Thursday, 26 June 2008

Same old, same old

Research and Development had a bit of a spring clean recently and found some notes for a library user group meeting held back in March 2001. Much has changed since then - not least the library user group closing - but much has stayed the same.

The notes show that 24 hour access was the top of the agenda. The situation now is the same as it was then - we're housed in an old building that is a little off site, and is vulnerable to break in and vandalism. There is therefore no out of hours access. Eventually there will be a new library, and rooms offering 24 hour access are right at the top of the wish list. They will probably be study rooms or computer rooms, rather than access too books and journals. Some books and journals are, of course, available 24 hours online with Athens.

In 2001 we proudly announced 12 (yes - twelve) online full text journals. Now we have over 1000 to offer you. In 2001 there were concerns over lack of databases for literature searching, now we offer you seven different databases through NLH.

In those days databases were bought on CD and copied onto the library servers for use on the library network. Eventually a select few pilot sites were granted access outside the library! The user group was busy discussing pay as you surf internet access. Now, of course, the library is on the Trust next work and everyone can access intranet and internet for free, and all the databases you need are internet-based. What progress!

In 2001 we were just finding our feet with offering training for you on literature searching. We started advertising courses in the Trust Training Prospectus and and handing out certificates to people who completed training. Now we offer very little training, as a team restructure left us without the relevant team members to train.

The issue of quiet study space over a space where people can chat still rumbles on. Again, we still lack the space to offer separate areas for different uses. Keep your fingers crossed for that new library where break out rooms are heading the wish list.

Finally, the user group asked about bibliographic software including Reference Manager or Endnote. We declined to buy it then, and don't buy it now, simply because demand is very low.

We no longer have a user group - sadly, it died young. However, its ghost lives on as we are always happy to have feedback, suggestions, compliment and complaints from you through any of our contact channels. You could even leave a comment on the blog!

Wednesday, 25 June 2008

Anyone for tennis elbow?

Ah - Wimbledon. There's nothing like it. The crowds, the strawberries, the top players, the strapped knees, the ice packs, the players forced to withdraw due to injury. We're constantly reminded, it seems, of the dangers of exercise. So now seems a good time to have a look at resources for sports medicine and physiotherapy.

For literature searches of any kind around physiotherapy issues Cinahl is always useful. This is one of the databases you can access through the National Library for Health with your Athens password.

NLH has no dedicated library for sports medicine, but there is a section in the orthopaedics and trauma library dedicated to sports injuries.

Visit the Intute website and type "sports medicine" into the search box and you'll find links to various journals, clinics and institutes of sports medicine.

Sports injury is a real problem, with guidelines being issued to American schools to ensure they enable their athletes to remain healthy and fit. NICE is currently working on guidance for promoting physical activity in children, although the scoping paper doesn't suggest that injury prevention will be a big part of the guidance.

The BBC has information for people wanting to do some sport without injuring themselves, including advice on warming up. NHS Direct has a sports injuries section.

Beware when Googling for sports injury information - a lot of results are private clinics advertising their services. While they may produce good quality information don't forget that they might have reasons to be biased toward suggesting treatment is necessary.

It's no surprise that a third of us prefer not to do any sport. Most of those blame poor health - perhaps sports injuries preventing them being active? Even sitting at home playing imaginary sport on computers can be bad for you. Best sit still on the sofa, crack open a punnet of strawberries and watch the rain fall on centre court.

Friday, 20 June 2008

Dead or alive?

The BBC is running story today about a family in Mumbai who were taking their "stillborn" baby to the cemetery and when she began to gurgle. They were apparently "astonished". There is no indication as to how a man in Paris felt when he woke up on the operating table to find he was being prepared for surgery to remove his organs for transplantation.

In both cases the issue was around defining and diagnosing death. In the second case, which happened in Paris, the man had been diagnosed as dead under new experimental rules brought in to ensure that more organs are available for transplant. The article is vague about the rules, but refers to "heart stopped" which I assume is similar to "non-heart-beating organ donation" described in the Journal of Hospital Medicine. In the UK the criteria is brainstem death.

UK Transplant has a number of FAQs, including "how do they know you are really dead?" I'm surprised not to see listed as an FAQ "will doctors make an attempt to save my life if I am a donor or will they be more worried about having my organs?" It's certainly an objection I've heard from people- a fear of being used as a source of organs rather than being treated as a patient in need of care. It's a question more people will ask while incidents such as this French case continue to appear in the news.

Thursday, 19 June 2008

Guess how much I love you

Some things in life can be counted, weighed and measured. Two books, half a bar of chocolate, three pounds of cherries, 50g of hand dyed cashmere yarn, a metre of string. Or perhaps two hours wait in in A&E, one hairline fracture, three beds, fifteen stitches.

Other things are less measurable, expect perhaps by comparison. How funny is Jeremy Hardy? Does he make you laugh more or less than Andy Hamilton? Is an oak tree lovelier than a copper beech? Is Brief Encounter the saddest film you've ever seen?

The government thinks nurses should be more compassionate. It also thinks this is something that can be measured. How do you measure compassion? If I am compassionate towards one old lady in the morning can I treat a second old lady like second class citizen in the afternoon and still reach my compassion target? How many times do I need to say "there, there" before I can record it as compassionate activity? Is mopping a brow more or less compassionate that fetching someone a cup of tea? What is compassion, anyway? What happens if I feel as though I am being compassionate, but the recipient of my compassion feels I am being patronising, maudlin, overly familiar or intrusive?

Compassionate care is a good idea - as is treating patients with dignity. We should also treat our colleagues with compassion and dignity. We know what these things are - we certainly recognise when they are absent. But there are some things in life that just can't be measured (Elizabeth Barrett Browning not withstanding) or made into targets. They are the very things that are most important.

Invasion of the body snatchers?

I'm not a great fan of sci-fi, but those films I do enjoy are the older ones that raise philosophical questions (The Fly considers a classic question in philosophy around identity and the mind/body problem) or political questions (the original Body Snatchers airs concern over communism). The Invasion of the Body Snatchers is particularly scary because the point is that you can't tell who is still human and who is now alien. When you can't tell it's so easy to get yourself trapped with the wrong sort of person.

This conundrum - how do you tell good from bad, real from fake - arose this morning. There was an item on the news about a man whose skin cancer had been cured by an injection of his own cloned immune cells. The report is full of detail - the cancer was advanced, had spread, five billion cloned cells were used. It all sounds plausible to the lay person, and it's on the BBC website and in the Guardian so it must be true, mustn't it?

It's certainly a rather bizarre story. For years we've been told cancer can be cured only through radical surgery, chemotherapy that makes you feel worse then the cancer ever did, and a very large dose of luck. Now we're being told that our own immune systems can reverse very advanced cancer.

Only two days ago the American Food and Drug Administration warned people off products sold on the internet as cancer cures. These "cures" include shark cartilage, coral calcium and various mushrooms. To the untutored eye shark cartilage is no more or less mad an idea than injections of cloned cells. Quackwatch even has a section refuting claims that animal cells injected into the body can cure cancer, which seems very similar to this current story.

This story comes from good sources, and I hope that the research will be proved to be correct, verifiable and repeatable. But in the meantime people with cancer - and other diseases - will continue to clutch at straws, to take the hands of Pod People and to chose the fake and the dangerous over the safe and the real. Who can save them? Perhaps a well informed, thoughtful, understanding clinician with time to listen and explain?

Wednesday, 18 June 2008

A brief history of books in libraries

Prehistory. Ugh?

Ancient and Classical world. Scrolls? Yes. Are you a member?

Mediaeval. Book? Yes - over there, chained to the wall. Wash you hands before you look at it.

1439. Books? Yes - piles, thanks to that Gutenberg chap. What's that? You can't read? Oh well, never mind. Mass literacy will be upon us one day.

1700 - 1900s. Books? Certainly sir. Why not take one home with you to read it there? This is a modern circulating library, after all.

21st Century. Books? Books? Bless you, no, madam, this is a LIBRARY! Computers that way, CDs and DVDs that way, children's entertainment upstairs, cafe in the basement. Have you had a look at the art exhibition? Knit your own community classes start in 5 minutes in the foyer.

2008. Click, tap, tap, tap, click. Aha!

Thursday, 12 June 2008

Three of a kind

Today I wanted to draw together some information about our local Strategic Health Authority. I hoped to open with a snappy analogy to explain exactly how and where the SHA sits - between the Department of Health and individual trusts, commissioning but not providing services, providing strategic leadership, considering finance.

However, try as I might I cannot find a good analogy for the NHS and its different layers and functions, so we'll go straight to the SHA and let it speak for itself, as it were.

The SHA has existed for almost two years, being established on 1st July 2006. It describes itself as "the regional headquarters of the NHS". The current SHA strategy, "Towards the Best, Together" is out for consultation now. There are also various consultations on local services and what they should include.

The SHA website is part of a triumvirate of lookalike websites. The second is the website of the East of England Multi-Professional Deanery. Deaneries used to oversee eduction for doctors and dentists, but have now expanded their remit. There are sections on the website for AHPs and Healthcare Scientists. The deanery is also concerned with workforce development.

The final strand of this online trio is Leadership and Talent Management. This strand focuses on developing leaders and on succession planning. Their document library covers everything from Action Learning to happiness.

Each of the three sites can be reached from the home page of the others. It's a clear indication that, however things work, strategic planning, delivery of services, education and training for staff, and leadership and workforce planning go hand in hand.

Monday, 9 June 2008

Money down the drain

Recently we suggested an easy way to do your bit towards saving the planet. Today we extend our advice to encompass ways of saving money.

We recently paid in all the cash we'd taken off you in the last month or so. Over half of it - and it was a good chunk of cash - was fines for late return of books. Fines are like tooth - decay easy to avoid if you follow a few simple rules. Here's how (to avoid fines, I mean - for tooth decay, make friends with a dentist and buy a good toothbrush)

1. Bring your books back on time. (I like this option - simple, but effective).

2. Renew your books by phone or email on or before the day they are due and write the new date on the handy date stamp label in the front of the book to remind you.

3. Bring the books to the postgrad centre when we're closed and post them in the big blue book drop box outside the door.

4. Make sure we have your current full and correct postal address and email address so we can remind you when your books are overdue.

5. Let us know when you borrow books that actually you will be out of the country in the week the books are due.

6. Let us know if you are sick/have been kidnapped by aliens and will not be able to get your books back on the due date.

The one thing not to do is to ignore any letters or emails we send out as this tends to make us rather cross and less inclined to be nice to you when we do finally see you and your books. The thing is, we don't really want you to waste you money on fines. We just want our books in circulation for everyone to share.

What are you looking for?

A reminder for those of you who use Dialog for searching that it is shortly to be withdrawn. We suggest you use the new NLH Search 2.0 instead.

Do I hear you say "PubMed"? Feel free, but don't forget that PubMed is just Medline - you'll be missing out on Cinahl, EMBASE and Psychinfo. What's that at the back? Oh - you use Google. Again - fine. I use it myself and we're here to offer useful suggestions, not to run a library dictatorship.... Try Google advanced searching, Google Scholar and the advanced scholar.

Any other options? Well, you could always try asking a librarian to search for you. It's a free service.

Oh - and a final word to the Google addicts. You are sitting in an aeroplane and you hear the following: "Ladies and Gentlemen, good afternoon. This is your captain speaking. We have an unexplained fault in our engines. However, the Chief Engineer is looking it up on Google and hopes to get it all fixed soon." How do you feel about that? Maybe a phone call to your lawyer. "What are your rights in case of mid Atlantic air failure? One moment - I'll just need to Google that before I can give you can answer..."

Wednesday, 4 June 2008

Read all about it!

I've mentioned the "Behind the Headlines" service before. It replaced the "Hitting the Headlines" service that the National Library for Health used to produce. Although still available through the National Library for Health it's actually produced as part of NHS Choices - the patient information site.

As with Hitting the Headlines this takes stories that are in the news looks at the science behind it. It presents the information in a really useful way. Take a recent example - reports in various papers that chlorinated water causes birth defects. Scary stuff - but it is it true?

The report on this topic is broken down into sections. There's a brief explanation an summary of what the news stories were about, what the stories were based on, and a brief appraisal of that original source. This section alone is useful, but there is more.

There are details of who wrote the paper, the researchers' affiliations, and the publication it appeared in. There is a longer section looking at the study and explaining what sort of study it was an how it was carried out. This is rounded off with an explanation of the researchers' findings and conclusions.

The next section is what the National Knowledge Service thinks about the paper - basically a critical appraisal of the original research. It looks at how the study was carried out, considers the statistical significance of figures in the study, and highlights gaps in the information presented.

The whole piece concludes with links to the original newspaper stories and also to the actual paper that sparked off the whole debate.

I think this is an excellent resource. It's a useful example of how we should look at evidence and appraise it, but also useful for sitting down with patients and explaining to them why they don't need to worry about the latest doom and gloom health headline.

In fact, I like these so much I have a nice RSS feed to bring Behind the Headlines to my Google Reader and from there I often flip them into the current awareness service.

Save the planet!

OK - so you may not expect to get environmental tips from a health library, but we're currently selling these very fetching natural hessian, biodegradable bags. They are sturdy and stylish, and just the thing for filling with a spot of shopping or even an armful of library books. How do you get your mitts on these limited edition lovelies? Why - you trundle down to the library, of course. At just £2 each you wont find a cheaper way to save the planet this year!