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?