05 December 2012

MedNar: Free Federated Searching

Holiday rush is just around the corner and although that often means work is one of the last things on people's mind it (unfortunately) doesn't actually disappear.  I've posted before that there's no single search tool (database, engine etc.) that covers it all, despite appearances, so being comprehensive in your search can be quite a difficult and lengthy task.  I also often get people asking about what the easiest way to search across many different databases and resources and in the Library world we call that a federated search.  Last year I also posted about a tool called iMediseach which I absolutely love and use on a regular basis: it searches grey literature with ease and although not a perfect or single solution is an absolute must on your bookmarks list.

Another tool like this that I came across the other day is called MedNar, a federated search tool searching commercial websites, government resources, National Institute of Health resources (US), medical societies and patent sources.

The look and feel of the MedNar site is clean and easy to use, very much like Google, and although you can use Boolean operators (AND, OR, NOT) you can type your query in what we Librarians also like to call 'natural language' (essentially how you would search Google).  The results appear by relevancy to your search term and can be narrowed by date, author publication, source etc.  You can also check off results , save print or email them or create an automated alert for your search when the results update. Overall it's a pretty handy tool to have and definitely will be added to my own ammo of info resources.

One major thing to remember is that federated searching is not as good as searching each resource individually, you loose the control and depth of a search when you do so across multiple different resources. Nevertheless, in the health care environment, or even the holiday season when time is at    a minimum it's always good to have a quick and easy option (tailored to the healthcare field) at your fingertips that you can reply on more than a generic search engine!

23 October 2012

Seeing Science: The Wonderful World of Health Infographics

In previous posts I've claimed that I am more right-brained than left (recall my lack of interest in anything math related "Dammit, I'm a Doctor not a Mathematician!"...Well I'm a Librarian, But I'm Still Not a Mathematician).   Lets indulge my right side for a moment, from what I've been told about my ruling 'stars' I seem to have a bit of Virgo's 'attention to detail'  creeping in on my Libra 'easygoing-ness'. Sounds like the best of both worlds right? WRONG!  What this actually does is create a monster of a non-traditional Librarian who is constantly battling between being manic for minutia and broad brainstorming. Where one little thing can set my crazed inner Librarian off, another gets lost in an ever-growing pile of who-knows-what-or-when-it-got-there on my desk. Imagine then the daily, yet toxic mix, both elating and overwhelming, of  information coming across my desk (with only one way out from my Info Wading Room being an alternate career).

Now that I've set the scene enter the day I came across a new form of information: The Infographic (which in my mind deserves capitalization).  It was the day I realized there may be others out there like me, those that love the detail but prefer it not to be at the expense of the aesthetic, like a true Libra, this Librarian likes the scales to be balanced.  An Infographic is essentially a truckload of detail distilled down in an easy to digest graphic form with minimal text.  They are fun, informative, visually pleasing and content rich: like I said, the perfect balance!

For the often complicated realm of health and healthcare this sort of tool has so many possibilities. I've made a home-grown one to convey a little of what the Library does and I kid you not I'm hoping some day I have enough time to create an Infographic annual report! More than anything I think they are a great way to get across health information to consumers patients, and families.  I have posted the Information is Beautiful Infographic Snake Oil in The Science of Supplements but there are so many more!  Lastly though, like any information out there, there's always the issue of quality, bias, intent etc. so keep these close at hand when looking at Infographics.

03 October 2012

Over-Treatment Doesn't Equate to Better Health

Check out this video from the BMJ on over-treatment in healthcare.  Not only interested but a needed reform in research!

18 September 2012

Evidence Based Shared Decision Making: Building patient relationships

 I remember a while back I went to the doctor, the first visit with this physician at a walk in, and when they found out I was a Medical Librarian I was given an uninvited and not-so-polite spiel about Evidence Based Medicine (EBM).  In particular it was the term that was eating away at this person who staunchly claimed that it implied that's not what they've been doing all along!  Where I agree this could be a misconception I think it's important to understand EBM as a group of thought, a practice ethos with a coined name vs. a jab at clinical expertise and experience. In reality there needs to be a healthy dose of both.  One of the glaring pitfalls of 'too much EBM'  is that what may be proven in a study may not in fact be what's best for a particular patient with a particular issue at a particular time and place in their life.  In other words it may not be individualized enough:  enter clinical expertise/experience and something called Shared Decision Making.  It seems a straight forward concept but often times may be overlooked whether it be lack of time or honing skills for information translation to a patient audience.

"Image courtesy of [basketman] / FreeDigitalPhotos.net"

Shared Decision Making (SDM) allows patients and providers to build a relationship whereby the patient is informed and empowered with options to take control of their health.  Physician expertise and EBM work together to inform the patient's choices but ensures it's an individualized decision based on the patient's needs not just the physician's experience and evidence.  What may be best for one patient may not be considered best for another.  The Informed Medical Decisions Foundation website details much more about Shared Decision Making and includes some quick provider tools to help guide the process.

To help your patients along without reinventing the wheel try these excellent decision aids compiled from across the web by the Ottawa Hospital Research Institute and each given clear ratings by the International Patient Decision Aid Standards (IPDAS)

To be fair, by the end of my visit to this doc, despite the tirade, I felt like I was given information and options: in fact this physician was actually very much practicing what I would consider to be EBM and SDM!  Maybe it was their eventual consideration to the meat and potatoes of my profession but I appreciated the transparency and candor of what the latest research was and how that affected my options for care. In fact I appreciated it so much and found it to be such a rare approach that despite the rocky start I left the office only after they agreed to take me as a permanent patient!

23 August 2012

Do You Know Where Your Resources Are? Professional Association Info Benefits

Librarian, like many professionals, risk becoming so zoned into our professional world we forget to look around: 'What I'm NOT the be all and end all of information?  That's ludicrous talk!'  Librarians have a VERY rapidly changing role in health care and even the name Librarian can cause huge controversy in our world: are we Librarians anymore, Information professionals, Knowledge Managers?  This is just the tip of the iceberg that's melting fast into one overflowing pool of information expertise.  Nevertheless, one thing that I think we all can agree on  is that a MAJOR goal of our profession is to connect people with needed and useful high quality information.  So goodbye are the dreams of grandeur, to thoughts of gate-keeping access to information, and hello to the utopia of flowing (though unfortunately not often free) quality information with your Librarian as guide.

Image courtesy of: Vichy81 & DigitalArt / FreeDigitalPhotos.net

Now, let's traverse into a short tale,  one of a solo-Librarian trying to promote a new Library service to health care staff but restricted by the evil price increases of quality resources and ever-shrinking budgets.  Was there nothing affordable left? Enter a colleague of mine (Ken McFarlan of Lakeridge Health) who nicely pointed out another colleague's work (Gail Nichol from the University of Toronto) titled "Information Resources From Your Professional Association" recently presented at our national conference.  The poster not only lists some of the wonderful and often expensive resources available through your professional body but also the cost-benefit of the dues (if you restricted 'benefit' to info resources available).

This should be great news for Nurses, Physicians and OT's who see an excellent return for their dues whilst the outlook is not as great for Dentists and Pharmacists.  Keep in mind again, this is only taking into account the information resources, not all the other benefits of membership.  It also means mostly good news for the tale of two Librarian evils: rising costs and shrinking budgets;  the happy ending being we can still take on the role of professional and expert guide to these resources even if we may not be able to afford them in our collections.

Thanks again to Gail and Ken and be sure to check out the details offered through your association and/or speak to your Librarian!: "Information Resources From Your Professional Association"

26 July 2012

The Science of Supplements

Check out this great Interactive Infographic from Information is Beautiful!

Snake Oil?  Inforgraphic on popular supplements
Click on the bubbles and it links you straight to the study visualized be it via Cochrane or PubMed.  A great way to make sometimes-heavy information interesting!

25 June 2012

Surging Social Media: Finding the Golden Info-Nugget

If you haven't heard of the Blogosphere, Twitterverse, and of course we can't forget the less-catchy moniker, but still ever popular Facebook, then this is not the post for you.

 For those of you who have heard/use them you know how powerful the impact of social media can be: highlighting information instantly & across many traditional boundaries.  It can take less than a day for something to start "Trending" on Twitter, a page or post to receive hundreds of thousands of "Likes", or for a relatively unknown Blog to become an international hit. A recent example was the KONY 2012 video campaign which first surfaced in March of this year an in less than a month had 86 million views on YouTube alone.  To say the power of social media is incredible is an understatement.  That's not to say it's all useful, truthful, or even of any quality but surely in just under 350 million tweets per day there has to be some golden nuggets of quality information, but I'll get to that in a moment.  Though health and health care may not 'Trend' as easily as some other topics it would nevertheless be wonderful if there was a way to discover at least some of the health information being written out there in the social mediasphere.

Enter the people from the TRIP database (a clinical search engine) who are attempting to do just that with their tool "Blitter" (or at least in part).  Blitter defines itself as "a clinical search engine with content highlighted by clinicians who blog or tweet" and that "If they think it's important enough to comment on, we consider it great content".  The tool is is a simple search bar where the user can type in the topic/subject of interest and hope for returned content!  The resource includes a list of contributors and the creators have defined a basic criteria for 'following' these contributors: 1) they are blogging or tweeting on clinical content 2) there is no obvious conflict of interest.  Though it's great to have criteria it should be noted that this is a very broad set.

Though most who are active in social media and health care know to take the output of these tools with a grain of salt it nevertheless is worth mentioning the dangers of taking personalized tweets and blogs at face value.  That's the beauty of the blog and tweet: people like me can have a voice to a larger audience; nevertheless, they are by no means peer-reviewed or subject to quality controls!  There is of course a time and a place where these items are useful, and if nothing else may alert one to a piece of information they may otherwise not have known about:  in the world of information it's always good to collect a range and then assess.  Blitter is one new tool to use when collecting!  The creators also make clear on the website that it is an experimental approach and welcome any feedback.

Check it out today, and while you're at it, check out the parent org. TRIP!

11 June 2012

Caring for Culture: Relevent care for all

Growing up I thought I would never plant roots in Canada: I had the travel bug from a young age and craved adventure.  It wasn't until I left the country for a few years that I began to appreciate Canada for everything that it was instead of what it wasn't (e.g. warm 52 weeks of the year! :) )

Image taken from criticalmeasures.net (no endorsement of site)
I now happily live in Toronto in an 'ethnic' area and although the definition of such an area can be as broad as the cultural makeup in my neighborhood it's one of the things I love most about this city. I love the amalgamation of differences and relish learning about these as well as the similarities across cultures.  I like to think I'm a fairly aware and culturally sensitive person but I know that my knowledge is only the tip of the iceberg and likely have very little knowledge of the plethora of cultural nuances.  Working in healthcare inside AND outside of Toronto it is increasingly important to be mindful that there is no 'Excellent Healthcare' prescription for all and that being sensitive to the cultural differences in all aspects of care is increasingly a must.

If your health care facility has a Librarian on staff they help provide you with resources and advice on this topic, or for a specific aspect of care.  It's just as important to ensure the information you are accessing on this is high quality and trusted: for example suggesting a mental health intervention to some cultures may be frowned upon or misunderstood so it is important to ensure a good working knowledge these differences to ensure optimal care and respect. 

A great free resource available online is called Ethnomed where you can browse topics by culture, specific clinical topics or even patient education materials.  If you're looking to provide a patient or family member with some information you can also check the National Network of Libraries of Medicine for quality Consumer Health info in many languages (based in the US).  You can also try the NSW, Australian government site that breaks items down by language!

These resources are by no means all there is to culturally competent care but it's a good starting place to ensuring your patients and families are respected as well as informed about the care you're providing.

30 May 2012

The wrong services at the wrong time?: Triage at home with FreeMD**

Two months: that's almost how long it's been since my last post (!)  I can excuse it because not only did I get married but I, like many other brides I've since spoken to since, came down with a pretty nasty cold the day after (thank goodness the honeymoon wasn't til later).  It's strange how the most common ailment can be so hard to diagnose: was it simply stress, an actual bug I caught, or has something more sinister been brewing for some time?  I took the worst days off of work, because I was determined not to remain sick for our honeymoon, and while the worst is definitely over I still have this strange nagging cough that rears its ugly head at random times and for no apparent reason.

Despite my plethora of resources in front of me there's only so much information I can get back for "annoying, random cough with no other sickly symptoms" :).   A quick search in Google, and I kid you not, my random cough is apparently typhus ha!  That's not to say there's not good info out there but really, typhus?!  I'd be running for the nearest emergency room if my sensible little shoulder-doctor (who replaced my shoulder angel a while back) didn't assure me this couldn't be true.  But what happens when weighing in on the other shoulder is my resident  hypochondriac (obviously a replacement for my shoulder-devil) whispering in my ear that: "well there was that one case in Texas just a few days ago"?  Well it's back to the emergency room for me!
However, what if I had a tool to check my symptoms better than a simple Google search, or perusing the posting boards filled with people who are clearly being brow-beaten by their shoulder-hypochondriacs.  FreeMD.com does just that.  It's a tool created, authored, and run by qualified physicians that walks you step by step through a series of questions that arise based on your answers.  An actual emergency physician Dr. Schueler accompanies you via pre-recorded video to help you along.  At the end of the 'triage' you receive some possible suggestions about what your symptoms may mean, you are given an option for care (urgent care, doctor's office, emerg. or dentist) and you also have the option to print a copy of your online triage to take with you to your healthcare provider (which may help clarify some items when giving their own triage). 

It's a great and fun tool that may save your patients from utilizing the wrong services at the wrong time.  Don't get me wrong it's not perfect:  I answered questions for elbow pain and had an option of elbow cellulitis which I can almost guarantee I don't have; nevertheless, I was also given the option of elbow bursitis...which I actually do have!  I was then advised to visit my doctor's office instead of urgent care or the emergency and have a paper copy of my online checkup so I don't blank when I'm hit with twenty questions in person.

Check out these different checkups offered: Symptom, Injury, Disease, Women's, Men's, Pregnancy and Baby!

**Just remember to clarify this with any patients that this is a supplementary tool not a replacement of actual medical care!

04 April 2012

Working Out the Rotten Potatoes: Nutrition & Fitness Info You Can Trust!

Spring has arrived & bathing suit season is just around the corner. For many this is reason enough to trade the meat and potato lethargy of winter for the fruit & veg activity of the warmer months. Nevertheless, for me the potato is not a part-time obsession, and neither is my love of its cousin-carbs, bread and pasta.  Combined with what I like to excuse as 'a staunch work ethic' I have caught myself saying all too often "I simply don't have time to go to the gym”. I can also guarantee that with the long and often unusual hours of healthcare workers I am not the only one. But has my crush on carbs and crappy cardio routine destined me to being 'unfit'?  Fad diets and exercise routines often tell me yes.

Despite this, I know deep down the little potato is both friend AND legitimate food, and that my lack of ‘no-pain no-gain’ workout sessions doesn’t negate my 'lower-intensity' exercise.  Still, it's hard not to be overwhelmed by the latest diet, workout craze and even conflicting 'scientific' evidence they all claim.  In January I posted this video called 23 1/2 hours by Dr. Mike Evans, which tries to hit home a very simple and basic fitness message and definitely worth a watch.  Yet there's so much more quality info out there: so instead of taking advice from an over-energized, over-muscled guru in too-tight shorts check out these quality resources you CAN trust!

Nutrition & Fitness Info and Tools (US)
SuperTracker (tracks & helps plan your diet and activity)

Info for Healthy Aging (US)

Medline Plus (National Library of Medicine - US)

Health Canada

Check with your Librarian or Consumer Health Library for more quality resources and tools...now back to my morning bagel :)

05 March 2012

Taking Care: Putting Yourself First

I'm sure we've all heard in one form or another the old adage Take care of yourself before you take care of others yet all too often this doesn't happen.  For a long time we've been able to blame our culture of work: Work hard, play hard (though working hard leaves little room for playing hard).  Although we can still point fingers, more and more resources are being created to help get to the root of the issue, or provide tools to ensure we try and take care of ourselves.

 For clinical staff this modus operandi is particularly important given their role of taking care of the masses; but are they really taking care of themselves?  Long hours, stressful situations, and intense responsibility over arguably the most valuable aspects of people's being brew the perfect storm.  When, and how, can they turn the clinical eye around at themselves? 

A new free resource from leading Canadian Physicians and eLearning experts is perfectly poised to help fill in this gap: ePhysicianHealth. Topics include: disruptive behavior (medical students & physicians), depression, substance abuse, burnout, resilience, nutrition and fitness. This resource is filled with videos, interactive features and links to provincial Physician health programs making it easy to navigate & enjoyable to browse!

So for all those devoting their lives to the health of others there's now an excellent resource devoted to their own to help ensure they're taking care of themselves so they can better take care of us!

08 February 2012

Media Muddle: The Diet and the Doctor...

I'll start with I'm a transit commuter.  This is important because it means I have about 4 hours every day (yes 4!) sitting on a train with nothing better to do than to daydream of grandeur or do what every living Librarian does: read.  While I used to grab one of those free morning papers everyday, I've stopped for two reasons. Number one, because although I am fully capable of making spelling and grammatical errors (and do), I have very little tolerance for the plethora of errors littering these papers that have qualified editors on staff.  Number 2 because this year I've decided to de-stress a bit and I've pinpointed the never-ending 'bad' news I was reading day in and day out to be causing me some form of anxiety.   It's not an easy thing for an information professional to read something without picking it apart trying to separate the high quality pieces from the naff.  Nevertheless, that critical eye is needed, and what about those who may not be so used to picking information apart?

Enter the growing amounts of health advice/studies reported in the media (a topic I've written about in previous posts).  I get asked about those studies everyday and I don't think it'll be a surprise for many to reveal (!) they're not all good.  We're told one day that drinking less coffee can avoid cardiovascular 'stress', and told the next day to drink way more than most people already do to avoid breast cancer!  It's the tale of two evils only there's too many tales with similar contradictory advice.

Now there's help from a few different places:

Media Doctor Canada is a website dedicated to improving "Canadian media coverage of new medical drugs and treatments" through the use of a standardized rating scale rated by a qualifies and professional staff.  For more visit: http://www.mediadoctor.ca/

Media Doctor Australia is the original site that Media Doctor Canada comes from.  For more visit: http://www.mediadoctor.org.au/

Health News Review is a similar site, updated more often, aimed at improving the accuracy of health news stories & helping consumers evaluate health evidence.  Evaluations are also by qualified professionals.  For more visit: http://www.healthnewsreview.org/

These sites also review the actual media outlets for their overall rating which may help in the decision of what paper to buy or what TV show to watch if you don't take my recent 'head in the sand' approach.  They try and cut to the core of what's really important: the gold nugget of health information minus the sensationalizing often 'bad' news or endlessly conflicting headlines.  So while I'm on a newsprint diet for 2012 so far I still can't help gobbling up the good 'healthy' news these sites offer. Whether it be this choice or my lessened caffeine intake I've become much less anxious on my very, very, very, long commute. :)

24 January 2012

Out From Under the Pileup: Health Advice Made Easy!

It's been a busy 2012 so far and I'm late on my posting!  With the post-holiday pileup of work I figure this video would be a nice 'sit back and relax' item for those of you also under paperwork-siege.

With all this health advice constantly bombarding you in the news it can be overwhelming to say the least: I know because It's my job to deal with this raging river of information and I find it difficult to keep up so you're not alone!  Sometimes it's nice to have a more simplified tested view on health and that's exactly the beauty of this video.  Its author, Dr. Mike Evans,  practices at St. Micheal's Hospital here in Toronto and is an Associate Professor  of Family Medicine and Public Health at the University of Toronto and he does a great job of hitting home his message in the video, 23 and 1/2 hours