Atishoo!

It's that time of year again when we all start wondering if this is the year when we will have a huge outbreak of flu and drop like flies. Luckily there are lots of places to find the latest information.

NHS direct, which has information for patients, has an explanation of what flu is, how to avoid it, and what to do if you get it.

The Department of Health provides guidance on flu, and some useful links. Some of the guidance covers pandemic flu.

The Health Protection Agency has epidemiological information, factsheets and more guidance.

Finally CKS - Clinical Knowledge Summaries - has information to help decision making on flu vaccination.

Anyone wanting to know what a real flu pandemic looks like will find no shortage of information on the web about the pandemic that hit after World War l. The Health protection Agency has a page covering the history of flu pandemics, the Wellcome Trust ponders Spanish flu while Wikipedia has a comprehensive page with pictures, graphs and lots of links.

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A good TRIP

The TRIP (Turning Research into Practice) database has been tweaked and the search facility has improved. There are also now some specialist search engines which, they say, "allow users to simultaneously search the core TRIP content plus the top 10-15 journals specific to that area". They see this as a link between TRIP and Medline.

There is also extra content in the database, including wikis and podcasts.

When you search TRIP your results are categorised as systematic reviews, guidelines, research textbooks and evidence based synopses. You can use these categories to filter your results. The final category is "more" and this is where podcasts, UK approved education resources and wikis will appear.

You can also search TRIP for patient information leaflets and for medical images (but beware - these are mostly copyrighted!)

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New resource for neurological conditions

The National Library for Health website now has a specialist library for neurological conditions. The library covers a range of conditions including epilepsy, MS, Parkinson's, dementia, stroke and sleep disorders.

The library is one of a collection at the National Library for Health. Others cover cancer, oral health, mental health, skin disorders, later life, trauma and orthopaedics and patient and public involvement.

Each library is a one stop shop for breaking news, guidelines, NSFs, patient information and evidence.

Pretty as a picture

I've been inspired by Newham University Hospital's library blog (plus some I use for fun, at home) to add some pictures here. I'm using Flickr pictures that are under creative commons licences.

Pictures are useful, especially when trying to explain something to someone. However, most pictures are copyrighted - that is, they belong to someone. When I look at patient leaflets - a panel of us in the Trust vets all leaflets - one of the comments I am most likely to make is "who holds the copyright on this picture?"

As a rule of thumb unless you have drawn the picture yourself it does not belong to you. Writing "copyright" under the picture doesn't help. You must seek permission from the copyright holder to reproduce the picture. Don't forget that an organisation might have spent a lot of money employing someone to draw up that lovely set of diagrams and when you put those pictures on your own leaflet you are stealing them.

Many health organisations in practice do seem happy to share their pictures, so do please ask them. Make sure you get their permission in writing and keep a copy of it. There are various sources of pictures that are copyright free, although photos are easier to find than health related diagrams and drawings. Alternatively, why not get a pencil and piece of paper out and sketch something yourself.

Sometimes I find leaflets that have lifted text as well as pictures, which is plagiarism. If the leaflet you find on a website says everything you want to tell your patient then rather than typing it out again, tweaking the wording a little and sticking your name at the bottom, consider this. Do you need a leaflet at all? Can you not just tell your patient where to find a copy of the existing leaflet? You may be able to print the relevant leaflet from a website, or you may need to ring and ask for a paper copy.

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Remember, remember

This Bonfire Night NLH version 3.1 will appear - hopefully without any bangs, but with oohs and aahs of delight.

"NLH who?" I hear you say. This is the National Library for Health, which is growing and changing at a rate of knots. Version 3.1 gives you two extra facilities. When you search for guidance you will have an extra box to allow you to search for guidance from some overseas resources. Secondly, when you search for evidence based reviews, you'll be able to include Bandolier in your search.

More changes will follow as NLH continues to develop.

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Best of both worlds

I understand that some of you prefer PubMed to Dialog via Athens. Fair enough. However, why not have the best of both worlds? If you sign yourself up for a “MyNCBI” account you can ensure that when you search anything you have full text access to via the NHS is flagged up.

Here’s how. Go to PubMed and set up a MyNCBI account – just register a username and password, a memorable fact and copy some letters into a box. It takes a couple of minutes.

Once registered you need to set up a filter. So, log into your MyNCBI account, select "Filters (including LinkOut)" from the left hand menu. Click on the “PubMed” link. Select the “Browse” tab. Click on “libraries”. Now scroll down, down, down until you find “NHS Core Content”. (It’s in the middle of the N section, not at the start as you might expect for an abbreviation….) Found it? Click on it!

Now select "Add a result tab for all items that match this category". Now when you search you’ll get a separate tab to show the results where your Athens password will get you free full text access.

The other ways of getting this same service is to go to PubMed via the link on the National Library for Health.

Of course, this system wont show you which journals we hold in the library. Don't forget that any paper can be requested from us - use the "request a paper" link on the quick links page of the library website.

The wake up pill

I've been tracking the use of this blog with Google Analytics and was interested to see that several people stumbling across it had been looking for information on the ethics of coma. As I've mentioned before ethics is about how we look after the vulnerable - and those in comas are vulnerable because they are unable to tell us about themselves and their wishes.

One recent coma story covered here was the women whose family fought for her not to be given Zolpidem to wake her up. Today the Telegraph reports on a story of a young woman who has been woken by Zolpidem and seems to be recovering.

Looking at the pictures of this young woman, slumped in a wheel chair, it strikes me that we move on to a second area of ethics - care of the disabled and issues around quality of life. What does it mean to have quality of life? How can it be defined and measured? Is it enough not to suffer or should there be more to it than that?

This ties in, too, to the debate on abortion. Some abortions are carried out because the child will be disabled. How badly disabled must one be in order for life not to be worth living? I think of the range of cases - from the young girl in Ireland and was carrying a anencephalic child (that's a child with most of its head missing, in lay terms) to the vicar who asked the police to prosecute in a case where a child was aborted after 24 weeks for cleft palate.

Abortion is a complex issue. The BBC provides a page on ethical issues around abortion. Organisations on different sides of the debate include the Society for the Protection of Unborn Children , British Pregnancy Advisory Service the Catholic Church in England and Wales and Marie Stopes International.