abnormal smear result; (ii) identify predictors of greater negative psychosocial impact of an abnormal result; and (iii) prospectively estimate the quality-adjusted life-years (QALYs) lost following an abnormal result.Between 08/2006 and 08/2008, 492 women with an abnormal result and 460 women with a normal result, frequency matched for age and clinic, were recruited across Canada. HrQoL was measured at recruitment and 4 and 12 weeks later with the EuroQol, Short Form-12, short Spielberg State-Trait Anxiety Inventory (STAI) and HPV Impact Profile. Three blocks of potential predictors of higher psychosocial impact were tested by hierarchical modeling: (i) socio-demographics; (ii) sexual activity; and (iii) smear result severity, communication, and understanding.Receiving an abnormal result significantly increased anxiety (STAI mean difference between both groups = 8.3). Initial anxiety decreased over time for the majority of women. However, 35% of women had clinically meaningful anxiety at 12 weeks (i.e. STAI scores ≥0.5 standard deviation of the controls). These women reported a lower socio-economic level, did not completely understand the information about their result and perceived themselves at higher risk of cancer. QALY lost following an abnormal result were between 0.007 and 0.009.Receiving an abnormal smear has a statistically significant and clinically meaningful negative impact on mental health. However, this negative impact subsides after 12 weeks for the majority of women.

Logical Memory and Visual Reproduction subtests of the Wechsler Memory Scale-Revised (WMS-R) were administered as a part of a comprehensive neuropsychological test battery to 50 inpatient and outpatient male veterans (M = 52 years) with diagnoses of neurologic, alcoholic, and psychiatric conditions. Tests were scored blindly by two trained examiners and kappa values were reported for Logical Memory text, and individual scoring criteria for Visual Reproductions. Almost perfect interrater agreement beyond chance was generally observed, thus replicating excellent interrater reliability obtained from a healthy normative sample. Mild variability (moderate agreement) on individual items is discussed.

This paper traces the developments of the past 40 years that have impacted the way publishers, vendors, and libraries operate and interact among themselves. Five areas of current concern are noted.

There is growing interest in mind-body therapies as adjuncts to mainstream cancer treatment, and an increasing number of patients turn to these interventions for the control of emotional stress associated with cancer. Increased research funding has enabled many such interventions to be evaluated for their efficacy, including studies of mind-body interventions to reduce pain, anxiety, insomnia, anticipatory, and treatment-related nauseas, hot flashes, and improved mood. Mind-body treatments evaluated for their utility in oncology include relaxation therapies, biofeedback, meditation and hypnosis, yoga, art and music therapy, tai chi, and qigong. Although studies are not always methodologically sound and results mixed, a growing number of well-designed studies provide convincing evidence that mind-body techniques are beneficial adjuncts to cancer treatment. The evidence is sufficient to recommend further investigation and adoption of these techniques in mainstream oncology care.

The assessment, treatment and management of aggressive youth represent a major clinical challenge facing pediatric mental health professionals today. Although a number of studies have examined physiological differences among aggressive patients vs. controls, the current literature lacks a comprehensive examination of the electroencephalographic activity of impulsively aggressive juveniles. The current study was designed to fill this void in the literature via a retrospective chart review of 80 male and female juveniles undergoing inpatient treatment for pathologically impulsive aggression. Clinical reports for mid- and late-latency event-related potentials (ERPs) were examined to determine their correlations with aggression characteristics, as well as any differential predictive utility of hemispheric differences and auditory vs. visual potentials. Results indicated that decrements of mid-latency potentials and ERPs evoked by auditory stimuli (vs. late-latency components and visual ERPs) were more highly predictive of aggressive behavior. No significant hemispheric differences were noted. Taken together, these results have theoretical significance for the etiology of impulsive aggression, and perhaps also clinical relevance for the treatment of this condition.

This paper looks at electronic publishing and its potential impact on the publication and distribution of library materials. Potential barriers to the “electronic library”e are also discussed.

William Fisher received his Ph.D. in mathematics from the University of Oregon in 1974 and is currently a professor of mathematics at California State University, Chico. His profes? sional interests are in mathematics education, and he is actively involved in many in-service projects with area teachers. He continually strives to have students actively involved in the process of doing mathematics. Bill enjoys fly-fishing and cycling; in fact, ideas for this paper stem from training for a century ride the authors recently completed.

Summary Two cases of Paget's disease of bone are presented in which nasal symptoms were prominent. The clinical and radiographic features of Paget's disease of the maxilla and ethmoids are described. Medical and surgical treatment is discussed with the recommendation that surgery is kept to a minimum and covered by prophylactic antibiotics to prevent osteomyelitis. Sudden enlargement of the involved bones should raise the suspicion of malignancy.

This report documents the validation of the stand-alone Standard Mobility Application Programming Interface (STNDMob API) at Fidelity I and 2, hereafter referred to as the STNDMob. Fidelity 1 and 2 functionality addresses the lower resolution speed prediction capability of STNDMob, Version 3.2.3.0. Future efforts may consider STNDMob's medium resolution speed prediction capability referred to as Fidelity 3 and 4. At the time of this writing, the validation of Fidelity 3 and 4 functionality is not planned. The North Atlantic Treaty Organization Reference Mobility Model II (NRMM) Version 2.7.2 is the standard by which the STNDMob Fidelity 1 and 2 predictions were validated. The Training and Doctrine Command Analysis Center (TRAC) is the developer of the Combined Arms Analysis Tool for the 21St Century (COMBAT XX!) model. TRAC has designated the U.S. Army Materiel Systems Analysis Activity (AMSAA) as the verification and validation (V&V) agent for the physical algorithms. COMBAT XXI is the Army's next generation Brigade and below combat effectiveness simulation. COMBAT XXI will allow for higher fidelity ground mobility predictions relative to legacy combat effectiveness models. The core element that allows COMBAT XXI to effectively simulate mobility at these higher fidelity levels is the STNDMob. It was determined that a validation of the stand-alone STNDMob prior to its integration with COMBAT XXI was appropriate. The STNDMob is being developed by the U.S. Army Corps of En ineers, Engineer Research and Develoment Center (ERDC).

To investigate the contraception and sexual health-related awareness, attitudes, and practices of a representative sample of Canadian women of childbearing age.A self-report survey was mailed to a national sample of 3345 women, aged 15 to 44 years, who were members of a pre-recruited market research panel. Survey questions and methodology were similar to 3 previous Canadian Contraception Studies, allowing for description of current patterns of behaviours and beliefs and comparison of trends over time.Of 3345 women contacted, 1582 returned completed surveys, for a response rate of 47.3%. Responses were weighted to represent Canadian women by region, age, and marital status on the basis of current census data. Eighty-six percent of women sampled had ever had sexual intercourse and 78% were currently sexually active. Women's familiarity with oral contraceptives and condoms as methods of contraception was high (96% and 93%, respectively), but familiarity with other methods was much lower (sterilization, 62%; withdrawal, 59%; the morning-after pill, 57%; intrauterine devices, 50%; depot [injectable] medroxyprogesterone acetate, 38%). A very favourable opinion was held by 63% of respondents concerning oral contraceptives, by 38% concerning condoms, and by 39% and 28% concerning male and female sterilization, respectively. Among respondents who have ever had sexual intercourse, the most frequently used current methods were oral contraceptives (32%), condoms (21%), male sterilization (15%), female sterilization (8%), and withdrawal (6%). Nine percent of these respondents reported using no method of contraception at all. The currently reported rate of female sterilization is the lowest ever recorded in Canada. Survey results show that adherence to contraceptive methods is a challenge for many women and their partners, and that risk of sexually transmitted disease is an ongoing concern.This study provides a wide-ranging examination of contraception awareness, beliefs, and use among Canadian women that may provide guidance for clinical and public health practice. Part 1 of this report describes the methodology of the 2002 Canadian Contraception Study and the overall results of this study; Part 2 considers results pertaining specifically to adolescent women and women in their later reproductive years, reports on indicators of women's sexual function and reproductive health history, describes approaches to addressing challenges in contraception counselling, and presents data concerning trends in Canadian women's awareness and use of contraception over the past 2 decades.

The Royal College of Surgeons in Edinburgh has launched career guidance groups for surgeons. The “professional excellence groups” will provide guidance for surgeons on career progression and …

(1991). Education for acquisitions: An informal survey. Library Acquisitions: Practice & Theory: Vol. 15, No. 1, pp. 29-31.

The glycosaminoglycan, hyaluronan, can be detected in human synovial fluid by capillary electrophoresis (CE). Variations in peak shape make this technique unsuitable for quantitative analysis of hyaluronan in raw synovial fluid. Quantitative analysis was achieved by hydrolysis of the polymeric hyaluronan to the tetrasaccharide by the action of testicular hyaluronidase and separation of the product using CE. A UV detector operating at 200 nm was used. The X-ray contrast material, omnipaque, a propriety aqueous solution of iohexol was used as internal standard. A second peak in the electropherogram of synovial fluid was quantified. The variation in concentrations of these two components correlate with the arthritic disease state of a joint.

The Air Travel Information System (ATIS) domain serves as the common evaluation task for ARPA spoken language system developers. To support this task, the Multi-Site ATIS Data COllection Working group (MADCOW) coordinates data collection activities. This paper describes recent MADCOW activities. In particular, this paper describes the migration of the ATIS task to a richer relational database and development corpus (ATIS-3) and describes the ATIS-3 corpus. The expanded database, which includes information on 46 US and Canadian cities and 23,457 flights, was released in the fall of 1992, and data collection for the ATIS-3 corpus began shortly thereafter. The ATIS-3 corpus now consists of a total of 8297 released training utterances and 3211 utterances reserved for testing, collected at BBN, CMU, MIT, NIST and SRI. 2906 of the training utterances have been annotated with the correct information from the database. This paper describes the ATIS-3 corpus in detail, including breakdowns of data by type (e.g. context-independent, context-dependent, and unevaluable)and variations in the data collected at different sites. This paper also includes a description of the ATIS-3 database. Finally, we discuss future data collection and evaluation plans.

L'auteur examine le niveau de formation de 124 bibliothecaires travaillant tous dans des bibliotheques specialisees et il evalue 11 elements de formation. Les conclusions de cette etude soulignent l'importance d'une formation polyvalente des specialistes de l'information

A survey was conducted among special libraries as to their use of government publications. It was found that most of the special libraries sampled do acquire and use government publications, but there appears to be no systematic way in which these publications are acquired, classified, or housed. This preliminary report suggests the need for further study of this seemingly neglected area of document usage in the special library environment.

Standard weeding criteria of age of the material and last date of circulation were both applied to the same collection of business/economics material in an academic library. Eight per cent of the collection was found to be weedable based on age, and 30% was found to be weedable based on past use. The conclusion from this study was to recognize both criteria and weed only the older and little-used material.

It is unfortunate, but students in high school algebra and geometry classes of- tentimes do not get to see some very useful applications of their studies. I’m thinking specifically of problems that in- volve finding maxima and minima. These types of problems are generally thought of as part of calculus and are usually avoided until then.

The use of United States federal government publications by the science and engineering faculty of UCLA is examined. Replicating a study performed by Peter Hernon in 1979, this study describes and analyzes information-seeking behavior. It further tests Hernon's hypothesis that the use of documents by faculty does not differ significantly from one discipline to another. The results of this study support previous findings, indicating that federal government documents are under-utilized, especially by scientists, engineers, and faculty. Results also suggest that when using federal government documents, scientists and engineers exhibit atypical information-seeking behavior.