Popping up in Unexpected Places: Posing a Pop-Up Library to Healthcare Staff.

Pop-up libraries have been a trending form of outreach by public and academic libraries during recent years but they are still a novel concept in clinical and hospital settings. Engaging with healthcare staff in common spaces with an inviting temporary display provides an opportunity to proactively raise awareness of library resources and services to non-library users while also piquing interest in a timely topic or special theme. Mayo Clinic librarians describe how a pop-up library was implemented as a unique form of outreach at the Rochester, Minnesota campus in early 2020.

Health care cost savings from Australian Poisons Information Centre advice for low risk exposure calls: SNAPSHOT 2.

Introduction: To estimate cost savings from the Australian Poisons Information Centres (PIC) through reductions in unnecessary health resources following unintentional low toxicity poisonings.Methods: Two telephone surveys were conducted. The first to PIC callers over a one-week period about unintentional exposures where the callers' alternate course of action in the hypothetical situation in which the PIC did not exist was questioned. The second survey to determine the proportion of callers followed PIC advice. We estimated cost savings associated with instances where individuals acted on advice not to present to hospital, when they indicated they would have otherwise as well as savings from preventing unnecessarily utilisation of medical resources. Database records of unintentional poisonings from all Australian PICs for 2017 were used.Results: A total of 958 consecutive callers were surveyed. PIC advised 91% of callers to stay at home, remaining callers were referred to hospital (5%), to their GP (3%) or given other recommended management advice (1%). PIC advice was followed by 97.6% of callers. In PIC absence, 22% of callers who were advised to stay home would have presented to hospital (3% via ambulance), 8% would visit their General Practitioner (GP) and only 9% would stay at home. In 2017, PICs were called about 94,913 unintentional poisonings; and PICs generated at least $10.1 million in annual savings.Conclusion: In 2017, PICs provided at least a three-fold return on investment for every dollar invested, demonstrating that PICs are a highly cost effective service.

Drug information centres and their provision of decision support: The Scandinavian experience.

WHAT IS KNOWN AND OBJECTIVE: Appraisal of drug information centres (DICs) is mainly by word of mouth communication and surveys of overall user satisfaction. Efforts to study the impact of this type of informatics and decision support systematically are generally lacking within the healthcare system. COMMENT: Scandinavian DICs question-answering databases are relevant sources for identifying recurring problems in pharmacotherapy, including drug safety questions, and for re-use of previous answers. Recent studies in this setting have shown that high-quality answers demand easily accessible literature sources, skills in literature search and critical assessment of the retrieved documentation. Furthermore, patient-specific advice in clinical cases presented within a requested time frame is appraised by clinicians. WHAT IS NEW AND CONCLUSIONS: Effective decision support by Scandinavian DICs depends on skills among staff and technological resources. Our experience could motivate further studies investigating methods and evaluating the impact of DICs in the healthcare system.

Community perceptions and utilization of a consumer health center.

The purpose of this study was to understand factors that may affect the usage of a consumer health center located in a public library. More specifically, the authors wanted to know what health resources are of interest to the community, what patrons' perceptions of their experience at the center are, and finally, how staff can increase utilization of the center. In general, perceptions of the center were positive. The findings support that participants appreciate efforts to provide health information in the public library setting and that utilization could be improved through marketing and outreach.

Factors associated with time consumption when answering drug-related queries to Scandinavian drug information centres: a multi-centre study.

PURPOSE: There is little research-based documentation on the services provided by drug information centres (DICs). The aim of this multi-centre study was to explore for the first time the factors associated with time consumption when answering drug-related queries at eight different but comparable DICs. METHODS: During an 8-week period, staff members at eight Scandinavian DICs recorded the number of minutes during which they responded to queries. Mixed model linear regression analyses were used to explore the factors associated with time consumption when answering queries. RESULTS: The mean time consumption per query was 178 min (range 4-2540 min). The mean time consumed per query increased by 28 (95 % confidence interval (CI) 23 to 33, p < 0.001) min higher for queries for which there was a lack of documentation and 139 (95 % CI 74 to 203, p < 0.001) min higher when conflicting information was present in the literature. Staff members with less than 1 year of experience consumed a mean of 91 more minutes (95 % CI 32 to 150, p = 0.003) per query than staff members with more than 2 years of experience. CONCLUSIONS: This study demonstrates the large variation in time consumed answering queries posed to Scandinavian DICs. The results highlight the need for highly competent staff members and easy access to drug information sources. Further studies are required to explore the association between time consumption and response quality.

Psychosocial factors associated with failure to use contraception among adolescents with repeat pregnancies in Puerto Rico.

UNLABELLED: Social, medical, psychological and economic problems are often associated to teen pregnancy. This is a reality worldwide; Puerto Rico is not an exception, documented in statistics and previous research projects. There are many risks associated with pregnancies among adolescents, including increased maternal morbidity and infant morbidity. In Puerto Rico, the adolescent repeat births reed are 22% for a second child and 6% for a third child. Repeated teen pregnancy has a higher than expected incidence; therefore the investigation of psychosocial factors associated with failure to use contraception is needed,especially to address the intervention at clinics with this population of different needs, mainly when these patients with repeated teen pregnancies have been through the health care system already. METHODOLOGY: The project is a cross sectional survey study, seventy articipants between 12-19 years of age who attended obstetrics or postpartum clinics at an adult University Hospital. A self-administered questionnaire included some psychosocial factors that have been associated withthe failure to use contraceptives as well as demographics tion, education, socioeconomic status and support system. RESULTS: Their partner's age ranged from 15 to 38 years of age. Most participants lived with their partner. Their main activity at the time of the study was housework. Most had left school beforebecoming pregnant and received government help. Of all participants, a small number was legally married. The lack of use of contraceptive was found to be significantly associated to partner (p < 0.05). CONCLUSION: The lack of contraceptive use is a key factor in adolescent pregnancy. It is expected that this data can be helpful for documentation and intervention measurements something canbe done at an educational level, family planning and medical care.

Trends in CNS affecting drugs in the calls to the Toxicological Information Center from 1997 to 2012.

OBJECTIVES: To analyze the number and trends in calls to the Toxicological Information Center (TIC) concerning pharmaceutical poisoning retrospectively during the past 15 years and to compare selected characteristics of the poisonings. DESIGN: Inquiries arising from drug poisonings in the years 1997-2012 were extracted and evaluated from the Czech database recording the consultations of TIC specialists. In addition, their cause, severity and dose evaluation (data electronically collected after 2005) were compared in the years 2005-2012 using standard statistical methods. RESULTS: During 15 years total 152,649 calls due to all types of potentially toxic agents were recorded in the TIC database. Central nervous system (CNS) affecting drugs represented 39.8% of calls due to all pharmaceutical poisonings. The proportion of adults was 72.2% and women comprised 64.4% of all patients. Whereas the number of calls caused by poisoning with tricyclic antidepressants (TCAs) and barbiturates decreased (by 366.7% and 340%, respectively), the calls due to selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines overdose increased (by 1347.4% and 359.8%). The dose of CNS affecting drugs in 2005-2012 was considered lethal in 14.6% of the inquiries due to barbiturates and 8.6% due to TCAs, but only in 1.6% calls due to SSRIs and 0.5% of benzodiazepines. The highest percentage of medications errors was found during the treatment with barbiturates (16.4%). CONCLUSIONS: The current drugs prescription with improved safety profiles brings the beneficial effect of lowering the severity of poisonings and better prognosis of intoxications as observed in the TIC statistics.

Caracterización del perfil epidemiológico de las llamadas alCentro de Información Toxicológica de la Universidad Católica (CITUC), en el año 2010 / Characterization of the epidemiological profile of calls received at the Poison Information Center of the Catholic University (CITUC), in 2010

Objetivo: Describir y caracterizar el perfil epidemiológico de las llamadas recibidas en el año 2010 correspondiente a exposiciones, por el Centro de Información Toxicológica de la Pontificia Universidad Católica de Chile. Método: Se realizó un estudio retrospectivo y descriptivo de las llamadas registradas por el CITUC durante el año 2010. Se analizaron los siguientes datos: número total de llamadas, lugar de la llamada, circunstancia de la exposición, tipo y número de los agentes involucrados, vías de exposición, tiempo desde la exposición, género y edad de los pacientes. Resultados: Se registraron 29.592 llamadas. 45,2 por ciento de las consultas provenían del hogar y 53,2 por ciento de instalaciones médicas. 69,3 por ciento fueron exposiciones accidentales y 27,6 por ciento intencionales. Los medicamentos se presentaron como agente causal de una exposición en 58,4 por ciento de las llamadas, seguidos por los productos de uso doméstico (18,7 por ciento) y plaguicidas (5,8 por ciento). La ingestión fue la vía de exposición que predominó en un 79,3 por ciento del total de casos. 41,0 por ciento del total de las llamadas, se realizaron dentro de la primera hora post-exposición. Las exposiciones en niños menores de 14 años correspondieron a 51,6 por ciento de las llamadas. Conclusiones: Los medicamentos constituyen el principal agente involucrado en intoxicaciones. La principal vía de exposición es la ingesta y el principal grupo de población afectado son los niños menores de 14 años,. Estos indicadores muestran la necesidad imperante de desarrollar campañas de prevención e información avaladas por el Ministerio de Salud, respecto al correcto uso de los medicamentos, como también la introducción del envase resistente ala manipulación de los niños y la educación de la población.

Objective: To describe and to characterize the epidemiologoc profile of the entering pone calls in 2010 belonging to exposures by the Centro de Información Toxicológica de la Pontificia Universidad Católica de Chile. Method: A retrospective and descriptive study of pone calls registered by the CITUC has been made during 2010. The following has been analyzed: total pone calls number, place of the call, exposure circumstances, kind and number ofagents involved, exposure way, time from exposure, gender and age of the patients. Outcomes: 29.592 phone calls were registered. 45,2 percent of the questions came from home and 53,2 percent from medical institutions. 69,3 percent were non intented exposures and 27,6 percent were intented. The drugs were the causal agent of exposures in 58,4 percent of the phone calls, followed by cleaning use products (18,7 percent) and insecticides (5,8 percent). Swallowing was the predominant exposure way with 79,3 percent of the total. 41 percent of total of phone calls, were made in the first hour after exposure. The children under 14 years exposure cases, were were 51,6 percent of total phone calls. Conclusions: Medical drugs are the principal involved agent in intoxications. The main way of exposition is swallowing and the major population group involved is children under 14 years. These indicators shows the need of developing prevention and information campaigns supported by Secretary of Health, oriented to right use of drugs, as well as the use of safety drug boxes for children and population education.

[Evaluation of the flu call center and medical system data on pandemic (H1N1) 2009 influenza. Comparison of cases in Kobe city and Ibaraki prefecture].

OBJECTIVES: To make recommendations on the revision of the Pandemic Influenza National Action Plan and Guidelines, we reviewed the data from the flu call center and medical institutions in Kobe city and compared them with data from Ibaraki prefecture. METHODS: The overall duration of study from May 2009 to December 2009 was divided into 4 periods; we analyzed details of the calls received by the call center and examined the correlation between them and cases who were seen at medical institutions in Kobe. We used a mathematical model to approximate the cumulative growth curve of the number of calls received by the call center and the number of cases attending fever clinics in Kobe. We compared the above data with data from Ibaraki because the total number of confirmed cases of pandemic (H1N1) 2009 influenza was similar: Kobe identified the first confirmed case of the influenza in Japan, while Ibaraki reported their first case 1 month later. RESULTS: Following the report of the initial domestic case, the Kobe call center received 30,067 calls in a month. A "delayed sigmoid curve" fitted well for both the rise in the number of calls at the call center and of cases attending the fever clinics. "Feeling sick despite no overseas travel history" was the most common reason for call. More than 2,000 calls/day were received, and the responses to such calls were instructions to consult a general medical institution (40%), instructions to refer to a fever clinic (8%), guidance on home care or how to manage underlying disorders, and listening to callers' anxieties and complaints. The numbers of calls decreased towards the end ofJuly; the number of calls increased again when outbreaks were reported in schools and a death due to influenza was confirmed. After November, on an average, 500 calls/day were received; most were complaints regarding vaccination. Unlike Kobe, Ibaraki did not experience a surge in the number of calls to the call center or consultations to fever clinics within a short period of time. CONCLUSION: The outbreak of pandemic (H1N1) 2009 influenza showed different call patterns and medical consultations in different regions. The time of disease outbreak and the availability of medical resources differ among regions; hence, each municipality should act practically and flexibly according to the situation in their locality.

Increased syphilis trend among patients in an AIDS information and prevention center.

OBJECTIVE: A rebound of syphilis cases has recently been observed. This study describes the trend in syphilis infection among persons attending the AIDS information and prevention center of Valencia, Spain. METHODS: We performed a cohort study of all persons attended from 2000 to 2006. The calendar effect was assessed by a logistic regression model adjusted by sexual and sociodemographic variables. RESULTS: A total of 71% were heterosexuals (HT) and 19% were men who had sex with men (MSM). Among the 10,850 users of the center, the prevalence of syphilis was 0.7%. Among MSM, the prevalence of syphilis was 2.4% for the whole period and was 4.6% for 2006. Multivariate analysis showed that the risk of infection was lower in persons with a university education (OR=0.10; 95%CI: 0.03-0.59) than in those without. The risk was higher in persons who took drugs (OR=5.49; 95%CI: 1.55-19.43) or who practiced prostitution (OR=6.83; 95%CI: 2.52-18.53). In 2006, the risk of having syphilis was greater (OR=5.05; 95%CI: 1.12-22.72). CONCLUSIONS: Syphilis infection increased substantially among MSM. In this collective, the prevalence of infection is related to educational level, prostitution and the use of non-injected recreational drugs.

[Preventive intervention in venues for interaction used by men who have sex with men]. / Intervención preventiva en lugares de interacción social de hombres que mantienen relaciones sexuales con otros hombres.

An intervention in venues for interaction used by men who have sex with men in Valencia (Spain) was performed to prevent human immunodeficiency virus (HIV) infection or avoid delay in diagnosis and to facilitate contact with the health circuit. Information was provided on prevention and a rapid test for HIV and syphilis was performed. We contacted 500 men and the intervention was performed in 171; 37% of the subjects in saunas and one in four of those in prostitution apartments had never been tested. The prevalence of HIV was 1.6% (n=2) in the saunas, and 11% (n=5) in the apartments (n=5). For syphilis, these percentages were 5% and 2.3% respectively. The intervention revealed the existence of highly exposed population groups with low compliance and facilitated access to the health system in these groups.

New developments in the use of citation analysis in research evaluation.

This paper presents an overview of research assessment methodologies developed in the field of evaluative bibliometrics, a subfield of quantitative science and technology studies, aimed to construct indicators of research performance from a quantitative statistical analysis of scientific-scholarly documents. Citation analysis is one of its key methodologies. The paper illustrates the potentialities and limitations of the use of bibliometric indicators in research assessment. It discusses the relationship between metrics and peer review; databases used as sources of bibliometric analysis; the pros and cons of indicators often applied, including journal impact factors, Hirsch indices, and normalized indicators of citation impact; and approaches to the bibliometric measurement of institutional research performance.

Addressing underutilization of consumer health information resource centers: a formative study.

PROBLEM: Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. METHOD: Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. RESULTS: There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. CONCLUSIONS: Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted.

Telephone helpline for parents of children with congenital anomalies.

AIM: This paper is a report of a study to evaluate how often and for what reason parents of children born with severe anatomical congenital anomalies use a 24-hour telephone helpline, and to identify differences between callers and non-callers. BACKGROUND: Children born with severe congenital anomalies often remain dependent on medical care and technology after discharge. Adequate medical consultation in the home situation may lower parental burden. METHOD: Observational study of telephone contacts from 2000 to 2006 with parents of congenital anomaly patients discharged home after neonatal intensive care admission. Frequency of telephone calls was categorized per type of anomaly. Resulting interventions in terms of consultation and hospital admission were recorded. Finally, costs of personnel needed to provide 24-hour telephone helpline availability were calculated. FINDINGS: A total of 670 calls occurred outside office hours, from 34.4% of all parents; 23.7% of these calls concerned feeding problems. Parents of children with oesophageal atresia, urogenital malformation and congenital diaphragmatic hernia called most frequently (44.3-50.6%). Non-callers were more often first-time parents, divorced/separated or immigrants. Nurses handled 24.5% of calls by themselves and 20.2% of calls led to emergency room consultations resulting in 4.9% admissions. First contact took place at median age 3 months, last contact at median age 8 months. Total personnel costs amounted to euro27,191 per year. CONCLUSION: A 24-hour telephone helpline provides easy access to medical and supportive care for parents of children with congenital anomalies at relatively low cost. Nurses can effectively run this telephone helpline with paediatrician back-up.

Radio advertising increases hospital call center volume by 48%.

Since the fall of 2005, call volume at University of Southern California University Hospital of Los Angeles' call center has increased by nearly 50%. How? The hospital embarked on a long-term radio campaign to promote its presence as a premier academic medical center and to increase patient volume.

Using Ontario's "Telehealth" health telephone helpline as an early-warning system: a study protocol.

BACKGROUND: The science of syndromic surveillance is still very much in its infancy. While a number of syndromic surveillance systems are being evaluated in the US, very few have had success thus far in predicting an infectious disease event. Furthermore, to date, the majority of syndromic surveillance systems have been based primarily in emergency department settings, with varying levels of enhancement from other data sources. While research has been done on the value of telephone helplines on health care use and patient satisfaction, very few projects have looked at using a telephone helpline as a source of data for syndromic surveillance, and none have been attempted in Canada. The notable exception to this statement has been in the UK where research using the national NHS Direct system as a syndromic surveillance tool has been conducted. METHODS/DESIGN: The purpose of our proposed study is to evaluate the effectiveness of Ontario's telephone nursing helpline system as a real-time syndromic surveillance system, and how its implementation, if successful, would have an impact on outbreak event detection in Ontario. Using data collected retrospectively, all "reasons for call" and assigned algorithms will be linked to a syndrome category. Using different analytic methods, normal thresholds for the different syndromes will be ascertained. This will allow for the evaluation of the system's sensitivity, specificity and positive predictive value. The next step will include the prospective monitoring of syndromic activity, both temporally and spatially. DISCUSSION: As this is a study protocol, there are currently no results to report. However, this study has been granted ethical approval, and is now being implemented. It is our hope that this syndromic surveillance system will display high sensitivity and specificity in detecting true outbreaks within Ontario, before they are detected by conventional surveillance systems. Future results will be published in peer-reviewed journals so as to contribute to the growing body of evidence on syndromic surveillance, while also providing an non US-centric perspective.

Requests for information by family and friends of cancer patients calling the National Cancer Institute's Cancer Information Service.

PURPOSE: To characterize their information needs, we examined the main topics of inquiry and discussion (subjects of interaction, SOI) of calls made by family and friends of cancer patients to the National Cancer Institute's Cancer Information Service's (CIS) 1-800-4-CANCER telephone information service and summarized differences by sociodemographic characteristics. DESIGN AND ANALYSIS: Data from 26 789 family or friends of cancer patients calling the CIS between September 2002 and August 2003 were analyzed. Frequencies, chi(2)'s, and logistic regressions were conducted to ascertain sample characteristics and sociodemographic correlates of each SOI. RESULTS AND CONCLUSIONS: The greatest proportion of calls concerned specific treatment information (54.9%) and general cancer site information (36.9%). Calls about specific treatment information were more likely among Asians, Hawaiian Natives, and Pacific Islanders (OR = 1.23, 1.04-1.45), and those with higher education (OR = 1.21, 1.18-1.25). As age increased, the odds of calls about specific treatment information also increased (OR = 1.05, 1.03-1.07). Females (OR = 0.78, 0.72-0.84), Hispanics (OR = 0.77, 0.67-0.89), African-Americans (OR = 0.68, 0.61-0.76), and American-Indians and Alaskan Natives (OR = 0.74, 0.58-0.93) were less likely to inquire about specific treatment information. Inquiries about general cancer site information were more likely among females (OR = 1.14, 1.06-1.23) and less likely among younger callers (OR = 0.95, 0.93-0.97) and African-Americans (OR = 0.87, 0.78-0.98). Differences in inquiries made by sociodemographic subgroups can inform the CIS' and other cancer-related organizations' efforts to develop and disseminate cancer information for family and friends of cancer patients.

Estudio bibliométrico de la revista Actas Dermo-Sifiliográficas (1984-2003) II. Análisis de las referencias bibliográficas / Bibliometric study of the journal Actas Dermo-Sifiliográficas(1984-2003) II. Analysis of bibliographical references

Objetivo. Cuantificar el número de referencias de cada uno de los artículos publicados en los números ordinarios de la revista Actas Dermo-Sifiliográficas (AD) durante el periodo 1984-2003 y calcular el índice de referencias para cada uno de estos años. Estudiar el consumo de la información por parte de los autores de los documentos publicados en AD mediante el análisis de todas las referencias bibliográficas emitidas por los artículos publicados en los años 1984, 1993 y 2003. Material y métodos. Se revisó manualmente el número de referencias para cada uno de los artículos científicos publicados en los números ordinarios de la revista entre 1984 y 2003. Para los años 1984, 1993 y 2003 se analizó el género documental, idioma, país de origen y antigüedad de las referencias. Resultados. Los 2.604 artículos publicados en la revista AD entre los años 1984 y 2003 proporcionaron 56.144 referencias. La media de referencias por artículo para todo el periodo fue de 21,56 ± 21,2. El tipo de documento con mayor índice de referencias fue la revisión (67,06 ± 59,9), seguido de los trabajos originales (24,76 ± 19) y los casos clínicos (17,95 ± 9,7). El principal género documental de las referencias en los 3 años del estudio fue el artículo de revista, que pasó del 84,8 % en 1984 al 95,4 % en 2003. Las citas a libros, por el contrario, disminuyeron desde el 10,6 % en el primer periodo al 3,3 % en el último (p < 0,001). Estados Unidos fue el país de origen de gran parte de las referencias recogidas para los 3 años del estudio (55,4 %). De lejos le siguieron Reino Unido (15,7 %) y España (9 %). El inglés fue el idioma en el que estaban escritas la mayoría de las referencias de los tres periodos, que pasaron del 72,9 % en 1984 al 87,5 % en 2003. El español fue el segundo idioma más empleado por las referencias (9,1 %), contrariamente a lo esperado, su utilización disminuyó a lo largo de los tres periodos. Las principales revistas citadas por los autores de AD fueron las norteamericanas Archives of Dermatology (12,3 %) y Journal of the American Academy of Dermatology (10,3 %). AD recibió un porcentaje de autocitación del 4 %, fue la cuarta revista más citada después de la revista británica British Journal of Dermatology (7,4 %). Conclusiones. Los dermatólogos españoles se documentan esencialmente en la bibliografía anglosajona, utilizan información actualizada contenida en su mayoría en publicaciones periódicas y un porcentaje importante de la información se encuentra en un grupo reducido de revistas que coinciden con las de mayor impacto internacional para nuestra especialidad

Objective: To quantify the number of references for each of the articles published in the regular issues of the journal Actas Dermo-Sifiliográficas (AD) between 1984 and 2003, and to calculate the average number of references for each of these years. To study the consumption of information by the authors of documents published in AD through the analysis of all of the bibliographical references listed in the articles published in 1984, 1993 and 2003. Material and methods: The number of references for each of the scientific articles published in the regular issues of the journal Actas Dermo-Sifiliográficas between 1984 and 2003 was reviewed manually. For the years 1984, 1993 and 2003, the type of document, language, country of origin and age of the references were analyzed. Results: The 2,604 articles published in the journal AD between 1984 and 2003 provided 56,144 references. The average number of references per article for the entire period was 21.56 ± 21.2. The type of document with the most references was the review (67.06 ± 59.9), followed by original works (24.76 ± 19) and clinical cases (17.95 ± 9.7). The primary type of document for references in the three years studied was the review article, which went from 84.8 % in 1984 to 95.4 % in 2003. References to books, on the other hand, dropped from 10.6 % in the first year to 3.3 % in the last one (p < 0.001). The United States was the country of origin of a large part of the references reflected in the three years studied (55.4 %). Following at a great distance were the United Kingdom (15.7 %) and Spain (9 %). English was the language in which most of the references were written in the three years studied, increasing from 72.9 % in 1984 to 87.5 % in 2003. Spanish was the second most used language in the references (9.1 %); contrary to what was expected, its use decreased over the three years. The main journals referenced by the authors published in AD were the American publications Archives of Dermatology (12.3 %) and Journal of the American Academy of Dermatology (10.3 %). References to AD itself accounted for 4 % of the total; it was the fourth most referenced journal after the British Journal of Dermatology (7.4 %). Conclusions: Spanish dermatologists primarily use English-language publications for their research. They mostly obtain current information from periodicals, with a significant percentage of the information being found in a small group of journals, which are the ones with the greatest international impact for our field of specialization