Wednesday, December 30, 2015

Commentary searching

"Commentary driving" is the technique of describing what you are doing and seeing as you are driving, and is a technique employed by instructors working to train the police, and as part of advanced driving tests.  It helps, it is said,  you use your eyes properly and improves your hazard perception.  Here, from driver trainer Chris Gilbert, is more information about the technique.  

What about commentary searching?   What about getting someone to describe what they are doing when they are searching, say, Medline, and why they are doing it?   Devising a mark scheme for this might be a bit of a challenge, but as a formative assessment?   Perhaps getting people in pairs to commentate on their search to each other?  And then to comment on each other's commentary?

Well, something to try in the new year, perhaps.

Monday, December 28, 2015


I wasn't paying complete attention, but in Christmas Day's Call the Midwife, there were cases of measles.  At least one was fatal.  Local schools were closed early for Christmas and quarantine was imposed by the Board of Health.

The (US) Centers for Disease Control and Prevention reports that measles was declared eliminated from the USA in 2000.  However, in the decade before vaccination became available in the USA, almost all children caught it (3 - 4 million cases annually) and 400 to 500 people died.  48000 people were hospitalised and 4000 suffered encephalitis.

Clinical Knowledge Summaries (a resource compiled for the NHS) reports that measles is rare in the UK but has become more prevalent due to a reduction in the take up of vaccination (measles being, of course, the first "M" in MMR).  It is self limiting, but some complications are serious - encephalitis, panencephalitis, convulsions.  Adults have more complications, so measles is a more serious condition in adults. And measles in pregnancy is a serious thing, possibly resulting in miscarriage and premature birth. Presumably these things explain why vaccination is thought necessary and why it is a notifiable disease.

Here are some resources about measles:

CDC - as well as the historical information referred to above, there is information about more recent outbreaks in the US, information for parents, including why measles is still serious (1 in 4 who get it in the US will be hospitalised, and 1 or 2 out of every 1000 will die, for starter.  CDC information is also available in Spanish - there are links from some of the pages, but you can start at the Spanish home page and look for (I think!) sarampion.

CKS - information for primary care practitioners,  with scenarios, and supporting evidence.

NHS Choices - information for patients, but also links to information about clinical trials.

Healthcare robots

I started this post when my sons and I went to see Big Hero Six.  Something for all of us - visual humour, Japanese culture and influence, and health care.   But that was weeks ago and I forgot about this post. 

Then yesterday we saw it again, on a satellite television movie channel.  And I remembered this post.   There is a lot in the plot - microbots, a robotics institute, some self styled "nerds" who end up as a superhero team, and a lot more.   But it was the healthcare theme that particularly caught my attention. 

Baymax is an inflatable healthcare robot.  Activated when people are distressed, he asks you to tell him the level of pain you are feeling, on scale of 1 to 10, which appears on his chest with a chart of smiley faces.  He scans you and can detect your hormone and neurotransmitter levels and therefore work out if you are under stress or agitated.  His chip is programmed with information about medical conditions.

Baymax will not become inactive until you say you are satisfied with your care.  So, if you say you are not, or do not answer, he is not deactivated.

A search today in PubMed for Baymax retrieves zero (and in fact is changed into a search for Bayman).  A similar search in Google Scholar finds references to various bays by people called Max, among other things, but nothing about this inflatable robot.

But, somewhere on the second page of results for a search of Google for Baymax is this page from the School of Computer Science at Carnegie Mellon University, Pittsburgh, who work on care giving robots.  They are fundraising to build a "real Baymax", a personal health care companion robot, and this page gives links to information about work already done.  Professor Chris Atkeson  does appear in PubMed and in Google Scholar (and there is a list of his publications on his own personal page, linked from this page), so off I go to investigate!   Balalalalala!

I was originally going to include learning robots (after watching, again, The Incredibles), and although that connects here, I think it needs a separate post.  Which I might write in 2016 sometime.

Sunday, December 27, 2015

Week three

Week three as a clinical librarian was just one day, the Wednesday before Christmas.  I travelled to the library at Glenfield hospital to meet my line manager, and while there found a section in a book that answered the information need of a visitor, and looked a book up on the catalogue in response to another enquiry.

I then travelled back to the Odames Library, where I caught up with email (two more literature search requests - one a new one and one a revised version of one I did last week), sent some messages to contacts suggested by the Cancer Information Centre, and printed off some thoughts for a meeting that I then had with a doctor in the Clinical Genetics Centre.  At that meeting we talked about three literature searches, and then I came back to the office and did two of those searches.

I had been before to the Clinical Genetics Centre, when I was based at the old Clinical Sciences Library, so it was nice to be back.   One of their other doctors had been at my interview setting the search scenario, but unfortunately she was not there on this particular occasion.

I also answered the phone, renewing someone's books and their library membership.

So, several places where I was close to the clinical work of the hospital, and several where I was doing things that don't form part of my work in my other job.

Yesterday I became aware that there is a site in the original Thunderbirds movie that is called Glen Field - it sounded like it was said as two words, but the sign says "Glenfield". On my next visit, I shall look out for Lady Penelope.  You rang, my Lady?

Saturday, December 26, 2015

Miracle on 34th Street

We watched the 1947 version at a film night at church.  I had never seen it.  There are many things of interest - 1940s New York and a scene in Dutch.  That scene - there is a transcript on the IMDB site at the link in the first line - involves a young girl who has come to New York from the Netherlands. I assumed, because she had no English and I thought it was post war, that this was for reasons related to the post war state of affairs there, but no reason is given.  There is only one African American character (in the kitchen).  And then there is the role of men and women - there is one very central female character, a divorcee and single parent, but the other women seem to be at home, with an allowance and having martinis made for them by their husbands...

But the reason for this post is mental health.   The central character, Kris Kringle, is convinced he is Santa Claus.   He has taken part in Macy's Thanksgiving Parade, as Santa, but thinks he actually is.  The State of New York wishes to have him declared insane and there is a court case.   Santa's lawyer (or Kris Kringle's) argues that because the post office can deliver letters to "Santa Claus" to Mr Kringle, therefore (because they are a federal agency), he must be Santa Claus.  There is the proof.

There's a shot of a news report referring to psychiatrists as "alienists", which is interesting.

But, the thing that I found really interesting was the reason why Santa / Kris was put into a hospital and then taken to court was because he had confronted Macy's in store psychologist about his dealings with Alfred, the janitor in Macy's.  His appointments with Alfred had convinced Alfred that he had "issues" (a modern term for it).  Santa/Kris was sure the psychologist had no qualifications, and after hitting him with his cane, was taken away to a secure hospital.  Santa/Kris had actually already had his own appointment with the psychologist, and he had obviously had this sort of appointment before, as he knew exactly  what to expect and had upset the psychologist by apparently not taking things seriously, because he knew what the questions were going to be, and what the answers were.

There is a lot in this film that perhaps would not have been commented on in 1947, but would be now.  And that includes the things about mental health and the attitudes to it.  Who is sane and who is not?   And who is anyone to say what is wrong with someone else, and judge their demeanour or attitude?

Then there's the smoking - of a pipe in the house, and then of a cigarette in the bedroom.  But that is a whole other blog post. 

Friday, December 18, 2015

Lyme disease

You wait for a blog post and then three come along at once.

Last but not least, Lyme disease.  News reports like this one in the Guardian report a rise in cases of this tick borne disease.  News reports are investigated in this NHS Choices Behind the Headlines piece.

There is more about Lyme disease here: 

(US) National Institute of Allergy and Infectious Diseases
This site includes a history of discoveries about the disease.

Clinical Knowledge Summaries

Public Health England

There is also Lyme Disease Action, which works to raise awareness of the disease, including amongst clinicians.

My first two weeks

So, in my first two weeks as a Clinical Librarian, I have:

Sent an email to introduce myself to some of the members of my departments.   I did this on the first Friday, and had two instant replies, one asking for articles, and one saying hello.   By the next Wednesday (the next work day) I had had four more, including one request for a literature search, and two mentioning the possibility of going to a meeting in that department.  

I have also:

  • Visited the excellent Cancer Information Centre, getting two contacts to follow up;
  • Done a literature search related to sickle cell anaemia;
  • And another related to length of stay in hospital;
  • Explored the Evidence Updates that we send out, thought a bit about how we might redesign one, and sent colleagues some bits and pieces for them;
  • Let someone into the library;
  • Answered two questions at the desk (everyone else was at Christmas lunch), only one of which I had to pass on to colleagues;
  • Done induction training on infection control, basic resuscitation skills, moving and handling, equality and diversity, and safeguarding.
  • Asked IT colleagues about two matters;
  • Found some cancer information sites to put on a webpage.
I have met one person for literature searching advice, and have another such appointment next week, and have a meeting with a research and development lead in the New Year.

Next week, week three.

Hello my name is...

Quite a long while since the last post, and this is partly due to a new job, and partly due to general disorganisation, something I did not mention at the interview.

I have started a second, part time, job, returning to full time working for the first time since 2008.  I have joined the Clinical Librarian team at University Hospitals of Leicester, based in the Odames Library at the Leicester Royal Infirmary.  The Library began life in 1907 as a hospital ward, paid for by Samuel Odames, hosiery manufacturer of Leicester.

I am looking forward to being involved in the NHS again, and especially at the hospital site where I started in Leicester in 2003.  Some of the site I don't remember (some of it has changed, of course), but some of it I vaguely do.  And today I met in the corridor someone I used to meet frequently at the University, as he was at that time a member of one of the departments I support.  

I have a name badge with a photo on it, and another with just my name and role, and the statement "Hello my name is", which I have also put on my email signature.   The trust have signed up to a campaign of the same name, to encourage health staff to introduce themselves when meeting patients.   Dr Kate Granger, the founder of the campaign, noticed when a patient herself that many staff did not introduce themselves.  As a non clinical member of staff, it is nice to be included in the campaign.

On my third day, I met someone at the issue desk, who had come to request a literature search and happened to be in one of my departments.  Afterwards, I realised I had not introduced myself.   I always remember when answering the phone, even at home (how formal!) to say who I am, so it is interesting that I forgot in person.  It perhaps shows how easy it is not to introduce yourself to people you meet in person and why the Hello my name is campaign is so useful.

So, Hello, my name is Keith Nockels.  How can I help?

Sunday, November 22, 2015

Understanding maths, or writing down the answers

Bipods have two legs, and tripods have three.   At least two of each land on earth, and they have 23 legs.  How many of each are there?

Well, I thought of solving it with equations.  But there are two unknowns and only one equation.  So I borrowed two primary maths books from the excellent Educational Resource Collection (for trainee teachers - hope they also got the ones they wanted!) at work.   Starting with a guess, was the suggestion.  So we did, and with a bit of use of the 2 and 3 times tables, we arrived at an answer.

There is more than one answer, so we tried to find another.   But we did not understand how we had got to the first answer, so we could go not go any further.

I was not sure what to do next.  I am a Primary PGCE drop out.   So, I recommended we (well, my son) ask his teacher.

The next night, my son wrote down his own fraction problems.  He wanted to do them himself, and take them to school to show his teacher.  An admirable application of what he had learned. 

Some were easily solved using the techniques he had learned at school.

One was 5/10 of 48.  He drew 10 boxes and proceeded to share 48 dots between them.  He ended up with some boxes with 6 and some with 5 dots and was not sure what to do next.   I asked how else you could write 5/10?    1/2, he said.   He tried again, with two boxes, and worked it out.  

Then the next was 6/9 of 50.  The same problem with the boxes, and with no solution in sight, he was very upset that he would have to take the answers to school with blank spaces in.  One of his friends had written out some questions and had no blank spaces, he said.   Maybe, I said, he had not come up with any questions that he had not done at school.  Remember, these were questions my son had written himself, and however many times I told him not to worry, because he had come up against some maths he did not know, he was most upset.   Having the answers was more important than knowing how you got there, and more important than saying "I don't know" and realising that the methods you know don't work, even if you don't know why.

So, when devising assessments or assignments, I need to remember - make them so people have to understand a process, as well as having an answer.

Talking with children about the news

Son #2 has become fascinated by skyscrapers, especially the Burj Khalifa in Dubai, the world's tallest building and definitely a tremendous piece of engineering.  His fascination extends beyond this building, and includes skyscrapers in New York.  His mum and I were lucky enough to visit the city some years ago, and came back with a lovely illustrated book about the city's skyscrapers.  He can also tell you, if you want to know, some of the world's previous tallest buildings, which include several in New York, of course, and also the Eiffel Tower, which has also been met at school as part of a project about "Fantastic France".

The news?   Recent news.  Our son's class spent some time at circle time earlier this week remembering the recent terrible events in Paris, after a classmate had mentioned seeing about it.

The Guardian reported what the French education ministry had done to help teachers. 

And older news.  From 1970 to 1973, the tallest building in the world was the original World Trade Center in New York.  It appears in books we had read, but so does the new one (as a design), and so I had said that the original one was no longer there, that it had been replaced by new buildings, including the "Freedom Tower", which we had read about.  

And that was going to be that, until he was older.

And then, there we were, watching a documentary about building an enormous artificial island in Dubai.  The island was designed to increase tourist visits to Dubai, to start to develop alternative sources of income to replace, in due course, oil.   Work started in August 2001, and was affected by the global downturn in tourism that followed 9/11.   And the programme showed, briefly, what happened to the World Trade Center.  I am glad I was watching it with him.  So, we had to talk about what had happened.

I don't think the answer he needs now to the question of "why" is the one that he will need when he is older.  For now, I hope it was ok to tell him that it was not an accident, and that people did die (he asked both those things, and he had seen a photo of a plane that crashed some years back into the Empire State Building). 

So, how do you talk to children about the news?    I am not thinking here about breaking bad news to them about their health or the health of family members.  That should be the subject of a separate post.   But, how you talk to them about difficult stories in the news.  You can, as I tried to, not tell them, but they will find out about the news story sooner or later and they will want to know.

Here are a few things that look useful. 

BBC's Newsround has advice for children/young people on what to do if you are upset by the news.

PBS Parents

Common Sense Media - an American Academy of Pediatrics site.  

A lot of British advice that I found was about dealing with bereavement, abuse or illness, but Cranmer Primary School in Mitcham, Surrey, has taken some American advice and amended it for a British context. 

A interesting newspaper item is this one from the New York Times, reporting French sources and media.

Saturday, November 21, 2015


American actor Charlie Sheen recently announced on a television chat show that he was living with HIV, which has got some media coverage, including some that suggested that not everyone knows how HIV is spread.   

I don't know how typical this Guardian story is, but it does suggest that some people do need more information, and up to date accurate information, about HIV.

When I started working in health libraries in 1986, AIDS was a very current topic.  I remember hearing ideas about who was most at risk, and what some people said definitely conveyed the idea that it was a condition that affected gay men, and not anyone else.  I also remember learning about Edinburgh, where I had just moved from, that the group most affected there was not that group at all.  Richard Holloway, who became Bishop of Edinburgh the year after I left the city, realised when he moved there that the community affected in Edinburgh was not the same as the one affected in Boston, Massachusetts, where he had lived and worked before.

Then there was the government's television advert and leaflet, "Don't Die of Ignorance", preserved here at the National Archives.

For today's information about HIV, including how it is spread, and all the developments in treatment and pre- and post-exposure prophylaxis, have a look at these:

NHS Choices: symptoms, causes, diagnosis, prevention and living with HIV and AIDS, plus stories, details of clinical trials, and a discussion forum.

Clinical Knowledge Summaries: for primary care health practitioners, covering diagnosis and management, with scenarios.  CKS links to supporting evidence, but in this case it is guidelines and review articles, with no information about anti retroviral treatments, which are beyond the scope of the information.  CKS information was last updated in September this year.  CKS is one of the sources picked up by NICE Evidence Search, which you should try for other sources.

The Terrence Higgins Trust, founded in 1982 and named after one of the first men to die of AIDS, has publications, information on sexual health and on living with HIV, and the history of the Trust gives an insight into the history of what is known about HIV and AIDS.  There is also information on the activities of the Trust itself, and its local centres.

Thanks to the THT site, I know that National HIV Testing Week begins today, 21st November.

In the United States there is information at (managed by the Department of Health and Human Services), CDC, and Aidsinfo, from the NIH.  Aidsinfo uses Google Translate to provide information in other languages, and the other sites are available also in Spanish.

The World Health Organization has information, including data and statistics, information on treating children, on mother to child transmission, and on co-infections.  Use the links at the top right to get the information in Arabic, Chinese, French, Russian and Spanish.

Friday, November 13, 2015

Elizabeth Blackwell

We read the excellent Judy Moody books to son #1, and now we have started reading the first one in the series to son #2.  I can't remember how we first came across the books, but if you are not familiar with them, you can find out more about Judy and the books on her website.

You may by now be wondering what Judy has to do with the title of this post.  Well, Judy knows about Elizabeth Blackwell, first woman doctor, and wants to be a doctor too.  Elizabeth Blackwell was the first woman to be awarded an MD degree in the United States, in 1849.  She supported medical education for women, and wrote books about it, and founded a hospital in New York in 1857 as a way to enable women to get medical internships.  She was actually born in Bristol, England, and moved to the United States as a child.

Here are some places to find out more:

National Library of Medicine - Changing the Face of Medicine.  This site celebrates America's women physicians, with biographies of physicians past and present.

National Women's History Museum, Alexandria, Virginia (as it happens, Judy Moody's home state).

Schlesinger Library Newsletter, Radcliffe Institute for Advanced Study, Harvard.   The Library has information about the Blackwell family, which included Elizabeth's sister Emily, who with her promoted medical education for women.  Other family members included important people in the abolition movement, and the first woman church minister in the United States.  The Library's information about the family includes a link to digitised family papers.  

Wellcome Trust

Hobart and William Smith Colleges,  New York State.  The colleges are the successor to Geneva Medical College, where Blackwell studied.

Science Museum, London.

NNDB. Biographical site, whose NNDB Mapper enables you to explore links between the subjects of the biographies and learned societies.  There are no links for Blackwell, not yet, anyway.

Blackwell's Wikipedia entry is quite extensive and has links to a range of other material.

Elizabeth Garrett Anderson, the first woman in England to qualify in medicine, met Blackwell, and needs to have a post all to herself.

Tuesday, November 10, 2015

Hans Krebs

The University of Sheffield is currently holding its Krebs Festival, a celebration of the work of Hans Krebs, who won the Nobel Prize in Physiology and Medicine in 1953, for work done at the University.  The Festival is the reason for the giant E. coli in the Winter Gardens, as described in an earlier post.

Hans Krebs was born in Hildesheim in 1900.  He was Jewish and was dismissed from a University post when Hitler came to power in 1933.  He came to England, working in Cambridge before taking up a post at the University of Sheffield in 1935. After 3 years in Sheffield, he became a professor in the newly formed Department of Biochemistry, and then led an MRC funded research unit.  He moved to Oxford in 1954 and took this unit with him.

Here are a few sites about Hans Krebs and his work. 

The official website about the Nobel Prize: information about Hans Krebs and Fritz Zimmer, winners of the 1953 prize in physiology or medicine.  Click the links on the left to read a biography of Krebs, his Nobel lecture and a speech given at dinner.

University of Sheffield: KrebsFest

To discover how the Krebs Cycle is linked to the Tour de France, have a look at this page from the Deconstructing the Tour site, also from the University of Sheffield.

School of Biomedical Sciences wiki, University of Newcastle upon Tyne,  last updated in October 2015.

This is a search of PubMed for articles with H Krebs as a personal subject.   The list of results includes obituaries (Krebs died in 1981), a paper from the Biographical Memoirs of the Fellows of the Royal Society of London and a supplement to FEBS Letters published in 1980, containing papers to mark his 80th birthday.

To discover the Krebs Cycle through music, look at Science Music Videos, for a video of the song, interactive lyrics, diagrams and flashcards.  The songwriter is Glenn Wolkenfield, a high school teacher in Berkeley, California.    The song is also on YouTube

This made me think of the Biochemists' Songbook, which I encountered a long time ago, and looking it up on Amazon reveals the second edition had a foreword by Hans Krebs.  The songs are available as MP3 files on a site hosted at California State University, Long Beach, and also on this site at Queen's University Belfast.  And that seems a good place to end this post.

Friday, November 06, 2015

Critically appraised topics

Via social media I find out about this paper from the British Journal of Dermatology (you will need a subscription to see the full paper).  It is a critically appraised topic about the use of diphenylcyclopropenone to treat alopecia areata, and involves a literature search carried out by Jacqueline Limpens, a medical librarian at the Academic Medical Center in Amsterdam, which is how I found out about it.

What is a "critically appraised topic"?  

Also known as a "CAT", a critically appraised topic is "is a short summary of the best available evidence, created to answer a specific clinical question", quoting from the University of Groningen listed below.  

Here are some resources about what a CAT is and how to carry one out:

BestBETs - Best Evidence Topics are a modification of the CAT.

CATMaker, software for creating CATs, from the Centre for Evidence Based Medicine, Oxford. 

CATWalk: a guide to critically appraised topics (University of Alberta)

LibGuide from the University of Groningen (in English)

Occupational therapy critically appraised topic
Physiopedia: Critically Appraised Topics

University of Texas Health Science Center - what is a CAT?

And here are some articles with links to PubMed:

Kelly AM, Cronin P.
AJR Am J Roentgenol. 2011 Nov;197(5):1039-47.
PMID: 22021494

Kelly AM, Cronin P.
AJR Am J Roentgenol. 2011 Nov;197(5):1048-55.
PMID: 22021495

Sadigh G, Parker R, Kelly AM, Cronin P.
Acad Radiol. 2012 Jul;19(7):872-88.

There is also this:

Sauve S, Lee HN, Meade MD, et al. The critically appraised topic: a practical approach to learning critical appraisal. Ann Roy Soc Phys Surg Can 1995; 28:396–398
(One of the et al. is David Sackett, and I wonder if this is the original description of the idea).

Reusing a search strategy

Other people's search strategies can be a useful source of search terms, and synonyms.   I wrote in an earlier post that you should not just reuse a strategy.  Using an existing strategy as a source of ideas is ok, but you need to understand how it works, and make sure that there is nothing missing. 

But, of course, you might be updating a review.  In which case, you would want to rerun the existing search.  I think these are the issues to look for, assuming that you are not changing the research question or topic of the review.

1.  Is there anything that should have been done differently?  Is there anything missing?  Is it ok to amend the strategy, just because you now see a better way to do it?    At the moment, I think this is a matter for your supervisor, tutor, or someone with more knowledge of systematic review methodology than me!

2.  Are there any new subject headings to include?   MeSH is updated annually, and perhaps since the search was first run, there is a new heading.  I think in these cases, it is ok to amend.   For example, there is a MeSH term Patient Handoff/.  It was first used in 2013.  If the original search predates that, it will not include the term, so you ought to add it.   What should you do to ensure you still find older references?  How are they indexed?   Checking MeSH (for example, in PubMed's MeSH database) may tell you. 

3.  Was the original search run in the same interface?   Perhaps it was run in Medline via Ebsco, and you have access to Medline via Ovid.  If this is the case, you need to translate the strategy and make sure that proximity operators and truncation are correct for the new interface.   I wrote an earlier post about this sort of thing.  It is also possible that the capabilities of the interface have changed since the search was first run, and this is a "translation" as well.

Translating search strategies

Not sure if I borrowed this term, or invented it, but I mean modifying a search strategy for use in another database.   For example, if you have a Medline strategy, what do you need to change to make it work in, say, PsycINFO or Embase?  Other databases might have different features or functionality.

There are two areas where translation is necessary, once you have finalised your strategy.  I have assumed in what follows that you have a Medline strategy, and want to translate it for use in other databases.

One area is search syntax (proximity operators, truncation, and so on), and the other is subject headings.

For example:

Proximity operators.   In Ovid Medline, adj finds your two terms adjacent to each other, so:

heart adj disease 

finds heart disease.

More usefully, perhaps, adjn finds your two terms within n words of each other, in either order.  So:

heart adj2 disease

finds heart disease, disease of the heart.

heart adj2 disease* 

finds those, and also diseases of the heart.

adj and adjn work in Ovid Embase, and also in the HDAS NHS England databases.

In PsycINFO via Ebsco, adjn is Nn.  In Web of Science and the Cochrane Library (via the Wiley interface) it is NEAR/n.

Truncation and wildcards.  In many databases truncation is done with *.  Ovid Medline, Embase and HDAS use * but will also accept $. So, disease* finds disease, diseases, diseas* finds those and diseased.  In many databases, you can use ? and # in the middle of words to stand for one character, or for one character or a space, respectively.  So:

wom?n finds woman, women
p#ediatrics finds paediatrics, pediatrics

You would need to check in your database that * is the truncation symbol, and if you can use wildcards like ?, #.

Phrase searching.   Ovid assumes that two adjacent words are a phrase, but NHS databases, Cochrane, Web of Science and PsycINFO via Ebsco do not and you need to mark phrases "like this", in speech marks/double quotes.

Subject headings.  Your Medline search will (or should!) include MeSH terms.  But your next database might not have MeSH.  Cochrane does use MeSH (but not in all databases), and you need to use the Search Manager to be able to browse headings.  Web of Science has no thesaurus, and PsycINFO and Cinahl have their own.  

In PsycINFO or Cinahl, identify the term that is used for the concept you are searching, by entering the MeSH term or another keyword and exploring the thesaurus.    

Cinahl's thesaurus is, I think, based on MeSH, but the term might differ, or it might be possible to explode it in Medline but not in Cinahl (Diabetes Mellitus, Type 2, is an example).

PsycInfo will have more detailed terms for psychological concepts, but possibly less detailed for other things.  For example, there is only one subject heading for Diabetes, which includes Type 1 and Type 2.   

Embase's thesaurus goes into more detail with regard to things like drug delivery route, and may have different terms for a concept.  For example, type 2 diabetes in Medline is indexed under Diabetes Mellitus, Type 2, and in Embase under non insulin dependent diabetes mellitus.

In a database without a thesaurus, I would ensure I have searched for the MeSH term as free text.  

Finally, I have learned that having a Medline strategy where MeSH and freetext are on separate lines makes translation easier.

Identifying search terms

For any literature search, you will need to identify your search terms.  What words or phrases are you going to search for?   What thesaurus terms are you going to choose?

If you are doing a detailed search for evidence for a systematic review, or doing a systematic search for some other reason, identification of search terms will include identification of synonyms, that is, alternative terms for the concept you are interested in.

Here are some possible ways to identify thesaurus and free text terms, and synonyms. 

Scoping search

Use a PICO grid or similar to identify the search concepts, and search for those.   For example:

Search question: antibiotics to treat otitis media in children under 5.

P - under fives with otitis media
I - antibiotics
C - no stated comparision
O - no stated outcomes

So, search for otitis media and antibiotics, and see what terms are used in titles and abstracts of the articles you find.

Existing strategies

An existing systematic review should include the search strategy used.  Don't feel you have to copy it (of course, if you are doing this exercise for a dissertation, assignment or thesis, you should not and must not copy it!), but it may give you useful terminology.

Background research

Use clues from any background reading you have done about the topic, textbooks, reputable websites, NICE Evidence Search for any clinical topic.

Drug information sources

The British National Formulary is included in NICE Evidence Search, but also try Electronic Medicines Compendium, the European Medicines Agency, and  Include generic names (long acting insulin) and brand names (glargine), include classes of drugs (antibiotics) and specific types (penicillin).  eMC is a collection of drug information sheets and patient information leaflets.

“Used for” in thesauri 

In a search of Medline, Embase or Cinahl, you must identify relevant thesaurus terms.   Your scoping search will help you - in Ovid or the NHS interface, when you type in a search term, thesaurus terms are suggested to you.  But use the "scope note" and check the "used for" entries.  Articles using those terms in title or abstract will be indexed using the thesaurus term you are looking at.   Therefore, those "used for" entries are useful synonyms to include in your search.

Other people

If you are working on a research project as part of a team, then team members will have suggestions for search terms.   So will patients with that condition, and the team may be able to ask them.  If you are working on an assignment, dissertation or thesis, you may be on your own (although if you have a supervisor, ask if they can advise you).   It is worth talking to others, and checking that you understand the search keywords in the same way as them, and that you know what they mean. 

Known items

You looked at titles and abstracts of items that appeared in the results of your scoping search.  But have a look at the titles and abstracts, and full text, of items that you know about already, and items you find in your actual search.   And look at the titles of references in the bibliographies of relevant items.

MeSH on Demand

This is a National Library of Medicine service, which identifies MeSH terms in text that you enter.  I have not yet tried this, but it seems to have possibilities.  I have written a separate post about this.

Tuesday, November 03, 2015

George Boole

What do you do with Boolean operators?  Play Booles with them.

That's the awful joke out of the way, that I used some time back in a quiz to check that students remembered what we had covered in a previous session.

Google's Doodle yesterday marked the 200th anniversary of the birth of George Boole, born in Lincoln on 2nd November 1815, and appointed Professor of Mathematics at Queen's College Cork in 1849.  University College Cork's Library is named after him.

The Doodle links to resources about him (by searching for George Boole).  Here are a few:

George Boole 200 - a website from University College Cork, including a life of Boole, the opportunity to sign up for school resources, reproductions of exam papers set by Boole while a professor in Cork, and news and events.

Scientific American - a blog about the bicentennial. 

George Boole - page from MacTutor History of Mathematics Archive at the University of St. Andrews.

If you want a Halloween themed image of Boolean operators (BOOlean!), try this from Librarian Design Share

Tuesday, October 20, 2015

How much is enough?

Younger son's homework is to choose a country and find out about it.  He has a list of questions.  What is the climate like?   Does it rain?  Is it hot?   What animals live there?   What about the culture?

We found something about animals in "Planet Earth", a BBC related book he was given by a friend.  We found the names of three ("mountain monkey", kodkod, a small wild cat, and the pudu, the world's smallest deer, in case you want to guess which country it might be!).  

It was the weather that made me write this.   The country in question is so large that the climate in different parts of it is very different.  Some parts are very high, and cold, some parts are very far from the Equator and also a bit cold, but other parts are equatorial and tropical.   So what is the answer to the question on the sheet?  What would the answer be if the country was the UK?  Would it depend who you asked?  How much detail is required?   We went for an answer about how there was a range of climate, which is a way did not answer the question.

It made me think: how much detail was needed?   Was I thinking too hard about the question, which after all was designed for a 7 year old, not a *@ year old parent.  Was a quick to write sentence what was needed, even if it was not the whole story?  Was the point to be able to write something, or to realise that climate is different in different countries?

Then I thought, what about the level of detail needed when thinking about literature searching?   What a first year undergraduate needs to be able to do is different from a PhD researcher or systematic reviewer.   What a clinician looking for evidence for practice needs to find will be different from that systematic reviewer.  I think I knew this, but had not really thought about how it was ok not to go into detail or give what I, as an experienced searcher, thought was the complete answer.  An answer that enables people to do what they need to, at that time, is the one to look for.

The point of my son's question was not to test the knowledge or information finding powers of the parent, or to write a complete account, but to look for particular qualities in the student, which suggests that an answer incomplete to the parent is ok.

de Clérambault, and Enduring Love again

Some more thoughts about the "appendix" to Ian McEwan's Enduring Love, discussed in an earlier post.  The appendix is, or, as it turns out, purports to be, a reprint from the "British Review of Psychiatry", by Wenn and Camia, about de Clérambault's syndrome.  An early review of the book,as you may remember from that earlier post, thought it was the article on which the novel was based.  But others were suspicious, noting that the journal was not one they had heard of, and also that the authors' names were an anagram of Ian McEwan.

I was interested to know what would happen if you critically appraised the paper.   Could you tell that it was (as McEwan admitted in Psychiatric Bulletin) fictional?

Of course, the psychiatric science in the article might well not be fictional at all.  According to Oliver Burkeman's Guardian article (cited in my earlier post), this paper was submitted for publication to the British Journal of Psychiatry, but did not make it into print - it would be fascinating to know why!  An appraisal of the content, though, would be a critical appraisal exercise for psychiatrists or mental health nurses.  But I wondered - what about the references?

The last one is also by Wenn and Camia, so once you know that these are fictional authors, this one is suspect.  It turns out the volume number and year don't match, and those pages in that volume are something else entirely.

One of the British Journal of Psychiatry references has an author name and title belonging to different page numbers and volume, but the page numbers and volume cited actually belong to another article about the same syndrome.

The other British Journal of Psychiatry references are correct, as is the one from Social Science and Medicine (which is, however, missing a section title, being made up of many sections at the time).

One reference has no article title.   Another has different punctuation. 

But apart from the Wenn and Camia article, and that mixed up British Journal of Psychiatry reference, this is all relatively trivial.   In days gone by I was "bibliographic adviser" for a microbiology journal, and checked the reference lists for accuracy.   There were often errors of this sort, so this "British Review of Psychiatry" paper is, I suspect, no worse!

de Clérambault is cited as C.G., rather than G.G., but that again is minor (although possibly if you were a psychiatrist, you would know - possibly not, though).

Here, in closing, is some reading material about de Clérambault and his work.  He was a French psychiatrist, who trained first in law, who published many articles, and whose "Oeuvres psychiatriques" were collected together after his death.

de Clérambault's syndrome, from

Signer, S. F. (1991). “Les psychoses passionnelles” reconsidered: a review of de Clérambault’s cases and syndrome with respect to mood disorders. Journal of Psychiatry and Neuroscience, 16(2), 81–90. 
(Another of Signer's papers is cited in the appendix, but with the wrong initials, I think).

Clérambault, from Encyclopedia Universalis (in French)