Reminder: NLM Gateway Changing
Reminder: NLM Gateway Changing
On December 1, 2011, the Lister Hill National Center for Biomedical Communications (LHNCBC) will complete the transition of the NLM® Gateway to the new LHNCBC pilot project. The new site will retain the Web address of the former NLM Gateway. It will have two databases: Meeting Abstracts and Health Services Research Projects in Progress (HSRProj). HSRProj also remains available via a separate search engine through the portal HSR Information Central.
The Meeting Abstracts database contains abstracts from HIV/AIDS, Health Services Research, and Space Life Sciences meetings and conferences. The final update to the Meeting Abstracts database is the addition of the abstracts from the 2010 18th International AIDS Conference which will be completed in December 2011. After this addition, no new meeting abstract data will be loaded.
For additional information on the transition to the pilot project, see the article NLM Gateway Transitioning to New Pilot Project Site.
NLM Gateway Transitioning to New Pilot Project Site
On December 1, 2011, the NLM® Gateway will transition to a new pilot project from the Lister Hill National Center for Biomedical Communications (LHNCBC). The current version of the NLM Gateway provides search access across multiple databases; however, all but one of these databases is available from other NLM sources, and most users of those databases search them directly and do not use the NLM Gateway. Only one database, Meeting Abstracts, is uniquely located on the Gateway system. Although NLM has invested in and supported the NLM Gateway for eleven years, based on current budget limitations and the results of evaluations of the use of NLM Gateway, the Library has recently decided to discontinue this service, as currently configured, and transition to a new pilot project site.
The new site will focus on two databases: Meeting Abstracts and Health Services Research Projects in Progress (HSRProj). A forthcoming NLM Technical Bulletin will provide more information on this new service from the LHNCBC. Once the new pilot system is available in December, the current Gateway URL will redirect any visitors to the new Web site. The Meeting Abstracts database will still be unique to this site, while HSRProj will continue to be accessible from its home site.
The Meeting Abstracts database contains selected abstracts from meetings and conferences in the subject areas of AIDS, Health Services Research, and Space Life Sciences. The last update to the Meeting Abstracts Database is anticipated to be the addition of the 2010 18th International AIDS Conference, which is expected to be loaded in the fall of 2011. After this addition, the Meeting Abstracts database will still be accessible, but no new data will be loaded.
All of the other resources currently accessed through the NLM Gateway will be available through their individual sites (see Table 1). The home sites for these systems are listed on the NLM Databases & Electronic Resources page. This directory of resources is easily located by clicking on the “All NLM Databases” link in the Databases column on theNLM homepage.
Table 1: The NLM Resources, and homepage URLs, that will no longer be available through the NLM Gateway.
If you are accustomed to the NLM Gateway cross file searching function you may want to try using the cross database features provided by TOXNET® and by the NCBI Entrez system.
The search box on the TOXNET homepage offers a cross database search function for the databases in the Toxicology Data Network (see Figures 1 and 2).

Figure 1: TOXNET homepage with “Search All Databases” feature.

Figure 2: TOXNET Search All Databases Results Page.
The NCBI global query feature on the NCBI homepage provides a cross database search feature for all of the Entrez databases (see Figures 3 and 4). Selecting “All Databases” in the search box will return a summary search page identifying possible results across all of the NCBI Entrez databases, including PubMed, PubMed Central, BookShelf, NLM Catalog, and the genetic and protein databases such as Gene, OMIM, BLAST, dbGaP, and others.
You can simply bookmark the Web page http://www.ncbi.nlm.nih.gov/gquery to access the global query search feature. However, going to the NCBI homepage may be the easier way to access this function; the NCBI logo on the top left corner of any Entrez-based system links to the NCBI homepage.

Figure 3: NCBI homepage and “All Databases” option in the search box.

Figure 4: Entrez global query search results page.
By David Gillikin
Bibliographic Services Division
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A disconnect between medical resources and health care delivery
by MAGGIE KOZEL, MD at KevinMD.com (November 27, 2011)
Imagine what health care in the United States could look like if we devised a system that was based on sound medical practice and proven cost effectiveness. What if we put our brains, energies and passion behind designing the smartest health care system possible?
That was the question that kept poking through my train of thought as I read a study that appeared in the most recent issue of Pediatrics, the official journal of the American Academy of Pediatrics. Thestudy, out of UCLA, examined the association between length of well-child visits and quality of the visits, including things like developmental screening and anticipatory guidance. No big surprise that the longer the duration of the well child visit, the greater the likelihood that the content of the visit was aligned with recommended practice guidelines from the AAP. The discouraging news however is that one third of visits were reported as being less than 10 minutes in duration; these occurred to a greater degree in private practice. Longer visits of 20 minutes or more made up 20% of the encounters, and were more likely to occur in community health centers.
The big winners in the pinch for time? Guidance on immunizations and breastfeeding were offered in 80% of even the shortest visits. The biggest loser: developmental assessments, which don’t even achieve a mediocre occurrence of 70% until we pass the 20-minute mark for visit duration….
…
Our fee for service approach to health care dictates that procedures and tests pay well while addressing a child’s emotional problem gets a doctor little more than a backed up waiting room. From the patient’s view, underinsured children have to rely too much on emergency rooms, while insured parents can only get basic child rearing advice from someone with a medical degree. Health insurance companies and the pharmaceutical industry shape medical practice – and our collective health – through their reimbursement policies, marketing and aggressive lobbying. So 25% of US children are on chronic medications, while half the children in pediatric practice are not receiving basic screening and advice. The obsolete business models that the health care industries rely on are like the tyrannosaurus-rex in the room, emphasizing expensive, short term quantity rather than cost-effective long term quality, while cognitive care – a high level of skill and expertise delivered face to face in a personal manner – is what is becoming extinct.
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