Tuesday, 29 April 2008

Gone out backson bisy backson

We're currently short staffed - down to one full timer and a part timer, the other full timer being off sick. Next week our part timer will be on leave. While we're trying to get anything you request from us as quickly as normal it does mean we have a slight issue with covering our advertised hours. We've had to close early once or twice, and we've had to close at lunch from time to time.

If you are making a special trip to see us then please give us a ring before you set out.

When we close we open the book drop box, so you can leave your books there. The wesbite and all the stuff you can do with Athens carries on while we're not here.

Thursday, 24 April 2008

Boxing clever

As previously promised I am going to give you a brief guide to searching the various bits of of the National Library for Health. If you've visited the site you'll know that there are an awful lot of search boxes scattered through out it. Which one should you use?

For those of you who are Essex Rivers staff, when at work you can search the National Library for Health box on the intranet home page under "quick search". This currently runs a search for you across the various specialist libraries.

If you visit the NLH site there is a search box at the top of the home page. If you put something in that box and hit "search" it will search the specialist libraries, guidance and evidence based reviews for items that have your search words in the title. You can also tick the boxes here to search images, books and journals and patient information. Note that (at least on my screen) the tick boxes are a little adrift from the text, so the box for "images" is on the preceding line.

You can also opt to search for your term in the title and abstract of items. This should give you a lot more hits.

Although you can search journals from here its a rough and ready search. Despite the big NLH 2.0 logo next to it, it is not NLH 2.0 and is not the best place to search journals.

For a proper search in the journals scroll down under the Resources section to "Books, Journals and Healthcare Databases". Click on that heading to get through to NLH 2.0. This is where you search for papers on specific topics. Type your search in the box and click on search. You can also (and I do recommend you try this) click on the advanced search link below the search box. This will give you more options. There's "mapping to the thesaurus", which basically means finding the words that articles have been indexed with. This is a nice fixed list and means you don't need to worry so much about UK and US spelling or about the horrible number of synonyms there are in health.

The advanced search also lets you click boxes to combine searches using AND (both the terms needed - say, diabetes and insulin) or OR (meaning either term would be useful - perhaps chronic or long term). You can select which dates you want to search and a few other bits.

For best results here you need to log in with you Athens password. You do this in the boxes on the top left where it says LOGIN.

Meanwhile, back on the home page, scroll down to that same heading of "Books, Journals and Healthcare Databases". This time, don't click the heading, click the "my journals" (NB - split over two lines - click on either bit). Again, you need to log in with Athens for this to work. Now, this is where you go when you already have the details of papers you want, but wonder where you can get them. You search for the journal you want and it will tell you if we hold a paper copy here or if you can get it online, with links through to the online text.

Search box at the bottom of the NLH homepage searches dictionaries for definitions.

If you click on evidence based reviews, specialist libraries or guidance under resources on the home page, each of those links will take you to a search box to search just that bit of the NLH.

In brief - go to the specific area you want (a specialist library, the guidance) to search just that area. Use the box at the top of the home page to search across various bits of the whole website. Use the link under "Books, Journals and Healthcare Databases" to do a literature search.

Friday, 18 April 2008


Demi Moore uses leech therapy to "optimize" her health. It sounds like the latest celeb fad, up there with Gwyneth Paltrow and her cupping or the latest mad diet. We might associate leeches and bloodletting with the middle ages, but there are uses for leeches, and maggots, in modern healthcare.

Leeches are being used in operations - plastic surgery, orthopaedics - where there is a danger that blood will flow into veins, and not out again, leading to congestion and possible loss of limbs. David Isitt's leg was saved last year by 30 leeches following surgery on his leg at Barts and the London. It's not such a new concept - the student BMJ considered "creepy crawly medicine" back in 2002.

Biopharm Leeches sell leeches for medicine, and their website has a range of facts, from contra-indications and how to attach a leech, to such fascinating snippets as leeches have 32 brains and their nearest relative is the earthworm.

To search the internet for health stories on leeches, avoiding Ms Moore, try using Google Scholar. Because it indexes serious journals it wont find results from the various entertainment and gossip websites. Or use Google but type "-demi" (that's Demi with a minus sign before it) to ask Google to ignore items with that word in it.

You can also search for papers on leeches using the National Library for Health's NLH 2.0 search. This isn't the search box on the home page - it's the one you'll find when you scroll down and click on Books, Journals and Healthcare Databases - more on that next week.

Thursday, 17 April 2008

Golden oldie

Today, a look at some of the resources on care of the elderly. No prizes for spotting a pattern here - many of the same places that offer information and resources on men, women and children also cover later life.

The NLH has a Specialist Library on Later Life, and those on Palliative and Supportive Care, Mental Health and Muscuoloskeletal Diseases might also be of interest.

The BBC has a special section on health for the over fifties. For further information they suggest the sections on cancer (breast awareness and prostate), bereavement and arthritis.

From the Department of Health comes a slew of relevant National Service Frameworks - Long Term Conditions, diabetes, CHD and COPD. The section on integrated care covers hospital discharge, NHS funded nursing care and end of life care. There is also a section on privacy and dignity and general section on older people as part of the DH's information on adult social care.

Those nice people at Journal Watch have a section dedicated to aging and geriatrics (their words, not mine). On the library current awareness page there are sections on long term conditions, diabetes and cancer, as well as link to a separate weekly mental health bulletin.

The BMA Library website has suggestions for books, journals and website with information on health of the elderly. The GP Notebook has a section on geriatric medicine.

Age Concern has advice on everything from bogus callers and losing a partner to moving abroad and getting a job. Later Life is a website for people in their fifties and over. They have advice on jobs, dating, travel and health, as well as offering retirement courses. SAGA has a similarly wide spread of information. Patient UK has a lot of links for information for and about the elderly and NHS Choices has an over 60s page. The Citizen's Advice Bureau has information on wills, benefits and finances.

There are various organisations with information and support on elder abuse - Action on Elder Abuse, Help the Aged and Age Concern.

In the library, consider books on palliative care, communication, bereavement and grief, dementia, rehabilitation, community care, quality of life and falls as well as traditional care of the elderly titles.

(c) image creative commons attributed

Child's play

Men or women, we were all children once. There are lots of resources relevant to child health/paediatrics. Here is a taster.

Lining up the usual suspects, we have a NLH Specialist Library for Child Health while the BBC has sections on children, babies and teenagers. Their parenting section covers everything from breastfeeding to father's rights, from the terrible twos to speech development.

There's a (rather unattractive) website called "Your child's health" from the Wirral University Trust. The king of child health is, of course, the Great Ormond Street hospital, and they have a range of resources. There is the rather serious-looking centre for evidence-based child health, factsheets for parents and children, and a glossary of terms.

Dial - the paediatric medicine information advisory line - has a journal watch section, with monthly updates. NEJM's Journal Watch has a paediatric and adolescent medicine section. Nothing on our own current awareness page. Want it? Ask me for it!!

The Royal College of Paediatrics and Child Health is a resource for professionals in this area. The GMC offers guidance to all doctors on dealing with people between 0 and 18.

For GPs there is the online GP notebook with a dedicated section on paediatrics and the BMJ runs a masterclass on women's and child health for GPs.

Cancer Backup and Cancer Research UK both have information on childhood cancers. Charity CLIC Sargent has information, and a helpline.

There is a National Service Framework covering children's services. The government site Every Child Matters covers policy for children's services.

The library stocks books on paediatrics, child development, child protection and child mental health.

Wednesday, 16 April 2008

Anything you can do

Men and women are not so different in many ways. Men can have breast cancer, suffer from eating disorders and menopause, and enjoy being actively involved in the birth of their children.

Men also have huge amounts of health information resources dedicated to them. As ever the BBC and Medline Plus offer a range of good general resources. Bandolier has a page gathering together resources (heavily slanted towards sexual health issues).

Malehealth addresses chaps as one bloke to another, but comes from the very serious Male Health Forum, which focuses on health policy. MIND has a section devoted to men's mental health. The Fatherhood Institute has research on fathers and fatherhood.
Prostate Cancer has its own cancer charities - The Prostate Cancer Charity and the Americsan Prostate Cancer Foundation. Otherwise the usual suspects (Cancerbackup, Cancer Research UK) cover male cancers.

Gay men have their own health issues, and there are organisations to support them.

Poor chaps - in some ways they are missing out. There is no section on Journal Watch dedicated to men's health, nor can I find any medical librarians blogging on the topic. NLH doesn't have a Specialist Library on male health, and there is nothing on our own current awareness service specific to men, other than the prostate cancer section.

The bee's knees

Cochrane is a name that seems to stick in people's minds. I suspect that they hear (quite rightly) the words "best evidence" and "gold standard" strung together in the same sentence as "Cochrane" and then, when needing to do a search, feel that nothing but Cochrane will do.

It is true, Cochrane has full text systematic reviews, the bee's knees of evidence. However, a systematic review isn't always what you need. Cochrane sets out to answer questions such as "what works best to treat X?", "Which is the better treatment for X - therapy a or therapy b?" Cochrane does not answer questions on how to diagnose a particular illness, issues of prognosis, statistics, epidemiology or give any handy round-ups of current therapies and thinking. Its job is quite specific and although it does what it sets out to do very well, there are plenty of things it wont do.

The other issue with Cochrane is that it is (compared with Medline, Cinahl or Embase) very small. This is partly because producing a systematic review takes a very long time to do. So it's often possible to find that no systematic review has been done in your particular area of interest.

What if Cochrane is the database you need? It's not part of the NLH 2.0 (although you will find a link to it from the NLH homepage under "Evidence Based Reviews"). It's not searched in the same way as NLH databases. You don't need an Athens password, for a start, or any other password, but it is free to use. It can be a little unwieldy, and require an amount of perseverance. Wiley - who publish the Library - have recently produced a set of tutorials on using Cochrane. These cover a general introduction, tips on advanced searching using the subject headings, and saving searches and setting up email alerts. (You need to register, for free, to use these.)

The Cochrane help page has links to PowerPoint presentations, e-learning modules and pdf guides.

By the way- if you visit the Cochrane Collaboration page they have podcasts offering audio summaries of some reviews.

Tuesday, 15 April 2008

Sometimes it's hard to be a woman

Women. Despite regularly being lumped together with minority groups, we actually outnumber men. Although there are more boys born than girls, women are somehow more robust and live longer.

It's not easy being a woman, however, especially when health stories seem to suggest that if we would only behave like 1950s housewives, doing our own housework, barely touching alcohol and having babies in our twenties, we could be happier and healthier.

At least we need never be ignorant about our health as there are lots of resources dedicated to the fairer sex. Starting with patient information, NHS Choices has a whole section on gynaecology - everything from periods to STDs - and on pregnancy. The BBC's women's health site covers a range of issues from sexual health to mental health. Medline Plus ranges wide in its selection on women's health, including alcohol problems, travellers and heart health.

The National Library for Health has a separate Women's Health Specialist Library and even Bandolier has a page that collects together issues gynaecological and obstetric.

There is an Association of Chartered Physiotherapists in Women's Health (ACPWH), the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives, all dedicated to looking after women. (Spare a thought, please, for Midwives, who are no longer supported by their own library.)

There are resources for women's cancers. Breast cancer has its own charity, website and pink ribbon, but other websites also cover the condition. Ovarian cancer is less glam - no Kylie - and doesn't seem to have a dedicated charity. Uterine cancer also lacks a dedicated website.

There are websites for menopause (but not menarche), for pregnancy, lack of pregnancy, unwanted pregnancy and postnatal depression.
There isn't (other than breast cancer) a separate women's health section on our current awareness page. Want one? Then contact me and say so!! Journal Watch (from the NEJM) gathers together items from various journals covering women's health, while a medical librarian in the States has a blog on this topic.

It's rather disconcerting, looking at all these sites, to find that in health terms being a woman is all about sexual organs and pregnancy. You'd be forgive for thinking women didn't have kidneys, livers, legs, eyes and all the other bits that make up a human being. That's why many of the books in the library with "women's health" in the title end up in the Obs and Gynae sections, because they really do only cover what used to be coyly referred to as "women's bits" or "women's troubles." If you are dealing with a woman, and happen not to be one yourself, please remember that women are people, too.

In the interests of avoiding gender bias the next post will cover men's health!

Friday, 11 April 2008

The big cheese

Another interactive post! I was recently asked for help by a regular library user. He had just been elected to a grand post on a grand committee. While up on all things medical he was in need of some help finding information on the policies and politics. This is the list I gave him, with a few embellishments.

Most Trust's these days have their own website. Essex Rivers has one, so has the Mental Health Trust and the local PCT. These should hopefully give you names of senior managers, a strategy, perhaps some financial information and other basics about the Trust as an organisation. There is also the Strategic Health Authority.

The National Library for Health has a section on health management, explaining everything you need to know in short documents. The King's Fund has a useful collection of information, including some nice briefings on key issues (although beware a slight bias towards all things London).

The Department of Health, of course, is the bit that churns out a lot of the policy and documentation. They have a whole section on management issues. Everything new on the site gets mentioned on this page, and the latest "policies and initiatives" for secondary care also have a page.

The BMA have information on health policy, NHS funding and "system reform". Just bear in mind that the BMA is a union and so may have a not entirely unbiased view of things...

Current hot topics are Lord Darsi's review of the NHS and (for medics) the Tooke report on modernising medical careers.

Heath policy is always big in the news, so keep your eye on the BBC and on a couple of newspapers - perhaps the Guardian and the Telegraph, to keep abreast of the issues. There is also a section on the on the library current awareness page on local Trusts in the news.

Finally, for a grounding in the how and why of where we got where we are today, there are plenty of books in the library on the history, the whys and wherefores of the NHS.

Image (c) creative commons


This Monday - 14th April - the library will close at 12.30. Apologies for this - it's due to a mix of staff sickness and my needing to be out for the day.

The book drop box will be open, all the usual gubbins is online, you can leave an email or voicemail message. We'll be back on Tuesday.

(c) image creative commons

Thursday, 10 April 2008

Peer review

Today's post is interactive. Someone came in today with this very question, and it seemed to be one of wider interest.

When writing an essay you need to ensure your cited references are (a) recent and (b) from peer reviewed journals.

The up to date bit is easy enough. Any paper that you photocopy or print will have a date on it somewhere.

But what about the peer reviewed bit of it? How do you know if something is peer reviewed? Come to that - what IS peer review? It always makes me think of an elderly, dusty old party squinting myopically at a pile of papers...

Peer review, also known as refereeing, basically means asking people in the same field of expertise to have a look at any paper submitted for publication. These reviewers or referees check the paper for problems or weaknesses and may make suggestions for improvement.

The problem with this is that it's time consuming. If you've discovered something new and important it must be frustrating to have the paper announcing your findings held up for months while various people look at it. Some journals will actually show the data a paper was submitted, and the date it was accepted for publication (both dates can be some time before publication).

Sense About Science has a nice guide to peer review, written for the layperson in ordinary language. Peer review is supposed to improve the quality of articles, but doesn't guarantee that papers are free from errors. Not everyone thinks peer review is a good idea. And what about evidence that peer review works? Because asking if a paper is peer reviewed is just a part of the process of assessing the quality of evidence.

How do you know which journals are peer reviewed? When I was asked this today my first reaction was that you don't. Certainly an individual paper wont stat on it that it's peer reviewed. For that information you need the paper journals (remember those?) or the journal's website. Somewhere under information for authors, perhaps, or in a statement about the journal's purpose and readership) it will state that the journal is peer reviewed, that papers are refereed or give instructions for referees.

My second reaction was that surely there is a list somewhere. But there isn't. Now, wouldn't that be a nice project for someone...

Wednesday, 9 April 2008

Change is the only constant

Yesterday when I got home the sun was out, the sky was blue. I stood in the garden, admiring some saxifrages I had just planted. My husband was cooking dinner - which included the always cheerful sound of a cork being pulled - birds sang, and next door's cat came to say hello. I stood there and thought - why can't life always be like this?

The thing is that life goes on a bit - day in and day out for (hopefully) three score years and ten, and a little variety keeps us going. Which brings me neatly on to the various changes cropping up at the moment.

First up - Search 2.0. I've mentioned it before, it has now been released. If you recall it's the one stop shop for searching on the National Library for Health. It's new, it's an IT thing and it's the NHS, so can you guess what I'm going to say next? That's right - it has a few teething problems (most pressingly the nice red search 2.0 logo on the home page leads to a blank page...) But try it (you'll need to sign in with Athens first). Oh, and did I say Search 2.0? Because that's another change - it's now called NLH 2.0. The old Dialog Datastar search is still working for a couple of months, or you can go through PubMed, remembering to tell it you're with the NHS so you get your full text links.

Another NLH change is Hitting the Headlines. This was the handy service that looked at health stories in the news, identified the research behind them, and considered how well the news story had represented the facts. This service no longer exists, although the "archive" (library speak for "old stuff") is still available, hidden away under "News and RSS".

Hitting the Headlines has been replaced by Behind the Headlines, from NHS Choices. I've not had a good look at this service yet, but I note that it seems to cover more stories than Hitting the Headlines. I'm pleased to see it's available as RSS . I'll be adding the feed to my newsreader and posting useful items on the current awareness page.

I've also noticed that while I was away the BBC tweaked the look of their news pages, which is in addition to their rather nice home page, which can be customised.