What one needs in Online Libraries?

free-online- booksSummary: Online libraries provide contents in a compact and easy to refer form. If you are a student or researcher, you would be very well aware of how much importance online libraries are. Like any other online source, there are the one stop hub for your academic as well as research work. It is not a easy task to keep on searching for the contents that you want. Frankly, the internet has made searching for contents easier but we always want the contents to be tailored made as per our requirement.

In a sense, if the content is as per our needs and requirements, it becomes easy for us to access it and refer it. Plus one important aspect is time saving as there would be no wastage of time and efforts. With digital libraries, it is compact and like a package. What information you want, you get it in the right format as well as content.

Now there are multiple contents online, but how would you differentiate the ones that are informative or not. The simple means is to check the source or the educational institution that is providing this content. Most of the prominent educational institutions would be having their own online libraries. Such libraries are bound to be informative as the eminent faculties and scholars would be the ones who upload the contents in them.

Referring from such educational institutions can be a great thing. In addition, the way the contents are presented plays a great role in ensuring that you have a easy go in referring them. The contents present in the digital libraries have to be in proper format and easy to refer. There should be no burden for any individual to refer them or even download. Well, some online libraries websites are quite user-friendly but there are those which don’t look pleasant and have the least amount of option to check and research for contents.

It is important that online libraries have to be quite easy to use and user-friendly. The user should be able to get the content that he or she wants without any hassle. Plus one would like to refer those digital libraries which have multiple contents in various formats. Such rich content filled websites will be quite in demand and the amount of traffic they get would be huge.

Previously, whenever anyone thinks of library, one would get the feeling of a place stacked with books all around the walls. But now it is nothing but a website which has millions of books of variety subjects jam-packed into a single website.

Online Libraries – The Best Alternative for the Conventional Libraries

best-online-librarySummary: With the help of online libraries, individuals can now save up a lot with regards to their time and effort as they only have to browse the different for books and other study references.

With the advent of several online courses by different schools and universities, the students now prefer to pursue their degrees online. The remarkable fact about studying online is that the individuals can study at their own convenience and appear for examinations whenever it is comfortable. The study materials will be made available in the online libraries so that it is possible to refer at any time.

Today, access to the information is made easy with the help of the Internet. The digital libraries not only assist the students in acquiring the online degree but also allow the students to read several eBooks and journals to acquire in-depth information about the subject. Today, thousands of libraries are available online to provide information. Access to these digital libraries is even easier. Just register yourselves with these libraries and get exclusive access to eBooks, videos, e-journals, videos and other multimedia modules.

Digital libraries are used not only by the online students but also the students who pursue their degrees in regular colleges. Any student would require textbooks and other study materials to take the examinations. Online library can help the students in cutting down the expenses for the course by rendering eBooks, e-journals and a lot more. You just have register with the e-libraries to pursue studies online thereby reduce the expenses.

In the online libraries, most of the eBooks and journals will be of renowned authors and writers. One of the added advantages related to the digital libraries is that the student can find any subject with ease. Unlike the printed books, the online books can be saved as long as you want and do not exceed the space.  With a handful of advantages of the online libraries over the normal libraries, the people of this age would desire to register themselves in the same and access the books from anywhere in the world and would enjoy reading books.

The option of reading should not be exclusive to only those people who can afford to buy books. The digital library makes it convenient for the people to access different books and references regardless to any detentions.

Digital book is in at your fingertip with the click of a mouse! Digital library is dominated over the offline libraries these days. In some places or locales, if the conventional libraries are not available, the people over there will not be aware of it. But in case of the digital libraries where no such problem occurs as it is made accessible from anywhere in the world provided computers and Internet is available.

Addition of Disease Related Contents in Texila Digipedia

disease-texila-digipedia-comSummary: TAU has started this initiative where students can get valuable contents related to dangerous and communicable diseases through its digital library.

Texila American University (TAU) has been innovative in all its venture, so it comes no surprise when it launched interesting and informative contents about diseases in its online digital library – Texila Digipedia. Given that hoards of diseases are prevailing all over the world, such information can be quite advantageous in knowing more about these diseases.

In the past various researchers and scientist have found it difficult to access informative and latest content. Not that the Internet was the last place they searched for, but somehow there was a lack of a digital collection of the medical researches and finding. Hundreds of digital libraries were there, but people found it difficult to know which library had genuine contents.

Knowing very well that the young and evolving minds need a good source for their reference, TAU has started this initiative where students can get valuable contents related to dangerous and communicable diseases.

Initially, it has started with Cancer, Diabetes, Asthma, etc and hopes to add more contents related to other diseases in the Huge Online Library. As per most of the doctors and medical institutions, there are quite a lot of people who are not aware of how to combat with deadly diseases. They don’t know how to prevent them and get these diseases treated.

In addition, TAU has started the GKEP (Global Knowledge Enhancement Program) where the students of TAU can take part in providing information related to diseases. This program initiates the students to research about the diseases and expands their horizons in the field of education.

More on http://www.texiladigipedia.com/

Statins: Preventing Heart Attacks and Strokes

statins-prevent-heart-attackWhen sweeping new advice on preventing heart attacks and strokes came out last November, it wasn’t clear how many more Americans should be taking daily statin pills to lower their risk.

A provides an answer: a whole lot. Nearly 13 million more, to be precise.  If the were followed to the letter, about half of all Americans over 40 would be on cholesterol-lowering statins — more than double the current level.

Even more striking, the new recommendations would make prescription of the drugs almost universal among older men. “What was personally most surprising to me, is that it turns out the difference between the old and new guidelines is very small in younger adults — 40 to 59,” says Duke University biostatistician , lead author of the study.

“The vast majority of those affected by the new guidelines are between 60 and 75,” he says. “So much so that 87 percent of men 60 to 75 and 54 percent of women [in that age range] should be on statins.”

The great majority of Americans newly recommended for statin treatment have no known heart disease, Pencina and his colleagues say.

The analysis was published online Wednesday by the New England Journal of Medicine.

Statin drugs are pretty cheap these days. Most are generics. Common doses of atorvastatin, the generic form of Lipitor, can be had for 50 cents a day. Older statins cost even less. Still, the number of potential patients is so huge that the recommended expansion in treatment has major cost implications.

If all those newly recommended for treatment got the drugs, the expansion would cost from $2 billion to $6.6 billion a year more than the price tag under the old guidelines, which is $7.8 billion to $22.4 billion depending on cost assumptions for a year’s worth of the drugs.

In fact, far from everybody eligible for treatment under the previous guidelines is taking statins. Pencina and his colleagues calculate that 22 percent of adults between 40 and 75 are on statins now — about 60 percent of the recommended number. About 25.2 million people take statins now, at an annual cost of about $6 billion to $13 billion.

The new guidelines more than double the potential number of statin-takers to 56 million people.

Pencina says over 10 years, the change in statin use could potentially prevent nearly a half-million heart attacks, strokes and cardiovascular deaths. He thinks the benefit could be worth the lifetime cost of statin treatment, which he thinks could be well below the cost of treating the victims of heart attacks and strokes over their remaining lifetimes.

“We’re going to identify more people at truly high risk and give them more statins, so we’ll potentially prevent more cardiovascular deaths,” Pencina says.

But the price will be a good deal of overtreatment. “We will treat a fair amount of people who will not have developed the disease,” he says. And the drugs , including an increased risk for developing diabetes.

The new guidelines, formulated by the American Heart Association and the American College of Cardiology, are a major departure from those in place for decades. They throw out the notion that doctors should prescribe cholesterol-lowering drugs when a patient’s LDL, or , reaches a certain threshold — in recent years, above 130.

Instead, the new guidelines say everybody with known heart disease should be taking statins.

And for adults over 40 without known cardiovascular disease, the new trigger for statin use is a 10-year risk of heart attack or stroke of 7.5 percent or more, according to a new . The old guidelines, using a different calculator, prescribed statin use at a 10-year risk above 20 percent, along with an LDL-cholesterol reading above 130.

Under the new guidelines, statin therapy is urged for everybody over 40 who has diabetes. The drugs are also recommended for younger adults if their LDL cholesterol is over 190.

It’s not yet clear what the impact of the new recommendations has been. They’re complicated for doctors and patients to understand, and they’re controversial in the medical community.

“I’ve hear very varied responses,” Pencina says. “Some say the guidelines overtreat in the older age group. And I have colleagues who say the guidelines don’t go far enough in the younger age group.”

The new analysis used data from the National Health and Nutrition Examination surveys to estimate the effect of the current cholesterol guidelines. info from: npr,org

Corruption: Deadly Medicines and Organized Crime From the Book Review

deadly-medicineI have long been concerned about the conduct of drug companies. I worry about pervasive conflict of interest in the generation, synthesis and dissemination of the evidence that guides my clinical practice. So, when I was asked to review Peter Gøtzsche’s book on these topics, I was excited.

It is hard to imagine someone better qualified to write this book: a biology and chemistry graduate, Peter Gøtzsche began his career as a sales rep for Astra. In 1977, he took responsibility for setting up a medical department at Astra-Syntex and saw from the inside how trials can be abused to build a case for particular products – in his case Naproxen, a non steroidal anti-inflammatory drug (NSAID). In 1978 he started medical school, whilst still working for the company, only leaving Astra-Syntex on qualification six years later.

Gøtzsche’s PhD focussed on bias in randomised controlled trials of NSAIDs for rheumatoid arthritis, generating important results regarding the impact of funding on outcome. He went on to help found the Cochrane Collaboration and to found the Nordic Cochrane Centre. His academic career has focussed on bias, trials and evidence synthesis.

Before I review Deadly Medicines and Organised Crime, I wish to state unequivocally that I agree with Gøtzsche on many fundamental points. I think that industry funded research is inefficient and systematically favours the products of the sponsor. I am appalled by pervasive hidden trials data and publication bias. As receipt of information from industry appears to be harmful, I think industry should play no role in medical education. The current model is clearly broken and some of the solutions Gøtzsche suggests, for example requiring independent trials before licensing medicines, are good ones.

Given the importance of raising these issues, particularly with prescribers, and the obvious expertise Gøtzsche had to draw on, it is a real shame this is not a better book. The sentences are long and often muddled. Chapter three, in particular, is almost unreadable. The superlatives and hyperbole are pervasive, tiresome and, in places, a little offensive:

‘Drug reps are advised to work with key opinion leaders and turn them into ‘product champions’, and also to find younger people who can have their profile raised so that they also become key opinion leaders. A bit like Hitler-Jugend, so they can go out and terrorise common sense among those who are not yet members of the Party.’ (p. 82)

‘…the results generated huge ‘controversy’, with innumerable letters and papers written by seemingly independent whore doctors who were hired guns for the company.’ (p. 100)

‘Whore doctors’, bizarrely, is indexed.

Gøtzsche tries to cram in too many anecdotes and ideas, many of them not clearly related to the preceding sentences. Chapter 21, the book’s manifesto for change, attempts to take on income inequality, the financial crisis and the organisation of US healthcare, in addition to the regulation of health research.

Given Gøtzsche’s background in evidence synthesis, a surprising feature of the book is the frequency with which strong assertions are backed up with stories, reference to a single trial or, occasionally, simply left unreferenced.

‘…bipolar disorder…is mainly iatrogenic, caused by SSRIs [selective serotonin reuptake inhibitors] and ADHD [attention deficit hyperactivity disorder] drugs…’ (unreferenced claim, p. 230)

Often I found claims unconvincing but did not know enough to be sure. Occasionally I did know a little of the literature and could be more confident I was being given an incomplete picture. For example, studying the association between antidepressants and falls is difficult. In observational studies, it is hard to adjust for clinicians favouring particular medications in frail patients they feel at high risk of falls.

‘…a carefully controlled cohort study of depressed people over 65 years of age showed that SSRIs more often lead to falls than older antidepressants or if the depression was left untreated.’ (p. 198)

Whilst I am unfamiliar with the study cited by Gøtzsche to support his claim, I know that case only methods, which theoretically deal with this form of confounding better, find SSRIs and older antidepressants increase the risk of falls to similar extent. From a founder of the Cochrane Collaboration, I would have expected a more rounded account of the literature.

To be fair, there are some fascinating ideas in this book. The section on active placebos (p. 49) is great; the extent of the publication bias in trials of granisetron for post operative nausea and vomiting (p. 96) startling; some of the leaked industry documents truly frightening (for example, the table on page 239); and I really like the idea that scientists involved in important trials should conduct the analysis whilst still blinded to the treatment allocation, write two versions of the paper and only unblind the data when all co-authors have approved the manuscripts (p. 266). The reference lists are also likely to be useful to those taking more than a passing interest in these issues.

If you haven’t read much on this topic, you should.  You should then take action. I would recommend reading Ben Goldacre’s Bad Pharma or Jerome Kassirer’s On the Take. Peter Gøtzsche has made many important contributions to this field. Sadly, this book is not one of them.

“Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare” by Peter Gøtzsche is published by Radcliffe, ISBN: 9781846198847

Tom Yates is a clinician, currently studying TB transmission in rural South Africa. He is a member of Healthy Skepticism and has supported both the Bad Guidelines campaign and the (currently inactive) Conflict Free Conferences project. Tom has worked on studies supported by Pasante, GSK and Sanofi. He has not benefited financially from these relationships.

Books reviewed in Speaking of Medicine are independent of the book’s publisher. Reviewers do not receive a fee but are allowed to keep the review copy of the book.
source; blogs plos org