Britain needs lerts

Keeping up to date - being alert to new things coming up - can be quite straightforward using the alert service on Search 2.0 at the National Library for Health. The nice people at Shrewsbury and Telford Health Libraries have put together a short guide, but a guide is barely needed. There is (once you have logged in and run your first search) a pair of buttons "save selected rows" and "save all". Select rows, or click "save all" and the next screen has a "save and create alert" button. Then all you need to do it give it your email address and tell it how often you want to be emailed. The system will then run that search for you once a week, month or fortnight, and email you the results. The search can be as basic or as complex as you like, focus on a topic, or an author, or even a particular journal.

If you are asking the system to email alerts to you at work then you must give it your full email address. So if you are at Colchester Hospital University NHS Foundation Trust, and your name is Rafael Nadal then your email address is rafael.nadal@colchesterhospital.nhs.uk. If you'd rather give it your Hotmail, Gmail, BT or other address, then feel free.

For other ways to keep up to date (our own current awareness service aside) think about using RSS feeds. This is a ways of making headlines or new items from news sites or journals or even blogs pop up on a single page. It saves you having to look at lots of other pages. You can gather together as many - or as few - feeds as you like through a "news reader" or "feed reader" service. NLH has a tutorial using the example of Bloglines as a feed reader.

A second option is to personalise your home page (the page you see when you first go in to the internet) to include news feeds. If you use the personalised version of Google (just sign up for a free account) you can "add stuff" using the link at the right hand side of your page and then "add a feed" using the link on the left of the page.

If you have Internet Explorer 7 on your PC then you can add feeds as you would favourites, and you can look at those no matter which page on the internet you are on. However, this only works on a PC where you have Explorer 7 and have set up the feeds. A news reader or personalised Google can be reached whichever PC you are using, at work or home.

Keeping up to date is a "little and often" activity. If you leave it for months you've got more to look at and it becomes a huge chore. If you make a date in your diary every Thursday morning, or every other Tuesday afternoon, or whatever suits you, you'll keep on top of it much more easily.

As we used to say at school - "be alert - Britain needs lerts."

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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.

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Cover to cover

I don't know about you, but I like to get my money's worth out of things. That might mean staying to the bitter end of a film I hate, just because I paid to get into the cinema. More usually it means that when I buy magazines I like to read from cover to cover and back again. If there are a couple of bits I can cut out and keep - a review of a book I want to order from the library, a recipe I want to try, a web address I might visit - so much the better. The thought of paying out for an annual subscription to a magazine where I might - if I get round to it - flick through some of the copies, and perhaps read bits of one or two articles, makes my toes curl.

How is this relevant to you? Well, as departments find their budgets being nibbled away I find more of them phoning me up to ask if I will take on their journal subscriptions for them. My standard response is that I wont.

That's partly because the library budget has had its fair share of cuts, the same as everywhere else. But it's also because I don't believe that having two, three or four journals in a department is useful any more. Most people in the department wont know they are there. Those who do wont always remember to look at every issue, and when they do they will probably just flick through it. The number of papers that are read from end to end is probably very small. And when you want an older copy...well, somehow it isn't on the shelf and no one has seen it.

The better way to go about keeping up to date is to have the table of contents of journals sent to you on a regular basis. You can do this using eTOCs, where the journal itself emails the contents to you, or you can try RSS feeds using a feed reader. Either way you can normally see abstracts. Then, when you find a paper you actually want to read you ask us to send you a copy. We will get it from one of our partner libraries or the British Library. Yes, it costs us, although we don't charge you. But I guarantee that your department will not request enough papers from any given journal for the total cost to match or exceed the cost of subscribing.

Better still, in addition to the eTOCs or feeds - as many as you like - do a regular search on Medline or Cinahl. The point is that you will find papers of interest published in your favourite journals, some in more general journals, and others in journals you hadn't even heard of. Yes, there are standard journals that like to think they cover everything, but why miss out on papers just because they haven't appeared in the two titles you hoard in your department? There's a whole world of evidence out there - why restrict your reading?

Now, if you'll excuse me, there are still some snippets in the latest IWR I haven't read yet...

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Feeling groovy

New(ish) to the current awareness page is a section on Long Term Conditions, which is one of the government's current hot topics.

What are long term conditions? According to the London Health Observatory these are defined by WHO as all health problems that need ongoing management over years or decades. It encompasses everything from mental illness to cancer, and from HIV to blindness. Seventeen and a half million people in the UK have such a condition. The BMA, which has resources for GPs on long term conditions, says the figure is 15 million.

If you are commissioning services for these conditions there is a website just for you, while the King's Fund brings together a variety of resources for managing conditions, including reading lists. If you want to avoid working alone or reinventing the wheel then try the NHS network for long term conditions.

Linked to long term conditions is the concept of the expert patient, who is actively involved in the management of his or her condition, because patients can understand their illness better than their carers, according to the Department of Health. Self-management is linked to patient education, which can help people manage their conditions.

Some conditions have their own National Service Frameworks - cancer, diabetes, COPD and mental health. There is a NSF for long term conditions, and one for long term neurological conditions.

Many conditions have specialist libraries devoted to them in the National Library for Health - cancer, diabetes, cardiovascular, musculoskeletal diseases, neurological conditions, mental health and genetic conditions.

If you are looking to do a literature search for information on care at home and in the community, then as well as the usual sources try the Social Care Online Database from the Social Care Institute for Excellence. The Department of Health has resources for social care, too.

Another aspect of self care is telecare or telehealth, which is about using technology to help people live independently, and "virtual wards" ensure conditions don't turn into the sort of problems that end up with patients being hospitalized. Croydon PCT is leading the field in this area.

If you are interested in the financial cost of long term conditions Audit Scotland has a report, and even a podcast.

A simple Google search for any of these aspects of long term conditions will find lots of results. For any research on long term conditions, think about also looking for "chronic illness" or for the specific illness or condition.

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Tie a yellow ribbon

Betcha didn't know that this is National Knowledge Week for acne vulgaris. National Knowledge Weeks are an idea from the National Library for Health. Each of the weeks highlights one of their specialist libraries and the latest information in it.

Practically every day, week or month is designated to celebrate or highlight something. Next week is Prostate Cancer Awareness Week, this week is Endometriosis Awareness Week. March is also National Bed Month and Ovarian Cancer Awareness Month. In fact there is a whole list of health awareness events on the EQUIP website, from the West Midlands Library Services Development Unit. The Department of Health, in its wisdom, no longer produces its list of events.

Awareness events aim to make people more aware of a particular disease or condition. They help raise funds for research and perhaps encourage people to come forward for screening. Awareness weeks are sometimes behind the odd stories in the press. I suspect that the recent story in the Mail on how a bad pillow can ruin your sleep makes might not have got into print were it not National Bed Month, although they didn't mention that in their article.

Do awareness campaigns work? Some people think they just give the worried well one more thing to fret about - and increase unnecessary trips to the GP's surgery. News coverage of the latest celeb to get breast cancer may send thousands of young women scuttling home to check their breasts, but it also skews their understanding of risk; the main risk factor for breast cancer is age.

With awareness comes ribbons - red for AIDs, pink for breast cancer - in fact there is a whole world of ribbon campaigns out there.

If you really want to be aware of all the latest health news then plug into our current awareness service. No ribbon required.

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